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Clinical Transplantation

Jérémy Clément, Benjamin Taton, Pierre Merville, Jean-François Viallard, Estibaliz Lazaro, Lionel Couzi, Etienne Rivière
No abstract text is available yet for this article.
June 15, 2018: Clinical Transplantation
Sarah Streeter Hutcheson, Victoria Phillips, Rachel Patzer, Andrew Smith, J David Vega, Alanna A Morris
BACKGROUND: Medicaid insurance in Georgia provides limited reimbursement for heart transplant (HT) and left ventricular assist devices (LVAD). We examined whether insurance type affects eligibility for and survival after receipt of HT or LVAD. METHODS AND RESULTS: We retrospectively identified patients evaluated for HT/LVAD from 2012 to 2016. We used multivariable logistic and Cox proportional hazards regression to examine the association of insurance type on treatment eligibility and one year survival...
June 15, 2018: Clinical Transplantation
Jasper M M Vanhoof, Bert Vandenberghe, David Geerts, Pieter Philippaerts, Patrick De Mazière, Annette DeVito Dabbs, Sabina De Geest, Fabienne Dobbels
Traditional quantitative and qualitative research methods inadequately capture the complexity of patients' daily self-management. Contextual inquiry methodology, using home visits, allows a more in-depth understanding of how patients integrate immunosuppressive medication intake, physical activity and healthy eating in their daily lives, and which difficulties they experience when doing so. This mixed-method study comprised two home visits in 19 purposively selected adult heart, lung, liver and kidney transplant patients, asking them to demonstrate how they implement the aforementioned health behaviours...
June 13, 2018: Clinical Transplantation
Tony Lu, Stephanie G Yi, Jean Bismuth, Richard J Knight, A Osama Gaber, Carlos F Bechara
Renal transplantation remains the definitive treatment for end stage renal disease (ESRD). The shorter renal vein in right donor nephrectomies is associated with higher incidence of technical failure. We present here our experience with autologous internal jugular vein (IJV) conduits to facilitate living-donor transplants. Six patients underwent right, living-donor kidney transplant with simultaneous IJV harvest over a one year period. All had bilateral jugular duplex scans preoperatively, and were placed on aspirin 81 mg postoperatively...
June 11, 2018: Clinical Transplantation
Petra Glander, Johannes Waiser, Silke Kasbohm, Frank Friedersdorff, Robert Peters, Birgit Rudolph, Kaiyin Wu, Klemens Budde, Lutz Liefeldt
The use of once-daily tacrolimus in de novo kidney transplantation is increasingly common. Therefore, we were interested in bioavailability aspects of novel once-daily tacrolimus (LCPT, Envarsus) and once-daily tacrolimus extended-release formulation (ER-Tac, Advagraf) compared with twice-daily immediate-release tacrolimus (IR-Tac, Prograf). Furthermore, we calculated the costs. Kidney allograft recipients on tacrolimus-based immunosuppression within two clinical trials were included in a single center analysis...
June 11, 2018: Clinical Transplantation
Laura J Wozniak, Tian L Mauer, Robert S Venick, Jonathan W Said, Roy L Kao, Pamela Kempert, Elizabeth A Marcus, Vilayphone Hwang, Elaine Y Cheng, Ronald W Busuttil, Sue V McDiarmid, Douglas G Farmer
Post-transplant lymphoproliferative disease (PTLD) has the highest incidence following intestinal transplantation (ITx). Our center has seen a recent increase in PTLD. Our aim was to review a single-center PTLD experience with a focus on clinical characteristics and outcomes. We completed a retrospective review of biopsy-proven PTLD cases using a prospectively maintained database of 115 ITx recipients transplanted between 1991-2014. Nineteen (17%) ITx recipients developed 25 PTLD cases during a median follow-up time of 6...
