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Clinical Transplantation

Hong Fu, Kai Sun, Jun Li, Weiyi Gong, Vatche Agopian, Min Yan, Ronald W Busuttil, Randolph H Steadman, Victor W Xia
Nonselective Beta blockade (NSBB) is commonly prescribed for liver transplantation (LT) candidates, but its impact on intraoperative hemodynamics is not well understood. In this study, we investigated if preoperative NSBB was associated with severe bradycardia during LT and if severe intraoperative bradycardia was associated with 30-day mortality. Adult patients undergoing LT between 2005 and 2014 were included. Propensity matching was used to control selection bias. Intraoperative hemodynamics were compared between patients with and without preoperative NSBB...
October 12, 2018: Clinical Transplantation
Jin K Kim, Armando J Lorenzo, Walid A Farhat, Michael E Chua, Jessica M Ming, Martin A Koyle
PURPOSE: To determine whether there is a benefit to pre-emptive kidney transplantation in reducing surgical complications in pediatric population. METHODS: A retrospective review of kidney transplantations in our institution from 2000 to 2015 was performed. Intra- and post-operative complication rates and one-year graft survival were compared in their respective donor type groups (DD pre-emptive vs. DD post-dialysis; LD pre-emptive vs. LD post-dialysis). RESULTS: 318 patients were identified (DD pre-emptive n=21, DD post-dialysis n=145, LD pre-emptive n=54, LD post-dialysis n=98)...
October 10, 2018: Clinical Transplantation
Severine Beaudreuil, Jean Michel Schermann, Céline Verstuyft, Aurelie Barrail-Tran, Maria Smirnova, Antoine Durrbach, Laurent Becquemont
No abstract text is available yet for this article.
October 8, 2018: Clinical Transplantation
P K Jewani, S M Pouch, K T Kissling
BACKGROUND: Cytomegalovirus (CMV) is a major cause of morbidity and mortality in cardiac transplant recipients. Use of induction immunosuppression in cardiac transplantation may have an impact on the incidence of CMV, but literature is limited. METHODS: Single center, retrospective cohort study comparing the risk of CMV infection and disease in cardiac transplant patients receiving antithymocyte globulin (ATG) induction therapy to those receiving no antibody induction...
October 5, 2018: Clinical Transplantation
Yasbanoo Moayedi, C S Fan, Kathryn J Tinckam, Heather J Ross, Jennifer A McCaughan
BACKGROUND: It is estimated that 25-35% of heart transplant recipients develop de novo donor specific antibodies (dnDSA). One factor that appears to play a role in clinical outcomes is DSA persistence. The objective of this study was to determine the incidence of transient and persistent dnDSA in a Canadian heart transplant population and to evaluate their impact on coronary allograft vasculopathy (CAV), graft function and mortality. METHODS: A retrospective study of consecutive adult and transitioned pediatric heart transplant recipients (2008-2015) in Toronto was performed...
October 1, 2018: Clinical Transplantation
Nicholas W Lange, David M Salerno, Chelsea M Sammons, Arun B Jesudian, Elizabeth C Verna, Robert S Brown
BACKGROUND: To investigate the impact of delayed calcineurin inhibitor (CNI) initiation in liver transplant recipients (LTR) with peri-operative renal insufficiency receiving basiliximab induction, we compared renal outcomes of LTR stratified by the degree of achieved post-operative renal recovery (RR) prior to CNI initiation. METHODS: All adult LTR transplanted between 01/2007 and 12/2015 who received basiliximab were included. Patients who received multi-organ transplantations, were repeat transplant recipients, or expired prior to post-operative day (POD) 90 were excluded...
October 1, 2018: Clinical Transplantation
Utku Iltar
No abstract text is available yet for this article.
September 27, 2018: Clinical Transplantation
Francisco Caballero
No abstract text is available yet for this article.
September 24, 2018: Clinical Transplantation
Adetokunbo Taiwo, Kiran Khush, Margaret R Stedman, Yuanchao Zheng, Jane C Tan
Many heart transplant recipients experience declining kidney function following transplantation. We aimed to quantify change in kidney function in heart transplant recipients stratified by pre-transplant kidney function. 230 adult heart transplant recipients between May 1, 2008 and December 31, 2014 were evaluated for up to 5 years post-transplant (median 1 year). Using 19,398 total eGFR assessments, we evaluated trends in estimated glomerular filtration rate (eGFR) in recipients with normal/near normal (eGFR >45 mL/min/1...
