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Current Transplantation Reports

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https://www.readbyqxmd.com/read/29177124/harnessing-apoptotic-cells-for-transplantation-tolerance-current-status-and-future-perspectives
#1
Anil Dangi, Xunrong Luo
Purpose of review: The use of donor apoptotic cells is an emerging therapy for inducing transplantation tolerance. In this review, we will discuss current understanding of mechanisms of this approach, as well as crucial aspects necessary for successful translation of this approach to clinical transplantation. Recent findings: Transplantation tolerance by donor apoptotic cells is mediated by their homeostatic interaction with recipient phagocytes, and subsequent expansion of suppressor cell populations as well as inhibition of effector T cells via deletion and anergy...
December 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28948134/contemporary-issues-in-lung-transplant-allocation-practices
#2
Wayne M Tsuang
PURPOSE OF REVIEW: To discuss the current state of donor lung allocation in the United States, and future opportunities to increase the efficiency of donor lung allocation. RECENT FINDINGS: The current donor lung allocation system prioritizes clinical acuity by use of the Lung Allocation Score (LAS) which has reduced waitlist mortality since its implementation in 2005. Access to donor lungs can be further improved through policy changes using broader geographic sharing, and developing new technology such as ex vivo lung perfusion to recover marginal donor lungs...
September 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29123971/concepts-of-genomics-in-kidney-transplantation
#3
William S Oetting, Casey Dorr, Rory P Remmel, Arthur J Matas, Ajay K Israni, Pamala A Jacobson
Purpose of review: Identification of genetic variants to aid in individualized treatment of solid organ allograft recipients would improve graft survival. We will review the current state of knowledge for associations of variants with transplant outcomes. Recent findings: Many studies have yet to exhibit robust and reproducible results, however, pharmacogenomic studies focusing on cytochrome P450 (CYP) enzymes, transporters and HLA variants have shown strong associations with outcomes and have relevance towards drugs used in transplant...
June 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29109929/opportunities-for-therapeutic-intervention-during-machine-perfusion
#4
Negin Karimian, Heidi Yeh
Purpose of review: There is a vast discrepancy between the number of patients waiting for organ transplantation and the available donor organs. Ex vivo machine perfusion (MP) has emerged in an effort to expand the donor pool, by improving organ preservation, providing diagnostic information, and more recently, acting as a platform for organ improvement. This article reviews the current status of MP with a focus on its role in organ preconditioning and therapeutic interventions prior to transplantation...
June 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29057203/nanotechnological-approaches-to-immunosuppression-and-tolerance-induction
#5
Kunal Patel, Carl Atkinson, Danh Tran, Satish N Nadig
PURPOSE OF REVIEW: Several preclinical studies have engineered nanoparticles for immune regulation, and have shown promising results in the fields of autoimmunity and cancer. In solid organ transplantation, the use of nanoparticle-based immune regulation has only just begun to emerge but holds significant promise for the improvement of our current standard of care immunosuppressive regimens. In this review, we will shed light on the current status of nanoparticle-engineered immunotherapeutics, and the potential application of these technologies to the field of organ transplantation...
June 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28989853/xenotransplantation-where-are-we-with-potential-kidney-recipients-recent-progress-and-potential-future-clinical-trials
#6
Kazuhiko Yamada, Jigesh A Shah, Tatsu Tanabe, Miguel A Lanaspa, Richard J Johnson
PURPOSE: Inter-species transplantation, xenotransplantation, is becoming a realistic strategy to solve the organ shortage crisis. Here we focus on seminal publications that have driven research in xenotransplantation, as well as recently published literature and future endeavors. RECENT FINDINGS: Advances in gene editing technology have allowed for the efficient production of multi-transgenic porcine donors leading improved xenograft survival in baboons, up to 2-years following heterotopic heart xenotransplantation and from weeks to several months following life-supporting kidney xenotransplanation...
June 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29034143/decision-aids-to-increase-living-donor-kidney-transplantation
#7
Jennifer C Gander, Elisa J Gordon, Rachel E Patzer
PURPOSE OF REVIEW: For the more than 636,000 adults with end-stage renal disease (ESRD) in the U.S., kidney transplantation is the preferred treatment compared to dialysis. Living donor kidney transplantation (LDKT) comprised 31% of kidney transplantations in 2015, an 8% decrease since 2004. We aimed to summarize the current literature on decision aids that could be used to improve LDKT rates. RECENT FINDINGS: Decision aids are evidence-based tools designed to help patients and their families make difficult treatment decisions...
