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Clinical Transplantation

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https://www.readbyqxmd.com/read/28523792/the-impact-of-calcineurin-inhibitors-on-neutrophil-gelatinase-associated-lipocalin-and-fibroblast-growth-factor-23-in-long-term-kidney-transplant-patients
#1
Inger Hjørdis Bleskestad, Inga Strand Thorsen, Grete Jonsson, Øyvind Skadberg, Lasse Gunnar Gøransson
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL), a protein with bacteriostatic functions rapidly excreted from stimulated or damaged epithelial cells, is elevated in acute and chronic kidney disease. A calcineurin dependent signaling pathway for fibroblast growth factor 23 (FGF23) has been revealed, but the effect of calcineurin inhibitors (CNIs) on the levels of NGAL and markers of mineral metabolism in long-term kidney transplant patients has not been explored. METHODS: In a cross-sectional study, 39 patients who received a first kidney transplant more than 10 years ago were split into two groups based on whether (n=28) or not (n=11) they used CNIs...
May 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28523715/dual-en-bloc-technique-for-adult-renal-transplantation
#2
Kim Chi Tran, David Li, Ali Taqi, Alp Sener, Vivian C McAlister, Patrick P Luke
INTRODUCTION: We describe and provide follow-up for a novel simplified technique permitting dual en-bloc (DEB) transplantation of adult organs using single in situ arterial and venous anastomoses. METHODS: Twenty-two adult DEB transplants were performed at our centre between 2001 and 2012, utilizing 44 kidneys en bloc. Results were compared with 20 solitary transplants from expanded criteria donors (ECD) associated with lower terminal serum creatinines and Remuzzi biopsy scores vs...
May 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28517493/accuracy-of-computed-tomography-for-detecting-hepatic-steatosis-in-donors-for-liver-transplantation-a-meta-analysis
#3
Danping Zheng, Wenshuo Tian, Zhouying Zheng, Jincui Gu, Zhiyong Guo, Xiaoshun He
BACKGROUND: The accuracy of computed tomography (CT) for detecting donor hepatic steatosis (HS) before liver transplantation is not well established. METHODS: A meta-analysis was performed to determine the accuracy of CT for HS detection in liver donor candidates. Pooled sensitivity, specificity, positive and negative likelihood ratios, hierarchical summary receiver operating characteristic (HSROC) curves, and the area under the curve (AUC) were estimated using HSROC and bivariate random-effects models...
May 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28517242/race-ethnicity-is-associated-with-abo-non-identical-liver-transplantation-in-the-united-states
#4
Jin Ge, John P Roberts, Jennifer C Lai
United Network for Organ Sharing (UNOS) policies allows for ABO non-identical liver transplantation (LT) in candidates with Model for End-Stage Liver Disease (MELD) scores greater than 30. Previous studies showed ABO non-identical LT resulted in an 18% and 55% net gain in livers for B and AB candidates. These results suggested that the current liver ABO allocation policies may need refinement. There are, however, strong associations between ABO blood groups and race/ethnicity. We hypothesized that race/ethnicity is associated with ABO non-identical LT and that this is primarily influenced by recipient ABO status...
May 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28517112/patterns-and-correlates-of-adherence-to-self-monitoring-in-lung-transplant-recipients-during-the-first-12-months-after-discharge-from-transplant
#5
Lu Hu, Annette DeVito Dabbs, Mary Amanda Dew, Susan M Sereika, Jennifer H Lingler
Self-monitoring of lung function, vital signs, and symptoms is crucial for lung transplant recipients (LTRs) to ensure early detection of complications and prompt intervention. This study sought to identify patterns and correlates of adherence to self-monitoring among LTRs over the first 12-months post-discharge from transplant. This study analyzed existing data from the usual care arm participants of a randomized clinical trial who tracked self-monitoring activities using paper-and-pencil logs. Adherence was calculated as the percent of days LTRs recorded any self-monitoring data per interval: hospital discharge-2 months, 3-6 months, and 7-12 months...
May 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28510343/no-effect-of-hla-c-mismatch-after-allogeneic-hematopoietic-stem-cell-transplantation-with-unrelated-donors-and-t-cell-depletion-in-patients-with-hematological-malignancies
#6
I Magalhaes, M Uhlin, M Schaffer, M Sundin, D Hauzenberger, M Remberger, J Mattsson
HLA-C mismatch in unrelated donors hematopoeitic stem cell transplantation (HSCT) has been associated with poor patient outcome. However, the impact of HLA-C mismatch in the context of HSCT combined with in vivo T-cell depletion remains unclear. We therefore performed a single-center, retrospective analysis of the clinical outcome on patients with hematological malignancies treated with allo-HSCT, who underwent T-cell depletion. The majority of the patients (n=276) received a HLA-A, -B, -DRB1 matched graft that were either also HLA-C matched (n=260), or patients with the permissive HLA-C*03:03/03:04 mismatch (n=16), while the remaining patients (n=95) received a HLA-C mismatched graft (excluding HLA-C*03:03/03:04 mismatches)...
May 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#7
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction of immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a five year period following the initiation of a serum BKV screening protocol...
