Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. Favorable outcomes require careful screening for eligible recipients, as well as a well-calibrated live or deceased donor match.
Omphalocele or omphalocoele also called exomphalos, is a rare abdominal wall defect. Beginning at the 6th week of development, rapid elongation of the gut and increased liver size reduces intra abdominal space, which pushes intestinal loops out of the abdominal cavity. Around 10th week, the intestine returns to the abdominal cavity and the process is completed by the 12th week. Persistence of intestine or the presence of other abdominal viscera in the umbilical cord results in an omphalocele.
Situs ambiguus is a rare congenital defect in which the major visceral organs are distributed abnormally within the chest and abdomen. Clinically heterotaxy spectrum generally refers to any defect of Left-right asymmetry and arrangement of the visceral organs; however, classical heterotaxy requires multiple organs to be affected. This does not include the congenital defect situs inversus, which results when arrangement of all the organs in the abdomen and chest are mirrored, so the positions are opposite the normal placement. Situs inversus is the mirror image of situs solitus, which is normal asymmetric distribution of the abdominothoracic visceral organs. Situs ambiguus can also be subdivided into left-isomerism and right isomerism based on the defects observed in the spleen, lungs and atria of the heart.
Short bowel syndrome is a rare malabsorption disorder caused by a lack of functional small intestine. The primary symptom is diarrhea, which can result in dehydration, malnutrition, and weight loss. Other symptoms may include bloating, heartburn, feeling tired, lactose intolerance, and foul-smelling stool. Complications can include anemia and kidney stones.
The suspensory muscle of duodenum is a thin muscle connecting the junction between the duodenum and jejunum, as well as the duodenojejunal flexure to connective tissue surrounding the superior mesenteric and coeliac arteries. The suspensory muscle most often connects to both the third and fourth parts of the duodenum, as well as the duodenojejunal flexure, although the attachment is quite variable.
Pediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults.
A volvulus is when a loop of intestine twists around itself and the mesentery that supports it, resulting in a bowel obstruction. Symptoms include abdominal pain, abdominal bloating, vomiting, constipation, and bloody stool. Onset of symptoms may be rapid or more gradual. The mesentery may become so tightly twisted that blood flow to part of the intestine is cut off, resulting in ischemic bowel. In this situation there may be fever or significant pain when the abdomen is touched.
Intestinal malrotation is a congenital anomaly of rotation of the midgut. It occurs during the first trimester as the fetal gut undergoes a complex series of growth and development. Malrotation can lead to a dangerous complication called volvulus, in which cases emergency surgery is indicated. Malrotation can refer to a spectrum of abnormal intestinal positioning, often including:
The University of Pittsburgh Medical Center (UPMC) is an American integrated global nonprofit health enterprise that has 92,000 employees, 40 hospitals with more than 8,000 licensed beds, 800 clinical locations including outpatient sites and doctors' offices, a 3.8 million-member health insurance division, as well as commercial and international ventures. It is closely affiliated with its academic partner, the University of Pittsburgh. It is considered a leading American health care provider, as its flagship facilities have ranked in U.S. News & World Report "Honor Roll" of the approximately 15 to 20 best hospitals in America for over 15 years. As of 2016, its flagship hospital UPMC Presbyterian was ranked 12th nationally among the best hospitals by U.S. News & World Report and ranked in 15 of 16 specialty areas when including UPMC Magee-Womens Hospital. This does not include UPMC Children's Hospital of Pittsburgh which ranked in the top 10 of pediatric centers in a separate US News ranking.
Thomas Earl Starzl was an American physician, researcher, and expert on organ transplants. He performed the first human liver transplants, and has often been referred to as "the father of modern transplantation." A documentary, entitled "Burden of Genius," covering the medical and scientific advances spearheaded by Starzl himself, was released to the public in 2017 in a series of screenings. Dr. Starzl also penned his autobiography, "The Puzzle People: Memoirs Of A Transplant Surgeon," which was published in 1992.
