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Boillot O, Dawahra M, Méchet I, Poncet G, Choucair A, Henry L, Boucaud C, Sagnard P, Scoazec JY. Liver transplantation using a right liver lobe from a living donor. Transplant Proc 2002; 34:773-6. [PMID: 12034179 DOI: 10.1016/s0041-1345(01)02908-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- O Boillot
- Unité de Transplantation Hépatique, Pavillon D, Hôpital Edouard Herriot, Lyon, France.
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Dawahra M, Petruzzo P, Lefrançois N, Thivolet C, Badet L, Dubernard JM, Martin X. Portal drainage of pancreas allograft: surgical complications and graft survival. Transplant Proc 2002; 34:817-8. [PMID: 12034194 DOI: 10.1016/s0041-1345(01)02922-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- M Dawahra
- Service de Transplantation, Hôpital Edouard Herriot, Lyon, France
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Lanzetta M, Nolli R, Borgonovo A, Owen ER, Dubernard JM, Kapila H, Martin X, Hakim N, Dawahra M. Hand transplantation: ethics, immunosuppression and indications. J Hand Surg Br 2001; 26:511-6. [PMID: 11884098 DOI: 10.1054/jhsb.2001.0635] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- M Lanzetta
- Hand Surgery and Reconstructive Microsurgery Unit, San Gerardo Hospital, University of Milan-Bicocca, Italy.
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Touiti D, Seket B, Deligne E, Badet L, Colombel M, Dawahra M, Martin X, Maréchal JM, Dubernard JM. [Bilateral adrenal pheochromocytomas in von Hippel-Lindau disease]. Ann Urol (Paris) 2001; 35:323-8. [PMID: 11774764 DOI: 10.1016/s0003-4401(01)00053-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The pheochromocytoma is a medullo-adrenal tumor which develops at the cost of the chromaffin cells. It appears in 11-19% of cases of von Hippel-Lindau's disease (VHL), is often bilateral, and the symptomatology is often crude: arterial hypertension is frequently isolated and unstable, and the classic triad of headache, palpitations and sweating is quite rarely observed. We report four observations of bilateral pheochromocytomas in patients with von Hippel-Lindau's disease (three with phenotype IIA and one with phenotype IIB). The tumor was bilateral during the diagnosis in three cases; in the fourth patient, the attack on the contralateral adrenal gland came two years after the first adrenalectomy. All the patients had undergone an adrenalectomy by open surgery after a short preparation of 48 hours; replacement therapy was begun in each patient. Morbidity was low, and the patients submitted to a prolonged follow-up in order to screen for the onset of future lesions of VHL.
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Affiliation(s)
- D Touiti
- Service d'urologie et de chirurgie de la transplantation, hôpital Edouard Herriot, 5, place d'Arsonval, 69437 Lyon, France
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Dubernard JM, Owen E, Lefrançois N, Petruzzo P, Martin X, Dawahra M, Jullien D, Kanitakis J, Frances C, Preville X, Gebuhrer L, Hakim N, Lanzettà M, Kapila H, Herzberg G, Revillard JP. First human hand transplantation. Case report. Transpl Int 2001; 13 Suppl 1:S521-4. [PMID: 11112064 DOI: 10.1007/s001470000288] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J M Dubernard
- Service d'Urologie et de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Abstract
We report the case of a 48 year-old woman presently with a pararenal tumor, with a history of pyelotomy in 1978 for the extraction of a renal pelvic stones. Results of surgery showed a foreign body. The clinical and diagnostic aspects of retained surgical gauze have been discussed and the need for radio-opaque markers in them have been emphasized.
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Affiliation(s)
- D Touiti
- Service d'urologie et de transplantation, hôpital Edouard Herriot, 5, place d'Arsonval, 69430 Lyon, France
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Petruzzo P, Lefrançois N, Kanitakis J, Gebuhrer L, Da Silva M, Konan PG, Dawahra M, Martin X, Revillard JP, Dubernard JM. Immunosuppression in composite tissue allografts. Transplant Proc 2001; 33:2398-9. [PMID: 11377574 DOI: 10.1016/s0041-1345(01)02036-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- P Petruzzo
- Service de Chirurgie de la Transplantation, Hopital Edouard Herriot, Lyon, France
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Affiliation(s)
- E R Owen
- Microresearch Foundation of Australia, Sydney, Australia
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Lefrançois N, Petruzzo P, Sepeteanu I, Da Silva M, McGregor B, Dawahra M, Hadj-Aissa A, Dubernard JM, Touraine JL, Martin X. Impact of the functioning pancreas on long-term renal function in pancreas-kidney transplantation. Transplant Proc 2001; 33:1690-1. [PMID: 11267471 DOI: 10.1016/s0041-1345(00)02642-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- N Lefrançois
- Transplant Unit, Edouard Herriot Hospital, Lyon, France
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Affiliation(s)
- M Lanzetta
- University of Milan-Bicocca, Milan, Italy
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Dawahra M, Fassi-Fehri H, Konan PG, Marechal JM, DaSilva M, Lefrançois N, Dubernard JM, Martin X. Continent urinary cutaneous diversion in kidney transplantation: long-term results. Transplant Proc 2000; 32:2770. [PMID: 11134795 DOI: 10.1016/s0041-1345(00)01875-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Dawahra
- Service d'Urologie et de Chirurgie de la Transplantation, Hopital Edouard Herriot, Lyon, France
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Petruzzo P, Da Silva M, Feitosa LC, Dawahra M, Lefrançois N, Dubernard JM, Martin X. Simultaneous pancreas-kidney transplantation: portal versus systemic venous drainage of the pancreas allografts. Clin Transplant 2000; 14:287-91. [PMID: 10945198 DOI: 10.1034/j.1399-0012.2000.140403.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Simultaneous pancreas-kidney (SPK) transplantation is considered a valid therapeutic option for patient with type I diabetes mellitus and end-stage diabetic nephropathy. This study was performed to determine whether the technique of pancreas venous drainage affects patient survival as well as graft survival and function. From October 1996 to April 1999 34 uremic patients with type I diabetes mellitus were randomly assigned to two groups: the first group (SV group = 17) received SPK transplantation with systemic venous drainage, and the second group (PV group = 17) received pancreas allograft with portal drainage. A Roux-en-Y loop was performed in all the patients. Patient follow-up included clinical course and metabolic studies. At 1 yr, patient survival rates were 88.2% in the SV group and 94.1% in the PV group while graft survival rate was 76.4% in both groups. Several surgical complications were attributed to the enteric drainage without any graft failure in both groups. One venous thrombosis occurred in each group. No significant differences have been evidenced in kidney and pancreas function. The preliminary results of this randomized trial did not evidence any significant differences between portal and systemic venous drainage of pancreas allograft.
