Comments for Surgery for Surgeons http://forsurgeons.net surgery blog for surgeons Fri, 21 May 2010 11:06:22 -0700 http://wordpress.org/?v=2.8.1 hourly 1 Comment on Hyperacute rejection in liver transplantation? by Joe http://forsurgeons.net/cases/hyperacute-rejection-in-liver-transplantation/comment-page-1#comment-48 Joe Fri, 21 May 2010 11:06:22 +0000 http://forsurgeons.net/?p=135#comment-48 Thanks for sharing this case. Thanks for sharing this case.

]]> Comment on Hyperacute rejection in liver transplantation? by I. Mitsiev http://forsurgeons.net/cases/hyperacute-rejection-in-liver-transplantation/comment-page-1#comment-47 I. Mitsiev Sun, 09 May 2010 21:16:01 +0000 http://forsurgeons.net/?p=135#comment-47 Thank you for you comment and the very reasonable question, Amit! The cold ischemia time (CIT) plays a significant role in the delayed graft function (DGF) in kidney transplantation. 11.5 hours shouldn't be the time a liver dies completely when appropriately preserved, like in this case. In a good meta-analysis about the role of CIT in primary non-function (PNF) of liver allografts by a mixed (MGS and Pittsburgh) group (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430537/?tool=pubmed) from about 2 years ago, the authors show that there is not a linear dependency between the CIT and the PNF. Furthermore, the graft survival was excellent in the CIT-group of 10–12.5 hrs. There is no doubt that a prolonged CIT does not help. But I just don't believe that the role of the CIT in the PFN of this liver was crucial. The liver was also not really fatty. Much fattier livers have been transplanted without any significant problems. The common sense would tell that a prolonged CIT would result in DGF prior to a PNF. But there was no DGF here! There must have been something else that killed the liver in this case, Amit... but I don't know what. Thank you for you comment and the very reasonable question, Amit!
The cold ischemia time (CIT) plays a significant role in the delayed graft function (DGF) in kidney transplantation. 11.5 hours shouldn’t be the time a liver dies completely when appropriately preserved, like in this case.
In a good meta-analysis about the role of CIT in primary non-function (PNF) of liver allografts by a mixed (MGS and Pittsburgh) group (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430537/?tool=pubmed) from about 2 years ago, the authors show that there is not a linear dependency between the CIT and the PNF. Furthermore, the graft survival was excellent in the CIT-group of 10–12.5 hrs.

There is no doubt that a prolonged CIT does not help. But I just don’t believe that the role of the CIT in the PFN of this liver was crucial. The liver was also not really fatty. Much fattier livers have been transplanted without any significant problems.

The common sense would tell that a prolonged CIT would result in DGF prior to a PNF. But there was no DGF here!
There must have been something else that killed the liver in this case, Amit… but I don’t know what.

]]> Comment on Hyperacute rejection in liver transplantation? by Amit Jain http://forsurgeons.net/cases/hyperacute-rejection-in-liver-transplantation/comment-page-1#comment-46 Amit Jain Sun, 09 May 2010 20:02:35 +0000 http://forsurgeons.net/?p=135#comment-46 Thanks a lot for sharing this case. What are your thoughts on - if the cold ischemia time of 11.5 hr had to play a part in the primary non function of this fatty liver ? Thanks a lot for sharing this case. What are your thoughts on – if the cold ischemia time of 11.5 hr had to play a part in the primary non function of this fatty liver ?

