• Title/Summary/Keyword: Organ preservation

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Extracorporeal Life Support in Organ Transplant Donors

  • Chang, Wonho
    • Journal of Chest Surgery
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    • v.51 no.5
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    • pp.328-332
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    • 2018
  • Background: Extracorporeal life support (ECLS) can be applied in brain-dead donors for organ perfusion before donation, thereby expanding the donor pool. The aim of this study was to examine the benefits and early clinical outcomes of ECLS for organ preservation. Methods: Between June 2012 and April 2017, 9 patients received ECLS with therapeutic intent or for organ preservation. The following data were collected: demographics, purpose and duration of ECLS, cause of death, dose of vasoactive drugs, and need for temporary dialysis before organ retrieval. The early clinical outcomes of recipients were studied, as well as survival and graft function at 1 month. Results: ECLS was initiated for extracorporeal cardiopulmonary resuscitation in 5 patients. The other patients needed ECLS due to hemodynamic deterioration during the assessment of brain death. We successfully retrieved 18 kidneys, 7 livers, and 1 heart from 9 donors. All organs were transplanted and none were discarded. Only 1 case of delayed kidney graft function was noted, and all 26 recipients were discharged without any significant complications. Conclusion: The benefits of protecting the vital organs of donors is significant, and ECLS for organ preservation can be widely used in the transplantation field.

Neoadjuvant Chemotherapy and Radiotherapy in the Treatment of Advanced Head and Neck Cancer : Protocol Based Study (진행성 두경부암에서 선행항암요법과 방사선요법의 치료성적)

  • Kim Chul-Ho;Choi Jin-Hyuk;Lee Jin-Seok;Oh Young-Taek
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.172-176
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    • 2004
  • Background and Objectives: Standard treatment of locally advanced laryngeal, hypopharyngeal, and some oropharyngeal cancers includes total laryngectomy. In an attempt to preserve the larynx through induction chemotherapy, we designed induction chemotherapy followed by definitive radiation in patients with potentially respectable head and neck cancer to determine whether organ preservation is feasible without apparent compromise of survival. Materials and Methods: The twenty-six patients diagnosed advanced head and neck squamous cell carcinoma, Stage III or IV (AJCC 2002) and performed organ preservation protocols in Ajou university hospital from 1994 to 2001 were included in this study. Results: Neoadjuvant chemotherapy showed an overall response rate of 84.6% and a complete remission (CR) rate was 59.1% following neoadjuvant chemotherapy and radiation. Seven of thirteen patients were able to preserve their larynges for more than two years by chemotherapy and radiation. There were no treatment related mortality after 2 cycles of induction chemotherapy. Conclusion: Although Organ preservation protocol through neoadjuvant chemotherapy and radiation need more controlled randomized study, it was considered alternative treatment modality in advanced head and neck cancer.

Organ preservation with neoadjuvant chemoradiation in patients with orbit invasive sinonasal cancer otherwise requiring exenteration

  • Amsbaugh, Mark J.;Yusuf, Mehran;Silverman, Craig;Bumpous, Jeffrey;Perez, Cesar A.;Potts, Keven;Tennant, Paul;Redman, Rebecca;Dunlap, Neal
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.209-215
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    • 2016
  • Purpose: We sought to determine if organ preservation (OP) with neoadjuvant chemoradiation (CRT) was feasible in patients with sinonasal cancer determined to require exenteration. Materials and Methods: Twenty patients were determined to require exenteration for definitive treatment from 2005 to 2014. Fourteen patients underwent OP and 6 patients received exenteration with adjuvant CRT. Exenteration free survival (EFS), locoregional control (LRC), progression-free survival (PFS), and overall survival (OS) were estimated. Results: Five patients (36%) receiving OP had complete disease response at time of surgery. With a median follow-up of 18.8 months, EFS was 62% at 2 years for patients undergoing OP. At 2 years, there were no significant differences in LRC, PFS or OS (all all p > 0.050) between the groups. Less grade 3 or greater toxicity was seen in patients undergoing OP (p = 0.003). Visual function was preserved in all patients undergoing OP. Conclusion: For patients with sinonasal cancer, OP may avoid exenteration, offering similar disease control and improved toxicity.

A Case of Partial Pharyngectomy Using Transoral Robotic Surgical System in Hypopharyngeal Cancer (경구강 로봇을 이용해 시행한 근치적 하인두암 이상와 절제술 1례)

  • Park, Young-Min;Jung, Jin-Sei;Baek, Seung-Jae;Kim, Won-Shik;Choi, Eun-Chang;Kim, Se-Heon
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.47-51
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    • 2009
  • Hypopharyngeal cancer have shown poor prognosis though various treatment modalities were developed for several decades. Therefore current trend in managing hypopharyngeal cancer is organ preservation therapy to improve patient's quality of life. Recently, surgery via robotic surgical system in genitourinary surgery improved minimal invasive technique and reduced morbidity dramatically. Hypopharyngeal cancer treatment using Transoral robotic surgery (TORS) in treating lesions of hypopharynx could reduce the morbidity and achieve organ preservation.

Clinical Experiences of Multiple Organ Failure after Surgery for Acquired Cardiovascular Disease

  • 김병열
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.275-284
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    • 1990
  • A serious problem after cardiovascular surgery known as Multiple Organ Failure[MOF] whereby several vital organs successively demonstrate dysfunction in spite of intensive postoperative treatment has recently arisen. We have made a retrospective study of the clinical records of 137 patients who underwent cardiovascular surgery during past two years [1987-1988]. Fourteen patients [10%] developed multi-organ failure postoperatively with the results of seven death [50%]. In fatal group, preoperative poor cardiac function [Cardiac Index<2.0L/min/m2] was considered important prognostic factor and infection 5 disseminated intravascular coagulation complicating gastrointestinal bleeding were the leading cause of death. In conclusion, evaluation of multiple factors concerning multi-organ failure demonstrates preoperative poor functional preservation of vital organs is the main factor. So early diagnosis k management for each of the failing organs & prevention of infection are mandatory of the treatment of these critically ill patients.

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