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

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https://www.readbyqxmd.com/read/28622441/cardiovascular-mortality-among-liver-transplant-recipients-with-nonalcoholic-steatohepatitis-nash-in-the-united-states
#1
Sanjaya K Satapathy, Yu Jiang, James D Eason, Satish K Kedia, Emily Wong, Ashwani K Singal, Elizabeth A Tolley, Donna Hathaway, Satheesh Nair, Jason M Vanatta
Nonalcoholic Steatohepatitis (NASH) has become an increasingly important indication for liver transplantation (LT), and there has been a particular concern of excessive cardiovascular-related mortality in this group METHODS: Using the United Network for Organ Sharing-Standard Transplant Analysis and Research (UNOS-STAR) dataset, we reviewed data on 56,995 adult transplants (January 2002 through June 2013). 3,170 NASH liver-only recipients were identified and were matched with 3,012 non-NASH HCV+ and 3,159 non-NASH HCV- controls [matched 1:1 based on gender, age at LT (±3 years), and MELD score (±3)] RESULTS: Cox regression analysis revealed significantly lower hazard of all-cause (HR 0...
June 16, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28608637/regulatory-t-cell-therapy-in-liver-transplantation
#2
REVIEW
Gavin P Whitehouse, Andrew Hope, Alberto Sanchez-Fueyo
Modern immunosuppression drug regimens have produced excellent short term survival after liver transplantation but it is generally accepted that the side effects of these medications remain a significant contributing factor for less satisfactory long term outcomes. The liver has unique tolerogenic properties as evidenced by the higher rates of operational tolerance seen in liver transplant recipients compared to other solid organ transplants and therefore liver transplantation offers an attractive setting in which to study tolerising therapies...
June 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28608627/all-s-well-following-living-kidney-donation
#3
John Scandling
Wellbeing following living kidney donation, both physical and psychosocial, continues to be a concern and area of investigative focus decades following the acceptance of kidney transplantation as treatment for end-stage kidney disease. In this issue, Maple and colleagues report their prospective study of wellbeing in living kidney donors during the first year after donation, using a comprehensive array of psychosocial outcome measures. Their aim was to produce a quantitative analysis to better inform both transplant teams and potential donors...
June 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28608619/efficacy-and-safety-of-daclatasvir-based-antiviral-therapy-in-hcv-recurrence-after-liver-transplantation-role-of-cirrhosis-and-genotype-3-a-multi-centre-cohort-study
#4
Magdalena Salcedo, Martín Prieto, Lluís Castells, Juan Manuel Pascasio, Jose Luis Montero Alvarez, Inmaculada Fernández, Gloria Sánchez-Antolín, Luisa González-Diéguez, Miguel García-Gonzalez, Alejandra Otero, Sara Lorente, Maria Dolores Espinosa, Milagros Testillano, Antonio González, Jose Castellote, Fernando Casafont, Maria-Carlota Londoño, Jose Antonio Pons, Esther Molina Pérez, Valentín Cuervas-Mons, Sonia Pascual, Jose Ignacio Herrero, Isidoro Narváez, Carmen Vinaixa, Jordi Llaneras, Jose Manuel Sousa, Rafael Bañares
BACKGROUND & AIMS: Direct-acting antiviral agents (DAA) combining daclatasvir (DCV) have reported good outcomes in the recurrence of hepatitis C virus (HCV) infection after liver transplant (LT). However, its effect on the severe recurrence and the risk of death remains controversial. We evaluated the efficacy, predictors of survival, and safety of DAC-based regimens in a large real-world cohort. METHODS: A total of 331 patients received DCV-based therapy. Duration of therapy and ribavirin use were at the investigator's discretion...
June 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28608574/the-attitude-of-latin-american-immigrants-in-florida-usa-towards-deceased-organ-donation
#5
Antonio Ríos, Ana Isabel López-Navas, José Antonio García, Gregorio Garrido, Marco Antonio Ayala-García, María José Sebastián, Antonio Miguel Hernandez, Pablo Ramírez, Pascual Parrilla
INTRODUCTION: The Latin American (LA) population resident in the USA is a growing subgroup of the population. OBJECTIVE: To find out the structure of attitude towards organ donation in the LA population resident in Florida (USA). METHODS: A sample was taken of LA residents in Florida, randomised and stratified by nationality, age and sex (n=1524). Attitude was assessed using a validated questionnaire (PCID-DTO Rios), that was self-completed anonymously...
