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Clinical Transplantation

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https://www.readbyqxmd.com/read/29245181/revealing-a-new-mode-of-sensitization-induced-by-mechanical-circulatory-support-devices-impact-of-anti-at1-r-antibodies
#1
X Zhang, J Mirocha, T Aintablian, S Dimbil, J Moriguchi, F Arabia, J A Kobashigawa, N L Reinsmoen
BACKGROUND: Increased levels of angiotensin II type 1 receptor (AT1 R) antibody have been shown to be associated with allograft rejection. This study aims to determine the rate of development of antibody to AT1 R after Mechanical Circulatory Support Device (MCS) implantation, and if development of strong binding AT1 R antibodies is associated with survival. METHODS: 88 patients who had one MCS implantation were accessed based on serum availability. MCS in this cohort included pneumatic bilateral paracorporeal ventricular assist device, continuous flow left ventricular assist device, and total artificial heart...
December 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29226480/successful-pancreas-transplantation-alone-is-associated-with-excellent-self-identified-health-score-and-glucose-control-a-retrospective-study-from-a-high-volume-center-in-the-united-states
#2
Joseph R Scalea, Lauren Pettinato, Blythe Fiscella, Amanda Bartosic, Allison Piedmonte, Jastine Paran, Niket Todi, Eric J Siskind, Stephen T Bartlett
BACKGROUND: The benefits of pancreas transplantation are often difficult to measure. Here, we sought to determine the difference in quality of life for diabetic patients with and without a functional pancreas transplant alone (PTA). METHODS: PTA cases from 1993-2015 were considered. An IRB-approved survey inclusive of 15 questions spanning 4 domains was employed. Chi-square, Fischer's exact, and the T-test were used where appropriate. RESULTS: 137 PTAs were performed during the study period...
December 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29226393/analysis-of-abo-chimera-from-peripheral-red-cells-and-reticulocytes-by-flow-cytometry-and-micro-gel-column-technique-in-patients-post-abo-incompatible-hsct
#3
Jianhua Chen, Feng Liu
BACKGROUND: How to choose an appropriate method to monitoring dynamic ABO chimera post ABO incompatible HSCT is crucial to not only assess the status of erythroid engraftment but achieve personalized safety transfusion. METHODS: We evaluated the efficacy of micro gel column technique(MGCT) and flow cytometry(FCM) by series of artificial ABO chimera mixtures from 0.5% to 50% and by investigated 15 cases of ABO incompatible HSCT patients with longitudinally ABO blood grouping and ABO chimera from RBCs and reticulocytes...
December 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29226391/experience-with-leflunomide-as-treatment-and-as-secondary-prophylaxis-for-cytomegalovirus-infection-in-lung-transplant-recipients-a-case-series-and-review-of-the-literature
#4
Jose Tiago Silva, Virginia Pérez-González, Francisco López-Medrano, Rodrigo Alonso-Moralejo, Mario Fernández-Ruiz, Rafael San-Juan, Patricia Brañas, María Dolores Folgueira, José María Aguado, Alicia de Pablo-Gafas
Data concerning the use of leflunomide -a drug approved for rheumatoid arthritis with in vitro anti-cytomegalovirus (CMV) activity- in lung transplant (LT) recipients are scarce. We performed a single center retrospective study including LT recipients who received leflunomide for CMV infection or as secondary prophylaxis after viremia clearance. We also conducted a full systematic PubMed search until June 30, 2017. We identified 5 LT recipients in our center, plus 7 patients reported in the literature. All patients had previously received ganciclovir (GCV) and foscarnet, with drug-induced adverse effects described in 6 recipients (50%)...
December 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29222929/hiv-deceased-donor-referrals-a-national-survey-of-organ-procurement-organizations
#5
Ayla Cash, Xun Luo, Eric K H Chow, Mary Grace Bowring, Ashton A Shaffer, Brianna Doby, Corey E Wickliffe, Charles Alexander, Deborah McRann, Aaron A R Tobian, Dorry L Segev, Christine M Durand
BACKGROUND: HIV-infected (HIV+) donor organs can be transplanted into HIV+ recipients under the HIV Organ Policy Equity (HOPE) Act. Quantifying HIV+ donor referrals received by Organ Procurement Organizations (OPOs) is critical for HOPE Act implementation. METHODS: We surveyed the 58 US OPOs regarding HIV+ referral records and newly discovered HIV+ donors. Using data from OPOs that provided exact records and CDC HIV prevalence data, we projected a national estimate of HIV+ referrals...
