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Your search term(s) "Thrombocytosis or thrombosis" returned 95 results.

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Long-Term Results of Renal Transplantation Using Kidneys Harvested From Non-Heartbeating Donors: a 15-Year Experience. Journal of Urology. 169(1): 28-31. January 2003.

This article reports on an organ procurement program of non-heartbeating donors that was developed to expand the pool of suitable organ donors. The authors compare graft survival in patients receiving renal transplants procured from non-heartbeating with recipients of kidneys from heartbeating donors over a period of 15 years. In the study, there were 60 renal transplantations selected from 70 non-heartbeating donors based on age younger than 50 years, warm ischemia (no blood flow) less than 30 minutes, creatinine less than 200, and no hypertension or major histological lesions. Long-term results of graft survival and complications were compared with a series of 1,065 renal (kidney) transplantations performed during the same period with kidneys procured from heartbeating donors. Mean age of the recipients was statistically different as non-heartbeating donors were older. However, the 10 year graft survival rates were similar in both groups. Incidence of ureteral stenosis (narrowing) and fistula, arterial stenosis and thrombosis (clotting) was not statistically different in both groups. On the other hand, delay graft function was more frequent in non-heartbeating donors. The authors conclude that despite a high rate of acute tubular necrosis (ATN, tissue death of some of the kidney tubules), kidneys harvested from non-heartbeating donors had the same graft survival rates as those procured from heartbeating donors. 2 figures. 1 table. 20 references.

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Sirolimus Does Not Increase the Risk for Postoperative Thromboembolic Events Among Renal Transplant Recipients. Transplantation. 76(2): 318-323. July 2003.

Deep venous thrombosis (DVT) tends to occur in greater frequency among cyclosporine (CsA) treated renal (kidney) transplant recipients. This article reports on a study undertaken to assess the impact of a combination regimen (CsA and sirolimus) on the incidence, predisposing factors, and consequences of postoperative DVT, transplant renal vein or artery thrombosis, and pulmonary embolus. The authors retrospectively evaluated two cohorts of renal transplant recipients: CsA or prednisone plus or minus azathioprine (n = 136, group A) or sirolimus plus CsA plus prednisone (n = 354, group B). The 7 of 136 (5.1 percent) incidence of thrombotic events in group A was similar to the 20 of 354 (5.6 percent) incidence in group B. No patient lost a graft as a complication of DVT, nor did these events produce other lasting adverse effects. The authors conclude that addition of sirolimus to a CsA and prednisone regimen does not increase the incidence of postoperative thrombotic events among renal transplant recipients. 1 figure. 5 tables. 26 references.

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Vascular Diseases of the Liver. In: Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 2517-2525.

This chapter on vascular diseases of the liver is from a comprehensive gastroenterology textbook that provides an encyclopedic discussion of virtually all the disease states encountered in a gastroenterology practice. In this chapter, the author discusses systemic circulatory disease, Budd-Chiari syndrome, obstruction of the inferior vena cava, portal vein thrombosis, sinusoidal obstruction syndrome (hepatic venoocclusive disease), nodular regenerative hyperplasia, and peliosis hepatis. The chapter is illustrated with black-and-white graphs and drawings. 1 figure. 4 tables. 95 references.

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Case Against Chronic Venous Hemodialysis Access. JASN. Journal of the American Society of Nephrology. 13(8): 2195-2197. August 2002.

The provision of adequate hemodialysis is dependent on repeated and reliable access to the central circulation of the patient's body. This access to the circulation is best provided by primary arteriovenous fistulas (AVF) and to a lesser extent by AV grafts (AVG). However, due to changing patient demographics, reliance on less desirable modes of vascular access such as synthetic (PTFE) grafts and tunneled, cuffed catheters (CVC) has increased. These latter two types of access are more prone to both thrombosis (clotting) and infection. Venous access in particular has emerged as a substantial cause of hemodialysis morbidity and mortality. This editorial serves as an introduction to two articles in this issue that deal with these dilemmas. The editorial first considers the development of these types of problems and the guidelines for medical care regarding vascular access practice. The authors then summarize the two articles and conclude that the best way to deal with these venous access problems is by finding mechanisms to limit venous hemodialysis complications with new techniques and devices, but also to use venous access less and for shorter periods of time. 22 references.

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Circulating Platelet-Derived Microparticles With Procoagulant Activity May be a Potential Cause of Thrombosis in Uremic Patients. Kidney International. 62(5): 1757-1763. November 2002.

Clinical experience indicates that bleeding and thrombotic (clotting) tendencies coexist in uremic patients. Numerous studies have shown that platelet functional defects contribute to the bleeding tendency in uremic patients. In contrast, there are no solid studies clarifying the pathogenesis (development) of the prothrombotic state in uremic patients. This article reports on a study that considered the role of platelet-derived microparticles (PMPs) which are small vesicles with procoagulant activity released from activated platelets and are thought to be involved in clinical thrombogenesis. The study included predialyzed patients, patients on hemodialysis, or continuous ambulatory peritoneal dialysis (CAPD) patients, and age-matched healthy controls. Results showed that PMP counts were significantly greater in each uremic group than in controls. The PMP counts were not different among three types of uremic groups. PMP counts were significantly higher in uremic patients with thrombotic events than in those without thrombotic events. The hemodialysis procedure and existence of an arteriovenous (AV) fistula (for access) did not affect PMP counts, but erythropoietin (rHuEPO) treatment possibly enhanced the PMP release in these patients. The authors conclude that elevated PMP counts may trigger thrombosis in uremic patients. The primary cause of PMP elevation in uremia was not clarified in this study. 5 figures. 2 tables. 35 references.

