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Experimental and Clinical Transplantation

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https://www.readbyqxmd.com/read/28847264/pre-and-posttransplant-refractory-idiopathic-membranous-glomerulonephritis-the-forgotten-potential-culprit
#1
Antoine Barbari
Idiopathic membranous nephropathy has been recently recognized as an autoimmune disease that may recur or develop de novo posttransplant, whereby specific auto- or alloantibodies are directed against recently recognized podocyte structures such as the phospholipase receptor PLAR2 and the thrombospondin receptor THSD7A. The observed inconsistencies in therapeutic responses with all presently recognized therapies irrespective of immunosuppressive regimen used and the superiority of complete and sustained remission rates in recurrent disease after kidney transplant compared with native disease imply the existence of different immunopathogenic signatures that may be operational, either isolated or combined, in the pathogenesis of membranous nephropathy...
August 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28847263/immunosuppression-practices-in-liver-transplantation-a-survey-of-north-american-centers
#2
Trana Hussaini, Ricky D Turgeon, Nilufar Partovi, Siegfried R Erb, Charles H Scudamore, Eric M Yoshida
OBJECTIVES: There is a clear lack of clinical evidence guiding immunosuppressive management in long-term stable liver transplant recipients. As a result, anecdotal experience suggests wide variability across transplant centers. We aimed to identify patterns of immunosuppression practices in liver transplant centers across Canada and the United States. MATERIALS AND METHODS: From February 9 to May 31, 2015, we invited clinicians from all liver transplant centers in Canada and the United States to answer a 6-question survey generated using SurveyMonkey...
August 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28847262/effect-of-over-10-year-cryopreserved-encapsulated-pancreatic-islets-of-langerhans
#3
Joanna Kinasiewicz, Magdalena Antosiak-Iwanska, Ewa Godlewska, Elzbieta Sitarek, Marek Sabat, Piotr Fiedor, Ludomira Granicka
OBJECTIVES: Immunoisolation of pancreatic islets of Langerhans performed by the encapsulation process may be a method to avoid immunosuppressive therapy after transplant. The main problem related to islet transplant is shortage of human pancreata. Resolution of this obstacle may be cryopreservation of encapsulated islets, which enables collection of sufficient numbers of isolated islets required for transplant and long-term storage. Here, we assessed the ability of encapsulated islets to function after long-term banking at low temperature...
August 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28836934/sirolimus-associated-with-tacrolimus-at-low-doses-in-elderly-kidney-transplant-patients-a-prospective-randomized-controlled-trial
#4
Cristiane Akemi Kojima, Hong Si Nga, Henrique Mochida Takase, Ariane Moyses Bravin, Márcia de Fátima Faraldo Martinez Garcia, Paula Dalsoglio Garcia, Mariana Moraes Contti, Luis Gustavo Modelli de Andrade
OBJECTIVES: There is no consensus on the best immunosuppressive regimen for elderly renal transplant recipients. The objective of this study was to assess cytomegalovirus infection incidence and kidney transplant outcomes in elderly recipients treated with mammalian target of rapamycin inhibitors sirolimus/ tacrolimus at low doses compared with those receiving tacrolimus/mycophenolate sodium. MATERIALS AND METHODS: In this single-center prospective randomized study (Trial Registration No...
August 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28836933/intracerebral-hemorrhage-related-with-penicillium-species-following-deceased-donor-liver-transplant
#5
Huseyin Yonder, Sami Akbulut, Huseyin Kocaaslan, Volkan Ince, Nese Karadag, Gokhan Demirtas, Ayse Selimoglu, Sezai Yilmaz
Early or late posttransplant opportunistic infections are among the leading complications after liver transplant. The source of early posttransplant opportunistic infections is usually the patient, the implantation of an infected graft, contamination during a surgical procedure, or invasive interventions performed at the intensive care unit. A 10-year-old male patient with Wilson disease (Pediatric End-Stage Liver Disease Score of 42, Child-Pugh score of 12, total bilirubin 40 mg/dL, platelet count 55?000/mL, hemoglobin level 6...