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Affiliation(s)
- P Petruzzo
- Service d'Urologie et de la Chirurgie de la Transplantation, Hopital Edouard Herriot, Lyon, France
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Martin X, Petruzzo P, Dawahra M, Feitosa Tajra LC, Da Silva M, Pibiri L, Chapuis F, Dubernard JM, Lefrançois N. Effects of portal versus systemic venous drainage in kidney-pancreas recipients. Transpl Int 2000; 13:64-8. [PMID: 10743692 DOI: 10.1007/s001470050010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A randomized study of combined kidney-pancreas transplantation was performed on 30 insulin-dependent diabetic patients with end-stage renal disease to compare the consequences of pancreas transplantation with portal venous (PV) and systemic venous (SV) drainage. Fourteen patients (SV) group) received systemically drained and sixteen (PV group) portally drained pancreas allografts. Enteric drainage was performed in both groups. The routine follow-up included documentation of the clinical course and detailed endocrine studies. At 1 year after transplantation, the patient survival rate was 92% for the SV group and 96% for the PV group; the graft survival rate was 78% and 82%, respectively. Endocrine studies indicated no difference in fasting and stimulated glucose or in glycosylated hemoglobin between the two groups. In addition, no hyperinsulinemia and lipidic abnormalities were evidenced in either group Long-term studies are required to conclude whether PV and SV drainage in pancreas transplantation are equivalent in terms of patient and graft survival as well as metabolic consequences.
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Affiliation(s)
- X Martin
- Service de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Martin X, Petruzzo P, Dawahra M, Feitosa Tajra LC, Da Silva M, Pibiri L, Chapuis F, Dubernard JM, Lefrançois N. Effects of portal versus systemic venous drainage in kidney-pancreas recipients. Transpl Int 2000. [PMID: 10743692 DOI: 10.1111/j.1432-2277.2000.tb01038.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A randomized study of combined kidney-pancreas transplantation was performed on 30 insulin-dependent diabetic patients with end-stage renal disease to compare the consequences of pancreas transplantation with portal venous (PV) and systemic venous (SV) drainage. Fourteen patients (SV) group) received systemically drained and sixteen (PV group) portally drained pancreas allografts. Enteric drainage was performed in both groups. The routine follow-up included documentation of the clinical course and detailed endocrine studies. At 1 year after transplantation, the patient survival rate was 92% for the SV group and 96% for the PV group; the graft survival rate was 78% and 82%, respectively. Endocrine studies indicated no difference in fasting and stimulated glucose or in glycosylated hemoglobin between the two groups. In addition, no hyperinsulinemia and lipidic abnormalities were evidenced in either group Long-term studies are required to conclude whether PV and SV drainage in pancreas transplantation are equivalent in terms of patient and graft survival as well as metabolic consequences.
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Affiliation(s)
- X Martin
- Service de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Petruzzo P, Andreelli F, McGregor B, Lefrançois N, Dawahra M, Feitosa LC, Dubernard JM, Thivolet C, Martin X. Evidence of recurrent type I diabetes following HLA-mismatched pancreas transplantation. Diabetes Metab 2000; 26:215-8. [PMID: 10880896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Type 1 diabetes mellitus is considered as an autoimmune disease against beta cells. Diabetes recurrence after pancreas transplantation is well known in HLA-identical twins while it is rarely reported in recipients of cadaveric pancreatic grafts. In the present case report, diabetes recurrence occurred in a recipient who underwent cadaveric combined pancreas kidney transplantation. Seven years after transplantation the patient exhibited progressive hyperglycemia needing insulin therapy while the renal graft was well functioning. The diagnosis of recurrent disease was obtained on the histological features such as selective loss of beta cells without clear signs of insulitis and on the presence of markers (GAD 65 and IA-2) for humoral autoimmunity. It is intriguing that, at the time of recurrence of type 1 diabetes, the patient had stopped steroids and azathioprine, while only cyclosporine was maintained as immunosuppressive treatment. Our case report underlines the relevance of studying the humoral autoimmune response directed to islet autoantigens in cadaveric pancreas allograft recipients. Furthermore, it suggests that an efficient immunosuppressive treatment after transplantation may be able to reduce the autoimmune response against the pancreatic allograft.
