Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Clinical intestinal transplantation: A decade of experience at a single center
Autore:
Abu-Elmagd, K; Reyes, J; Bond, G; Mazariegos, G; Wu, T; Murase, N; Sindhi, R; Martin, D; Colangelo, J; Zak, M; Janson, D; Ezzelarab, M; Dvorchik, I; Parizhskaya, M; Deutsch, M; Demetris, A; Fung, J; Starzl, TE;
Indirizzi:
Univ Pittsburgh, Med Ctr, Thomas E Starzl Transplantat Inst, Pittsburgh, PA 15213 USA Univ Pittsburgh Pittsburgh PA USA 15213 at Inst, Pittsburgh, PA 15213 USA Univ Pittsburgh, Med Ctr, Dept Radiat Oncol, Pittsburgh, PA 15213 USA UnivPittsburgh Pittsburgh PA USA 15213 t Oncol, Pittsburgh, PA 15213 USA
Titolo Testata:
ANNALS OF SURGERY
fascicolo: 3, volume: 234, anno: 2001,
pagine: 404 - 416
SICI:
0003-4932(200109)234:3<404:CITADO>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
SMALL-BOWEL TRANSPLANTATION; ORGAN CLUSTER TRANSPLANTATION; ORTHOTOPIC SMALL-BOWEL; VERSUS-HOST DISEASE; MULTIVISCERAL TRANSPLANTATION; GRAFT ACCEPTANCE; IMMUNOLOGICAL CONSIDERATIONS; LIVER-TRANSPLANTATION; CELL-MIGRATION; BROWN-NORWAY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
61
Recensione:
Indirizzi per estratti:
Indirizzo: Abu-Elmagd, K Univ Pittsburgh, Med Ctr, Thomas E Starzl Transplantat Inst,Falk Med Bldg,4th Floor,3601 5th Ave, Pittsburgh, PA 15213 USA Univ Pittsburgh Falk Med Bldg,4th Floor,3601 5th Ave Pittsburgh PA USA 15213
Citazione:
K. Abu-Elmagd et al., "Clinical intestinal transplantation: A decade of experience at a single center", ANN SURG, 234(3), 2001, pp. 404-416

Abstract

Objective To assess the long-term efficacy of intestinal transplantation under tacrolimus-based immunosuppression and the therapeutic benefit of newly developed adjunct immunosuppressants and management strategies. Summary Background Data With the advent of tacrolimus in 1990, transplantation of the intestine began to emerge as therapy for intestinal failure. However, a high risk of rejection, with the consequent need for acute and chronic high-dose immunosuppression, has inhibited its widespread application. Methods During an 11-year period, divided into two segments by a 1-year moratorium in 1994, 155 patients received 165 intestinal allografts under immunosuppression based on tacrolimus and prednisone: 65 intestine alone, 75 liver and intestine, and 25 multivisceral. For the transplantations since the moratorium (n = 99), an adjunct immunosuppressant (cyclophosphamide or daclizumab) was used for 74 transplantations, adjunct donor bone marrow was given in 39, and the intestine of 11 allografts was irradiated with a singledose of 750 cGy. Results The actuarial survival rate for the total population was 75% at 1 year, 54% at 5 years, and 42% at 10 years. Recipients of liver plus intestine had the best long-term prognosis and the lowest risk of graft loss from rejection (P = .001). Since 1994, survival rates have improved. Techniques for early detection of Epstein-Barr and cytomegaloviral infections, bone marrow augmentation, the adjunct use of the interleukin-2 antagonist daclizumab, and most recently allograft irradiation may have contributed to the better results. Conclusion The survival rates after intestinal transplantation have cumulatively improved during the past decade. With the management strategies currently under evaluation, intestinal transplant procedures have the potentialto become the standard of care for patients with end-stage intestinal failure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 06:27:00