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Current Opinion in Organ Transplantation

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https://www.readbyqxmd.com/read/28922300/recent-advances-in-the-field-of-warm-ex-vivo-liver-perfusion
#1
Dagmar Kollmann, Markus Selzner
PURPOSE OF REVIEW: Organ shortage remains a major obstacle for liver transplantation, resulting in an increased mortality on the liver transplant waiting list. The usage of extended criteria donors (ECD) is a strategy to increase the number of available donor organs, however, with the risk of a higher rate of posttransplant graft dysfunction. Novel preservation strategies, such as warm ex-vivo liver perfusion, could improve the outcome of liver transplantation with ECD grafts. The present review summarizes the advances in the field of warm ex-vivo liver perfusion over the last 12 months...
September 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28922301/hypothermic-liver-perfusion
#2
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
PURPOSE OF REVIEW: The review describes recent developments in hypothermic machine liver perfusion with a special focus on underlying protective mechanisms, and the role of this perfusion technique in high-risk donor-recipient combinations. RECENT FINDINGS: To maximize the number of transplantable donor livers, several centres are exploring new machine preservation techniques. In this context, hypothermic machine perfusion has been recently introduced into the clinical setting of human liver transplantation, and the effect of endischemic cold liver perfusion on posttransplant complications is currently under investigation in two multicentre, randomized controlled trials...
September 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28915137/xenoislets-porcine-pancreatic-islets-for-the-treatment-of-type-i-diabetes
#3
Nizar I Mourad, Pierre Rene Gianello
PURPOSE OF REVIEW: Porcine islets are being extensively investigated as alternative sources of insulin-secreting cells for transplantation in insulin-dependent diabetic patients. The present review focuses on recent advances in porcine islet transplantation with particular emphasis on new transgenic pig models, islet encapsulation, and biosafety considerations. RECENT FINDINGS: Genetic modifications aimed to reduce islet cell immunogenicity, to prolong their survival, and to improve their secretory function have been reported...
September 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28914641/elderly-recipients-of-liver-transplantation-impact-of-age-and-psychosocial-variables-on-outcome
#4
Shehzad Niazi, Terry Schneekloth, C Burcin Taner
PURPOSE OF REVIEW: With expanding experience and success of liver transplantation, increasing numbers of elderly candidates await and undergo liver transplantation. There is accumulating evidence that graft survival and mortality does not appear to differ significantly between the young and carefully selected elderly liver transplantation recipients. Although existing evidence suggests that psychosocial factors impact outcomes after liver transplantation in general, no such information is available specifically for elderly (age ≥65 years) liver transplantation recipients...
September 12, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28901972/normothermic-machine-perfusion-of-the-kidney
#5
Annemarie Weissenbacher, James Hunter
PURPOSE OF REVIEW: Normothermic machine perfusion (NMP) is a preservation method that is generating increasing interest. The aim of this review is to summarise the current status of NMP in regards of kidney viability assessment, reducing organ damage and improving transplant logistics. RECENT FINDINGS: The results of recent large animal experiments and clinical trials show that continuous prolonged normothermic ex-vivo kidney perfusion appears better than a brief period of NMP after static cold storage in terms of renal injury and function...
September 8, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28901971/xenotransplantation-past-present-and-future
#6
Burcin Ekser, Ping Li, David K C Cooper
PURPOSE OF REVIEW: To review the progress in the field of xenotransplantation with special attention to most recent encouraging findings which will eventually bring xenotransplantation to the clinic in the near future. RECENT FINDINGS: Starting from early 2000, with the introduction of galactose-α1,3-galactose (Gal)-knockout pigs, prolonged survival especially in heart and kidney xenotransplantation was recorded. However, remaining antibody barriers to non-Gal antigens continue to be the hurdle to overcome...