June 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28605573/prediction-of-biliary-anastomotic-stricture-after-deceased-donor-liver-transplantation-the-impact-of-platelet-counts
#6
Kazuhiro Takahashi, Shunji Nagai, Krishna G Puchakayala, Mohamed Safwan, Masahiko Gosho, Amy Y Li, William J Kane, Priyanka L Singh, Michael D Rizzari, Kelly M Collins, Atsushi Yoshida, Marwan S Abouljoud, Gabriel T Schnickel
Biliary stricture is a common cause of morbidity after liver transplantation (LT). This study aimed to determine the risk factors for post-transplant biliary anastomotic strictures (BAS), focusing on perioperative platelet counts. We enrolled 771 consecutive recipients who underwent ABO-identical/compatible deceased donor LT with duct-to-duct biliary reconstruction from January 2000 to June 2012. BAS was identified in 142 cases. The median time for stricture development was 176 days. Preoperative and postoperative platelet counts within 5 days after LT were significantly lower in patients with BAS than those without BAS...
June 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28590558/tangential-extraperitoneal-retrorenal-ter-approach-a-specified-uniform-technique-for-renal-transplant-biopsy
#7
LETTER
Miro Dominik Boban, Martin Tiefenthaler
while rarely discussed in literature, we want to draw attention to the fact that the risk for complications induced by percutaneous renal transplant biopsy (PRTB) might depend on the topography of the chosen biopsy path. Only a few possible techniques and approaches have been adequately described by now. In 2010, Patel et al. indicated substantial advantages of various tangential biopsy approaches [1]. Still, their study reported cases of transfusion-requiring bleedings, intraperitoneal hemorrhage and rectus sheath hematoma...
June 7, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28585408/increased-risk-of-infection-associated-death-with-incompatible-kidney-transplantations
#8
Christian Morath, Martin Zeier, Caner Süsal
In times of organ shortage, transplantation over the blood group A/B and HLA antibody barriers helps increasing the living donor pool in kidney transplantation. Waiting times are reduced while patient survival may be improved. By desensitization, both blood group A/B as well as HLA antibodies are eliminated from the patient's circulation using plasmapheresis, double filtration plasmapheresis or selective or unselective immunoadsorption. In addition, antibody production and posttransplant antibody rebound are prevented by powerful immunosuppression and induction therapy with or without B-cell eliminating anti-CD20 antibody rituximab...
June 6, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28574620/rescue-allocation-and-recipient-oriented-extended-allocation-in-kidney-transplantation-influence-of-the-eurotransplant-allocation-system-on-recipient-selection-and-graft-survival-for-initially-non-accepted-organs
#9
Roger Wahba, Barbara Suwelack, Wolfgang Arns, Figen Cakiroglu, Ute Eisenberger, Thorsten Feldkamp, Anita Hansen, Kathrin Ivens, Thomas Klein, Andreas Kribben, Christine Kurschat, Ulrich Lange, Anja Mühlfeld, Martin Nitschke, Stefan Reuter, Kevin Schulte, Richard Viebahn, Rainer Woitas, Martin Hellmich, Dirk L Stippel
Non-accepted kidneys grafts enter the rescue allocation (RA) process to avoid discards. In December 2013 recipient oriented extended allocation (REAL) was introduced to improve transparency. Aim of this study was to evaluate the influence of REAL on recipients' selection and graft function compared to the formerly existing RA as well as to identify factors that influence graft outcome. Therefore, a multicenter study of 10 transplant centers in the same region in Germany was performed. All transplantations after RA or REAL from 1st December 2012 until 31st December 2014 with a follow-up time until 31st December 2015 were analyzed...
June 2, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28556989/weight-based-dosing-of-alemtuzumab-an-ounce-of-prevention
#10
Joshua J Augustine
Alemtuzumab is a lymphocyte-depleting humanized monoclonal antibody that targets CD52 and binds to T and B lymphocytes, macrophages, monocytes and natural killer cells.(1) It was approved decades ago for the treatment of B-cell chronic lymphocytic leukemia (CLL), and the use of alemtuzumab in kidney transplantation was first described in the late 1990s as a drug that could promote tolerance and allow for maintenance drug minimization.(2) Although there has been variability in dosing in renal transplantation(3-5) , alemtuzumab is typically administered at a dosage of 30 mg intravenously once or twice in the perioperative transplant period, which is a fraction the cumulative dosage used for CLL...
