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Transplantation Direct

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https://www.readbyqxmd.com/read/28894795/liver-enzymes-and-the-development-of-posttransplantation-diabetes-mellitus-in-renal-transplant-recipients
#1
Gerald Klaassen, Eva Corpeleijn, Nicole P E Deetman, Gerjan J Navis, Stephan J L Bakker, Dorien M Zelle
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) is common in renal transplant recipients (RTR), increasing the risk of graft failure, cardiovascular disease, and mortality. Early detection of a high risk for PTDM is warranted. Because liver function and liver fat are involved, we investigated whether serum liver markers are associated with future PTDM in RTR. METHODS: Between 2001 and 2003, 606 RTR with a functioning allograft beyond the first year after transplantation were included of which 500 participants (56% men; age, 50 ± 12 years) were free of diabetes at baseline and had liver enzyme values (1 missing) available...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28894794/short-and-long-term-outcomes-of-de-novo-liver-transplant-patients-treated-with-once-daily-prolonged-release-tacrolimus
#2
Yuichiro Okumura, Takehiro Noda, Hidetoshi Eguchi, Yoshifumi Iwagami, Daisaku Yamada, Tadafumi Asaoka, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Yutaka Takeda, Masahiro Tanemura, Shigeru Marubashi, Koji Umeshita, Yuichiro Doki, Masaki Mori
BACKGROUND: Tacrolimus is the key immunosuppressive drug for liver transplantation. Once-daily prolonged-release tacrolimus (TAC-PR) exhibits good drug adherence but has difficulty controlling the trough level in the early phase of liver transplantation. The aim of this study was to compare the feasibility and efficacy of immediately starting oral TAC-PR versus traditional twice-daily tacrolimus (TAC-BID) in de novo liver transplantation recipients. METHODS: The study included 28 patients treated with conventional TAC-BID and 60 patients treated with TAC-PR (median follow-up 70...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28894793/infiltrative-hepatocellular-carcinoma-with-portal-vein-tumor-thrombosis-treated-with-a-single-high-dose-y90-radioembolization-and-subsequent-liver-transplantation-without-a-recurrence
#3
Meaghan S Dendy, Juan C Camacho, Johannes M Ludwig, Alyssa M Krasinskas, Stuart J Knechtle, Hyun S Kim
BACKGROUND: Infiltrative hepatocellular carcinoma with macrovascular invasion is a relatively rare presentation and usually fatal disease. METHODS: Both patients exceeded Milan and University of California-San Francisco (UCSF) criteria, and per Barcelona Clinic Liver Cancer group guidelines, they were enrolled in a prospective open-label radioembolization phase II trial that gave them optimized lobar doses of Yttrium-90 as solely the first-line therapy without concomitant or additional pharmacological or locoregional therapies...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28894792/influence-of-hla-matching-on-the-efficacy-of-allogeneic-mesenchymal-stromal-cell-therapies-for-osteoarthritis-and-degenerative-disc-disease
#4
Javier García-Sancho, Ana Sánchez, Aurelio Vega, David C Noriega, Mercedes Nocito
BACKGROUND: The necessity for more effective therapies for chronic osteoarticular diseases has led to the development of treatments based on mesenchymal stem cells (MSCs), the natural precursors of musculoskeletal tissue. Treatments with autologous MSCs yielded excellent results, with nearly 70% improvement of pain and disability in osteoarthritis and degenerative disc disease. Using allogeneic MSCs is logistically more convenient and would widen the pool of eligible patients, but potential immune rejection should be considered...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28894791/pancreas-transplantation-with-portal-enteric-drainage-for-patients-with-endocrine-and-exocrine-insufficiency-from-extensive-pancreatic-resection
#5
Andrew S Barbas, David P Al-Adra, Nicolas Goldaracena, Martin J Dib, Markus Selzner, Gonzalo Sapisochin, Mark S Cattral, Ian D McGilvray
Although the primary indication for pancreas transplantation is type I diabetes, a small number of patients requires pancreas transplantation to manage combined endocrine and exocrine insufficiency that develops after extensive native pancreatic resection. The objective of this case report was to describe the operative and clinical course in 3 such patients and present an alternative technical approach.
