title: Application of combined liver-intestinal transplantation as a staged procedure.
abstract: Liver-intestinal transplantation is a complex surgical procedure that historically has required prolonged operative periods. This report is the first series where liver-intestinal transplantation was performed as a staged procedure. Specifically, allograft reperfusion was followed by resuscitation and stabilization in an intensive care unit before completion of the transplant procedure. Triage of recipients to the intensive care unit following allograft reperfusion was determined at the time of operation and was based upon the clinical condition of the recipient including hemodynamic stability, evidence of coagulopathy, and assessment of early liver function. Medical stabilization was followed by completion of the transplant procedure and definitive abdominal closure within 72 hours. The application of combined liver-intestinal transplantation as a staged procedure demonstrated no effect upon early graft function, incidence of complications, or ability to perform a definitive abdominal closure.
authors.affiliation: Center for Liver Disease and Transplantation, College of Physicians and Surgeons of Columbia University, New York-Presbyterian Hospital, New York, NY 10032, USA. jfr2103@columbia.edu
authors.forename: J F
authors.initials: JF
authors.lastname: Renz
authors.forename: S V
authors.initials: SV
authors.lastname: McDiarmid
authors.forename: S
authors.initials: S
authors.lastname: Edelstein
authors.forename: H
authors.initials: H
authors.lastname: Yersiz
authors.forename: G M
authors.initials: GM
authors.lastname: Hisatake
authors.forename: S
authors.initials: S
authors.lastname: Gordon
authors.forename: B H
authors.initials: BH
authors.lastname: Saggi
authors.forename: R W
authors.initials: RW
authors.lastname: Busuttil
authors.forename: D G
authors.initials: DG
authors.lastname: Farmer
mesh_terms: D000328:Adult; D002648:Child; D006439:Hemodynamics; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation / Q000379:methods*; D016343:Monitoring, Intraoperative; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000379:methods*