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Affiliation(s)
- P Petruzzo
- Service de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Martin X, Dawahra M, Lefrançois N, Da Silva M, Petruzzo P, Pibiri L, Feitosa LC, Dubernard JM. Kidney-pancreas transplantation: our experience with systemic and portal drainage of pancreatic graft. Transplant Proc 2000; 32:421-2. [PMID: 10715463 DOI: 10.1016/s0041-1345(00)00836-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- X Martin
- Service de Chirurgie et de Medecine de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Abstract
Tubular ectasia of the rete testis (TERT) is a benign entity due to dilation of the tubules of the rete testis. Most of the time it is discovered incidentally on scrotal sonograms and may be misinterpreted as malignant. This article outlines the diagnostic criteria of TERT, its possible causes, its incidence and its potential evolution. Recognizing this entity owing to its characteristic clinical, sonographic and, if necessary, MRI features is important to avoid unnecessary surgery or biopsies.
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Affiliation(s)
- O Rouvière
- Department of Genitourinary Radiology, Pavillon P, Hôpital E. Herriot, Place d'Arsonval, F-69003 Lyon, France
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Dubernard JM, Martin X, Lefrancois N, Dawahra M, Feitosa LC. Future of pancreatic transplantation. Transplant Proc 1999; 31:3190-1. [PMID: 10616435 DOI: 10.1016/s0041-1345(99)00780-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J M Dubernard
- Service d'urologie et de chirurgie de la transplantation, Hospital Edouard Herriot, Lyon, France
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Martin X, Aboutaieb R, Soliman S, el Essawy A, Dawahra M, Lefrancois N. The use of long-term defunctionalized bladder in renal transplantation: is it safe? Eur Urol 1999; 36:450-3. [PMID: 10516458 DOI: 10.1159/000020029] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Evaluation of the use of defunctionalized bladder in renal transplantation, concerning surgical complications. METHODS In order to assess the complication rate of ureteral reimplantation in long-term defunctionalized bladder, we compared 20 patients on haemodialysis for more than 15 years (group I) with another 20 patients on haemodialysis for less than 5 years (group II). None of these patients had renal failure due to urological causes or neurogenic bladder. Non-stented extravesical ureteroneocystostomy was done routinely in all patients except 1 in group II who underwent Politano-Leadbetter ureteroneocystostomy and 7 patients in group I who underwent Politano-Leadbetter (3 patients) and pyelo-ureteral anastomosis using the recipient's native ureter (4 patients). The amount of residual urine was insignificant (<100 cm(3)) in both groups. RESULTS The mean postoperative bladder catheterization period was 7.8 days in group I and 4.2 days in group II. Postoperative urinary tract infections were observed in 9 cases of group I and in 4 cases of group II. No surgical complications occurred in patients of group II, while there were 6 patients with surgical complications in group I: stenosis after a pyelo-ureteral anastomosis (1 case), stenosis after a ureterovesical anastomosis with Politano-Leadbetter technique (1 case), urinary fistulae (3 cases; 1 with Politano-Leadbetter ureteroneocystostomy and 2 cases with pyelo-ureteral anastomosis), and vesico-ureteral reflux (1 case with Politano-Leadbetter ureteroneocystostomy). These 6 cases had the lowest bladder capacity (30-150 cm(3)) among our 40 patients. Graft losses were comparable between the two groups and were not due to surgical complications. CONCLUSION Small defunctionalized bladders can be used in kidney transplantation, but it may represent an increased surgical risk due to difficulty in performing ureteral reimplantation.
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Affiliation(s)
- X Martin
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard-Herriot, Lyon, France
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Dubernard JM, Owen E, Herzberg G, Martin X, Guigal V, Dawahra M, Pasticier G, Mongin-Long D, Kopp C, Ostapetz A, Lanzetta M, Kapila H, Hakim N. [The first transplantation of a hand in humans. Early results]. Chirurgie 1999; 124:358-65; discussion 365-7. [PMID: 10546388 DOI: 10.1016/s0001-4001(00)80007-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The first hand allograft was performed on September 23, 1998. The right distal forearm and hand of a brain dead donor was transplanted to a 48 year old recipient who had undergone a traumatic amputation of the distal third of his right forearm. The donor's arm was irrigated with organ preservation solution (UW) and transported to Lyon in a cool container. Two teams simultaneously dissected the donor's limb and the recipient's stump to identify anatomical structures. Transplantation involved bone fixation, arterial and venous anastomoses, nerve sutures, joining of the muscles and tendons, and skin closure. Immunosuppression consisted of anti-lymphocyte, polyclonal and monoclonal antibodies, tacrolimus, mycophenolic acid, and prednisone. Mild clinical and histological signs of rejection occurred at week 9 after surgery. They disappeared with adjustments of the immunosuppressant doses. Seven months after surgery the patient was in good general condition. Intensive physiotherapy led to satisfactory progress of motor function. Sensory progress is excellent, reaching the fingertips. A longer follow-up is necessary to appreciate the final result. In the absence of further rejection, the functional prognosis of the graft should be similar to that reported after successful autoreconstruction.
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Affiliation(s)
- J M Dubernard
- Service de chirurgie de la transplantation et d'urologie, hôpital Edouard-Herriot, Lyon, France
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Martin X, Tajra LC, Gelet A, Dawahra M, Konan PG, Dubernard JM. Complete staghorn stones: percutaneous approach using one or multiple percutaneous accesses. J Endourol 1999; 13:367-8. [PMID: 10446798 DOI: 10.1089/end.1999.13.367] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- X Martin
- Urology and Transplantation Department, Edouard Herriot Hospital, Lyon, France.
