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Clinical Transplantation

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https://www.readbyqxmd.com/read/28805270/histoplasmosis-in-transplant-recipients
#1
REVIEW
Kiran Gajurel, Reshika Dhakal, Stan Deresinski
Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-transplant histoplasmosis (PTH) in SOT is uncommon with an incidence of ≤ 1% and is even rarer in HCT patients. The majority of PTH in SOT is diagnosed in the first 2 years following transplantation...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28805267/practices-in-the-evaluation-of-potential-kidney-transplant-recipients-who-are-elderly-a-survey-of-us-transplant-centers
#2
Didier A Mandelbrot, Aaron Fleishman, James R Rodrigue, Silas P Norman, Milagros Samaniego
Limited data exists regarding the evaluation and selection of older candidates for transplantation. To help guide the development of program protocols and help define research questions in this area, we surveyed US transplant centers regarding their current practices in the evaluation of older kidney transplant candidates. We emailed a 28-question survey to the medical and surgical directors of 190 adult kidney transplant programs in the US. We received usable responses from 59 programs, a 31.1% response rate...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28805261/pregnancy-outcomes-and-impact-of-pregnancy-on-graft-function-in-women-after-kidney-transplantation
#3
Fa Mohammadi, M Borg, A Gulyani, S P Mcdonald, S Jesudason
BACKGROUND: Kidney transplantation facilitates pregnancy in women with end-stage kidney disease, however impact of pregnancy on short and longer-term graft function is uncertain. METHODS: Obstetric, foetal and graft outcomes for pregnancies from a large Australian transplant unit (1976-2015) were reviewed. RESULTS: There were 56 pregnancies in 35 women with mean age at conception 30.4±0.6 years and mean transplant-pregnancy interval 5.5±0...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28801969/anesthetic-management-for-intestinal-transplantation-a-decade-of-experience
#4
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previous published reports suggest that these cases should be managed peri-operatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of sixty-seven isolated intestinal, intestinal-pancreas and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28792635/favorable-results-in-abo-incompatible-renal-transplantation-without-b-cell-targeted-therapy-advantages-and-disadvantages-of-rituximab-pretreatment
#5
Manabu Okada, Yoshihiko Watarai, Kenta Iwasaki, Kenta Murotani, Kenta Futamura, Takayuki Yamamoto, Takahisa Hiramitsu, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Asami Takeda, Kunio Morozumi, Kazuharu Uchida, Takaaki Kobayashi
The effectiveness of desensitization with rituximab in ABO-incompatible renal transplantation (ABO-I) has been widely reported. However, ABO-I outcomes are still worse than those of ABO-identical or ABO-compatible renal transplantation (ABO-Id/C). We retrospectively examined the outcomes in consecutive living donor ABO-Id/C (n = 412) and ABO-I (n = 205) cases to elucidate the causes of inferiority in ABO-I. ABO-I cases included recipients treated with rituximab (RIT, n = 131), splenectomy (SPX, n = 21), or neither because of low anti-A/B antibody titers (NoR/S, n = 53)...
August 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28787529/significant-arterial-complications-after-pancreas-transplantation-a-single-center-experience-and-review-of-literature
#6
Kunal Yadav, Shamar Young, Erik B Finger, Raja Kandaswamy, David E R Sutherland, Jafar Golzarian, Ty B Dunn
Arterial fistulas and pseudoaneurysms are rarely described significant arterial complications associated with pancreas transplantation that sometimes present with herald or catastrophic bleeding. We herein describe our institutional case series with a focus on management and outcomes. Of 2256 pancreas transplants, 24 arterial complications were identified in 23 recipients. Chart review was performed to describe the clinical characteristics, treatments and outcomes of the complications (pseudoaneurysm, arterial enteric/cystic/ureteric fistula, or arteriovenous fistula)...
August 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28786501/angiogenesis-on-coronary-angiography-is-a-marker-for-accelerated-cardiac-allograft-vasculopathy-as-assessed-by-intravascular-ultrasound
#7
Richard Cheng, Evan P Kransdorf, Janet Wei, Jignesh K Patel, Jon A Kobashigawa, Babak Azarbal
BACKGROUND: Errant neovascularization and coronary artery fistulae (CAF) are frequently observed after cardiac transplantation. The relationship between angiographic neovascularization/CAF and coronary plaque progression is unknown. METHODS: Angiography and intravascular ultrasound were routinely performed at 4-6 weeks and 1-yr post-transplant. Pts were divided into three groups: no angiographic angiogenesis (Group 1), neovascularization only (Group 2), and CAF (Group 3)...
August 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28772351/the-influence-of-functional-warm-ischemia-time-on-dcd-liver-transplant-recipients-outcomes
#8
Jessica C Coffey, Kerollos N Wanis, Diethard Monbaliu, Nicholas Gilbo, Markus Selzner, Neeta Vachharajani, Mark A Levstik, Max Marquez, Mb Majella Doyle, Jacques Pirenne, David Grant, Julie K Heimbach, William Chapman, Kelly Vogt, Roberto Hernandez-Alejandro
BACKGROUND: Duration of functional warm ischemia (f-WIT) is thought to have a causal effect on outcomes in controlled donation after circulatory death (DCD) liver transplantation (LT). METHODS: A retrospective cohort study was conducted at five centers. Data were extracted on donor and recipient characteristics, with attention to parameters recorded during withdrawal of life support to in-situ cold perfusion. F-WIT was the time elapsed from any of the hemodynamic and oxygenation parameters to the start of in-situ cold perfusion...
