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

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https://www.readbyqxmd.com/read/27896874/five-myths-about-variable-selection
#1
REVIEW
Georg Heinze, Daniela Dunkler
Multivariable regression models are often used in transplantation research to identify or to confirm baseline variables which have an independent association, causally or only evidenced by statistical correlation, with transplantation outcome. Although sound theory is lacking, variable selection is a popular statistical method which seemingly reduces the complexity of such models. However, in fact, variable selection often complicates analysis as it invalidates common tools of statistical inference such as p-values and confidence intervals...
November 29, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27896866/re-conceptualising-the-organ-trade-separating-trafficking-from-trade-and-the-implications-for-law-and-policy
#2
LETTER
Seán Columb, Frederike Ambagtsheer, Michael Bos, Ninoslav Ivanovski, Gregory Moorlock, Willem Weimar
The trade in human organs is considered a major international concern. In 2007 the World Health Organization (WHO) estimated that approximately 6000 kidney transplants are performed illegally each year (1). More recently, the Council of Europe declared that organ trade constitutes a "major threat to public health" and that it is growing worldwide due to the "greed of unscrupulous traffickers" (3). This article is protected by copyright. All rights reserved.
November 29, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27896862/hcv-and-hev-recurrence-after-liver-transplantation-one-antiviral-therapy-for-two-viruses
#3
LETTER
Eleonora De Martin, Teresa Maria Antonini, Audrey Coilly, Gabriella Pittau, Eric Vibert, Jean-Charles Duclos-Valée, Didier Samuel, Anne Marie Roque-Afonso
In LT recipients, the prevalence of HEV-RNA is about 1-3%, possibly leading to cirrhosis within 1-2 years (1). Seroprevalence, without viremic infection, is highly variable, reported up to 42% in US patients treated for HCV recurrence after LT (2). We report for the first time the concomitant recurrence of HCV and HEV after LT. This article is protected by copyright. All rights reserved.
November 29, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27896858/efficacy-and-safety-of-simeprevir-and-sofosbuvir-with-and-without-ribavirin-in-subjects-with-recurrent-genotype-1-hepatitis-c-post-orthotopic-liver-transplant-the-randomized-galaxy-study
#4
Jacqueline G O'Leary, Robert J Fontana, Kimberly Brown, James R Burton, Roberto Firpi-Morell, Andrew Muir, Christopher O'Brien, Mordechai Rabinovitz, K Rajender Reddy, Robert Ryan, Adam Shprecher, Shirley Villadiego, Avinash Prabhakar, Robert S Brown
This prospective, randomized, phase 2 study in subjects with recurrent hepatitis C virus (HCV) genotype 1 post-orthotopic liver transplant evaluated once-daily simeprevir 150mg+sofosbuvir 400mg, with and without ribavirin 1,000mg. Primary endpoint was proportion of subjects with Week 12 sustained virologic response (SVR12). Thirty-three subjects without cirrhosis were randomized 1:1:1 into three arms (stratified by geno/subtype and Q80K): Arm 1, simeprevir+sofosbuvir+ribavirin, 12 weeks; Arm 2, simeprevir+sofosbuvir, 12 weeks; Arm 3, simeprevir+sofosbuvir, 24 weeks; 13 additional subjects (2 with cirrhosis, 11 without cirrhosis) entered Arm 3...
November 29, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27896854/decreased-graft-survival-in-liver-transplant-recipients-of-donors-with-positive-blood-cultures-a-review-of-the-unos-dataset
#5
Moises A Huaman, Valery Vilchez, Xiaonan Mei, Malay B Shah, Michael F Daily, Jonathan Berger, Roberto Gedaly
Liver transplantation using blood culture positive donors (BCPD) has allowed a significant expansion of the donor pool. We aimed to characterize BCPD and assess the outcomes of BCPD liver transplant recipients. We retrieved data from the United Network for Organ Sharing (UNOS) registry on all adults who underwent primary, single organ deceased-donor liver transplantation in the U.S. between 2008 and 2013. Patients were classified in two cohorts: the BCPD cohort and the non-BCPD cohort. One-year graft and patient survival were compared between cohorts using Kaplan-Meier estimates and Cox models...
