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Transplantation Reviews

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https://www.readbyqxmd.com/read/28427741/management-of-biliary-anastomotic-strictures-after-liver-transplantation
#1
REVIEW
Aydin Seref Koksal, Ahmet Tarik Eminler, Erkan Parlak, Ahmet Gurakar
Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28390796/handle-with-care-a-systematic-review-on-frailty-in-cardiac-care-and-its-usefulness-in-heart-transplantation
#2
REVIEW
Oliver Mauthner, Veerle Claes, Mieke Deschodt, Sunita R Jha, Sandra Engberg, Peter S Macdonald, Phillip J Newton, Sabina De Geest
BACKGROUND: There is growing consensus that frailty, a state of vulnerability and a decline in functioning across multiple physiological body systems, is a valuable criterion to guide clinicians' risk prediction for poor outcomes in adult transplant candidates. In its 2016 listing criteria for heart transplantation the International Society for Heart Lung Transplantation recommends frailty assessment. We aimed to summarize the usefulness of frailty assessment in heart transplant candidates or recipients reported throughout the literature...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28396194/the-use-of-kinase-inhibitors-in-solid-organ-transplantation
#3
REVIEW
S Dholakia, J E Fildes, P J Friend
INTRODUCTION: Despite the efficacy of current immunosuppression regimes used in solid organ transplantation, graft dysfunction, graft lost and antibody-mediated rejection continue to be problematic. As a result, clear attraction in exploiting key potential targets controlled by kinase phosphorylation has led to a number of studies exploring the use of these drugs in transplantation. Aim In this review, we consider the role of tyrosine kinase as a target in transplantation and summarize the relevant studies on kinase inhibitors that have been reported to date...
March 25, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28318823/cutaneous-fungal-infections-in-solid-organ-transplant-recipients
#4
REVIEW
Muneeb Ilyas, Amit Sharma
Although there is an abundance of information on cutaneous malignancies in transplant recipients, information on cutaneous infections in solid organ transplant recipients is underrepresented in dermatologic and transplant literature. Our paper provides a comprehensive review of fungal cutaneous infections within the solid organ transplant population. We compiled literature specific to the solid organ transplant population, reviewing cutaneous manifestations owing to fungal infections. Furthermore, we discuss the diagnosis and treatment of such infections...
March 11, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28284465/neurological-disorders-in-liver-transplant-candidates-pathophysiology-and-clinical-assessment
#5
REVIEW
Paolo Feltracco, Annachiara Cagnin, Cristiana Carollo, Stefania Barbieri, Carlo Ori
Compromised liver function, as a consequence of acute liver insufficiency or severe chronic liver disease may be associated with various neurological syndromes, which involve both central and peripheral nervous system. Acute and severe hyperammoniemia inducing cellular metabolic alterations, prolonged state of "neuroinflammation", activation of brain microglia, accumulation of manganese and ammonia, and systemic inflammation are the main causative factors of brain damage in liver failure. The most widely recognized neurological complications of serious hepatocellular failure include hepatic encephalopathy, diffuse cerebral edema, Wilson disease, hepatic myelopathy, acquired hepatocerebral degeneration, cirrhosis-related Parkinsonism and osmotic demyelination syndrome...
February 27, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28279567/optimizing-everolimus-exposure-when-combined-with-calcineurin-inhibitors-in-solid-organ-transplantation
#6
REVIEW
Teun van Gelder, Lutz Fischer, Fuad Shihab, Maria Shipkova
The mammalian target of rapamycin (mTOR) inhibitor everolimus is a narrow therapeutic index drug for which optimal exposure levels are essential. The consistent pharmacokinetic profile of everolimus allows trough concentration (C0) measurement to be an appropriate and reliable index for therapeutic drug monitoring (TDM). Exposure-response analyses of data from early fixed-dose trials demonstrated that rates of biopsy-proven acute rejection (BPAR) are significantly higher if everolimus C0 declines below 3 ng/mL, an observation confirmed in subsequent concentration-controlled trials...
February 27, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28262425/sex-differences-in-transplantation
#7
REVIEW
Jeremiah D Momper, Michael L Misel, Dianne B McKay
Sex plays a role in the incidence and progression of a wide variety of diseases and conditions related to transplantation. Additionally, a growing body of clinical and experimental evidence suggests that sex can impact the pharmacokinetics and pharmacodynamics of several commonly used immunosuppressive and anti-infective drugs in transplant recipients. A better understanding of these sex differences will facilitate advances in individualizing treatment for patients and improve outcomes of solid organ transplantation...
