Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome

Autores
Moulin, L.; Pedraza, N.; Padin, J.; Niveyro, S.; Tuhay, G.; Rumbo, C.; Barros Schelotto, Pablo; Crivelli, A.; Solar Muñiz, H.; Ramisch, D.; Gondolesi, Gabriel Eduardo
Año de publicación
2016
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
CASE REPORT:A 24-year-old man diagnosed with Peutz-Jeghers syndrome as a child underwent multiple surgeries owing to intussusception. Pretransplant workup showed >150 polyps along the gastrointestinal (GI) tract, some of them with high-grade dysplasia. Despite having intestinal sufficiency, a modified multivisceral transplantation was offered.PROCEDURE:An 18-year-old donor was procured using University of Wisconsin solution. The recipient´s surgery started with a midline incision. Mobilization of the right colon and the root of the mesentery was done to isolate the superior mesenteric artery. The same maneuver was done with the left and sigmoid colon. The common bile duct was then isolated and transected at the cystic duct level. The abdominal portion of the esophagus and the proximal stomach were isolated and divided at the gastroesophageal junction. After that, the pancreas was mobilized, preserving the spleen with the splenic vessels. The distal GI tract was transacted at the level of the proximal rectum. For engraftment, an arterial conduit was placed in the infrarenal aorta and anastomosed to the graft´s aortic patch. End-to-side portal reconstruction was made at the level of the portal vein, allowing performing a duct-to-duct biliary reconstruction over a 5-Fr T-tube. A hand-sewn gastrogastric anastomosis and piloroplasty were performed; the distal anastomosis was done with circular staplers. A gastrojejunostomy and a loop ileostomy were the final steps of the procedure.RESULTS:The patient stayed in intensive care for 2 days and enteral feeds were started on day 7. Currently, 23 months after transplant he is alive with an excellent quality of life
Fil: Moulin, L.. Fundación Favaloro; Argentina
Fil: Pedraza, N.. Fundación Favaloro; Argentina
Fil: Padin, J.. Clínica “La Pequeña Familia”; Argentina
Fil: Niveyro, S.. Fundación Favaloro; Argentina
Fil: Tuhay, G.. Fundación Favaloro; Argentina
Fil: Rumbo, C.. Fundación Favaloro; Argentina
Fil: Barros Schelotto, Pablo. Fundación Favaloro; Argentina
Fil: Crivelli, A.. Fundación Favaloro; Argentina
Fil: Solar Muñiz, H.. Fundación Favaloro; Argentina
Fil: Ramisch, D.. Fundación Favaloro; Argentina
Fil: Gondolesi, Gabriel Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación Favaloro; Argentina
Materia
Peutz-Jeghers Syndrome
Multivisceral Transplantation
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/43725
Acceder
id CONICETDig_d69cc96817d220b038159aa9615948d1
oai_identifier_str oai:ri.conicet.gov.ar:11336/43725
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers SyndromeMoulin, L.Pedraza, N.Padin, J.Niveyro, S.Tuhay, G.Rumbo, C.Barros Schelotto, PabloCrivelli, A.Solar Muñiz, H.Ramisch, D.Gondolesi, Gabriel EduardoPeutz-Jeghers SyndromeMultivisceral Transplantationhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3CASE REPORT:A 24-year-old man diagnosed with Peutz-Jeghers syndrome as a child underwent multiple surgeries owing to intussusception. Pretransplant workup showed >150 polyps along the gastrointestinal (GI) tract, some of them with high-grade dysplasia. Despite having intestinal sufficiency, a modified multivisceral transplantation was offered.PROCEDURE:An 18-year-old donor was procured using University of Wisconsin