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Clinical Transplantation

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https://www.readbyqxmd.com/read/28316109/airway-inflammation-and-symptoms-in-children-following-liver-and-heart-transplantation
#1
Andrew J Redmann, John C Bucuvalas, Robert E Wood, Clifford Chin, Catherine K Hart
OBJECTIVES: Describe the upper airway endoscopic findings of children with upper airway symptoms after liver transplantation (LT) or heart transplantation (HT). METHODS: Review of children undergoing airway endoscopy after LT or HT from 2011 to 2015 at a tertiary care pediatric hospital. Airway findings, biopsy results, immunosuppression and Ebstein Barr virus (EBV) levels were recorded. RESULTS: Twenty-three of 158 LT (111) and HT (47) recipients underwent endoscopy...
March 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28314081/delirium-after-lung-transplantation-association-with-recipient-characteristics-hospital-resource-utilization-and-mortality
#2
Yelizaveta Sher, Joshua Mooney, Gundeep Dhillon, Roy Lee, José R Maldonado
BACKGROUND: Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized. METHODS: The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS and one-year mortality...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28314080/brain-natriuretic-peptide-and-right-heart-dysfunction-after-heart-transplantation
#3
REVIEW
Samy Talha, Anne Charloux, François Piquard, Bernard Geny
Heart transplantation (HT) should normalize cardiac endocrine function but brain natriuretic peptide (BNP) levels remain elevated after HT, even in the absence of left ventricular haemodynamic disturbance or allograft rejection. Right ventricle (RV) abnormalities are common in HT recipients (HTx), as a result of engraftment process, tricuspid insufficiency and/or repeated inflammation due to iterative endomyocardial biopsies. RV function follow-up is vital for patient management since RV dysfunction is a recognized cause of in-hospital death and is responsible for a worse prognosis...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28314079/low-serum-testosterone-is-associated-with-graft-function-early-after-heart-transplantation
#4
Gregor Poglajen, Mojca Jensterle, Nika Kravos, Andrej Janež, Bojan Vrtovec
BACKGROUND: We sought to investigate a correlation between serum testosterone levels and graft function early after heart transplantation. METHODS: In a cross-sectional study we measured serum testosterone levels 4 weeks after heart transplantation in 49 consecutive male recipients. Echocardiography was done to evaluate graft function. Low serum testosterone was defined as <11 nmol/L. RESULTS: Low serum testosterone was present in 21 (43%) recipients (Group A), and 28 (57%) had normal testosterone levels (Group B)...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28314071/epidemiology-risk-factors-and-outcome-of-clostridium-difficile-infection-in-heart-and-heart-lung-transplant-recipients
#5
Jackrapong Bruminhent, Kelly A Cawcutt, Charat Thongprayoon, Tanya M Petterson, Walter K Kremers, Raymund R Razonable
BACKGROUND: Clostridium difficile is a major cause of diarrhea in thoracic organ transplant recipients. We investigated the epidemiology, risk factors and outcome of Clostridium difficile infection (CDI) in heart and heart-lung transplant (HT) recipients. METHODS: This is a retrospective study from 2004-2013. CDI was defined by diarrhea and a positive toxigenic Clostridium difficile in stool measured by toxin enzyme immunoassay (2004-2006) or polymerase chain reaction (2007-2013)...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28314069/factors-contributing-to-employment-patterns-after-liver-transplantation
#6
Eliza W Beal, Dmitry Tumin, Khalid Mumtaz, Michael Nau, Joseph D Tobias, Don Hayes, Kenneth Washburn, Sylvester M Black
BACKGROUND: Many liver transplant recipients return to work, but their patterns of employment are unclear. We examine patterns of employment 5 years after liver transplantation. METHODS: First-time liver transplant recipients ages 18-60 years transplanted from 2002-2009 and surviving at least 5 years were identified in the United Network for Organ Sharing registry. Recipient's post-transplant employment status was classified as (1) never employed; (2) returned to work within 2 years and remained employed (continuous employment); (3) returned to work within 2 years, but was subsequently unemployed (intermittent employment); or (4) returned to work ≥3 years post-transplant (delayed employment)...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28314052/incidence-of-acute-cellular-rejection-following-granulocyte-colony-stimulating-factor-administration-in-lung-transplantation-a-retrospective-case-cohort-analysis
#7
Nicole Casciello, Amanda Hulbert, Laurie Snyder, Jennifer Byrns
Granulocyte colony-stimulating factor (GCSF) is an option to treat leukopenia in lung transplant recipients. Conflicting evidence exists regarding its effects on acute cellular rejection (ACR). A retrospective, case-cohort study was conducted to assess whether the use of GCSF in lung transplant recipients is associated with an increased incidence of ACR. Patients had to have received at least one dose of GCSF but were excluded if they received GCSF within 30 days prior to transplant or received a lymphocyte-depleting agent within 14 days of GCSF administration...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28301681/biliary-reconstruction-in-liver-transplant-patients-with-primary-sclerosing-cholangitis-duct-to-duct-or-roux-en-y
#8
Alireza Shamsaeefar, Mohammad Shafiee, Saman Nikeghbalian, Kourosh Kazemi, Mohsenreza Mansorian, Nasrin Motazedian, Bita Geramizadeh, Seyed Ali Malekhosseini
INTRODUCTION: Roux-en-Y choledochojejunostomy and duct-to-duct anastomosis are biliary reconstruction methods for liver transplantation. However, there is a controversy over which method produces better results. We have compared the outcome of duct-to-duct anastomosis vs. Roux-en-Y hepaticojujenostomy in patients with primary sclerosing cholangitis who had undergone liver transplant in Shiraz Organ Transplant Center. MATERIALS: The medical records of 405 PSC patients who had undergone liver transplant from 1996-2015 were reviewed...
