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D Houssin

Publications and source records attributed to D Houssin.

At least 181 records · Page 10Linked to original sources
PubMed1991

[Technique and results of lung transplantation in rats].

Lung transplantation has recently emerged as an efficient therapy for a variety of endstage pulmonary diseases. Nevertheless, many problems remain unsolved. A simple and reproducible experimental model allows examination of some of the problems encountered. We report here our experience of lung transplantation in the rat. One hundred and thirty six lung transplantations have been performed. After the initial phase necessary to master the technique, an overall survival rate of 86% was achieved. Graft function, as assessed by chest X-rays and lung isotope scans, was satisfactory up to 4 months after transplantation. Lung transplantation in the rat is a reliable and reproductible experimental model allowing the development of research projects in this field.

Animals↗
PubMed1991

Liver transplantation in patients with a surgical portasystemic shunt.

Of 220 patients undergoing liver transplantation between March 1982 and April 1991, eighteen (8.1 percent) already had a surgical portasystemic shunt. Four patients had a distal splenorenal shunt, six a side-to-side portacaval shunt, three an end-to-side portacaval shunt, and five, a mesocaval shunt. The splanchnic venous system was assessed by Doppler ultrasound examination and angiography before liver transplantation. Perioperative mortality rate was higher but not significantly different from that observed in the population of patients without previous portasystemic shunt (33.3 percent versus 21.7 percent). Liver transplantation was particularly difficult in the six patients with a previous side-to-side portacaval shunt, in which the perioperative mortality rate was high (66.6 percent). Liver transplantation is feasible in patients with a previous portasystemic shunt but carries a higher risk. It is easier when no previous dissection of the hepatic pedicle has been done. Suppression of the shunt after revascularization of the graft must be performed in order to provide optimal venous flow to the hepatic graft.

Adolescent↗
PubMed1991

Liver transplantation in Langerhans' cell histiocytosis (histiocytosis X).

Two children with biopsy-proven LCH underwent successful hepatic transplantation for end-stage liver disease. These patients were thought not to have active LCH disease at the time of transplantation, although one had developed a new osteolytic lesion a few months before the operation and the other had suspicious osteolytic lesions at the time of transplantation. The histologic examination of the excised liver showed features consistent with primary sclerosing cholangitis. The two patients had an excellent recovery with no evidence of progression of LCH or recurrence of the underlying disease in the hepatic allograft at 1 and 3 years after organ transplantation.

Adolescent↗
PubMed1991

[Ectasing cholangitis and secondary biliary cirrhosis following intra-arterial hepatic chemotherapy. Treatment by liver transplantation].

A case of ectasing cholangitis, following intra-arterial chemotherapy with discontinuous infusion of fluorouracile, is described. The severe destruction of the intra-hepatic biliary ducts led to the constitution of large cavities in continuity with the biliary tree. These cavities were responsible for images which were mistakenly thought to be metastases. Consequently, secondary biliary cirrhosis developed, requiring orthotopic liver transplantation.

Adenocarcinoma↗
PubMed1990

Variability of clinical presentation of hepatic artery thrombosis in pediatric liver transplantation: role of imaging modalities.

Among a series of 90 pediatric liver transplantations, 9 cases of hepatic artery thrombosis (HAT) in 8 patients are reported. All cases were diagnosed in the first two weeks and confirmed angiographically and surgically. Clinical presentation was often unreliable with only 2 cases showing the typical pattern of massive hepatic necrosis. Five cases presented with biliary complications and in 2 cases, HAT was discovered fortuitously on duplex sonography. The role of imaging modalities is emphasized. Duplex sonography is the best non-invasive screening method and we recommend a routine daily examination in the first 2 weeks. CT is the most useful method to assess the extension of liver infarction. PTC remains necessary to evaluate biliary complications and to plan the best therapeutic approach in this devastating event. Two patients died, 2 had to be retransplanted (one patient twice) and are doing well, 2 are on a waiting list for retransplantation and one underwent an emergency surgical arterial desobstruction and is completely asymptomatic.

Child↗
PubMed1990

Feeding pattern of liver-transplanted rats.