June 11, 2018: Clinical Transplantation
Quirino Lai, Fabio Melandro, Massimo Rossi, Franco Ruberto, Francesco Pugliese, Gianluca Mennini
Growing enthusiasm around machine perfusion (MP) in clinical liver transplantation (LT) may be the preamble for standardized practice to expand the donors' pool. The present systematic review investigated all the liver transplantations performed using grafts treated with MP. A systematic review of 309 papers was performed. Eventually, 27 articles were enrolled for the study. A total number of 173 cases was reported. Only 12 cohort studies were identified: the remaining ones were case reports or case series...
June 6, 2018: Clinical Transplantation
Yasbanoo Moayedi, Aliya F Gulamhusein, Heather J Ross, Jeffrey J Teuteberg, Kiran K Khush
The current mismatch between supply of and demand for donor organs has prompted transplant clinicians to consider innovative solutions to broaden the donor pool. Despite a 10% increase in the number of organ donors available from 2015 to 2016, wait times remain unacceptable for the 4,000 patients listed for heart transplantation in the United States (US). (1) Many hearts that would otherwise be acceptable go unused because the donors have hepatitis C virus (HCV). Advancements and availability of highly efficacious and safe direct acting antiviral (DAA) therapy for chronic HCV allows consideration of use of organs from viremic, nucleic acid testing (NAT) positive donors in HCV negative recipients...
June 5, 2018: Clinical Transplantation
Harpreet Singh Grewal, Kristin B Highland, Kenneth McCurry, Olufemi Akindipe, Marie Budev, Atul C Mehta
Lung transplant remains an established treatment for end stage lung disease, but limited organ availability remains a major barrier and contributor to waitlist mortality.1 Only 20% of available organs are considered suitable for lung transplantation.1,2 Successful lung transplantation has been reported from donors infected with bacterial or fungal organisms but there is a paucity of evidence regarding the use of donors with bacterial meningitis.3-5 METHOD: The Cleveland Clinic lung transplant database was retrospectively reviewed for patients between January 1998 and December 2014...
June 4, 2018: Clinical Transplantation
Avi Baskin, Ariella Maghen, Tom Mone, Jeffrey Veale
No abstract text is available yet for this article.
June 3, 2018: Clinical Transplantation
Attila Kovács, Bálint Lakatos, Endre Németh, Béla Merkely
No abstract text is available yet for this article.
June 3, 2018: Clinical Transplantation
Juan Betuel Ivey-Miranda, Marta Farrero-Torres
No abstract text is available yet for this article.
June 3, 2018: Clinical Transplantation
Fatemeh Hendijani, Negar Azarpira, Maryam Kaviani
We systematically collected eligible data to measure the effect of CYP3A5*1 expression on personalized tacrolimus therapy. Six databases were searched for studies on adult liver transplant recipients and donors of liver graft which reported tacrolimus dose requirement, trough blood concentration and/or concentration/dose (C/D) ratio in expressers and non-expressers of CYP3A5*1. Eligible data were pooled by meta-analysis. Sixteen observational studies (1309 recipients, 1044 donors of liver graft) were included in the analyses...
June 1, 2018: Clinical Transplantation
Shareen Forbes, Anna Lam, Angela Koh, Sharleen Imes, Parastoo Dinyari, Andrew J Malcolm, Am James Shapiro, Peter A Senior
Following islet transplantation, mixed meal tolerance tests (MMTs) are routinely utilised to assess graft function, but how the 90-minute MMTT glucose value relates to a 120 minute glucose concentration of ≥11.1mmol/L used to diagnose diabetes following a standardised 75g-OGTT, is not known. We examined this relationship further. Thirteen subjects with Type 1 diabetes and stable transplant grafts, not on exogenous insulin with HbA1c<7% (53mmol/mol), were studied on 17 occasions with paired OGTTs and MMTTs...
