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Current Opinion in Organ Transplantation

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https://www.readbyqxmd.com/read/28723698/application-technical-issues-and-interpretation-of-c1q-for-graft-outcome
#1
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
#2
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/28719390/total-pancreatectomy-with-islet-autotransplantation-recent-updates-and-outcomes
#3
Yoshitaro Shindo, Mazhar A Kanak
PURPOSE OF REVIEW: Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indications to include benign and malignant pancreatic disease has been suggested. Improved methods for evaluating the functional quality of islets and predicting transplant outcome have been discussed...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28708813/application-and-interpretation-of-histocompatibility-data-in-liver-transplantation
#4
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
#5
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
#6
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/28700386/editorial-introductions
#7
Kiran K Dhanireddy, Andrew L Singer, Andrea A Zachary, Mary S Leffell
No abstract text is available yet for this article.
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28692441/histocompatibility-and-management-of-the-highly-sensitized-kidney-transplant-candidate
#8
Bonnie E Lonze
PURPOSE OF REVIEW: Increasing national participation in kidney paired donation and implementation of new sharing policies via the current kidney allocation system have brought about greater opportunities for the most highly sensitized patients awaiting a kidney transplant. The purpose of this review is to discuss the application of histocompatibility data in the context of the clinical practice of kidney transplantation as pertains to the sensitized candidate. RECENT FINDINGS: With desensitization techniques, transplantation across virtually any antibody barrier is technically feasible, but long-term outcomes after transplantation are improved when the immunologic match between donor and recipient is optimized...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28682797/surgery-of-pancreas-transplantation
#9
Mark Reza Laftavi, Angelika Gruessner, Rainer Gruessner
PURPOSE OF REVIEW: The surgical techniques of pancreas transplantation have been evolving and significantly improved over time. This article discusses different current techniques and their modifications. RECENT FINDING: At this time, the most commonly used technique is systemic venous drainage (for venous outflow) and enteric drainage (for management of exocrine pancreatic secretions). However, new modifications of established techniques such as gastric or duodenal exocrine drainage and venous drainage to the inferior vena cava continue to be introduced...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28678058/donors-after-circulatory-death-pancreas-transplantation
#10
Shruti Mittal, James Gilbert, Peter J Friend
PURPOSE OF REVIEW: The use of organs from donors after circulatory death (DCD) has become standard practice in solid organ transplantation of most abdominal organs and has been used successfully in some centres for pancreas transplantation. Nevertheless, concerns regarding poor graft outcomes and complications remain. This review aims to discuss the current state of DCD pancreas transplantation and the associated outcomes. RECENT FINDINGS: In many countries, whereas the number of donors after brainstem death (DBD) remains stable, the mean age and BMI have increased making these donors, previously considered to be low risk, now more marginal...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28654443/application-and-interpretation-of-histocompatibility-data-in-thoracic-heart-and-lung-transplantation
#11
Kelly H Schlendorf, Ashish S Shah
PURPOSE OF REVIEW: The purpose of the review is to update our current understanding and utilization of immunogenetic tools in heart and lung transplant. RECENT FINDINGS: Increasingly, complex patients have been managed perioperatively for heart and lung transplant using a variety of tests and techniques. Recent treatment regimens and listing strategies have exploited recent laboratory advances. However, the better characterization has led to an even more complex description of sensitized heart and lung candidates...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28632700/editorial-on-histocompatibility-section-2017
#12
Andrea A Zachary, Mary S Leffell
No abstract text is available yet for this article.