It has been proposed that the liver is involved in the control of food intake (FI). Various studies utilizing hepatic vagotomy have cast doubt on the role of hepatic metabolic receptors. Feeding patterns of male adult Lewis rats were continuously recorded in one group of animals after orthotopic liver transplantation (T), without reestablishing arterial flow. Rats of a second group were dearterialized (D) and had their livers freed from the hepatic pedicle, while rats of a third group were laparotomized (L) and served as sham-operated controls. Meal pattern analyses and body weight (BW) changes were followed after surgery. When T rats began to recover BW, a fourth nonoperated control group (C) was added with BW paired to the T group. From days 15 to 25 the T rats gained significantly less BW than C rats and their 24-hour FI was reduced: daytime FI was augmented while nighttime FI was decreased. Meal number was unchanged. Daytime meal size was increased while nighttime meal size was diminished. Between days 50-60, the BW gain of the T group was nearly identical to that of D or L rats from days 15-25. Data from these two periods were compared. The 24-hour FI was identical, nighttime FI remained significantly lower in T rats. Because of variation in BW recovery of the T rats an additional comparison was made between the T rats after they recovered their BW following surgery, and the D and L rats (days 15-25). All feeding pattern parameters were identical in T, D and L rats. Liver transplantation was followed only by small long-lasting changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Immunocytochemical and ultrastructural changes of islet cells in rats treated long-term with cyclosporine at immunotherapeutic doses.

Daily cyclosporine doses of 10 mg/kg body weight for 21 days in Wistar rats cause impairment in glucose homeostasis and changes in the amount of immunostainable hormones and in the ultrastructure of the cells of the pancreatic islets. CsA induces hyperglycemia and reduced glucose tolerance, and causes a decrease in immunoreactive insulin and an increase of somatostatin and pancreatic polypeptide (PP) immunoreactivities, leaving glucagon immunoreactivity unaffected. Ultrastructurally, different degrees of dilation of rough endoplasmic reticulum cisternae and enlargement of Golgi apparatus can be observed in B cells, together with a pronounced reduction in the number of secretory granules. Nevertheless, there were no apparent morphological changes of the other cytoplasmic organelles, suggesting that the drug, besides a depression of protein synthesis, as previously stated, also induces a substantial defect in granulogenesis, probably due to impairment in the intracellular transport of the hormone from the sites of synthesis to the secretory granules. The B cell alterations are not accompanied by any sign of B cell degeneration or death. Non-B cells did not show any of the ultrastructural changes found in B cells and were similar to those of the control rats. The above findings indicate that CsA at immunotherapeutic doses causes impairment in the secretory processes of B cells specifically. An hypothesis on the mode of action of CsA on B cells is drawn.

Animals↗
PubMed1990

Orthotopic liver transplantation for Byler disease.

Byler disease is a rare form of familial intrahepatic cholestasis that is fatal before puberty. This retrospective study reviewed the results of orthotopic liver transplantation in 14 children with Byler disease using 12 whole-liver grafts and 2 reduced-size grafts. One post-operative death occurred after retransplantation for arterial thrombosis. In the other patients, infectious problems and rejection episodes were the most frequent complications during the postoperative period. In the 13 patients alive, graft function, growth, and quality of life were good after an average follow-up of 17 months without any sign of disease recurrence.

Adolescent↗
PubMed1990

Morphological changes in rat pancreatic acinar cells induced by long-term treatment with cyclosporine and their reversal after withdrawal.

Cyclosporine (CsA), administered to rats at daily doses of 10 and 50 mg/kg body weight, for 21 days, influenced negatively the structures involved in the synthesis, storage and secretion of digestive enzymes in pancreatic acinar cells. A dose-related, significant reduction in basophilic cell regions, secretion granule content, and overall size of acinar cells was appreciable by light microscopy and morphometry. By electron microscopy, the acinar cells of the rats given 10 mg/kg/day CsA were similar to the controls, whereas with the higher dose most cells showed reduction in the size of nucleoli, increase in the number of lysosomes, and evidence of autophagy. In only a few cells was autophagy particularly severe and involved almost the entire cytoplasm. Nine weeks after withdrawal from CsA treatment, the structural recovery of acinal cells was complete, and features indicating enhanced protein synthesis and mitochondrial multiplication were observed by electron microscopy. In conclusion, prolonged administration of CsA to rats induces changes in the acinar cells indicating a depression of their activity, without substantial impairment in the viability of the most of them, even at high doses. This accounts for complete restoration of the acinar tissue upon withdrawal.

