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American Journal of Transplantation

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https://www.readbyqxmd.com/read/28432744/kidney-paired-donation-program-versus-global-kidney-exchange-in-india
#1
LETTER
Vivek Kute, Rahul M Jindal, Narayan Prasad
We read with interest the recent article on global kidney exchange (GKE) to overcome financial incompatibility in developing country for living kidney transplantation. Authors proposed that enabling GKE will overcome "poverty barrier" in developing countries and "immunologic barrier" in developed countries. The need for renal replacement therapy in India is staggering; only 2% of patients with renal failure were managed with kidney transplantation(2) . This article is protected by copyright. All rights reserved...
April 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28432742/living-donor-uterus-transplantation-a-single-center-s-observations-and-lessons-learned-from-early-setbacks-to-technical-success
#2
G Testa, E C Koon, L Johannesson, G McKenna, T Anthony, G B Klintmalm, R T Gunby, A M Warren, J M Putman, G dePrisco, J M Mitchell, K Wallis, M Olausson
Uterus transplantation is a vascularized composite allograft transplantation. It allows women who do not have a uterus to become pregnant and deliver a baby. In this paper we analyze the first 5 cases of Living Donor Uterus Transplantation performed in the US. The first 3 recipients lost their uterus grafts at day 14, 12 and 6 after transplant. Vascular complications, related to both inflow and outflow problems, were identified as the primary reason for the graft losses. Two recipients, 6 and 3 months post-transplant have functioning grafts with regular menstrual cycles...
April 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28432723/comment-kidney-exchange-to-overcome-financial-barriers-to-kidney-transplantation
#3
LETTER
L S Baines, R M Jindal
Rees et al. have shown the feasibility of global kidney exchange (GKE) to overcome financial cost and address the current shortage of organs for transplantation. Wiseman and Gill, question their interpretation of definition of "financial incompatibility". The authors(1) do not factor in the well documented cognitive and emotional aspects of kidney transplantation. Particularly, relevant to kidney transplantation is how patients calculate risk and the emotional turmoil characterised by anxiety and fear which are directly correlated to post-transplant adherence...
April 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28432716/deciphering-tacrolimus-induced-toxicity-in-pancreatic-%C3%AE-cells
#4
J Triñanes, A E Rodriguez-Rodriguez, Y Brito, A Wagner, A P J De Vries, G Cuesto, A Acebes, E Salido, A Torres, E Porrini
β-cell transcription factors like: FoxO1, MafA, PDX-1, NeuroD, are dysfunctional in type 2 diabetes (T2DM). PTDM resembles T2DM and reflects interaction between pre-transplant insulin resistance and immunosuppressants, mainly calcineurin inhibitors. We evaluated the effect of tacrolimus, cyclosporine-A and metabolic stressors (glucose+palmitate) on insulinoma β-cells (INS-1) in vitro and in pancreata of obese and lean Zucker rats. Cells were cultured for five days with 100μM palmitate and 22mM glucose; cyclosporin-A (250ng/mL) or tacrolimus (15ng/mL) were added the last 48h...
April 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28425206/considering-tangible-benefit-for-interdependent-donors-extending-a-risk-benefit-framework-in-donor-selection
#5
Sarah E Van Pilsum Rasmussen, Macey L Henderson, Jeffrey Kahn, Dorry Segev
From its infancy, live donor transplantation has operated within a framework of acceptable risk to donors. Such a framework presumes that risks of living donation are experienced by the donor while all benefits are realized by the recipient, creating an inequitable distribution that demands minimization of donor risk. We suggest that this risk-tolerance framework ignores tangible benefits to donor. A previously proposed framework more fully considers potential benefits to the donor and argues that risks and benefits must be balanced...
