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Ítem Echocardiographic assessment of valve prostheses in the pediatric population(Sociedad Colombiana de Cardiologia y Cirugia Cardiovascular, 2014-01-01) Santos, Raúl D.En niños con insuficiencia o estenosis valvular significativa, la intervención de la válvula, ya sea valvuloplastia o reemplazo valvular, suele ser inevitable. El seguimiento de estos pacientes puede ser complejo; los síntomas iniciales de disfunción valvular protésica son inespecíficos y en ocasiones es difícil diferenciar entre los efectos de la disfunción valvular, las patologías no cardíacas, la disfunción ventricular y la hipertensión pulmonar. Aunque el examen físico puede alertar al clínico acerca de alteraciones, se requieren otros métodos diagnósticos para evaluar la función de la prótesis. La ecocardiografía Doppler es el método de elección no invasivo para estudiar la función valvular y pese a que muchas de las mediciones y parámetros de normalidad y anormalidad son extrapolados de estudios en adultos, se han tratado de definir estándares en pacientes pediátricos. Este documento ofrece una revisión acerca de las técnicas usadas en el estudio de las válvulas protésicas con base en literatura científica, consensos internacionales y opiniones de expertos.
Ítem Comparative evaluation of adhesion formation of prosthetic meshes after intra-abdominal implantation in wistar rats / Evaluación comparativa de la formación de adherencias de mallas protésicas después de la implantación intraabdominal en ratas(IEEE, 2012-04-07) Arboleda, A.Increasingly biomaterials for the repair of abdominal wall defects are used. The aim of this study was to evaluate adhesion formation of prosthetic meshes after intraabdominal implantation to repair a surgical defect in the anterior abdominal wall. This anatomical defect was repaired by one of the three types of previously sterilized meshes: 1) fibroin 2) fibroin with polyethylene glycol and 3) commercial polypropylene mesh as control. The grip score was significantly higher in the commercial polypropylene mesh. Fibroin is a promising biomaterial for treating defects of the abdominal wall. © 2014 IEEE.Ítem Liver Angiosarcoma: Rare tumour associated with a poor prognosis, literature review and case report(Elsevier Ltd, 2016-09-29) Millan, Mauricio I.We report a case of minimally invasive nephrectomy of a kidney transplanted into the abdominal cavity in a child. A 15-year-old girl underwent transplantation with a cadaveric donor kidney due to congenital pyelonephritis, vesicoureteral reflux, and secondary bladder atrophy. The transplant was complicated by hyperacute rejection, cytomegalovirus infection, and anastomotic stenosis of the Bricker neobladder. After recurrent urinary tract infections, the patient was reintroduced to hemodialysis in 2010. After pneumo-peritoneum, we placed 2 10-mm trocars in the hypochondrium and left side and 2 5-mm in the left iliac fossa and right upper quadrantÍtem Liver transplantation for unresectable metastases from colon adenocarcinoma(S. Karger AG, 2016-10-06) Caicedo, Luis ArmandoLiver transplantation is an option that improves quality of life and prolongs life expectancy in patients with different types of liver disease. Liver transplantation is controversial for colorectal metastases and is not recommended in clinical practice guidelines. In this case report, we present, to our knowledge, the first liver transplantation for colorectal metastases conducted in Colombia, with a successful follow-up of more than 2 years. Patients with these characteristics who underwent liver transplantation experience reduced mortality and exponentially improved quality of life.Ítem Genetically-Engineered Pig-to-Baboon Liver Xenotransplantation: Histopathology of Xenografts and Native Organs(Public Library of Science, 2012-01-11) Echeverri Junca, Gabriel JaimeOrthotopic liver transplantation was carried out in baboons using wild-type (WT, n = 1) or genetically-engineered pigs (a1,3- galactosyltransferase gene-knockout, GTKO), n = 1; GTKO pigs transgenic for human CD46, n = 7) and a clinically-acceptable immunosuppressive regimen. Biopsies were obtained from the WT pig liver pre-Tx and at 30 min, 1, 2, 3, 4 and 5 h posttransplantation. Biopsies of genetically-engineered livers were obtained pre-Tx, 2 h after reperfusion and at necropsy (4–7 days after transplantation). Tissues were examined by light, confocal, and electron microscopy. All major native organs were also examined. The WT pig liver underwent hyperacute rejection. After genetically-engineered pig liver transplantation, hyperacute rejection did not occur. Survival was limited to 4–7 days due to repeated spontaneous bleeding in the liver and native organs (as a result of profound thrombocytopenia) which necessitated euthanasia. At 2 h, graft histology was largely normal. At necropsy, genetically-engineered pig livers showed hemorrhagic necrosis, platelet aggregation, platelet-fibrin thrombi, monocyte/macrophage margination mainly in liver sinusoids, and vascular endothelial cell hypertrophy, confirmed by confocal and electron microscopy. Immunohistochemistry showed minimal deposition of IgM, and almost absence of IgG, C3, C4d, C5b-9, and of a cellular infiltrate, suggesting that neither antibody- nor cell-mediated rejection played a major role.