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Current Opinion in Organ Transplantation

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https://www.readbyqxmd.com/read/29324518/the-dawn-of-liver-perfusion-machines
#1
Danielle Detelich, James F Markmann
PURPOSE OF REVIEW: Despite high demand, a severe shortage of suitable allografts limits the use of liver transplantation for the treatment of end-stage liver disease. The transplant community is turning to the utilization of high-risk grafts to fill the void. This review summarizes the reemergence of ex-vivo machine perfusion for liver graft preservation, including results of recent clinical trials and its specific role for reconditioning DCD, steatotic and elderly grafts. RECENT FINDINGS: Several phase-1 clinical trials demonstrate the safety and feasibility of machine perfusion for liver graft preservation...
January 9, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29324517/long-term-care-of-transplant-recipients-de-novo-neoplasms-after-liver-transplantation
#2
Patrizia Burra, Sarah Shalaby, Alberto Zanetto
PURPOSE OF REVIEW: Since the first liver transplantation in the early 1960s, there have been significant improvements in the recipients' long-term outcome. Patients who have undergone transplantation are exposed to a high risk of developing neoplastic disease, not only because of their chronic immunosuppression, but also related to physiological aging, lifestyle, chronic viral infections, liver disease cause, and carcinogenic immunosuppressants. The present review covers the latest and most relevant data on de novo neoplasms after liver transplantation, and discusses their implications for clinical practice...
January 9, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29206661/the-need-and-opportunity-for-donation-after-circulatory-death-worldwide
#3
Martí Manyalich, Helen Nelson, Francis L Delmonico
PURPOSE OF REVIEW: The global shortage of organ donors will not be resolved solely by relying on deceased donation following a brain death determination (DBD). Expansion of deceased donation after circulatory death (DCD) will be needed to address the shortfall of organs for transplantation. Approximately 120 000 organ transplants are performed each year; however, the WHO estimates that this number of transplants only resolves 10% of the annual worldwide transplant need. RECENT FINDINGS: The report addresses the opportunity of DCD expansion by evaluating the DCD potential that is not being realized, the utility of DCD enabling DBD to emerge in some clinical situations, by the effectiveness of a donor registry in achieving DCD, and by the current clinical research of heart, lung, and liver transplantation from DCD...
December 4, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29194071/revisiting-the-phenotypic-and-genetic-profiling-of-anergic-t-cells-mediating-long-term-transplant-tolerance
#4
Sylvaine You, Lucienne Chatenoud
PURPOSE OF REVIEW: Herein our focus will be to revisit peripheral tolerance mechanisms and in particular 'active' or 'dominant' tolerance as originally defined and mediated by regulatory CD4FoxP3 T lymphocytes (Treg) and also T-cell anergy that appears as a major mainstay to support long-term allograft survival. RECENT FINDINGS: It is at the same time interesting and rewarding that the tool that recently guided our efforts along this path is the in-vivo use of CD3 antibody, the first monoclonal introduced in the clinic (Orthoclone OKT3) about 35 years ago to treat and prevent rejection of renal allografts...
November 30, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29210728/are-donor-lymphocytes-a-barrier-to-transplantation-tolerance
#5
Jawaher Alsughayyir, Reza Motallebzadeh, Gavin J Pettigrew
PURPOSE OF REVIEW: Following solid organ transplantation (SOT), populations of donor lymphocytes are frequently found in the recipient circulation. Their impact on host alloimmunity has long been debated but remains unclear, and it has been suggested that transferred donor lymphocytes may either promote tolerance to the graft or hasten its rejection. We discuss possible mechanisms by which the interaction of donor passenger lymphocytes with recipient immune cells may either augment the host alloimmune response or inhibit it...
November 27, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29210727/regulatory-t-cells-from-the-bench-to-the-clinic-and-back
#6
Basmah S Al Dulaijan, Amr Mansouri, Jordan Karnyski, Jamil Azzi
PURPOSE OF REVIEW: The main objective of this review is to briefly highlight how we gradually came to understand regulatory T cells (Tregs) and forkhead box p3 (FoxP3) biology, including their function and regulation. We will also discuss how this knowledge is being translated into the clinical setting and the significant challenges that need to be overcome. RECENT FINDINGS: CD4FoxP3 Tregs are key players in immune regulation. Their deficiency and dysfunction have been implicated in the pathogenesis of many autoimmune diseases...
