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Lauren Brasile, Nicholas Henry, Bart Stubenitsky
BACKGROUND: We have previously reported on a novel organ-specific immunomodifying therapy that provides protection from early allograft rejection in the absence of systemic immunosuppressive drugs. This novel therapy is a nano-barrier membrane called ImmunoCloak, consisting of a matrix of laminin, proteoglycans, fibronectin and collagens. The membrane "immunocloaks" the luminal surfaces within the renal vasculature by covering the point of contact between donor vascular endothelial cells and the recipient's immune cells; without adversely affecting renal function...
October 19, 2016: Transplantation
Hannah K Choe, Usama Gergis, Sebastian A Mayer, Himanshu Nagar, Adrienne A Phillips, Tsiporah B Shore, Michael J Smith, Koen van Besien
BACKGROUND: Preliminary evidence indicates that the addition of low dose TBI (2-4 Gy) to reduced intensity conditioning may reduce the rate of relapse in allogeneic stem cell transplants. In very high risk patients receiving combination haploidentical-single unit cord blood transplants, we have added 4 Gy TBI to the widely used fludarabine, melphalan conditioning regimen, in hopes of reducing relapse and decreasing graft rejection. METHODS: We retrospectively reviewed the posttransplant outcomes of patients who underwent haplo-cord SCT between May 2013 and March 2015 and who received fludarabine 30mg/m2 D-7 to -3, melphalan 140mg/m2 D-2, and 2 Gy TBI D-4 and -3...
October 19, 2016: Transplantation
Darren E Stewart, Victoria C Garcia, John D Rosendale, David K Klassen, Bob J Carrico
BACKGROUND: The proportion of deceased donor kidneys recovered for transplant but discarded increased steadily in the U.S. over 2 decades, from 5.1% in 1988 to 19.2% by 2009. Over 100,000 patients are waiting for a kidney transplant, yet 3,159 kidneys were discarded in 2015. METHODS: We evaluated trends in donor characteristics, discard reasons, and OPO-specific discard rates. Multivariable regression and propensity analysis were used to estimate the proportion of the discard rate rise in the 2000's attributable to changes in donor factors and decisions to biopsy and pump kidneys...
October 19, 2016: Transplantation
David Shaw, Denie Georgieva, Bernadette Haase, Dale Gardiner, Penney Lewis, Nichon Jansen, Tineke Wind, Undine Samuel, Maryon McDonald, Rutger Ploeg
Millions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) occur in circumstances where the opportunity to donate organs is possible. Even for those who do die in the 'right' way and have recorded their wishes or live in a jurisdiction with a 'presumed consent' system, donation often does not go ahead because of another issue: their families refuse to allow donation to proceed...
October 19, 2016: Transplantation
Philip O'Connell
No abstract text is available yet for this article.
October 19, 2016: Transplantation
Fernando Rotellar, Fernando Pardo, Alberto Benito, Gabriel Zozaya, Pablo Martí-Cruchaga, Francisco Hidalgo, Luis Lopez, Mercedes Iñarrairaegui, Bruno Sangro, Ignacio Herrero
BACKGROUND: The pure laparoscopic approach in right hepatectomy (LRH) for living donor liver transplantation (LDLT) is a controversial issue. Some authors have reported the procedure to be feasible but surgical outcomes and impact on short and long-term morbidity rates are yet to be determined. The aim of this study is to present the results of a preliminary 5 consecutive cases series of LRH for LDLT and to compare it with a successive cohort of open right hepatectomies (ORH) for LDLT...
October 17, 2016: Transplantation
Emanuele Nicastro, Sara Giovannozzi, Paola Stroppa, Anna Paola Callegaro, Alessandra Tebaldi, Claudio Farina, Michele Colledan, Lorenzo DʼAntiga
BACKGROUND: Most pediatric liver transplantation (LT) centers administer long courses of prophylaxis against Cytomegalovirus (CMV) without evidence of benefit and with significant drug exposure and costs. We aimed at evaluating overall outcomes, direct and putative indirect effects of CMV, possible impact of viremia and risk factors for CMV infection in pediatric LT recipients managed with ganciclovir-based preemptive therapy (PET). METHODS: The records of all the children who underwent LT between 2008 and 2014 were retrospectively analyzed...
