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

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https://www.readbyqxmd.com/read/29341300/inflammatory-and-related-biomarkers-are-associated-with-post-transplant-diabetes-mellitus-in-kidney-recipients
#1
Torbjørn F Heldal, Thor Ueland, Trond Jenssen, Anders Hartmann, Anna V Reisaeter, Pål Aukrust, Annika Michelsen, Anders Åsberg
In this study we investigate the association between selected inflammatory related biomarkers and post transplant hyperglycemia in kidney transplant recipients. This retrospective analysis comprises 852 patients receiving a kidney transplant at the Norwegian national transplant centre between 2007 and 2012, all having a normal oral glucose tolerance test (OGTT) before transplantation. A diagnostic OGTT was performed 10 weeks post-transplant to examine the association between inflammation related biomarkers and two-hour plasma glucose (2HPG) by multivariable linear regression models adjusting for BMI, age, graft function, fasting insulin levels, dosage of prednisolone, and concentration of calcineurin inhibitors...
January 16, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29341290/early-failure-of-kidney-transplants-in-the-current-era-a-national-cohort-study
#2
Ilkka Helanterä, Juulia Räihä, Patrik Finne, Marko Lempinen
Although short-term outcome after kidney transplantation has improved, a small proportion of grafts are lost during the first year. We characterize in detail all early graft losses in the current era in a nationwide cohort of kidney transplant recipients. Altogether 2447 kidney transplantations, performed between June 2004 and October 2016, were included. All graft losses (return to dialysis or patient death) occurring during the first posttransplant year were characterized. During the first posttranplant year altogether 109 grafts were lost, 67 grafts failed, and 42 patients died...
January 16, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29341270/pre-transplant-depression-in-lung-recipients-a-lost-battle
#3
Ivan Knezevic, Bojan Zalar
What have we learned so far about the relationship of the recipient's pre-transplant depression and his survival after lung transplantation? First, every chronic disease is always accompanied by somatic changes, functional limitations and emotional, cognitive and social changes as part of the disease. From the first symptoms, to the time of diagnosis of the chronic disease with the expected future, the patient is exposed to the terrible stress of denying and accepting life with a serious chronic illness whose end result is death...
January 16, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29341248/are-kidney-transplantation-outcomes-improved-in-children-weighting-15-kilograms-or-less-in-the-last-decades
#4
George S Reusz, Miklos Z Molnar
As perinatal and postnatal care of neonates with impaired kidney function is constantly improving, the number of infants needing renal replacement therapy is increasing. Consequently, the general attitude of clinicians to offer renal replacement therapy (RRT) during the first year of life is changing gradually. The ideal renal replacement modality for children and adolescents is renal transplantation (RTX), as both the short-term and long-term medical complications of hemo- and peritoneal dialysis confer inferior survival rates compared to RTX to this patent group...
January 16, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29328536/rituximab-as-monotherapy-for-the-treatment-of-chronic-active-antibody-mediated-rejection-after-kidney-transplantation
#5
LETTER
Yannick D Muller, Ghaleb Nseir, Samuel Rotman, Julien Vionnet, Mathieu Halfon, Emmanuelle Catana, Déla Golshayan, Jean-Pierre Venetz, Vincent Aubert, Manuel Pascual
Chronic active antibody-mediated rejection (caAMR) is a major cause of allograft loss after kidney transplantation (1). The BANFF 2013 classification redefined caAMR by the presence of donor-specific anti-HLA antibodies (DSA) together with immuno-histopathological evidence for active vascular lesions of the endothelium (C4d deposits, glomerulitis, peritubular capillaritis) as well as evidence of chronic tissue injury (transplant glomerulopathy, peritubular capillary basement membrane multilayering or arterial intimal fibrosis) (2,3)...