December 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29220082/benefits-of-multimodal-enhanced-recovery-pathway-in-patients-undergoing-kidney-transplantation
#6
Kevin A Espino, J Reinier F Narvaez, Michael C Ott, Liise K Kayler
BACKGROUND: Use of Enhanced recovery after surgery (ERAS) pathways to accelerate functional recovery and reduce length of stay (LOS) has rarely been investigated in kidney transplantation (KTX). MATERIALS AND METHODS: Consecutive adult isolated KTXs between 7/2015-7/2016 (ERAS, n=139) were compared with a historical cohort between 1/2014-7/2015 (HISTORIC, n=95). RESULTS: ERAS recipients were significantly more likely to receive kidneys that were non-local (56...
December 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29220079/hepatitis-c-virus-genotyping-of-organ-donor-samples-to-aid-in-transplantation-of-hcv-positive-organs
#7
Caren Gentile, Vivianna M Van Deerlin, David S Goldberg, Peter P Reese, Richard D Hasz, Peter Abt, Emily Blumberg, Midhat S Farooqi
Given the availability of new highly efficacious anti-HCV therapies, some clinicians have advocated for wider use of kidneys from hepatitis C virus-positive (HCV+) donors, including transplanting them into HCV-negative recipients. Since treatment regimens for HCV are commonly guided by genotype, pre-transplant HCV genotyping of tissue donors would be beneficial. To our knowledge, donor HCV genotyping has never been reported. We retrieved archived frozen plasma samples for 17 previous organ donors through a local organ procurement organization...
December 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29194767/evolution-of-lung-and-kidney-allograft-function-in-patients-receiving-kidney-after-lung-transplantation
#8
Nina T Weber, Marco Bonani, Christian Benden, Andreas Schleich, Thomas Fehr, Thomas F Mueller, Macé M Schuurmans
Calcineurin inhibitor (CNI) toxicity leads to ESRD in almost half of long-term survivors after lung transplantation, some of them receiving kidney transplants. Little is known about the outcomes of kidney and lung allograft function following kidney after lung transplantation (KALTPL) in the modern era. We retrospectively analyzed a group of 13 consecutive patients who received a KALTPL with respect to their renal and pulmonary function and immunological evolution over 2 years. We documented a stable evolution of forced expiratory volume in one second (FEV1) after KALTPL in most patients as well as an excellent kidney graft during the 2-year follow-up period...
December 1, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29194762/cholinesterase-levels-predict-exercise-capacity-in-cardiac-recipients-early-after-transplantation
#9
Kazufumi Kitagaki, Michio Nakanishi, Rei Ono, Kazuya Yamamoto, Yuji Suzuki, Noriyuki Fukui, Hidetoshi Yanagi, Harumi Konishi, Masanobu Yanase, Norihide Fukushima
PURPOSE: Although cardiac rehabilitation is recommended for patients early after heart transplantation (HTx), adequate exercise effect cannot always be obtained, partly because in patients with chronic heart failure, exercise capacity is reduced due to malnutrition during waiting for HTx. This study aimed to investigate the relationships between exercise capacity and clinical variables, including nutritional indicators, early after HTx. PATIENTS AND METHODS: Forty three HTx recipients were studied...
December 1, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29194758/utility-of-transthoracic-needle-biopsy-after-lung-transplantation
#10
John Kavanagh, Miranda Siemienowicz, Shaf Keshavjee, Patrik Rogalla, Lianne Singer, Sonja Kandel
The purpose of this study was to assess the diagnostic yield and complications of CT guided transthoracic needle biopsy (TTNB) after lung transplantation. A database search identified all TTNB performed in lung transplant patients over a 14-year period. 42 biopsies in transplant patients (transplant group) were identified and matched to the next biopsy performed in native lungs by the same operator (non-transplant group) as a control. Primary outcomes recorded were diagnosis, diagnostic yield, pneumothorax requiring intervention and symptomatic pulmonary hemorrhage...