May 30, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28556538/a-retrospective-database-analysis-to-evaluate-the-potential-of-evlp-to-recruit-declined-lung-donors
#11
An Martens, Dirk E Van Raemdonck, Jacqueline Smits, Stijn E Verleden, Robin Vos, Bart M Vanaudenaerde, Geert M Verleden, Karlien Degezelle, Bruno Desschans, Arne P Neyrinck
BACKGROUND: Ex-vivo lung perfusion (EVLP) is currently used for both standard and extended-criteria donor (ECD) lungs. To enlarge the donor pool, we might have to extend the threshold for ECD donation. The purpose of this study was to estimate how many additional ECD lungs could be recruited by EVLP. METHODS: We reviewed all multi-organ donors (MODs) from our collaborative donor hospitals (January 2010 - June 2015). All unused lung donors, were categorized using registered donor data and evaluated by two independent investigators to identify which lungs could be transplanted after EVLP...
May 27, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28556488/induction-therapy-with-rabbit-antithymocyte-globulin-versus-basiliximab-after-kidney-transplantation-a-health-economic-analysis-from-a-german-perspective
#12
Liana Cremaschi, Regina von Versen, Thomas Benzing, Michael Wiesener, Nikolai Zink, Gary Milkovich, Thomas Paivanas, Meghan Gallagher, Friedrich Thaiss
A health economic analysis was undertaken based on the one-year database from a randomized study of rabbit anti-human thymocyte immunoglobulin (rATG) versus basiliximab, in kidney transplantation using resource utilization data and cost estimates from three German hospitals. A three-state Markov model was applied to estimate cost effectiveness to 10 years post-transplant. Total mean treatment cost per patient to year 1 post-transplant was €62,075 versus €59,767 for rATG versus basiliximab (p<0.01). rATG therapy was associated with similar treatment costs to basiliximab by year 2, and a predicted cumulative treatment cost saving of €4,259 under rATG versus basiliximab by year 10 post-transplant...
May 27, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28543637/evidence-of-the-immunomodulatory-role-of-dual-pi3k-mtor-inhibitors-in-graft-survival
#13
Valery Vilchez, Lilia Turcios, D Allan Butterfield, Mihail I Mitov, Cristin L Coquillard, Anthony J Brandon, Virgilius Cornea, Roberto Gedaly, Francesc Marti
The PI3K/mTOR signaling cascade is fundamental in T-cell activation and fate decisions. We showed the distinct regulation of PI3K/mTOR in regulatory and effector T-cells and proposed the potential therapeutic benefit of targeting this pathway to control the balance between effector and regulatory T-cell activities. Substantial adverse effects in long-term clinical usage of Rapamycin suggest the use of alternative treatments in restraining effector T-cell function in transplant patients. We hypothesize that dual PI3K/mTOR inhibitors may represent an immunosuppressant alternative...
May 24, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28543878/mitap-compliant-characterisation-of-human-regulatory-macrophages
#14
REVIEW
James A Hutchinson, Nobert Ahrens, Edward K Geissler
This article provides a transparent description of Mreg_UKR cell products, including manufacture and quality-control processes, using the structure and vocabulary of the 'Minimum Information about Tolerogenic Antigen-presenting Cells' reporting guidelines. This information is intended as a resource for those in the field, as well as a stimulus to develop a new wave of immunoregulatory and tissue-reparative monocyte-derived cell therapies. This article is protected by copyright. All rights reserved.
May 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28544183/clinical-outcomes-of-intestinal-transplant-recipients-colonized-with-multi-drug-resistant-organisms-a-retrospective-study
#15
Jacques Simkins, Michele I Morris, Jose F Camargo, Rodrigo Vianna, Thiago Beduschi, Lilian M Abbo
Rates of multi-drug resistant organisms (MDRO) colonization among intestinal transplant (ITx) recipients have not been reported. Colonization rates with vancomycin-resistant Enterococcus (VRE), carbapenem-resistant gram-negative bacteria (CR-GNB) and methicillin-resistant Staphylococcus aureus (MRSA) were obtained retrospectively in adults undergoing ITx (isolated or multi-visceral) from 1/2009-12/2015. We assessed for VRE, CR-GNB and MRSA bacteremia during the first year post-transplant for patients colonized with VRE, CR-GNB and MRSA respectively and for those who were not colonized...
