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Grafts Used (graft + used)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Grafts Used

bone graft used

Selected Abstracts

Living Donor Liver Transplantation for Biliary Atresia: A Single-Center Experience with First 100 Cases

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2006
C.-L. Chen
The aim of this study is to present our institutional experience in living donor liver transplantation (LDLT) as a treatment for end-stage liver disease in children with biliary atresia (BA). A retrospective review of transplant records was performed. One hundred BA patients (52 males and 48 females) underwent LDLT. The mean follow-up period was 85.5 months. The mean age was 2.4 years. The mean preoperative weight, height, and computed GFR were 12.2 kg, 82.5 cm, and 116.4 ml/min/1.73 m2, respectively. Twenty-seven patients were below 1 year of age, and 49 patients were below 10 kg at the time of transplantation. Ninety-six had had previous Kasai operation prior to transplant. The mean recipient operative time was 628 min. The mean recipient intraoperative blood loss was 176 ml. Thirty-five did not require blood or blood component transfusion. The left lateral segment (64) was the most common type of graft used. There were 27 operative complications which included 3 reoperations for postoperative bleeding, 9 portal vein, 4 hepatic vein, 4 hepatic artery, and 7 biliary complications. There was one in-hospital mortality and one retransplantation. The overall rejection rate was 20%. The overall mortality rate was 3%. The 6-month, 1-year and 5-year actual recipient survival rates were 99%, 98% and 98%, respectively. [source]

Compliance properties of conduits used in vascular reconstruction,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2000
N. R. Tai
Background Compliance mismatch between native artery and prosthetic graft used for infrainguinal bypass is implicated in the aetiology of graft failure. The aim was to quantify the elastic properties of a new compliant poly(carbonate)polyurethane (CPU) vascular graft, and to compare the compliance properties of grafts made from CPU, expanded polytetrafluoroethylene (ePTFE), Dacron and human saphenous vein with that of human muscular artery. Methods A pulsatile flow phantom was used to perfuse vessel and prosthetic graft segments at physiological pulse pressure and flow. Intraluminal pressure was measured using a Millar Mikro-tip catheter transducer and vessel wall motion was determined with duplex ultrasonography using an echo-locked wall-tracking system. Diametrical compliance and a stiffness index were then calculated for each type of conduit over mean pressures ranging from 30 to 100 mmHg by 10-mmHg increments. Results The compliance values of CPU and artery (mean over the pressure range) were similar (mean(s.d.) 8·1(0·4) and 8·0(5·9) per cent per mmHg × 10,2 respectively), although the elastic behaviour of artery was anisotropic unlike CPU, which was isotropic. Dacron and ePTFE grafts had lower compliance values (1·8(1·2) and 1·2(0·3) per cent per mmHg × 10,2 respectively, averaged over the pressure range). In both these cases, compliance and stiffness differed significantly from that of artery over a mean pressure range of 30,90 mmHg. Human saphenous vein exhibited anisotropic behaviour and, although compliant at low pressure (30 mmHg), was markedly incompliant at higher pressures. Conclusion Compliant polyurethane grafts offer a greater degree of compliance match than either ePTFE or Dacron. © 2000 British Journal of Surgery Society Ltd [source]

Does platelet-rich plasma promote remodeling of autologous bone grafts used for augmentation of the maxillary sinus floor?

