Primary Central Nervous System Posttransplant Lymphoproliferative Disease in a Bilateral Transfemoral Lower Extremity Transplantation Recipient

Cavadas, Pedro C.; Thioné, Alessandro; Blanes, Margarita; Mayordomo‐Aranda, Empar

doi:10.1111/ajt.13313

Cited by 23 publications

(17 citation statements)

References 23 publications

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“…Din nefericire, evoluţia acestui caz a fost nefavorabilă prin dezvoltarea, pe fondul imunosupresiei, a unui sindrom proliferativ posttransplant (PTLD -posttransplant lymphoproliferative disorder) la nivelul sistemului nervos central. A fost întreruptă imunosupresia, necesitând ulterior îndepartarea membrelor pelvine la doi ani după transplant [61,62].…”

Section: Alotransplantul De Membre Pelvineunclassified

Current status of vascularized composite allografts transplant

Grosu-Bularda¹,

Lascăr²,

Teodoreanu³

2019

Ro J Med Pract.

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RezumatIntroducere. După anul 1998, când a fost efectuat primul transplant de mână în Franţa, la Lyon, s-a produs o dezvoltare neaşteptată a chirurgiei reconstructive de transplant. Transplanturile alogrefelor vascularizate compozite (VCA) se adresează unor pacienţi atent selectionaţi, în instituţii acreditate, pentru îmbunătăţirea prognosticului funcţional şi a calitaţii vieţii acestora. Scopul acestei lucrari este trecerea în revistă a rezultatelor clinice obţinute în transplantul vascularizat compozit la nivel mondial. Metodă. Au fost analizate publicaţiile relevante în domeniul alotransplantului vascularizat compozit, inclusiv datele din cadrul Registrului Internaţional de Transplant de Mână şi Ţesuturi Compozite (International Registry on Hand and Composite Tissue Transplantation:IRHCTT), resursă de mare importanţă în evaluarea globală a transplanturilor tisulare compozite. Rezultate şi discuţii. Până în prezent, au fost efectuate la nivel mondial peste 200 de astfel de proceduri, cu numeroase aplicaţii clinice, incluzând transplanturi ale membrelor toracice uni sau bilaterale, transplant de faţă, laringe, trahee, perete abdominal, membru pelvin, uter şi penis. Având o experienţă clinică de aproape două decenii, cu standardizarea indicaţiilor şi protocoalelor chirurgicale, singurele limitări în ceea ce priveşte utilizarea pe scară largă a alogrefelor vascularizate compozite sunt aspectele imunologice: fiind proceduri non-vitale, devine discutabilă expunerea pacienţilor la terapie imunosupresoare pentru tot restul vieţii, cu efectele adverse legate de administrarea acesteia. Concluzii. Chirurgia reconstructivă de transplant are potenţial să devină un standard terapeutic, fiind unica soluţie reconstructivă în cazul anumitor defecte tisulare complexe, implicând multiple structuri cu importanţă funcţională, imposibil de reparat utilizând tehnicile chirurgicale convenţionale. Rezultatele favorabile atestând fezabilitatea acestor tehnici, depăşirea dilemelor etice, elaborarea unor protocoale chirurgicale şi imunologice standardizate asigură extinderea utilizării alotransplanturilor vascularizate compozite în practica clinică. Cuvinte cheie: transplant, alogrefe vascularizate compozite (VCA), transplant de mână, transplant de faţă, imunosupresie Abstract Introduction. The field of composite tissue allotransplatation became a clinical reality since first hand transplant performed in 1998 at Lyon, France and has been progressing over the past two decades. Vascularized composite allotransplantation (VCA) is now performed for life enhancing indications in a selected group of patients under institutional protocols.Aim. This paper is an attempt to review the outcomes of VCA to date. Method. Analysis of relevant publications of composite tissue allotransplantation was performed, including the International Registry on Hand and Composite Tissue Transplantation (IRHCTT).Results and discussion. To date, there are more than 200 composite tissue allograft transplants performed worldwide, including upper limb, face, larynx, tr...

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Section: Alotransplantul De Membre Pelvineunclassified

Current status of vascularized composite allografts transplant

Grosu-Bularda¹,

Lascăr²,

Teodoreanu³

2019

Ro J Med Pract.

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“…6 That graft has now been maintained with good function for more than 20 years. 7 In addition to knee and upper extremity VCAs, the field includes lower extremity, 8 esophagus, 9 larynx, 10 abdominal wall, 11 penis, 12 uterus 13,14,15 and craniofacial transplants. 16 All forms of VCA remain relatively rare.…”

Section: History Of Vascularized Composite Allotransplantationmentioning

confidence: 99%

How to Help Patients Considering VCA

2019

AMA Journal of Ethics

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Patients who might benefit from some form of vascularized composite allotransplantation (VCA) can be expected to have prior long-standing relationships with one or more primary care professionals or specialists who are well-positioned to help patients make well-informed decisions about whether and when to pursue VCA. Helping patients decide requires becoming familiar with VCA, its various forms, eligibility criteria, prior and possible outcomes, and potential risks and benefits. This article shares key points for helping patients.

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“…In 2006, a whole unilateral leg was successfully transplanted between conjoined twins, avoiding the necessity of immunosuppression . This was followed by the first bilateral above‐knee lower limb transplantation performed by Cavadas et al in 2011. However, despite good initial recovery, the legs had to be removed due to oncologic complications 1.5 years after transplantation.…”

Section: Other Vcasmentioning

confidence: 99%

“…Diabetes mellitus, hypertension, hypercholesterinemia, and kidney function deterioration are the most commonly encountered metabolic complications in VCA . The field of RT could not be spared of malignancies; either nonmelanoma skin cancers, posttransplant lymphoproliferative disorders, or malignancies whose occurrence is not particularly known to be associated with immunosuppression were encountered in VCA recipients and eventually led, in some cases, to allograft loss or the patient’s death …”

Section: Complicationsmentioning

confidence: 99%

Innovations in reconstructive microsurgery: Reconstructive transplantation

Kollar

Tasigiorgos

Dorante

et al. 2018

Journal of Surgical Oncology

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In the past 20 years, reconstructive transplantation (RT) has emerged as a viable reconstructive option for carefully selected patients. More than 100 upper extremity and 40 face transplants have been performed worldwide to date. Concomitantly, the portfolio of reconstructive transplantation has been extended by additional procedures such as lower extremities, abdominal wall, neck, uterus, genitourinary, and pediatric transplants. In the present review article, we aim to summarize the current state of knowledge about this exciting field.

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Primary Central Nervous System Posttransplant Lymphoproliferative Disease in a Bilateral Transfemoral Lower Extremity Transplantation Recipient

Cited by 23 publications

References 23 publications

Current status of vascularized composite allografts transplant

Current status of vascularized composite allografts transplant

How to Help Patients Considering VCA

Innovations in reconstructive microsurgery: Reconstructive transplantation

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