March 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28299838/pilot-cohort-study-on-the-potential-role-of-tcf7l2-rs7903146-on-ischemic-heart-disease-among-non-diabetic-kidney-transplant-recipients
#9
Marco Quaglia, Claudio Musetti, Guido Merlotti, Armando A Genazzani, Sarah Cargnin, Tiziana Cena, Vincenzo Cantaluppi, Salvatore Terrazzino
BACKGROUND: TCF7L2 rs7903146 C>T polymorphism is associated with diabetes in the general population but its independent impact on cardiovascular disease is debated. On this basis we investigated its association with major adverse cardiac events (MACE) in a single-center cohort of non-diabetic kidney transplant recipients (KTRs). METHODS: Patients with pre-transplant diabetes were excluded and patients who developed post-transplant diabetes were censored at time of diagnosis...
March 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295646/the-epidemiology-of-clostridium-difficile-infection-in-a-national-kidney-transplant-centre
#10
C Kennedy, C Waldron, M Skally, L Gaughan, C Magee, K Burns, F Fitzpatrick
BACKGROUND: We aimed to describe the epidemiology and outcomes of CDI in a national kidney transplant centre from 2008-2015. METHODS: Adult kidney and kidney-pancreas transplant recipients were included for analysis if they met the surveillance CDI case definition. Rates of new healthcare-associated CDI (HA-CDI) were expressed per 10,000 KTR/KTPR bed days used (BDU) to facilitate comparisons. RESULTS: Fifty-two cases of CDI were identified in 42 KTRs and KPTRs...
March 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295629/increased-mid-abdominal-circumference-is-a-predictor-for-surgical-wound-complications-in-kidney-transplant-recipients-a-prospective-cohort-study
#11
M Taha, N F Davis, R Power, P Mohan, J Forde, G Smyth, D M Little
Kidney transplant recipients are at an increased risk of developing surgical site wound complications due to their immunosuppressed status. We aimed to determine if increased mid-abdominal circumference (MAC) is predictive for wound complications in transplant recipients. A prospective study was performed on all kidney transplant recipients from October 2014 to October 2015. 'Controls' consisted of kidney transplant recipients without a surgical site wound complication and 'cases' consisted of recipients that developed a wound complication...
March 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28294407/assessment-of-cardiac-allograft-systolic-function-by-global-longitudinal-strain-from-donor-to-recipient
#12
Adam D DeVore, Fawaz Alenezi, Arun Krishnamoorthy, Mads Ersboll, Marc D Samsky, Phillip J Schulte, Chetan B Patel, Joseph G Rogers, Carmelo A Milano, Eric J Velazquez, Michel G Khouri
BACKGROUND: Cardiac allografts are routinely evaluated by left ventricular ejection fraction (LVEF) before and after transplantation. However, myocardial deformation analyses with LV global longitudinal strain (GLS) are more sensitive for detecting impaired LV myocardial systolic performance compared with LVEF. METHODS: We analyzed echocardiograms in 34 heart donor-recipient pairs transplanted at Duke University from 2000-2013. Assessments of allograft LV systolic function by LVEF and/or LV GLS were performed on echocardiograms obtained pre-explanation in donors and serially in corresponding recipients...
March 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295581/pharmacokinetics-of-prolonged-release-tacrolimus-versus-immediate-release-tacrolimus-in-de-novo-liver-transplantation-a-randomized-phase-iii-sub-study
#13
Bo-Göran Ericzon, Evaristo Varo, Pavel Trunečka, Lutz Fischer, Michele Colledan, Bruno Gridelli, Andrés Valdivieso, John O'Grady, James Dickinson, Nasrullah Undre
BACKGROUND: With the same dose of tacrolimus, lower systemic exposure on the first day of dosing has been reported for prolonged-release tacrolimus compared with immediate-release tacrolimus, prompting investigation of differing initial doses. METHODS: This sub-study of a double-blind, randomized, phase III trial in de novo liver transplant recipients compared the pharmacokinetics of once-daily prolonged-release tacrolimus (initial dose: 0.2mg/kg/day) versus twice-daily immediate-release tacrolimus (initial dose: 0...
