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Current Opinion in Organ Transplantation

journal
https://www.readbyqxmd.com/read/28212160/current-controversies-in-organ-transplantation
#1
Douglas W Hanto
No abstract text is available yet for this article.
February 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28212159/liver-allocation-and-distribution-time-for-a-change
#2
Ranjit Deshpande, Ryutaro Hirose, David Mulligan
PURPOSE OF REVIEW: Liver allograft allocation has been a topic of hot debate for over a decade. New redistricting changes have been proposed by the Liver and Intestinal Transplant Committee to the existing United Network for Organ Sharing (UNOS) liver allocation policy. The basis of this new proposal is similar to the old one with an aim to distribute organs in a fair, efficient and equitable fashion. In this review, we plan to look in depth at the redistribution proposals thus far, their merits and how they may help patients who do not have adequate access to livers...
February 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28212158/an-integrated-understanding-of-the-immunology-of-allograft-inflammation
#3
Brenna Houlihan, Priscilla Cha, Michael Zasloff, Thomas M Fishbein, Alexander Kroemer
PURPOSE OF REVIEW: The purpose of this review is to summarize recent advances in our understanding of the complex immunology of intestinal transplantation and allograft rejection. RECENT FINDINGS: Recent findings highlight the importance of the intestinal microbiome for intestinal homeostasis and the role of newly discovered innate lymphoid cells in intestinal transplantation. In addition, the role of host antimicrobial Th17 responses in the pathogenesis of inflammatory bowel diseases and intestinal allograft rejection has been further elucidated...
February 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28151810/are-geographic-differences-in-transplantation-inherently-wrong
#4
Keren Ladin, Douglas W Hanto
PURPOSE OF REVIEW: Geographic variation in liver transplantation has been the subject of extensive scrutiny, reflecting concerns that location is unfairly determinative for people needing organ transplantation. Drawing upon a number of established ethical approaches, we examine whether geographic differences in access to livers are inherently unethical. RECENT FINDINGS: We posit that the ethical imperative for redistribution largely hinges upon the belief that access to organs systematically disadvantages certain identifiable groups of patients over others...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28151809/liver-transplantation-around-the-world
#5
James F Trotter
PURPOSE OF REVIEW: In the past few years, there have been important changes in the development of liver transplantation around the world. In particular, several emerging countries have rapidly developed transplant programs. There have also been important changes in liver allocation, utilization of donors by cardiac death, and living donors. A review of the practices in different countries around the world will help provide the reader with a better appreciation of their own program as well as the recognition of potential areas of improvement based on the experience of their colleagues...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28151808/techniques-for-abdominal-wall-reconstruction-in-intestinal-transplantation
#6
Gabriel E Gondolesi, Nicolás F Aguirre
PURPOSE OF REVIEW: One of the most important challenges in the intestinal (ITx) and multivisceral transplant (MVTx) is to achieve a successful abdominal wall closure. RECENT FINDINGS: A tension-free primary closure should be our aim. In most of the cases, we need to perform a component separation technique, alone or combined, to the use of a synthetic mesh. If those options are not feasible, the abdominal wall composite vascularized allograft transplant (AW-CVA) utilizing direct orthotopic vascularization can be considered...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28151807/the-impact-of-antibodies-and-virtual-crossmatching-on-intestinal-transplant-outcomes
#7
Elaine Y Cheng, Bernard J DuBray, Douglas G Farmer
PURPOSE OF REVIEW: Sensitization to human leukocyte antigens (HLAs) limits access to potential donors and contributes to inferior graft survival after transplantation. In this article, we will review the effects of HLA-specific antibodies on intestinal transplant outcomes, and discuss considerations in the monitoring and treatment of anti-HLA antibodies. RECENT FINDINGS: Only a handful of studies has investigated the effects of donor-specific anti-HLA antibodies (DSAs) on intestinal allograft outcomes...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28079558/once-daily-tacrolimus-in-liver-transplantation-a-me-too-drug-or-a-therapeutic-advantage
#8
Pavel Trunečka
PURPOSE OF REVIEW: To provide latest information on differences between standard tacrolimus (TAC BID) and slow-released formulation of tacrolimus (Advagraf) in liver transplantation (LTx), and to discuss the latter's therapeutic value as a distinct entity. RECENT FINDINGS: Two articles on de-novo studies, several on conversion and one on survival analysis from the European Liver Transplant Registry published recently showed that low-dose Advagraf immediately after transplantation provided same protection to the kidney as standard dose delayed until day 5, and was associated with lower rejection rate; to maintain the same trough level after late conversion to Advagraf, an approximately 1...