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Abstract
BACKGROUND Long-term survival of animal limb allografts with new immunosuppressant combinations and encouraging results of autologous limb replantations led us to believe that clinical application of hand transplantation in human beings was viable. METHODS On Sept 23, 1998, we transplanted the right distal forearm and hand of a brain-dead man aged 41 years on to a man aged 48 years who had had traumatic amputation of the distal third of his right forearm. The donor's arm was irrigated with UW organ preservation solution at 4 degrees C, amputated 5 cm above the elbow, and transported in a cool container. We dissected the donor limb and the recipient's arm simultaneously to identify anatomical structures. Appropriate lengths of viable structures were matched. Transplantation involved bone fixation, arterial and venous anastomoses (ischaemic time 12.5 h), nerve sutures, joining of muscles and tendons, and skin closure. Immunosuppression included antithymocyte globulins, tacrolimus, mycophenolic acid, and prednisone. Maintenance therapy included tacrolimus, mycophenolic acid, and prednisone. Follow-up included routine post-transplant laboratory tests, skin biopsies, intensive physiotherapy, and psychological support. FINDINGS The initial postoperative course was uneventful. No surgical complications were seen. Immunosuppression was well tolerated. Mild clinical and histological signs of cutaneous rejection were seen at weeks 8-9 after surgery. These signs disappeared after prednisone dose was increased (from 20 mg/day to 40 mg/day) and topical application of immunosuppressive creams (tacrolimus, clobetasol). Intensive physiotherapy led to satisfactory progress of motor function. Sensory progress (Tinel's sign) was excellent and reached the wrist crease (20 cm) on day 100 for the median and ulnar nerves, and at least 24 cm to the palm by 6 months when deep pressure, but not light touch sensation, could be felt at the mid palm. INTERPRETATION Hand allotransplantation is technically feasible. Currently available immunosuppression seems to prevent acute rejection. If no further episode of rejection occurs, the functional prognosis of this graft should be similar to if not better than that reported in large series of autoreconstruction.
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Affiliation(s)
- J M Dubernard
- Service de Chirugie de la Transplantation et d'Urologie, Hôpital Edouard Herriot, Lyon, France.
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Boillot O, Dawahra M, Méchet I, Czyglik O, Bernard P, Le Derf Y, Branche P, Bobineau I, Cabrera J, Sagnard P, Dumortier J, Henry L, Partensky C. [Orthotopic liver transplantation from a living adult donor to an adult using the right hepatic lobe]. Chirurgie 1999; 124:122-9; discussion 130-1. [PMID: 10349748 DOI: 10.1016/s0001-4001(99)80054-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY AIM In children, living donor liver transplantation has been shown to be efficient in treating end-stage liver diseases when the left lateral segment is harvested. In adults, more liver mass is needed to provide adequate hepatic function. The aim of this study is to report 2 successful cases of living donor liver transplantation using a right hepatic lobe from adult. PATIENTS AND METHODS In 2 sons, the right hepatic lobe was harvested without the middle hepatic vein for transplantation in their fathers who were suffering from end-stage liver cirrhosis. Hepatectomy was done without vascular inflow occlusion after dissection of vascular and biliary structures, itself strictly restricted to the right side. In recipients, the graft was implanted orthotopically with preservation of the native inferior vena cava and after temporary porto-caval shunt. RESULTS The duration of donors procedures was 7 h and 11 h 45 min; intra-operative transfusions comprised of 700 mL from cell-saver in the first case, and 1300 mL plus 1 autologous red blood cell unit in the second case. Graft weights were 770 g and 1100 g. None of the donors experienced liver failure and both were able to leave the hospital 9 days after the operation. In recipients, initial graft function was excellent in the first case and correct in the second case, despite the necessity to redo intra-operatively the hepatic vein anastomosis secondary to a twisting. Patients were discharged 20 and 40 days respectively following transplantation. CONCLUSION Adult living donor liver transplantation using a right hepatic lobe is efficient and safe. This option could contribute to reducing the mortality of patients on the waiting list.
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Affiliation(s)
- O Boillot
- Unité de transplantation hépatique, hôpital Edouard-Herriot, Lyon, France
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Dubernard JM, Martin X, Lefrançois N, Dawahra M, Tajra LC, Martin C. [Pancreas transplantation]. Presse Med 1999; 28:287-91. [PMID: 10073174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- J M Dubernard
- Service d'Urologie et de Chirurgie de la transplantation, Hôpital E. Herriot, Lyon
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Dubernard JM, Martin C, Lefrancois N, Thivolet CH, Dawahra M, Petruzzo P, Martin X. Advances in pancreas transplantation-1999. Indications and contraindications. J Pediatr Endocrinol Metab 1999; 12 Suppl 3:765-70. [PMID: 10626268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- J M Dubernard
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Dubourg L, Hadj-Aïssa A, Parchoux B, Dawahra M, Martin X, David L, Pozet N, Cochat P. Role of the donor in post-transplant renal function. Nephrol Dial Transplant 1998; 13:1494-8. [PMID: 9641181 DOI: 10.1093/ndt/13.6.1494] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The donor, i.e. adult or paediatric, might influence the outcome of the graft function. METHODS The glomerular filtration rate (GFR) of 120 transplanted children (47 girls) aged 10.4+/-4.6 years (0.7-17.2) was prospectively assessed over a 5-year period. The patients were divided into two groups according to the age of donor: adult (donor age > 18 years; n=33) and paediatric (donor age < 18 years; n=87). GFR was assessed by inulin clearance at 3, 6 and 12 months and yearly thereafter. RESULTS The average GFR was stable in the range of 70 ml/min/1.73 m2 for the whole follow-up period. The adjusted GFR in adult graft recipients was significantly higher at 3 months post-transplantation: 80.6+/-36.9 vs 65.1+/-22.0, P=0.02. However, from the second year post-transplantation, the adjusted GFR in paediatric graft recipients became significantly higher than that of adult graft recipients. Such results could be due to an improvement in the absolute GFR (ml/min) of paediatric graft recipients with time (P=0.0001) whereas that of the adult graft recipients remained stable despite the children's growth. CONCLUSIONS The adjusted GFR of adult graft recipients was significantly higher than that of paediatric graft recipients in the early post-transplant period. In the long-term, a progressive decrease in adjusted GFR was noted in adult graft recipients. On the one hand, this may be due to a functional adaptation and/or inadequate compensatory growth of the graft. On the other hand, the absolute GFR of paediatric graft recipients increased, suggesting an ongoing capacity for growth and/or compensatory hypertrophy after child-to-child renal transplantation.
