Delayed-Onset Chylous Ascites After a Living-Donor Liver Transplant: First Case Successfully Treated With Conservative Treatment?
Identifieur interne : 000967 ( PubMed/Checkpoint ); précédent : 000966; suivant : 000968Delayed-Onset Chylous Ascites After a Living-Donor Liver Transplant: First Case Successfully Treated With Conservative Treatment?
Auteurs : Jian-Han Chen [Taïwan] ; Chun-Ming Chang ; Min-Chi Lu ; Chang-Kuo Wei ; Wen-Yao YinSource :
- Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation [ 2146-8427 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Agents gastro-intestinaux (usage thérapeutique), Ascite chyleuse (), Ascite chyleuse (diagnostic), Ascite chyleuse (étiologie), Chyle, Donneur vivant, Facteurs temps, Humains, Immunosuppresseurs (administration et posologie), Immunosuppresseurs (effets indésirables), Mâle, Nutrition parentérale totale, Octréotide (usage thérapeutique), Récupération fonctionnelle, Résultat thérapeutique, Transplantation hépatique (), Transplantation hépatique (effets indésirables).
- MESH :
- administration et posologie : Immunosuppresseurs.
- diagnostic : Ascite chyleuse.
- effets indésirables : Immunosuppresseurs, Transplantation hépatique.
- usage thérapeutique : Agents gastro-intestinaux, Octréotide.
- étiologie : Ascite chyleuse.
- Adulte d'âge moyen, Ascite chyleuse, Chyle, Donneur vivant, Facteurs temps, Humains, Mâle, Nutrition parentérale totale, Récupération fonctionnelle, Résultat thérapeutique, Transplantation hépatique.
English descriptors
- KwdEn :
- Chyle, Chylous Ascites (diagnosis), Chylous Ascites (etiology), Chylous Ascites (therapy), Gastrointestinal Agents (therapeutic use), Humans, Immunosuppressive Agents (administration & dosage), Immunosuppressive Agents (adverse effects), Liver Transplantation (adverse effects), Liver Transplantation (methods), Living Donors, Male, Middle Aged, Octreotide (therapeutic use), Parenteral Nutrition, Total, Recovery of Function, Time Factors, Treatment Outcome.
- MESH :
- chemical , administration & dosage : Immunosuppressive Agents.
- chemical , adverse effects : Immunosuppressive Agents.
- chemical , therapeutic use : Gastrointestinal Agents, Octreotide.
- adverse effects : Liver Transplantation.
- diagnosis : Chylous Ascites.
- etiology : Chylous Ascites.
- methods : Liver Transplantation.
- therapy : Chylous Ascites.
- Chyle, Humans, Living Donors, Male, Middle Aged, Parenteral Nutrition, Total, Recovery of Function, Time Factors, Treatment Outcome.
Abstract
Chylous ascites is a rare complication in liver transplant. Few cases have been reported to date. In most cases, chylous ascites is diagnosed within 1 month after surgery because of intraoperative injury of the hilar lymphatic system. Preoperative massive ascites and use of a LigaSure vessel sealing system for hilar dissection have been reported as risk factors. We report a case of chylous ascites after a living-donor liver transplant that was diagnosed after 6 months of uneventful follow-up. Sirolimus was added to cyclosporine early (2 wk after the operation) owing to poor renal function and it was found to be high (> 22 ng/mL) when the chylous ascites occurred. The patient was treated with total parenteral nutrition in combination with Sandostatin and rapid tapering of sirolimus after the failed initial conservative treatment. Residual abdominal fullness after meals and lymphedema of the legs disappeared 1 month after discontinuing sirolimus. This is the first case of delayed-onset chylous ascites after a liver transplant that was successfully treated conservatively.