October 17, 2016: Transplantation
Jie Qin, Yusuke Arakawa, Miwa Morita, John J Fung, Shiguang Qian, Lina Lu
BACKGROUND: Islet transplantation is a promising therapeutic approach for restore the physical response to blood glucose in type 1 diabetes. Current chronic use of immunosuppressive reagents for preventing islet allograft rejection is associated with severe complications. In addition, many of the immunosuppressive drugs are diabetogenic. The induction of transplant tolerance to eliminate the dependency on immunosuppression is ideal, but remains challenging. METHODS: Addition of hepatic stellate cells allowed generation of myeloid-derived suppressor cells (MDSC) from precursors in mouse bone marrow...
October 17, 2016: Transplantation
Hanneke de Kort, Kirstin M Heutinck, Jurjen M Ruben, Alessa E Valverde da Silva, Katja C Wolthers, Jörg Hamann, Ineke J M Ten Berge
BACKGROUND: BK polyomavirus (BKV)-associated nephropathy is a threat to kidney allograft survival affecting up to 15% of renal transplant patients. Previous studies revealed that tubular epithelial cells (TEC) show a limited response towards BKV infection. Here we investigated the interplay between BKV and TEC in more detail. In particular, we questioned whether BKV suppresses and/or evades antiviral responses. METHODS: Human primary tubular epithelial cells (TEC) and peripheral blood mononuclear cells were infected with BKV Dunlop strain or other viruses...
October 17, 2016: Transplantation
Benjamin M Anderson, Jemma L Mytton, Felicity Evison, Charles J Ferro, Adnan Sharif
INTRODUCTION: Outcomes for weekend hospital admissions or emergency procedures have become a topical and controversial issue for the UK National Health Service (NHS). Deceased-donor kidney transplantation is frequently performed at weekends and evidence for its relative safety are lacking. METHODS: We undertook a population-based cohort analysis, obtaining data from every deceased-donor kidney-alone transplant procedure performed in England between January 2003 and December 2014...
October 17, 2016: Transplantation
Toru Ikegami, Tomonari Shimagaki, Junji Kawasaki, Tomoharu Yoshizumi, Hideaki Uchiyama, Noboru Harada, Norifumi Harimoto, Shinji Itoh, Yuji Soejima, Yoshihiko Maehara
INTRODUCTION: Biliary anastomosis stricture (BAS) is still among the major concerns after living donor liver transplantation (LDLT), even after the technical refinements including the universal use of the blood flow-preserving hilar dissection technique. The aim of this study is to investigate what are still the factors for BAS after LDLT. METHODS: An analysis of 279 adult-to-adult LDLT grafts (left lobe, n=161; right lobe, n=118) with duct-to-duct (DD) biliary reconstruction, since the universal application of minimal hilar dissection technique and gradual introduction of eversion technique, was performed...
October 12, 2016: Transplantation
Martin J Hoogduijn
No abstract text is available yet for this article.
October 12, 2016: Transplantation
Carla C Baan
Over 3000 delegates attended the 26st International Congress of the Transplantation Society in Hong Kong, which marked the 50th anniversary of the society. In his presidential address, Professor Phil O'Connell from the Westmead Hospital in Sydney, Australia, commented that a major challenge for the future is improving long-term outcomes after solid organ transplantation. He highlighted that 40% of transplanted organs are lost within 10 years, and that a high proportion of patients suffer from immunosuppression-related side effects...
