Introduction. Previous studies have suggested that African‐American (AA) ethnicity is a risk fact... more Introduction. Previous studies have suggested that African‐American (AA) ethnicity is a risk factor for rejection and graft loss after kidney transplantation. However, little data is available regarding outcomes after simultaneous kidney–pancreas transplantation (SKPT) in AA recipients. The objective of this study was to compare the outcomes of SKPT in AA patients to matched Caucasian patients as controls. Methods. From January 1996 to September 1999, we performed 79 SKPTs, including 10 in AA recipients. Ten Caucasian controls were selected and matched for age, gender, weight, timing and technique of transplantation, and immunosuppressive regimen. Clinical outcomes were collected and compared between the two groups. Results. The two groups were well matched for donor and recipient demographic, immunologic and transplant characteristics, including 2 patients in each group with type 2 diabetes. All patients received tacrolimus (TAC), mycophenolate mofetil (MMF) and steroids, and abo...
Fistulae arising from the intestinal tract are associated with significant morbidity and mortalit... more Fistulae arising from the intestinal tract are associated with significant morbidity and mortality rates. Most contemporary studies of fistulae report mortality rates between 6 and 20 per cent. The major causes of death in these patients are sepsis, electrolyte imbalance, and malnutrition. A total of 48 patients with either external or internal intestinal fistulae were reviewed in this study over a 5-year period at the Louisiana State University Medical Center at Shreveport. Intestinal fistulae were classified into three types, anatomic site, physiologic type, and etiology, to evaluate morbidity and mortality rates. We also attempted to evaluate the role of parenteral nutrition in this patient population, but our data were inconclusive because of the limited number of patients. There was no difference in mortality rates associated with anatomical sites. High-output fistulae were associated with a higher mortality rate compared to low-output fistulae. Fifty-six per cent of the patien...
This study was conducted to investigate the progression of lower extremity ischemia following kid... more This study was conducted to investigate the progression of lower extremity ischemia following kidney transplantation to iliac artery in patients with peripheral arterial disease. A retrospective chart review of all renal transplant patients completed at a university teaching medical center from January 2006 to December of 2011 was performed. A total of 219 patients underwent successful kidney transplantation to the common, external, or internal iliac artery. Pre- and post-transplantation ischemic changes in the ipsilateral lower extremity were reviewed and analyzed. Thirty-eight of the 219 patients had ipsilateral peripheral arterial disease and seven of them were symptomatic. Six of the seven symptomatic patients remained stable and one patient's rest pain improved, postoperatively. Eight patients developed new symptoms of ischemia 12 months later, including four with claudication, two with ischemic ulcers, and two with gangrene toes. The ulcers were healed following superficia...
Introduction. Previous studies have suggested that African‐American (AA) ethnicity is a risk fact... more Introduction. Previous studies have suggested that African‐American (AA) ethnicity is a risk factor for rejection and graft loss after kidney transplantation. However, little data is available regarding outcomes after simultaneous kidney–pancreas transplantation (SKPT) in AA recipients. The objective of this study was to compare the outcomes of SKPT in AA patients to matched Caucasian patients as controls. Methods. From January 1996 to September 1999, we performed 79 SKPTs, including 10 in AA recipients. Ten Caucasian controls were selected and matched for age, gender, weight, timing and technique of transplantation, and immunosuppressive regimen. Clinical outcomes were collected and compared between the two groups. Results. The two groups were well matched for donor and recipient demographic, immunologic and transplant characteristics, including 2 patients in each group with type 2 diabetes. All patients received tacrolimus (TAC), mycophenolate mofetil (MMF) and steroids, and abo...
Fistulae arising from the intestinal tract are associated with significant morbidity and mortalit... more Fistulae arising from the intestinal tract are associated with significant morbidity and mortality rates. Most contemporary studies of fistulae report mortality rates between 6 and 20 per cent. The major causes of death in these patients are sepsis, electrolyte imbalance, and malnutrition. A total of 48 patients with either external or internal intestinal fistulae were reviewed in this study over a 5-year period at the Louisiana State University Medical Center at Shreveport. Intestinal fistulae were classified into three types, anatomic site, physiologic type, and etiology, to evaluate morbidity and mortality rates. We also attempted to evaluate the role of parenteral nutrition in this patient population, but our data were inconclusive because of the limited number of patients. There was no difference in mortality rates associated with anatomical sites. High-output fistulae were associated with a higher mortality rate compared to low-output fistulae. Fifty-six per cent of the patien...
This study was conducted to investigate the progression of lower extremity ischemia following kid... more This study was conducted to investigate the progression of lower extremity ischemia following kidney transplantation to iliac artery in patients with peripheral arterial disease. A retrospective chart review of all renal transplant patients completed at a university teaching medical center from January 2006 to December of 2011 was performed. A total of 219 patients underwent successful kidney transplantation to the common, external, or internal iliac artery. Pre- and post-transplantation ischemic changes in the ipsilateral lower extremity were reviewed and analyzed. Thirty-eight of the 219 patients had ipsilateral peripheral arterial disease and seven of them were symptomatic. Six of the seven symptomatic patients remained stable and one patient's rest pain improved, postoperatively. Eight patients developed new symptoms of ischemia 12 months later, including four with claudication, two with ischemic ulcers, and two with gangrene toes. The ulcers were healed following superficia...
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