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Affiliation(s)
- L Dubourg
- Département de Pédiatric, Service d'Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot and Université Claude Bernard, Lyon, France
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Martin X, Ndoye A, Konan PG, Feitosa Tajra LC, Gelet A, Dawahra M, Dubernard JM. [Hazards of lumbar ureteroscopy: apropos of 4 cases of avulsion of the ureter]. Prog Urol 1998; 8:358-62. [PMID: 9689667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Ureteroscopy is frequently indicated in the treatment of stones of the pelvic ureter. Access to the lumbar ureter is associated with a higher complication rate: wounds, ureteric rupture, haemorrhage, or more serious lesions such as avulsions of the ureter. We present 4 cases of avulsion of the ureter seen in our department, corresponding to 4 men with stones of the lumbar ureter treated by ureteroscopy, 2 of them after failure of in situ extracorporeal lithotripsy (ESWL) and an attempt to "flush" the stone and the other two because ESWL was not available. The ureteric lesion was related to a Dormia catheter in 2 cases and the ureteroscope in 2 cases. The lesion was diagnosed and treated immediately in 2 patients and after a delay in the other 2 cases. Repair consisted of ureteric reimplantation on a Boari flap (1 case), implantation onto a psoas bladder (1 case), ureteroileoplasty (1 case) and autologous transplantation (1 case). Ureteric lesions prevented uretero-ureterostomy. Ureteric reimplantation on psoas bladder and/or Boari flap appears to be the simplest method, but it cannot always be performed. In the case of avulsion of the ureteropelvic junction with a large defect, autologous transplantation is a method of choice in young subjects. Ureteroileoplasty appears to be reserved for elderly patients.
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Affiliation(s)
- X Martin
- Service d'Urologie et de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Dubernard JM, Tajra LC, Lefrançois N, Dawahra M, Martin C, Thivolet C, Martin X. Pancreas transplantation: results and indications. Diabetes Metab 1998; 24:195-9. [PMID: 9690050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pancreatic transplantation is the best method of replacing the endocrine function of the gland in Type 1 insulin-dependent diabetic patients. At the end of 1996, 9,000 pancreas transplants had been reported to the international Pancreas Transplant Registry. For 1994-1996, one-year pancreas survival rates were 81% for simultaneous pancreas and kidney transplantation (n = 1,516), 71% for pancreas after kidney (n = 141) and 64% for pancreas alone (n = 64). In patients with a functional graft, glycosylated haemoglobin, fasting blood sugar, and 24-h metabolic profiles are normal. The effect of pancreatic transplantation on secondary complications often appears after several years of normal pancreatic function. Successful transplantation is associated with an improvement in different aspects of the quality of life. The decision to perform pancreatic transplantation depends on the balance between the risks of transplantation, mainly surgical or related to immunosuppression, and those of diabetes development. The advantages and drawbacks of pancreatic transplantation and insulin therapy need to be honestly and carefully analysed for specific populations of diabetic patients as well as for each individual. At present, simultaneous pancreaticorenal transplantation is the best treatment for diabetic patients with chronic renal failure. Transplantation of the pancreas alone in non-uraemic patients may also be considered in carefully selected subjects.
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Affiliation(s)
- J M Dubernard
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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Dubourg L, Hadj-Aïssa A, Dawahra M, Parchoux B, Martin X, David L, Pozet N, Long D, Cochat P. [Graft function following renal transplantation in children]. Arch Pediatr 1998; 5:602-9. [PMID: 9759203 DOI: 10.1016/s0929-693x(98)80160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Since renal transplantation is known to be the best choice for the growing child with end-stage renal failure, we prospectively evaluated early and late graft function in transplanted children. POPULATION AND METHODS The study included 78 children (32 girls, 46 boys) 10.4 +/- 0.6 years at the time of transplantation. Renal investigations were performed at 3, 6 and 12 months post-transplantation and yearly thereafter. Inulin clearance was used to evaluate the glomerular filtration rate (GFR), and the reabsorption rates of Na, P and Ca were measured concomitantly. RESULTS The overall adjusted GFR was approximately 70 mL/min/1.73 m2 and remained unchanged during the first 5 years post-transplantation. In the mean time the absolute GFR increased significantly, suggesting a remaining capacity for compensatory hypertrophy of the transplanted kidney. Renal function was significantly influenced by the number of rejection episodes during the first 2 years post-transplantation but no correlation was found between GFR and the number of HLA mismatches or the use of preemptive transplantation.