September 21, 2018: Clinical Transplantation
David D Lee, Ricardo Paz-Fumagalli, Kristopher P Croome, Diego Paz, Lauren Wright, Justin H Nguyen, C Burcin Taner
BACKGROUND: Hepatic Artery Stenosis (HAS) after liver transplant (LT) is a source of significant morbidity. Some reports have suggested higher arterial complications in patients who receive donation after cardiac death (DCD) livers. METHODS: 2860 consecutive LT were reviewed from a prospectively collected database. All angiograms performed in LT recipients were reviewed and primary patency rates determined by need for further intervention or graft loss due to HAT...
September 21, 2018: Clinical Transplantation
Annarein J C Kerbert, Enric Reverter, Lara Verbruggen, Madelon Tieleman, Miguel Navasa, Bart J A Mertens, Sergio Rodríguez-Tajes, Marleen de Vree, Herold J Metselaar, Fang W T Chiang, Hein W Verspaget, Bart van Hoek, Jaime Bosch, Minneke J Coenraad
Overt hepatic encephalopathy (OHE) negatively impacts the prognosis of liver transplant candidates. However, it is not taken into account in most prioritizing organ allocation systems. We aimed to assess the impact of OHE on waitlist mortality in 3 cohorts of cirrhotic patients awaiting liver transplantation, with differences in composition of patient population, transplantation policy and transplantation rates. These cohorts were derived from two centres in the Netherlands (reference and validation cohort, n=246 and n=205, respectively) and one in Spain (validation cohort, n=253)...
September 19, 2018: Clinical Transplantation
F Darstein, F Häuser, B K Straub, J J Wenzel, R Conradi, J Mittler, H Lang, P R Galle, T Zimmermann
BACKGROUND: Hepatitis E virus (HEV) infection is a potential reason for elevated liver enzymes after liver transplantation (LT). Our aim was to analyze a real world cohort of LT patients, who underwent liver biopsy for elevated transaminases and suspected acute rejection, to evaluate frequency of post-transplant HEV infection. PATIENTS: Data from 160 liver biopsies were analyzed. 71 patients were biopsied on schedule after LT without elevated liver enzymes. A subgroup of 25 patients with elevated liver enzymes and suspected rejection was chosen for further analysis...
September 19, 2018: Clinical Transplantation
Ariane T Michelson, Demetra S Tsapepas, S Ali Husain, Corey Brennan, Mariana C Chiles, Brian Runge, Jennifer Lione, Byum H Kil, David J Cohen, Lloyd E Ratner, Sumit Mohan
BACKGROUND: Studies have demonstrated the Timed Up and Go Test's (TUGT) ability to forecast post-operative outcomes for several surgical specialties. Evaluations of TUGT for waitlist and post-transplant outcomes has yet to be examined in kidney transplantation. OBJECTIVE: To assess the prognostic utility of TUGT and its associations with waitlist and post-transplant outcomes for kidney transplant candidates. DESIGN AND METHODS: Single-center, prospective study of 518 patients who performed TUGT during their transplant evaluation between 9/1/2013-11/30/2014...
September 19, 2018: Clinical Transplantation
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, E Jordan Pearsall, Richard S Mangus
INTRODUCTION: This study reports the incidence, anatomic location, and outcomes of graft-versus-host disease (GVHD) at a single active intestine transplant center. METHODS: Records were reviewed for all patients receiving an intestine transplant from 2003 to 2015. Pathology reports and pharmacy records were reviewed to establish the diagnosis, location, and therapeutic interventions for GVHD. RESULTS: A total of 236 intestine transplants were performed during the study period, with 37 patients (16%) developing GVHD...
September 17, 2018: Clinical Transplantation
Peter P Reese, Matthew B Allen, Caroline Carney, Daniel Leidy, Simona Levsky, Ruchita Pendse, Adam S Mussell, Francisca Bermudez, Shimrit Keddem, Carrie Thiessen, James R Rodrigue, Ezekiel J Emanuel
BACKGROUND: A better understanding of the consequences of being turned down for living kidney donation could help transplant professionals to counsel individuals considering donation. METHODS: In this exploratory study, we used survey instruments and qualitative interviews to characterize nonmedical outcomes among individuals turned down for living kidney donation between July 1, 2010 - December 31, 2013. We assembled a comparator group of kidney donors. RESULTS: Among 83 turned-down donors with contact information at a single center, 43 (52%) participated in the study (median age 53 years; 53% female; 19% black)...
