Carbapenem-resistant Klebsiella pneumoniae infection causing rupture of graft artery in solid organ recipients: Case report and review of literature

We reported 1 patient with donor-derived CRKP infection following liver transplantation and 2 patients following renal transplantation (1 liver and 2 kidneys were from the same donor), who experienced sudden abdominal pain and abdominal hemorrhage almost at the same time after organ transplantation. Diagnosis: The patients were diagnosed as graft arteries rupture due to corrosion caused by CRKP infection based on computed tomography scan, blood culture, laparotomy, and pulse-field gel electrophoresis. Interventions: Anti-shock treatment, exploratory laparotomy, broad-spectrum antibiotics, and abdominal puncture and drainage were given. Outcomes: The liver recipient survived as well as the liver graft, still under treatment of multiple abdominal infections. The 2 renal recipients were alive after resection of the renal grafts and underwent hemodialysis. Lessons: Rupture of graft artery should be foreseen when donor-derived CRKP infection was confirmed and broad-spectrum antibiotics and other interventions need to be considered.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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Publication date: Available online 11 December 2019Source: Urology Case ReportsAuthor(s): Nobufumi Ueda, Hirohito Naito, Mikio SugimotoAbstractWe experienced a case of retroperitoneal hematoma secondary to spontaneous lumbar artery rupture in a kidney transplant patient. A 48-year-old woman underwent kidney transplantation for end-stage renal disease. Fifteen days after transplantation, the patient presented with strong abdominal and back pain on the right side, and blood examination showed severe anemia. Contrast-enhanced computed tomography and emergent angiography was performed, which showed extravasation from the lumba...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
ConclusionsThe factors associated positively with DKT were duration after surgery, improvement of physical activities, mobility, alleviation of pain, and patient satisfaction.
Source: Journal of Public Health - Category: Health Management Source Type: research
Surgeons at the Cleveland Clinic managed to implant a donor kidney into a patient using a surgical robot, and all through one small incision. The technique, in which instruments as well as the donor kidney can be passed through a four centimeter (1.6...
Source: Medgadget - Category: Medical Devices Authors: Tags: Surgery Urology Source Type: blogs
Robert Chelsea turned down the first face he was offered. It was a fine face, one that could have taken him off the transplant waiting list after just a couple months. But Chelsea—severely disfigured after a catastrophic car accident five years earlier—was in no hurry. He’d gotten used to tilting his head back so food and water wouldn’t fall out of his nearly lipless mouth. He knew how to respond compassionately to children who stared in shock and fear. The face, offered in May 2018, had belonged to a man with skin that was much fairer than what remained of Chelsea’s—so light that Chelse...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Healthcare Source Type: news
CONCLUSIONS: Bisphosphonate therapy may reduce fracture and bone pain after kidney transplantation, however low certainty in the evidence indicates it is possible that treatment may make little or no difference. It is uncertain whether bisphosphonate therapy or other bone treatments prevent other skeletal complications after kidney transplantation, including spinal deformity or avascular bone necrosis. The effects of bone treatment for children and adolescents after kidney transplantation are very uncertain. PMID: 31637698 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract Kidney transplant is a choice option for treatment of chronic kidney failure because it is associated with cost-effective and normal quality of life. To increase the number of living kidney donors, laparoscopic and minimal invasive modalities have been introduced. Here, we present a case of a living donor with an extremely rare complication after laparoscopic donor nephrectomy that presented as massive chylous ascites. Kidney donor operation can be performed with the use of 3 modalities: traditional open, laparoscopic, and open with minimally invasive. All 3 modalities may be associated with some complica...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
By SAURABH JHA, MD Despite an area under the ROC curve of 1, Cassandra’s prophesies were never believed. She neither hedged nor relied on retrospective data – her predictions, such as the Trojan war, were prospectively validated. In medicine, a new type of Cassandra has emerged –  one who speaks in probabilistic tongue, forked unevenly between the probability of being right and the possibility of being wrong. One who, by conceding that she may be categorically wrong, is technically never wrong. We call these new Minervas “predictions.” The Owl of Minerva flies above its denominator. ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Artificial Intelligence Data Medical Practice Physicians RogueRad @roguerad acute kidney injury AI deep learning machine learning predictions Saurabh Jha Source Type: blogs
ConclusionWith increasing experience, grafts with challenging vascular anatomy can be taken up for RAKT and GMVs should not be considered as a contraindication for RAKT.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Conditions:   Opioid Use;   Kidney Diseases;   Pain, Postoperative;   Postoperative Complications;   Postoperative Nausea and Vomiting Interventions:   Procedure: multimodal pain management;   Other: goal directed fluid management;   Other: preoperative carbohydrate loading;   Procedure: Donor nephrectomy;   Procedure: regional anesthesia Sponsor:   Thomas Jefferson University Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionWe found multiple heterogeneous predictors for SL with a common denominator related to surgical management of the retroperitoneal space, peritoneum and the ureter. Future prospective studies are necessary to evaluate the influence of these variables on the development of SL.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
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