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2005
Gerry M. Raghoebar
Abstract: The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) on remodeling of autologous bone grafts used for augmentation of the floor of the maxillary sinus. In five edentulous patients suffering from insufficient retention of their upper denture related to a severely resorbed maxilla, the floor of both maxillary sinus was augmented with an autologous bone graft from the iliac crest. Randomly, PRP was added to the bone graft used to augment the floor of the left or right sinus (split-mouth design). Three months after the reconstruction, bone biopsies were taken with a trephine from the planned implant sites (N=30). Subsequently, three implants were placed in the left and right posterior maxilla. Microradiograms were made of all biopsies (N=30), whereafter the biopsies were processed for light microscopic examination. In addition, clinical parameters were scored. Wound healing was uneventful, clinically no difference was observed between the side treated with PRP or not. Also microradiographical and histomorphological examination of the biopsies revealed no statistical difference between the PRP- and non-PRP side. One implant placed in the PRP side of the graft was lost during the healing phase. Implant-retained overdentures were fabricated 6 months after implantation. All patients functioned well (follow-up 20.2±4.3 months). In this study, no beneficial effect of PRP on wound healing and bone remodeling was observed. It is posed that PRP has no additional value in promoting healing of grafted non-critical size defects. Résumé Le but de cette étude a été d'évaluer l'effet du plasma riche en plaquettes sur le remodelage de greffons osseux autogènes utilisés pour l'épaississement du plancher sinusal. Chez cinq patients édentés souffrant d'une rétention insuffisante de leur prothèse supérieure en relation avec un maxillaire sévèrement résorbé, les planchers sinusaux des deux maxillaires ont étéépaissis avec un greffon d'os autogène provenant de la crête iliaque. Au hasard, du plasma riche en plaquettes (PRP) a été ajouté au greffon osseux utilisé pour épaissir le plancher du sinus gauche ou droit (modèle de bouche divisée). Trois mois après la reconstruction, des biopsies osseuses ont été obtenues avec un trépan des sites planifiés pour placer des implants (N=30). Ensuite, trois implants ont été placés dans les parties maxillaires gauches et droites. Des microradiogrammes des 30 biopsies ont été effectuées, ces dernières ont ensuite été utilisées pour l'examen au microscope optique. De plus, des paramètres cliniques ont été enregistrés. La guérison a été parfaite, cliniquement aucune différence n'a été observée entre les sites traités avec PRP ou sans. L'examen microradiographique et histomorphologique des biopsies n'a révélé aucune différence significative entre les sites PRP et non-PRP. Un implant placé dans le site PRP du greffon a été perdu durant la phase de guérison. Des prothèses retenues sur implants ont été fabriquées six mois après l'insertion des implants. Tous les patients ont une mise en fonction excellente après un suivi de 20±4,3 mois. Dans cette étude, aucun effet bénéfique additionnel du PRP sur la guérison et le remodelage osseux n'a été observé. Le PRP n'aurait aucune valeur supplémentaire à promouvoir la guérison dans ce type d'opération. Zusammenfassung Das Ziel dieser Studie war, den Einfluss von plättchenreichem Plasma auf die Remodellierung von autologen Knochentransplantaten, welche für die Augmentation des Sinusbodens vom Sinus maxillaris verwendet wurden, auszuwerten. Bei 5 zahnlosen Patienten, welche aufgrund einer stark resorbierten Maxilla über einen ungenügenden Halt der Oberkieferprothese klagten, wurde der Sinus maxillaris mit autologem Knochen vom Beckenkamm augmentiert. Zufällig wurde dem Knochen, der zur Augmentation des rechten oder linken Sinusbodens verwendet wurde, plättchenreiches Plasma (PRP) hinzugefügt (unterschiedlich behandelte Seiten). Drei Monate nach der Augmentation wurden mittels Hohlfräsen Biopsien an den geplanten Implantatlokalisationen entnommen (N=30). Danach wurden je drei Implantate in die rechte und linke posteriore Maxilla eingesetzt. Von allen Biopsien wurde Mikroröntgenbilder angefertigt (N=30), danach wurden die Biopsien für die lichtmikroskopische Untersuchung aufgearbeitet. Zusätzlich wurden klinische Parameter aufgenommen. Die Wundheilung war unauffällig. Klinisch konnten keine Unterschiede zwischen den mit und ohne PRP behandelten Seiten beobachtet werden. Ebenso ergab die mikroradiographische und histomorphometrische Untersuchung der Biopsien keine statistisch signifikanten zwischen der PRP und nicht-PRP Seite. Ein Implantat, welches in eine PRP Seite eingesetzt worden war, ging während der Einheilphase verloren. Die implantatgetragenen Hybridprothesen wurden 6 Monate nach Implantation angefertigt. Alle Patienten funktionierten problemlos (Beobachtungszeit bis 20.2±4.3 Monate). In dieser Studie konnte kein positiver Einfluss des PRP auf die Wundheilung und die Knochenremodellierung beobachtet werden. Es wird vermutet, dass PRP keinen zusätzlichen Effekt bei der Förderung der Heilung von Transplantaten in Defekten mit nicht-kritischer Grösse hat. Resumen La intención de este estudio fue evaluar el efecto del plasma rico en plaquetas en el remodelado de injertos de hueso autólogo usado para aumento del suelo del seno maxilar. Se aumentó el suelo de ambos senos maxilares con injertos de hueso autólogo de la cresta iliaca en 5 pacientes edéntulos que padecían de insuficiente retención de su dentadura superior relacionada con un maxilar severamente reabsorbido. Aleatoriamente, se añadió plasma rico en plaquetas (PRP) al injerto óseo usado para aumentar el suelo del seno derecho o izquierdo (diseño de boca partida). Tres meses tras la reconstrucción, se tomaron biopsias de hueso con un trépano de los lugares de implantes planificados (N=30). Subsecuentemente se colocaron tres implantes en el maxilar posterior derecho e izquierdo. Se hicieron microrradiogramas de todas las biopsias (N=30), posteriormente las biopsias se procesaron para microscopía óptica. Además se tomaron parámetros clínicos. La cicatrización de la herida tuvo lugar sin incidentes. Clínicamente no se observó diferencia alguna entre el lado tratado con PRP o no. Tampoco el examen microrradiográfico e histomorfológico de las biopsias revelaron diferencias estadísticamente significativas entre los lados con o sin PRP. Un implante colocado en el lado del PRP se perdió durante la cicatrización. Las dentaduras implantorretenidas se fabricaron a los seis meses de la implantación. Todos los pacientes funcionaron bien (seguimiento de 20.2±4.3 meses). En este estudio no se observó ningún efecto beneficioso del PRP sobre la cicatrización y sobre el remodelado óseo. Se plantea que el PRP no tiene ningún valor adicional en promover la cicatrización de defectos no críticos injertados. [source]