February 20, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28259374/supplemental-oxygen-during-hypothermic-kidney-preservation-a-systematic-review
#8
REVIEW
J M O'Callaghan, K T Pall, Lhm Pengel
We reviewed the evidence for ex-vivo Supplemental Oxygen during Hypothermic preservation (SOH) for deceased donor kidneys. Bibliographic databases were searched for human and animal studies of SOH in kidney transplantation reporting on patient or animal survival rate, discard rate, technical complications or renal function outcomes. We make special reference to a specific subgroup: supplemental oxygen applied during cold perfusion, referred to as Hypothermic Oxygenated Perfusion (HOP). Four human and 25 animal studies were identified...
February 17, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28254530/current-understanding-and-management-of-splenic-steal-syndrome-after-liver-transplant-a-systematic-review
#9
REVIEW
Chaolun Li, Baljendra Kapoor, Eunice Moon, Cristiano Quintini, Weiping Wang
BACKGROUND: Splenic steal syndrome (SSS) is a condition that can occur after orthotopic liver transplant (OLT). However, limited information is available about this condition. METHODS: A systematic literature search of studies performed through May 2016 was conducted to identify reports of angiographically confirmed SSS and its variants. All of the factors relevant to this disorder were collected and analyzed. RESULTS: A total of 219 cases of SSS and its variants were identified...
February 17, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28214240/bridging-locoregional-therapy-longitudinal-trends-and-outcomes-in-patients-with-hepatocellular-carcinoma
#10
REVIEW
Hayley C Oligane, Orrie N Close, Minzhi Xing, Hyun S Kim
The purpose of this article is to analyze longitudinal trends in locoregional therapy (LRT) use and review locoregional therapy's role in the management of hepatocellular carcinoma prior to orthotropic liver transplantation Porrett et al. (2006) . LRT has a role in both bridge to transplantation and downstaging of patients not initially meeting Milan or UCSF Criteria. Due to the lack of randomized controlled trials, no specific bridging LRT modality is recommended over another for treating patients on the waiting list, however each modality has unique and patient-specific advantages...
February 2, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28209246/the-clinical-course-of-iga-nephropathy-after-kidney-transplantation-and-its-management
#11
REVIEW
Sophia Lionaki, Konstantinos Panagiotellis, Christine Melexopoulou, John N Boletis
Immunoglobulin (Ig) A nephropathy is one of the most common primary glomerulonephritides worldwide causing end stage renal disease in up to 20-40% of affected patients, nearly two decades post diagnosis. Kidney transplantation is the treatment of choice for patients with renal failure, secondary to glomerular diseases. However, IgA nephropathy has a strong tendency to recur in the graft, and although initially thought to be a benign condition, several reports of graft loss, due to recurrent IgA nephropathy, there have been over the last three decades...
February 2, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28187998/a-systematic-review-of-the-use-of-rituximab-for-the-treatment-of-antibody-mediated-renal-transplant-rejection
#12
REVIEW
Philip S Macklin, Peter J Morris, Simon R Knight
Rituximab is a B-lymphocyte depleting agent that is used to treat hematological malignancies and autoimmune diseases. Recently, it has gained interest as an immunomodulatory agent in renal transplantation. This systematic review evaluates the evidence for its use in the treatment of acute and chronic antibody-mediated renal transplant rejection (AAMR; CAMR). A systematic search of four databases and three trial registries was conducted. The small number and heterogeneous nature of included studies precluded meta-analysis and thus a narrative review was conducted...
January 24, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28131494/immunomodulation-by-hyperimmunoglobulins-after-solid-organ-transplantation-beyond-prevention-of-viral-infection
#13
REVIEW
Rogier van Gent, Herold J Metselaar, Jaap Kwekkeboom
Hyperimmunoglobulins are pharmaceutical formulations of human IgG which contain high titers of antibodies against specific viruses. They have been successfully used in solid organ transplantation (SOT) to prevent Cytomegalovirus (CMV) and Hepatitis B Virus (HBV) infection. The introduction of effective and cheaper antiviral drugs has resulted in decreasing usage of hyperimmunoglobulins in SOT. However, it may still be attractive to combine antiviral drug therapy with hyperimmunoglobulins after SOT, as there is some evidence that hyperimmunoglobulins, similar to high doses of intravenous immunoglobulins (IVIgs), might exert anti-inflammatory activity and thereby prevent immunological graft damage and improve graft and patient survival...