November 27, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29176362/significance-of-biologics-in-renal-transplantation-past-present-and-future
#7
Ivica Grgic, Anil Chandraker
PURPOSE OF REVIEW: Finding the right immunosuppressive approach for the individual transplant patient is of utmost importance. In truth, a 'one size fits all' does not exist, and as patients differ, so should therapeutic suppression of the immune system be individualized. For over three decades, biologics have been a central component of transplant immunosuppression. Our growing knowledge of immunological processes combined with biotechnological advances is leading to promising new therapeutic concepts and possibilities including novel biologics...
November 25, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29176361/active-targeted-delivery-of-immune-therapeutics-to-lymph-nodes
#8
Baharak Bahmani, Ishaan Vohra, Nazila Kamaly, Reza Abdi
PURPOSE OF REVIEW: Organ transplantation is a life-saving procedure and the only option for patients with end-organ failure. Immune therapeutics have been key to the success of organ transplantation. However, immune therapeutics are still unable to eliminate graft rejection and their toxicity has been implicated in poorer long-term transplant outcomes. Targeted nanodelivery has the potential to enhance not only the therapeutic index but also the bioavailability of the immune therapeutics...
November 25, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29189414/what-s-new-in-transplantation-tolerance
#9
Maria-Luisa Alegre
No abstract text is available yet for this article.
November 20, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29189413/emerging-role-of-exosomes-in-allorecognition-and-allograft-rejection
#10
Bruno Gonzalez-Nolasco, Mengchuan Wang, Aurore Prunevieille, Gilles Benichou
PURPOSE OF REVIEW: This article reviews recent literature on the nature of extracellular vesicles released by allogeneic transplants and examine their role in T-cell alloimmunity involved in rejection and tolerance of these grafts. RECENT FINDINGS: Donor cells release extracellular vesicles, including exosomes, after transplantation of allogeneic organs and tissues. Consequently, recipient APCs take up these exosomes and present donor MHC antigens on their surface (allo-MHC cross-dressing) thus, activating some alloreactive T cells via a mechanism called semi-direct pathway of allorecognition...
November 20, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29189411/diverse-roles-of-tim4-in-immune-activation-implications-for-alloimmunity
#11
Martina M McGrath
PURPOSE OF REVIEW: T-cell immunoglobulin and mucin domain-containing molecule (TIM)4 is a costimulatory molecule and phosphatidylserine receptor. Its dominant function varies according to the expressing cell and site of activation. In recent years, studies have identified its role in diverse disease processes and increasingly in alloimmunity. Herein, we will comprehensively review the literature on TIM4 and outline its function in shaping the alloimmune response. RECENT FINDINGS: TIM4 expression on dendritic cells increases following transplantation...
November 20, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29189293/mechanisms-of-rejection-in-vascular-composite-allotransplantation
#12
Joanna W Etra, Giorgio Raimondi, Gerald Brandacher
PURPOSE OF REVIEW: For patients with devastating injuries in whom standard reconstruction is not an option, vascularized composite allotransplantation (VCA) has become a viable means of restoring form and function. However, immunological rejection continues to be a problem in VCA and has not yet been fully characterized. As the field is relatively new, much of the data on rejection and immunosuppression have been extrapolated from that of solid organ transplantation. In this review, we cover the basic mechanisms of rejection as they relate specifically to VCA with analysis of recent literature and future directions...
November 18, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29140829/guiding-regulatory-t-cells-to-the-allograft
#13
Caroline Lamarche, Megan K Levings
PURPOSE OF REVIEW: The application of regulatory T cell (Treg) therapy in organ transplantation is actively being pursued using unmodified, typically polyclonal cells. As the results of these ongoing clinical trials emerge, it is time to plan the next wave of clinical trials of Tregs. Here we will review a key strategy to improve Treg effectiveness and reduce side effects, namely increasing Treg specificity - both in terms of antigen recognition and localization to the allograft. RECENT FINDINGS: Study of chemokine signatures accompanying acute rejection has revealed several chemokines that could be targeted to increase Treg homing...