August 24, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28836932/a-better-journey-for-patients-a-better-deal-for-the-nhs-the-successful-implementation-of-an-enhanced-recovery-program-after-renal-transplant-surgery
#6
Ahmed Halawa, Stephen Rowe, Fleur Roberts, Chidambaram Nathan, Ahmed Hassan, Avneesh Kumar, Branislav Suvakov, Ben Edwards, Cavin Gray
OBJECTIVES: Our aim was to apply the principles of enhanced recovery in renal transplant recipients and to assess the changes in the quality of patient care and patient satisfaction. MATERIALS AND METHODS: Our study included 286 consecutive renal transplant patients. Of these, 135 patients went through the enhanced recovery program and 151 patients had traditional recovery. Patient education and discharge planning were commenced on admission. For enhanced recovery, prolonged preoperative fasting was avoided by carbohydrate loading...
August 24, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28836931/liver-stiffness-measurements-using-acoustic-radiation-force-impulse-in-recipients-of-living-donor-and-deceased-donor-orthotopic-liver-transplant
#7
Kemal Murat Haberal, Hale Turnaoğlu, Adnan Özdemir, Nihal Uslu, Asuman Nihan Haberal Reyhan, Gökhan Moray, Mehmet Haberal
OBJECTIVES: The aim of this study was to evaluate the diagnostic efficiency of the acoustic radiation force impulse (Siemens Medical Solutions, Erlangen, Germany) elastography in assessment of fibrosis in orthotopic liver transplant patients. MATERIALS AND METHODS: We enrolled 28 orthotopic liver transplant patients (deceased and living donors), whose biopsy decision had been prospectively given clinically. Ten acoustic radiation force impulse elastographic measurements were applied before the biopsy or within 3 days after the biopsy by 2 radiologists...
August 24, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28810825/regulatory-t-cell-levels-in-the-longest-surviving-asian-patient-after-heart-lung-transplant
#8
Lei Huang, Ming Ji, Shounan Yi, Xinmin Zhou
Heart-lung transplant is the most effective therapy for patients with end-stage cardiopulmonary disease. Here, we report an initial assessment of a 31-year-old man who had survived more than 11 years after heart-lung transplant, which represents the longest survival time in this procedure in Asian studies. At his 11th anniversary after transplant, extensive tests were carried out, especially to detect regulatory T-cell levels for the first time in a surviving heart-lung transplant recipient. Preliminarily data revealed the status of his immunologic function in relation to chronic allograft rejection...
August 13, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28810824/laparoscopic-donor-nephrectomy-early-experience-at-a-single-center-in-pakistan
#9
Rehan Mohsin, Asad Shehzad, Uspal Bajracharya, Bux Ali, Tahir Aziz, Muhammed Mubarak, Altaf Hashmi, Adibul Hasan Rizvi
OBJECTIVES: Laparoscopic donor nephrectomy has become the criterion standard for kidney retrieval from living donors. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Pakistan. The objective of the study was to identify benefits and harms of using laparoscopic compared with open nephrectomy techniques for renal allograft retrieval. MATERIALS AND METHODS: In this a retrospective study, patient files from May 2014 to September 2015 were analyzed...
August 13, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28810823/validation-of-ultrasonographic-kidney-volume-measurements-a-reliable-imaging-modality
#10
Shiromani Janki, Hendrikus J A N Kimenai, Marcel L Dijkshoorn, Caspar W N Looman, Joy S Dwarkasing, Jan N M IJzermans
OBJECTIVES: To investigate the kidney selection procedure before donation to maximize donor safety, we investigated whether ultrasonographic measurements of kidney volume are comparable with computed tomography measurements. Predonation volume and increases in kidney size may be important indicators of renal function after donation and subsequent loss of function. MATERIALS AND METHODS: Consecutive donors with predonation computed tomography scans were approached preoperatively for additional ultrasonographic examinations...
