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

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https://www.readbyqxmd.com/read/28926143/recurrence-of-iga-nephropathy-after-kidney-transplantation-in-steroid-continuation-versus-early-steroid-withdrawal-regimens-a-retrospective-analysis-of-the-unos-optn-database
#1
Napat Leeaphorn, Neetika Garg, Eliyahu V Khankin, Francesca Cardarelli, Martha Pavlakis
In the past 20 years, there has been an increase in use of steroid-withdrawal regimens in kidney transplantation. However, steroid withdrawal may be associated with an increased risk of recurrent IgA nephropathy (IgAN). Using UNOS/OPTN data, we analyzed adult patients with ESRD due to IgAN who received their first kidney transplant between 2000 and 2014. For the primary outcome, we used a competing risk analysis to compare the cumulative incidence of graft loss due to IgAN recurrence between early steroid-withdrawal (ESW) and steroid continuation groups...
September 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28926130/clostridium-difficile-infection-in-intestinal-transplant-recipients
#2
LETTER
V Goldenberg, A Berbel, J F Camargo, J Simkins
Clostridium difficile infection (CDI) is a common complication among solid organ transplant (SOT) recipients with an estimated incidence of 7-31% for lung recipients, 8-15% for heart, 3-19% for liver, 9% for intestinal, 4-16% for kidney and 2-8% for pancreas-kidney recipients (1) and it is associated with increased mortality (2). There is limited data on CDI in intestinal transplant (ITx) recipients. This is a retrospective study that was conducted at Jackson Memorial Hospital, a 1558-licensed bed tertiary care teaching hospital...
September 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28926127/recall-features-and-allorecognition-in-innate-immunity
#3
REVIEW
Hirofumi Uehara, Koichiro Minami, Markus Quante, Yeqi Nian, Timm Heinbokel, Haruhito Azuma, Abdala El Khal, Stefan G Tullius
Alloimmunity traditionally distinguishes short-lived, rapid and non-specific innate immune responses from adaptive immune responses that are characterized by a highly specific response initiated in a delayed fashion. Key players of innate immunity such as natural killer (NK) cells and macrophages present the first-line defense of immunity. The concept of unspecific responses in innate immunity has recently been challenged. The discovery of pattern recognition receptors (PRRs) has demonstrated that innate immune cells respond in a semi-specific fashion through the recognition of pathogen-associated molecular patterns (PAMPs) representing conserved molecular structures shared by large groups of microorganisms...
September 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28906029/il-6-production-by-monocytes-is-associated-with-graft-function-decline-in-patients-with-borderline-changes-suspicious-for-acute-t-cell-mediated-rejection-a-pilot-study
#4
Olivier Désy, Stéphanie Béland, Patrice Vallin, Julie Riopel, Eva Latulippe, Nader Najafian, Anil Chandraker, Mohsen Agharazii, Ibrahim Batal, Sacha A De Serres
Although borderline changes (BL) suspicious for acute T-cell-mediated rejection represents a diagnostic category its clinical relevance is questioned leading to heterogeneous therapeutic management. We hypothesized that measuring IL-6 secretion by peripheral blood mononuclear cells identifies patients with ongoing graft damage. We examined the association between secreted IL-6 and the change in estimated glomerular filtration rate at 6 months after the biopsy (ΔeGFR). We then conducted phenotypic and functional studies on patient and mouse innate immune cells in the blood and the kidney...
September 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28906028/graft-outcomes-following-diagnosis-of-posttransplant-lymphoproliferative-disease-in-pediatric-kidney-recipients-a-retrospective-study
#5
Nele K Kanzelmeyer, Britta Maecker-Kolhoff, Henriette Zierhut, Christian Lerch, Murielle Verboom, Dieter Haffner, Lars Pape
Data related to graft outcomes following posttransplant lymphoproliferative disease (PTLD) in pediatric kidney transplantation are scarce. Data were analyzed retrospectively from 12 children (8 boys) for three years after diagnosis of PTLD, with a loss of follow-up after 2 years in 2/12. In all cases, intensity of immunosuppressive therapy was reduced, with switch from calcineurin inhibitor to a mammalian target of rapamcyin (mTOR) inhibitor in 6 cases. Nine children were treated with 6 doses of rituximab according to the PED-PTLD-2005 protocol, with additional treatment in one child as per protocol...
