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Transplant International: Official Journal of the European Society for Organ Transplantation

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https://www.readbyqxmd.com/read/30636065/chronic-histological-changes-in-deceased-donor-kidneys-at-implantation-do-not-predict-graft-survival-a-single-centre-retrospective-analysis
#1
Benedict L Phillips, Theodoros Kassimatis, Kerem Atalar, Hannah Wilkinson, Nicos Kessaris, Naomi Simmonds, Rachel Hilton, Catherine Horsfield, Chris J Callaghan
BACKGROUND: The use of pre-implantation kidney biopsies (PIKBs) to aid deceased donor kidney utilisation decisions is controversial. Outcomes of transplants that had been biopsied after the decision had been made to implant were analysed, in order to determine the association between chronic histological changes at implantation and graft outcomes. METHODS: A retrospective analysis of transplants between 2006-2015 was performed. Karpinski scores on biopsies were collected, and graft outcomes were analysed using univariate and multivariable techniques...
January 12, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30633815/infections-after-upper-extremity-allotransplantation-a-worldwide-population-cohort-study-1998-2017
#2
Anne Conrad, Palmina Petruzzo, Jean Kanitakis, Aram Gazarian, Lionel Badet, Olivier Thaunat, Philippe Vanhems, Fanny Buron, Emmanuel Morelon, Antoine Sicard
Risk-to-benefit analysis of upper extremity allotransplantation (UEA) warrants a careful assessment of immunosuppression-related complications. This first systematic report of infectious complications after UEA aimed to compare incidence and pattern of infections to that observed after kidney transplantation (KT). We conducted a matched cohort study among UEA and KT recipients from the International Registry on Hand and Composite Tissue Transplantation and the French transplant database DIVAT. All UEA recipients between 1998 and 2016 were matched with KT recipients (1:5) regarding age, sex, CMV serostatus and induction treatment...
January 11, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30632208/dornase-alfa-during-lower-respiratory-tract-infection-post-lung-transplantation-a-randomized-controlled-trial
#3
Benjamin James Tarrant, G I Snell, Steven Ivulich, Brenda Button, Bruce Thompson, Anne Holland
BACKGROUND: Lung transplant (LTx) recipients are at risk of lower respiratory tract infection (LRTI), while altered physiology may lead to difficulty clearing sputum. Mucoactive agents alter sputum properties and facilitate mucociliary clearance, however there are no randomized controlled trials (RCTs) studying this post LTx. This RCT evaluated the safety and efficacy of nebulized dornase alfa during LRTI post LTx. METHODS: Inpatient adults with LRTI and abnormal sputum following bilateral sequential LTx were eligible...
January 10, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30632206/occurrence-of-newly-discovered-human-polyomaviruses-in-skin-of-liver-transplant-recipients-and-their-relation-with-scc-in-situ-and-actinic-keratosis
#4
Y Wang, A Keinonen, S Koskenmies, S Pitkänen, N Fyhrquist, M Sadeghi, H Mäkisalo, M Söderlund-Venermo, K Hedman
To date 14 human polyomaviruses (HPyVs) have been identified. The newly found HPyVs have not been examined with regard to post-transplant skin carcinogenesis. To determine the occurrences in skin and possible pathological associations of the HPyVs, we studied their genoprevalences in squamous cell carcinoma (SCC) in situ or actinic keratosis and benign skin in liver transplant recipients (LiTRs); and of healthy skin in immunocompetent adults. We used highly sensitive and specific HPyV PCRs of two types. Overall, Merkel cell polyomavirus (MCPyV), human polyomavirus 6 (HPyV6), human polyomavirus 7 (HPyV7), trichodysplasia spinulosa polyomavirus (TSPyV) and Lyon IARC polyomavirus (LIPyV), were found in 58/221 (26...
January 10, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30597634/investigation-of-the-influence-of-xenoreactive-antibodies-on-activation-of-complement-and-coagulation-in-an-ex-vivo-perfusion-animal-study-using-porcine-kidneys
#5
Wolf Ramackers, Sonja Werwitzke, Johannes Klose, Lars Friedrich, Kai Johanning, Sabine Bergmann, Jürgen Klempnauer, Michael Winkler, Andreas Tiede
BACKGROUND: During pig-to-primate xenotransplantation or perfusion of porcine organs with human blood, a xenogeneic coagulopathy with consecutive development of thrombotic microangiopathy (TMA) can be observed. The aim of this study was to elucidate the influence of the reduction of xenoreactive natural antibodies (XNA) on the coagulopathy using an ex vivo perfusion system. METHODS: Thirteen perfusion experiments using landrace wildtype porcine kidneys were performed in three different experimental groups: autologous, xenogeneic and immunoadsorption...