March 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295612/relationship-between-pre-transplant-physical-function-and-outcomes-after-kidney-transplant-elizabeth
#14
C Lorenz, Andrea L Cheville, Hatem Amer, Brian R Kotajarvi, Mark D Stegall, Tanya M Petterson, Walter K Kremers, Fernando G Cosio, Nathan K LeBrasseur
BACKGROUND: Performance-based measures of physical function predict morbidity following non-transplant surgery. Study objectives were to determine whether physical function predicts outcomes after kidney transplant and assess how physical function changes post-transplant. METHODS: We conducted a prospective study involving living donor kidney transplants recipients at our center 5/2012 to 2/2014. Physical function was measured using the Short Physical Performance Battery (SPPB) (balance, chair stands, gait speed) and grip strength testing...
March 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295657/severe-acute-cellular-rejection-after-intestinal-transplantation-is-associated-with-poor-patient-and-graft-survival
#15
Genevieve Huard, Thomas D Schiano, Jang Moon, Kishore Iyer
BACKGROUND: Severe acute cellular rejection (ACR) occurs frequently after intestinal transplantation (ITx). AIM: To evaluate the outcomes and the risk factors for graft failure and mortality in patients with severe ACR after ITx. METHODS: Retrospective study evaluating all ITx recipients who developed severe ACR between 01/2000 and 07/2014. Demographic and histologic data were reviewed. RESULTS: 20/126 (15.9%) ITx recipients developed severe ACR...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295652/long-term-survival-following-kidney-transplantation-in-previous-lung-transplant-recipients-an-analysis-of-the-unos-registry
#16
Asishana A Osho, Sameer A Hirji, Anthony W Castleberry, Michael S Mulvihill, Asvin M Ganapathi, Paul J Speicher, Babatunde Yerokun, Laurie D Snyder, Robert D Davis, Mathew G Hartwig
BACKGROUND: Kidney transplantation has been advocated as a therapeutic option in lung recipients who develop end-stage renal disease. This analysis outlines patterns of allograft survival following kidney transplantation in previous lung recipients (KAL). METHODS: Data from the UNOS lung and kidney transplantation registries (1987-2013) were cross-linked to identify lung recipients who were subsequently listed for and/or underwent kidney transplantation. Time-dependent Cox models compared survival in KAL patients vs...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295630/screening-for-asymptomatic-bacteruria-at-one-month-after-adult-kidney-transplantation-clinical-factors-and-implications
#17
Y S B Goh, Z L Deng, P S C Cheong, R Lata, T H A Goh, A Vathsala, H Y Tiong
OBJECTIVE: Urinary tract infections(UTI) account for significant morbidity after kidney transplantation(KT). Screening for asymptomatic bacteruria(AB) has proven to be beneficial in certain population including pregnant women; however it is not well-studied in KT population. We reviewed the incidence, clinical features and implications of asymptomatic bacteruria one-month after KT. METHODS: 171 adult KT patients(86(50.3%) living transplants, 87(50.9%) males, mean age 47...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295622/low-vitamin-d-exposure-is-associated-with-higher-risk-of-infection-in-renal-transplant-recipients
#18
Hari V Kalluri, Lauren M Sacha, Amanda I Ingemi, Michael A Shullo, Heather J Johnson, Puneet Sood, Amit D Tevar, Abhinav Humar, Raman Venkataramanan
BACKGROUND: Vitamin-D is a steroid hormone with multiple vital roles within the immune system. Various studies evaluated the influence of vitamin-D on infections post-renal transplantation and found contrasting results. This study aims to assess the relationship between vitamin-D status and the incidence of infection in renal transplant recipients. METHODS: This is a retrospective cohort study of adult renal transplant recipients at the University of Pittsburgh Medical Center between 2005 and 2012...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295601/idiopathic-hyperammonemia-after-solid-organ-transplantation-primarily-a-lung-problem-a-single-center-experience-and-systematic-review
#19
Dustin Krutsinger, Alejandro Pezzulo, Amy E Blevins, Robert M Reed, Michael Voigt, Michael Eberlein
BACKGROUND: Idiopathic hyperammonemia syndrome (IHS) is an uncommon, often deadly complication of solid organ transplantation. IHS cases in solid organ transplantation seem to occur predominantly in lung transplant (LTx) recipients. However to the best of our knowledge the occurrence of IHS has not been systematically evaluated. We set out to identify all reported cases of IHS following non-liver solid organ transplantations. METHODS: Retrospective review of our institutional experience and systematic review of the literature...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28267882/early-conversion-to-belatacept-after-renal-transplantation
#20
V Nair, L Liriano-Ward, R Kent, Shirish Huprikar, M Rana, S Florman, V Delaney, M Menon, V Sehgal, L Miko, R Khaim, A Benvenisty, S Lerner, A Arvelakis, V Wadhera, S Ames, R Shapiro
Belatacept is a non-nephrotoxic immunosuppressive agent, which may make it the ideal agent for patients with delayed or slow graft function on calcineurin inhibitors. There are limited data on conversion of patients to belatacept within 6 months of transplantation. Between 1/2012 and 12/2015 sixteen patients were converted to belatacept for delayed or poor graft function (eGFR <30 ml/min/1.73m, MDRD); three were HIV+. Conversion protocols were analyzed in patients < 4 months and 4-6 months post transplantation...
March 7, 2017: Clinical Transplantation
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