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Affiliation(s)
- L Dubourg
- Unité de néphrologie pédiatrique, Université Claude-Bernard et hôpital Edouard-Herriot, Lyon, France
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Denis E, Nicolas F, Ben Rais N, Cloix P, Dawahra M, Maréchal JM, Gelet A. [Laparoscopic surgical treatment of simple cysts of the kidney]. Prog Urol 1998; 8:195-200. [PMID: 9615927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To demonstrate the efficacy of laparoscopic treatment of symptomatic renal cysts or cysts suspicious of malignancy. MATERIAL AND METHODS 10 patients (mean age: 58 years) were operated by laparoscopy either for compressive or symptomatic cysts (7 cases), or for cysts suspicious of malignancy (3 cases). The mean cyst diameter was 7.8 cm. All patients were evaluated by preoperative CT scan. There were 8 Bosniak type I and 3 Bosniak type II cysts. RESULTS The procedure was performed via an intraperitoneal approach (8 cases) or via a retroperitoneal approach (2 cases). The mean operating time was 92 min and the mean hospital stay was 5.4 days. One patient was operated (conversion to lumbotomy) for uncontrolled haemorrhage of the base of the cyst. The 10 cysts were found to be benign histologically. All 10 patients are asymptomatic (mean follow-up: 8.3 months) with disappearance of the cyst on the follow-up CT scan. CONCLUSION Laparoscopic treatment of renal cysts is feasible and effective. However, this treatment must be reserved for Bosniak type I and II cysts, associated with a low risk of malignancy.
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Affiliation(s)
- E Denis
- Service Urologie et Chirurgie de Transplantation, Hôpital Edouard Herriot, Lyon, France
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31
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Mahmoud A, Saïd MH, Dawahra M, Hadj-Aïssa A, Schell M, Faraj G, Long D, Parchoux B, Martin X, Cochat P. Outcome of preemptive renal transplantation and pretransplantation dialysis in children. Pediatr Nephrol 1997; 11:537-41. [PMID: 9323275 DOI: 10.1007/s004670050333] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The present study compares the outcome of 40 children (39%) transplanted without prior dialysis, i.e., preemptive transplantation (PET), with 63 children (61%) transplanted after a variable duration of dialysis, i.e., pretransplantation dialysis (PTD). The two groups were matched for recipient and donor age and for immunological risk factors. There was no statistical difference in the time to first acute rejection episode nor in the number of acute rejection episodes during the 1st year after renal transplantation. In the PET group, 78% of the recipients received blood transfusion versus 92.5% in the PTD group (P < 0.05), and the average number of blood units per patient was 3.2 and 7.8, respectively (P < 0.05). Arterial hypertension was found in 55% of the patients in the PET group versus 73% in the PTD group (P < 0.05). The number of functioning grafts at the end of the study period was 87.5% in the PET group and 73% in the PTD group (NS). The major cause of graft failure was vascular thrombosis in the PET group (3/5) and chronic allograft rejection in the PTD group (10/17). In the PET group, the actuarial graft survival rate was 100%, 84%, 81%, and 76% at 1, 3, 5, and 7 years, which was not statistically different from the PTD group at 1, 3, and 5 years (98%, 91%, and 73%, respectively) but there was a significantly lower graft survival (59%) after 7 years in the PTD (P < 0.05). The 7-year actuarial patient survival rate was 97% in the PET group and 90% in the PTD group (NS). In the PTD group, children on dialysis for less than 1 year (group 1, n = 25) were compared with those on dialysis for more than 1 year (group 2, n = 38). Arterial hypertension was noted in 40% of patients from group 1 and 65% from group 2 (P < 0.05); there was no significant difference in graft loss rate. In conclusion, these results confirm PET as the preferred approach rather than PTD in children who need renal replacement therapy.
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Affiliation(s)
- A Mahmoud
- Unité de Néphrologie Pédiatrique, Hôpital Edouard Herriot, Lyon, France
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Affiliation(s)
- X Martin
- Service d'Urologie et Chirugie de la Transplantation, Hopital Edouard Herriot, Lyon, France
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Feitosa Tajra LC, Martin X, Benchaib M, Dawahra M, Lefrançois N, Ishibashi M, Dubernard JM. Long-term metabolic control in pancreas transplant patients (follow-up 3 to 13 years). Transplant Proc 1997; 29:2367-8. [PMID: 9270767 DOI: 10.1016/s0041-1345(97)00406-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- L C Feitosa Tajra
- Service d'Urologie et Chirurgie de la Transplantation, Hopital Edouard Herriot, Lyon, France
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Dawahra M, Martin X, Tajra LC, Cloix P, Marechal JM, Garnier JL, Dubernard JM. Renal transplantation using continent urinary diversion: long-term follow-up. Transplant Proc 1997; 29:159-60. [PMID: 9122942 DOI: 10.1016/s0041-1345(96)00048-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M Dawahra
- Service d'urologie et chirurgie de la transplantation, Lyon, France
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Gelet A, Combe M, Ramackers JM, Ben Rais N, Martin X, Dawahra M, Maréchal JM, Dubernard JM. Endopyelotomy with the Acucise cutting balloon device. Early clinical experience. Eur Urol 1997; 31:389-93. [PMID: 9187895 DOI: 10.1159/000474494] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the efficacy of the Acucise balloon cutting device in the treatment of ureteropelvic junction (UPJ) stenosis. METHODS Forty-four patients with primary (21) or secondary (23) UPJ stenosis underwent Acucise endopyelotomy between July 1992 and February 1995. RESULTS The average operating time was 53 min and the average hospital stay was 6 +/- 4 days. The follow-up schedule included a symptom questionnaire, intravenous urography and diuretic renal scan. Of the 44 patients, 38 have been followed for a minimum of 3 months postoperatively (mean: 12 months, range: 3-39 months). Overall success was achieved in 29 (76%). The procedure was successful in 16 out of 19 cases (84%) with secondary strictures. When the technique was used for the treatment of primary UPJ strictures, the success rate was only 68% (13 out 19). The presence of a large periureteric urinoma was identified as the cause of failure in 2 cases of primary strictures. CONCLUSION We recommend the use of the Acucise device as the first-line therapy for treatment of secondary UPJ stenosis (except in the presence of large enclosed stones). We do not approve the use of the Acucise device for treatment of primary UPJ strictures. In primary hydronephrosis, the negative role of periureteric extravasation probably explains the low success rate of 68% (as opposed to 85% for a large series of percutaneous endopyelotomies.