September 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28905519/the-cost-of-sarcopenia
#6
Michael A Dunn
van Vugt and colleagues found that sarcopenia is an independent risk factor for increased hospital costs for liver transplant candidates. (1) They report that diminished muscle mass measured on CT imaging as the skeletal muscle index (SMI, cm(2) muscle area/m(2) patient height) is strongly associated with increased hospitalizations and cost of care. The association was significant on multivariable modeling adjusted for potential confounders. This original observation using an anatomic muscle mass measurement is consistent with work showing that physical frailty measured by gait speed indicates similar risk for increased hospitalization and healthcare costs in such patients...
September 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28892571/regenerative-immunology-the-immunological-reaction-to-biomaterials
#7
Paolo Cravedi, Samira Farouk, Andrea Angeletti, Lauren Edgar, Riccardo Tamburrini, Jerome Dusuit, Laura Perin, Giuseppe Orlando
Regenerative medicine promises to meet two of the most urgent needs of modern organ transplantation, namely immunosuppression-free transplantation and an inexhaustible source of organs. Ideally, bioengineered organs would be manufactured from a patient's own biomaterials-both cells and the supporting scaffolding materials in which cells would be embedded and allowed to mature to eventually regenerate the organ in question. While some groups are focusing on the feasibility of this approach, few are focusing on the immunogenicity of the scaffolds that are being developed for organ bioengineering purposes...
September 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28892567/using-omics-to-explore-complications-of-kidney-transplantation
#8
REVIEW
Caragh P Stapleton, Peter J Conlon, Paul J Phelan
The importance of genetic and biochemical variation in renal transplant outcomes has been clear since the discovery of the HLA in the 1950's. Since that time, there have been huge advancements in both transplantation and omics. In recent years, there has seen an increased number of genome-, proteome- and transcriptome-wide studies in the field of transplantation moving away from the earlier candidate gene/protein approaches. These areas have the potential to lead to the development of personalised treatment depending on individual molecular risk profiles...
September 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28871657/seasonality-of-mortality-and-graft-failure-among-kidney-transplant-recipients-in-the-us
#9
Brad C Astor, M L Melamed, D A Mandelbrot, Arjang Djamali
Mortality in the general population and in patients on chronic hemodialysis is significantly higher in winter than summer. It is unknown whether such a seasonal difference exists for mortality or graft failure among kidney transplant recipients. We analyzed United Network for Organ Sharing (UNOS) data to assess whether the annual distribution of deaths and graft failures differed significantly from expected. There was significant annual variation in both deaths (n=52,523) and graft failures (n=50,301; both p<0...
September 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28871624/low-skeletal-muscle-mass-is-associated-with-increased-hospital-costs-in-patients-with-cirrhosis-listed-for-liver-transplantation
#10
Jeroen L A van Vugt, Stefan Buettner, Louise J M Alferink, Niek Bossche, Ron W F de Bruin, Sarwa Darwish Murad, Wojciech G Polak, Herold J Metselaar, Jan N M IJzermans
Low skeletal muscle mass (sarcopenia) is associated with increased morbidity and mortality in liver transplant candidates. We investigated the association between sarcopenia and hospital costs in patients listed for liver transplantation. Consecutive patients with cirrhosis listed for liver transplantation between 2007-2014 in a Eurotransplant center were identified. The skeletal muscle index ([SMI], cm(2) /m(2) ) was measured on CT performed within 90 days from waiting list placement. The lowest sex-specific quartile represented patients with sarcopenia...
