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Current Opinion in Organ Transplantation

Nathaly P Llore, Karina A Bruestle, Adam Griesemer
PURPOSE OF REVIEW: The aim of this study was to review the recent progress in xenotransplantation achieved through genetic engineering and discuss the potential of tolerance induction to overcome remaining barriers to extended xenograft survival. RECENT FINDINGS: The success of life-saving allotransplantation has created a demand for organ transplantation that cannot be met by the supply of human organs. Xenotransplantation is one possible solution that would allow for a nearly unlimited supply of organs...
December 2018: Current Opinion in Organ Transplantation
Rachele Ciccocioppo, Marzia Fioravante, Luca Frulloni
PURPOSE OF REVIEW: The advent of cell therapies, mainly based on the use of mesenchymal stromal cells (MSCs), represents a great step forward in the treatment of immune-mediated conditions. Here, we focus on those intestinal disorders wherein MSCs have been applied for immunotherapeutic purposes and whose results are available. RECENT FINDINGS: By virtue of their ability to favour both tissue regeneration and immune tolerance, together with a substantial lack of immunogenicity, MSCs have gained huge attention in the last decade...
December 2018: Current Opinion in Organ Transplantation
Juan J Uriarte, Franziska E Uhl, Sara E Rolandsson Enes, Robert A Pouliot, Daniel J Weiss
PURPOSE OF REVIEW: Bioengineering the lung based on its natural extracellular matrix (ECM) offers novel opportunities to overcome the shortage of donors, to reduce chronic allograft rejections, and to improve the median survival rate of transplanted patients. During the last decade, lung tissue engineering has advanced rapidly to combine scaffolds, cells, and biologically active molecules into functional tissues to restore or improve the lung's main function, gas exchange. This review will inspect the current progress in lung bioengineering using decellularized and recellularized lung scaffolds and highlight future challenges in the field...
December 2018: Current Opinion in Organ Transplantation
Anoma Nellore
PURPOSE OF REVIEW: Xenotransplantation offers a solution for the global shortage of available organs. However, cross-species transplantation and immunosuppression raises concerns about transmission of zoonotic infections to the recipient as well as to the public. RECENT FINDINGS: Here, we review the major infections of concern after xenotransplantation, risks of their transmission, diagnostic, therapeutic as well as prevention modalities for these infections after xenotransplantation...
December 2018: Current Opinion in Organ Transplantation
Arielle Cimeno, Rolf N Barth, John C LaMattina
PURPOSE OF REVIEW: This review highlights advances in liver xenotransplantation, focusing on immunologic barriers and mechanisms underlying graft failure and recipient demise, and discussion of recent in-vivo results. RECENT FINDINGS: Pig to primate models of liver xenotransplantation have been plagued by thrombocytopenia, anemia, and coagulopathy. It is now known that platelet sequestration is mediated by liver sinusoidal endothelial cells and Kupffer cells in part by asialoglycoprotein receptor 1-driven mechanisms...
December 2018: Current Opinion in Organ Transplantation
Doris A Taylor, Abdelmotagaly Elgalad, Luiz C Sampaio
PURPOSE OF REVIEW: Heart transplantation is the only curative treatment option for end-stage heart failure. However, a shortage of donor organs is a major limitation of this approach. Regenerative medicine targets the goal of increasing the number of available hearts for transplantation. In this review, we highlight the state of the art of building a bioartificial heart. We summarize the components needed, the hurdles, and likely translational steps to make the dream of transplanting a totally functional bioartificial heart a possibility...
December 2018: Current Opinion in Organ Transplantation
Elisabeth Kemter, Eckhard Wolf
PURPOSE OF REVIEW: Xenotransplantation of porcine islets is a realistic option to restore β-cell function in type 1 diabetic patients. Among other factors, such as islet donor age (fetal, neonatal and adult) and genotype (wild type and genetically modified), choice of the transplantation site, and immune protection of the islets, efficient strategies for islet isolation, culture and engraftment are critical for the success of islet xenotransplantation. RECENT FINDINGS: Neonatal porcine islets (NPIs) are immature at isolation and need to be matured in vitro or in vivo before they become fully functional...
December 2018: Current Opinion in Organ Transplantation
Lars Burdorf, Agnes M Azimzadeh, Richard N Pierson
PURPOSE OF REVIEW: Recent progress in genetic engineering has facilitated development of transgenic donor animals designed to overcome the known barriers to discordant xenotransplantation, and greatly accelerated progress in the field of xenotransplantation. Here we review and summarize recent progress in lung xenotransplantation, and discuss possible additional genetic modifications and other interventions that may further advance the use of pulmonary xenografts towards clinical applications based on known mechanisms of xeno lung injury...
December 2018: Current Opinion in Organ Transplantation
Mohamed Ali, Anil Kumar P R, Sang Jin Lee, John D Jackson
PURPOSE OF REVIEW: Loss of organ function is a critical issue that threatens a patient's life. Currently, the only available treatment is organ transplantation; however, shortage of donor organs, histocompatibility, and life-long immunosuppression present major challenges. Three-dimensional bioprinting technology holds a promising solution for treating organ failure by fabricating autologous tissues and organs for transplantation. To biofabricate a functional tissue, target-cell types are combined with an appropriate biomaterial for structural support and a bioink that supports cell function and maturation...