November 29, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27896857/former-smoking-and-early-and-long-term-graft-outcome-in-renal-transplant-recipients-a-retrospective-cohort-study
#6
Steven Van Laecke, Evi Vanessa Nagler, Patrick Peeters, Francis Verbeke, Wim Van Biesen
Smoking is associated with unfavourable outcome in solid organ transplant recipients. Nicotine may predispose to kidney injury by increasing oxidative stress. We hypothesized that former smoking negatively affects graft outcome in kidney transplant recipients and especially those with delayed graft function (DGF). We included adult recipients of a kidney transplant between January 1(st) 2003 and October 1(st) 2015 at Ghent University Hospital and recorded outcomes until October, 31(st) 2015. We used Kaplan-Meier and multivariable Cox proportional hazard analysis to examine the relationship between former smoking at the time of transplantation and the incidence of 10-year graft loss with and without censoring for death in 1013 participants...
November 28, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27889929/twenty-eight-years-of-intestinal-transplantation-in-paris-experience-of-the-oldest-european-centre
#7
F Lacaille, S Irtan, L Dupic, C Talbotec, F Lesage, V Colomb, N Salvi, F Moulin, F Sauvat, Y Aigrain, Y Revillon, O Goulet, C Chardot
AIM: Our aim is to describe our achievements in pediatric intestinal transplantation (ITx) and define areas for improvement. METHODS: After a period (1987-90) of 9 isolated small bowel transplants (SBTx) where only one patient survived with her graft, 110 ITx were performed on 101 children from 1994 to 2014: 60 SBTx, 45 liver-small bowel, 4 multivisceral (3 with kidneys), 1 modified multivisceral. Indications were short bowel syndrome (36), motility disorders (30), congenital enteropathies (34) and others (1)...
November 27, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27874968/professionalization-of-surgical-abdominal-organ-recovery-leading-to-an-increase-in-pancreatic-allografts-accepted-for-transplantation-in-the-netherlands-a-serial-analysis
#8
H D Lam, A F Schaapherder, W H Kopp, H Putter, A E Braat, A Baranski
Professional abdominal organ recovery with certification has been mandatory in the Netherlands since 2010. This study analyses the effects of certification (January 2010 - September 2015) on pancreas transplantation and compares it to an era before certification (February 2002 - May 2008) for surgical injuries and the number of pancreases transplanted. A total of 264 cases were analysed. Eighty-four recovered pancreases (31.8%) with surgically injuries were encountered. Forty six of those were surgically salvaged for transplantation, resulting in a total of 226 (85...
November 22, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27864901/kidney-temperature-course-during-living-organ-procurement-and-transplantation
#9
Thomas G J Kuipers, J Hellegering, M El Moumni, C Krikke, J W Haveman, S P Berger, Henri G Leuvenink, Robert A Pol
Little is known about the actual kidney graft temperature during the 2nd warm ischemia time (WIT2). We aimed to determine the actual temperature course of the WIT2, with emphasis on the 15°C metabolic threshold. Data of 152 consecutive adult living donor kidney transplantations were collected. The mean WIT2 was 41.3 ± 10.1 (SD) minutes with a temperature of 5.4 °C at baseline which gradually increased to 13.7 °C, 17.4 °C and 20.2 °C after 10, 20 and 30 minutes respectively. The percentage of kidneys with a temperature of 15 °C or higher was 81...
November 19, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27864897/tolerogenic-dendritic-cell-therapy-in-organ-transplantation
#10
REVIEW
Aurélie Moreau, Brigitte Alliot-Licht, Maria-Cristina Cuturi, Gilles Blancho
Although the occurrence of acute rejection was significantly reduced and the allograft survival at one year was massively improved by the development of pharmacological immunosuppressive drugs, little progress has been made regarding long-term graft survival. Cell therapy appears to be an innovative and promising strategy to minimize the use of immunosuppression in transplantation and consequently increases long-term graft survival. The strength of cell therapy is that it will induce graft-specific tolerance and not a general immunosuppression of the patients...
