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Experimental and Clinical Transplantation

Junji Uchida, Tomoaki Iwai, Shunji Nishide, Kazuya Kabei, Nobuyuki Kuwabara, Toshihide Naganuma, Norihiko Kumada, Yoshiaki Takemoto, Tatsuya Nakatani
OBJECTIVES: Here, we report our 1-year follow-up data of stable ABO-incompatible kidney transplant recipients who converted from mycophenolate mofetil plus a standard dose of a calcineurin inhibitor to everolimus plus low exposure to calcineurin inhibitors. MATERIALS AND METHODS: Our study included 17 recipients of ABO-incompatible kidney transplant procedures performed at our institution. At baseline and at 3 and 12 months after conversion, graft biopsies were performed to check for acute rejection and C4d deposition...
September 4, 2018: Experimental and Clinical Transplantation
Evren Hizal, Aydincan Akdur, Fuat Buyuklu, Levent Naci Ozluoglu, Mehmet Haberal
OBJECTIVES: The aim of this study was to define the otorhinolaryngologic manifestations and clinical characteristics of patients who received kidney or liver transplants at a university hospital. MATERIALS AND METHODS: Medical records of patients who received a kidney or liver transplant between 2000 and 2013 and who were referred or applied to the ear, nose, and throat clinic were retrospectively reviewed. Otorhinolaryngologic complaints, signs, examination findings, and diagnoses of patients were noted...
September 4, 2018: Experimental and Clinical Transplantation
Arnaldo N S Silva, Wasif Tahir, Niaz Ahmad
We describe a case of fusiform aneurysm of the renal artery on a background of dolichoectasia in a kidney recovered from a deceased donor. The donor, a 57-year-old female, had died of an extensive nonsurvivable subarachnoid hemorrhage. Fusiform aneurysms involving the main renal artery and its superior branch had extended into the hilum with insufficient accessible stump for safe reconstruction. Placement of a stent through an intraoperative radiologic intervention was not possible without compromising renal perfusion...
September 4, 2018: Experimental and Clinical Transplantation
Sami Akbulut, Tevfik Tolga Sahin, Mehmet Kolu, Burak Isik, Yasar Bayindir, Sezai Yilmaz
The major advantage of preoperative magnetic resonance cholangiopancreatography is that living liver donor candidates with complicated biliary tracts may not be exposed to unnecessary laparotomy. To the best of our knowledge, the case presented here features a condition so far not seen by the Liver Transplantation Society. A 27-year-old woman who presented to our clinic as a living liver donor candidate was evaluated but did not have a preoperative magnetic resonance cholangiopancreatography due to technical factors...
August 17, 2018: Experimental and Clinical Transplantation
Kunjin Bae, Daelim Jee
An interaction between regained renal function in a transplanted kidney and hyperventilation syndrome may interfere with correct diagnosis of acid-base status in patients with preoperative nongap acidosis. Here, we present a patient with glomerular nephritis and hyperchloremia who underwent kidney transplant. Progressively increasing bicarbonate reabsorption by the renal graft, which thereby changed the arterial carbon dioxide tension-to-bicarbonate ratio, resulted in a time-sequence swing of an acid-base interpretation despite persistent mixed respiratory alkalosis due to hyperventilation syndrome and nongap metabolic acidosis due to preexisting hyperchloremia...
August 17, 2018: Experimental and Clinical Transplantation
Damien C O'Neill, Niall F Davis, Timothy É Murray, Michael J Lee, Dilly Little, Martina M Morrin
OBJECTIVES: Prospective renal donors are a select population of healthy individuals who have been thoroughly screened for significant comorbidities before they undergo multidetector computed tomography. Our aim was to determine the prevalence of incidental findings on preoperative multidetector computed tomography in a healthy cohort of potential living donors for kidney transplant. MATERIALS AND METHODS: A prospective study was performed of prospective living kidney transplant donors at a national kidney transplant center...
August 17, 2018: Experimental and Clinical Transplantation
Paulo N Martins, Amanda Rawson, Babak Movahedi, Isabel M A Brüggenwirth, Natasha H Dolgin, Ann-Britt Martins, Paria Mahboub, Adel Bozorgzadeh
OBJECTIVES: Elevation of transaminases has been used as a marker of hepatic ischemic injury and as a crucial parameter for liver graft assessment. However, analysis of serum transaminases has limitations regarding the quantitative assessment of liver necrosis and is not a reliable predictor of outcomes. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all liver transplants (N = 238) performed at the UMass Memorial Medical Center from 2009 to 2013...