November 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29140828/biomimetic-nanoparticles-for-transplantation-tolerance
#14
Silvia Minardi, Sahil Shah, Xunrong Luo
PURPOSE OF REVIEW: The current review aims to provide a current landscape and future trends of biomimetic nanoparticles which have the potential to revolutionize the field of transplantation in the next decade. RECENT FINDINGS: Currently, the inability to safely induce robust donor-specific immunological tolerance makes it difficult to achieve immunosuppression-free graft survival. Despite progresses in the development of nanotherapeutics for antigen-specific immunomodulation in autoimmune diseases and in cancer treatments, few have been proposed and tested in transplantation with success...
November 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29120883/equipping-the-islet-graft-for-self-defence-targeting-nuclear-factor-%C3%AE%C2%BAb-and-implications-for-tolerance
#15
Nathan W Zammit, Shane T Grey
PURPOSE OF REVIEW: Clinical islet transplantation does not enjoy the success seen for solid organ transplants, indicating a need for new therapeutic approaches to improve patient outcomes. This has prompted investigation into islet autonomous factors and pathways that may represent druggable targets. These have the potential to synergize with approaches aimed at generating graft-specific tolerance. RECENT FINDINGS: There are emerging data that nuclear factor κB (NF-κB) activation can prevent and or overcome tolerance, whereas dampening NF-κB activation in immune cells is associated with prolonged allograft survival...
November 7, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29120882/donation-after-circulatory-death-and-its-expansion-in-spain
#16
Eduardo Miñambres, Juan J Rubio, Elisabeth Coll, Beatriz Domínguez-Gil
PURPOSE OF REVIEW: Donation after circulatory death (DCD) is still performed in a limited number of countries. This article summarizes the development of DCD in Spain and presents recent Spanish contributions to gain knowledge on the potential benefits and the practical use of normothermic regional perfusion (nRP). RECENT FINDINGS: DCD now contributes to 24% of deceased donors in Spain. The development of DCD has been based on an assessment of practices in the treatment of cardiac arrest and end-of-life care to accommodate the option of DCD; the creation of an adequate regulatory framework; and institutional support, professional training and public education...
November 7, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29120881/atp-and-t-cell-mediated-rejection
#17
Eduardo Castillo-Leon, Sergio Dellepiane, Paolo Fiorina
PURPOSE OF REVIEW: Purine nucleosides and nucleotides are released in the extracellular space following cell injury and act as paracrine mediators through a number of dedicated membrane receptors. In particular, extracellular ATP (eATP) significantly influences T-lymphocyte activation and phenotype. The purpose of this review is to discuss the role of ATP signaling in the T-cell-mediated alloimmune response. RECENT FINDINGS: In various animal models of solid transplantation, the purinergic axis has been targeted to prevent acute rejection and to promote long-term graft tolerance...
November 7, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29064833/micro-rnas-in-transplant-tolerance
#18
James T Harden, Sheri M Krams
PURPOSE OF REVIEW: Micro-RNAs (miRNAs) are highly conserved small RNA molecules that have selective gene-regulatory functions. This posttranscriptional regulation by miRNAs is critical for many immunological processes. Many developments in establishing the biological role of miRNAs in solid organ transplantation have been generated in the last decade. Discoveries of immune regulation by miRNAs, resulting in graft prolongation and transplant tolerance, are rapidly advancing and are the subject of this review...
October 23, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29189412/harnessing-the-lymph-node-microenvironment
#19
Natalie A O'Neill, Haleigh B Eppler, Christopher M Jewell, Jonathan S Bromberg
PURPOSE OF REVIEW: To evaluate role of the lymph node in immune regulation and tolerance in transplantation and recent advances in the delivery of antigen and immune modulatory signals to the lymph node. RECENT FINDINGS: Lymph nodes are a primary site of immune cell priming, activation, and modulation, and changes within the lymph node microenvironment have the potential to induce specific regulation, suppression, and potentially tolerance. Antigen enters the lymph node either from tissues via lymphatics, from blood via high endothelial venules, or directly via injection...
February 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29099729/cryptococcal-disease-in-the-solid-organ-transplant-setting-review-of-clinical-aspects-with-a-discussion-of-asymptomatic-cryptococcal-antigenemia
#20
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Current Opinion in Organ Transplantation
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