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Transplantation Reviews

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https://www.readbyqxmd.com/read/29983261/bilirubin-a-new-therapeutic-for-kidney-transplant
#1
REVIEW
Vikram L Sundararaghavan, Sivjot Binepal, David E Stec, Puneet Sindhwani, Terry D Hinds
In patients with end-stage renal disease, kidney transplantation has been associated with numerous benefits, including increased daily activity, and better survival rates. However, over 20% of kidney transplants result in rejection within five years. Rejection is primarily due to a hypersensitive immune system and ischemia/reperfusion injury. Bilirubin has been shown to be a potent antioxidant that is capable of potentially reversing or preventing damage from reactive oxygen species generated from ischemia and reperfusion...
June 28, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29907370/outcome-of-transplantation-performed-outside-the-regular-working-hours-a-systematic-review-and-meta-analysis-of-the-literature
#2
REVIEW
Jore Hendrikx, Dirk Van Raemdonck, Jacques Pirenne, Steffen Fieuws, Steffen Rex
Transplant procedures are frequently performed outside the regular working hours (after hours). In general surgery, several studies observed worse outcomes for operations performed after hours. The predetermined hypothesis was that patients undergoing transplantation during after hours might suffer from an excess in post-operative mortality and morbidity when compared to patients undergoing transplantations during the regular working hours. A systematic review of the PubMed database identified 11,993 records, of which eleven cohort studies including a total of 287,741 patients investigated the association between the starting time of transplant surgery and postoperative mortality (primary outcome) and/or morbidity (secondary outcome)...
May 8, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29804793/the-clinical-impact-of-donor-specific-antibodies-in-heart-transplantation
#3
REVIEW
Markus J Barten, Uwe Schulz, Andres Beiras-Fernandez, Michael Berchtold-Herz, Udo Boeken, Jens Garbade, Stephan Hirt, Manfred Richter, Arjang Ruhpawar, Tim Sandhaus, Jan Dieter Schmitto, Felix Schönrath, Rene Schramm, Martin Schweiger, Markus Wilhelm, Andreas Zuckermann
Donor-specific antibodies (DSA) are integral to the development of antibody-mediated rejection (AMR). Chronic AMR is associated with high mortality and an increased risk for cardiac allograft vasculopathy (CAV). Anti-donor HLA antibodies are present in 3-11% of patients at the time of heart transplantation (HTx), with de novo DSA (predominantly anti-HLA class II) developing post-transplant in 10-30% of patients. DSA are associated with lower graft and patient survival after HTx, with one study suggesting a three-fold increase in mortality in patients who develop de novo DSA (dnDSA)...
May 8, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29935708/innate-networking-thrombotic-microangiopathy-the-activation-of-coagulation-and-complement-in-the-sensitized-kidney-transplant-recipient
#4
REVIEW
Miriam Manook, Jean Kwun, Steven Sacks, Anthony Dorling, Nizam Mamode, Stuart Knechtle
Thrombotic microangiopathy (TMA) is a histological feature of antibody-mediated rejection and has the potential to cause problematic graft dysfunction, particularly for highly sensitized cross-match positive kidney transplant recipients. Prompt recognition of pertinent histopathological and systemic features of TMA in kidney transplantation is necessary. Underlying mechanisms of this process involve the activation of both complement and coagulation systems as a response to HLA antibody. As serine proteases, coagulation and complement cascades exhibit similar characteristics with respect to homeostatic function...
July 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29731387/challenges-of-immunosuppressive-and-antitrypanosomal-drug-therapy-after-heart-transplantation-in-patients-with-chronic-chagas-disease-a-systematic-review-of-clinical-recommendations
#5
REVIEW
Silas Santana Nogueira, Amanda Aparecida Felizardo, Ivo Santana Caldas, Reggiani Vilela Gonçalves, Rômulo Dias Novaes
BACKGROUND: Although contraindicated for decades, heart transplantation (HT) has finally become a feasible therapeutic option for the treatment of Chagasic patients with end-stage heart failure. Part of the success in achieving acceptable survival rates after HT is due to the enhancement of the pharmacological management of allograft rejection and reactivation of Trypanosoma cruzi infection. METHODS: By using the framework of a systematic review, we investigated if Chagasic patients who have undergone a HT are treated with similar immunosuppressive and antitrypanosomal regimens in endemic and non-endemic countries and exhibits similar T...
July 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29628415/review-management-of-patients-with-kidney-allograft-failure
#6
REVIEW
Kim L W Bunthof, Marc Hazzan, Luuk B Hilbrands
Late allograft loss in kidney transplant recipients remains a common problem and is associated with high mortality and morbidity. The management of patients with a failed kidney allograft includes a few major dilemmas: when to start dialysis, what is the optimal management regarding immunosuppression, and should an allograft nephrectomy be performed. In suitable candidates for a repeated transplantation there are additional matters to take in consideration. In this review we will discuss these dilemmas by providing an overview of current evidence and gaps in our knowledge...