September 15, 2018: Clinical Transplantation
Stefania Bussolino, Caterina Dolla, Claudia Ariaudo, Federica Civiletti, Maria Messina, Alberto Mella, Cristiana Caorsi, Antonio Amoroso, Antonella Barreca, Mauro Papotti, Sara Giunti, Fabrizio Fop, Luigi Biancone
BACKGROUND: Transplant glomerulopathy (TG) is an important cause of late graft loss. The role of angiotensin type 1-receptor antibodies (AT1 R-Ab) in TG is not known. METHODS: All the TG cases (N=137) between January 2007 and December 2014 (N=1410) were analyzed. Donor specific anti-HLA antibodies (DSA) at the time of biopsy and AT1 R-Ab IgG (positive, >17 UI/ml; "at risk", 10-17 UI/ml; negative, <10 UI/ml) in pre-transplant sera (PT-Ab) and at biopsy time (BT-Ab) were studied...
September 15, 2018: Clinical Transplantation
Xingxing S Cheng, Stephan Busque, Jenny Lee, Kevin Discipulo, Christine Hartley, Zeynep Tulu, John D Scandling, Jane C Tan
Kidney transplant waitlist management is becoming increasingly complex. We introduced a novel waitlist management strategy at our center, the Transplant Readiness Assessment Clinic (TRAC), whereby patients whose Kidney Allocation Scores surpass a threshold are actively managed. From January 1, 2016 through June 30, 2017, we evaluated 195 patients through TRAC. Compared to pre-TRAC systems at our institution, TRAC resulted in a higher proportion of activation at 18-months (38% versus 22-26%, p<0.0001), despite being enriched in patients with long dialysis duration...
September 15, 2018: Clinical Transplantation
Mario Spaggiari, Frances Rose Lendacki, Caterina Di Bella, Pier Cristoforo Giulianotti, Enrico Benedetti, Jose Oberholzer, Ivo Tzvetanov
The pre-transplant weight loss required of end-stage renal disease patients is often unachievable. Though robot-assisted procedures among extremely obese have shown minimal complication, long-term outcomes are understudied. Previously, we reported no difference in 6-month patient and graft survival among 28 robot-assisted transplant cases (2009-2013), and 28 open controls (2004-2010). Groups were frequency-matched on age, sex, race, donor compatibility, disease and dialysis history. Cases had greater median pre-transplant BMI (42...
September 14, 2018: Clinical Transplantation
Atif S Siddiqui, Gagan Kumar, Tilottama Majumdar, Edward A Graviss, Duc T Nguyen, Ahmad Goodarzi, Thomas Kaleekal
BACKGROUND: Chronic lung allograft dysfunction (CLAD) is a complication of lung transplantation. We sought to determine whether bronchial hyperresponsiveness detected by the methacholine challenge test (MCT) at 3 months after lung transplant (LT) predicts the development of CLAD. METHODS: We performed a retrospective cohort study of 140 LT patients between 1/2008 and 6/2014 who underwent MCT at 3 months after LT. Pearson's chi-squared test and Kruskal-Wallis test were used to compare categorical and continuous variables, respectively...
September 7, 2018: Clinical Transplantation
Derek A DuBay, Nataliya V Ivankova, Ivan Herby, David T Redden, Cheryl Holt, Laura Siminoff, Mona N Fouad, Zemin Su, Thomas A Morinelli, Michelle Y Martin
African American (AA) organ donation registration rates fall short of national objectives. The goal of the present study was to utilize data acquired from a quantitative telephone survey to provide information for a future Department of Motorized Vehicles (DMV) intervention to increase AA organ donor registration at the DMV. AAs (n = 20 177) that had visited an Alabama DMV office within a 3-month period were recruited via direct mailing to participate in a quantitative phone survey. Data from 155 respondents that participated in the survey were analyzed...
September 4, 2018: Clinical Transplantation
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