August 3, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28766766/graft-quality-matters-impact-of-kdpi-and-delayed-kidney-transplantation-in-combined-liver-kidney-transplantation
#9
LETTER
Burcin Ekser, Richard S Mangus, Chandrashekhar A Kubal, John A Powelson, Jonathan A Fridell, William C Goggins
No abstract text is available yet for this article.
August 2, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28766759/value-of-a-flow-cytometry-crossmatch-in-the-setting-of-a-negative-complement-dependent-cytotoxicity-crossmatch-in-heart-transplant-recipients
#10
Britton C Keeshan, Matthew J O'Connor, Kimberly Y Lin, Dimitrios Monos, Curt Lind, Christopher E Mascio, J Eduardo Rame, Thomas L Spray, Robert E Shaddy, Joseph W Rossano
Complement-dependent cytotoxicity crossmatch (CDCXM) is used for evaluation of preformed HLA-specific antibodies in patients undergoing heart transplantation. Flow cytometry crossmatch (FCXM) is a more sensitive assay and used with increasing frequency. To determine the clinical relevance of a positive FCXM in the context of negative CDCXM in heart transplantation, the United Network for Organ Sharing (UNOS) database was analyzed. Kaplan-Meier analysis and Cox proportional hazard modeling were used to assess graft survival for three different patient cohorts defined by crossmatch results: T-cell and B-cell CDCXM+ ("CDCXM +" cohort), CDCXM- but T-cell and/or B-cell FCXM+ ("FCXM+" cohort), and T-cell/B-cell CDCXM- and FCXM- ("XM-" cohort)...
August 2, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28758244/lung-transplantation-delays-gastric-motility-in-patients-without-prior-gastro-intestinal-surgery-a-single-center-experience-of-412-consecutive-patients
#11
Sameer A Hirji, Brian C Gulack, Brian R Englum, Paul J Speicher, Asvin M Ganapathi, Asishana A Osho, Rahul A Shimpi, Alexander Perez, Matthew G Hartwig
PURPOSE: To examine the impact of lung transplantation on gastric motility. METHODS: Adult recipients at a large, single center, who were retrospectively evaluated with solid gastric emptying (SGE) study post lung transplantation, but had no history of gastrointestinal intervention (i.e. pyloroplasty or fundoplication), were selected between June 2005 and August 2013. Multivariable logistic regression was performed to determine risk factors associated with delayed gastric emptying (DGE) after transplantation...
July 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28758236/morphometric-age-and-survival-following-kidney-transplantation
#12
Michael N Terjimanian, Patrick W Underwood, David C Cron, Joshua J Augustine, Kelly A Noon, Devan A Cote, Stewart C Wang, Michael J Englesbe, Kenneth J Woodside
BACKGROUND: As patients with chronic kidney disease become older, there is greater need to identify who will most benefit from kidney transplantation. Analytic morphomics has emerged as an objective risk assessment tool distinct from chronologic age. We hypothesize that morphometric age is a significant predictor of survival following transplantation. METHODS: A retrospective cohort of 158 kidney transplant patients from 2005 to 2014 with 1-year pre-operative imaging was identified...
July 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28753240/risk-of-early-intermediate-and-late-rejection-following-heart-transplantation-trends-over-the-past-25-years-and-relation-to-changes-in-medical-management-tertiary-center-experience-the-sheba-heart-transplantation-registry
#13
Moshe Katz, Dov Freimark, Eugenia Raichlin, Yedael Har-Zahav, Michael Arad, Yigal Kassif, Amir Peled, Elad Asher, Dan Elian, Alexander Kogan, Nir Shlomo, Efrat Ofek, Jacob Lavee, Ilan Goldenberg, Yael Peled
AIM: To explore the trends in the risk for rejection following heart transplantation (HT) over the past 25 years, and their relation to changes in medical management. METHODS: The study population comprised 216 HT patients. Rejection periods were defined: 0-3 months (early), 3-12 months (intermediate), 12+ months (late). HT era was dichotomized: 1991-1999 (remote era) and 2000-2016 (recent era). Medication combination was categorized as newer (TAC, MMF, everolimus) vs...
July 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28753218/a-review-of-late-complications-of-allogeneic-hematopoietic-stem-cell-transplantations
#14
REVIEW
Erden Atilla, Pinar Ataca Atilla, Selami Kocak Toprak, Taner Demirer
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treament of different malignant and nonmalignant diseases. Early transplant-related mortality after allo-HSCT has decreased with reduced-intensity conditioning regimens and effective anti-infectious treatments, but late transplant related mortality is still a problem. Physicians are now paying more attention to late complications that may worsen the quality of life of many transplant recipients. Chronic graft versus host disease (cGVHD) is one of the major causes of late transplant-related mortality after allo-HSCT...
