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Clinical Transplantation

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https://www.readbyqxmd.com/read/28206695/graft-quality-matters-survival-after-simultaneous-liver-kidney-transplant-according-to-kdpi
#1
Colleen Jay, Jacqueline Pugh, Glenn Halff, Greg Abrahamian, Francisco Cigarroa, Ken Washburn
BACKGROUND: Poor renal function is associated with higher mortality after liver transplantation. Our aim was to understand the impact of kidney graft quality according to kidney donor profile index (KDPI) score on survival after simultaneous liver-kidney (SLK) transplantation. METHODS: Using United Network of Organ Sharing data from 2002-2013 for adult deceased donor SLK recipients, we compared survival and renal graft outcomes according to KDPI. RESULTS: Of 4,207 SLK transplants, 6% were from KDPI >85% donors...
February 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28199752/effect-of-transversus-abdominis-plane-block-in-combination-with-general-anesthesia-on-perioperative-opioid-consumption-hemodynamics-and-recovery-in-living-liver-donors-the-prospective-double-blinded-randomized-study
#2
Mehmet Ali Erdogan, Ulku Ozgul, Muharrem Uçar, Rıdvan Yalin, Yusuf Ziya Colak, Cemil Çolak, Huseyin Ilksen Toprak
BACKGROUND: Transversus abdominis plane (TAP) block provides effective postoperative analgesia after abdominal surgeries. It can be also a useful strategy to reduce perioperative opioid consumption, support intraoperative hemodynamic stability and promote early recovery from anesthesia. The aim of this prospective randomized double-blind study was to assess the effect of subcostal TAP blocks on perioperative opioid consumption, hemodynamic and recovery time in living liver donors. METODS: The prospective, double-blinded, randomized controlled study was conducted with 49 living liver donors, aged 18-65 years, who were scheduled to undergo right hepatectomy...
February 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28196295/association-of-pre-transplant-kidney-function-with-outcomes-after-lung-transplantation
#3
Amit Banga, Manish Mohanka, Jessica Mullins, Srinivas Bollineni, Vaidehi Kaza, Fernando Torres, Bekir Tanriover
PURPOSE: There is a lack of data regarding the independent association of pre-transplant kidney function with early and late outcomes among lung transplant (LT) recipients. METHODS: We queried the UNOS database for adult patients (≥ 18 years of age) undergoing LT between 1987 and 2013. Glomerular filtration rate (GFR) was estimated using the Modification of diet in renal disease (MDRD) and the Chronic kidney disease epidemiology collaboration (CKD-EPI) equations...
February 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28190259/early-post-transplant-conversion-from-tacrolimus-to-belatacept-for-prolonged-delayed-graft-function-improves-renal-function-in-kidney-transplant-recipients
#4
D Wojciechowski, S Chandran, F Vincenti
Prolonged delayed graft function (DGF) in kidney transplant recipients imparts a risk of poor allograft function; tacrolimus may be detrimental in this setting. We conducted a retrospective single center analysis of the first 20 patients converted to belatacept for prolonged DGF as part of a clinical protocol as a novel treatment strategy to treat prolonged DGF. Prior to conversion patients underwent an allograft biopsy to rule out rejection and confirm tubular injury. The primary outcome was the eGFR at 12 months post-transplant; secondary outcome was the change in eGFR 30 days post-belatacept conversion...
February 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28186357/short-and-long-term-outcomes-with-renin-angiotensin-aldosterone-inhibitors-in-renal-transplant-recipients-a-meta-analysis-of-randomized-controlled-trials
#5
Ruo-Xi Liao, Xia-Fei Lyu, Wen-Jiao Tang, Kai Gao
BACKGROUND: Angiotensin-convertingenzyme inhibitors (ACEIs) and angiotensin II receptor type 1 blockers (ARBs) are often prescribed for renal transplant recipients (RTRs), but the outcomes of these medications in RTRs remain controversial. METHODS: The PubMed, Embase, and Cochrane Library databases were systematically searched. Randomized controlled trials investigating the outcomes of ACEI/ARBs in RTRs were included for meta-analysis. RESULTS: Twenty-two trials with 2242 patients were identified...