November 19, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27864895/the-postreperfusion-syndrome-is-associated-with-acute-kidney-injury-following-donation-after-brain-death-liver-transplantation
#11
Marit Kalisvaart, Jubi E de Haan, Dennis A Hesselink, Wojciech G Polak, Bettina E Hansen, Jan N M IJzermans, Diederik Gommers, Herold J Metselaar, Jeroen de Jonge
Acute kidney injury (AKI) is frequently observed after DBD liver transplantation (LT) and associated with impaired recipient survival and chronic kidney disease. Hepatic ischemia/reperfusion injury (IRI) is suggested to be an important factor in this process. The postreperfusion syndrome (PRS) is the first manifestation of severe hepatic IRI directly after reperfusion. We performed a retrospective study on the relation between hepatic IRI and PRS and their impact on AKI in 155 DBD LT recipients. Severity of hepatic IRI was measured by peak postoperative AST levels and PRS was defined as >30% decrease in MAP ≥1 minute <5 minutes after reperfusion...
November 19, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27864893/high-alcohol-intake-in-deceased-donors-has-no-effect-on-pancreas-graft-survival-a-registry-analysis
#12
R Motallebzadeh, M Aly, M El-Khairi, M Drage, J Olsburgh, C J Callaghan
Outcomes of pancreas transplantation from donors with high alcohol consumption are poorly described. The UK Transplant Registry was used to determine if donor alcohol intake influenced pancreas survival in simultaneous pancreas-kidney (SPK) transplants performed between 2006-2012 (n=770). Recipients were stratified by donor alcohol intake: group I (n=122) - high recent alcohol intake (>21 or >14 units of alcohol/week in males or females, respectively) or previous alcohol abuse; group II (n=648) - low/unknown current intake and no previous alcohol abuse...
November 19, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27862417/ureteral-stent-placement-and-immediate-graft-function-are-associated-with-increased-risk-of-bk-viremia-in-the-first-year-after-kidney-transplantation
#13
Joseph G Maliakkal, Daniel C Brennan, Charles Goss, Timothy A Horwedel, Howard Chen, Dennis K Fong, Nikhil Agarwal, Jie Zheng, Kenneth B Schechtman, Vikas R Dharnidharka
Ureteral stent (UrSt) placement has been shown to be a significant independent risk factor for BK viruria, viremia and BK virus nephropathy. We assessed if this observation could be validated at our high volume kidney transplant center that has had a strong historical focus on BK virus nephropathy detection. We performed a retrospective case-control study of adults receiving a kidney-only transplant and followed for one year between 2004 and 2011 with uniform immunosuppression and use of blood BK virus PCR screening protocol...
November 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27862352/de-novo-donorspecific-anti-hla-antibodies-after-kidney-transplantation-are-associated-with-impaired-graft-outcome-independently-of-their-c1q-binding-ability
#14
Teresa Kauke, Cornelia Oberhauser, Viviane Lin, Michaela Coenen, Michael Fischereder, Andrea Dick, Ulf Schoenermarck, Markus Guba, Joachim Andrassy, Jens Werner, Bruno Meiser, Martin Angele, Manfred Stangl, Antje Habicht
BACKGROUND: Many aspects of post-transplant monitoring of donorspecific (DSA) and non-donorspecific (nDSA) anti-HLA antibodies on renal allograft survival are still unclear. Differentiating them by their ability to bind C1q may offer a better risk assessment. METHODS: We retrospectively investigated the clinical relevance of de novo C1q-binding anti-HLA antibodies on graft outcome in 611 renal transplant recipients. Acute rejection (AR), renal function and graft survival were assessed within a mean follow-up of 6...
November 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27859672/immune-activation-and-regulation-related-patterns-in-stable-hand-transplant-recipients
#15
Dorota Kamińska, Katarzyna Kościelska-Kasprzak, Magdalena Krajewska, Adam Chełmoński, Jerzy Jabłecki, Marcelina Żabińska, Marta Myszka, Mirosław Banasik, Maria Boratyńska, Agnieszka Gomółkiewicz, Piotr Dzięgiel, Marian Klinger
BACKGROUND: We assessed cell subsets and expression of a set of genes related to the T cell populations in peripheral blood mononuclear cells to elucidate whether immune status of stable hand transplant recipients (HTx) differs from stable kidney transplant recipients (KTx). MATERIAL AND METHODS: The study was conducted on 5 HTx 4.8 ± 1.7 years after transplantation and 30 stable KTx 7.9 ± 2.4 years after transplantation as well as 18 healthy volunteers. The research involved PBMC gene expression analysis of CD4, CD8, CTLA4, GZMB, FOXP3, IL10, IL4, ILR2A, NOTCH, PDCD1, PRF1, TGFB, TNFA genes on a custom designed low density array (TaqMan) as well as flow cytometry assessment of lymphocyte subpopulations...
