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Cordero C, Loboda C, Clerc-Urmès I, Clément L, Pochon C, Chastagner P. Unexpected acute renal injury after high-dose etoposide phosphate and total body irradiation in children undergoing hematopoietic stem cell transplantation. Pediatr Blood Cancer 2017; 64. [PMID: 28696051 DOI: 10.1002/pbc.26669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 04/19/2017] [Accepted: 05/08/2017] [Indexed: 11/07/2022]
Abstract
High-dose etoposide phosphate, a water-soluble prodrug of etoposide, may be used after total body irradiation (TBI) in pediatric allogeneic bone marrow transplantation for lymphoblastic leukemia. In a retrospective study of 21 children treated at the Nancy University Hospital (2000-2014), we identified unprecedentedly an unexpectedly high incidence (57%) of acute renal injury following etoposide phosphate infusion. Patients who developed renal function impairment experienced more severe mucositis but had outcomes similar to those who did not. No risk factors were identified. We speculate that the etoposide phosphate diluent, dextran 40, may have been the causative agent in these post-TBI renal toxicity cases.
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Affiliation(s)
- C Cordero
- PediatricOncology/Hematology Department, Children's University Hospital of Nancy, Vandoeuvre-les-Nancy, France
| | - C Loboda
- Pharmacy Department, University Hospital of Nancy, Vandoeuvre-les-Nancy, France
| | - I Clerc-Urmès
- Platform of Clinical Research Support PARC (MDS unity), University Hospital of Nancy, Vandoeuvre-les-Nancy, France
| | - L Clément
- Hematology Department, University Hospital of Bordeaux, Bordeaux, France
| | - C Pochon
- PediatricOncology/Hematology Department, Children's University Hospital of Nancy, Vandoeuvre-les-Nancy, France
| | - P Chastagner
- PediatricOncology/Hematology Department, Children's University Hospital of Nancy, Vandoeuvre-les-Nancy, France
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Momeni A, Liu X, Januszyk M, Wan DC, Buncke GM, Buntic RF, Parrett BM. Microsurgical ear replantation-is venous repair necessary?-A systematic review. Microsurgery 2015; 36:345-50. [DOI: 10.1002/micr.22411] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/11/2015] [Accepted: 03/17/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Arash Momeni
- Division of Plastic and Reconstructive Surgery; Stanford University Medical Center; Palo Alto CA
| | - Xiangxia Liu
- Division of Plastic and Reconstructive Surgery; Stanford University Medical Center; Palo Alto CA
| | - Michael Januszyk
- Division of Plastic and Reconstructive Surgery; Stanford University Medical Center; Palo Alto CA
| | - Derrick C. Wan
- Division of Plastic and Reconstructive Surgery; Stanford University Medical Center; Palo Alto CA
| | - Gregory M. Buncke
- California Pacific Medical Center; The Buncke Clinic; Division of Microsurgery; San Francisco CA
| | - Rudolf F. Buntic
- California Pacific Medical Center; The Buncke Clinic; Division of Microsurgery; San Francisco CA
| | - Brian M. Parrett
- California Pacific Medical Center; The Buncke Clinic; Division of Microsurgery; San Francisco CA
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Bear AS, Hanley PJ, Bosque DM, Cruz CR, Kaur I, Liu H, Kebriaei P, Hosing C, Rezvani K, Oran B, De Lima MJ, Bollard CM, Shpall EJ. Low rate of infusional toxicity after expanded cord blood transplantation. Cytotherapy 2014; 16:1153-7. [PMID: 24582458 DOI: 10.1016/j.jcyt.2013.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 12/16/2013] [Accepted: 12/22/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND AIMS Umbilical cord blood (CB) is used with increasing frequency to restore hematopoiesis in patients with bone marrow transplant who lack a suitable human leukocyte antigen-matched donor. CB transplantation is limited by low cell doses and delays in neutrophil and platelet engraftment. CB progenitors expanded ex vivo before transplantation provide more rapid hematopoietic and immune reconstitution as well as less engraftment failure compared with unmanipulated CB. However, the safety of infusing double and ex vivo-expanded CB has not been systematically examined. METHODS We reviewed the immediate adverse events (AE) associated with the infusion of CB occurring within 24 hours in 137 patients enrolled in clinical CB transplant trials at the MD Anderson Cancer Center from February 2004 to May 2010. All patients received an unmanipulated CB unit followed by infusion of a second unmanipulated CB unit or a second CB unit expanded ex vivo with the use of cytokines in a liquid culture system or in mesenchymal stromal cell co-cultures. RESULTS A total of three grade 2 and two grade 3 infusion reactions occurred within 24 hours of CB transplantation. This resulted in an AE rate of 3.7%. The majority of AEs manifested as signs of hypertension. No association with patient age, sex, disease status, premedication, ABO compatibility or total infusion volume was observed. In summary, the incidence of infusion-related toxicities in patients who receive unmanipulated and ex vivo-expanded double CB transplantation is low. CONCLUSIONS We conclude that the infusion of unmanipulated followed by expanded CB products is a safe procedure associated with a low probability of inducing severe reactions.
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Affiliation(s)
- Adham S Bear
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, Texas, USA
| | - Patrick J Hanley
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Center for Cancer and Immunology Research, and Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, 20010
| | - Doyle M Bosque
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
| | - Conrad R Cruz
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Center for Cancer and Immunology Research, and Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, 20010
| | - Indresh Kaur
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
| | - Hao Liu
- Dan L. Duncan Cancer Center, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, Texas, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
| | - Katayoun Rezvani
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
| | - Betul Oran
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
| | - Marcos J De Lima
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
| | - Catherine M Bollard
- Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Center for Cancer and Immunology Research, and Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, 20010.