]]> Comment on The process of organ procurement: Liver – the warm dissection by Ivo Mitsiev http://forsurgeons.net/transplant-surgery/the-process-of-organ-procurement-liver-the-warm-dissection/comment-page-1#comment-43 Ivo Mitsiev Tue, 12 Jan 2010 00:41:55 +0000 http://forsurgeons.net/?p=53#comment-43 Alger: Thank you very much for your comment! You (should) know that a significant portion of this particular knowledge I have gained because of you! You probably recognize situations and comments in this text, that we both discussed while I tried to learn from your experience. I will not forget your support and manner of teaching which helped me a lot especially in the hard initial time. Thank you so much! Keep up your great work, my friend! :) Alger:
Thank you very much for your comment!
You (should) know that a significant portion of this particular knowledge I have gained because of you! You probably recognize situations and comments in this text, that we both discussed while I tried to learn from your experience.
I will not forget your support and manner of teaching which helped me a lot especially in the hard initial time. Thank you so much!
Keep up your great work, my friend! :)

]]> Comment on The process of organ procurement: Liver – the warm dissection by alger http://forsurgeons.net/transplant-surgery/the-process-of-organ-procurement-liver-the-warm-dissection/comment-page-1#comment-42 alger Tue, 12 Jan 2010 00:27:36 +0000 http://forsurgeons.net/?p=53#comment-42 Ivo: Found your website surfing for some information, want to complement you on a great job!! Ivo:
Found your website surfing for some information, want to complement you on a great job!!

]]> Comment on Metastasis dependancy on the primary tumor? by bouazza http://forsurgeons.net/general-surgery/metastasis-dependancy-on-the-primary-tumor/comment-page-1#comment-36 bouazza Tue, 10 Nov 2009 19:42:20 +0000 http://forsurgeons.net/general-surgery/metastasis-dependancy-on-the-primary-tumor#comment-36 In Africa the surgeons put Silvadene inside a deep wound of a diabetic foot to help it heel better. Does this make any sense? Thanks ! In Africa the surgeons put Silvadene inside a deep wound of a diabetic foot to help it heel better.
Does this make any sense?
Thanks !

]]> Comment on Metastasis dependancy on the primary tumor? by bouazza http://forsurgeons.net/general-surgery/metastasis-dependancy-on-the-primary-tumor/comment-page-1#comment-35 bouazza Tue, 10 Nov 2009 19:40:14 +0000 http://forsurgeons.net/general-surgery/metastasis-dependancy-on-the-primary-tumor#comment-35 Do you guys evacuate a hematoma that collects into a subcutaneous chemotherapy reservoir area ? Do you guys evacuate a hematoma that collects into a subcutaneous chemotherapy reservoir area ?

]]> Comment on The process of organ procurement: Liver – the cold dissection by Ivo Mitsiev http://forsurgeons.net/transplant-surgery/the-process-of-organ-procurement-liver-the-cold-dissection/comment-page-1#comment-31 Ivo Mitsiev Wed, 07 Oct 2009 23:08:44 +0000 http://forsurgeons.net/?p=101#comment-31 Thank you for your positive feedback! :) Of course I added your website to my links list. Thank you for your positive feedback! :)
Of course I added your website to my links list.

]]> Comment on The process of organ procurement: Liver – the cold dissection by surg http://forsurgeons.net/transplant-surgery/the-process-of-organ-procurement-liver-the-cold-dissection/comment-page-1#comment-30 surg Wed, 07 Oct 2009 16:33:21 +0000 http://forsurgeons.net/?p=101#comment-30 HI great post.I am a transplant surgeon myself and enjoyed reading your article I wonder if you would like to exchange link with my site www.mcqsurgery.com HI great post.I am a transplant surgeon myself and enjoyed reading your article
I wonder if you would like to exchange link with my site http://www.mcqsurgery.com

]]> Comment on Breast implants in elderly women from Egypt. by Surgeon Thailand http://forsurgeons.net/cases/breast-implants-in-elderly-women-from-egypt/comment-page-1#comment-19 Surgeon Thailand Sun, 16 Aug 2009 01:09:27 +0000 http://forsurgeons.net/cases/breast-implants-in-elderly-women-from-egypt#comment-19 Amazing! IT REALLY does prove that breast augmentation is something all women think about, no matter what their age or religion. Amazing! IT REALLY does prove that breast augmentation is something all women think about, no matter what their age or religion.

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