July 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29720347/a-review-of-the-use-of-direct-oral-anticoagulant-use-in-orthotopic-heart-transplantation-recipients
#7
REVIEW
Rosaleen Boswell, Glen J Pearson
No abstract text is available yet for this article.
April 16, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29709248/identifying-risk-profiles-in-liver-transplant-candidates-and-implications-for-induction-immunosuppression
#8
REVIEW
Umberto Cillo, Wolf O Bechstein, Gabriela Berlakovich, Philipp Dutkowski, Frank Lehner, Silvio Nadalin, Faouzi Saliba, Hans J Schlitt, Johann Pratschke
Changes in recipient and donor characteristics are redefining the role of induction in liver transplant recipients. Older recipients are more common, with greater concomitant comorbidity. Moderate or severe renal dysfunction is now estimated to affect 40% of liver transplant recipients. Donors are also becoming older, and other factors such as more frequent non-alcoholic fatty liver disease (NAFLD) compromise the quality of some grafts. Rejection rates are now relatively low (~10%) but some patients have a markedly increased risk such as younger recipients and those undergoing re-transplantation...
April 13, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29691119/ex-situ-liver-perfusion-organ-preservation-into-the-future
#9
REVIEW
Mariusz Bral, Boris Gala-Lopez, David L Bigam, Darren H Freed, A M James Shapiro
In recent years, remarkable progress has occurred in the development of technologies to support ex situ liver perfusion. Building upon extensive preclinical studies in large animal models, pilot and randomized clinical trials have been initiated, and preliminary outcomes suggest more optimal protection of both standard and extended criteria liver grafts. There currently exists an incredible opportunity and need to further refine this technology, determine appropriate viability measures to predict usable liver grafts, and to explore potent protective additive strategies to further optimize the quality of extended criteria organs...
April 5, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29395726/renal-scintigraphy-for-post-transplant-monitoring-after-kidney-transplantation
#10
REVIEW
S Benjamens, S P Berger, A W J M Glaudemans, J S F Sanders, R A Pol, R H J A Slart
BACKGROUND: Clinicians use several diagnostic modalities to recognize post-transplant complications, such as acute tubular necrosis, acute rejection, urologic and vascular complications. Currently, there is no consensus about the best procedural approach to evaluate post-transplant renal dysfunction. Renal needle-biopsy is often required, however, this is invasive and may lead to sample errors and complications, and most clinicians prefer using one of the noninvasive diagnostic modalities...
April 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29366537/circulating-and-urinary-micrornas-as-possible-biomarkers-in-kidney-transplantation
#11
REVIEW
Noémi Janszky, Caner Süsal
No abstract text is available yet for this article.
April 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29275111/clinical-impact-of-culture-positive-preservation-fluid-on-solid-organ-transplantation-a-systematic-review-and-meta-analysis
#12
REVIEW
Isabel Oriol, N Sabé, C Tebé, M Veroux, I F S F Boin, J Carratalà
Contamination of the preservation fluid (PF) used for donated organs is a potential source of post-transplant infection. However, the information on this issue is scarce. We therefore conducted a systematic review and meta-analysis to assess the incidence of culture-positive PF and its impact on solid organ transplant (SOT) recipients. Seventeen studies were identified and included. The overall incidence of culture-positive PF was 37% (95% CI: 27% to 49%), and the incidence of PF-related infections among SOT recipients with PF cultures that grew pathogenic microorganisms was 10% (95% CI: 7% to 15%)...
April 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29242033/the-evidence-and-rationale-for-the-perioperative-use-of-loop-diuretics-during-kidney-transplantation-a-comprehensive-review
#13
REVIEW
Shaifali Sandal, Pannya Bansal, Marcelo Cantarovich
PURPOSE: Loop diuretics (LD) attenuate ischemic injury in nephrons. They are thought to decrease delayed graft function (DGF) during kidney transplantation (KT). This review aimed to summarize the current evidence for the perioperative use of LD during KT. METHODS: We performed an analysis of all articles that were published since the inception of Medline and Embase: 26 studies were selected for inclusion. Scope was LD use during the perioperative phase of KT only...
April 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29198413/is-carotid-revascularization-worthwhile-in-patients-waiting-for-kidney-transplantation
#14
REVIEW
Peter Balaz, Petrut Gogalniceanu, Chris Callaghan
Renal failure and haemodialysis are associated with an increased risk of cardiovascular disease. Patients undergoing renal transplantation undergo rigorous pre-operative vascular assessment, including optimisation of risk factors for stroke. The indication for carotid intervention and the threshold for carotid endarterectomy in asymptomatic patients with incidental carotid disease has not been clarified in the context chronic kidney disease (CKD). This review aims to analyse outcomes following carotid endarterectomy in patients with CKD, in order to ascertain whether general guidelines for carotid artery revascularisation apply to this specific cohort...