January 11, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28060025/antibody-mediated-rejection-what-is-the-clinical-relevance
#9
Rachel Hogen, Joseph DiNorcia, Kiran Dhanireddy
PURPOSE OF REVIEW: The review outlines the diagnosis, clinical implications, and treatment strategies for acute and chronic antibody-mediated rejection (AMR) after orthotopic liver transplantation (OLT). RECENT FINDINGS: A combination of clinical work-up, histopathology, C4d staining, and donor-specific antibody (DSA) should be used to diagnose AMR. The differential diagnosis for idiopathic fibrosis now includes chronic AMR. Characterization of pathogenic DSA continues to progress...
January 3, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28030433/the-case-against-imminent-death-donation
#10
Grace S Lee, Vishnu S Potluri, Peter P Reese
PURPOSE OF REVIEW: Imminent death donation (IDD) is a proposal to procure organs from patients prior to the withdrawal of life support, which is anticipated to lead to death. In this review, we outline substantial concerns that the transplant community should consider when deliberating the possibility of practicing IDD. RECENT FINDINGS: Although there are several compelling theoretical and intuitive reasons to support IDD, its application has been hindered because of inadequate definitions or protocols...
December 26, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28030432/outcomes-and-disparities-in-liver-transplantation-will-be-improved-by-redistricting-cons
#11
David Seth Goldberg, Seth Karp
PURPOSE OF REVIEW: Over the last 2 years, the liver transplant community has been debating a proposal to redraw the maps of organ distribution. The basis for these proposed changes is reported disparities in severity of illness at transplantation across the USA - however, this is based on the allocation model for end-stage liver disease score. In this review, we provide a critical overview of the redistribution proposal, its flaws and how it may worsen outcomes and exacerbate disparities in liver transplantation...
December 26, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28027062/organ-donation-and-imminent-death-pro-position
#12
Paul E Morrissey
PURPOSE OF REVIEW: Donation after cardiac death is associated with many problems including ischemic injury, high rates of delayed allograft function, prolonged time to asystole, and frequent organ discard. Imminent death donation (IDD) has been proposed as a separate category of organ donation: distinct from living donation and donation after cardiac death. RECENT FINDINGS: A protocol for IDD was developed at Rhode Island Hospital and published in the ethics literature...
December 23, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27941468/liver-perfusion-devices-how-close-are-we-to-widespread-application
#13
Amelia J Hessheimer, Constantino Fondevila
PURPOSE OF REVIEW: Ex-situ liver machine perfusion has been the focus of increasing interest over the past decade as a means to improve the quality of livers for transplantation and the applicability of liver transplantation in general. The present review aims to evaluate the experimental basis for liver machine perfusion and the significance of recent reports on its clinical application. RECENT FINDINGS: Although liver machine perfusion has been studied experimentally over a range of temperatures, clinical liver transplant work that has been performed to date has been done using either hypothermic machine perfusion (0-12 °C), HMP or normothermic machine perfusion (35-38 °C, NMP)...
