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Clinical Transplantation

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https://www.readbyqxmd.com/read/28083977/nephrectomy-induced-reduced-renal-function-and-the-health-related-quality-of-life-hrqol-of-living-kidney-donors-lkds
#1
Xiao Han, Joel Yu Ming Lim, Lata Raman, Tai Bee Choo, Hersharan Kaur, Angeline Ting Hui Goh, Anantharaman Vathsala, Ho Yee Tiong
OBJECTIVE: To evaluate the health impact of nephrectomy on LKDs by comparing the HrQOL scores measured by Short Form-36 (SF36) between those with and without post-donation renal function impairment (PRFI). METHODS: 82 LKDs (47 females, mean age = 50.2 ± 11.2 years) were prospectively recruited to participate in a SF-36 HrQOL survey. Chart review, individual baseline and postoperative renal function (eGFR) was determined using the Modification of Diet in Renal Disease (MDRD) formula...
January 13, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28075034/abdominal-lean-muscle-is-associated-with-lower-mortality-among-kidney-waitlist-candidates
#2
Jayme E Locke, J Jeff Carr, Sangeeta Nair, James G Terry, Rhiannon D Reed, Grant D Smith, Dorry L Segev, Vineeta Kumar, Cora E Lewis
Morphometric assessments, such as muscle density and body fat distribution, have emerged as strong predictors of cardiovascular risk and post-operative morbidity and mortality. To date, no study has examined morphometric mortality risk prediction among kidney transplant (KT) candidates. KT candidates, waitlisted 2008-2009 were identified (n=96) and followed to the earliest of transplant, death, or administrative end of study. Morphometric measures, including abdominal adipose tissue, paraspinous and psoas muscle composition, and aortic calcification were measured from CTs...
January 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28054388/good-outcome-of-living-donor-liver-transplantation-in-drug-induced-acute-liver-failure-a-single-centre-experience
#3
Narendra Singh Choudhary, Sanjiv Saigal, Neeraj Saraf, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Vijay Vohra, Deepak Govil, Arvinder S Soin
INTRODUCTION: Drug induced acute liver failure (ALF) is associated with high mortality. There is limited literature on results of living donor liver transplantation (LDLT). MATERIAL AND METHODS: The study was conducted at a tertiary care centre in North India. All patients who received LDLT for drug induced ALF were included. The data is shown as median (IQR). RESULTS: A total of 18 patients (15 females and 3 males), aged 34(25-45) years, underwent LDLT for DILI related ALF...
January 5, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28054385/pre-liver-transplant-red-cell-distribution-width-predicts-post-liver-transplant-mortality
#4
M Thure Caire, Ambuj Kumar, R Todd Stravitz, Nyingi Kemmer
PURPOSE: Prognostication following liver transplantation is limited. Red cell distribution width has been associated with morbidity and mortality in a variety of diseases. We hypothesize Red cell distribution width is predictive of mortality post liver transplantation. METHODS: We performed a retrospective cohort study of all consecutive liver transplantation recipients at a tertiary care center from Jan 1 2012 - Dec 31 2012. The primary end point was association of red cell distribution width with 1 year mortality...
January 5, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28039946/why-do-patients-die-after-a-liver-transplantation
#5
K E Daniel, J Eickhoff, M R Lucey
BACKGROUND: As more patients achieve long-term survival, it has become important to understand mortality in LT recipients. METHODS: We conducted retrospective reviews of long-term outcome in two adult LT cohorts: 85,031 in the UNOS database and 1,458 transplanted at the University of Wisconsin (UW). RESULTS: During median follow-up of 3.2 years (UNOS); and 6.6 years (UW), 35.1% of UNOS patients and 44.2% of UW patients died. 43.1% of all UNOS deaths occurred in year one compared to 25...