Reconstruction of maxillary and mandibular defects using prefabricated microvascular fibular grafts and osseointegrated dental implants , a prospective study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2004
Claude Jaquiéry
Abstract: The fibular flap can be used for a variety of indications. Recently, the treatment of four patients with severely atrophied upper jaws using a method to prefabricate the vascularized fibular graft has been published. This technique consists of a two-stage operation procedure that allows simultaneous prosthodontic rehabilitation and immediate placement of dental implants. In this paper eight patients with 29 ITI implants (Straumann AG, Waldenburg, Switzerland) who had reconstruction of either the upper or lower jaw are presented. The aim of the study was (i) to evaluate the behavior of the newly formed soft tissue around implants inserted in the fibula by applying periodontal parameters, (ii) to monitor prospectively the integration of the implants in the fibular graft, and (iii) to assess the osseous integration of the fibular graft used for reconstruction of the upper or lower jaw. Two implants failed during the observation time because of avascular bone at the distal end of the fibular graft. Stabilization of the graft, however, was never compromised. Due to the prefabrication firmly attached gingiva-like soft tissue could be provided preventing periimplant soft tissue inflammation and facilitating oral hygiene. After 1 year of observation the mean attachment level was similar to implants placed in original bone whereas vertical bone loss measured radiographically was lower in the present study. This may indicate that the remodeling of a bicortical bone requires a longer period of time compared with the bone of the alveolar crest. The prospective 1-year results are promising but long-term evaluation of periodontal and radiological parameters are required. Résumé Le lambeau péroné peut être utilisé pour une variété d'indications. Récemment le traitement de quatre patients avec une atrophie sévère des mâchoires supérieures et utilisant une méthode pour préfabriquer un greffon péroné vascularisé a été publié. Cette technique consiste en une opération en deux étapes qui permet la réhabilitation prothétique simultanée et le placement immédiat des implants dentaires. Dans ce rapport huit patients avec 29 implants ITI (Straumann AG, Waldenburg, Switzerland) ont eu une reconstruction de la mâchoire supérieure ou inférieure. Le but de cette étude a été 1) d'évaluer le comportement des tissus mous nouvellement formés autour des implants insérés dans le péroné en appliquant les paramètres parodontaux, 2) de suivre d'une manière prospective l'intégration des implants dans le greffon péroné et 3) d'examiner l'intégration osseuse de l'implant péroné utilisé pour la reconstruction de ces mâchoires. Deux implants ont échoué durant la période d'observation parce que l'os alvéolaire n'était pas vasculariséà la partie distale du greffon. La stabilisation du greffon n'a cependant jamais été compromise. La préfabrication d'un tissu ressemblant à de la gencive préfabriquée a permit d'éviter l'inflammation gingivale et de faciliter l'hygiène buccale. Après une année d'observation le niveau d'attache moyen était semblable au niveau des implants placés dans l'os original tandis que la perte osseuse verticale mesurée radiographiquement était inférieure dans l'étude présente. Ceci peut indiquer que le remodelage de l'os bicortical requiert une période plus importante comparée à l'os du rebord alvéolaire. Ces résultats prospectifs à une année sont encourageants mais l'évaluation à long terme des paramètres parodontaux et radiologiques reste encore nécessaire. Zusammenfassung Der Fibula-Lappen kann bei einer Vielzahl von Indikationen angewendet werden. Kürzlich