January 19, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28340885/immunosuppression-for-kidney-transplantation-where-are-we-now-and-where-are-we-going
#14
REVIEW
Mary Ann Lim, Jatinder Kohli, Roy D Bloom
Advances in immunosuppression have propelled kidney transplantation from a scientific curiosity to the optimal treatment for patients with end stage kidney disease. Declining rates of acute rejection have led to improvements in short term kidney transplant survival, culminating in incrementally better long term patient and allograft outcomes. Contextualized around established immune-suppressing drug targets, this review summarizes the history of the clinical science and highlights the pivotal trials that have led to present-day treatment standards at the level of both individual agents and multidrug regimens for kidney recipients...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28284304/kidney-paired-exchange-and-desensitization-strategies-to-transplant-the-difficult-to-match-kidney-patients-with-living-donors
#15
REVIEW
Thomas A Pham, Jacqueline I Lee, Marc L Melcher
With organs in short supply, only a limited number of kidney transplants can be performed a year. Live donor donation accounts for 1/3rd of all kidney transplants performed in the United States. Unfortunately, not every donor recipient pair is feasible because of Human leukocyte antigen (HLA) sensitization and ABO incompatibility. To overcome these barriers to transplant, strategies such as kidney paired donation (KPD) and desensitization have been developed. KPD is the exchange of donors between at least two incompatible donor-recipient pairs such that they are now compatible...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28139330/management-of-the-obese-kidney-transplant-candidate
#16
REVIEW
Julie Lesage, John S Gill
Obesity is an increasingly common condition that can exclude end stage renal disease patients from consideration of kidney transplantation. The optimal management of obese transplant candidates is uncertain, especially the use of pharmacologic therapies or bariatric surgery. We review the rationale to consider transplantation in obese patients, the impact of obesity on access to kidney transplantation, the evidence for obese patients to lose weight loss prior to kidney transplantation, peri-operative management considerations and specific weight loss strategies prior to transplantation...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28126347/acute-antibody-mediated-rejection-in-kidney-transplant-recipients
#17
REVIEW
Scott Davis, James E Cooper
Antibody-mediated rejection has now been recognized as one of the most important causes of graft loss. Transplantation across HLA barriers and nonadherence can result in acute antibody-mediated rejection, which is associated with particularly worse graft outcomes. New technologies, including genomic studies and assays to detect and define donor-specific antibodies, have provided important insights into the pathophysiology and diagnosis of acute antibody-mediated rejection but have engendered many questions about the clinical application of these tests in the prognosis and prevention of this protean disease process...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28089555/epstein-barr-virus-and-renal-transplantation
#18
REVIEW
Jade Le, Christine M Durand, Irfan Agha, Daniel C Brennan
Epstein-Barr virus (EBV) is a gamma herpesvirus associated with diseases ranging from asymptomatic viremia to post-transplant malignancies in kidney transplant recipients. EBV specifically is associated with post-transplantation lymphoproliferative disorder (PTLD), in kidney transplant recipients, with increased risk in EBV seronegative patients with EBV seropositive donors on intensified immunosuppression. The diagnosis of PTLD relies on clinical suspicion plus tissue biopsy with polymerase chain reaction (PCR) testing of blood currently used for risk determination in high-risk recipients...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/27919635/a-critical-assessment-on-kidney-allocation-systems
#19
REVIEW
Richard N Formica
The kidney allocation system that took effect on December 4, 2014 represents a significant improvement over the prior approach. It seeks to improve outcomes by longevity matching - pairing kidneys expected to function the longest with recipients expected to live the longest. It addresses the biological barriers faced by highly sensitized patients in an evidence based fashion and it begins to introduce the concept of medical need into kidney allocation by crediting time from the starting dialysis to a patient's waiting time...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/27847221/chronic-allograft-injury-mechanisms-and-potential-treatment-targets
#20
REVIEW
Leonardo V Riella, Arjang Djamali, Julio Pascual
Improving long-term graft survival remains one of the critical challenges facing kidney transplantation since a great portion of kidney grafts are lost by 10years after transplantation. Understanding the causes of chronic allograft injury and providing timely therapeutic interventions are essential for improving these outcomes. In this review, we will discuss the recent data that emerged turning down calcineurin inhibitors as the primary cause of long-term graft injury and highlighting the increased importance of non-compliance, antibody-mediated injury, disease recurrence, and BK nephropathy as culprits...
January 2017: Transplantation Reviews
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