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

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https://www.readbyqxmd.com/read/28512790/ultrastructural-changes-of-the-glomerular-basement-membrane%C3%A2-unmasked-by-c4d-staining
#1
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
#2
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
#3
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
#4
G Normand, F Brunner, L Badet, F Buron, M Catton, J Massardier, L Esposito, P Grimbert, G Mourad, J E Serre, S Caillard, G Karam, D Cantarovich, E Morelon, O 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
#5
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
https://www.readbyqxmd.com/read/28493630/clinical-outcomes-of-abo-and-hla-incompatible-kidney-transplantation-a-nationwide-cohort-study
#6
Eun Jeong Ko, Ji Hyun Yu, Chul Woo Yang, Byung Ha Chung
This was a nationwide cohort study to investigate the impact of anti-A/B and donor-specific anti-HLA (HLA-DSA) antibodies on the clinical outcomes in kidney transplant recipients (KTRs). We classified a total of 1,964 KTRs into four groups: transplants from ABO-incompatible donors (ABOi, n=248); transplants in recipients with HLA-DSA (HLAi, n=144); transplants from combined ABOi and HLAi donors (ABOi+HLAi, n=31); and a control group for whom neither ABOi nor HLAi was applicable (CONT, n=1541). We compared the incidence of biopsy proven acute rejection (BPAR), allograft and patient survival rates...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28493629/it-is-the-time-to-rethink-the-criteria-to-define-transplantable-kidneys-should-we-combine-histological-and-clinical-evaluation
#7
Giovanni Stallone, Giuseppe Grandaliano
In this issue of Transplantation International, Sanchez-Escudero et al [1] report the results obtained from a prospective single centre study enrolling 485 consecutive transplant recipients receiving a kidney with a Remuzzi score (RS) [2] of Pre Transplant Donor Biopsies (PTDB) lower or equal to 4. Then retrospectively, the authors compared their organ allocation policy based on RS with kidney donor profile index (KDPI) [3] and evaluated the discard rate between KDPI and PTDB and five years graft and patients survival...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28493615/why-we-need-fairer-allocation-rules-for-patients-with-hepatocellular-carcinoma-awaiting-a-liver-transplant
#8
Herold J Metselaar, Aad van den Berg, Minneke J Coenraad
The incidence of both cirrhosis and hepatocellular carcinoma (HCC) is increasing worldwide, despite the current available effective therapy for HCV infection [1]. As liver transplantation is a potential curative option for many patients, the demand for liver transplantation is rising too. Unfortunately, the availability of cadaveric donor livers has remained stable over the years, leading to a widening of the gap between donor organ supply and demand and a higher waiting list mortality or removal rate. The current waiting list mortality and removal rate within Eurotransplant is respectively 18% and 4% [2]...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28493506/alemtuzumab-dose-adjusted-for-body-weight-is-associated-with-earlier-lymphocyte-repletion-and-less-infective-episodes-in-the-first-year-post-renal-transplantation
#9
Michelle Willicombe, Dawn Goodall, Adam G McLean, David Taube
The optimal dose of alemtuzumab for renal transplant induction is not known and the doses reported in the literature vary. This study compares 2 separate dosing regimens of alemtuzumab in renal transplantation. The first is a standard fixed dose of 30mg (SD) and the second is a dose adjusted for body weight at 0.04mg/kg (AD). In this first-year post transplant, there was no difference in patient [HR 0.64 (0.22-1.86), p=0.39] or allograft survival [HR 1.18 (0.48-2.90), p=0.72] between the two groups. There was also no difference in overall rejection free survival [HR 1...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28480540/pharmacological-modulation-of-cell-death-in-organ-transplantation
#10
REVIEW
Pietro E Cippà, Thomas Fehr
New options to pharmacologically modulate fundamental mechanisms of regulated cell death are rapidly evolving and found first clinical applications in cancer therapy. Here we present an overview on how the recent advances in the understanding of the biology and pharmacology of cell death might influence research and clinical practice in solid organ transplantation. Of particular interest are the novel opportunities related to organ preservation and immunomodulation, which might contribute to promote organ repair and to develop more selective ways to modulate allogeneic immune responses to prevent rejection and induce immunological tolerance...
May 8, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28453891/towards-a-better-risk-stratification-for-late-antibody-mediated-rejection-in-abo-incompatible-kidney-recipients
#11
Philippe Grimbert
During the last 25 years, increasing organ shortage enforced the development for living donor programs including ABO-incompatible (ABOi) renal transplantation, paired donor exchange program and transplantation across a positive cross-match. ABOi kidney transplantation has become a routine procedure with death-censored graft survival rates comparable to the rates in compatible transplantation. This article is protected by copyright. All rights reserved.
April 28, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28445627/psychosocial-wellbeing-after-living-kidney-donation-a-longitudinal-prospective-study
#12
Hannah Maple, Joseph Chilcot, John Weinman, Nizam Mamode
Living kidney donation (LKD) has become routine practice across the world as the gold standard treatment of end-stage renal failure. Whilst the physical risks and harms of LKD surgery are well documented, relatively little is known about psychosocial outcomes. The aim of this study was to determine whether it was possible to quantify the psychosocial impact of LKD. A prospective longitudinal study of 93 living kidney donors was performed. Data were collected pre-operatively, and 3 and 12 months after donation...