December 30, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30597643/factors-at-de-novo-dsa-initial-detection-associated-with-allograft-loss-a-multicenter-study
#6
C A Schinstock, D M Dadhania, M J Everly, B Smith, M Gandhi, E Farkash, V K Sharma, M Samaniego-Picota, M D Stegall
We aimed to evaluate patient factors including nonadherence and viral infection and de novo donor specific antibody (dnDSA) characteristics [Total IgG, C1q, IgG3, and IgG4] as predictors of renal allograft failure in a multicenter cohort with dnDSA. We performed a retrospective observational study of 113 kidney transplant recipients with dnDSA and stored sera for analysis. Predictors of death-censored allograft loss were assessed by Cox-proportional modeling Death censored allograft survival was 77.0%(87/113) during a median follow-up of 2...
December 29, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30582255/late-hepatic-artery-thrombosis-after-liver-transplantation-which-strategy
#7
Rafaela Capelli, Marc-Antoine Allard, Oriana Ciacio, Gabriella Pittau, Nicolas Golse, Eric Vibert, Antonio Sa Cunha, Denis Castaing, Daniel Cherqui, René Adam
The management of late hepatic artery thrombosis (LHAT) after liver transplantation (LT) is not codified. The objective of this study was to retrospectively evaluate outcomes after LHAT. All patients with HAT diagnosed 3 months or later after LT on computed tomography between 1993 to 2017 were included. Our policy was to apply a conservative management for asymptomatic or mild symptomatic patients And reserve retransplantation to symptomatic patients with diffuse cholangitis or liver abscess. A total of 56 patients were analyzed...
December 23, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30580473/impact-of-hcv-and-direct-acting-antivirals-on-kidney-recipients-a-retrospective-study
#8
Mohamed Gendia, Pietro Lampertico, Carlo Maria Alfieri, Roberta D'Ambrosio, Maria Teresa Gandolfo, Maria Rosaria Campise, Fabrizio Fabrizi, Piergiorgio Messa
BACKGROUND: HCV in kidney transplanted patients (KTx-p) carries a high risk for a worse outcome. This retrospective study evaluates the impact of HCV and of the new direct acting antivirals (DAAs) on patient and graft outcomes in KTx patients. METHODS: Forty (6.5%) of the 616 KTx-p, who received a kidney transplantation (KTx) in our Centre had antibodies against HCV: 13 were positive for HCV RNA and received DAAs (Group A); 11 were HCV RNA positive and did not receive any treatment (Group B; n=11); 16 were negative for HCV RNA (Group C)...
December 23, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30565748/no-clinical-benefit-of-rapid-vs-gradual-tapering-of-immunosuppression-to-treat-sustained-bk-virus-viremia-after-kidney-transplantation-a-single-center-experience
#9
Arnaud Devresse, Claire Tinel, Agathe Vermorel, Renaud Snanoudj, Lise Morin, Véronique Avettand-Fenoel, Lucile Amrouche, Anne Scemla, Julien Zuber, Christophe Legendre, Marion Rabant, Dany Anglicheau
Immunosuppressive drug tapering is currently the recommended treatment of BK virus (BKV) viremia after kidney transplantation, however its exact modalities remain unclear. We retrospectively compared two consecutive strategies in 111 patients with sustained viremia: a gradual monitoring/tapering group (GT, n=57) before 2012 and a rapid monitoring/tapering group (RT, n=54) after. At viremia diagnosis, the dose of mycophenolic acid (MPA) and tacrolimus levels (T0 ) were similar among patient groups. However, following onset, the dose of MPA at 1 month (P=0...
December 19, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30561097/evaluation-of-the-impact-of-conventional-immunosuppressant-on-the-establishment-of-murine-transplantation-tolerance-an-experimental-study
#10
Haruki Katsumata, Satoshi Miyairi, Masako Ikemiyagi, Toshihito Hirai, Hironori Fukuda, Taichi Kanzawa, Rumi Ishii, Kan Saiga, Yasuyuki Ishii, Kazuya Omoto, Masayoshi Okumi, Takashi Yokoo, Kazunari Tanabe
Regulatory T cells (Tregs) play a significant role in immune tolerance. Since Treg function deeply depends on Interleukin-2 signaling, calcineurin inhibitors could affect their suppressive potentials, whereas mammalian target of rapamycin (mTOR) inhibitors may have less impact, as mTOR signaling is not fundamental to Treg proliferation. We previously reported a novel mixed hematopoietic chimerism induction regimen that promotes Treg proliferation by stimulating invariant natural killer T cells under CD40 blockade...