January 12, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29284181/clinical-validation-of-a-novel-elispot-based-in-vitro-diagnostic-assay-to-monitor-cmv-specific-cell-mediated-immunity-in-kidney-transplant-recipients-a-multicenter-longitudinal-prospective-observational-study
#6
Bernhard Banas, Dominik Steubl, Lutz Renders, Dominik Chittka, Miriam C Banas, Thomas Wekerle, Martina Koch, Oliver Witzke, Anja Mühlfeld, Claudia Sommerer, Antje Habicht, Christian Hugo, Thomas Hünig, Monika Lindemann, Traudel Schmidt, Anne Rascle, Sascha Barabas, Ludwig Deml, Ralf Wagner, Bernhard K Krämer, Bernd Krüger
Impaired cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) is a major cause of CMV reactivation and associated complications in solid-organ transplantation. Reliably assessing CMV-CMI is desirable to individually adjust antiviral and immunosuppressive therapy. This study aimed to evaluate the suitability of T-Track® CMV, a novel IFN-γ ELISpot assay based on the stimulation of peripheral blood mononuclear cells with pp65 and IE-I CMV proteins, to monitor CMV-CMI following kidney transplantation...
December 28, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29281761/outcomes-of-kidney-transplantations-in-children-weighing-15-kilograms-or-less-a-retrospective-cohort-study
#7
Benedetta Chiodini, Jean Herman, Ksenija Lolin, Brigitte Adams, Elise Hennaut, Pierre Lingier, Dimitri Mikhalski, Thierry Schurmans, Noël Knops, Karl M Wissing, Daniel Abramowicz, Khalid Ismaili
Kidney transplantation (KT) is often delayed in small children because of fear of post-operative complications. We report early and long-term outcomes in children transplanted at ≤15 kg in the two largest Belgian pediatric transplant centers. Outcomes before (period1) and since the introduction of basiliximab and mycophenolate-mofetil in 2000 (period2) were compared. Seventy-t wo KTs were realized between 1978 and 2016: 38 in period1 and 34 in period2. Organs came from deceased donors in 48 (67%) cases. Surgical complications occurred in 25 KTs (35%) with no significant difference between the two periods...
December 27, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29274240/do-clinical-trials-reflect-reality-a-systematic-review-of-inclusion-exclusion-criteria-in-trials-of-renal-transplant-immunosuppression
#8
Anam A Ayaz-Shah, Samia Hussain, Simon R Knight
Renal transplant recipients and donors are becoming increasingly more marginal, with more expanded criteria (ECD) and donation after circulatory death (DCD) donors and older recipients. Despite this, high risk donors and recipients are often excluded from clinical trials, leading to uncertainty about the generalizability of findings. We extracted data regarding inclusion/exclusion criteria from 174 trials of immunosuppression in renal transplant recipients published over a 5-year period, and compared criteria with those specified in published trial registries...
December 23, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29265514/clinical-utility-of-c3d-binding-donor-specific-anti-hla-antibody-detection-by-single-antigen-beads-after-kidney-transplantation-a-retrospective-study
#9
R P Pelletier, I Balazs, P Adams, A Rajab, N R DiPaola, M L Henry
Development of donor specific antibodies (DSA) after renal transplantation is known to be associated with worse graft survival, yet determining which specificities in which recipients are the most deleterious remains under investigation. This study evaluated the relationship of the complement binding capacity of post-transplant de novo anti-HLA antibodies with subsequent clinical outcome. Stored sera from 265 recipients previously identified as having de novo DSA were retested for DSA and their C3d binding capacity using Luminex based solid phase assays...
December 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29210109/xenotransplantation-back-to-the-future
#10
REVIEW
Raphael P H Meier, Yannick D Muller, Alexandre Balaphas, Philippe Morel, Manuel Pascual, Jörg D Seebach, Leo H Buhler
The field of xenotransplantation has fluctuated between great optimism and doubts over the last 50 years. The initial clinical attempts were extremely ambitious but faced technical and ethical issues that prompted the research community to go back to preclinical studies. Important players left the field due to perceived xenozoonotic risks and the lack of progress in pig-to-non-human-primate transplant models. Initial apparently unsurmountable issues appear now to be possible to overcome due to progress of genetic engineering, allowing the generation of multiple-xenoantigen knockout pigs that express human transgenes and the genome-wide inactivation of porcine endogenous retroviruses...