August 13, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28800720/jc-virus-related-progressive-multifocal-leukoencephalopathy-after-living-donor-liver-transplant-a-rare-case
#11
Archana Rastogi, Natasha Gulati, Chhagan Bihari, Ashok Chaudhary, Kalpana Bansal, Shridhar Sasturkar, Shalini Thapar, Viniyendra Pamecha
Progressive multifocal leukoencephalopathy caused by polyoma JC virus is a rare and severe demyelinating disease of the central nervous system. It occurs in immunocompromised patients and is scarcely reported in liver transplant recipients. Brain biopsy demonstrating demyelination with presence of foamy macrophages, relative preservation of axons, astrogliosis, and typical polyomavirus inclusions in the enlarged oligodendroglial nuclei is essential for diagnosis. Here, we report a case of JC virus-associated progressive multifocal leukoencephalopathy in a living-donor liver transplant recipient who was transplanted for hepatitis C virus-related decompensated cirrhosis...
August 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28760119/autologous-stem-cell-rescue-for-graft-failure-of-second-allogeneic-stem-cell-transplant-after-engraftment-of-primary-allogeneic-transplant
#12
Atsushi Watanabe, Takeshi Inukai, Koshi Akahane, Shinpei Somazu, Hiroko Oshiro, Kumiko Goi, Keiichi Koizumi, Norikazu Harii, Kenichi Matsuda, Kanji Sugita
Here, we describe a case of primary graft failure with severe sepsis in a boy who experienced frequent relapses of osteosarcoma. The patient had undergone haploidentical bone marrow transplant after engraftment of unrelated cord blood transplant performed 10 months earlier. Considering his severe condition, we transfused autologous peripheral stem cells along with a single dose of etoposide (50 mg/m2). Granulocyte engraftment was confirmed on human leukocyte antigen-microsatellite analysis of bone marrow on day 14...
July 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28760118/renal-transplant-in-the-abnormal-bladder-long-term-follow-up
#13
Baher Salman, Ahmed Hassan, Sultan Sultan, Paul Tophill, Ahmed Halawa
OBJECTIVES: Normal urinary bladder stores urine at low pressure, does not leak, and completely empties by natural voiding. An abnormal bladder may be due to neurologic or urologic disorders that render the bladder of small capacity, of high storage pressure, or of poor compliance. The aim of this study was to determine the long-term outcomes of renal transplant in patients with abnormal bladders. MATERIALS AND METHODS: We retrospectively compared 30 transplanted kidneys in 25 patients with abnormal bladders with a control group comprising 30 grafts transplanted simultaneously during the same period of time (1990-2014) in 30 patients without bladder abnormality...
July 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28760117/successful-transplant-of-a-nonagenarian-liver-graft-with-fully-replaced-right-hepatic-artery-reconstruction
#14
Davide Ghinolfi, Desirée Gianardi, Giulia Cirillo, Paolo De Simone, Daniele Pezzati, Giuseppe Arenga, Valentina Battaglia, Franco Filipponi
Organ shortage and increasing donor age in liver transplant are stimulating transplant centers to accept otherwise discarded grafts due to donor age or vascular abnormalities; nevertheless, the use of nonagenarian donor grafts is uncommon because advanced age is associated with a higher risk of ischemic-type biliary lesions and worse long-term graft survival. We herein report the case of a 90-year-old donor with fully replaced right hepatic artery. After back-table vascular assessment, the donor right hepatic artery was anastomosed end-to-end with the gastroduodenal artery with 2 polypropylene 8/0 running sutures...
July 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28760115/a-model-of-acute-antibody-mediated-renal-allograft-rejection-in-the-sensitized-rata
#15
Sharmila Ramessur Chandran, William R Mulley, John Kanellis, David J Nikolic-Paterson, Frank Y Ma
OBJECTIVES: Antibody-mediated rejection in transplant recipients with preexisting donor-specific antibodies is a challenging clinical situation. However, we lack suitable animal models to study this scenario. The aim of this study was to develop an animal model of acute antibody-mediated rejection of renal allografts in sensitized recipients. MATERIALS AND METHODS: We used major histocompatibility complex class I and II incompatible rat strains (Dark Agouti RT1av1 and Lewis RT1l), which develop aggressive rejection...