December 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30556935/expanded-living-donor-liver-transplantation-criteria-for-patients-with-hepatocellular-carcinoma-based-on-the-japanese-nationwide-survey-the-5-5-500-rule
#11
Tsuyoshi Shimamura, Nobuhisa Akamatsu, Masato Fujiyoshi, Atushi Kawaguchi, Satoshi Morita, Seiji Kawasaki, Shinji Uemoto, Norihiro Kokudo, Kiyoshi Hasegawa, Hideki Ohdan, Hiroto Egawa, Hiroyuki Furukawa, Satoru Todo
Expansion of the liver transplantation indication criteria for patients with hepatocellular carcinoma (HCC) has long been debated. Here we propose new, expanded living-donor liver transplantation (LDLT) criteria for HCC patients based on a retrospective data analysis of the Japanese nationwide survey. A total of 965 HCC patients undergoing LDLT were included, 301 (31%) of whom were beyond the Milan criteria. Here, we applied the Greenwood formula to investigate new criteria enabling the maximal enrollment of candidates while securing a 5-year recurrence rate (95% upper confidence limit) below 10% by examining various combinations of tumor numbers and serum alpha-fetoprotein values, and maintaining the maximal nodule diameter at 5 cm...
December 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30549305/for-the-many-permitting-deceased-donor-kidney-transplantation-across-low-titre-blood-group-antibodies-can-reduce-wait-times-for-blood-group-b-recipients-and-improve-the-overall-number-of-000mm-transplants-a-multicentre-observational-cohort-study
#12
Miriam Manook, Lisa Bradbury, A Nicholas R Barnett, Daniel Osei-Bordom, Bynvant Sandhu, David Veniard, Tim Maggs, Olivia Shaw, Nicos Kessaris, Anthony Dorling, Sapna Shah, Nizam Mamode
Blood group O or B recipients wait longer for a kidney transplant. We studied the distribution of anti-ABO blood group antibody titres in patients awaiting a kidney transplant, and modelled the effect of altering the UK National Kidney Allocation Scheme to allow for patients with 'LOW' titres (≤1:8, ≤3 dilutions) to receive a deceased donor ABOi (ddABOi) transplant. In a prospective study of 239 adult patients on the waiting list for a transplant in 2 UK centres, ABO-antibody titres (anti-A and anti-B) were measured...
December 14, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30548094/simultaneous-liver-kidney-transplantation
#13
REVIEW
Ashwani K Singal, Song Ong, Sanjaya Satpathy, Patrick S Kamath, Russel H Wiesner
Kidney injury is frequently seen in patients with end stage liver disease from cirrhosis and liver failure. Among select patients, simultaneous liver kidney (SLK) transplantation provides improved post-transplant graft and patient outcomes compared to liver transplantation alone. We conducted review of the existing literature on SLK transplant criteria and outcomes. Since the introduction of the model for end-stage disease score in 2002, there has been an increased use of simultaneous liver kidney transplantation...
December 10, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30536448/perioperative-antithrombotic-therapy-does-not-increase-the-incidence-of-early-postoperative-thromboembolic-complications-and-bleeding-in-kidney-transplantation-a-retrospective-study
#14
Tamar A J van den Berg, Robert C Minnee, Ton Lisman, Gertrude J Nieuwenhuijs-Moeke, Jacqueline van de Wetering, Stephan J L Bakker, Robert A Pol
Perioperative antithrombotic therapy could play a role in preventing thromboembolic complications (TEC) after kidney transplantation (KTx), but little is known on postoperative bleeding risks. This retrospective analysis comprises 2000 single-organ KTx recipients transplanted between 2011-2016 in the two largest transplant centers of the Netherlands. TEC and bleeding events were scored ≤7 days post-KTx. Primary analyses were for associations of antithrombotic therapy with incidence of TEC and bleeding. Secondary analyses were for associations of other potential risk factors...
