title: Pulmonary embolism with bone fragments following vertebral body marrow infusion for tolerance induction.
abstract: Protocols of donor bone marrow infusion for tolerance induction are receiving increasing attention in clinical trials of organ allotransplantation. We report pulmonary embolism with bone fragments following vertebral body marrow infusion in a recipient of a liver and intestinal transplant. Even though pulmonary embolism with bony microfragments has been widely described following bone marrow transplantation, the use of single, high-dose donor bone marrow infusion and/or multiple infusions currently under clinical investigation for induction of donor specific unresponsiveness, may warrant the implementation of additional steps in the vertebral body marrow processing technique to decrease or eliminate the component of bony microfragments in the final preparation.
authors.affiliation: Veterans Administration Medical Center, Division of Surgery, Miami, FL, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Fernandez
authors.forename: R
authors.initials: R
authors.lastname: Romaguera
authors.forename: A L
authors.initials: AL
authors.lastname: Viciana
authors.forename: P
authors.initials: P
authors.lastname: Ruiz
authors.forename: A G
authors.initials: AG
authors.lastname: Tzakis
authors.forename: C
authors.initials: C
authors.lastname: Ricordi
mesh_terms: D001630:Bezoars; D016026:Bone Marrow Transplantation / Q000379:methods; D001842:Bone and Bones; D002675:Child, Preschool; D003606:Dacarbazine; D004761:Enterocolitis, Pseudomembranous / Q000601:surgery; D017809:Fatal Outcome; D005355:Fibrosis / Q000209:etiology / Q000601:surgery; D006470:Hemorrhage; D006801:Humans; D007421:Intestine, Small / Q000637:transplantation; D017093:Liver Failure / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology* / Q000473:pathology; D012778:Short Bowel Syndrome / Q000209:etiology / Q000628:therapy; D014184:Transplantation, Homologous
chemical_list: D003606:Dacarbazine