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Clinical Transplantation

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https://www.readbyqxmd.com/read/28445586/predictors-of-outcome-among-patients-on-extracorporeal-membrane-oxygenation-as-a-bridge-to-lung-transplantation
#1
Amit Banga, Elizabeth Batchelor, Manish Mohanka, Srinivas Bollineni, Vaidehi Kaza, Jessica Mullins, Melissa Tran, Pietro Bajona, Matthias Peltz, Michael Wait, Fernando Torres
BACKGROUND: There is a lack of data regarding clinical variables associated with successful bridge to lung transplantation (LT) using extracorporeal membrane oxygenation (ECMO) support. METHODS: We reviewed the institutional database for patients supported with veno-venous (VV) or veno-arterial ECMO as a bridge to LT (n=25; mean age:50.6±14.2 years). We recorded clinical and laboratory variables, findings on echocardiogram and development of organ dysfunction along with hospital and one-year survival...
April 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28444815/endoscopic-findings-following-retroperitoneal-pancreas-transplantation
#2
Alexey Valer'evich Pinchuk, Ilya Victorovich Dmitriev, Nonna Valer'evna Shmarina, Yury Sergeevich Teterin, Aslan Galievich Balkarov, Roman Vasil'evich Storozhev, Yuri Andreevich Anisimov, Ali Magomedovich Gasanov
AIM: An evaluation of the efficacy of endoscopic methods for the diagnosis and correction of surgical and immunological complications after retroperitoneal pancreas transplantation. MATERIALS AND METHODS: From October 2011 to March 2015, 27 patients underwent simultaneous retroperitoneal pancreas-kidney transplantation (SPKT). Diagnostic oesophagogastroduodenoscopy (EGD) with protocol biopsy of the donor and recipient duodenal mucosa and endoscopic retrograde pancreatography (ERP) were performed to detect possible complications...
April 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28432802/subsequent-malignancies-after-allogeneic-hematopoietic-stem-cell-transplantation
#3
Mehmet Gündüz, Mehmet Özen, Uğur Şahin, Selami Koçak Toprak, Sinem Civriz Bozdağ, Meltem Kurt Yüksel, Önder Arslan, Muhit Özcan, Taner Demirer, Meral Beksaç, Osman İlhan, Günhan Gürman, Pervin Topçuoğlu
We evaluated 979 patients for the development of post-transplant lymphoproliferative disease (PTLD) and solid malignancies after allogeneic hematopoietic stem cell transplantations (allo-HSCT) as a late complication. We found 15 (1.5%) subsequent malignancies; three of these malignancies were PTLD, and twelve were solid tumors. The median time from allo-HSCT to the development of PTLD was 9 (3-20) months and that from allo-HSCT to the development of solid tumors was 93 (6-316) months. The cumulative incidence of evolving subsequent malignancy in patients was 1...
April 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28429399/association-of-myocardial-injury-with-increased-mortality-after-liver-transplantation
#4
LETTER
Gui-Zhen Yang, Fu-Shan Xue, Ya-Yang Liu, Hui-Xian Li
No abstract text is available yet for this article.
April 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28425132/early-post-operative-management-after-lung-transplantation-results-of-an-international-survey
#5
Christopher S King, Vincent Valentine, Ashok Cattamanchi, Domingo Franco-Palacios, Oksana A Shlobin, A Whitney Brown, Ramesh Singh, Linda Bogar, Steven D Nathan
INTRODUCTION: Little data exists regarding optimal therapeutic strategies post-operatively after lung transplant (LTx). Current practice patterns rely on expert opinion and institutional experience resulting in non-uniform post-operative care. To better define current practice patterns, an international survey of LTx clinicians was conducted. METHODS: A 30-question survey was sent to transplant clinicians via email to the ISHLT open forum mailing list and directly to the chief transplant surgeon and pulmonologist of all LTx centers in the United States...