December 31, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28039914/the-metabolic-syndrome-and-its-components-in-pediatric-survivors-of-allogeneic-hematopoietic-stem-cell-transplantation
#6
Bella Bielorai, Yael Weintraub, Daphna Hutt, Rina Hemi, Hannah Kanety, Dalit Modan-Moses, Gal Goldstein, Dana Hadar, Liat Lerner-Geva, Amos Toren, Orit Pinhas-Hamiel
MetS is a known complication after HSCT that contributes to long-term morbidity. We assessed the prevalence of components of the MetS in pediatric survivors of allogeneic HSCT, and identified associated risk factors. Thirty-eight patients, median age at HSCT, 8.5 years, were evaluated at a median of 3.9 years post HSCT. Overweight or obesity were seen in 23.7% of the patients, 15.8% had hypertension, 15.8% had hypertriglyceridemia and 13% had low HDL-C levels according to age and gender. Four (10.5%) met the criteria of MetS, all were transplanted for malignant disease...
December 31, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28039882/psycho-social-aspects-before-and-up-to-2-years-after-heart-or-lung-transplantation-experience-of-patients-and-their-next-of-kin
#7
Susanna Ågren, Trygve Sjöberg, Björn Ekmehag, Maj-Britt Wiborg, Bodil Ivarsson
BACKGROUND: Psychosocial factors are important for patients undergoing heart (HTx) or lung (LTx) transplantation, and for their next of kin (NoK). AIM: To describe health-related quality of life (patients only), anxiety, depression, stress, coping ability and burden (NoK only) for patients and their NoK before and up to 2 years after HTx or LTx. DESIGN: Adult patients (28 heart and 26 lung) and their appointed NoK were surveyed with questionnaires about specific psychosocial topics when they were accepted for the transplantation waiting list and 6 months, 1 year, and 2 years after transplantation...
December 31, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28035688/reconditioning-by-endischaemic-hypothermic-in-house-machine-perfusion-a-promising-strategy-to-improve-outcome-in-ecd-kidney-transplantation
#8
Anja Gallinat, Vera Amrillaeva, Dieter P Hoyer, Peri Kocabayoglu, Tamas Benko, Jürgen W Treckmann, Marieke van Meel, Undine Samuel, Thomas Minor, Andreas Paul
This clinical study evaluates end-ischaemic hypothermic machine perfusion (eHMP) in ECD kidneys. eHMP was initiated upon arrival of the kidney in our center and continued until transplantation. Between 11/2011 and 8/2014 eHMP was performed in 66 ECD-kidneys for 369 (98-912) minutes after 863 (364-1567) minutes of CS. In 49 out of 66 cases the contralateral kidney from the same donor was preserved by static cold storage (CS) only and accepted by another Eurotransplant center. Fife (10.2%) of these kidneys were ultimately judged as "not transplantable" by the accepting center and discarded...
December 30, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28008662/efficacy-and-safety-of-short-term-treatment-with-isoniazid-and-rifampicin-for-latent-tuberculosis-infection-in-lung-transplant-candidates
#9
Emilio Guirao-Arrabal, Francisco Santos, Javier Redel, José Manuel Vaquero, Julián Torre-Cisneros
BACKGROUND: The current recommendation for the treatment of latent tuberculosis infection (LTBI) in solid organ transplant candidates is isoniazid for 9 months but this treatment has the main problem of frequently reaching the posttransplant period. METHODS: Study of efficacy and safety of a 3 months regimen with isoniazid and rifampicin (3HR) in lung transplant candidates in the Reina Sofía Hospital in Córdoba. RESULTS: 398 lung transplant patients were evaluated...
December 23, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28008661/rescue-alemtuzumab-for-refractory-acute-cellular-rejection-and-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#10
Christopher R Ensor, Lindsey C Rihtarchik, Matthew R Morrell, J W Awori Hayanga, Alicia B Lichvar, Joseph M Pilewski, Stephen Wisniewski, Bruce A Johnson, Jonathan D'Cunha, Adriana Zeevi, John F McDyer
Refractory acute-cellular rejection (rACR) is associated with death and bronchiolitis obliterans syndrome (BOS) post-lung transplantation. We report the largest cohort of lung transplant recipients (LTR) treated with rescue alemtuzumab for rACR or BOS. RACR outcomes included burden of ACR 30-days before and 180-days after rescue assessed by a novel composite rejection standardized score (CRSS, range 0-6); freedom from ≥A2 ACR. BOS outcomes included freedom from BOS progression and FEV1 decline >10%. Univariate parametric and nonparametric statistical approaches were used to assess treatment response...
