Homotransplantation of multiple visceral organs

It was technically possible to perform simultaneous homotransplantation of multiple visceral organs including the liver, spleen, pancreas, omentum and the entire gastrointestinal tract. Arterialization of the cooled graft was accomplished through the donor aorta which was removed with the graft and attached to that of the recipient dog. Gastrointestinal hemorrhage after surgery accounted for a high operative mortality and was thought to be due to denervation of the graft. The five dogs which survived the immediate trauma of surgery lived for five and a half to nine days. After the second day, these animals were physically active and able to resume oral alimentation. In three dogs, there was metabolic evidence of rejection of the liver. In two others, jaundice did not develop. These observations were compared with chemical, hematologic and pathologic data obtained in previous experiments involving homotransplantation of the liver alone. In some cases, there was less evidence of host versus graft rejection after the multiple organ transplants. Other data in the present study suggested the possibility that a significant graft versus host reaction may have been an important contributory cause of death. © 1962

Mechanisms, pathophysiology, and diagnostic imaging of left ventricular outflow tract obstruction following mitral valve surgery and transcatheter mitral valve replacement

© 2019 Wiley Periodicals, Inc. Left ventricular outflow tract obstruction is a serious complication of mitral valve surgery (repair and replacement) and transcatheter mitral valve replacement. An appreciation of the various mechanisms which cause outflow obstruction in these settings is critical to avoiding this complication and to initiating appropriate treatment. This article discusses the mechanisms, pathophysiology, and imaging of left ventricular outflow tract obstruction which can arise following insertion of a variety of mitral valve prosthetics