February 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28185318/cognitive-function-after-heart-transplantation-comparing-everolimus-based-and-calcineurin-inhibitor-based-regimens
#6
Britta S Bürker, Lars Gullestad, Einar Gude, Anne R Authen, Ingelin Grov, Per K Hol, Arne K Andreassen, Satish Arora, Mary Amanda Dew, Arnt E Fiane, Ira R H Haraldsen, Ulrik F Malt, Stein Andersson
BACKGROUND: Studies have shown conflicting results concerning the occurrence of cognitive impairment after successful heart transplantation (HTx). Another unresolved issue is the possible differential impact of immunosuppressants on cognitive function. In this study, we describe cognitive function in a cohort of HTx recipients and subsequently compare cognitive function between subjects on either everolimus- or calcineurin inhibitor (CNI)-based immunosuppression. METHODS: Cognitive function, covering attention, processing speed, executive functions, memory, and language functions, was assessed with a neuropsychological test battery...
February 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28185307/professional-interpersonal-dynamics-and-burnout-in-european-transplant-surgeons
#7
Michelle T Jesse, Marwan Abouljoud, Anne Eshelman, Chantal De Reyck, Jan Lerut
: Burnout within the health professions has become an increasingly important topic. Evidence suggests there are differences in burnout across different countries. Research has yet to examine burnout in transplant surgeons throughout Europe. METHODS: A cross-sectional survey of transplant surgeons across Europe. Survey included sociodemographics, professional characteristics, frequency and discomfort with difficult patient interactions, decisional autonomy, psychological job demands, support (coworker, supervisor, and hospital administration), and burnout including emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA)...
February 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28185297/physical-activity-in-solid-organ-transplant-recipients-participation-predictors-barriers-and-facilitators
#8
Tanya Gustaw, Emma Schoo, Colleen Barbalinardo, Nicole Rodrigues, Yalda Zameni, Vinícius Nogueira Motta, Sunita Mathur, Tania Janaudis-Ferreira
BACKGROUND: Our objectives were to describe the physical activity (PA) levels, predictors, barriers and facilitators to PA in SOT recipients. METHODS: A web-based questionnaire was sent to members of the Canadian Transplant Association including the Physical Activity Scale for the Elderly (PASE), and questions regarding barriers and facilitators of PA. RESULTS: One hundred and thirteen SOT recipients completed the survey. The median PASE score was 164...
February 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28181305/de-novo-dq-donor-specific-antibodies-are-associated-with-worse-outcomes-compared-to-non-dq-dndsa-following-heart-transplantation
#9
Robert Townsend Cole, Jonathan Gandhi, Robert A Bray, Howard M Gebel, Alanna Morris, Andrew McCue, Michael Yin, S Raja Laskar, Wendy Book, Maan Jokhadar, Andrew Smith, Duc Nguyen, J David Vega, Divya Gupta
BACKGROUND: Antibody mediated rejection (AMR) resulting from de novo donor-specific antibodies (dnDSA) leads to adverse outcomes following heart transplantation (HTx). It remains unclear what role dnDSA to specific HLA antigens play in adverse outcomes. This study compares outcomes in patients developing dnDSA to DQ antigens with those developing non-DQ dnDSA and those free from dnDSA. METHODS: Single-center, retrospective analysis of 122 consecutive HTx recipients...
February 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28181304/treatment-of-cutaneous-and-or-soft-tissue-manifestations-of-corticosteroids-refractory-chronic-graft-versus-host-disease-cgvhd-by-a-total-nodal-irradiation-tni
#10
G Peyraga, T Lizee, P Gustin, K Clement-Colmou, C Di Bartolo, S Supiot, M A Mahe, S François, M Mege
The management of corticosteroids refractory chronic graft versus host disease (cGVHD) remains controversial. Retrospective analysis of patients treated at the Integrated Center of Oncology by total nodal irradiation (TNI) was performed to evaluate its therapy potency. TNI delivers a dose of 1 Gy in a single session. The delimitation of the fields is clinical (upper-limit : external auditory meatus; lower-limit : mid-femur). No pre-therapeutic dosimetry scanner was necessary. Evaluation of the efficacy was by clinical measures at 6 months after the treatment...