September 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28869805/pre-operative-trans-catheter-arterial-chemo-embolization-increases-hepatic-artery-thrombosis-after-liver-transplantation-a-retrospective-study
#11
Nicholas Gilbo, Laura Van Praet, Ina Jochmans, Mauricio Sainz-Barriga, Chris Verslype, Geert Maleux, Wim Laleman, Schalk van der Merwe, David Cassiman, Frederik Nevens, Diethard Monbaliu, Jacques Pirenne
Little is known about nonsurgical risk factors for hepatic artery thrombosis (HAT) after liver transplantation (LT). We determined risk factors for HAT occurring within 90 days post-LT and analysed the effect of HAT on graft and patient survival. Donor and recipient demographics, surgery-related data and outcome in transplants complicated by thrombosis (HAT+) and their matched controls (HAT-) were compared. Risk factors were assessed by univariate logistic regression. Median (IQR) is given. A total of 25 HAT occurred among 1035 adult LT (1/1997-12/2014) and 50 controls were manually matched...
September 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28865128/mechanisms-underlying-human-genetic-diversity-consequence-for-anti-graft-antibody-responses
#12
REVIEW
Roman Reindl-Schwaighofer, Andreas Heinzel, Lorenzo Signorini, Olivier Thaunat, Rainer Oberbauer
This review focuses on the emerging concept of genome-wide genetic variation as basis of an alloimmune response. Chronic antibody mediated rejection is the major cause of long-term graft loss and growing evidence supports the clinical relevance of HLA but also non-HLA related alloimmune responses. Several polymorphic gene products have been identified as minor histocompatibility antigens. The formation of donor specific alloantibodies is driven by indirect allorecognition of donor derived peptides representing a form of conventional T-cell response...
September 2, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28865119/we-have-to-do-more-for-former-paediatric-renal-transplant-recipients
#13
Guido Filler, Maria Ferris
Renal transplantation is the therapy of choice for end-stage kidney disease (ESKD) in children and adolescents.[1] Patients, caregivers and physicians deem a successful transplantation as a highly rewarding and definitive treatment. With current cost-effective immunosuppression regimes [2] rejection rates are low, and the recipient can look forward to long-term graft survival. This article is protected by copyright. All rights reserved.
September 2, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28865096/the-predictive-value-of-coronary-artery-calcium-detected-by-computed-tomography-in-a-prospective-study-on-cardiac-allograft-vasculopathy-in-heart-transplant-patients
#14
Anne Günther, Rune Andersen, Einar Gude, Jarl Jakobsen, Thor Edvardsen, Leiv Sandvik, Andreas Abildgaard, Lars Aaberge, Lars Gullestad
The predictive value of coronary artery calcium (CAC) in heart transplant (HTX) patients is not established. We explored if the absence of CAC on computed tomography (CT) could exclude moderate and severe cardiac allograft vasculopathy (CAV₂₋₃; the International Society for Heart and Lung Transplantation [ISHLT] recommended nomenclature) and significant coronary artery stenosis (diameter reduction ≥50%), and predict long-term clinical outcomes. HTX recipients (n=133) were prospectively included and underwent CT for CAC scoring and invasive coronary angiography (ICA) 7...
September 2, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28850737/the-elpat-living-organ-donor-psychosocial-assessment-tool-epat-from-what-to-how-of-psychosocial-screening-a-pilot-study
#15
Emma K Massey, Lotte Timmerman, Sohal Ismail, Nathalie Duerinckx, Alice Lopes, Hannah Maple, Inês Mega, Christina Papachristou, Fabienne Dobbels
BACKGROUND: Thorough psychosocial screening of donor candidates is required in order to minimize potential negative consequences and to strive for optimal safety within living donation programmes. We aimed to develop an evidence-based tool to standardize the psychosocial screening process. METHODS: Key concepts of psychosocial screening (1) were used to structure our tool: motivation and decision-making, personal resources, psychopathology, social resources, ethical and legal factors and information and risk processing...