April 20, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422434/rat-hindlimb-cryopreservation-and-transplantation-a-step-towards-organ-banking
#6
Amir Arav, Or Friedman, Yehudit Natan, Eyal Gur, Nir Shani
In 2016 over 5 million reconstructive procedures were performed in the USA. The recent successes of clinical vascularized composite allotransplantations (VCA), hand and face transplantations included, established the tremendous potential of these life-enhancing reconstructions. Nevertheless, Due to limited availability and lifelong immunosuppression, application is limited. Long term banking of composite transplants may increase the availability of esthetically compatible parts with partial or complete HLA matching, reducing the risk of rejection and the immunosuppressive burden...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422431/effect-of-empagliflozin-on-tacrolimus-induced-pancreas-islet-dysfunction-and-renal-injury
#7
J Jin, L Jin, K Luo, S W Lim, B H Chung, C W Yang
An inhibitor of sodium glucose co-transporter type 2 (SGLT-2) is recommended in type 2 diabetes mellitus (DM) but its use is still undetermined in Tacrolimus (TAC)-induced DM. We evaluated the effect of empagliflozin (Em) on TAC-induced pancreatic islet dysfunction and renal injury in experimental model of TAC-induced DM and in vitro. TAC induced a two-fold increase in SGLT-2 expression, while Em decreased SGLT-2 expression and further increased urinary glucose excretion compared to the TAC group. Em reduced hyperglycemia and increased plasma insulin level, pancreatic islet size and glucose-stimulated insulin secretion (GSIS) compared to the TAC group...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422412/histological-evolution-of-bk-virus-associated-nephropathy-importance-of-integrating-clinical-and-pathological-findings
#8
Cinthia B Drachenberg, John C Papadimitriou, Muhammad R Chaudhry, Richard Ugarte, Manju Mavanur, Beje Thomas, Charles Cangro, Nadiesda Costa, Emilio Ramos, Matthew R Weir, Abdolreza Haririan
Long term clinicopathological studies of BK-associated nephropathy (PyVAN) are not available. We studied 206 biopsies (71 patients), followed 3.09±1.46y after immunosuppression reduction. The biopsy features (% SV40+staining and inflammation +/- acute rejection) were correlated with viral load dynamics and serum creatinine to define the clinicopathological status (PyVCPS). Incidence of acute rejection was 28% in the 2(nd) biopsy and 50% subsequently (25% mixed TCMR+AMR; rejection overall affected 38% of patients (>50% AMR)...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422410/reply-to-comment-on-the-article-optn-srtr-2015-annual-data-report-pancreas
#9
LETTER
R Kandaswamy, P G Stock, S K Gustafson, M Skeans, B Thompson, B L Kasiske
The OPTN/SRTR Annual Data Report surveys all solid-organ transplants, and deceased donor recovery and transplant economics, and attempts to maintain methodological consistency across chapters. We include multivisceral transplants in each organ-specific chapter, unless otherwise noted in a figure caption, as the most practical approach for including all transplants in the survey. This article is protected by copyright. All rights reserved.
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#10
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Model for End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422403/blood-chimerism-in-dizygotic-monochorionic-twins-during-five-years-observation
#11
Morten Hanefeld Dziegiel, Morten Høgh Hansen, Sofie Haedersdal, Angela Natalie Barrett, Klaus Rieneck, Katharina Maria Main, Anne Todsen Hansen, Frederik Banch Clausen
Dizygotic monochorionic twin pregnancies can result in blood chimerism due to in utero twin-to-twin exchange of stem cells. In this case, we examined the proportion of allogeneic red blood cells (RBCs) by flow cytometry and the proportion of allogeneic nucleated cells by digital PCR at seven months and again at five years. We found an increase in the proportion of allogeneic cells from 63% to 89% in one twin, and a similar increase in autologous cells in the other twin from 57% to 84%. A paradigm for stem cell therapy could be modelled on this case: induction of tolerance and chimerism by antenatal transfusion of donor stem cells...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28421672/a-transplant-specific-quality-initiative-introducing-transqip-a-joint-effort-of-the-asts-and-acs
#12
Justin Parekh, Clifford Ko, Jacqueline Lappin, Stuart Greenstein, Ryutaro Hirose
In an attempt to improve surgical quality in the field of transplantation, the American College of Surgeons (ACS) and American Society and Transplant Surgeons have initiated a national quality improvement program in transplantation. This transplant specific quality improvement program, called TransQIP, has been built from the ground up by transplant surgeons and captures detailed information on donor and recipient factors as well as transplant specific outcomes. It is built upon the existing ACS/NSQIP infrastructure and is designed to capture 100% of liver and kidney transplants performed at participating sites...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28397388/risk-of-thyroid-cancer-among-solid-organ-transplant-recipients
#13
Cari M Kitahara, Elizabeth L Yanik, Paul W Ladenson, Brenda Y Hernandez, Charles F Lynch, Karen S Pawlish, Eric A Engels
Solid organ transplant recipients have an elevated incidence of thyroid cancer. We evaluated a wide range of potential risk factors in a cohort of 229,300 U.S. solid organ transplant recipients linked with 15 stage/regional cancer registries (1987-2012). Incidence rate ratios (IRRs) were adjusted for age, sex, race/ethnicity, transplanted organ, year of transplant, and time since transplant. Hazards ratios (HRs) for death and/or graft failure were adjusted for age, sex, race/ethnicity, transplanted organ, and year of transplant...