December 5, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29210108/kidney-transplant-outcomes-from-older-deceased-donors-a-paired-kidney-analysis-by-the-era-edta-registry
#11
Maria Pippias, Kitty J Jager, Fergus Caskey, Anna Casula, Helen Erlandsson, Patrik Finne, James Heaf, Georg Heinze, Andries Hoitsma, Reinhard Kramar, Marko Lempinen, Angela Magaz, Karsten Midtvedt, Lisa L Mumford, Julio Pascual, Karl G Prütz, Søren S Sørensen, Jamie P Traynor, Ziad A Massy, Rommel Ravanan, Vianda S Stel
As the median age of deceased kidney donors rises, updated knowledge of transplant outcomes from older deceased donors in differing donor-recipient age groups is required. Using ERA-EDTA Registry data we determined survival outcomes of kidney allografts donated from the same older deceased donor (55-70 years), and transplanted into one recipient younger and one recipient of similar age to the donor. The recipient pairs were divided into two groups: group 1; younger (median age: 52 years) and older (60 years), and group 2; younger (41 years) and older (60 years)...
December 5, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29210106/preemptive-second-kidney-transplantation-is-associated-with-better-graft-survival-compared-to-non-preemptive-second-transplantation-a-multicenter-french-2000-2014-cohort-study
#12
S Girerd, N Girerd, K Duarte, C Legendre, G Mourad, V Garrigue, E Morelon, F Buron, N Kamar, A Del Bello, M Ladrière, M Kessler, L Frimat
BACKGROUND: The impact of preemptive second kidney transplantation (2KT) on graft and patient survival is poorly established. METHODS: The association between preemptive 2KT (p2KT, N=93) and outcomes was estimated in a multicenter French cohort of 2KT (N=1314) recipients using propensity score methods. RESULTS: During follow-up, there were 274 returns to dialysis and 134 deaths. p2KT was associated with lower death-censored graft loss = 0...
December 5, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29205539/liver-first-versus-lung-first-a-new-dilemma-in-combined-organ-transplantation
#13
LETTER
L J Ceulemans, R Vos, A Neyrinck, J Pirenne, G Warnecke, D Van Raemdonck
One-staged combined liver-lung transplantation (cLiLuTx) is a life-saving procedure for patients with dual organ failure[1]. The classic sequence dictates LuTx priority over LiTx, due to the tolerable cold ischemic time, which is considered shorter for the lungs (6-8 hours) than for the liver (8-10 hours). However recent reports describe successful LuTx following longer ischemic time (10-12 hours)[2,3]; and safe extension of the lung out-of-body time by ex-vivo lung perfusion (EVLP)[4]. This article is protected by copyright...
December 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29178601/the-prevalence-risk-factors-and-outcomes-of-medication-tradeoffs-in-kidney-and-liver-transplant-recipients-a-pilot-study
#14
Marina Serper, Peter Reese, Rachel Patzer, Josh Levitsky, Michael S Wolf
High out-of-pocket medication costs negatively impact adherence in transplantation. We evaluated the association of "medication tradeoffs" - defined as choosing to spend money on other expenses over medications -with medication non-adherence and transplant outcomes. From 2011-2012, we performed a prospective study of 201 transplant recipients (n=103 liver, n=98 kidney and) at two large US transplant centers. Structured interviews assessed socio-demographics, medication adherence, and medication tradeoffs. Multivariable models assessing risk factors for medications tradeoffs and the association between medications tradeoffs and post-transplant hospital admissions were performed...
November 25, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29150966/current-policy-for-allocation-of-donor-livers-in-the-netherlands-advantages-primary-sclerosing-cholangitis-patients-on-the-liver-transplantation-waiting-list-a-retrospective-study
#15
Jorn C Goet, Bettina E Hansen, Madelon Tieleman, Bart van Hoek, Aad P van den Berg, Wojciech G Polak, Jeroen Dubbeld, Robert J Porte, Cynthia Konijn-Janssen, Robert A de Man, Herold J Metselaar, Annemarie C de Vries
Studies from the USA and Nordic countries indicate primary sclerosing cholangitis (PSC) patients have low mortality on the liver transplantation (LTx) waiting list. However, this may vary among geographical areas. Therefore, we compared waiting list mortality and post-transplant survival between laboratory model for end-stage liver disease (LM) and MELD exception (ME)-prioritized PSC and non-PSC candidates in a nationwide study in the Netherlands. A retrospective analysis of patients waitlisted from 2006 to 2013 was conducted...