wurde eine Publikation über die Behandlung von vier Patienten mit stark atrophierten Oberkiefern mittels vorfabrizierten vaskularisierten Fibula transplantaten veröffentlicht. Diese Technik besteht aus einer Operation in zwei Phasen, welche die Sofortimplantation von dentalen Implantaten und gleichzeitige prothetische Rekonstruction erlaubt. In diesem Artikel werden acht Patienten mit 29 Implantaten (Straumann AG, Waldenburg, Switzerland), bei welchen entweder eine OK- oder UK-Rekonstruktion durchgeführt wurde, präsentiert. Das Ziel der Studie war (i) das Verhalten des neu gebildeten Gewebes um die Implantate, welche in die Fibula eingesetzt worden waren mittels parodontalen Parametern zu untersuchen, (ii) die Integration der Implantate in das Fibula-Transplantat prospektiv aufzuzeichnen und (iii) die ossäre Integration des für die Rekonstruktion des OK oder UK verwendeten Fibula-Transplantats zu ermitteln. Zwei Implantate zeigten während der Beobachtungsperiode Misserfolge wegen avaskulärem Knochen an den distalen Enden des Fibula-Transplantats. Die Stabilisierung des Transplantats war jedoch niemals beeinträchtigt. Durch die Vorfabrizierung konnten gut angewachsene gingiva-ähnliche Weichgewebe geschaffen werden, welche eine periimplantäre Entzündung der Weichgewebe verhinderten und die Mundhygiene erleichterten. Nach einer Beobachtungszeit von einem Jahr war das mittlere Attachmentniveau ähnlich dem von Implantaten, welche in alveolären Knochen inseriert worden waren, während der radiologisch gemessene Knochenverlust in der vorliegenden Studie geringer war. Dies könnte ein Indiz dafür sein, dass die Remodellierung eines bikortikalen Knochens im Vergleich zum Alveolarknochen längere Zeit benötigt. Die prospektiven Resultate nach einem Jahr sehen vielversprechend aus, aber es muss eine Auswertung der parodontalen und radiologischen Parameter über einen längeren Zeitraum durchgeführt werden. Resumen El colgajo peroneal puede ser usado para una variedad de indicaciones. Recientemente se ha publicado el tratamiento de cuatro pacientes con maxilares superiores severamente atróficos usando un método para prefabricar el injerto peroneal vascularizado. Esta técnica consiste en un procedimiento de operación de dos fases que permite la rehabilitación prostodóntica y la colocación inmediata de implantes dentales simultáneamente. En este artículo se presentan ocho pacientes con 29 implantes ITI (Strauman AG, Waldenburg) teniendo una reconstrucción de tanto el maxilar superior como del inferior. La intención del presente estudio fue (i) evaluar el comportamiento de del tejido blando neoformado alrededor de los implantes insertados en la tibia aplicando parámetros periodontales, (ii) monitorizar prospectivamente la integración de los implantes en el injerto perineal y (iii) valorar la integración ósea del injerto perineal usado para la reconstrucción del maxilar superior o inferior. Dos implantes fracasaron durante el periodo de observación debido a hueso sin vascularización en el final distal del injerto perineal. De todos modos, la estabilización del injerto no se vio nunca comprometida. Debido a la prefabricación se pudo suministrar un tejido blando tipo encía adherida previniendo inflamación del tejido blando periimplantario y facilitando la higiene oral. Tras un año de observación el nivel de inserción medio fue similar a los implantes insertados en las áreas de hueso original mientras que la pérdida de hueso vertical medida radiograficamente fue menor en el presente estudio. Esto puede indicar que el remodelado de un hueso bicortical requiere un periodo mas largo de tiempo comparado con el hueso de la cresta alveolar. Los resultados prospectivos de un año son prometedores pero se requieren evaluaciones de los parámetros periodontales y radiológicos a largo plazo. [source]