September 8, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28872471/lung-xenotransplantation
#7
Hisashi Sahara, Hironosuke Watanabe, Thomas Pomposelli, Kazuhiko Yamada
PURPOSE OF REVIEW: This review describes the most recent progress in xeno lung transplantation (XLTx) to date. It describes the potential mechanisms of early xeno lung graft loss, as well as the latest therapeutic strategies to overcome them. RECENT FINDINGS: Using ex-vivo perfusion models of porcine lungs with human blood, the use of genetically modified pig lungs along with novel pharmaceutical approaches has recently been studied. Strategies that have demonstrated improved lung survival include the knockout of known xenoantigens (GalTKO and N-glycolylneuraminic acid-KO), genes that regulate complement activation (hCD46 and hCD55), as well as the inflammation/coagulation cascade (human leukocyte antigen-E, human thrombomodulin, human endothelial protein C receptor, hCD47, hCD39, hCD73 and heme oxygenase-1)...
September 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28857844/the-ethical-challenges-of-uterus-transplantation
#8
Giuliano Testa, Liza Johannesson
PURPOSE OF REVIEW: As the techniques of uterus transplantation have evolved, culminating in a birth in 2014, the ethical debate has been enriched by several considerations. Uterus transplantation raises issues because of its unique features of being temporary, nonlifesaving, experimental, and expensive, with established alternatives. RECENT FINDINGS: Uterus transplantation entails risks for the recipient related to multiple surgeries and immunosuppression, yet studies have shown that women see infertility as a distressing element in their lives, justifying the risks...
August 28, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28857843/altruistic-nondirected-kidney-donation-attitudes-characteristics-and-ethical-implications
#9
Maja Ehlers, Frank Vitinius, Michael Langenbach
PURPOSE OF REVIEW: Altruistic nondirected kidney donation involves a person donating one of their kidneys to an unknown recipient. The donor's mental health and motives are frequently questioned. We want to highlight this topic and also encourage discussions about ethical implications. RECENT FINDINGS: The main topics are the mental health of altruistic nondirected kidney donors and the general attitude towards the practice of this form of donation as well as the willingness of the public to donate this way...
August 28, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28817400/liver-xenotransplantation
#10
Madhukar S Patel, Nathan Louras, Parsia A Vagefi
PURPOSE OF REVIEW: There continues to be an inadequate organ supply and lack of effective temporary support, for patients with liver failure. The purpose of this review is to discuss recent progress in the field of orthotopic pig-to-nonhuman primate (NHP) liver xenotransplantation (LXT). RECENT FINDINGS: From 1968 to 2012, survival in pig-to-NHP LXT was limited to 9 days, initially due to hyperacute rejection which has been ameliorated through use of genetically engineered donor organs, but ultimately because of profound thrombocytopenia, thrombotic microangiopathy, and bleeding...
August 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28795955/editorial-pancreatic-islet-cell-transplantation
#11
Marlon F Levy
No abstract text is available yet for this article.
August 8, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28759463/immunosuppression-maintenance-in-vascularized-composite-allotransplantation-what-is-just-right
#12
Molly Howsare, Christopher M Jones, Allan M Ramirez
PURPOSE OF REVIEW: Over the last two decades advances in vascularized composite allotransplantation have achieved clinically significant milestones. This review provides a synopsis for immunosuppressive maintenance therapy for VCA and discusses the nuances surrounding the determination of the right amount of immunosuppression in vascularized composite allotransplantation. RECENT FINDINGS: Functional results after vascularized composite allotransplantation remain highly encouraging as are the immunologic outcomes, however, challenges persist...
July 28, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28759462/pig-islet-xenotransplantation
#13
Maheswaran Dhanasekaran, Johnathan J George, Gopalakrishnan Loganathan, Siddharth Narayanan, Michael G Hughes, Stuart K Williams, Appakalai N Balamurugan
PURPOSE OF REVIEW: The current article reviews the rationale, sources and preparation of pig islets for xenotransplantation, and presents current progress in solving the problems associated with establishing pig islet transplant as a clinical treatment for type 1 diabetes. SUMMARY: Islet transplantation is an effective treatment option for type 1 diabetes, but the available supply of human pancreases is insufficient to meet the need and demand for obtaining islets...