May 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28512790/ultrastructural-changes-of-the-glomerular-basement-membrane%C3%A2-unmasked-by-c4d-staining
#16
LETTER
Jan von der Thusen, Remco de Louw, Mark Bourgondien, Marian Clahsen-van Groningen
I was very pleased to have read the Epub ahead of print of a Transplant International's article entitled "glomerular C4d deposits can mark structural capillary wall remodeling in thrombotic microangiopathy and transplant glomerulopathy: C4d beyond active antibody-mediated injury: a retrospective study". Until now, no studies have reported on the importance of using glomerular C4d staining in the evaluation of ultrastructural changes of the glomerular basement membrane. This article is protected by copyright...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28512755/evaluation-of-safety-of-concomitant-splenectomy-in-living-donor-liver-transplantation
#17
Amr Badawy, Yuhei Hamaguchi, Satoru Seo, Tochimi Kaido, Hideaki Okajima, Shinji Uemoto
In Asian countries, concomitant splenectomy in living donor liver transplantation (LDLT) is indicated to modulate the portal vein pressure in the small sized graft to protect against small for size syndrome. While concomitant splenectomy in deceased donor liver transplantation is almost contraindicated based on western reports of increased mortality and morbidity rate due to septic complications, there are few studies about that in LDLT. So, we retrospectively investigated the clinical outcome of adult LDLT at Kyoto University Hospital from July 2010 to July 2016...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28500792/changing-trends-in-the-aetiology-treatment-and-outcomes-of-bloodstream-infection-occurring-in-the-first-year-after-solid-organ-transplantation-a-single-centre-prospective-cohort-study
#18
Isabel Oriol, Núria Sabé, Antonella F Simonetti, Laura Lladó, Anna Manonelles, Jose González, Fe Tubau, Jordi Carratalà
To analyse trends in the aetiology, treatment and outcomes of BSI within the first year post-transplant over the last 10-year period, we prospectively recorded all episodes of BSI occurring in SOT recipients during the first year post-transplant from 2007 to 2016. Trends of factors were analysed by 2-year periods. Of 475 consecutive episodes of BSI, 218 occurred within a year of SOT in 178 SOT recipients. Gram-positive BSI decreased over time (40.5% to 2.2%). In contrast, there was a steady increase in Gram-negative bacilli (GNB) BSI (54...
May 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28500781/pregnancy-outcomes-in-simultaneous-pancreas-and-kidney-transplant-recipients-a-national-french-survey-study
#19
Gabrielle Normand, Flora Brunner, Lionel Badet, Fanny Buron, Marielle Catton, Jérôme Massardier, Laure Esposito, Philippe Grimbert, Georges Mourad, Jean E Serre, Sophie Caillard, Georges Karam, Diego Cantarovich, Emmanuel Morelon, Olivier Thaunat
Simultaneous pancreas and kidney transplantation (SPK) is currently the best therapeutic option for patients with type 1 diabetes and terminal renal failure. Renal transplantation restores fertility enabling women to pursue pregnancies. However, scarcity of available data on pregnancy outcomes in SPK impedes fair medical counseling. Medical files of all pregnancies that lasted ≥3 months among recipients of functional SPK performed between 1990 and 2015 in France were retrospectively analyzed. Twenty-six pregnancies in 22 SPK recipients were identified...
May 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28493634/an-experimental-study-of-the-recovery-of-injured-porcine-lungs-with-prolonged-normothermic-cellular-ex-vivo-lung-perfusion-following-donation-after-circulatory-death
#20
John R Spratt, Lars M Mattison, Paul A Iaizzo, Roland Z Brown, Haylie Helms, Tinen L Iles, Brian Howard, Angela Panoskaltsis-Mortari, Gabriel Loor
INTRODUCTION: Donation after circulatory death (DCD) is an underused source of donor lungs. Normothermic cellular ex vivo lung perfusion (EVLP) is effective in preserving standard donor lungs but may also be useful in the preservation and assessment of DCD lungs. METHODS: Using a model of DCD and prolonged EVLP, the effects of donor warm ischemia and postmortem ventilation on graft recovery were evaluated. Adult male swine underwent general anesthesia and heparinization...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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