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Transplantation Reviews

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https://www.readbyqxmd.com/read/28318823/cutaneous-fungal-infections-in-solid-organ-transplant-recipients
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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/28284304/kidney-paired-exchange-and-desensitization-strategies-to-transplant-the-difficult-to-match-kidney-patients-with-living-donors
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27836384/sensitization-assessment-before-kidney-transplantation
#17
REVIEW
Ben C Reynolds, Kathryn J Tinckam
Kidney transplantation is the treatment of choice for patients with end stage renal disease to optimize survival, freedom from morbidity and quality of life. A fundamental aspect of the pre-transplant assessment is a thorough understanding of their immunological history and prior exposures, so that the immunological risk from a given donor can be estimated, if not quantified, in order to guide interventions to optimize transplant access and success. The methodologies available to complete this assessment have evolved rapidly, with flow cytometric based analyses now standard in many laboratories, availability of comprehensive molecular methods for HLA typing of both donors and recipients, and an increasing recognition of the vital dialogue that must occur between the HLA laboratory and transplant clinicians...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/27776929/kidney-transplantation-for-hiv-positive-patients
#18
REVIEW
Deirdre Sawinski
HIV+ patients are at increased risk for end-stage renal disease, but HIV infection was once considered a contraindication to renal transplantation. However, contemporary studies from the United States and Europe have now demonstrated that renal transplantation is a safe and effective treatment for end-stage renal disease in HIV patients, with equivalent patient and allograft survival to those uninfected. Broader experience in transplantation in HIV+ patients has identified unique challenges including high rates of acute rejection, delayed graft function, and significant drug-drug interactions...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/27989547/graft-inflow-modulation-in-adult-to-adult-living-donor-liver-transplantation-a-systematic-review
#19
REVIEW
Roberto I Troisi, Giammauro Berardi, Federico Tomassini, Mauricio Sainz-Barriga
INTRODUCTION: Small-for-size syndrome (SFSS) has an incidence between 0 and 43% in small-for-size graft (SFSG) adult living donor liver transplantation (LDLT). Portal hypertension following reperfusion and the hyperdynamic splanchnic state are reported as the major triggering factors of SFSS. Intra- and postoperative strategies to prevent or to reduce its onset are still under debate. We analyzed graft inflow modulation (GIM) during adult LDLT considering the indications, efficacy of the available techniques, changes in hemodynamics and outcomes...
December 8, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/28011070/prevention-and-management-of-lymphocele-formation-following-kidney-transplantation
#20
REVIEW
Mohammad Golriz, Miriam Klauss, Martin Zeier, Arianeb Mehrabi
Despite preventive methods, lymphoceles frequently form following kidney transplantation (KTx), with an incidence of 0.6%-51%. Here, we summarize the current strategies for preventing and managing this complication, and describe the approach used in our department. Rapid diagnosis and early treatment of lymphoceles through a well-defined approach can prevent or reduce the risk of organ loss. Diagnosis can be made by ultrasound, computed tomography, or magnetic resonance imaging and laparoscopic fenestration is the current therapy of choice when non-surgical methods fail...
November 16, 2016: Transplantation Reviews
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