March 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28966901/measuring-transplant-center-performance-the-goals-are-not-controversial-but-the-methods-and-consequences-can-be
#8
Colleen Jay, Jesse D Schold
PURPOSE OF REVIEW: Risks of regulatory scrutiny has generated widespread concern about increasingly risk averse transplant center behaviors regarding both donor and candidate acceptance patterns. To address potential unintended consequences threatening access to care, we discuss recent changes in regulatory metrics and potential improvements in quality oversight of transplant centers. RECENT FINDINGS: Despite many recent changes to one-year patient and graft survival regulatory criteria, the capacity to accurately identify true underperforming centers and avoiding false positive flagging remains an area of great concern...
March 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28944160/strategies-for-assessing-gfr-and-albuminuria-in-the-living-kidney-donor-evaluation
#9
Lesley A Inker, Naya Huang, Andrew S Levey
PURPOSE OF REVIEW: The international guideline development group Kidney Disease Improving Global Outcomes (KDIGO) recently published a comprehensive set of recommendations for living donor evaluation which contains a new framework for decision making in the evaluation of kidney donor candidates. RECENT FINDINGS: The guidelines recommend that decisions to accept or decline a candidate donor should be based on incorporation of multiple sources of information pertaining to the donor candidate's likelihood of serious adverse outcomes after donation...
March 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29214126/pharmacologic-complement-inhibition-in-clinical-transplantation
#10
REVIEW
Vasishta S Tatapudi, Robert A Montgomery
Purpose of Review: Over the past two decades, significant strides made in our understanding of the etiology of antibody-mediated rejection (AMR) in transplantation have put the complement system in the spotlight. Here, we review recent progress made in the field of pharmacologic complement inhibition in clinical transplantation and aim to understand the impact of this therapeutic approach on outcomes in transplant recipients. Recent Findings: Encouraged by the success of agents targeting the complement cascade in disorders of unrestrained complement activation like paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS), investigators are testing the safety and efficacy of pharmacologic complement blockade in mitigating allograft injury in conditions ranging from AMR to recurrent post-transplant aHUS, C3 glomerulopathies and antiphospholipid anti-body syndrome (APS)...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29201600/donation-not-disease-a-multiple-hit-hypothesis-on-development-of-post-donation-kidney-disease
#11
REVIEW
Xingxing S Cheng, Richard J Glassock, Krista L Lentine, Glenn M Chertow, Jane C Tan
Purpose of Review: The risks following living kidney donation has been the subject of rigorous investigation in the past several decades. How to utilize the burgeoning new knowledge base to better the risk assessment, education, and health maintenance of donors is unclear. We review the physiologic and epidemiologic evidences on the post-donation state and submit a multiple-hit hypothesis to reconcile the finite elevation in risk of kidney disease after donation with the benign course of most kidney donors...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29201599/combining-adoptive-treg-transfer-with-bone-marrow-transplantation-for-transplantation-tolerance
#12
REVIEW
Nina Pilat, Nicolas Granofszky, Thomas Wekerle
Purpose of Review: The mixed chimerism approach is an exceptionally potent strategy for the induction of donor-specific tolerance in organ transplantation and so far the only one that was demonstrated to work in the clinical setting. Regulatory T cells (Tregs) have been shown to improve chimerism induction in experimental animal models. This review summarizes the development of innovative BMT protocols using therapeutic Treg transfer for tolerance induction. Recent Findings: Treg cell therapy promotes BM engraftment in reduced conditioning protocols in both, mice and non-human primates...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28932651/extracorporeal-membrane-oxygenation-ecmo-and-the-critical-cardiac-patient
#13
REVIEW
David A Baran
PURPOSE OF REVIEW: This review is to summarize the basics of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) as it is utilized for critically ill cardiac patients. RECENT FINDINGS: ECMO may be instituted in a variety of health care settings, from the emergency room to the operating room. The types of patients who may benefit from ECMO are reviewed in detail. The complications of ECMO are reviewed, including access-related issues and hematologic and neurologic problems...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28932650/gene-editing-gene-therapy-and-cell-xenotransplantation-cell-transplantation-across-species
#14
REVIEW
Nizar I Mourad, Pierre Gianello