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA
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Abstract
Since the first successful salvage of an amputated finger using microsurgical anastomoses in 1965, replantation has been widely used in these decades and is now firmly established as a viable treatment option in traumatic limb amputation. The current concepts of replantation surgery for upper limb amputation are discussed in this review article in terms of history of replantation, present indications for the procedure, pre-theater care, technical refinements, postoperative management and functional outcome. In this article, we demonstrated that the advent of microsurgery has led to replantation of almost every amputated part of the upper limb possible. Replantation of digits and the hand can restore not only circulation but also function and cosmetic appearance. However, major amputations remain a challenge and the functional outcome is often disappointing, albeit the success rate of replantation exceeds 80%. Proper patient selection, adequate pre-theater preservation, good operative skill and postoperative care, as well as tight cooperation among the patient, the surgeon, and the rehabilitation therapist will help to achieve a better final functional outcome.
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Affiliation(s)
- Pao-Yuan Lin
- Division of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Seng-Feng Jeng
- Department of Plastic Surgery, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Tsan-Shiun Lin
- Division of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Ching-Hua Hsieh
- Division of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
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Kouki T, Komiya I, Masuzaki H. The ratio of the blood urea nitrogen/creatinine index in patients with acute renal failure is decreased due to dextran or mannitol. Intern Med 2010; 49:223-6. [PMID: 20118599 DOI: 10.2169/internalmedicine.49.2681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Acute renal failure (ARF) induced by dextran or mannitol is a lethal adverse effect, and hemodialysis or plasma exchange is recommended to avoid fatal ARF. This report describes 2 cases of ARF; one caused by dextran and the other by mannitol. Both showed decreases in the blood urea nitrogen (BUN)/creatinine ratios after the administration of these reagents. They immediately recovered to the level of creatinine on admission after the administration of these reagents was stopped, without hemodialysis or plasma exchange. Decreases in the BUN/creatinine ratio might be a useful index for the diagnosis of ARF is caused by these reagents.
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Affiliation(s)
- Tsuyoshi Kouki
- Department of Endocrinology and Metabolism, University of the Ryukyus School of Medicine, Nishihara.
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Abstract
PURPOSE OF REVIEW Fluid (volume) therapy is an integral component in the management of critically ill patients and fluid management may influence outcome. There is much controversy, however, about the type, timing and amount of fluid therapy. Here, we discuss the evidence available to guide such choices. RECENT FINDINGS Fluid therapy is widely endorsed for resuscitation of critically ill patients across a range of conditions. Yet, the approach to fluid therapy is subject to substantial variation in clinical practice. Emerging data show that the choice, timing and amount of fluid therapy may affect clinical outcomes. Synthetic colloids may increase the risk of acute kidney injury. Albumin may benefit hypoalbuminemic patients with sepsis and acute lung injury but may worsen outcome in traumatic brain injury. Early administration of fluid therapy in sepsis may improve survival but may be unnecessary in patients with penetrating trauma. Later fluid therapy in acute lung injury patients will increase the duration of ventilator dependence without achieving better survival. A positive cumulative balance likely contributes to increased morbidity and mortality after major surgery. SUMMARY Emerging evidence shows that choice, timing and amount of fluid therapy affect outcome. Future studies need to focus on these aspects of fluid therapy by means of larger, more rigorous and blinded controlled trials.
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Affiliation(s)
- Sean M Bagshaw
- Division of Critical Care Medicine, University of Alberta Hospital, University of Alberta, Edmonton, Alberta, Canada
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Davidson IJ. Renal impact of fluid management with colloids: a comparative review. Eur J Anaesthesiol 2006; 23:721-38. [PMID: 16723059 DOI: 10.1017/s0265021506000639] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2006] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVES Colloids such as hydroxyethyl starch (HES), gelatin, dextran and albumin are useful for maintaining renal perfusion and function. The comparative renal effects of colloids have not been previously reviewed. METHODS Computer searches of the MEDLINE and EMBASE bibliographic databases and the Cochrane Library were conducted using the search terms: colloids; hetastarch; gelatin; dextrans; serum albumin; kidney failure; cardiac surgical procedures; and kidney transplantation. Relevant studies were also sought through hand searching and examination of reference lists. Results of identified studies were qualitatively summarized with account taken for potential confounding factors. RESULTS The three artificial colloids HES, gelatin and dextran all exhibited troublesome renal side-effects. Randomized trials have demonstrated adverse renal effects of HES in sepsis and surgery. Undesirable renal effects are common to all available HES solutions regardless of molecular weight, substitution or C2/C6 ratio. While some of its effects may be less severe than those of HES, gelatin also can adversely affect the kidney. A negative renal impact of dextran is well-established, although this colloid is now less extensively used than formerly. As the normal endogenous colloid, albumin exhibits a wide margin of renal safety, although albumin overdose needs to be avoided. Albumin also appears to exert protective effects on the kidney such as inhibition of apoptosis and scavenging of reactive oxygen species. CONCLUSIONS Colloids display important differences in their actions on the kidney. These contrasting renal effects should be considered in making fluid management decisions.
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Affiliation(s)
- I J Davidson
- The University of Texas Southwestern Medical Center at Dallas, Division of Surgical Transplantation, Dallas, Texas 75390, USA.
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