December 1, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29194769/intravascular-ultrasound-of-the-proximal-left-anterior-descending-artery-is-sufficient-to-detect-early-cardiac-allograft-vasculopathy
#11
Vincent Floré, Adam J Brown, Stephen J Pettit, Nick Ej West, Clive Lewis, Jayan Parameshwar, Stephen P Hoole
MAIN PROBLEM: Cardiac allograft vasculopathy (CAV) can be detected early with intravascular ultrasound (IVUS) but there is limited information on the most efficient imaging protocol. METHODS: Coronary angiography and IVUS of the 3 coronary arteries were performed. Volumetric IVUS analysis was performed and a Stanford grade determined for each vessel. RESULTS: 18 patients were included 18 (range 12-24) months after transplantation. Angiographic CAV severity ranged from none (CAV0) to mild (CAV1) whereas IVUS CAV severity ranged from none (Stanford grade I) to severe (grade IV)...
November 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29194757/response-to-renz-and-diaz-the-impact-of-adult-to-adult-living-donor-liver-transplantation-on-transplant-center-outcomes-reporting
#12
LETTER
Nicholas Salkowski, Andrew Wey, Jon J Snyder, Bertram L Kasiske
No abstract text is available yet for this article.
November 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29193383/blood-transfusion-is-a-critical-determinant-of-resource-utilization-and-total-hospital-cost-in-liver-transplantation
#13
Jose Ruiz, Adam Dugan, Daniel L Davenport, Roberto Gedaly
OBJECTIVE: The aim of this study is to identify factors associated with increased resource use and total hospital cost after liver transplantation (LT). METHODS: A study of liver transplantation patients undergoing surgery between January 2008 to December 2013 was performed. Main end points were LOS, ICU LOS, days on the ventilator, total hospital costs (THC), service area costs. RESULTS: 191 patients undergoing LT were included in the analysis...
November 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29193362/donor-specific-anti-hla-antibodies-are-not-associated-with-non-anastomotic-biliary-strictures-but-both-are-independent-risk-factors-for-graft-loss-after-liver-transplantation
#14
Anne Claire den Dulk, Xiaolei Shi, Cornelia J Verhoeven, Jeroen Dubbeld, Frans H J Claas, Ron Wolterbeek, Simone H Brand-Schaaf, Hein W Verspaget, Arantza Fariña Sarasqueta, Luc J W van de Laan, Herold J Metselaar, Bart van Hoek, Jaap Kwekkeboom, Dave L Roelen
Donor-specific alloantibodies (DSA) have been associated with rejection and shorter graft survival after orthotopic liver transplantation (OLT). We examined the role of DSA in non-anastomotic biliary strictures (NAS) after OLT. Patients receiving first OLT who developed NAS (n=68) and a control group without NAS (n=83), with pre-OLT and 12 months post-OLT serum samples were included. DSA were specified using the Luminex single antigen test. Risk factors for NAS and graft survival were analysed. The presence of preformed DSA was not significantly different between patients with NAS and controls (p=0...
November 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29193356/sofosbuvir-plus-daclatasvir-with-or-without-ribavirin-is-safe-and-effective-for-post-transplant-hepatitis-c-recurrence-and-severe-fibrosis-and-cirrhosis-a-prospective-study
#15
Raffaella Lionetti, Vincenza Calvaruso, Paola Piccolo, Rossella Letizia Mancusi, Chiara Mazzarelli, Stefano Fagiuoli, Marzia Montalbano, Ilaria Lenci, Paola Carrai, Giovanni Guaraldi, Ubaldo Visco-Comandini, Martina Milana, Marco Biolato, Laura Loiacono, Giovanna Valente, Antonio Craxì, Mario Angelico, Gianpiero D'offizi
BACKGROUND: In 2012 an Italian Named Patient Program began for hepatitis C virus (HCV)-infected liver transplant (LT) recipients with advanced fibrosis, before approval of direct antiviral agents (DAA), to benefit severely ill patients. Aim of this "real-life" study was to assess treatment efficacy and safety with an extended course of daclatasvir (DCV) plus sofosbuvir (SOF) with or without ribavirin (RBV). METHODS: All HCV LT recipients with severe fibrosis in 15 Italian transplant centers were treated with DCV+SOF±RBV for 24 weeks; sustained virological response was assessed at 12 weeks post-treatment (SVR12)...
