(no subject)

[novapsyche]

Woman's Abdominal Organs Removed in Unique Cancer Surgery: Taking out stomach, pancreas, liver, spleen, small intestine and large intestine led to lifesaving operation -- amazing, and why didn't anyone think of this before?

Comments

Oh, I can think of a handful of reasons why.

[flinx.livejournal.com]

Given my background in transplant research... yeah.

1) Removing 1 organ from a living donor for transplant purposes (i.e. a kidney or a liver lobe) is already considered a traumatic surgery with long recovery times and lots and lots and lots of post-surgical attention. Pulling 6 at once... eesh.

2) Ischemic injury is the single greatest threat to organ damage in transit/in storage for any organ. The damage that tissue suffers from losing a) blood flow, b) oxygen levels, and c) over-cooling can be subtle and pernicious, and there's no way of checking until well after the patient's in the RR.

3) They took out, what, 15% of the woman's total body mass? And chilled all of that mass to 4 degrees centigrade? And then re-inserted those organs? So, on top of anaesthesia, control of blood loss, major changes in blood pressure (they pulled the portal vein?!?!? Holeeeeeee... just wow), the surgical team has to then deal with a patient with major hypothermia.

4) Surgery on the intestines, especially the large intestines, is always, always, always a major operation for one issue and one alone: infection control. 75% of the organisms in your body live in your lower gut (large intestine), and the surgeons just opened that up into a previously sterile space. Doesn't matter if the bowel's empty of food... colonization density is insane.

So... yeah, I can think of a bunch of reasons why nobody wanted to attempt it. And I'm even more impressed that someone tried it, and pulled it off the first time--that's balls. I understand the woman's drive... but yowch.

Re: Oh, I can think of a handful of reasons why.

[blackwinterbyrd.livejournal.com]

ischemia=bad. isn't there some way of preserving living tissue temporarily? I dunno, If we can do explant culture...why isn't there some kind of perfusion media to keep the tissue oxygenated without chilling to slow degradation?

Re: Ischemia tech

[flinx.livejournal.com]

Well, explant culture is a significantly different beast from maintaining function in an intact organ. The additives thrown into tissue culture media are generally not suitable (and not allowed) for use in patients.

I suppose that if someone were far-seeing enough to stockpile their own blood and serum, that *could* be used to keep their own organs fed and oxygenated for an operation like this... but I haven't even heard of that being tried in animal research.

And one of the paradoxical things about trying to keep organ tissue oxygenated--there is the propensity for isolated organs to increase their oxygen requirements, often inducing oxidative damage to the cells in question.

So, for now, ice-cold lactated Ringer's is the best option surgeons have. I know a lot of work goes into finding improvements, but it's a slow process. =-/

[rmeidaking.livejournal.com]

What flinx said.

They didn't say how long it has been since she had the surgery. She has a long recovery process ahead of her. My cousin's husband has had multiple surgeries on his intestines due to a disease I can't find on line right now. Every time, there's a three-week lag before he can really eat again. This lady has to go through that healing process. I hope they publish an update in six months.

I think that someone had to get to where she was - imminent death without the procedure, and with enough money to pay for it, because I'll bet her insurance company isn't paying for it - before a doctor would take it on.

[blackwinterbyrd.livejournal.com]

well allright!
I'm interested/concerned about these artificial blood vessels. whats up with that? Are they permanent?