May 31, 2018: Clinical Transplantation
L S Vest, F M Koraishy, Z Zhang, N N Lam, M A Schnitzler, V R Dharnidharka, D Axelrod, A S Naik, T A Alhamad, B L Kasiske, G P Hess, K L Lentine
While guidelines support metformin as a therapeutic option for diabetic patients with mild-to-moderate renal insufficiency, the frequency and outcomes of metformin use in kidney transplant recipients are not well described. We integrated national U.S. transplant registry data with records from a large pharmaceutical claims clearinghouse (2008-2015). Associations (adjusted hazard ratio, 95% LCL aHR95% UCL ) of diabetes regimens (with and excluding metformin) in the first year post-transplant with patient and graft survival over the subsequent year were quantified by multivariate Cox regression, adjusted for recipient, donor, and transplant factors and propensity for metformin use...
May 31, 2018: Clinical Transplantation
Yusuf Aytaç Tohma, Hüseyin Akıllı, Mahir Kırnap, Asuman Nihan Haberal, Dilan Akyel, Hatice Yağmur Zengin, Hulusi Bülent Zeyneloğlu, Esra Kuşçu, Ali Ayhan, Mehmet Haberal
BACKGROUND: In this study, we aimed to determine the frequency of histopathologic outcomes of solid-organ transplantation in women with abnormal uterine bleeding (AUB) receiving immunosupressive therapies. METHODS: This is a retrospective study including a single-center experience. Data were extracted from hospital records, and solid-organ transplant recipients who were diagnosed with AUB were included. RESULTS: Fifty-five of these patients were renal transplant recipients (79...
May 31, 2018: Clinical Transplantation
Isabel Campos-Varela, Eliana Z Agudelo, Norah A Terrault
BACKGROUND: Clearance of hepatitis C virus (HCV) under antiviral therapy, including direct acting antivirals (DAAs), has been associated with higher risk of rejection. Whether patients who are not on immunosuppression (IS) during DAA therapy are at higher risk of rejection is unknown. METHODS: Four transplant recipients who were off IS and treated with DAA therapy were identified. For each identified patient, one control on stable IS was included. RESULTS: All patients were genotype 1 infection and treated for 12 weeks with sofosbuvir/ledipasvir/ribavirin...
May 31, 2018: Clinical Transplantation
Marilena Casartelli Liviero, Davide Simion, Francesco Procaccio
No abstract text is available yet for this article.
May 28, 2018: Clinical Transplantation
Jade M Kozuch, Ashley Feist, Gordon Yung, Linda Awdishu, Steven Hays, Jonathan P Singer, Rebecca Florez
In November 2013, posaconazole delayed release (DR) tablets were approved by the FDA with the labeled dose of 300 mg daily for fungal prophylaxis. There are no studies demonstrating the appropriate dose in lung transplant recipients (LTR). We performed a two-center retrospective cohort study of LTR taking posaconazole DR tablets for prophylaxis between January 2014 and January 2017. Mean serum trough concentrations and percentage of measurements ≥ 0.7 mcg/mL were compared by daily dose. Forty-nine subjects with 156 steady state serum posaconazole concentrations were included...
May 28, 2018: Clinical Transplantation
Amit Iyengar, Oh Jin Kwon, Yas Sanaiha, Christian Eisenring, Reshma Biniwale, David Ross, Abbas Ardehali
In 2005, the Lung Allocation Score (LAS) was implemented as the allocation system for lungs in the US. We sought to compare 5-year lung transplant outcomes before and after the institution of the LAS. Between 2000-2011, 501 adult patients were identified, with 132 from January 2000-April 2005 (Pre-LAS era) and 369 from May 2005-December 2011 (Post-LAS era). Kruskal-Wallis or chi-squared test was used to determine significance between groups. Survival was censored at 5 years. Overall, the post-LAS era was associated with more restrictive lung disease, higher LAS scores, shorter wait list times, more preoperative immunosuppression, and more single lung transplantation...
May 27, 2018: Clinical Transplantation
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