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28894790/aortic-dissection-and-severe-renal-failure-6-years-after-kidney-transplantation
#6
Amaury Dujardin, Awena Le Fur, Diego Cantarovich
We report the case of a patient with long-term history of hypertension, presenting with transient neurological disorders and severe graft failure several years after kidney transplantation. Cause of end-stage renal disease was hypertensive nephrosclerosis. Chronic hemodialysis lasted for 1 year. After transplantation and throughout follow-up, serum creatinine ranged from 200 to 230 μmol/L and maintenance immunosuppression included sirolimus and low-dose steroids. Six years after transplantation, the patient presented with right hip pain radiating to the lower back, transient aphasia, confusion, and hemiparesis...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28856244/design-and-methods-of-the-korean-organ-transplantation-registry
#7
Jaeseok Yang, Jong Cheol Jeong, Joongyub Lee, Young Hoon Kim, Hyo Chae Paik, Jae-Joong Kim, Hyun-Young Park, Myoung Soo Kim, Curie Ahn
BACKGROUND: Beneficial aspects of solid organ transplantation, which encompass survival benefit, improved quality of life, and cost efficacy, have been clearly demonstrated. However, regional and ethnic differences require further studies to identify prognostic factors and transplant outcomes against various backgrounds. After previous efforts of a nationwide, retrospective study on the kidney transplant outcomes in Korea, a new prospective-designed version of the Korean Organ Transplantation Registry (KOTRY) was launched in 2014...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795151/kidney-transplantation-in-patients-with-active-multiple-myeloma-case-reports
#8
Erik Lawrence Lum, Neil Kogut, Thu Pham, Gabriel M Danovitch, Suphamai Bunnapradist
Kidney disease is a common complication in patients with multiple myeloma. Traditionally, patients with active multiple myeloma and end-stage renal disease have been excluded from kidney transplantation due to the risk of malignancy progression. The introduction of bortezomib-based therapy for patients with multiple myeloma and renal impairment has significantly improved survival in this population. In this report, we present 2 cases of patients with active and controlled multiple myeloma who underwent successful kidney transplantation without progression of their underlying malignancy...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795150/the-effects-of-tacrolimus-on-t-cell-proliferation-are-short-lived-a-pilot-analysis-of-immune-function-testing
#9
Benjamin L Laskin, Jing Jiao, H Jorge Baluarte, Sandra Amaral, Susan L Furth, Tatiana Akimova, Wayne W Hancock, Matthew H Levine, Peter P Reese, Ulf H Beier
BACKGROUND: Optimal immunosuppression after organ transplant should balance the risks of rejection, infection, and malignancy while minimizing barriers to adherence including frequent or time-sensitive dosing. There is currently no reliable immune function assay to directly measure the degree of immunosuppression after transplantation. METHODS: We developed an immune function assay to mea//sure T-cell proliferation after exposure to immunosuppression in vivo. We tested the assay in mice, and then piloted the approach using single time point samples, 11 pediatric kidney transplant recipients prescribed tacrolimus, mycophenolate, and prednisone 6 months to 5 years posttransplant, with no history of rejection, opportunistic infection, or cancer...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795149/access-to-heart-transplantation-a-proper-analysis-of-the-competing-risks-of-death-and-transplantation-is-required-to-optimize-graft-allocation
#10
Christelle Cantrelle, Camille Legeai, Aurélien Latouche, Philippe Tuppin, Carine Jasseron, Laurent Sebbag, Olivier Bastien, Richard Dorent
BACKGROUND: Heart allocation systems are usually urgency-based, offering grafts to candidates at high risk of waitlist mortality. In the context of a revision of the heart allocation rules, we determined observed predictors of 1-year waitlist mortality in France, considering the competing risk of transplantation, to determine which candidate subgroups are favored or disadvantaged by the current allocation system. METHODS: Patients registered on the French heart waitlist between 2010 and 2013 were included...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795148/optimal-and-equitable-allocation-of-donor-hearts-which-principles-are-we-translating-into-practices
#11
Maria Frigerio
No abstract text is available yet for this article.