Animals↗
PubMed1990

Comparison of rat liver preservation with Eurocollins and a modified University of Wisconsin solution: transplantation and isolation of hepatocytes for culture.

The efficiency of Eurocollins or modified University of Wisconsin (UW) solution (MUW) in preserving rat livers was compared. After cold storage with one of the solutions, the livers were transplanted or perfused by collagenase for isolation of hepatocytes. Five of the 6 rats receiving a graft preserved with MUW versus none of the 6 rat receiving a graft preserved with Eurocollins solution survived 24 h or more. A significantly greater number of hepatocytes were isolated from livers preserved with MUW than from livers preserved with Eurocollins solution. This suggests a better reperfusion of MUW-preserved livers by collagenase resulting from less endothelial injury. LDH release by cultured hepatocytes, ketone body production and stimulation by glucagon were not significantly different between the two groups. These results confirm the superiority of MUW solution over Eurocollins in preserving liver grafts. They suggest that the advantage of MUW solution results from better protection of vascular endothelium rather than of hepatocytes.

Adenosine↗
PubMed1990

[Xenogeneic hyperacute rejection of the lung in rats].

Xenotransplantation, with organs harvested from appropriate donor animals could be a potential solution to the shortage of donor organs in general and of lung grafts in particular. Unilateral orthotopic lung transplantation in the rat has been used to study the lung xenograft rejection in a discordant donor-recipient combination, i.e. guinea-pig to rat. With this microsurgical technique, a high post-operative survival rate has been reached. The good function of the grafts was assessed by serial chest x-ray, lung perfusion scintigraphy until several months after the transplantation. The survival of the xenografts has been then compared to that of allografts and isografts. Lung xenograft rejection in this combination has been very fast: 53 minutes. Macroscopic and histologic data displayed lung infarct with hemorrhagic edema.

Animals↗
PubMed1990

Portal and hepatic arterial blood flow measurements of human transplanted liver by implanted Doppler probes: interest for early complications and nutrition.

Hepatic artery thrombosis and early acute rejection are severe complications of orthotopic liver transplantation (OLT). Their rapid detection is most desirable. The purpose of this study was to assess the usefulness of monitoring hepatic artery (HABF) and portal vein (PVBF) blood flows during the first week after OLT. At the end of operation, microprobes were sutured to the vessels, and their connecting tubes were externalized and connected to a pulsed Doppler flowmeter operating at 8 MHz. In 10 patients (ages ranged from 2 to 54 years) of 106, measurements of HABF and PVBF were done during alternative clamping of both vessels and before and after abdominal closure, every 12 hours during 7 days, and at day 7, before and after a 150 gm carbohydrate meal. At day 7 the probes were pulled out by gentle traction without complication, and all patients were allowed to go home. Reciprocal increase of flow during selective clamping was only observed for HABF (+45.8% +/- 47.6%; p less than 0.01). Abdominal closure decreased both HABF and PVBF by 13.8%, p less than 0.01, and 26%, p less than 0.05, respectively. In seven cases no significant variation of HABF and PVBF was observed during 7 days. In two patients with histologically confirmed early acute rejection, a marked decrease of diastolic HABF, without modification in PVBF, was the first manifestation and was rapidly corrected by boluses of steroids. In one patient disappearance of systolic and diastolic HABF led us to diagnose an arterial obliteration caused by a plicature, which was successfully surgically treated in the emergency department. In all patients, after oral ingestion of the carbohydrate meal, and only after this type of diet, a significant and deep decrease (-87%, p less than 0.001) of HABF was observed between 7 and 120 minutes without any change in PVBF. Such an effect was not observed in control patients. We conclude that this Doppler flowmetric technique with implantable microprobes is useful for rapid diagnosis of and strategy in treating early complications and is a new tool for pathophysiologic study of OLT consequences.

Dietary Carbohydrates↗