August 29, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28850735/lower-quality-of-life-in-young-men-after-pediatric-kidney-transplantation-when-compared-to-healthy-controls-and-survivors-of-childhood-leukemia-a-cross-sectional-study
#16
Kira Endén, Juuso Tainio, Hannu Jalanko, Kirsi Jahnukainen, Timo Jahnukainen
PROBLEM: Data about health-related quality of life (HRQOL) in adult recipients after pediatric kidney transplantation (KTx) are scarce. METHODS: In this nationwide questionnaire-based study, HRQOL and social status in young adult men having undergone KTx during childhood (n=29) was studied and compared to age- and gender-matched healthy controls (n=56) and survivors of childhood acute lymphoblastic leukemia (n=52) comprising controls with another chronic disease of childhood...
August 29, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28850734/the-time-dependency-of-renal-allograft-histology
#17
REVIEW
Elisabet Van Loon, Evelyne Lerut, Maarten Naesens
Much of the complexity of the histological appearance of kidney transplant biopsies depends on the time at which the biopsies were obtained. It is well established that many elementary histological lesions and diagnoses have a time-dependent occurrence. While some "active" inflammatory lesions are noted primarily early after transplantation, other lesions are "chronic" and accumulate over time post-transplant, sometimes closely related to the prior active inflammatory lesions. With time after transplantation, the complexity of histology increases, by the co-occurrence of chronic damage and specific diseases...
August 29, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28833718/bovine-pericardium-for-multiple-artery-reconstruction-in-kidney-transplantation
#18
LETTER
Andrea Lauterio, Riccardo De Carlis, Stefano Di Sandro, Fabio Ferla, Alessandro Giacomoni, Ornella Rossetti, Luciano De Carlis
Multiple arterial reconstructions are often required in kidney transplantation (KT), and a variety of reconstruction strategies and implant techniques have been described (1,2). When an aortic Carrel patch cannot be safely used in older deceased donors with severely atherosclerotic aortas, or in living donor kidney procedures, multiple artery reconstruction may represent a surgical challenge requiring time-consuming technical solutions. Glutaraldehyde-treated bovine pericardium (BP) is one of the preferred biological materials in cardiovascular and thoracic surgical procedures (3) and was recently used for major venous reconstruction in oncological liver and pancreatic surgery (4,5)...
August 23, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28833662/survival-after-lung-transplantation-in-recipients-with-alpha-1-antitrypsin-deficiency-compared-to-other-forms-of-chronic-obstructive-pulmonary-disease-a-national-cohort-study
#19
Brian C Gulack, Michael S Mulvihill, Asvin M Ganapathi, Paul J Speicher, Godefroy Chery, Laurie D Snyder, R Duane Davis, Matthew G Hartwig
INTRODUCTION: Alpha-1-Antitrypsin deficiency (AATD) is grouped with chronic obstructive pulmonary disease (COPD); however, this may not be appropriate. This study assessed whether AATD confers a different prognosis than COPD following lung transplantation. METHODS: We employed the UNOS database, grouping patients by diagnoses of AATD or COPD. Kaplan-Meier methods and Cox modeling were performed to determine the association of diagnosis and overall survival. RESULTS: Of 9569 patients, 1394 (14...
August 23, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28833714/conversion-from-twice-daily-to-once-daily-tacrolimus-formulation-in-pediatric-liver-transplant-recipients
#20
Jesús Quintero, Javier Juampérez, Juan Ortega, José A Molino, Lluis Castells, Itxarone Bilbao, Carlos Rodrigo, Ramón Charco
OBJECTIVES: To assess the safety and efficacy of conversion from twice-daily tacrolimus to once-daily tacrolimus in pediatric liver transplant recipients. METHODS: Conversion from twice-daily to once- daily tacrolimus was made in stable pediatric liver transplant recipients. Doses and serum levels of tacrolimus, liver and renal function were recorded on the day before the conversion and at day 5, 30, 90 and 180 post-conversion. Patients were controlled every two to three months thereafter...
August 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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