August 17, 2018: Experimental and Clinical Transplantation
Samed Rahatli, Ozden Altundag, Ebru Ayvazoglu Soy, Gokhan Moray, Mehmet Haberal
OBJECTIVES: The risk of some cancer types increases after organ transplant compared with that shown in the general population; this has been well documented in clinical studies. With patients having longer survival and with the higher number of transplant procedures, cancer is an increasing health concern at high-volume transplant centers. Malignancy has an important effect on short- and long-term graft and patient survival. In this study, we evaluated cancer frequency during transplant patient follow-up...
August 17, 2018: Experimental and Clinical Transplantation
Paulo N Martins, Isabel M A Brüggenwirth, James McDaid, Martin Hertl, Tatsuo Kawai, Nahel Elias, Raymond T Chung, James F Markmann
Heat stroke is a multiple organ dysfunction syndrome of poorly understood pathogenesis. Exertional heat stroke with acute liver failure is a rarely reported condition. Liver transplant has been recommended as treatment in cases of severe liver dysfunction; however, there are only 5 described cases of long-term survival after this procedure in patients with heat stroke. Here, we present 2 cases of young athletes who developed heat stroke. Both patients developed acute liver failure and were listed for liver transplant...
August 17, 2018: Experimental and Clinical Transplantation
Andriy V Trailin, Tamara N Nykonenko, Tetyana I Ostapenko, Sergiy R Vildanov, Olexandr S Nykonenko
OBJECTIVES: Our aim was to evaluate which histologic lesions in a donor kidney were associated with graft function up to 5 years and with its dynamics. MATERIALS AND METHODS: We retrospectively investigated the association between acute and chronic individual histologic lesions and composite scores in preimplant and postreperfusion biopsies from deceased-donor (n = 101) and living-donor (n = 29) kidneys with initial graft function and function at discharge, at 6 months, and at 5 years and slopes of estimated glomerular filtration rate from discharge to 6 months and from 6 months to 5 years...
August 17, 2018: Experimental and Clinical Transplantation
Ivana Dedinská, Blažej Palkoci, Martin Vojtko, Denisa Osinová, Marianna Lajčiaková
OBJECTIVES: Kidneys from expanded criteria donors with diagnosis of brain death have become a part of the organ transplant program, which have thus increased the number of transplants. MATERIALS AND METHODS: In this retrospective analysis, we identified the expanded criteria donors in a group of 156 kidney donors at our center. Basic parameters of the donors before kidney recovery were collected. Graft function, graft survival, and patient survival at 1, 3, and 5 years posttransplant were compared in expanded criteria versus standard criteria donors...
August 6, 2018: Experimental and Clinical Transplantation
Shamik Dholakia, Sanjay Sinha, Georgios Vrakas, Mark Sullivan, Anil Vaidya, David Cranston, Peter John Friend
OBJECTIVES: The deficit of organs for renal transplant is a global issue. The United Kingdom Hospital Episode Statistics indicates there that were 8168 nephrectomies undertaken in 2014. Furthermore, according to the British Association of Urological Surgeons 2014 nephrectomy report, 71.8% of patients undergoing a nephrectomy had creatinine levels of less than 120 IU/L and roughly 20% had the procedure for benign and functional causes. MATERIALS AND METHODS: We report a prospective case series from March 2014 to March 2016 involving 6 patients showing 3 successful transplants performed following 3 native nephrectomies...
August 6, 2018: Experimental and Clinical Transplantation
Emrullah Söğütdelen, Tolga Yildirim, Hakan Bahadir Haberal, Uğur Canpolat, Tuncay Hazirolan, Hasan Serkan Doğan, Şeref Rahmi Yilmaz, Yunus Erdem, Fazil Tuncay Aki
OBJECTIVES: Our goal was to determine the short-term effects of donor nephrectomy on the cardiovascular system and to gain a better understanding of the recently recognized long-term increased risk of end-stage renal disease and cardiovascular mortality. MATERIALS AND METHODS: Living kidney donors who underwent donor nephrectomy between January 2010 and January 2015 at the Hacettepe University Transplantation Unit were retrospectively screened. Echocardiographic parameters, kidney volumes, and renal functions before nephrectomy were compared with measurements after nephrectomy...
August 6, 2018: Experimental and Clinical Transplantation
Juan Betuel Ivey-Miranda, Marta Farrero-Torres, Eduardo Flores-Umanzor, Evelyn Santiago, Felix Perez-Villa
OBJECTIVES: Moderate chronic renal insufficiency is often found in patients evaluated for heart transplant. Recovery of cardiac output after heart transplant might lead to improvement of renal function. In this study, our aim was to identify predictors of improvement of renal function after heart transplant. MATERIALS AND METHODS: Our study included a cohort of heart transplant patients treated from 2011 to 2016 whose main outcome was improved renal function, defined as glomerular filtration rate at 6 months after heart transplant of ≥ 10% compared with baseline (before transplant)...