December 2018: Current Opinion in Organ Transplantation
Piyumi Wijesekara, Wai Hoe Ng, Minrui Feng, Xi Ren
PURPOSE OF REVIEW: Engineering vasculature that meets an organ's specific physiology and function is a fundamental step in organ bioengineering. In this article, we review approaches for engineering functional vasculature for organ bioengineering, with an emphasis on the engineering of organ-specific endothelium and vasculature. RECENT FINDINGS: Recent advances in hydrogel-based engineering of vascularized organ bud enable vascular regeneration in self-assembled cellular niche containing parenchymal and stromal cells...
December 2018: Current Opinion in Organ Transplantation
Sue V McDiarmid
PURPOSE OF REVIEW: This review will focus on the lessons learned over several decades of solid organ transplantation in children, and their relevance to the emerging field of pediatric VCA. Particular attention will be focused on the risk-benefit ratio of immunosuppression as it applies to children receiving a life-enhancing transplant as compared with a life-saving transplant. Potential indications for pediatric VCA will be considered. RECENT FINDINGS: The report in 2015 of the first child to receive a VCA, bilateral upper extremity grafts from a nonrelated deceased donor, is a seminal event...
October 2018: Current Opinion in Organ Transplantation
Mats Brännström
PURPOSE OF REVIEW: The current review gives an updated synopsis of all cases of uterus transplantation (UTx) that has been published and technical details about surgery. The live births that so far have been reported are described regarding pregnancy and outcome. In addition, the review highlights some specific areas of live donor UTx, deceased donor UTx and UTx in general that need further research for clarification/optimization. It is predicted that the clinical field of UTx will expand rapidly and recommendations for a scientific development of the UTx field are presented...
October 2018: Current Opinion in Organ Transplantation
Thomas H Tung, Susan E Mackinnon
PURPOSE OF REVIEW: The current review will discuss the current understanding of nerve regeneration in vascularized composite allotransplantation (VCA). The success of proximal arm and leg transplants has been hampered by the limitations of nerve regrowth across long distances resulting in poor regeneration and functional recovery. Relevant research in stem-cell therapies to overcome these issues will be reviewed. RECENT FINDINGS: The effect of rejection on nerve regeneration in the VCA may be unpredictable and may be quite different for the nerve allograft...
October 2018: Current Opinion in Organ Transplantation
Emmanuel Morelon, Palmina Petruzzo, Jean Kanitakis
PURPOSE OF REVIEW: Vascularized composite allografts (VCA), which restore severely damaged body parts that cannot be repaired with conventional surgical techniques, often undergo acute skin rejection episodes in the early postgraft period. Although the risk of human VCA to be affected by chronic rejection was initially unknown, such cases were recently observed. RECENT FINDINGS: Chronic rejection targets preferentially the skin (dermal sclerosis, adnexal atrophy, necrosis) and vessels (graft vasculopathy) and may cause graft dysfunction, often resulting in ischemic graft loss...
October 2018: Current Opinion in Organ Transplantation
Gerald Brandacher
No abstract text is available yet for this article.
October 2018: Current Opinion in Organ Transplantation
Angus W Thomson
No abstract text is available yet for this article.
October 2018: Current Opinion in Organ Transplantation
Laura C Burlage, Shannon N Tessier, Joanna W Etra, Korkut Uygun, Gerald Brandacher
PURPOSE OF REVIEW: In this review, we discuss novel strategies that allow for extended preservation of vascularized composite allografts and their potential future clinical implications for the field of vascularized composite allotransplantation (VCA). RECENT FINDINGS: The current gold standard in tissue preservation - static cold preservation on ice - is insufficient to preserve VCA grafts for more than a few hours. Advancements in the field of VCA regarding matching and allocation, desensitization, and potential tolerance induction are all within reasonable reach to achieve; these are, however, constrained by limited preservation time of VCA grafts...
October 2018: Current Opinion in Organ Transplantation
Miguel I Dorante, Sotirios Tasigiorgos, Bohdan Pomahac
PURPOSE OF REVIEW: Face transplantation is no longer a young field. Reported outcomes suggest that this life-enhancing transplantation is viable and ethically justified for appropriate patients. Given that pediatric hand transplantation has been performed with promising reported outcomes, it is time to consider how to properly expand the field of face transplantation into pediatric patients. RECENT FINDINGS: Appropriate collaboration between adult and pediatric colleagues can mitigate risks associated with expanding surgical innovation between respective patient demographics...
October 2018: Current Opinion in Organ Transplantation
Adriano Taddeo, Catherine Tsai, Esther Vögelin, Robert Rieben
PURPOSE OF REVIEW: The long-term adverse effects of immunosuppressive treatment, the high rate of acute rejection and the development of chronic rejection are the main factors preventing a wider clinical application of vascularized composite allotransplantation (VCA). Targeted immunosuppression using innovative drug delivery systems (DDS) may help to overcome these hurdles, increasing therapeutic efficacy while reducing systemic toxicity. This review provides a summary of the recently developed strategies for targeted delivery of immunosuppressive drugs in VCA...
October 2018: Current Opinion in Organ Transplantation
Antoine Sicard, Dominic A Boardman, Megan K Levings
PURPOSE OF REVIEW: Adoptive cell therapy using CD4FOXP3 regulatory T cells (Treg) has emerged as a promising therapeutic strategy to treat autoimmunity and alloimmunity. Preclinical studies suggest that the efficacy of Treg therapy can be improved by modifying the antigen specificity, stability and function of therapeutic Tregs. We review recent innovations that considerably enhance the possibilities of controlling these parameters. RECENT FINDINGS: Antigen-specific Tregs can be generated by genetically modifying polyclonal Tregs to express designated T-cell receptors or single-chain chimeric antigen receptors...
October 2018: Current Opinion in Organ Transplantation
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