No abstract

Domino liver transplantation using FAP livers (DLTx/FAP) has become a worldwide strategy that is contributing significantly to the increase in liver grafts offered in Portugal. The safety of the procedure both in the FAP donors and in the recipients is emphasized in the series of 64 DLTx/FAP that has already been perfonned in the Hospital of the University of Coimbra (HUC). The occurrence of amyloidosis in the long-term survivors after DLTx/FAP is a serious possibility, although after 6 and 7 years post-transplant no symptoms have been reported by any of the patients. Indeed, amyloid deposits, although small, have been found in the skin and nerve biopsies of the first domino recipients (HUC unpublished data). Hopes that the disease will have a slow course in non-genetically affected patients still awaits the proof of time. Thus, DLTx/FAP should be considered an experimental procedure, although there is good reason to expect that the amyloidosis in the DLTx/FAP recipients will have a longer time course than in the genetically affected donors. The ethical implications of all these facts and expectations are discussed. A case by case approach is recommended. In such an approach, individual prognosis, urgency, graft shortage and the will of very well-informed patients or their legal representatives are determinants for judicious decisions when considering DLTx/FAP in patients under 50 years of age.

Summary Three cases of cystic seminal vesicles associated with unilateral agenesis of Kidyney, ureter and trigone are reported. In 2 of them, the cystic vesicle was unilateral with ipsilateral urimary agenesis. Ther third patient had patient and had bilateral cystic vesicles and ageneis of kidney, Ureter and tirgonia.

Deep endometriosis is still a challenging disease in terms of diagnosis and treatment. About 10-12% of women of reproductive age will have a form of endometriosis. This can affect pelvic as well as extra pelvic locations. Risk of malignant transformation has been studied over a long period of time. Medical and surgical treatments can be proposed to patients for endometriosis-associated pain depending on the severity of symptoms and location of the disease. Results and outcomes are different according to different publications. Understanding of the benefit of surgical treatment on fertility is increasing. The place of medical and surgical treatment in recurrent symptoms or disease is also of interest. Presented here is a review on the management of endometriosis in the light of recent data. Further investigations in many fields of endometriosis are still required.