DOI: 10.6002/ect.2014.0131
PubMed: 25365187
Affiliations:
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Few cases have been reported to date. In most cases, chylous ascites is diagnosed within 1 month after surgery because of intraoperative injury of the hilar lymphatic system. Preoperative massive ascites and use of a LigaSure vessel sealing system for hilar dissection have been reported as risk factors. We report a case of chylous ascites after a living-donor liver transplant that was diagnosed after 6 months of uneventful follow-up. Sirolimus was added to cyclosporine early (2 wk after the operation) owing to poor renal function and it was found to be high (> 22 ng/mL) when the chylous ascites occurred. The patient was treated with total parenteral nutrition in combination with Sandostatin and rapid tapering of sirolimus after the failed initial conservative treatment. Residual abdominal fullness after meals and lymphedema of the legs disappeared 1 month after discontinuing sirolimus. This is the first case of delayed-onset chylous ascites after a liver transplant that was successfully treated conservatively.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25365187</PMID><DateCreated><Year>2016</Year><Month>05</Month><Day>25</Day></DateCreated><DateCompleted><Year>2017</Year><Month>05</Month><Day>22</Day></DateCompleted><DateRevised><Year>2017</Year><Month>05</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2146-8427</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>3</Issue><PubDate><Year>2016</Year><Month>06</Month></PubDate></JournalIssue><Title>Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation</Title><ISOAbbreviation>Exp Clin Transplant</ISOAbbreviation></Journal><ArticleTitle>Delayed-Onset Chylous Ascites After a Living-Donor Liver Transplant: First Case Successfully Treated With Conservative Treatment?</ArticleTitle><Pagination><MedlinePgn>345-8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.6002/ect.2014.0131</ELocationID><Abstract><AbstractText>Chylous ascites is a rare complication in liver transplant. Few cases have been reported to date. In most cases, chylous ascites is diagnosed within 1 month after surgery because of intraoperative injury of the hilar lymphatic system. Preoperative massive ascites and use of a LigaSure vessel sealing system for hilar dissection have been reported as risk factors. We report a case of chylous ascites after a living-donor liver transplant that was diagnosed after 6 months of uneventful follow-up. Sirolimus was added to cyclosporine early (2 wk after the operation) owing to poor renal function and it was found to be high (> 22 ng/mL) when the chylous ascites occurred. The patient was treated with total parenteral nutrition in combination with Sandostatin and rapid tapering of sirolimus after the failed initial conservative treatment. Residual abdominal fullness after meals and lymphedema of the legs disappeared 1 month after discontinuing sirolimus. This is the first case of delayed-onset chylous ascites after a liver transplant that was successfully treated conservatively.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Jian-Han</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>From the Department of General Surgery, Dalin Tzu Chi General Hospital, Chia-I, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chang</LastName><ForeName>Chun-Ming</ForeName><Initials>CM</Initials></Author><Author ValidYN="Y"><LastName>Lu</LastName><ForeName>Min-Chi</ForeName><Initials>MC</Initials></Author><Author ValidYN="Y"><LastName>Wei</LastName><ForeName>Chang-Kuo</ForeName><Initials>CK</Initials></Author><Author ValidYN="Y"><LastName>Yin</LastName><ForeName>Wen-Yao</ForeName><Initials>WY</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>10</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>Turkey</Country><MedlineTA>Exp Clin Transplant</MedlineTA><NlmUniqueID>101207333</NlmUniqueID><ISSNLinking>1304-0855</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D005765">Gastrointestinal Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007166">Immunosuppressive Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>RWM8CCW8GP</RegistryNumber><NameOfSubstance UI="D015282">Octreotide</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002913" MajorTopicYN="Y">Chyle</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002915" MajorTopicYN="N">Chylous 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Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>11</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>11</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>5</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25365187</ArticleId><ArticleId IdType="doi">10.6002/ect.2014.0131</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Taïwan</li></country></list><tree><noCountry><name sortKey="Chang, Chun Ming" sort="Chang, Chun Ming" uniqKey="Chang C" first="Chun-Ming" last="Chang">Chun-Ming Chang</name><name sortKey="Lu, Min Chi" sort="Lu, Min Chi" uniqKey="Lu M" first="Min-Chi" last="Lu">Min-Chi Lu</name><name sortKey="Wei, Chang Kuo" sort="Wei, Chang Kuo" uniqKey="Wei C" first="Chang-Kuo" last="Wei">Chang-Kuo Wei</name><name sortKey="Yin, Wen Yao" sort="Yin, Wen Yao" uniqKey="Yin W" first="Wen-Yao" last="Yin">Wen-Yao Yin</name></noCountry><country name="Taïwan"><noRegion><name sortKey="Chen, Jian Han" sort="Chen, Jian Han" uniqKey="Chen J" first="Jian-Han" last="Chen">Jian-Han Chen</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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