February 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28181298/prediction-model-for-cardiac-allograft-vasculopathy-comparison-of-three-multivariable-methods
#11
Evan P Kransdorf, Natasha A Loghmanpour, Manreet K Kanwar, M'hamed H Temkit, Josef Stehlik
BACKGROUND: Cardiac allograft vasculopathy (CAV) remains an important cause of graft failure after heart transplantation (HT). Although many risk factors for CAV have been identified, there are no clinical prediction models that enable clinicians to determine each recipient's risk of CAV. METHODS: We studied a cohort of 14,328 heart transplant recipients whose data were reported to the International Society for Heart and Lung Transplantation Registry between 2000 and 2010...
February 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28181294/adverse-outcomes-associated-with-postoperative-atrial-arrhythmias-after-lung-transplantation-a-meta-analysis-and-systematic-review-of-the-literature
#12
REVIEW
Nathan H Waldron, Rebecca Y Klinger, Matthew G Hartwig, Laurie D Snyder, James P Daubert, Joseph P Mathew
BACKGROUND: Postoperative atrial arrhythmias (AAs) are common after lung transplantation but studies are mixed regarding their impact on outcomes. We therefore performed this systematic review and meta-analysis to determine whether AAs after lung transplantation impede postoperative recovery. METHODS: MEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched to identify studies comparing outcomes in adult patients undergoing lung transplantation who experienced postoperative AAs in the immediate postoperative period versus those without postoperative AAs...
February 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28160319/higher-anti-a-b-isoagglutinin-titres-of-igg-class-but-not-of-igm-are-associated-with-increased-red-blood-cell-transfusion-requirements-in-bone-marrow-transplantation-with-major-abo-mismatch
#13
Gil Cunha De Santis, Aline Cristina Garcia-Silva, Giuliana Martinelli Dotoli, Pamela Tinti de Castro, Belinda Pinto Simões, Dimas Tadeu Covas
BACKGROUND: Major ABO-mismatch between donor and recipient in bone marrow transplantation (BMT) may cause haemolysis, delayed red blood cell (RBC) engraftment and pure red cell aplasia (PRCA), which result in increased transfusion needs. High pre-transplant anti-A/B antibody titres have been associated with increased risk of PRCA. Herein we studied the impact of anti-A/B titres on transfusion needs after BMT with major ABO-mismatch. METHODS: We reviewed the medical charts of 27 patients who underwent to BMT with major ABO-mismatch, and categorized them into two groups according to anti-A/B titres of IgG (≤ 16 and ≥ 32)...
February 3, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28150415/pulmonary-thromboembolism-as-a-complication-of-lung-transplantation
#14
REVIEW
Anna Warncke Kristensen, Jann Mortensen, Ronan M G Berg
Post-transplantation mortality after lung transplantation (LTX) is higher than for other solid organ transplantations. Thoracic surgery is associated with increased risk of thromboembolic complications, and since LTX recipients lack the collateral bronchial circulation, pulmonary thromboembolism (PTE) may represent a pertinent yet largely under-diagnosed cause of post-transplantation respiratory failure. In the present systematic review, we sought to elucidate the occurrence and predilection site of PTE after LTX, and its potential impact on LTX-associated mortality...