October 7, 2016: Transplantation
Lucy Chen, Lisa Liberatore, Tom Chin, Scott Walker, Helen Fanous, Michelle M Nash, Lindita Rapi, Jennie Huckle, Jeffrey S Zaltzman, G V Ramesh Prasad
BACKGROUND: Ensuring reliable gastrointestinal drug absorption of orally-administered immunosuppressive medications posttransplant is critical to ensuring graft survival. METHODS: A 66 year old man of East Asian origin with a previous total gastrectomy was evaluated for living donor kidney transplantation. Pretransplant pharmacokinetic testing was performed to determine the most appropriate posttransplant medication strategy. The Gastrointestinal Quality of Life Index and Gastrointestinal Rating Scale questionnaires were administered to gauge immunosuppressive medication-related side effects in the absence of a stomach...
September 29, 2016: Transplantation
Karsten Midtvedt, Anders Åsberg
No abstract text is available yet for this article.
September 29, 2016: Transplantation
Renaud Snanoudj, Marc-Olivier Timsit, Marion Rabant, Claire Tinel, Hélène Lazareth, Lionel Lamhaut, Frank Martinez, Christophe Legendre
Use of expanded criteria donor (ECD) kidneys, which are associated with a reduced graft survival rate, has become widely adopted in elderly recipients in an old-to-old allocation system. However, the results are frequently unsatisfactory, and a high proportion of these ECD kidneys are discarded. Dual kidney transplantation (DKT) is an underutilized way to expand the pool of ECD kidneys and to rapidly transplant elderly patients with satisfactory results because of the transplantation of double the nephronic mass...
September 29, 2016: Transplantation
Oscar K Serrano, Scott Kerwin, William D Payne, Timothy L Pruett
BACKGROUND: The HIV Organ Policy Equity (HOPE) Act allows for transplantation of organs from Human Immunodeficiency virus (HIV) infected individuals (HIV+), provided it is performed under a research protocol. The safety assessment of an organ for transplantation is an essential element of the donation process. The risk for HIV associated opportunistic infections increases as circulating CD4+ lymphocytes decrease to <200 cells/μL; however, the numbers of circulating CD4+ cells in the HIV-negative (HIV-) brain dead donor (BDD) is not known...
September 29, 2016: Transplantation
Fanny Lanternier, Karima Amazzough, Loic Favennec, Marie-France Mamzer-Bruneel, Hendy Abdoul, Jérome Touret, Stéphane Decramer, Julien Zuber, Anne Scemla, Christophe Legendre, Olivier Lortholary, Marie-Elisabeth Bougnoux
BACKGROUND: Diarrhea is a frequent complication of solid organ transplantation. Cryptosporidiosis is classically reported in patients with acquired immunodeficiency syndrome and emerged as a cause of persistent diarrhea in solid organ transplant (SOT) patients. METHODS: Through the ANOFEL Cryptosporidium National Network and the French Transplantation Society, we collected all cryptosporidiosis cases identified in solid organ transplanted patients between 2006 and 2010 in France...
September 27, 2016: Transplantation
Sarah A Hosgood, Michael L Nicholson
BACKGROUND: The measurement of urinary biomarkers during ex-vivo normothermic kidney perfusion (EVKP) may aid in the assessment of a kidney prior to transplantation. This study measured levels of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and endothelin-1 (ET-1) during EVKP in a series of discarded human kidneys. METHODS: Fifty six kidneys from deceased donors were recruited into the study. Each kidney underwent 60 minutes of EVKP and was scored based on the macroscopic appearance, renal blood flow and urine output...
September 27, 2016: Transplantation
Xialian Xu, Nana Song, Xue Zhang, Xiaoyan Jiao, Jiachang Hu, Mingyu Liang, Jie Teng, Xiaoqiang Ding
BACKGROUND: Angiogenesis contributes to the repair process after renal ischemia/reperfusion (I/R) injury. In the present study, we tested the role of miR-21 in the angiogenesis induced by hypoxia inducible factor (HIF) -1α through inhibiting a predicted target gene thrombospondin 1(TSP-1). METHODS: To stabilize HIF-1α, hypoxia (1% O2 for 24h) was performed in human umbilical vein endothelial cells (HUVECs) and cobalt chloride (CoCl2) was pretreated intraperitoneally 24h prior to renal I/R in mice...
September 27, 2016: Transplantation
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