solution. The recipient´s surgery started with a midline incision. Mobilization of the right colon and the root of the mesentery was done to isolate the superior mesenteric artery. The same maneuver was done with the left and sigmoid colon. The common bile duct was then isolated and transected at the cystic duct level. The abdominal portion of the esophagus and the proximal stomach were isolated and divided at the gastroesophageal junction. After that, the pancreas was mobilized, preserving the spleen with the splenic vessels. The distal GI tract was transacted at the level of the proximal rectum. For engraftment, an arterial conduit was placed in the infrarenal aorta and anastomosed to the graft´s aortic patch. End-to-side portal reconstruction was made at the level of the portal vein, allowing performing a duct-to-duct biliary reconstruction over a 5-Fr T-tube. A hand-sewn gastrogastric anastomosis and piloroplasty were performed; the distal anastomosis was done with circular staplers. A gastrojejunostomy and a loop ileostomy were the final steps of the procedure.RESULTS:The patient stayed in intensive care for 2 days and enteral feeds were started on day 7. Currently, 23 months after transplant he is alive with an excellent quality of lifeFil: Moulin, L.. Fundación Favaloro; ArgentinaFil: Pedraza, N.. Fundación Favaloro; ArgentinaFil: Padin, J.. Clínica “La Pequeña Familia”; ArgentinaFil: Niveyro, S.. Fundación Favaloro; ArgentinaFil: Tuhay, G.. Fundación Favaloro; ArgentinaFil: Rumbo, C.. Fundación Favaloro; ArgentinaFil: Barros Schelotto, Pablo. Fundación Favaloro; ArgentinaFil: Crivelli, A.. Fundación Favaloro; ArgentinaFil: Solar Muñiz, H.. Fundación Favaloro; ArgentinaFil: Ramisch, D.. Fundación Favaloro; ArgentinaFil: Gondolesi, Gabriel Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación Favaloro; ArgentinaElsevier Science Inc2016-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/43725Moulin, L.; Pedraza, N.; Padin, J.; Niveyro, S.; Tuhay, G.; et al.; Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome; Elsevier Science Inc; Transplantation Proceedings; 48; 2; 3-2016; 546-5480041-1345CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1016/j.transproceed.2016.01.014info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S0041134516001585info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:47:55Zoai:ri.conicet.gov.ar:11336/43725instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:47:56.18CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
title Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
spellingShingle Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
Moulin, L.
Peutz-Jeghers Syndrome
Multivisceral Transplantation
title_short Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
title_full Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
title_fullStr Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
title_full_unstemmed Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
title_sort Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome
dc.creator.none.fl_str_mv Moulin, L.
Pedraza, N.
Padin, J.
Niveyro, S.
Tuhay, G.
Rumbo, C.
Barros Schelotto, Pablo
Crivelli, A.
Solar Muñiz, H.
Ramisch, D.
Gondolesi, Gabriel Eduardo
author Moulin, L.
author_facet Moulin, L.
Pedraza, N.
Padin, J.
Niveyro, S.
Tuhay, G.
Rumbo, C.
Barros Schelotto, Pablo
Crivelli, A.
Solar Muñiz, H.
Ramisch, D.
Gondolesi, Gabriel Eduardo
author_role author
author2 Pedraza, N.
Padin, J.
Niveyro, S.
Tuhay, G.
Rumbo, C.
Barros Schelotto, Pablo
Crivelli, A.
Solar Muñiz, H.
Ramisch, D.