February 1, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28135788/corticosteroid-wean-after-heart-transplantation-is-there-a-risk-for-antibody-formation
#15
Omeed Elboudwarej, Derek Phan, Jignesh Patel, Frank Liou, Tamar Aintablian, Ashley Osborne, Zhe Yu, Nancy Reinsmoen, Jon Kobashigawa
BACKGROUND: Corticosteroid withdrawal after heart transplantation is limited to select immune-privileged patients but it is not known if this predisposes patients to a higher risk for sensitization. METHODS: 178 heart transplant recipients had panel reactive antibody (PRA) measurements at transplant and every 6 months and were monitored for rejection with protocol endomyocardial biopsies. Corticosteroid withdrawal was initiated at 6 months post-transplant in select patients...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28135784/morphologic-patterns-and-treatment-of-transplant-glomerulopathy-a-retrospective-analyse
#16
Rui Abreu, Fernanda Carvalho, Helena Viana, Isabel Mesquita, Marília Possante, Inês Aires, Fernando Caeiro, Cecília Silva, Patrícia Cotovio, Aníbal Ferreira, Francisco Remédio, Fernando Nolasco
Transplant glomerulopathy is mainly due to chronic antibody-mediated rejection and actually represents a major cause of long-term allograft failure. The lack of effective treatment remains a serious problem in transplantation. A retrospective and uni-center study was performed in 48 kidney allograft recipients with transplant glomerulopathy between January 2010 and December 2015. Median time for diagnosis was 7,1 (3,6 - 11,8) years post-transplant. Light microscopy showed severity of transplant glomerulopathy in the majority of patients (cg1=10,4%; cg2=20,8%; cg3=68,8%)...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28135781/evaluating-living-donor-kidney-transplant-rates-are-you-reaching-your-potential
#17
Abraham J Matar, John Files, Ryan Burkholder, Thomas Chin, Michael Angelis
BACKGROUND: Traditionally, living donor kidney transplant (LDKT) rate has been calculated as a percentage of total kidney transplant volume. We believe this calculation to be inherently flawed because the of number deceased donor kidney transplants has no bearing on the number of LDKT performed. We propose an alternative calculation of LDKT rate as a percentage of the number of new waitlist registrants. METHODS: We evaluated 192 adult transplant centers in the United States with respect to their LDKT rate according to both the traditional and proposed calculation using data from the scientific registry of transplant recipients between July 2014 and June 2015...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28135779/risk-of-tumor-transmission-after-thoracic-allograft-transplantation-from-adult-donors-with-central-nervous-system-neoplasm-a-unos-database-study
#18
C F Hynes, K Ramakrishnan, F A Alfares, K M Endicott, K Hammond-Jack, D Zurakowski, R A Jonas, D S Nath
BACKGROUND: We analyzed the UNOS database to better define the risk of transmission of CNS tumors from donors to adult recipients of thoracic organs. METHODS: Data were procured from the Standard Transplant Analysis and Research dataset files. Donors with CNS tumors were identified, and recipients from these donors comprised the study group (Group I). The remaining recipients of organs from donors who did not have CNS tumors formed the control group (Group II). Incidence of recipient CNS tumors, donor related malignancies, and overall survival was calculated and compared in addition to multivariable logistic regression...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28135776/long-term-renal-outcome-after-allogeneic-haemopoietic-stem-cell-transplant-a-comprehensive-analysis-of-risk-factors-in-an-asian-patient-population
#19
Wei Zhou, Rehena Sultana, Colin Diong, Yeow-Tee Goh, Sathish Gopalakrishnan, Aloysius Ho, William Hwang, Liang-Piu Koh, Mickey Koh, Yvonne Loh, Patrick Tan, Yeh-Ching Linn
Allogeneic haemopoietic stem cell transplantation (allo-HSCT) poses a significant challenge to renal function due to multiple drug- and complication-related renal toxicity. In this single center series of 216 adult Asian patients with a long and complete follow up, 41 developed chronic kidney disease (CKD) giving a cumulative incidence of 19.0% at 25 years (median follow up duration 7.84 years, range 2.0 - 27.7 years), but only 2 of the 41 patients reaching stage 4 CKD and another 2 requiring dialysis. In contrast, acute kidney injury occurred in most patients, where glomerular filtration rate (GFR) suffered a mean fall of 50ml/min/1...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28111805/ureteric-complications-in-recipients-of-kidneys-from-donation-after-circulatory-death-donors
#20
Trina-Jo Mah, Dermot H Mallon, Oliver Brewster, Kourosh Saeb-Parsy, Andrew J Butler, J Andrew Bradley, Vasilis Kosmoliaptsis
A large increase in the use of kidneys from donation after circulatory death (DCD) donors prompted us to examine the impact of donor type on the incidence of ureteric complications (UCs; ureteric stenosis, urinary leak) after kidney transplantation. We studied 1072 consecutive kidney transplants [DCD n=494, live-donor (LD) n=273, donation after brain death (DBD) n=305] performed during 2008 to 2014. Overall, there was a low incidence of UCs after kidney transplantation (3.5%). Despite a trend towards higher incidence of UCs in DCD (n=22, 4...
January 23, 2017: Clinical Transplantation
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