December 23, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28008659/balf-cytokines-in-different-phenotypes-of-chronic-lung-allograft-dysfunction-in-lung-transplant-patients
#11
C Berastegui, S Gómez-Ollés, S Sánchez-Vidaurre, M Culebras, V Monforte, M López-Meseguer, C Bravo, M A Ramon, L Romero, J Sole, M J Cruz, A Román
The long-term success of lung transplantation (LT) is limited by chronic lung allograft dysfunction (CLAD). Different phenotypes of CLAD have been described, such as bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). The purpose of this study was to investigate levels of cytokines and chemokines in bronchoalveolar lavage fluid (BALF) as markers of these CLAD phenotypes. BALF was collected from 51 recipients who underwent (bilateral and unilateral) LT. The study population was divided into three groups: stable (ST), BOS, and RAS...
December 23, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28008651/determinants-of-pre-transplantation-pectoralis-muscle-area-and-post-transplantation-change-in-pectoralis-muscle-area-in-lung-transplant-recipients
#12
Van Hoang, Gloria W Li, Christina C Kao, Goutham Dronavalli, Amit D Parulekar
BACKGROUND: This study aimed to determine predictors of pectoralis muscle area (PMA) and assess change in PMA following lung transplantation and its relationship to outcomes. METHODS: A retrospective review of 88 lung transplant recipients at a single center was performed. PMA was determined on a single axial slice from chest computerized tomography. Pectoralis muscle index (PMI) was calculated from the PMA divided by the height squared. RESULTS: PMI decreased post transplantation (8...
December 23, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28008650/evolution-of-body-weight-parameters-up-to-3-years-after-solid-organ-transplantation-the-prospective-swiss-transplant-cohort-study
#13
Sonja Beckmann, Nataša Nikolic, Kris Denhaerynck, Isabelle Binet, Michael Koller, Elsa Boely, Sabina De Geest
Obesity and weight gain are serious concerns after solid organ transplantation (Tx); however, no unbiased comparison regarding body weight parameter evolution across organ groups has yet been performed. Using data from the prospective nationwide Swiss Transplant Cohort Study, we compared the evolution of weight parameters up to 3 years post-Tx in 1359 adult kidney (58.3%), liver (21.7%), lung (11.6%), and heart (8.4%) recipients transplanted between May 2008 and May 2012. Changes in mean weight and body mass index (BMI) category were compared to reference values from 6 months post-Tx...
December 23, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28004856/effect-of-early-allograft-dysfunction-on-outcomes-following-liver-transplantation
#14
Jana Hudcova, Catlin Scopa, Jawad Rashid, Ahsan Waqas, Robin Ruthazer, Roman Schumann
Early allograft dysfunction (EAD) following liver transplantation (LT) remains a challenge for patients and clinicians. We retrospectively analyzed the effect of predefined EAD on outcomes in a 10-year cohort of deceased-donor LT recipients with clearly defined exclusion criteria. EAD was defined by at least one of the following: AST or ALT > 2000 IU/L within first week post LT, total bilirubin ≥ 10mg/dL, and/or INR ≥ 1.6 on postoperative day 7. Ten patients developed primary graft failure and were analyzed separately...
December 22, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27992667/prognostic-impact-of-postoperative-low-platelet-count-after-liver-transplantation
#15
Kazuhiro Takahashi, Shunji Nagai, Krishna G Putchakayala, Mohamed Safwan, Amy Y Li, William J Kane, Priyanka L Singh, Kelly M Collins, Michael D Rizzari, Atsushi Yoshida, Gabriel T Schnickel, Marwan S Abouljoud
BACKGROUND: The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts. METHODS: We reviewed all deceased donor LT from 2000 to 2012, and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model. RESULTS: Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR] =1...