November 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29150964/de-novo-donor-specific-hla-antibodies-after-combined-intestinal-and-vascularised-composite-allotransplantation
#16
Annemarie Weissenbacher, Georgios Vrakas, Mian Chen, Srikanth Reddy, Philip Allan, Henk Giele, Martin Cnm Barnardo, Anil Vaidya, Peter J Friend, Susan V Fuggle
Combining vascularised composite allotransplantation (VCA) with intestinal transplantation to achieve primary abdominal closure has become a feasible procedure. Besides facilitating closure, the abdominal wall can be used to monitor intestinal rejection. As the inclusion of a VCA raises the possibility of an enhanced alloimmune response, we investigated the incidence and clinical effect of de novo donor specific HLA antibodies (dnDSA) in a cohort of patients receiving an intestinal transplant with or without a VCA...
November 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29130558/right-lobe-donor-hepatectomy-is-it-safe
#17
Sanjay Goja, Sanjay Kumar Yadav, Sanjiv Saigal, Arvinder Singh Soin
INTRODUCTION: Donor safety is utmost important in Living donor liver transplantation (LDLT). Small for size syndrome in some recipients with left lobe donors led to the evolution of right lobe LDLT. AIM: To analyse the safety of large series of right lobe (RL) donor hepatectomies and compare outcomes with left lobe (LL) and left lateral segment (LLS) donations. MATERIAL AND METHODS: A consecutive cohort of 726 donors from January 2011 to January 2014 were studied; RL (n=641, 88...
November 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29130541/depression-social-support-and-clinical-outcomes-following-lung-transplantation
#18
Patrick J Smith, Laurie D Snyder, Scott M Palmer, Benson M Hoffman, Gregory L Stonerock, Krista K Ingle, Caroline K Saulino, James A Blumenthal
BACKGROUND: Depressive symptoms are common among lung transplant candidates and have been associated with poorer clinical outcomes in some studies. Previous studies have been plagued by methodologic problems, including small sample sizes, few clinical events, and uncontrolled confounders, particularly perioperative complications. In addition, few studies have examined social support as a potential protective factor. We therefore examined the association between pre-transplant depressive symptoms, social support, and mortality in a large sample of lung transplant recipients...
November 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29130538/-what-if-this-is-my-chance-to-save-my-life-a-semi-structured-interview-study-on-the-motives-and-experiences-of-esrd-patients-who-engaged-in-public-solicitation-of-a-living-kidney-donor
#19
Mathilde C Pronk, Dorthe Slaats, Willij C Zuidema, Medard T Hilhorst, Frank J M F Dor, Michiel Betjes, Willem Weimar, Jacqueline van de Wetering, Emma K Massey
The increase of patients using public solicitation (PS) to find a living kidney donor has generated a debate about the ethical complexities of PS. To investigate why patients engaged in PS and what they experienced during PS we conducted semi-structured interviews with 20 Dutch end-stage renal disease patients who had publicly solicited a living donor. Transcipts were thematically analyzed. We identified ten themes on patients' considerations preceding PS: cautiousness in discussing living donation within social network; reluctance to accept a kidney from loved ones; rejection/withdrawal of related donor candidates; moral objections to black market organs/paid donation; the ease of social media; encouraged by others; ends justyfying the means; despair and urge to take action; public disclosure of vulnerability; fear of being (perceived to be) selfish...
November 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29130535/between-center-disparities-in-access-to-heart-transplantation-in-france-contribution-of-candidate-and-center-factors
#20
Christelle Cantrelle, Richard Dorent, Emilie Savoye, Philippe Tuppin, Guillaume Lebreton, Camille Legeai, Olivier Bastien
Transplantation represents the last option for patients with advanced heart failure. We assessed between-center disparities in access to heart transplantation in France one year after registration and evaluated the contribution of factors to these disparities. Adults (n=2,347) registered on the French national waiting list between January 1, 2010 and December 31, 2014 in the 23 transplant centers were included. Associations between candidate and transplant center characteristics and access to transplantation were assessed by proportional hazards frailty models...
November 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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