April 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28397363/improved-time-to-notification-of-impending-brain-death-and-increased-organ-donation-using-an-electronic-clinical-decision-support-system
#14
J L Zier, A B Spaulding, M Finch, T Verschaetse, R Tarrago
Early referral of patients to an organ procurement organization (OPO) may positively impact donation outcomes. We implemented an electronic clinic decision support (CDS) system to automatically notify our OPO of children meeting clinical triggers indicating impending brain death. Medical records of all patients who died in a pediatric critical care unit or were referred for imminent death for three years prior to installation of the initial CDS (pre-CDS) and for one year after implementation of the final CDS (post-CDS) were reviewed...
April 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28397358/depletion-resistant-cd4-t-cells-enhance-thymopoiesis-during-lymphopenia
#15
Katayoun Ayasoufi, Ran Fan, Anna Valujskikh
Lymphoablation is routinely used in transplantation, and its success is defined by the balance of pathogenic versus protective T cells within reconstituted repertoire. While homeostatic proliferation and thymopoiesis may both cause T cell recovery during lymphopenia, the relative contributions of these mechanisms remain unclear. The goal of this study was to investigate the role of the thymus during T cell reconstitution in adult allograft recipients subjected to lymphoablative induction therapy. Compared to euthymic mice, thymectomized heart allograft recipients demonstrated severely impaired CD4 and CD8 T cell recovery and prolonged heart allograft survival after lymphoablation with murine anti-thymocyte globulin (mATG)...
April 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28397351/the-resurgence-of-xenotransplantation
#16
Peter J Cowan, A Joseph Tector
There has been an upsurge of interest in xenotransplantation in recent years. This resurgence can attributed to a combination of factors. First, there has been a dramatic improvement in efficacy in several preclinical models, with maximum xenograft survival times increasing to 950 days for islets, 945 days for hearts, and 310 days for kidneys. Second, the rapid development of genome editing technology (particularly the advent of CRISPR/Cas9) has revolutionized the capacity to generate new donor pigs with multiple protective genetic modifications; what once took many years to achieve can now be performed in months, with much greater precision and scope...
April 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28394489/cancer-in-solid-organ-transplant-recipients-there-is-still-much-to-learn-and-do
#17
EDITORIAL
E A Engels
No abstract text is available yet for this article.
April 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28394486/chemotherapy-and-transplantation-the-role-of-immunosuppression-in-malignancy-and-a-review-of-antineoplastic-agents-in-solid-organ-transplant-recipients
#18
REVIEW
J C Krisl, V P Doan
It is estimated that solid organ transplant recipients have a two- to fourfold greater overall risk of malignancy than the general population. Some of the most common malignancies after transplant include skin cancers and posttransplant lymphoproliferative disorder. In addition to known risk factors such as environmental exposures, genetics, and infection with oncogenic viruses, immunosuppression plays a large role in the development of cancer through the loss of the immunosurveillance process. The purpose of this article is to explain the role of immunosuppression in cancer and to review the classes of chemotherapeutics...
April 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28390109/vascularized-composite-allograft-vca-donation-and-transplantation-a-survey-of-public-attitudes-in-the-united-states
#19
James R Rodrigue, David Tomich, Aaron Fleishman, Alexandra K Glazier
Vascularized composite allograft (VCA) transplantation has emerged as a groundbreaking surgical intervention to return identity and function following traumatic injury, congenital deformity, or disfigurement. While public attitudes toward traditional organ/tissue donation are favorable, little is known about attitudes toward VCA donation and transplantation. A survey was conducted of 1,485 U.S. residents in August 2016 to assess VCA donation attitudes. Participants also completed the Revised Health Care System Distrust Scale...
April 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28390107/post-transplant-lymphoproliferative-disorder-following-clinical-islet-transplantation-report-of-the-first-two-cases
#20
Anthea Peters, Tolu Olateju, Jean Deschenes, Santosh H Shankarnarayan, Neil Chua, A M James Shapiro, Peter Senior
We report the first two cases of post-transplant lymphoproliferative disorder (PTLD) in recipients of islet transplants worldwide. First, a 44-year old recipient of 3 islet infusions developed PTLD 80 months after his initial transplant, presenting with abdominal pain and diffuse terminal ileum thickening on imaging. He was treated with surgical excision, reduction of immunosuppression and rituximab. Seven months later he developed central nervous system PTLD, presenting with vertigo and diplopia; immunosuppression was discontinued, resulting in graft loss, and he was given high-dose methotrexate and consolidative autologous stem cell transplant...
April 8, 2017: American Journal of Transplantation
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