November 9, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27779800/the-expanded-criteria-donor-for-kidney-transplant-not-a-nearly-new-car
#16
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27774663/liver-and-serum-expression-of-matrix-metalloproteinases-in-asymptomatic-pediatric-liver-transplant-recipients
#17
Silja H Voutilainen, Silja K Kosola, Taina I Tervahartiala, Timo A Sorsa, Hannu J Jalanko, Mikko P Pakarinen
BACKGROUND: We related hepatic gene and serum expression of matrix metalloproteinases (MMP) and their tissue inhibitors (TIMP) to liver histology in pediatric LT recipients. METHODS: Liver biopsies and serum samples were obtained from 52 patients 10.6 years post-LT and age-matched controls for analyses of MMPs and TIMPs. RESULTS: Patients with fibrosis had significantly higher hepatic gene expression of MMP-2, MMP-9, MMP-14, TIMP-1 and TIMP-2 than patients without...
October 23, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27754570/primary-biliary-cirrhosis-has-high-wait-list-mortality-among-patients-listed-for-liver-transplantation
#18
Ashwani K Singal, Xiao Fang, Mohamed Kaif, Mohsen Hasanin, Brendan M Mcguire, Yong-Fang Kuo, Russell H Wiesner
Patients with primary sclerosing cholangitis (PSC) have frequent episodes of cholangitis with potential for high mortality while waiting for liver transplantation. However, data on wait-list mortality specific to liver disease etiology are limited. Using United Network for Organ Sharing (UNOS) database (2002-2013), of 81 592 listed patients, 11 284 (13.8%) died while waiting for transplant. Primary biliary cirrhosis (PBC) patients (N = 3491) compared to PSC (N = 4905) differed with age (56 vs. 47 years), female gender (88% vs...
October 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27754567/adhere-randomized-controlled-trial-comparing-renal-function-in-de-novo-kidney-transplant-recipients-receiving-prolonged-release-tacrolimus-plus-mmf-or-sirolimus
#19
Oleg O Rummo, Mario Carmellini, Lionel Rostaing, Rainer Oberbauer, Maarten H L Christiaans, Christiane Mousson, Robert M Langer, Franco Citterio, Bernard Charpentier, Malcolm Brown, Gbenga Kazeem, Frank Lehner
ADHERE was a randomized, open-label, Phase IV study comparing renal function at Week 52 post-kidney transplant, in patients who received prolonged-release tacrolimus-based immunosuppressive regimens. On days 0-27, patients received prolonged-release tacrolimus (initially 0.2mg/kg/day), corticosteroids and mycophenolate mofetil (MMF). Patients were randomized on Day 28 to receive either prolonged-release tacrolimus plus MMF (Arm 1) or prolonged-release tacrolimus (≥25% dose-reduction on Day 42) plus sirolimus (Arm 2)...
October 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27732754/balancing-competing-needs-in-kidney-transplantation-does-an-allocation-system-prioritizing-children-affect-the-renal-transplant-function
#20
Marcus Weitz, Onur Sazpinar, Maria Schmidt, Thomas J Neuhaus, Elisabeth Maurer, Claudia Kuehni, Paloma Parvex, Hassib Chehade, Sibylle Tschumi, Franz Immer, Guido F Laube
Children often merit priority in access to deceased donor kidneys by organ-sharing organizations. We report the impact of the new Swiss Organ Allocation System (SOAS) introduced in 2007, offering all kidney allografts from deceased donors <60 years preferentially to children. The retrospective cohort study included all paediatric transplant patients (<20 years of age) before (n = 19) and after (n = 32) the new SOAS (from 2001 to 2014). Estimated glomerular filtration rate (eGFR), urine protein-to-creatinine ratio (UPC), need for antihypertensive medication, waiting times to kidney transplantation (KTX), number of pre-emptive transplantations and rejections, and the proportion of living donor transplants were considered as outcome parameters...
October 12, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
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