April 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29566990/preserving-and-perfusing-the-allograft-pancreas-past-present-and-future
#15
REVIEW
Shamik Dholakia, Elisabeth Royston, Edward J Sharples, Visesh Sankaran, Rutger J Ploeg, Peter J Friend
The concept of organ preservation by perfusion dates back to the mid-19th century. Innovations since then have included temperature regulation, perfusion fluid composition and various pumping systems. Advances made in liver, heart and kidney machine preservation are now contributing to increased graft utilisation, assessment of graft viability and potentially improved graft survival. Pancreas transplantation has not benefitted to the same extent from the application of perfusion technology, although the need is just as great...
March 6, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29169958/cancer-evaluation-in-the-assessment-of-solid-organ-transplant-candidates-a-systematic-review-of-clinical-practice-guidelines
#16
REVIEW
Sergio A Acuna, Winnie Lam, Corinne Daly, S Joseph Kim, Nancy N Baxter
BACKGROUND: Active malignancies are a contraindication to transplantation, as immunosuppression can lead to worse cancer outcomes; therefore, ensuring transplant candidates are free of malignancy before transplantation is essential. This systematic review assesses the availability, quality, and consistency of recommended cancer evaluation prior to transplantation in Clinical Practice Guidelines (CPGs) for the selection of solid organ transplant candidates. METHODS: We systematically searched for CPGs for the assessment of transplant candidates...
January 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29157988/de-novo-thrombotic-microangiopathy-after-kidney-transplantation
#17
REVIEW
Neetika Garg, Helmut G Rennke, Martha Pavlakis, Kambiz Zandi-Nejad
Thrombotic microangiopathy (TMA) is a serious complication of transplantation that adversely affects kidney transplant recipient and allograft survival. Post-transplant TMA is usually classified into two categories: 1) recurrent TMA and 2) de novo TMA. Atypical hemolytic uremic syndrome (aHUS) resulting from dysregulation and over-activation of the alternate complement pathway is a rare disease but the most common diagnosis associated with recurrence in the allografts. De novo TMA, on the other hand, represents an overwhelming majority of the cases of post-transplant TMA and is a substantially more heterogeneous entity than recurrent aHUS...
January 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#18
REVIEW
J M Aguado, J T Silva, M Fernández-Ruiz, E Cordero, J Fortún, C Gudiol, L Martínez-Martínez, E Vidal, L Almenar, B Almirante, R Cantón, J Carratalá, J J Caston, E Cercenado, C Cervera, J M Cisneros, M G Crespo-Leiro, V Cuervas-Mons, J Elizalde-Fernández, M C Fariñas, J Gavaldà, M J Goyanes, B Gutiérrez-Gutiérrez, D Hernández, O Len, R López-Andujar, F López-Medrano, P Martín-Dávila, M Montejo, A Moreno, A Oliver, A Pascual, E Pérez-Nadales, A Román-Broto, R San-Juan, D Serón, A Solé-Jover, M Valerio, P Muñoz, J Torre-Cisneros
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection...
January 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/28637593/remote-ischemic-preconditioning-of-transplant-recipients-to-reduce-graft-ischemia-and-reperfusion-injuries-a-systematic-review
#19
REVIEW
Waqas Farooqui, Hans Christian Pommergaard, Allan Rasmussen
BACKGROUND: Solid organ transplantation is an accepted treatment for end-stage solid organ diseases. During the procedure, ischemia and reperfusion injury may affect graft and patient outcomes. Remote ischemic preconditioning (rIC) has been shown to reduce ischemia and reperfusion injury and can be performed safely. Thus, rIC may potentially improve outcomes after solid organ transplantation. Traditionally, the focus of rIC has been on the donor. However, preconditioning the recipient may be a more suitable approach in transplant settings...
January 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/28501338/risk-factors-for-metabolic-syndrome-after-liver-transplantation-a-systematic-review-and-meta-analysis
#20
REVIEW
Line Buch Thoefner, Andreas Arendtsen Rostved, Hans-Christian Pommergaard, Allan Rasmussen
INTRODUCTION: Metabolic syndrome is associated with increased risk of cardiovascular events, which contributes to the elevated mortality rate among liver transplant recipients. The objective of this systematic review and meta-analysis was to assess the prevalence and risk factors for metabolic syndrome after liver transplantation. METHODS: The databases Medline and Scopus were searched for observational studies evaluating prevalence and risk factors for metabolic syndrome after liver transplantation...
January 2018: Transplantation Reviews
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