Ítem Laparoscopic Approach for an Intra-Abdominal Kidney Allograft Nephrectomy After Pediatric Transplantation: A Case Report(Elsevier, 2012-09-01) Echeverri Junca, Gabriel JaimeWe report a case of minimally invasive nephrectomy of a kidney transplanted into the abdominal cavity in a child. A 15-year-old girl underwent transplantation with a cadaveric donor kidney due to congenital pyelonephritis, vesicoureteral reflux, and secondary bladder atrophy. The transplant was complicated by hyperacute rejection, cytomegalovirus infection, and anastomotic stenosis of the Bricker neobladder. After recurrent urinary tract infections, the patient was reintroduced to hemodialysis in 2010. After pneumoperitoneum, we placed 2 10-mm trocars in the hypochondrium and left side and 2 5-mm in the left iliac fossa and right upper quadrant. The transplanted kidney was skeletonized, the artery and vein were cut to the end-to-side anastomoses to the juxta-renal aorta and cava using an automatic 35-mm, stapler, and the ureter was dissected and closed with clips. Via a Pfannestiel minilaparotomy we extracted the allograft. The patient was discharged on the third postoperative day. After 4 months of follow-up, she is alive an on dialysis. Laparoscopic nephrectomy of a kidney transplanted into the abdominal cavity is feasible and safe in centers with skilled minimally invasive techniques.Ítem Assessment, Monitoring, and Management of Brain-Dead Potential Organ Donors in Europe(Springer New York, 2013-03-01) Echeverri Junca, Gabriel JaimeWith 34 donors per million population, Spain has impressed the international transplant community with the world's highest rate of organ donation (double the European average), short waiting lists, and reduced reliance on living donation. These data account for the World Health Organization's strategy for extending the so-called Spanish Model across the globe, and for the European Parliament's decision, on May 19, 2010, to incorporate some of the elements of the Spanish Model in its Action Plan on organ donation and transplantation. At present, there are a number of organ transplantation organizations in Europe, though no standardized protocol exists for all countries, and no standardized laws are in place. We describe the most successful model (the Spanish Model for organ donation) and describe in detail the most important recommendations of the 2009 Council of Europe's Guide to Safety and Quality Assurance for the Transplantation of Organs, Tissues and Cells. © 2013 Springer Science+Business Media New York. All rights reserved.Ítem Tolerancia a inhibidores selectivos de la ciclooxigenasa 2 en casos de alergia o intolerancia a los antiinflamatorios no esteroideos convencionales: experiencia en un centro.(Asociacion Colombiana de Dermatologia y Cirugia Dermatologica, 2012-07-01) Serrano Reyes, Carlos DanielBackground: Patients with non-steroidal anti-inflammatory drugs (NSAID) sensitivity have a low prevalence of cross-reaction to COX-2 selective inhibitors. Oral drug challenge with these agents can be done in a clinical setting with a good safety profile. Objective: To evaluate tolerance to COX-2 selective inhibitors in patients with history of NSAID sensitivity using a shortened oral drug challenge. Methods: Patients with NSAID sensitivity were included. A shortened oral drug challenge with a COX-2 selective inhibitor (meloxicam or etoricoxib) was carried out. The challenge was considered positive if any of the following symptoms appeared: urticaria, rhinoconjunctivitis, angioedema, anaphylaxis or bronchospasm, the latter defined as a fall in FEV1 equal or greater than 20%. Results: Fifty-four patients were enrolled (78% were women), with a mean age of 39.6 years (range, 13 to 70 years). Forty three patients were challenged with meloxicam (79.6%) and 11 with etoricoxib (20.4%). Forty nine patients tolerated the drug challenge (90.7%), and only five patients (all challenged with meloxicam) developed a reaction (9.3%): urticaria in two, urticaria plus angioedema in one, and broncospasm in other two. From these, three were rechallenged with etoricoxib and all of them tolerated it. Conclusion: Most of the subjects with NSAID sensitivity tolerated a COX-2 selective inhibitor by means of a shortened oral drug challenge. This is the first cohort of patients with NSAID sensitivity and its tolerance to COX-2 selective inhibitors published in our country. (English) [ABSTRACT FROM AUTHOR]Ítem Case report of cadaveric kidney transplantation with renal-portal venous drainage: A feasible way for a venous drainage in a complex generalized thrombosed vessels setting(Elsevier Ltd, 2016-09-30) Caicedo, Luis ArmandoIntroduction One of the frequent complications suffered by patients with chronic renal failure is the lack of vascular access due to venous thrombosis. This means that the transplant surgeon must have a detailed knowledge of the intra-abdominal venous system, and other alternative surgeries, at the time of performing the renal graft implant, in order to ensure a good venous drainage. Presentation of the case This article provides a case report regarding a patient with no vascular access and with surgical difficulties at the time of the kidney transplant, in whom a renal-portal venous drainage was performed with very good outcome. Discusion Renal-portal venous drainage is a way to performe kidney transplant with good outcome. In Fundación Valle del Lili we have overcome the lack of vascular access in patients that need a renal transplant by new surgical technics that improve the patients quality of life and survival. Conclusion We can conclude that new surgical alternatives exist for those patients with chronic renal failure that have no vascular access. These patients are a priority for kidney transplants and the surgeon must take in to account the need for a new surgical assessment. © 2016 The Authors