Search

Your search keyword '"Ravikumar, Reena"' showing total 8 results
Start Over Author "Ravikumar, Reena" Search Limiters Full Text
8 results on '"Ravikumar, Reena"'

3. Normothermic Machine Perfusion of Deceased Donor Liver Grafts Is Associated With Improved Postreperfusion Hemodynamics

Author

Angelico, Roberta, primary, Perera, M. Thamara P. R, additional, Ravikumar, Reena, additional, Holroyd, David, additional, Coussios, Constantin, additional, Mergental, Hynek, additional, Isaac, John R., additional, Iqbal, Asim, additional, Cilliers, Hentie, additional, Muiesan, Paolo, additional, Friend, Peter J., additional, and Mirza, Darius F., additional

Published
2016
Full Text
View/download PDF

5. A randomized trial of normothermic preservation in liver transplantation

Author

Nasralla, David, Coussios, Constantin C., Mergental, Hynek, Akhtar, M. Zeeshan, Butler, Andrew J., Ceresa, Carlo D. L., Chiocchia, Virginia, Dutton, Susan J., García-Valdecasas, Juan Carlos, Heaton, Nigel, Imber, Charles, Jassem, Wayel, Jochmans, Ina, Karani, John, Knight, Simon R., Kocabayoglu, Peri, Malagò, Massimo, Mirza, Darius, Morris, Peter J., Pallan, Arvind, Paul, Andreas, Pavel, Mihai, Perera, M. Thamara P. R., Pirenne, Jacques, Ravikumar, Reena, Russell, Leslie, Upponi, Sara, Watson, Chris J. E., Weissenbacher, Annemarie, Ploeg, Rutger J., and Friend, Peter J.

Abstract

Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.

Published
2018
Full Text
View/download PDF

7. Dexamethasone reduces emesis after major gastrointestinal surgery (DREAMS).

Author

Hamilton, Emma, Ravikumar, Reena, Bartlett, David, Hepburn, Elizabeth, Hwang, Mei-Ju, Mirza, Nazzia, Bahia, Sandeep S., Wilkey, Anthony, Chilton, Helen Bodenham, Handley, Kelly, Magill, Laura, Morton, Dion, Bodenham Chilton, Helen, and West Midlands Research Collaborative

Subjects
*DEXAMETHASONE, *VOMITING, *GASTROINTESTINAL diseases, *SURGICAL complications, *POSTOPERATIVE care, *DIGESTIVE system diseases, *SURGICAL excision, *CLINICAL trials
Abstract

Background: Postoperative nausea and vomiting is one of the most common complications affecting patients after surgery and causes significant morbidity and increased length of hospital stay. It is accepted that patients undergoing surgery on the bowel are at a higher risk. In the current era of minimally invasive colorectal surgery combined with enhanced recovery, reducing the incidence and severity of postoperative nausea and vomiting is particularly important. Dexamethasone is widely, but not universally used. It is known to improve appetite and gastric emptying, thus reduce vomiting. However, this benefit is not established in patients undergoing bowel surgery, and dexamethasone has possible side effects such as increased risk of wound infection and anastomotic leak that could adversely affect recovery.Design: DREAMS is a phase III, double-blind, multicenter, randomized controlled trial with the primary objective of determining if preoperative dexamethasone reduces postoperative nausea and vomiting in patients undergoing elective gastrointestinal resections. DREAMS aims to randomize 1,350 patients over 2.5 years.Patients undergoing laparoscopic or open colorectal resections for malignant or benign pathology are randomized between 8 mg intravenous dexamethasone and control (no dexamethasone). All patients are given one additional antiemetic at the time of induction, prior to randomization. Both the patient and their surgeon are blinded as to the treatment arm.Secondary objectives of the DREAMS trial are to determine whether there are other measurable benefits during recovery from surgery with the use of dexamethasone, including quicker return to oral diet and reduced length of stay. Health-related quality of life, fatigue and risks of infections will be investigated.Trial Registration: ISRCTN21973627. [ABSTRACT FROM AUTHOR]

Published
2013
Full Text
View/download PDF

8. Incidence and outcome of colorectal cancer in liver transplant recipients: A national, multicentre analysis on 8115 patients

Author

Keith J. Roberts, Andrea Monaco, Andrew K. Burroughs, Nicola E. Owen, Giuseppe Fusai, Gianluca Rompianesi, Stephen J. Wigmore, Michael Allison, Parthi Srinivasan, Emmanuel Tsochatzis, Bridget Gunson, Sophie Jose, Bimbi Fernando, R. Ravikumar, Anuja Athale, Gourab Sen, Derek Manas, Felicity Creamer, Darius F. Mirza, Rompianesi, Gianluca, Ravikumar, Reena, Jose, Sophie, Allison, Michael, Athale, Anuja, Creamer, Felicity, Gunson, Bridget, Manas, Derek, Monaco, Andrea, Mirza, Dariu, Owen, Nicola, Roberts, Keith, Sen, Gourab, Srinivasan, Parthi, Wigmore, Stephen, Fusai, Giuseppe, Fernando, Bimbi, Burroughs, Andrew, and Tsochatzis, Emmanuel

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Time Factor, Colorectal cancer, medicine.medical_treatment, Population, Cholangitis, Sclerosing, colorectal cancer, Colorectal Neoplasm, Kaplan-Meier Estimate, Liver transplantation, Gastroenterology, Primary sclerosing cholangitis, ulcerative coliti, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Retrospective Studie, Internal medicine, medicine, Humans, education, Retrospective Studies, education.field_of_study, Hepatology, liver transplantation, business.industry, Incidence (epidemiology), Incidence, Risk Factor, Retrospective cohort study, Middle Aged, medicine.disease, Ulcerative colitis, United Kingdom, Transplantation, Survival Rate, 030220 oncology & carcinogenesis, primary sclerosing cholangiti, 030211 gastroenterology & hepatology, Colitis, Ulcerative, Female, Colorectal Neoplasms, business, Human
Abstract

BACKGROUND AND AIMS: De novo malignancies after liver transplantation represent one of the leading causes of death in the long-term. It remains unclear if liver transplant recipients have an increased risk of colorectal cancer and if this negatively impacts on survival, particularly in those patients affected by primary sclerosing cholangitis and ulcerative colitis.METHODS: In this national multicentre cohort retrospective study, the incidence of colorectal cancer in 8115 evaluable adult patients undergoing a liver transplantation between January 1st 1990 and December 31st 2010 was compared to the incidence in the general population through standardised incidence ratios.RESULTS: 52 (0.6%) cases of colorectal cancer were identified at a median of 5.6 years post liver transplantation, predominantly grade 2 (76.9%) and stage T3 (50%) at diagnosis. The incidence rate of colorectal cancer in the whole liver transplant population was similar to the general UK population (SIR 0.92), but significantly higher (SIR 7.0) in the group of patients affected by primary sclerosing cholangitis/ulcerative colitis. One, five and ten-year survival rates from colorectal cancer diagnosis were 71%, 48% and 31% respectively and the majority of colorectal cancer patients died of cancer-specific causes.CONCLUSIONS: Liver transplantation alone is not associated with an increased risk of colorectal cancer development. The primary sclerosing cholangitis/ulcerative colitis liver transplant population showed a significantly higher risk of colorectal cancer development than the general population, with a high proportion of advanced stage at diagnosis and a reduced patient survival. This article is protected by copyright. All rights reserved.

Published
2019

Catalog

Books, media, physical & digital resources
See catalog results