December 9, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27926548/liver-transplantation-for-hepatocellular-carcinoma-current-update-on-treatment-and-allocation
#14
Leigh Anne Dageforde, Kathryn J Fowler, William C Chapman
PURPOSE OF REVIEW: This review discusses the current imaging modalities and criteria used to diagnose, and the role of liver transplantation as well as nonsurgical hepatic-directed therapies to treat hepatocellular carcinoma in the setting of chronic liver disease. RECENT FINDINGS: There has been continual evolution of guidelines, policies, and algorithms for the imaging diagnosis of hepatocellular carcinoma, particularly the Liver Imaging Reporting and Data System...
December 6, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27926547/liver-redistricting-what-are-the-upcoming-changes-in-liver-allocation-in-the-united-states
#15
Therese Bittermann, David S Goldberg
PURPOSE OF REVIEW: Geographic disparity in liver transplantation is substantial in the United States, and primarily a byproduct of artificially created zones of organ distribution. In 2016, the United Network for Organ Sharing (UNOS) put forward a formal redistricting proposal with the goal of reducing this variability by regrouping the country's 58 donation service areas into eight new districts. This review provides a summary of the redistricting proposal's methodologies, expected results, criticisms and next steps...
December 6, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28030436/editorial-introductions
#16
(no author information available yet)
No abstract text is available yet for this article.
February 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28005573/mesenchymal-stromal-cell-therapy-to-promote-cardiac-tissue-regeneration-and-repair
#17
Agata Bartczak, Ian McGilvray, Armand Keating
PURPOSE OF REVIEW: This review focuses on articles published from January 2015 to June 2016 on mesenchymal stromal cell (MSC) therapy for cardiac regeneration and repair. RECENT FINDINGS: During this period, reports published on MSCs address the best MSC tissue source for cellular therapy, mechanisms of MSC activity and improving MSC longevity, and homing in vivo. Currently, there is no definitive therapeutic advantage of any one tissue-derived MSC over another, and even combination therapies struggle with conflicting outcomes...
February 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28005572/polyreactive-natural-antibodies-in-transplantation
#18
Emmanuel Zorn, Sarah B See
PURPOSE OF REVIEW: Antibody-mediated rejection (ABMR), especially in its chronic manifestation, is increasingly recognized as a leading cause of late graft loss following solid organ transplantation. In recent years, autoantibodies have emerged as a significant component of the humoral response to allografts alongside anti-human leukocyte antigen antibodies. These include polyreactive antibodies also known as natural antibodies (Nabs) secreted by innate B cells. A hallmark of Nabs is their capacity to bind altered self such as oxidized lipids on apoptotic cells...
February 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27984277/impact-of-hyperlipidemia-on-alloimmunity
#19
Jessamyn Bagley, Jin Yuan, John Iacomini
PURPOSE OF REVIEW: Hyperlipidemia is a comorbidity affecting a significant number of transplant patients despite treatment with cholesterol lowering drugs. Recently, it has been shown that hyperlipidemia can significantly alter T-cell responses to cardiac allografts in mice, and graft rejection is accelerated in dyslipidemic mice. Here, we review recent advances in our understanding of hyperlipidemia in graft rejection. RECENT FINDINGS: Hyperlipidemic mice have significant increases in serum levels of proinflammatory cytokines, and neutralization of interleukin 17 (IL-17) slows graft rejection, suggesting that IL-17 production by Th17 cells was necessary but not sufficient for rejection...
February 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27984276/mechanisms-of-liver-induced-tolerance
#20
Demetrios Moris, Lina Lu, Shiguang Qian
PURPOSE OF REVIEW: To highlight the results of the ongoing research on the mechanisms of liver-induced tolerance focusing on results from the last year. RECENT FINDINGS: The liver is exposed to a massive antigenic burden of dietary and commensal products from the gastrointestinal tract via portal vein, most of which are necessary for survival. To prevent the immune system from destroying these foreign yet beneficial elements, the liver has developed unique mechanisms to suppress immune responses...
February 2017: Current Opinion in Organ Transplantation
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