July 28, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28737527/genitourinary-vascularized-composite-allotransplantation
#14
Ilse M Schol, Dicken S C Ko, Curtis L Cetrulo
PURPOSE OF REVIEW: Genitourinary vascularized allotransplantation (GUVCA) is gaining interest as a treatment option for patients with functional and aesthetic urogenital tissue loss. Only three cases have been done worldwide and research on the implementation and feasibility of this procedure is in an elementary state. RECENT FINDINGS: The psychosocial impact and ethical considerations with GUVCA are remote, particularly because of the intimate and personal nature of genital tissue...
July 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28723698/application-technical-issues-and-interpretation-of-c1q-for-graft-outcome
#15
Dolly B Tyan
PURPOSE OF REVIEW: Significant interest and controversy surround the use of C1q for determining risk of antibody-mediated rejection (AMR) and graft loss. Alternate models for predicting outcomes have been proposed. This review focuses on the correlation of currently utilized assays for outcome, together with the technical and theoretical limitations, to distill current thinking. RECENT FINDINGS: Results demonstrate that C1q status is significantly correlated with AMR and graft loss...
July 18, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28719391/pediatric-and-congenital-hand-transplantation
#16
Sandra Amaral, L Scott Levin
PURPOSE OF REVIEW: We review the approach and challenges associated with pediatric hand transplantation, including new knowledge gleaned from our recent case of bilateral hand-forearm transplantation in an 8-year old child. RECENT FINDINGS: Bilateral heterologous hand-forearm transplantation was performed in a child with a prior kidney transplant in July 2015. The initial surgery necessitated a large team of experts in microvascular surgery, transplant surgery, orthopedics and plastic surgery as well as pediatric anesthesia...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28708813/application-and-interpretation-of-histocompatibility-data-in-liver-transplantation
#17
Russell N Wesson, Eric W Etchill, Jacqueline Garonzik-Wang
PURPOSE OF REVIEW: There has been a resurgence of interest in histocompatibility as it applies to liver transplantation. The association of persistent and de-novo donor specific antibody (DSA) and outcomes after liver transplantation continues to be investigated. RECENT FINDINGS: Consensus continues to evolve regarding the existence of acute and chronic antibody-mediated rejection (AMR) and pathogenicity of DSA and associated pathologic findings after liver transplantation...
July 13, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28692442/current-issues-in-allogeneic-islet-transplantation
#18
Charles A Chang, Michael C Lawrence, Bashoo Naziruddin
PURPOSE OF REVIEW: Transplantation of allogenic pancreatic islets is a minimally invasive treatment option to control severe hypoglycemia and dependence on exogenous insulin among type 1 diabetes (T1D) patients. This overview summarizes the current issues and progress in islet transplantation outcomes and research. RECENT FINDINGS: Several clinical trials from North America and other countries have documented the safety and efficacy of clinical islet transplantation for T1D patients with impaired hypoglycemia awareness...
July 7, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28682798/accommodation-and-related-conditions-in-vascularized-composite-allografts
#19
Jeffrey L Platt, Christina L Kaufman, Mayara Garcia de Mattos Barbosa, Marilia Cascalho
PURPOSE OF REVIEW: The outcome of vascularized composite allografts (VCA) often appear unrelated to the presence of donor-specific antibodies (DSA) in blood of the recipient or deposition of complement in the graft. The attenuation of injury and the absence of rejection in other types of grafts despite manifest donor-specific immunity have been explained by accommodation (acquired resistance to immune-mediated injury), adaptation (loss of graft antigen) and/or enhancement (antibody-mediated antigen blockade)...
July 5, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28873074/adipose-derived-cellular-therapies-in-solid-organ-and-vascularized-composite-allotransplantation
#20
Katlin B Stivers, Jason E Beare, Paula M Chilton, Stuart K Williams, Christina L Kaufman, James B Hoying
PURPOSE OF REVIEW: Controlling acute allograft rejection following vascularized composite allotransplantation requires strict adherence to courses of systemic immunosuppression. Discovering new methods to modulate the alloreactive immune response is essential for widespread application of vascularized composite allotransplantation. Here, we discuss how adipose-derived cellular therapies represent novel treatment options for immune modulation and tolerance induction in vascularized composite allotransplantation...
October 2017: Current Opinion in Organ Transplantation
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