July 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28752907/down-regulation-of-protective-genes-are-associated-with-cellular-and-antibody-mediated-rejection
#15
Hui Tzu Lin-Wang, Reginaldo Cipullo, Jarbas Jakson Dinkhuysen, Marco Aurelio Finger, João Manoel Rossi, Edileide de Barros Correia, Mário Hiroyuki Hirata
Despite advances in immunosuppressive therapy, rejection still remains the main obstacle to a successful transplant. This study aims to explore the gene expression profile of the rejection process in order to decrease the number of unnecessary endomyocardial biopsies in stable patients. METHODS: Total of 300 formalin fixed and paraffin embedded (FFPE) endomyocardial biopsy, sampled from 63 heart allograft recipients were included in this study. Acute cellular rejection (ACR) and antibody mediated rejection (AMR) were diagnosed by histological analysis and immunohistochemical C4d staining, respectively...
July 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28748581/coronary-artery-calcium-may-stabilize-following-islet-cell-transplantation-in-patients-with-type-1-diabetes
#16
J M Madrigal, R S Monson, B Hatipoglu, J Oberholzer, G T Kondos, K A Varady, K K Danielson
Islet cell transplantation can functionally cure type 1 diabetes, and also improve carotid-intima media thickness. This study provides a preliminary description of changes in coronary artery calcium following islet transplantation, and associated factors. Coronary artery calcium was measured in 14 patients with type 1 diabetes (11 had measures both pre- and post-transplant [mean 2.3 years]) in the University of Illinois at Chicago's clinical trial. Multivariable mixed-effects linear regression of repeated measures was used to quantify calcium change, and determine if this change was longitudinally associated with risk/protective factors...
July 27, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28748575/kidney-transplantation-in-ghana-is-the-public-ready
#17
Vincent Boima, Vincent Ganu, Dzifa Dey, Ernest Yorke, Alfred Yawson, Yvonne Otchere, Stella Nartey, Anna Gyaban-Mensah, Margaret Lartey, C Charles Mate-Kole
BACKGROUND: The burden of End Stage Renal Disease (ESRD) is reported to be higher among people of African ancestry. Majority do not have access to kidney transplantation. Africans in general, are less likely to donate a kidney or receive a transplant. AIMS: The present study surveyed public perceptions of kidney transplantation in an inner city and suburban communities in Ghana. It examined people's willingness to either accept or donate a kidney to save a life...
July 27, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28736953/neutropenia-in-kidney-and-liver-transplant-recipients-risk-factors-and-outcomes
#18
Thomas A Mavrakanas, Marie-Andrée Fournier, Sarah Clairoux, Jacques-Alexandre Amiel, Marie-Eve Tremblay, Donald C Vinh, Christian Coursol, Daniel J G Thirion, Marcelo Cantarovich
No studies have directly compared the key characteristics and outcomes of kidney (KTx) and liver transplantation (LTx) recipients with neutropenia. In this single-center, retrospective, cohort study, we enrolled all adult patients who received a KTx or LTx between 2000 and 2011. Neutropenia was defined as two consecutive absolute neutrophil count (ANC) values <1500/mm(3) in patients without preexisting neutropenia. The first neutropenia episode occurring during the first-year posttransplantation was analyzed...
July 24, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28712148/influence-of-kidney-offer-acceptance-behavior-on-metrics-of-allocation-efficiency
#19
Andrew Wey, Nicholas Salkowski, Bertram L Kasiske, Ajay K Israni, Jon J Snyder
We investigated associations of deceased donor kidney offer acceptance with likelihood of the kidney being discarded, cold ischemia time at transplant (CIT), and likelihood of the kidney being exported outside the donation service area (DSA). We used kidney offers from donors in the Scientific Registry of Transplant Recipients July 1, 2015-June 30, 2016, and a stratified logistic regression to estimate odds ratios of acceptance for candidates wait-listed in a DSA. We estimated associations between these ratios and likelihood of discard or export and CIT at transplant...
July 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28712111/long-term-outcomes-and-transmission-rates-in-hepatitis-c-virus-positive-donor-to-hepatitis-c-virus-negative-kidney-transplant-recipients-analysis-of-united-states-national-data
#20
G Gupta, L Kang, J W Yu, A J Limkemann, V Garcia, D Bandyopadhyay, D Kumar, H Fattah, M Levy, A H Cotterell, A Sharma, C S Bhati, T Reichman, A L King, R K Sterling
The use of kidneys from hepatitis C virus (HCV) positive (D+) deceased donors for HCV negative recipients (R-) might increase the donor pool. We analyzed the national OPTN registry from 1994-2014 to compare the outcomes of HCV D+/R- (n=421) to propensity matched HCV donor negative (D-)/R- kidney transplants, as well as with, wait listed patients who never received a transplant, in a 1:5 ratio (n = 2105, per matched group). Both 5-year graft (44% vs. 66%; p < 0.001) and patient survival (57% vs. 79%; p < 0...
July 16, 2017: Clinical Transplantation
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