May 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28504869/kidney-outcomes-in-patients-with-liver-cirrhosis-and-chronic-kidney-disease-receiving-an-orthotopic-liver-transplant-alone
#8
Neeraj Singh, Shahab Ahmadzadeh, Hosein Shokouh-Amiri, Yasir Qazi, Adrian Sequeira, Hrishikesh Samant, Robert McMillan, Gazi B Zibari
Kidney transplant in patients with liver cirrhosis and non-dialysis chronic kidney disease (CKD) is controversial. We report 14 liver cirrhotic patients who had persistently low MDRD-6 estimated-glomerular filtration rate (e-GFR) < 40 ml/min/1.73m2 for ≥ 3 months and underwent either liver transplant alone (LTA) (n=9) or simultaneous liver-kidney transplant (SLKT) (n=5). Pre-transplant, patients with LTA compared with SLKT had lower serum creatinine (2.5±0.73 vs. 4.6±0.52 mg/dl, P= 0.001), higher MDRD-6 e-GFR (21...
May 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28497582/an-objective-definition-for-clinical-suspicion-of-t-cell-mediated-rejection-after-liver-transplantation
#9
Manuel Rodríguez-Perálvarez, Laura De Luca, Gonzalo Crespo, Ángel Rubin, Sandra Marín, Salvador Benlloch, Jordi Colmenero, Marina Berenguer, Miguel Navasa, Emmanuel Tsochatzis, Manuel De la Mata
A uniform definition of clinical suspicion of T-cell mediated rejection (TCMR) in liver transplantation (LT) is needed to homogenize clinical decisions, especially within randomized trials. The present multicentre study included a total of 470 primary LT recipients. The derivation cohort consisted of 142 patients who had clinically-driven liver biopsies at any time after LT. The external validation cohort included 328 patients who underwent protocol biopsies at day 7-10 after LT. The rates of moderate-severe histological TCMR were 33...
May 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28497523/high-meld-score-does-not-adversely-affect-outcome-of-living-donor-liver-transplantation-experience-in-1000-recipients
#10
S K Yadav, N Saraf, S Sigal, N S Choudhary, S Goja, A Rastogi, P Bhangui, A S Soin
In countries where deceased organ donation is scarce, there is big gap between demand and supply of organs and living donor liver transplantation (LDLT) plays an important role in meeting this unmet need. This study was conducted to analyse the effect of pre-transplant MELD score on outcomes following LDLT. Outcome of 1000 patients who underwent LDLT from July 2010 to March 2015 was analysed retrospectively. Patients were grouped into low MELD <25 and high MELD ≥25 score to compare short term outcomes...
May 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28489291/long-term-outcomes-of-early-compared-to-late-onset-choledocho-choledochal-anastomotic-strictures-after-orthotopic-liver-transplantation
#11
S K Satapathy, I Sheikh, B Ali, F Yahya, M Kocak, L Parsa, J D Eason, J M Vanatta, S Nair
BACKGROUND: Endoscopic treatment of anastomotic biliary stricture (ABS) after liver transplantation (LT) has been proven to be effective and safe, but long term outcomes of early compared to late onset ABS have not been studied. The aim of this study is to compare the long-term outcome of early ABS to late ABS. METHODS: Of the 806 adult LT recipients (04/2006-12/2012), 93 patients met the criteria for inclusion, and were grouped into non-ABS (No stenosis on ERCP, n=41), early ABS [stenosis < 90 days after LT, 18 (19...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28489256/clinical-and-virologic-outcomes-in-high-risk-adult-ebv-mismatched-organ-transplant-recipients
#12
Deepali Kumar, Nikhil Patil, Shahid Husain, Cecilia Chaparro, Mamatha Bhat, S Joseph Kim, Atul Humar
EBV D+/R- organ transplant recipients are a high-risk group for developing PTLD. Little data are available for prevention in the adult EBV mismatched population. We conducted a retrospective study of EBV D+/R- organ transplants performed during 2002-2014. Of the 153 patients identified, 82.4% patients received antiviral prophylaxis with valganciclovir for a median of 4.5 months (range 0.8-22 months) and 36.6% underwent viral load monitoring in the first post-transplant year. EBV viremia developed in 67.2% monitored patients...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28489255/increased-risk-of-portal-vein-thrombosis-in-patients-with-autoimmune-hepatitis-on-the-liver-transplantation-waiting-list
#13
Pablo Ruiz, Lydia Sastre, Gonzalo Crespo, Annabel Blasi, Jordi Colmenero, Juan Carlos García-Valdecasas, Miquel Navasa
Liver transplantation (LT) is indicated in autoimmune hepatitis (AIH) for both acute presentation with liver failure and end-stage chronic liver disease. Few studies have suggested an association between AIH and coagulation disorders and a higher incidence of portal vein thrombosis (PVT) in patients with AIH listed for LT. The aim of this study was to determine the incidence of thrombotic complications, particularly PVT, in a cohort of 37 patients undergoing LT because of AIH. PVT was present before transplantation in 30% (n=11) of these patients compared to 11% in the whole population transplanted in our centre (p=0...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28489254/use-of-intra-aortic-counterpulsation-in-cardiogenic-shock-post-liver-transplantation
#14
Arun P Palanisamy, Satish N Nadig, Gabriel R Chedister, Jacob E Dowden, David G Koch, William D Stoll, John W McGillicuddy, Kenneth D Chavin
Left ventricular dysfunction resulting in cardiogenic shock occurs infrequently following organ reperfusion in liver transplantation. The etiology of the cardiogenic shock is often multifactorial and difficult to manage due to the complex nature of the procedure and the patient's baseline physiology. Traditionally, this hemodynamic instability is managed medically using inotropic agents and vasopressor support. If medical treatment is insufficient, the use of an intra-aortic balloon pump for counterpulsation may be employed to improve the hemodynamics and stabilize the patient...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28485106/the-national-living-donor-assistance-center-perspective-on-barriers-to-the-use-of-federal-travel-grants-for-living-donors
#15
Amit K Mathur, Barry Hong, Akinolu Ojo, Robert M Merion
Recent research has identified important barriers that potential living organ donors face in utilizing travel reimbursement funds from the National Living Donor Assistance Center (NLDAC). In this article, we provide clarification and comment on these potential barriers from the NLDAC program perspective. The goal of financial neutrality for living donors requires further action. We discuss recent developments and further steps that may help achieve this goal and ultimately affect the shortage of donor organs...
