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Early Thrombosis (early + thrombosis)
Selected AbstractsSevere Vascular Lesions and Poor Functional Outcome in Kidney Transplant Recipients with Lupus Anticoagulant AntibodiesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010G. Canaud The impact of antiphospholipid antibodies (APA) on clinical outcome and graft histology following renal transplantation remains poorly known and controversial. We retrospectively explored the functional and histological significance of APA, primarily lupus anticoagulant (LA), in kidney transplant recipients using a systematic evaluation of 3- and 12-month posttransplant screening biopsies and glomerular filtration rate measurements (mGFR). During the study period, 37 patients had APA (2.7%), primarily LA, and 12 fulfiled antiphospholipid syndrome (APS) diagnostic criteria (0.8%) at the time of transplantation. Early after transplantion, 4 of the 12 APS patients died. Early thrombosis of graft vessels and deep venous thrombosis occurred more frequently in APA+ patients than in controls (27% vs. 7%, p < 0.05 and 35% vs. 14%, p < 0.05, respectively). The survival rate was significantly lower in patients with APS. Strikingly, the hallmark lesions of APS-associated nephropathy (APSN) were found in most of screening graft biopsies in APA+ patients but not in the controls. Accordingly, APA+ patients had a dramatic increase in chronic vascular scores and a faster decline in mGFR at 1 year. In conclusion, renal transplantation may be life-threatening in APS patients, and the presence of LA at the time of transplantation is associated with a high rate of allograft APSN and poor transplantation outcomes. [source] ENDOVASCULAR REPAIR OF POPLITEAL ARTERY ANEURYSMS: TECHNIQUES, CURRENT EVIDENCE AND RECENT EXPERIENCEANZ JOURNAL OF SURGERY, Issue 6 2006Ray Siauw Endovascular repair of popliteal artery aneurysms is a new technique, which has emerged as an alternative to open surgical bypass. However, evidence to support its use is limited. We present a review of current literature relevant to this technique. The MEDLINE search terms were popliteal artery, aneurysm, endovascular, endoluminal and stent. Fifty-eight articles were yielded, of which 21 were studies of endovascular repair by implantation of stent or stent graft of true aneurysms of the popliteal artery. There was only one randomized study. Small numbers of endovascular interventions are reported, with variations in study design and endovascular techniques. Long-term follow-up data is lacking; however, early results have been promising with high rates of initial treatment success. Early thrombosis of stent grafts occurs in approximately 10%, but this does not herald limb loss. Endovascular treatment offers potential benefits over traditional surgery, but needs to be studied further with a large-scale multicentre randomized trial. [source] Two novel fibrinogen variants found in patients with pulmonary embolism and their familiesJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 6 2003M. M. L. Hanss Summary.,Background:,The occurrence of dysfibrinogen is quite rare in comparison with other hemostatic defects, specially in cases of venous thrombosis. Objectives:,Fibrinogen is known to have multiple functions, which are not evaluated by simple coagulation testing. We have used gel electrophoresis to search for new mutations. Patients and methods:,Specimens of purified fibrinogen from 217 consecutive patients with familial or recurrent or early thrombosis and from 490 control subjects were evaluated by electrophoresis. Plasma fibrinogen levels and coagulation-dependent tests (electromechanical and optical coagulometric determinations, immunological measurement, thrombin and Reptilase® times) were normal. Results:,Two novel familial variants were detected. For a 42-year-old patient, an in-frame 117 base pair insertion in the A,-chain gene caused a 5-kDa mobility shift of the A, chain. This corresponds to a 39 amino acid duplication in the connector domain (fibrinogen Champagne au Mont d'Or). This pattern was also found in the patient's mother and child. A second 31-year-old patient presented an extra band under non-reducing conditions, 30 kDa larger than HMW fibrinogen and reacting with antifibrinogen antibodies (fibrinogen Lozanne). A heterozygous 5909A,G mutation was found on the B,-chain gene leading to heterozygous B, Tyr236, stop codon. The predicted truncated B, chain could participate in chain assembly. Two family members were also affected, one of whom had suffered early venous thrombosis. Conclusions:,Electrophoretic testing of apparently normal fibrinogens can reveal new variants which may be clinically relevant. [source] Hepatic artery thrombosis after orthotopic liver transplantation: A review of nonsurgical causesLIVER TRANSPLANTATION, Issue 2 2001Sabrina Pastacaldi Hepatic artery thrombosis (HAT) is one of the principal causes of morbidity and graft loss following liver transplantation. There are several risk factors for the development of HAT; technical aspects of the arterial anastomosis are important particularly for early thrombosis, but the improvement of surgical technique has lessened this problem. Apart from technical causes, other risk factors include a variety of conditions such as low donor/recipient age ratio, immunologic factors, clotting abnormalities, tobacco use, and infections. In particular, cytomegalovirus (CMV) infection of endothelial cells has been recently suggested as an infective cause of HAT, as it is known to be followed by a rapid procoagulant response. Thus, latent CMV in an allograft may become activated and promote or contribute to vascular thrombosis. This review evaluates these aspects, focusing on data relating CMV infection or viremia to HAT following liver transplantation. [source] Experimental model of heterotopic uterus transplantation in the laboratory ratMICROSURGERY, Issue 3 2003Lucian P. Jiga M.D. The present study describes a standardized experimental model of whole-uterus-and-ovaries heterotopic allotransplantation in the laboratory rat. Fifteen transplantation procedures were done. The anatomy of the pelvic region was studied with an additional 20 dissections, noting the topographical and vascular anatomy of the uterus, fallopian tubes, and ovarian vessels. Recipients were randomized into three groups. The average operative time was 150 min. The postoperative survival rate was 100%. Postoperative vascular anastomosis patency was 100%, and 26% at 72 hr. Recipients were euthanized at 24 hr (group I), 48 hr (group II), and 72 hr (group III); grafts were harvested and examined macroscopically, and fixed in formaline for histopathological and immunocytochemical analysis. Failure in 74% of the grafts at 72 hr was due to early thrombosis, starting from the capillary bed and progressing towards the main feeding pedicles. More studies must be undertaken to further understand the rejection mechanisms in transplanted reproductive organs. The efficiency, feasibility, and safety for such an operation in humans remain to be proven. We consider the present model a suitable tool to study all the above-mentioned goals. © 2003 Wiley-Liss, Inc. MICROSURGERY 23:246,250 2003 [source] | ||||||||||