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Affiliation(s)
- A Gelet
- Urology and Transplantation Department, Edouard Herriot Hospital, Lyon, France
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36
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Chassagne S, Martin X, Cloix P, Dawahra M, Bret P, Giraud S, Fendler JP, Dubernard JM. [Renal and adrenal involvement in von Hippel-Lindau disease: clinical features and therapeutic strategies]. Prog Urol 1996; 6:878-83. [PMID: 9235172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES We report our experience of renal and/or adrenal manifestations of von Hippel-Lindau disease and propose a practical approach. METHODS Eight patients (mean age: 43 years) presented with predominant renal and adrenal lesions in 6 cases and 2 cases, respectively. RESULTS All patients are alive with a mean follow-up of 8.1 years. A local recurrence after partial nephrectomy was observed in two cases. Two patients are in renal failure and are treated by dialysis and two patients require hormone replacement therapy for adrenal insufficiency. CONCLUSIONS The predegenerative nature of simple renal was not observed. Conservative renal surgery is adapted to small renal tumours, with a low cytological grade and without any distant lesions in the same kidney. Radical nephrectomy is reserved for large lesions (greater than 5 cm) with a high cytological grade. The presence of pheochromocytoma must be systematically excluded. Preservation of the adrenal gland in the case of homolateral renal surgery for cancer is recommended. The reliability of the genetic test allows early diagnosis of this disease.
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Affiliation(s)
- S Chassagne
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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37
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Mahmoud A, Said M, Dawahra M, Hadj-Aissa A, Schell M, Faraj G, Long D, Parchoux B, Martin X, Cochat P. Transplantation rénale (TR) avec ou sans dialyse préalable: 7 ans d'expérience. Arch Pediatr 1996. [DOI: 10.1016/s0929-693x(96)89541-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Castagnola C, Maréchal JM, Hanauer MT, Dawahra M, Dubernard JM. [Quality of life and skin urinary diversions. Results of a questionnaire completed by 73 patients]. Prog Urol 1996; 6:207-16. [PMID: 8777413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED The objective of this study was to evaluate the quality of life of patients with a cutaneous urinary diversion. MATERIAL AND METHODS A 25-item self-administered questionnaire was sent to 73 patients with a cutaneous urinary diversion, either non-continent (NCD), such as a transileal cutaneous ureterostomy, or continent (CD), such as a Mainz or Kock reservoir. RESULTS 66 patients answered the questionnaire: 34 NCD and 32 CD. The mean follow-up was 69.2 years for NCD and 58 years for CD. No significant difference was demonstrated between the two samples in terms of the interference of their diversion with their everyday life. Most patients declared that their sex life was now "severely disturbed". However, 3 patients regained a sexual activity after their diversion. Patients with an ideal conduit presented a higher incidence of stoma problems. Overall, 90% of patients with an NCD and 97% of those with a CD were satisfied or very satisfied with their diversion. CONCLUSION Regardless of the type of diversion, patients were satisfied with their operation. When a cutaneous diversion is necessary, the choice of a continent or non-continent diversion cannot be solely based on the argument of "continence". The best possible choice, as a function of surgical limitations and the patient's desires, can only be determined on the basis of a dialogue between the surgeon and the patient.
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Affiliation(s)
- C Castagnola
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon
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Combe M, Gelet A, Abdelrahim AF, Lopez JG, Dawahra M, Martin X, Marechal JM, Dubernard JM. Ureteropelvic invagination procedure for endopyelotomy (Gelet technique): review of 51 consecutive cases. J Endourol 1996; 10:153-7. [PMID: 8728681 DOI: 10.1089/end.1996.10.153] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Between 1990 and 1995, we performed 51 endopyelotomies on 38 cases of primary and 13 of secondary obstruction of the ureteropelvic junction (UPJ) using the ureteropelvic invagination technique. Of the 51 patients in the series, 49 have been followed for a minimum of 3 months postoperatively (mean follow-up 16 months). Overall, success was achieved in 38 (77.5%). Endoscopic endopyelotomy was successful in 11 of 13 cases (84.5%) with secondary strictures. When the technique was used for the treatment of primary UPJ stricture, the success rate was only 75% (27 of 36). The presence of a crossing vessel was identified as the cause of failure in five cases of primary strictures; hence, we advocate the use of angiography to identify crossing vessels preoperatively. We recommend the use of the ureteropelvic invagination technique as the first-line therapy for primary hydronephrosis in adults in the absence of a crossing vessel.
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Affiliation(s)
- M Combe
- Urology & Transplantation Department, Edouard Herriot Hospital, Lyon, France
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40
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Martin X, Aboutaieb R, Dawahra M, Lagha K, Garnier JL, Pangaud C, Lefrançois N, Marechal JM, Gelet A, Dubernard JM. [Treatment of lymphocele after kidney transplantation]. Prog Urol 1996; 6:260-3. [PMID: 8777420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Lymphocele is a possible postoperative complication of renal transplantation and its treatment is still controversial. Over a 3-year period (January 1992 to December 1993), 7 patients with a complicated lymphocele were treated by various modalities. Puncture-drainage was used in 7 cases, Povidone sclerotherapy was performed in 4 cases and internal drainage was performed by surgical marsupialization in one case and by laparoscopy in 4 cases. The results of external drainage and sclerotherapy were disappointing, with 1 good result out of 7 and 1 moderate result out of 4, respectively. On the other hand, internal drainage was effective in every case, whether it was performed by surgical or laparoscopic marsupialization. The latter technique avoids the disadvantages of open surgery in high-risk patients. Laparoscopy appears to be the treatment of choice for post-renal transplantation lymphoceles, as it is simple, rapid and effective.