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28598888/long-term-diabetes-complications-after-pancreas-transplantation
#13
Trond Jenssen, Anders Hartmann, Kåre I Birkeland
PURPOSE OF REVIEW: The intention of this study is to summarize present knowledge about adverse effects of hyperglycemia in diabetes, and in this context review more recent data concerning the effects of pancreas transplantation on a wide range of diabetic complications. RECENT FINDINGS: Effective blood glucose control by insulin delays progression of microvascular complications and probably improves survival in type 1 diabetes. A successful pancreas transplantation combined with a kidney graft has recently been found to prevent diabetic kidney lesions, and registry data support improved long-term patient survival...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28582321/cytomegalovirus-in-liver-transplant-recipients
#14
David Herman, Hyosun Han
PURPOSE OF REVIEW: Cytomegalovirus (CMV) is the most common opportunistic infection following solid-organ transplant and remains a cause of life-threatening disease and allograft rejection in liver transplant recipients. The purpose of this review is to highlight the current strategies in diagnosis and management of this disease in this vulnerable population. RECENT FINDINGS: Identification of high-risk individuals and aggressive treatment with antiviral agents, either via prophylaxis or by early initiation during active disease, has become the standard of care...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28582320/hepatitis-e-viral-infection-in-solid-organ-transplant-patients
#15
Stanley Y Fang, Hyosun Han
PURPOSE OF REVIEW: The purpose of this chapter is to review the literature published in the past 10 years with focus to the best literatures published since 2015 regarding chronic hepatitis E virus (HEV) infection in patients who received solid organ transplantation. RECENT FINDINGS: Diagnosis of this disease relies primarily on identification of HEV RNA in serum and more recently in stool as way of predicting relapse and guide therapy duration. Current management focuses primarily on primary prevention and supportive care, because additional research is needed to identify efficacious pharmacologic therapy, though use of ribavirin has shown promise in case series in treatment of some genotypes...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28562418/autologous-islet-transplantation-challenges-and-lessons
#16
Ty B Dunn, Joshua J Wilhelm, Melena D Bellin, Timothy L Pruett
PURPOSE OF REVIEW: Human islet isolation and autotransplantation [autologous islet transplant (AUTX)] is performed to prevent or ameliorate brittle diabetes after total pancreatectomy performed for benign disease. The success or failure of the transplant can be associated with a profound impact on the individual's quality of life and even survival. AUTX offers unique insights into the effects of pancreas quality, islet number, isolation technique and alternate site engraftment on transplant efficacy...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28562417/strongyloides-stercoralis-in-solid-organ-transplantation-early-diagnosis-gets-the-worm
#17
Constance M Mobley, Atiya Dhala, Rafik Mark Ghobrial
PURPOSE OF REVIEW: Strongyloidiasis is a parasitic infection affecting millions of people worldwide. Complications of infection are strongly associated with alcoholism, immunosuppression, and organ transplantation. Delayed diagnosis results in hyperinfection syndrome and disseminated strongyloidiasis leading to mortality rates approaching 80%. Early detection, and prevention of infection and transmission are key to diminish this illness. RECENT FINDINGS: In this review, we cover the basic concepts in immunity, immunosuppression, and disorder necessary for understanding the infectious syndromes associated with Strongyloides stercoralis infection...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28562416/cryptococcal-disease-in-the-solid-organ-transplant-setting-review-of-clinical-aspects-with-a-discussion-of-asymptomatic-cryptococcal-antigenemia
#18
Noah Wald-Dickler, Emily Blodget
PURPOSE OF REVIEW: Cryptococcal infections are an important cause of morbidity and mortality in solid organ transplant patients. Here, we review the microbiology, epidemiology, clinical course, treatment, and outcomes of Cryptococcus in solid organ transplant recipients. RECENT FINDINGS: We identify the unique findings in solid organ transplant patients when compared to other immunocompromised patients such as those with HIV. We also describe our experience and outcomes with regard to solid organ transplant patients who do not have positive fungal cultures, but cryptococcal antigen positivity and concern for cryptococcal disease...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28548995/invasive-fungal-infections-following-liver-transplantation
#19
Rachel Hogen, Kiran K Dhanireddy
PURPOSE OF REVIEW: The review outlines the microbiology, presentation, prophylactic strategies, resistance patterns, and consequences of invasive fungal infections (IFIs) in orthotopic liver transplantation (OLT) recipients. RECENT FINDINGS: There has been an increase in the proportion of non-albicans Candida causing IFIs. The biomarkers galactomannan and β-D-glucan should not be routinely used in the diagnosis of IFIs in OLT recipients due to their limited accuracy...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28542111/clostridium-difficile-infection-in-solid-organ-transplant-recipients
#20
Deepa Nanayakkara, Neha Nanda
PURPOSE OF REVIEW: Clostridium difficile infection (CDI) is a major healthcare-associated infection that causes significant morbidity and an economic impact in the United States. In this review, we provide an overview of Clostridium difficile infection in solid organ transplant recipients with an emphasis on recent literature. RECENT FINDINGS: C. difficile in solid organ transplant population has unique risk factors. Fecal microbiota transplantation has shown favorable results in treatment of recurrent C...
August 2017: Current Opinion in Organ Transplantation
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