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795147/impact-of-the-trough-level-of-calcineurin-inhibitor-on-the-prevalence-of-donor-specific-human-leukocyte-antigen-antibodies-during-long-term-follow-up-after-pediatric-liver-transplantation-antibody-strength-and-complement-binding-ability
#12
Kazuaki Tokodai, Shigehito Miyagi, Chikashi Nakanishi, Yasuyuki Hara, Wataru Nakanishi, Masafumi Goto, Michiaki Unno, Takashi Kamei
BACKGROUND: In pediatric patients, long-term immunosuppression after liver transplantation (LT) is typically minimal. However, posttransplant donor-specific HLA antibodies (DSAs) may be prevalent under these conditions. Here, we evaluated the effects of minimized calcineurin inhibitor (CNI) on DSA development to assess the validity of minimized/withdrawn immunosuppression. METHODS: We retrospectively examined 66 patients who underwent pediatric LT at our institution between July 1991 and October 2013...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795146/refining-the-policy-for-timing-of-kidney-transplant-waitlist-qualification
#13
Benjamin J Lee, Charles E McCulloch, Barbara A Grimes, Sindhu Chandran, Isabel Elaine Allen, Cynthia Delgado, Chi-Yuan Hsu
BACKGROUND: Earlier qualification for the kidney transplant waitlist expedites transplant and is therefore associated with improved outcomes. U.S. Organ Procurement and Transplantation Network policies state that "measured or calculated creatinine clearance or glomerular filtration rate less than or equal to 20 mL/min" triggers waitlist time accrual. The choice of qualification method is somewhat arbitrary, and the policy implies that decline in renal function is monotonic. METHODS: (1) We used survival analysis to quantify temporal differences in waitlist qualification by applying 3 kidney-function-estimating equations (Cockcroft-Gault, Modification of Diet in Renal Disease study, Chronic Kidney Disease Epidemiology Collaboration) to serial creatinine measurements from 3 patient cohorts: 1 of waitlisted patients at a major U...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795145/quantitative-evaluation-of-the-impact-of-ethylenediaminetetraacetic-acid-pretreatment-on-single-antigen-bead-assay
#14
Chang Liu, Sue Pang, Donna Phelan, Daniel C Brennan, Thalachallour Mohanakumar
BACKGROUND: Ethylenediaminetetraacetic acid (EDTA) pretreatment has been shown to overcome complement interference in the single-antigen bead (SAB) assay. However, a quantitative evaluation of its impact on the assay for preemptive application to diverse clinical samples is still lacking. METHODS: Serum samples from 95 renal transplant candidates were tested with and without EDTA-pretreatment in parallel. Changes in mean fluorescence intensity (MFI) values were analyzed to determine the impact of EDTA-pretreatment and the characteristics of complement interference...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795144/renal-outcomes-in-patients-with-iga-nephropathy-undergoing-liver-transplant-a-retrospective-cohort-study
#15
Musab S Hommos, Ziad M El-Zoghby
BACKGROUND: End-stage liver disease (ESLD) is the most common cause of secondary immunoglobulin A nephropathy (IgAN). Multiple mechanisms have been proposed to explain the association between liver disease and IgAN. Although some mechanisms are expected to reverse in patients after liver transplant, the long-term renal prognosis is unclear for these patients. METHODS: This observational retrospective cohort study examined the renal outcomes of 14 patients who had IgAN with end-stage liver disease and subsequently underwent either liver transplant alone or combined liver and kidney transplant at a single tertiary care center...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795143/high-intrapatient-variability-of-tacrolimus-levels-and-outpatient-clinic-nonattendance-are-associated-with-inferior-outcomes-in-renal-transplant-patients
#16
Dawn L Goodall, Michelle Willicombe, Adam G McLean, David Taube
