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Successful Weaning (successful + weaning)
Selected AbstractsRepair of ALCAPA in a 4-kg Patient Followed by Successful Weaning and "Off-Pump" Explantation of an Apical Venting Pulsatile LVADJOURNAL OF CARDIAC SURGERY, Issue 3 2005Michael Huebler M.D. Extracorporeal pneumatic pulsatile devices are considered the strategy of choice if long-lasting bridge to recovery or transplantation is expected. However, complete explantation of the device may be complicated by hemorrhage and subsequent transfusions due to the establishment of CPB. The present case demonstrates successful weaning and complete removal of an apical venting pulsatile LVAD in a 4-kg infant without the employment of CPB. [source] Identification of operationally tolerant liver transplant recipients,LIVER TRANSPLANTATION, Issue S2 2010Alberto Sánchez-Fueyo KEY POINTS: (1) Liver allografts exhibit intrinsic tolerogenic properties that result in their spontaneous acceptance in many experimental animal models. (2) In clinical transplantation, liver allografts require milder immunosuppression (IS) regimens than other organs, are remarkably resistant to antibody-mediated rejection, and only very rarely are lost because of immunological insults. (3) A fraction of stable liver transplant recipients can withdraw from all IS therapy and then maintain normal graft function and not experience rejection. This phenomenon is known as spontaneous operational tolerance. (4) The intentional discontinuation of IS in stable liver transplant recipients has led to successful weaning in almost 20% of recipients, but the true prevalence of spontaneous operational tolerance in unselected recipients is still unknown. (5) The prevalence could be higher in pediatric recipients undergoing transplantation before 1 year of age and in adult recipients with more than 10 years of posttransplant follow-up. (6) Rejection occurring during medically supervised IS weaning trials tends to be mild and, in the overwhelming majority of cases, can be easily resolved without the administration of high-dose IS. (7) Tolerant liver recipients exhibit specific transcriptional patterns in peripheral blood and in liver tissue that may constitute future diagnostic markers of tolerance. (8) There is still no formal proof that the discontinuation of low-dose IS in long-term surviving liver recipients improves the morbidity and mortality rates associated with IS therapy. Liver Transpl 16:S82-S86, 2010. © 2010 AASLD. [source] Bridge-to-recovery from Acute Myocarditis in a 12-year-old ChildARTIFICIAL ORGANS, Issue 6 2004Holger Hotz Abstract:, Fulminant myocarditis causes substantial morbidity and mortality, especially in children and young adults. Mechanical circulatory support has become the standard therapy to bridge patients with intractable heart failure to either transplantation or myocardial recovery. Yet, successful weaning from biventricular support with full recovery is extremely rare in the pediatric population. This report describes the successful use of the MEDOS HIA ventricular assist device to bridge a 12-year-old girl to myocardial recovery in a biventricular bypass configuration. The left and right ventricle were completely off-loaded by the pumps and the device provided sufficient cardiac output to normalize end-organ function. Anticoagulation was maintained with i.v. heparin infusion. No neurological complications were detectable and the pump system was free of any macroscopic thrombi. After 19 days of support, cardiac function had recovered and the patient was successfully weaned from the device. Following physical rehabilitation, the patient was discharged home. [source] | ||||||||||