دورية أكاديمية
أعرض في EDS

Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study.

التفاصيل البيبلوغرافية
العنوان: Early detection of complications in pancreas transplants by microdialysis catheters, an observational feasibility study.
المؤلفون: Kjøsen G; Department of Anesthesiology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Rydenfelt K; Department of Anesthesiology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Horneland R; Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway., Aandahl EM; Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.; Institute for Cancer Research, Oslo University Hospital, Oslo, Norway., Line PD; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway., Dorenberg E; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Berstad AE; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Brabrand K; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Hagen G; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Pischke SE; Department of Anesthesiology, Oslo University Hospital, Oslo, Norway.; Department of Immunology, Oslo University Hospital, Oslo, Norway., Bergmann GB; Department of Anesthesiology, Oslo University Hospital, Oslo, Norway., Nordheim E; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway., Jenssen TG; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway., Tønnessen TI; Department of Anesthesiology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Haugaa H; Department of Anesthesiology, Oslo University Hospital, Oslo, Norway.; Lovisenberg Diaconal University College, Oslo, Norway.
المصدر: PloS one [PLoS One] 2021 Mar 11; Vol. 16 (3), pp. e0247615. Date of Electronic Publication: 2021 Mar 11 (Print Publication: 2021).
نوع المنشور: Clinical Trial; Journal Article; Observational Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Graft Rejection/*diagnosis , Hematoma/*diagnosis , Microdialysis/*methods , Monitoring, Physiologic/*methods , Pancreas Transplantation/*adverse effects , Venous Thrombosis/*diagnosis, Adult ; Antilymphocyte Serum/therapeutic use ; Catheters, Indwelling ; Early Diagnosis ; Feasibility Studies ; Female ; Glucose/metabolism ; Glycerol/metabolism ; Graft Rejection/immunology ; Graft Rejection/metabolism ; Hematoma/etiology ; Hematoma/immunology ; Hematoma/metabolism ; Humans ; Immunosuppressive Agents/therapeutic use ; Lactic Acid/metabolism ; Male ; Microdialysis/instrumentation ; Middle Aged ; Mycophenolic Acid/therapeutic use ; Pyruvic Acid/metabolism ; Tacrolimus/therapeutic use ; Venous Thrombosis/etiology ; Venous Thrombosis/immunology ; Venous Thrombosis/metabolism
مستخلص: Background: Despite advances in immunosuppression and surgical technique, pancreas transplantation is encumbered with a high rate of complication and graft losses. Particularly, venous graft thrombi occur relatively frequently and are rarely detected before the transplant is irreversibly damaged.
Methods: To detect complications early, when the grafts are potentially salvageable, we placed microdialysis catheters anteriorly and posteriorly to the graft in a cohort of 34 consecutive patients. Glucose, lactate, pyruvate, and glycerol were measured at the bedside every 1-2 hours.
Results: Nine patients with graft venous thrombosis had significant lactate and lactate-to-pyruvate-ratio increases without concomitant rise in blood glucose or clinical symptoms. The median lactate in these patients was significantly higher in both catheters compared to non-events (n = 15). Out of the nine thrombi, four grafts underwent successful angiographic extraction, one did not require intervention and four grafts were irreversibly damaged and explanted. Four patients with enteric anastomosis leakages had significantly higher glycerol measurements compared to non-events. As with the venous thrombi, lactate and lactate-to-pyruvate ratio were also increased in six patients with graft surrounding hematomas.
Conclusions: Bedside monitoring with microdialysis catheters is a promising surveillance modality of pancreatic grafts, but differentiating between the various pathologies proves challenging.
Competing Interests: The authors have declared that no competing interests exist.
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المشرفين على المادة: 0 (Antilymphocyte Serum)
0 (Immunosuppressive Agents)
33X04XA5AT (Lactic Acid)
8558G7RUTR (Pyruvic Acid)
HU9DX48N0T (Mycophenolic Acid)
IY9XDZ35W2 (Glucose)
PDC6A3C0OX (Glycerol)
WM0HAQ4WNM (Tacrolimus)
تواريخ الأحداث: Date Created: 20210311 Date Completed: 20210907 Latest Revision: 20210907
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7951931
DOI: 10.1371/journal.pone.0247615
PMID: 33705460
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0247615