December 19, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27988992/outcomes-in-the-highest-panel-reactive-antibody-recipients-of-deceased-donor-kidneys-under-the-new-kidney-allocation-system
#16
Sandesh Parajuli, Robert R Redfield, Brad C Astor, Arjang Djamali, Dixon Kaufman, Didier A Mandelbrot
Since the institution of the new kidney allocation system in December 2014, kidney transplant candidates with the highest calculated panel reactive antibodies (cPRA) of 99-100 have been transplanted at much higher rates. However, concerns have been raised that outcomes in these patients might be impaired due to higher immunological risk and longer cold ischemia times resulting from long-distance sharing of kidneys. Here we compare outcomes at the University of Wisconsin between study patients with cPRA 99-100 and all other recipients of deceased donor kidneys transplanted between 12/04/2014 and12/31/2015...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27988990/cervical-human-papilloma-virus-infection-in-the-early-postoperative-period-after-liver-transplantation-prevalence-risk-factors-and-concordance-with-anal-infections
#17
Karolina Grąt, Michał Grąt, Karolina M Wronka, Bronisława Pietrzak, Barbara Suchońska, Szymon Walter de Walthoffen, Grażyna Młynarczyk, Marek Krawczyk, Mirosław Wielgoś
Solid organ transplant recipients are at increased risk of developing several human papilloma virus (HPV)-related malignancies, including cervical and anal cancers. The purpose of this prospective study was to assess the initial prevalence and risk factors for high-risk HPV (HR-HPV) cervical infections in liver transplant recipients, as well as their concordance with anal infections. A total of 50 female patients were enrolled in the Department of General, Transplant and Liver Surgery at the Medical University of Warsaw (centre with >1600 liver transplantations)...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27988989/single-center-outcomes-of-combined-heart-and-liver-transplantation-in-the-failing-fontan
#18
B A D'Souza, S Fuller, L P Gleason, N Hornsby, J Wald, K Krok, A Shaked, L R Goldberg, A Pochettino, K M Olthoff, Y Y Kim
Long-term outcomes of the Fontan operation include Fontan failure and liver disease. Combined heart-liver transplantation (CHLT) is an option for select patients although limited data exist on this strategy. A retrospective review of Fontan patients 18 years or older referred for cardiac transplant evaluation between 2000 and 2013 at the Hospital of the University of Pennsylvania was performed. All patients were considered for potential CHLT. Clinical variables such as demographics, perioperative factors, and short-term outcomes were reviewed...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27988988/prediction-of-nonalcoholic-fatty-liver-in-prospective-liver-donors
#19
Narendra S Choudhary, Neeraj Saraf, Sanjiv Saigal, Ajay Duseja, Dheeraj Gautam, Lipika Lipi, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Sumana K Ramchandra, Yalakanti Raghavendra Babu, Arvinder S Soin
BACKGROUND: metabolic risk factors should be important in addition to imaging for prediction of steatosis in prospective liver donors. MATERIALS AND METHODS: The study group included all prospective liver donors who had a liver biopsy during work-up. Risk factors of metabolic syndrome were analyzed and body mass index (BMI)≥25 Kg/M(2) was used in place of waist circumference.Three BMI cut-offs (25, 28 and 30 kg/m(2) ) and two CT measured liver attenuation index (LAI) cut-offs (<5 and ≤10) were used for steatosis assessmentof ≥5%, ≥10% and ≥20%...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27988982/pruritus-and-quality-of-life-in-renal-transplant-patients
#20
Vincenzo Panuccio, Rocco Tripepi, Marianna Bellantoni, Licia Saporito, Serena Quattrone, Viviana Lacava, Giovanna Parlongo, Giovanni Tripepi, Francesca Mallamaci, Carmine Zoccali
BACKGROUND: Pruritus has a negative impact on quality of life (QoL) in dialysis patients. The reversibility of this symptom after renal transplantation and its impact upon QoL has scarcely been studied in these patients. METHODS: Pruritus was evaluated by the Visual Analogue Scale (VAS), the Visual Rating Scale (VRS), and the Numerical Rating Scale (NRS) in 133 unselected renal transplant patients, 62 healthy subjects, and 29 hemodialysis patients. QoL was assessed by KDQOL-SF(™) 1...
December 17, 2016: Clinical Transplantation
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