April 26, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28445619/mtor-inhibitors-and-risk-for-chronic-antibody-mediated-rejection-after-kidney-transplantation-where-are-we-now
#13
REVIEW
Philippe Grimbert, Olivier Thaunat
Antibody-mediated rejection (AMR) usually starts with generation of donor-specific anti-HLA antibodies (DSA), arising from a B-cell response to antigen recognition. In vitro and preclinical data demonstrate that mammalian target of rapamycin (mTOR) inhibition attenuates the mTOR-mediated intracellular signaling pathway involved in AMR-related kidney damage. The limited available data from immunological studies in kidney transplant patients, however, have not shown such effects in vivo. In terms of clinical immunosuppression, the overriding influence on rates of de novo DSA (dnDSA) or AMR - regardless of the type of regimen - is patient adherence...
April 26, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28436117/early-introduction-of-oral-paricalcitol-in-renal-transplant-recipients-an-open-label-randomized-study
#14
Hege Kampen Pihlstrøm, Franscesca Gatti, Clara Hammarström, Ivar Anders Eide, Monika Kasprzycka, Junbai Wang, Guttorm Haraldsen, My Hanna Sofia Svensson, Karsten Midtvedt, Geir Mjøen, Dag Olav Dahle, Anders Hartmann, Hallvard Holdaas
In stable renal transplant recipients with hyperparathyroidism, previous studies have indicated that vitamin D agonist treatment might have anti-proteinuric effects. Animal studies indicate possible anti-fibrotic and anti-inflammatory effects. Early introduction of paricalcitol in de-novo renal transplant recipients might reduce proteinuria and prevent progressive allograft fibrosis. We performed a single-centre, prospective, randomized, open-label trial investigating effects of paricalcitol 2μg/day added to standard care...
April 24, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28432714/high-human-cytomegalovirus-dnaemia-early-post-transplantation-associates-with-irreversible-and-progressive-loss-of-renal-function
#15
Wouter T Lollinga, Lilli Rurenga-Gard, Willem van Doesum, Rik van Bergen, Arjan Diepstra, Judith M Vonk, Annelies Riezebos-Brilman, Hgm Niesters, Willem J van Son, Jacob van den Born, Jan-Stephan Sanders
BACKGROUND: Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. METHODS: 264 (age 50.9±13.5; male 55%) Renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL≤536, PVL536-6310 or PVL>6310 International Units/ml (IU/ml)...
April 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28419684/should-organs-from-hepatitis-c-virus-infected-donors-be-used-for-transplantation-in-the-era-of-daas
#16
Hideki Ohdan
Hepatitis C virus (HCV) infection has been demonstrated to deleteriously impact both patient and graft survival following non-hepatic organ transplantation [1, 2]. Interferon (IFN)-based therapies prior to non-hepatic transplant in HCV-infected patients improved their survival, however, tolerability and low cure rates practically limited those therapies [3]. In addition, due to the risk of allograft rejection, IFN-based therapy following non-hepatic solid organ transplant is not generally recommended. This article is protected by copyright...
April 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28419581/successful-kidney-transplantation-in-highly-sensitised-ultra-long-term-dialysis-patients
#17
LETTER
Jennifer A McCaughan, Aisling E Courtney
Achieving successful kidney transplantation for highly sensitised patients is a global challenge. These individuals face inequity of access to organs as a consequence of their HLA antibody status; this equates to a prolonged wait time on dialysis, a mounting burden of comorbidity and an increased risk of death [1-3]. Kidney allocation policies across the world aim to address this by prioritising highly sensitised patients for compatible kidney offers [4-6]. Despite this, those who wait the longest for a kidney transplant remain the most highly sensitised...
April 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28403575/comparison-of-two-equivalent-meld-scores-for-hepatocellular-carcinoma-patients-using-data-from-the-united-network-for-organ-sharing-liver-transplant-waiting-list-registry
#18
Sarah K Alver, Douglas J Lorenz, Kenneth Washburn, Michael R Marvin, Guy N Brock
Hepatocellular carcinoma (HCC) patients have been advantaged on the liver transplant waiting list within the United States, and a 6-month delay and exception point cap have recently been implemented to address this disparity. An alternative approach to prioritization is an HCC-specific scoring model such as the MELD Equivalent (MELDEQ ) and the mixed new deMELD. Using data on adult patients added to the UNOS waitlist between 9/30/2009 and 6/30/14, we compared projected dropout and transplant probabilities for HCC patients under these two models...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28403566/outcomes-and-risk-stratification-for-late-antibody-mediated-rejection-in-recipients-of-abo-incompatible-kidney-transplants
#19
Bonnie E Lonze, Sunjae Bae, Edward S Kraus, Mary J Holechek, Karen E King, Nada Alachkar, Fizza F Naqvi, Nabil N Dagher, Adnan Sharif, Niraj M Desai, Dorry L Segev, Robert A Montgomery
The required intensity of monitoring for antibody-mediated rejection (AMR) after of ABO-incompatible (ABOi) kidney transplantation is not clearly formulized. We retrospectively evaluated a single-center cohort of 115 ABO-incompatible (ABOi) kidney transplant recipients, of which 32% were also HLA-incompatible (ABOi/HLAi) with their donors. We used an adjusted negative binomial model to evaluate risk factors for late AMR. Using this model, we risk-stratified patients into high- and low-risk groups for the development of late AMR...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28403563/the-impact-of-infections-on-delisting-patients-from-the-liver-transplantation-waiting-list
#20
Louise J M Alferink, Rosalie C Oey, Bettina E Hansen, Wojciech G Polak, Henk R van Buuren, Robert A de Man, Carolina A M Schurink, Herold J Metselaar
BACKGROUND: Approximately 20% of the patients listed for liver transplantation die before transplantation can be accomplished. Understanding risk factors for waiting list mortality may help to improve survival and organ allocation. Infections are very common in patients with cirrhosis and are associated with significant morbidity and mortality. This study analysed the frequency and characteristics of infections in patients awaiting liver transplantation, identified risk factors for withdrawal from the waiting list and evaluated the impact of infections on the clinical outcome...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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