April 20, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#6
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies didn't identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. 50 (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28383790/post-transplant-lymphoproliferative-disease-in-lung-transplantation-a-nested-case-control-study
#7
Annelies Leyssens, Daan Dierickx, Eric K Verbeken, Thomas Tousseyn, Stijn E Verleden, Bart M Vanaudenaerde, Lieven J Dupont, Jonas Yserbyt, Geert M Verleden, Dirk E Van Raemdonck, Robin Vos
Post-transplant lymphoproliferative disorder (PTLD) may compromise long-term outcome of lung transplant (LTx) recipients. A case-control study was performed, comparing LTx recipients with PTLD (n=31) to matched recipients without PTLD (Controls, n=62). Risk factors for PTLD and post-transplant outcomes were assessed. PTLD prevalence was 3.9%, time to PTLD 323 (166-1132) days; and 54.8% had early-onset PTLD versus 45.2% late-onset PTLD. At LTx, more Epstein-Barr virus (EBV)-seronegative patients were present in PTLD (42%) compared to Controls (5%) (p<0...
April 6, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28376289/the-appropriate-dose-of-thymoglobulin-induction-therapy-in%C3%A2-kidney-transplantation
#8
Mohsen Nafar, Nooshin Dalili, Fatemeh Poor-Reza-Gholi, Pedram Ahmadpoor, Fariba Samadian, Shiva Samavat
BACKGROUND: Thymoglobulin is used effectively as an induction agent in kidney transplantation, but there is no consensus on the optimal dose. In order to delineate the safest effective dose, an open-labeled randomized clinical trial was designed. METHODS: In this study, 90 adult kidney transplant recipients (KTR) were randomized before transplantation in three groups to receive thymoglobulin: Arm A (4.5 mg/kg in 3 days), Arm B (4.5 mg/kg single bolus dose), and Arm C (6 mg/kg in 3 days)...
April 4, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28370484/graft-derived-macrophage-migration-inhibitory-factor-correlates-with-hepatocellular-injury-in-patients-undergoing-liver-transplantation
#9
Joanna Baron-Stefaniak, Judith Schiefer, Edmund J Miller, Walter Plöchl, Claus G Krenn, Gabriela A Berlakovich, David M Baron, Peter Faybik
Experimental studies suggest that macrophage migration inhibitory factor (MIF) mediates ischemia/reperfusion injury during liver transplantation. This study assessed whether human liver grafts release MIF during preservation, and whether the release of MIF is proportional to the extent of hepatocellular injury. Additionally, the association between MIF and early allograft dysfunction (EAD) after liver transplantation was evaluated. Concentrations of MIF, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) were measured in effluents of 38 liver grafts, and in serum of recipients...
April 1, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28370346/medication-adherence-and-rejection-rates-in-older-versus-younger-adult-liver-transplant-recipients
#10
Emily A Leven, Rachel Annunziato, Jacqueline Helcer, Sarah R Lieber, Christopher S Knight, Catherine Wlodarkiewicz, Rainier P Soriano, Sander S Florman, Thomas D Schiano, Eyal Shemesh
A growing number of older adults are undergoing liver transplantation (LT) in the US. In some settings, it is thought that adherence declines with age. This retrospective study examined adherence and clinical outcomes in older versus younger adult LT recipients. Medical records of adult LT recipients from 2009-2012 from a single urban center were reviewed. The medication level variability index (MLVI) was the pre-defined primary outcome, with nonadherence defined as MLVI >2.5. The secondary outcome was incidence of rejection...
April 1, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28345271/immunosuppression-with-mtor-inhibitors-prevents-the-development-of-donor-specific-antibodies-after-liver-transplant
#11
Katharina Willuweit, Andreas Heinold, Jassin Rashidi-Alavijeh, Falko M Heinemann, Peter A Horn, Andreas Paul, Guido Gerken, Kerstin Herzer
BACKGROUND: Donor-specific antibodies (DSAs) are an important cause of complications after solid organ transplant. Risk factors and, thus, strategies for preventing DSA development are not well defined. METHODS: The DSA status of 400 patients who underwent liver transplant (LT) at the outpatient clinic of the University Hospital Essen was determined. Human leukocyte antigen (HLA) antibodies were detected by single-antigen bead technology. The strength of DSAs was reported as mean fluorescence intensity...