PURPOSE OF REVIEW: Cell xenotransplantation has the potential to provide a safe, ethically acceptable, unlimited source for cell replacement therapies. This review focuses on genetic modification strategies aimed to overcome remaining hurdles standing in the way of clinical porcine islet transplantation and to develop neural cell xenotransplantation. RECENT FINDINGS: In addition to previously described genetic modifications aimed to mitigate hyperacute rejection, instant blood-mediated inflammatory reaction, and cell-mediated rejection, new data showing the possibility of increasing porcine islet insulin secretion by transgenesis is an interesting addition to the array of genetically modified pigs available for xenotransplantation...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28932649/hepatocyte-transplantation-cell-sheet-technology-for-liver-cell-transplantation
#15
REVIEW
Kohei Tatsumi, Teruo Okano
PURPOSE OF REVIEW: We will review the recent developments of cell sheet technology as a feasible tissue engineering approach. Specifically, we will focus on the technological advancement for engineering functional liver tissue using cell sheet technology, and the associated therapeutic effect of cell sheets for liver diseases, highlighting hemophilia. RECENT FINDINGS: Cell-based therapies using hepatocytes have recently been explored as a new therapeutic modality for patients with many forms of liver disease...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28546901/macrophages-as-effectors-of-acute-and-chronic-allograft-injury
#16
Yianzhu Liu, Malgorzata Kloc, Xian C Li
Organ transplants give a second chance of life to patients with end-stage organ failure. However, the immuno-logical barriers prove to be very challenging to overcome and graft rejection remains a major hurdle to long-term transplant survival. For decades, adaptive immunity has been the focus of studies, primarily based on the belief that T cells are necessary and sufficient for rejection. With better-developed immunosuppressive drugs and protocols that effectively control adaptive cells, innate immune cells have emerged as key effector cells in triggering graft injury and have therefore attracted much recent attention...
December 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28529840/adoptive-cell-therapy-with-tregs-to-improve-transplant-outcomes-the-promise-and-the-stumbling-blocks
#17
Mohamed B Ezzelarab, Angus W Thomson
The contribution of regulatory T cells (Treg) to the induction and maintenance of tolerance is well-recognized in rodents and may contribute to long-term human organ allograft survival. The therapeutic efficacy of adoptively-transferred Treg in promoting tolerance to organ allografts is well-recognized in mouse models. Early phase 1/2 clinical studies of Treg therapy have been conducted in patients with type-1 (autoimmune) diabetes and refractory Crohn's disease, and for inhibition of graft-versus-host disease following bone marrow transplantation with proven safety...
December 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28473952/liver-allocation-policies-for-patients-affected-by-hcc-in-europe
#18
Luciano De Carlis, Stefano Di Sandro, Leonardo Centonze, Andrea Lauterio, Vincenzo Buscemi, Riccardo De Carlis, Fabio Ferla, Raffaella Sguinzi, Stefano Okolicsanyi, Luca Belli, Mario Strazzabosco
The main goal of organ allocation systems is to guarantee an equal access to the limited resource of liver grafts for every patients on the waiting list, balancing between the ethical principles of equity, utility, benefit, need, and fairness. The European heath care scenario is very complex, as it is essentially decentralized and each Nation and Regions inside the nation, operate on a significant degree of autonomy. Furthermore the epidemiology of liver diseases and HCC, which is different among European countries, clearly inpacts on indications and priorities...
December 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28451515/islet-cell-transplant-update-on-current-clinical-trials
#19
Christian Schuetz, James F Markmann
In the last 15 years clinical islet transplantation has made the leap from experimental procedure to standard of care for a highly selective group of patients. Due to a risk-benefit calculation involving the required systemic immunosuppression the procedure is only considered in patients with type 1 diabetes, complicated by severe hypoglycemia or end stage renal disease. In this review we summarize current outcomes of the procedure and take a look at ongoing and future improvements and refinements of beta cell therapy...
September 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28090432/update-on-chronic-lung-allograft-dysfunction
#20
Jason M Gauthier, Ramsey R Hachem, Daniel Kreisel
Chronic lung allograft dysfunction (CLAD) encompasses a range of pathologies that cause a transplanted lung to not achieve or maintain normal function. CLAD manifests as airflow restriction and/or obstruction and is predominantly a result of chronic rejection. Three distinct phenotypes of chronic rejection are now recognized: bronchiolitis obliterans, neutrophilic reversible allograft dysfunction, and restrictive allograft syndrome. Recent investigations have revealed that each phenotype has a unique pathology and histopathological findings, suggesting that treatment regimens should be tailored to the underlying etiology...
September 2016: Current Transplantation Reports
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