BACKGROUND: Nonadherence to immunosuppressants is associated with rejection and allograft loss. Intrapatient variability (IPV) of immunosuppression levels is a marker of nonadherence. This study describes the impact of IPV of tacrolimus levels in patients receiving a tacrolimus monotherapy immunosuppression protocol. METHODS: We retrospectively analyzed the outpatient tacrolimus levels of kidney-only transplant patients taken between 6 and 12 months posttransplant...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795142/plasma-proenkephalin-and-poor-long-term-outcome-in-renal-transplant-recipients
#17
Lyanne M Kieneker, Oliver Hartmann, Joachim Struck, Andreas Bergmann, Ron T Gansevoort, Michel M Joosten, Else van den Berg, Rudolf A de Boer, Stephan J L Bakker
BACKGROUND: Proenkephalin (pro-ENK), a stable and reliable surrogate marker for unstable enkephalins, was found to be associated with acute kidney injury and chronic renal failure in previous studies. We aimed to investigate whether pro-ENK is linked to chronic kidney injury and poor long-term outcome in renal transplant recipients (RTR). METHODS: We included 664 stable RTR and 95 healthy kidney donors. Pro-ENK was measured in plasma with a double monoclonal sandwich immunoassay...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795141/posttransplant-outcomes-of-kidneys-donated-after-brain-death-followed-by-circulatory-death-a-cohort-study-of-128-chinese-patients
#18
Ning Na, Ke Li, Zhengyu Huang, Bin Miao, Cheng Hu, Heng Li, Dejuan Wang, Jianguang Qiu
BACKGROUND: Donation after brain death followed by circulatory death (DBCD) is a new class in the unique Chinese donor classification system. Currently, in China, the organ transplantation of DBCD is rising. However, there is a dearth of research on the characteristics and outcomes of DBCD kidney transplantation. METHOD: We collected 128 DBCD renal transplant patients who underwent surgery between June 2013 and May 2016 at our center to analyze clinical outcomes and to share our experience to enhance perioperative management in DBCD kidney transplantation...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795140/resting-and-exercise-energy-metabolism-after-liver-transplantation-for-nonalcoholic-steatohepatitis
#19
Josh Levitsky, Ajay Singhvi, H Steven Sadowsky, Ayelet Cohen, Alysen Demzik, Lisa VanWagner, Mary Rinella
BACKGROUND: Nonalcoholic steatohepatitis (NASH) is a leading indication for liver transplantation (LT). We hypothesized that weight gain after LT may be exacerbated by reduced metabolic rates due to the LT procedure, particularly during exercise. We aimed to compare resting and exercise energy expenditure between patients transplanted for NASH and nontransplant nonalcoholic fatty liver disease (NAFLD) subjects. METHODS: NASH LT recipients (>1-year post, n = 14) and NAFLD controls (n = 13) underwent analysis of body composition, resting energy expenditure (REE), and exercise energy expenditure (VO2max), the latter using a ramped-Bruce protocol assessed by expired gas analysis and peak heart rate...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795139/elevated-preoperative-serum-bilirubin-improves-reperfusion-injury-and-survival-postliver-transplantation
#20
Vinzent Spetzler, Nicolas Goldaracena, Johann Moritz Kaths, Max Marquez, Markus Selzner, Nazia Selzner
BACKGROUND: The cytoprotective effects of hemeoxygenase-1 and its product biliverdin/bilirubin are widely acknowledged in experimental transplant medicine. However, its potentially beneficial effect during organ reperfusion is not established. METHODS: In a matched study, we compared markers of reperfusion injury (alanine aminotransferase/aspartate aminotransferase) and transplantation outcome (complication rates, liver function, and survival) between recipient groups with "normal" versus "increased" preoperative bilirubin values...
August 2017: Transplantation Direct
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