May 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28481436/clinical-yield-of-endoscopic-ultrasound-and-endoscopic-ultrasound-guided-fine-needle-aspiration-for-incidental-pancreatic-cysts-in-kidney-transplant-evaluation
#16
Jared Rejeski, Jeffrey Rogers, Matthew Hauser, Girish Mishra
INTRODUCTION: For several reasons, including an elevated risk for malignancy after transplant, kidney transplant candidates undergo a thorough evaluation prior to transplantation. Further assessment of incidentally discovered pancreatic cysts on routine abdominal imaging has been assumed to be prudent, and the preferred method has been endoscopic ultrasound (EUS) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The clinical utility of EUS/EUS-FNA with respect to transplant decision-making has not been evaluated...
May 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28480572/acute-cellular-rejection-later-than-one-year-after-heart-transplantation-a-single-center-retrospective-study-at-sk%C3%A3-ne-university-hospital-in-lund-1988-2010
#17
Carl Söderlund, Göran Rådegran
Routine endomyocardial biopsy (EMB) to detect acute cellular rejection (ACR) late (> 1 year) after heart transplantation (HT) remains debated. To gain knowledge on late ACR and thereby approach this issue, we studied the incidence, predictors, and outcome of late ACR. 815 late EMBs from 183 patients transplanted 1988-2010 were retrospectively reviewed until June 30, 2012. Only 4.4% of the routine and 17.6% of the additional clinically indicated late EMBs showed ACR ≥ grade 2. With time post-HT, there was a clear trend towards fewer ACRs, a lower incidence of ACR per patient per year, and a deceleration in the decrease in the proportion of patients free from ACR...
May 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28477381/effect-of-diltiazem-on-exercise-capacity-after-heart-transplantation
#18
Sara Varnado, Yael Peled-Potashnik, Ashley Huntsberry, Brian D Lowes, Ronald Zolty, Adam Burdorf, Elizabeth R Lyden, Michael J Moulton, John Y Um, Eugenia Raichlin
BACKGROUND: Sinus tachycardia (ST) is common after heart transplantation (HTx). The aim of the study was to evaluate the effect of Diltiazem treatment during the first year after HTx on heart rate (HR), cardiac allograft function and exercise capacity. METHODS: From the total cohort, 25 HTx recipients started Diltiazem treatment 4±2 weeks after HTx and continued it for at least 1 year (Diltiazem group). Each study case was matched to a control. All patients underwent hemodynamic assessment and cardiopulmonary exercise test (CPET) at one year after HTx...
May 6, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28470796/vitamin-d-fgf-23-axis-in-kidney-transplant-recipients
#19
LETTER
Giuseppe Cianciolo, Irene Capelli, Gaetano La Manna
No abstract text is available yet for this article.
May 4, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28470884/follow-up-of-patients-with-refractory-or-relapsed-multiple-myeloma-after-allogeneic-hematopoietic-cell-transplantation
#20
Corina Schneidawind, Silke Duerr-Stoerzer, Christoph Faul, Lothar Kanz, Katja Weisel, Wolfgang Bethge, Dominik Schneidawind
BACKGROUND: The role of allogeneic hematopoietic cell transplantation (HCT) for the treatment of multiple myeloma is controversial. However, the introduction of proteasome inhibitors and immunomodulatory drugs might influence outcomes in case of relapse or refractory disease after allogeneic HCT. METHODS: We report 41 consecutive patients that underwent allogeneic HCT for the treatment of relapsed or refractory multiple myeloma. RESULTS: Three-year event-free survival (EFS) and overall survival (OS) of the whole cohort were 15% and 51%, respectively...
May 3, 2017: Clinical Transplantation
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