Intestinal neuronal dysplasia (IND) is an inherited disease of the intestine that affects one in 3000 children and adults. The intestine uses peristalsis to push its contents toward the anus; people with IND have a problem with the motor neurons that lead to the intestine, inhibiting this process and thus preventing digestion.
Intestinal pseudo-obstruction (IPO) is a clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterized by the signs and symptoms of intestinal obstruction without any lesion in the intestinal lumen. Clinical features mimic those seen with mechanical intestinal obstructions and can include abdominal pain, nausea, abdominal distension, vomiting, dysphagia and constipation depending upon the part of the gastrointestinal tract involved.
Sir Roy Yorke Calne was a British surgeon and pioneer in organ transplantation. He was part of the team that performed the first liver transplantation operation in Europe in 1968, the world's first liver, heart and lung transplantation in 1987, the first intestinal transplant in the UK in 1992 and the first successful combined stomach, intestine, pancreas, liver and kidney cluster transplantation in 1994.
The two main methods for replacing bladder function involve either redirecting urine flow or replacing the bladder in situ. Replacement can be done with an artificial urinary bladder, an artificial organ.
Double-balloon enteroscopy, also known as push-and-pull enteroscopy, is an endoscopic technique for visualization of the small bowel. It was developed by Hironori Yamamoto in 2001. It is novel in the field of diagnostic gastroenterology as it is the first endoscopic technique that allows for the entire gastrointestinal tract to be visualized in real time.
UPMC Children's Hospital of Pittsburgh (CHP), popularly known simply as Children's, is part of the University of Pittsburgh Medical Center and the only hospital in Greater Pittsburgh dedicated solely to the care of infants, children, teens and young adults through around age 26. UPMC Children's also sometimes treats older adults that require pediatric care. The hospital is affiliated with the University of Pittsburgh School of Medicine and features a state-verified level 1 pediatric trauma center, one of four in the state. CHP also has a rooftop helipad for emergent transport of pediatric patients.
Rainer W.G. Gruessner is a German-born American general surgeon and transplant surgeon, most noted as a surgical pioneer for his clinical and research innovations. Gruessner was the first transplant surgeon to perform all types of abdominal transplants from living donors.
Intestine transplantation is the surgical replacement of the small intestine for chronic and acute cases of intestinal failure. While intestinal failure can oftentimes be treated with alternative therapies such as parenteral nutrition (PN), complications such as PN-associated liver disease and short bowel syndrome may make transplantation the only viable option. One of the rarest type of organ transplantation performed, intestine transplantation is becoming increasingly prevalent as a therapeutic option due to improvements in immunosuppressive regimens, surgical technique, PN, and the clinical management of pre and post-transplant patients.
Intestinal bypass is a bariatric surgery performed on patients with morbid obesity to create an irreversible weight loss, when implementing harsh restrictions on the diets have failed. Jejunocolic anastomosis was firstly employed. Nonetheless, it led to some unexpected complications such as severe electrolyte imbalance and liver failure. It was then modified to jejunoileal techniques. Viewed as a novel form of treatment for obesity, many intestinal bypass operations were carried out in the 1960s and 1980s. Significant weight loss was observed in patients, but this surgery also resulted in several complications, for instance, nutritional deficiencies and metabolic problems. Due to the presence of surgical alternatives and anti-obesity medications, intestinal bypass is now rarely used.
UPMC Presbyterian is a 900-bed non-profit research and academic hospital located in the Oakland neighborhood of Pittsburgh, Pennsylvania, providing tertiary care for the Western Pennsylvania region and beyond. It comprises the Presbyterian campus of the combined UPMC Presbyterian Shadyside hospital entity. The medical center is a part of the University of Pittsburgh Medical Center health system and is the flagship hospital of the system. UPMC Presbyterian also features a state verified Level 1 Trauma Center, 1 of 3 in Pittsburgh. Although UPMC Presbyterian has no pediatric services, Presby has the equipment to stabilize and transfer pediatric emergency cases to the nearby UPMC Children's Hospital of Pittsburgh.