November 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29168222/the-prognostic-significance-of-frailty-compared-to-peak-oxygen-consumption-and-b-type-natriuretic-peptide-in-patients-with-advanced-heart-failure
#16
Yasbanoo Moayedi, Juan G Duero Posada, Farid Foroutan, Livia A Goldraich, Ana C Alba, Jane MacIver, Heather J Ross
Frailty assessment has become an integral part of the evaluation of potential candidates for heart transplantation and ventricular assist device (HTx/VAD). The impact of frailty, as a heart failure risk factor or to identify those who will derive the greatest benefit with HTx/VAD remains unclear. The aim of this study was to evaluate the independent prognostic relevance of frailty assessment from peak oxygen consumption (peak VO2 ) or B-type natriuretic peptide (BNP) on mortality in patients referred for advanced heart failure therapies...
November 23, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29161757/impact-of-cyp3a5-genomic-variances-on-clinical-outcomes-among-african-american-kidney-transplant-recipients
#17
Tomefa E Asempa, Lorita M Rebellato, Suzanne Hudson, Kimberly Briley, Angela Q Maldonado
Little is known about the impact of CYP3A5 polymorphisms on transplantation outcomes among African-American (AA) kidney transplant recipients. To assess this issue, clinical outcomes were compared between AA CYP3A5*1 expressers versus non-expressers. This retrospective cohort study analyzed AA kidney transplant recipients. Biopsy-proven acute rejection (BPAR), delayed graft function (DGF), glomerular filtration rate (GFR), infections and tacrolimus dosing requirements were examined in 106 immunologically high-risk AA kidney transplant patients over a 2 year follow-up period...
November 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29160909/revisiting-chronic-rejection-following-living-donor-liver-transplantation-in-the-tacrolimus-era-a-single-centre-experience
#18
Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Dheeraj Gautam, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Thiagrajan Srinivasan, Sanjay Kumar Yadav, Arvinder Soin
BACKGROUND AND AIMS: Chronic rejection (CR) is an uncommon but important cause of graft dysfunction, leading to graft loss and often requires re-transplantation. This study evaluates the incidence and outcome of patients with CR at a large living donor liver transplant (LDLT) centre. METHODS: Data of patients with CR was retrospectively analyzed in 1232 adult (age >18 years) LDLT on Tacrolimus (mainly) based immunosuppression. Sirolimus/Everolimus (mTOR inhibitors) were added to baseline immunosuppression as rescue therapy in patients with CR...
November 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29154411/effect-of-graft-size-matching-on-pediatric-living-donor-liver-transplantation-at-a-single-center
#19
Jun-Jie Li, Cai-Hua Zu, Shi-Peng Li, Wei Gao, Zhong-Yang Shen, Jin-Zhen Cai
We retrospectively analyzed 252 patients with end-stage liver disease who had undergone LDLT from January 2009 to September 2015. Of these, 25 had a GRWR of <2.0% (Group A), 204 had a GRWR of ≥2.0% or <4.0% (Group B), and 23 had a GRWR ≥4.0% (Group C). The three GRWR groups demonstrated similar characteristics, except for recipient age and recipient BMI. The overall one, two, and three-year graft survival rates were 95.1%, 93.5%, and 93.5%, respectively. However, among the three groups, graft survival rates at one year, two years and three years were significantly different (P=0...
November 20, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29151274/effect-of-hmg-coa-reductase-inhibitors-on-the-development-of-chronic-lung-allograft-dysfunction
#20
Amanda Szczepanik, Amanda Hulbert, Hui-Jie Lee, Clark Benedetti, Laurie Snyder, Jennifer Byrns
Lung transplant recipients (LR) have a reduced median five-year survival of approximately 55% primarily due to chronic lung allograft dysfunction (CLAD). Statins have anti-inflammatory and immunomodulatory effects that may facilitate CLAD prevention. This study sought to evaluate statin effect on CLAD development. Adult bilateral LR from January 2004-October 2013 were included. Statin group included recipients with early statin use and continued for minimum 6 months. Propensity score matching was performed for age, gender and native lung disease to select matched non-statin group...
November 19, 2017: Clinical Transplantation
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