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Affiliation(s)
- X Martin
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon
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Martin X, Pangaud C, Dawahra M, Lefrançois N, Marechal JM, Dubernard JM. [Role of celioscopy in the treatment of lymphocele after transplantation]. Bull Acad Natl Med 1996; 180:611-8; discussion 618-20. [PMID: 8766242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Lymphoceles can be observed after renal transplantation. Sometimes lymphoceles can cause symptoms (renal insufficiency, pain). In these cases they require surgical treatment. From january 92 to december 1993 seven patients with complicated lymphoceles were treated. Simple drainage with injections of polyvidone iodine was used in 4 cases without effect. Surgical drainage was performed in 5 cases with complete disappearance of the pouch (on open surgical procedure, four celioscopic procedures). Celioscopic marsupialization of lymphoceles after transplantation is a method of choice and is preferred to open surgery for lymphoceles which develop internally.
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Affiliation(s)
- X Martin
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot--Lyon
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42
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Rey N, Saïd MH, Dawahra M, Koch-Nogueira PC, Poultiaude JM, Ramackers JM, Cochat P. Thrombose précoce du transplant rénal : Faut-il tenter la fibrinolyse? Arch Pediatr 1996. [DOI: 10.1016/0929-693x(96)86313-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Friaa S, Gelet A, Manzan K, Dawahra M, Martin X, Marechal JM, Dubernard JM. [First clinical trials of a new endoscopic lithotriptor with ballistic energy (Waltz EL 25 Combilith)]. Prog Urol 1995; 5:679-83. [PMID: 8580978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The Waltz Combilith EL 25 is an endoscopic lithotriptor equipped with an electrohydraulic and ballistic function. The device which generates the ballistic energy is a hand-piece in which a projectile, driven by an electromagnet, strikes a metal rod which transmits the energy to the stone. The diameter and length of the rod are adapted to the site of the stone (bladder + kidney: 1.7 mm rod; ureter: 0.8 mm rod). 29 stones in 25 patients with a mean age of 43 years (range: 25-72) were treated using ballistic energy: 22 ureteric stones (mean dimensions: 9 x 6 mm), 2 renal stones (mean dimensions: 20 x 30 mm) and 5 bladder stones (mean dimensions: 15 mm). Satisfactory stone fragmentation was obtained for 26 of the 29 stones (89.6%) with a mean fragmentation time of 142 seconds. One minimal ureteric perforation was observed (cure without sequelae after drainage by a double J stent). The Combilith EL 25 presents an excellent efficacy/safety ratio and can be used throughout the urinary tract.
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Affiliation(s)
- S Friaa
- Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon
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44
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Boillot O, Voiglio E, Dawahra M, Benchetrit S, Porcheron J, Gille D. Surgical technique of left lateral hepatic lobectomy in a related living donor for pediatric transplantation. Transplant Proc 1995; 27:1708-9. [PMID: 7725464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- O Boillot
- Unité de Transplantation Hépatique, Hôpital Edouard Herriot, Lyon, France
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45
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Boillot O, Dawahra M, Benchetrit S, Houssin D, Porcheron J, Voiglio E, Gille D. Left lateral hepatic segmentectomy in a living related donor for pediatric transplantation: the problem of segment 4. Transplant Proc 1995; 27:1179. [PMID: 7878839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- O Boillot
- Unité de Transplantation Hépatique, Hôpital Edouard Herriot, Lyon, France
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46
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Said M, Beuvier R, Boillos O, Dawahra M, Cazin B, Lachaux A, Mousson B, Gagnadoux M, Morin D, Bérartl E, Desvigner V, Cochat P. P31 Nephropathie tubulo-interstitielle avec kystes corticaux et fibrose hepatique: Une indication de transplantation hepato-renale. Arch Pediatr 1995. [DOI: 10.1016/0929-693x(95)90043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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47
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Boillot O, Dawahra M, Porcheron J, Houssin D, Voiglio E, Cloix P, Boucaud C, Stamm D, Gille D, Bodnar D. Pediatric liver transplantation from living related donors. Transplant Proc 1994; 26:261-2. [PMID: 8108969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- O Boillot
- Unite de Transplantation hepatique, Hôpital Edouard Herriot, Lyon, France
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48
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Molina G, Feitosa LC, Martin X, LeFrancois N, Desmettre O, Cloix P, Boillot O, Dawahra M, Pouteil-Noble C, Brunet M. Incidence of vesico-ureteral reflux after allograft renal transplantation. Transplant Proc 1994; 26:292. [PMID: 8108987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- G Molina
- Service d'Urologie et de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France
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49
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Boillot O, Benchetrit S, Dawahra M, Porcheron J, Martin X, Fontaumard E. Early graft function in liver transplantation: comparison of two techniques of graft procurement. Transplant Proc 1993; 25:2626-7. [PMID: 8356700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- O Boillot
- Unité de Transplantation Hépatique, Hôpital Edouard Herriot, Lyon, France
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50
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Dawahra M, Cloix P, Martin X, Abbar M, Marechal JM, Dubernard JM. Simultaneous transplantation of kidney and pancreas in diabetes patients. Transplant Proc 1993; 25:2227-9. [PMID: 8516880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M Dawahra
- Service d'Urologie et Chirurgie de la Transplantation, Hopital Edouard Herriot, Lyon, France
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