Cartilage grafts in dorsal nasal augmentation of traumatic saddle nose deformity: A long-term follow-up,

THE LARYNGOSCOPE, Issue 11 2009
Johnny Mao MD
Abstract Objectives/Hypothesis: To document the long-term advantages and disadvantages of cartilage grafts used to correct traumatic saddle nose deformity. Additionally, to demonstrate functional improvement and cosmetic satisfaction with the use of this graft. Study Design: Retrospective chart review and prospective follow-up telephone survey of 20 patients after dorsal augmentation of saddle nose deformity secondary to trauma. Methods: This is a single-surgeon, single-institution investigation within an academic tertiary care medical center. All patients presented for correction of saddle nose deformity after trauma, and cartilage grafts were used for augmentation of the dorsum. Minimum postoperative follow-up period of 1 year was required. A modified and expanded Nasal Obstructive Symptoms Evaluation survey, which included questions pertaining to the appearance of their nose, was used to assess both functional and cosmetic changes after surgery. Results: Only 1 of the 20 patients was dissatisfied with the overall outcome. Three (15%) were extremely satisfied, 12 (60%) were very satisfied, three (15%) were somewhat satisfied, and one (5%) was indifferent. In terms of function, four (20%) experienced excellent relief in nasal obstruction, five (25%) moderate relief, four (20%) mild relief, and seven (35%) noted no difference. Regarding cosmesis, two (10%) noted excellent improvement, three (15%) moderate improvement, nine (45%) mild improvement, and five (25%) noted no significant change. One (5%) patient reported worsening due to tip edema. Mean follow-up time was 6.8 years. Conclusions: Autogenous cartilage grafts are useful in the correction of mild to moderate traumatic saddle nose deformity. The graft is readily available, preserves long-term structural stability, and achieves functional and cosmetic satisfaction in most patients. Laryngoscope, 2009 [source]

Liver Transplantation with Grafts from Controlled Donors after Cardiac Death: A 20-Year Follow-up at a Single Center

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2010
S. Yamamoto
The first liver transplantation (LTx) in Sweden was performed in 1984, but brain death as a legal death criterion was not accepted until 1988. Between November 1984 and May 1988, we performed 40 consecutive LTxs in 32 patients. Twenty-four grafts were from donors after cardiac death (DCD) and 16 grafts from heart-beating donors (HBD). Significantly, more hepatic artery thrombosis and biliary complications occurred in the DCD group (p < 0.01 and p < 0.05, respectively). Graft and patient survival did not differ between the groups. In the total group, there was a significant difference in graft survival between first-time LTx grafts and grafts used for retransplantation. There was better graft survival in nonmalignant than malignant patients, although this did not reach statistical significance. Multivariate analysis revealed cold ischemia time and post-LTx peak ALT to be independent predictive factors for graft survival in the DCD group. In the 11 livers surviving 20 years or more, follow-up biopsies were performed 18,20 years post-LTx (n = 10) and 6 years post-LTx (n = 1). Signs of chronic rejection were seen in three cases, with no difference between DCD and HBD. Our analysis with a 20-year follow-up suggests that controlled DCD liver grafts might be a feasible option to increase the donor pool. [source]

Cutting Torque Measurements in Conjunction with Implant Placement in Grafted and Nongrafted Maxillas as an Objective Evaluation of Bone Density: A Possible Method for Identifying Early Implant Failures?

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2004
Björn Johansson DDS
ABSTRACT Background: Bone grafts are frequently used to enable the placement of dental implants in atrophied jaws. The biomechanical properties of bone grafts used in one- or two-stage implant procedures (in comparison with the use of nongrafted bone) are not well known. Purpose: The purpose of this study was (1) to measure cutting torques during the placement of self-tapping dental implants in nongrafted bone and in bone grafts, either as blocks or in a milled particulate form, in patients undergoing implant treatment in an edentulous maxilla and (2) to identify implants with reduced initial stability and to correlate these findings with a clinical classification of jawbone quality. Materials and Methods: The study included 40 consecutive patients with edentulous maxillas, 27 of whom were subjected to bone grafting prior to or in conjunction with implant placement (grafting group) and 13 of whom received implants without grafting (nongrafted group). Grafted bone from the iliac crest bone was used (1) as onlay blocks, (2) as maxillary sinus inlay blocks, or (3) in particulate form in the maxillary sinus. Implants were placed after 6 to 7 months of healing, except in the maxillary sinus inlay blocks, where implants were placed simultaneously. Cutting torque values were obtained from 113 grafted implant sites and from 109 nongrafted implant sites. Results: Significantly lower cutting torque values were assessed in grafted regions than in nongrafted regions, irrespective of grafting technique. Lower values were also seen for implants placed in block grafts after 6 months when compared to other grafting techniques used. The cutting torque values revealed an inverse linear relation to the Lekholm and Zarb bone quality index. Conclusion: The cutting torque values correlated well with the Lekholm and Zarb index of bone quality. Significantly lower cutting torque values were seen in grafted bone than in nongrafted bone. [source]