July 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28697720/early-onset-pneumonia-after-liver-transplant-microbial-causes-risk-factors-and-outcomes-mansoura-university-egypt-experience
#16
Mohammad Khairy El-Badrawy, Raed El-Metwaly Ali, Amr Yassen, Mohammad Ahmad AbouElela, Rehab Ahmad Elmorsey
OBJECTIVES: Pneumonia has a negative effect on the outcome of liver transplant. Our aim was to analyze early-onset pneumonia that developed within the first month after transplant. MATERIALS AND METHODS: This prospective single-center study included 56 adult living-donor liver transplant recipients; those who developed early-onset pneumonia based on clinical and radiologic criteria were investigated as to causative pathogens and then followed up and compared with other recipients without pneumonia to illustrate risk factors, outcomes, and related mortality of posttransplant pneumonia...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28697719/high-position-of-the-third-renal-transplant-and-alternative-urinary-tract-reconstruction-in-a-complicated-case
#17
Wilhelmina M van den Dool, Andrzej G Baranski
The decision-making process for treatment of patients with end-stage renal failure, multiple failed renal transplants, and severe comorbidities can be exceedingly difficult due to the inapplicability of many common surgery methods. In this article, we report the treatment of such a patient who underwent a third renal transplant and subsequently developed a ureteral stenosis. The third kidney had been transplanted with a high abdominal position and a partially intra- and retroperitoneally placed ureter due to a bilaterally obtained iliac fossa and severe abdominal adhesions...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28697718/high-survival-and-mortality-characteristics-in-heart-transplant-patients-at-a-national-institute
#18
Christian Rojas, Gabriel De la Cruz-Ku, Amr Yassen, Bryan Valcarcel-Valdivia
OBJECTIVES: The identification of variables related to the survival of heart transplant patients is vital for a good medical practice. Few studies have examined this issue in a Latin American population. Therefore, the aim of this study was to analyze, retrospectively, the survival and mortality characteristics of patients after heart transplant. MATERIALS AND METHODS: Information on patients was obtained through review of medical records; we collected information on all patients who underwent this procedure from 2010 to 2015...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28697717/timing-and-predictors-of-early-urologic-and-infectious-complications-after-renal-transplant-an-analysis-of-a-new-york-statewide-database
#19
Wilson Sui, Michael J Lipsky, Justin T Matulay, Dennis J Robins, Ifeanyi C Onyeji, Maxwell B James, Marissa C Theofanides, Sven Wenske
OBJECTIVES: The most common complications after renal transplant are urologic and are a cause of significant morbidity in a vulnerable population. We sought to characterize the timing and predictors of urologic complications after renal transplant using a statewide database. MATERIALS AND METHODS: We queried the New York Statewide Planning and Research Cooperative System database to identify patients who underwent renal transplant from 2005 to 2013. Postoperative complications included hydronephrosis, ureteral stricture, vesicoureteral reflux, nephrolithiasis, and urinary tract infections...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28697716/case-series-of-10-patients-with-cirrhosis-undergoing-emergent-repair-of-ruptured-umbilical-hernias-natural-history-and-predictors-of-outcomes
#20
Miguel Malespin, Christopher M Moore, Andre Fialho, Silvio W de Melo, Tamara Benyashvili, Anai N Kothari, Diego di Sabato, Eric R Kallwitz, Scott J Cotler, Amy D Lu
OBJECTIVES: Ascites represents an important event in the natural history of cirrhosis, portending increased 1-year mortality. Umbilical herniation with rupture is an uncommon complication of large-volume ascites that is associated with significant morbidity and mortality. The aim of this study was to describe predictors of outcomes in patients undergoing emergent repair for spontaneous umbilical hernia rupture. MATERIALS AND METHODS: We report a case series of 10 patients with decompensated cirrhosis (mean age 66 ± 9 years, mean Model for End-Stage Liver Disease score of 21 ± 7) who presented with a ruptured umbilical hernia and had emergent repair...
July 11, 2017: Experimental and Clinical Transplantation
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