December 10, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30525265/primary-graft-dysfunction-and-beyond-after-lung-transplantation-in-the-current-era
#15
Norihisa Shigemura
When encountering early signs of primary graft dysfunction (PGD) at the end of the procedure following lung transplantation in operating rooms, aside from lung protective ventilation strategies, two key players as currently available therapeutic options include inhaled nitric oxide (iNO) and/or extracorporeal membrane oxygenation (ECMO) (1). While iNO plays a unique and relevant therapeutic role in the current clinical lung transplantation, its impact on posttransplant outcomes remains unclear mostly due to a large variety of iNO usage in clinical practice intra-, peri-, and post-operatively among the institutions (2-3)...
December 7, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30525251/response-to-ghinolfi-et-al
#16
LETTER
Sebastian Pratschke, Andreas Bender, Martin Angele
The authors welcome the discourse presented by Ghinolfi et al. [1] and appreciate the opportunity to respond to their comments on the manuscript "Association between donor age and risk of graft failure after liver transplantation: an analysis of the Eurotransplant database" [2]. The aim of our study was to estimate the effect of donor age on the risk of graft failure in liver transplantation. This article is protected by copyright. All rights reserved.
December 7, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30525250/retrospective-study-on-detection-treatment-and-clinical-outcome-of-graft-thrombosis-following-pancreas-transplantation
#17
Wouter W H Kopp, Claar C A T van Leeuwen, David H D Lam, Volkert V A L Huurman, Hans J W de Fijter, Sandro A F Schaapherder, Andre A G Baranski, Andries A E Braat
INTRODUCTION: Complete graft thrombosis is the leading cause of early graft loss following pancreas transplantation. Partial thrombosis is usually subclinical and discovered on routine imaging. Treatment options may vary in such cases. We describe the incidence and relevance of partial graft thrombosis in a large transplant center. METHODS: All consecutive pancreas transplantation at our center (2004-2015) were included in this study. Radiological follow-up, type and quantity of thrombosis prophylaxis, complications and graft and patient survival were collected...
December 7, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30488486/determinants-of-survival-in-lung-transplantation-patients-with-idiopathic-pulmonary-fibrosis-a-retrospective-cohort-study
#18
Sebastiaan Tuyls, Stijn E Verleden, Wim A Wuyts, Jonas Yserbyt, Robin Vos, Geert M Verleden
Survival after lung transplantation (LTx) for idiopathic pulmonary fibrosis (IPF) is worse compared to other indications for LTx. We investigated the effect of several pre-transplant variables including the use of pre-transplant corticosteroids (CS) on post-transplant graft and CLAD (chronic lung allograft dysfunction) free survival and functional testing (maximum inspiratory and expiratory pressure, six-minute walk test, quadriceps and hand pinch force) in a small cohort of IPF patients. We retrospectively compared 2 groups of IPF patients (n=36 on CS vs...
November 28, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30449027/inhaled-nitric-oxide-dependency-at-the-end-of-double-lung-transplantation-a-boosted-propensity-score-cohort-analysis
#19
Julien Fessler, Mathieu Godement, Romain Pirracchio, Jean-Yves Marandon, Jacques Thes, Edouard Sage, Antoine Roux, François Parquin, Charles Cerf, Marc Fischler, Morgan Le Guen
OBJECTIVE: Inhaled nitric oxide (iNO) is usually used during lung transplantation despite controversial postoperative benefits. Our group chose to administer iNO systematically during the procedure and stop at end of surgery. This study aims to describe the features of patients who cannot be weaned from iNO, the reasons for this and its impact on postoperative outcomes. METHODS: This is a monocentric cohort study comprised all consecutive patients who underwent double-lung transplantation (DLT) between January 1st, 2012 and January 1, 2016...
November 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/30427079/weekend-effect-on-early-allograft-outcome-after-kidney-transplantation-a-multi-centre-cohort-study
#20
Wai H Lim, Patrick T Coates, Graeme R Russ, Christine Russell, Bulang He, Bryon Jaques, Henry Pleass, Jeremy R Chapman, Germaine Wong
Weekend surgery may be associated with a higher risk of early complications, but the effect of the timing of kidney transplant surgery on early allograft outcome remains uncertain. The aim of this study is to evaluate whether the association between weekend transplant surgery and allograft failure was modified by prevalent vascular disease. Using data from the Australia and New Zealand Dialysis and Transplant registry, we examined the association between weekend status and 90-day and 1-year allograft failure in deceased donor transplant recipients between 1994-2012...
November 14, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
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