August 6, 2018: Experimental and Clinical Transplantation
Omid Sedigh, Maurizio Barale, Mirko Preto, Andrea Bosio, Davide Diena, Laura Rossi, Dorico Righi, Luigi Biancone, Paolo Gontero, Ettore Dalmasso
We present the use of a self-expandable covered metallic stent (UVENTA; TaeWoong Medical, Gyeonggi-do, South Korea) to treat a ureteral stricture after kidney transplant. In this report, we describe the procedure and short-term outcomes of a patient with a recurrent distal stricture who did not respond to percutaneous balloon dilation. We decided to place this temporary stent as an alternative to complex surgery. The aim of the procedure was to get a chronic dilation of the stricture up to 7 mm to stabilize the fibrotic tissue...
August 6, 2018: Experimental and Clinical Transplantation
Mustafa Yılmaz, Cihan Altın, Abdullah Tekin, İlker Arer, Hakan Yabanoğlu, Kenan Çalışkan, Gökhan Moray, Bülent Özin, Haldun Müderrsioğlu, Mehmet Haberal
OBJECTIVES: The association between end-stage renal disease with atrial fibrillation and ventricular arrhythmias is well documented. The aim of this study was to investigate whether kidney transplant has any effect on P-wave dispersion, a predictor of atrial fibrillation and corrected QT interval dispersion, T-wave peak-end interval, and T-wave peak-end/corrected QT ratio, which are predictors of ventricular arrhythmias in patients with end-stage renal disease. MATERIALS AND METHODS: In a retrospective study, 234 patients (125 kidney transplant and 109 healthy control patients) were examined...
August 6, 2018: Experimental and Clinical Transplantation
Behnam Saberi, Jacqueline Garonzik-Wang, Michelle Ma, Tokunbo Ajayi, Amy Kim, Harry Luu, Neha Jakhete, Aliaksei Pustavoitau, Robert A Anders, Christos Georgiades, Ihab Kamel, Shane Ottmann, Benjamin Philosophe, Andrew M Cameron, Ahmet Gurakar
OBJECTIVES: We aimed to investigate the accuracy of the Milan, University of California San Francisco, and Up-to-7 criteria in predicting tumor recurrence after liver transplant for hepatocellular carcinoma. MATERIALS AND METHODS: For this study, 165 patients with deceased-donor liver transplant for hepatocellular carcinoma were evaluated. The Milan, University of California San Francisco, and Up-to-7 criteria were calculated based on explant pathology. RESULTS: Tumor recurrence rate after liver transplant was 14...
August 6, 2018: Experimental and Clinical Transplantation
Theodore W James, Jessica E S Shay, David Furfaro, Burak Ozseker, Stuart D Russell, Aliaksei Pustavoitau, Nicole Rizkalla, Behnam Saberi, Benjamin Philosophe, Andrew M Cameron, Ahmet Gurakar
OBJECTIVES: Each year in the United States, approximately 40000 patients with a liver disorder will progress to end-stage liver disease and about 30000 of those patients will subsequently die from this condition. Liver transplant remains the definitive treatment option for end-stage liver disease, and understanding the causes of posttransplant mortality is an ongoing area of investigation. MATERIALS AND METHODS: In this retrospective cohort study, patients who underwent orthotopic liver transplant between January 2012 and January 2015 at the Johns Hopkins Hospital Liver Transplant Program were reviewed by a single reviewer for cardiac events in the 30 days after transplant or during the index admission...
August 6, 2018: Experimental and Clinical Transplantation
Jun-Li Tsai, Shang-Feng Tsai
Renal transplant is the preferred choice of treatment for end-stage renal diseases. To avoid rejection, increasingly potent immunosuppressants are administered to recipients of kidney transplants. Complications, when there is excess immunosuppression, include possible lethal infections, which reduce allograft survival and compromise patient survival. When there is insufficient immunosuppression, rejections could impair allograft outcomes. Moreover, recurrent primary diseases could also threaten allograft outcomes...
July 31, 2018: Experimental and Clinical Transplantation
Amir Human Hoveidaei, Hoda Soufi, Seyed Mohsen Dehghani, Mohammad Hadi Imanieh
Idiopathic thrombocytopenic purpura, a common acquired bleeding disorder in pediatric patients, is an autoimmune disorder characterized by a low platelet count. Organ transplant can transfer such diseases, but the occurrence of idiopathic thrombocytopenic purpura after liver transplant is rare. Here, we report a 17-month-old girl who was diagnosed with idiopathic thrombocytopenic purpura and who had a history of liver transplant 11 months earlier. Treatment of cytomegalovirus and Epstein-Barr virus infection led to a successful outcome...
July 31, 2018: Experimental and Clinical Transplantation
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