Gondolesi, Gabriel Eduardo
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Peutz-Jeghers Syndrome
Multivisceral Transplantation
topic Peutz-Jeghers Syndrome
Multivisceral Transplantation
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv CASE REPORT:A 24-year-old man diagnosed with Peutz-Jeghers syndrome as a child underwent multiple surgeries owing to intussusception. Pretransplant workup showed >150 polyps along the gastrointestinal (GI) tract, some of them with high-grade dysplasia. Despite having intestinal sufficiency, a modified multivisceral transplantation was offered.PROCEDURE:An 18-year-old donor was procured using University of Wisconsin solution. The recipient´s surgery started with a midline incision. Mobilization of the right colon and the root of the mesentery was done to isolate the superior mesenteric artery. The same maneuver was done with the left and sigmoid colon. The common bile duct was then isolated and transected at the cystic duct level. The abdominal portion of the esophagus and the proximal stomach were isolated and divided at the gastroesophageal junction. After that, the pancreas was mobilized, preserving the spleen with the splenic vessels. The distal GI tract was transacted at the level of the proximal rectum. For engraftment, an arterial conduit was placed in the infrarenal aorta and anastomosed to the graft´s aortic patch. End-to-side portal reconstruction was made at the level of the portal vein, allowing performing a duct-to-duct biliary reconstruction over a 5-Fr T-tube. A hand-sewn gastrogastric anastomosis and piloroplasty were performed; the distal anastomosis was done with circular staplers. A gastrojejunostomy and a loop ileostomy were the final steps of the procedure.RESULTS:The patient stayed in intensive care for 2 days and enteral feeds were started on day 7. Currently, 23 months after transplant he is alive with an excellent quality of life
Fil: Moulin, L.. Fundación Favaloro; Argentina
Fil: Pedraza, N.. Fundación Favaloro; Argentina
Fil: Padin, J.. Clínica “La Pequeña Familia”; Argentina
Fil: Niveyro, S.. Fundación Favaloro; Argentina
Fil: Tuhay, G.. Fundación Favaloro; Argentina
Fil: Rumbo, C.. Fundación Favaloro; Argentina
Fil: Barros Schelotto, Pablo. Fundación Favaloro; Argentina
Fil: Crivelli, A.. Fundación Favaloro; Argentina
Fil: Solar Muñiz, H.. Fundación Favaloro; Argentina
Fil: Ramisch, D.. Fundación Favaloro; Argentina
Fil: Gondolesi, Gabriel Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación Favaloro; Argentina
description CASE REPORT:A 24-year-old man diagnosed with Peutz-Jeghers syndrome as a child underwent multiple surgeries owing to intussusception. Pretransplant workup showed >150 polyps along the gastrointestinal (GI) tract, some of them with high-grade dysplasia. Despite having intestinal sufficiency, a modified multivisceral transplantation was offered.PROCEDURE:An 18-year-old donor was procured using University of Wisconsin solution. The recipient´s surgery started with a midline incision. Mobilization of the right colon and the root of the mesentery was done to isolate the superior mesenteric artery. The same maneuver was done with the left and sigmoid colon. The common bile duct was then isolated and transected at the cystic duct level. The abdominal portion of the esophagus and the proximal stomach were isolated and divided at the gastroesophageal junction. After that, the pancreas was mobilized, preserving the spleen with the splenic vessels. The distal GI tract was transacted at the level of the proximal rectum. For engraftment, an arterial conduit was placed in the infrarenal aorta and anastomosed to the graft´s aortic patch. End-to-side portal reconstruction was made at the level of the portal vein, allowing performing a duct-to-duct biliary reconstruction over a 5-Fr T-tube. A hand-sewn gastrogastric anastomosis and piloroplasty were performed; the distal anastomosis was done with circular staplers. A gastrojejunostomy and a loop ileostomy were the final steps of the procedure.RESULTS:The patient stayed in intensive care for 2 days and enteral feeds were started on day 7. Currently, 23 months after transplant he is alive with an excellent quality of life
publishDate 2016
dc.date.none.fl_str_mv 2016-03
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/43725
Moulin, L.; Pedraza, N.; Padin, J.; Niveyro, S.; Tuhay, G.; et al.; Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome; Elsevier Science Inc; Transplantation Proceedings; 48; 2; 3-2016; 546-548
0041-1345
CONICET Digital
CONICET
url http://hdl.handle.net/11336/43725
identifier_str_mv Moulin, L.; Pedraza, N.; Padin, J.; Niveyro, S.; Tuhay, G.; et al.; Case Report: Spleen-preserving Multivisceral Transplant for Peutz–Jeghers Syndrome; Elsevier Science Inc; Transplantation Proceedings; 48; 2; 3-2016; 546-548
0041-1345
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1016/j.transproceed.2016.01.014
info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S0041134516001585
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier Science Inc
publisher.none.fl_str_mv Elsevier Science Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1842268891266416640
score 13.13397

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