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Homocysteine and Vascular Access Thrombosis in Hemodialysis Patients. Renal Failure. 24(2): 215-222. 2002.

Vascular access (VA) remains the Achilles' heel of successful hemodialysis, and thrombosis (clotting) is the leading cause of VA failure. Hyperhomocystinemia (high levels of homocysteine in the blood) is common in patients on hemodialysis and is associated with venous and arterial thrombosis in patients without end stage renal disease (ESRD). In this article, the authors report on a study of 65 hemodialysis patients with native arteriovenous fistulae. Two groups of patients were defined: group A including 45 patients with their VA either never or only once thrombosed, and group B including 20 patients with two or more thromboses of their vascular access. The authors determined serum concentrations of total homocysteine in these patients. In 63 patients (96.9 percent), hyperhomocystinemia was present. There was no statistically significant difference between groups A and B regarding age, gender, and duration of hemodialysis treatment. Total homocysteine concentrations were higher in group A than in group B patients but the difference was small and not statistically significant. These results suggest that thrombosis of native arteriovenous fistulae may not be caused by hyperhomocystinemia in these patients. 40 references.

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Improving Dialysis Access Management. Seminars in Nephrology. 22(6): 507-514. November 2002.

Renal replacement therapy requires either placement of a functional hemodialysis vascular access or peritoneal dialysis catheter. This article reviews the current literature on the planning of dialysis access, with particular emphasis on issues pertaining to vascular access. Early provision of a dialysis access improves patient care with reduction in morbidity and reduces the economic burden incurred as a result of delayed access placement. Vascular access dysfunction, including thrombosis (clotting) and infection, poses the greatest burden on the end stage renal disease (ESRD) population. The authors highlight current concepts used to maximize access patency and to efficiently manage vascular access complications. 1 table. 59 references.

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Infection in Vascular Access Procedures. In: Wilson, S.E. Vascular Access: Principles and Practice. 4th ed. St. Louis, MO: Mosby, Inc. 2002. p. 189-203.

This chapter on infection in vascular access (VA) procedures is from a text that reviews the principles and practice of vascular access, including that used for hemodialysis and for critical care, chemotherapy, and nutrition. Infection is the most common complication of vascular access surgery after thrombosis (clotting) and is a frequent cause of hospitalization of hemodialysis patients. Infection of surgical sites or graft material may prematurely end the function of autogenous or prosthetic fistulas and threatens life, through hemorrhage or systemic sepsis, and jeopardizes limb, through disruption of arterial supply. The authors review the pathogenesis of vascular access infection in the hemodialysis patient and discuss its presentation, prevention, and management. Other topics include altered immune response, altered natural barriers to infection, altered bacterial flora, role of the access type and site, bacteriology, clinical features (symptoms), prevention, treatment of sepsis, the effect of human immunodeficiency virus (HIV), and hemodialysis equipment. 4 figures. 144 references.

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Pancreaticoportal Fistula in Association with Antiphospholipid Syndrome Presenting as Ascites and Portal System Thrombosis. Canadian Journal of Gastroenterology. 16(9): 601-605. September 2002.

Fistulous communication (an abnormal opening) between the pancreas and the portal venous system is extremely rare and is usually a complication of chronic pancreatitis or pancreatic pseudocysts. In this article, the authors describe a patient who presented with abdominal pain and ascites (fluid accumulation) secondary to a pancreaticoportal fistula and portal system thrombosis. The diagnosis was made by endoscopic retrograde cholangiopancreatography (ERCP) and confirmed by immediate postprocedure computed tomographic scanning (CT scan). Laboratory studies identified concomitant antiphospholipid syndrome. The patient responded favorably to supportive medical therapy. 5 figures. 32 references.

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Permanent Hemodialysis Vascular Access Survival in Children and Adolescents with End-Stage Renal Disease. Kidney International. 62(5): 1864-1869. November 2002.

Transplantation is the optimal therapy for children with end stage renal disease (ESRD), but in a subset of patients with peritoneal membrane failure, failed transplants, or poor social situations, chronic hemodialysis (HD) remains the only option. Long-term survival of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) in pediatric patients has not been well described. This article reports on a study of the survival of permanent vascular access in 34 pediatric ESRD patients treated with chronic HD between 1989 and 1995 and followed through 2000. Twenty-four AVFs and AVGs were created in 19 and 23 patients, respectively. Mean age and weight at insertion were 15.1 years (range 7.1 to 20.9 years) and 46 kilograms (18 to 81 kilograms) for AVFs and 13.3 years (3.8 to 21.1 years) and 41.5 kilograms (10.5 to 145 kilograms) for AVGs. Excluding primary failures, 1-year, 3-year, and 5-year patency rates for AVFs and AVGs were not significantly different. Patency did not correlate with patient weight or age at access creation. Primary access failure occurred more often in AVFs (8 of 24) than in AVGs (1 of 28). Access thrombosis (clotting), stenosis (narrowing), and infection occurred more frequently in AVG. The authors conclude that both AVF and AVG function well even in small pediatric patients and have survival rates equivalent to adult series and longer than cuffed venous catheters in pediatric patients. Both AVFs and AVGs are preferable for long-term HD access in pediatrics. 1 figure. 3 tables. 17 references.

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