March 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28342285/development-of-a-human-cadaver-model-for-training-in-laparoscopic-donor-nephrectomy
#12
Erica Sutton, Adrian Billeter, Devin Druen, Henry Roberts, Jonathan Rice, Hiram C Polk
BACKGROUND: The Organ Procurement Network recommends a surgeon record 15 cases as surgeon or assistant for laparoscopic donor nephrectomies (LDN) prior to independent practice. The literature suggests that the learning curve for improved perioperative and patient outcomes is closer to 35 cases. In this article, we describe our development of a model utilizing fresh tissue and objective, quantifiable endpoints to document surgical progress and efficiency in each of the major steps involved in LDN...
March 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28342282/pharmacokinetic-and-pharmacogenetic-analysis-of-immunosuppressive-agents-after-laparoscopic-sleeve-gastrectomy
#13
Tayyab S Diwan, Alicia B Lichvar, Abbie D Leino, Alexander A Vinks, Uwe Christians, Adele R Shields, Michael A Cardi, Tsuyoshi Fukuda, Tomoyuki Mizuno, Tiffany Kaiser, E Steve Woodle, Rita R Alloway
BACKGROUND: Severe obesity has been shown to limit access to renal transplantation in patients with end stage renal disease (ESRD). Laparoscopic sleeve gastrectomy (LSG) has been performed in the ESRD population to assist in achieving waitlist and transplant eligibility. Little is known about how LSG impacts the bioequivalence tacrolimus products and immunosuppression pharmacokinetics. METHODS: This was a prospective, open-label, single-dose, crossover, two-period pharmacokinetic (PK) study...
March 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28342278/simultaneous-pancreas-and-kidney-transplantation-incidence-and-risk-factors-for-amputation-after-10-years-follow-up
#14
E MacCraith, N F Davis, C Browne, P Mohan, D Hickey
INTRODUCTION: The incidence of amputation after simultaneous pancreas and kidney (SPK) transplantation ranges from 9.5-23% after 5 years of follow-up. The objective of this study was to investigate the incidence and risk factors for amputation in SPK transplant patients after a minimum follow-up of 10 years. METHODS: An analysis was performed on a prospectively maintained database of 81 SPK transplants and 43 kidney transplantation alone (KTA) consecutively performed in one centre for insulin dependent diabetes mellitus between December 1992 and January 2006...
March 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28342273/characteristics-of-compatible-pair-participants-in-kidney-paired-donation-at-a-single-center
#15
Francis L Weng, Tracy Grogan, Anup M Patel, Shamkant Mulgaonkar, Marie M Morgievich
Compatible pairs of living kidney donors and their intended recipients can enter into kidney paired donation (KPD) and facilitate additional living donor kidney transplants (LDKTs). We examined 11 compatible pairs (the intended recipients and their intended, compatible donors) who participated in KPD, along with the recipients' 11 matched, exchange donors. The 11 pairs participated in 10 separate exchanges (three were multicenter exchanges) that included 33 total LDKTs (22 additional LDKTs). All the intended donors were blood group O and female, with a mean living kidney donor profile index (LKDPI) of 27...
March 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28316109/airway-inflammation-and-symptoms-in-children-following-liver-and-heart-transplantation
#16
Andrew J Redmann, John C Bucuvalas, Robert E Wood, Clifford Chin, Catherine K Hart
OBJECTIVES: To 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 Epstein-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
#17
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
#18
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 hemodynamic 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 as 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-impaired-graft-function-early-after-heart-transplantation
#19
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 carried out 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
#20
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 to 2013. CDI was defined by diarrhea and a positive toxigenic C. difficile in stool measured by toxin enzyme immunoassay (2004-2006) or polymerase chain reaction (2007-2013)...
March 17, 2017: Clinical Transplantation
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