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Transplantation Direct

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https://www.readbyqxmd.com/read/28706987/influence-of-cold-ischemia-time-in-kidney-transplants-from-small-pediatric-donors
#1
Liise K Kayler, Michelle Lubetzky, Xia Yu, Patricia Friedmann
BACKGROUND: Clinicians may be reluctant to transplant small pediatric kidneys that have prolonged cold ischemia time (CIT) for fear of an additional deleterious effect because pediatric grafts are thought to be more sensitive to ischemia. We aimed to assess the risks associated with transplantation of small pediatric kidneys with prolonged CIT. METHODS: We performed a retrospective cohort study examining US registry data between 1998 and 2013 of adult first-time kidney-only recipients of small pediatric kidneys from donors weighing 10 to 20 kg, stratified by CIT levels of 0 to 18 (n = 1413), 19 to 30 (n = 1116), and longer than 30 (n = 338) hours...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706986/liver-preservation-by-aortic-perfusion-alone-compared-with-preservation-by-aortic-perfusion-and-additional-arterial-ex-situ-back-table-perfusion-with-histidine-tryptophan-ketoglutarate-solution-a-prospective-randomized-controlled-multicenter-study
#2
Gerd Otto, Michael Heise, Jochen Thies, Michael Pitton, Jens Schneider, Gernot Kaiser, Peter Neuhaus, Otto Kollmar, Michael Barthels, Josef Geks, Wolf Otto Bechstein, Achim Hellinger, Jürgen Klempnauer, Winfried Padberg, Nils Frühauf, Andre Ebbing, Dietmar Mauer, Astrid Schneider, Robert Kwiecien, Kai Kronfeld
BACKGROUND: Arterial ex situ back-table perfusion (BP) reportedly reduces ischemic-type biliary lesion after liver transplantation. We aimed to verify these findings in a prospective investigation. METHODS: Our prospective, randomized, controlled, multicenter study involved livers retrieved from patients in 2 German regions, and compared the outcomes of standard aortic perfusion to those of aortic perfusion combined with arterial ex situ BP. The primary endpoint was the incidence of ischemic-type biliary lesions over a follow-up of 2 years after liver transplantation, whereas secondary endpoints included 2-year graft survival, initial graft damage as reflected by transaminase levels, and functional biliary parameters at 6 months after transplantation...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706985/clinical-utility-of-epstein-barr-virus-viral-load-monitoring-and-risk-factors-for-posttransplant-lymphoproliferative-disorders-after-kidney-transplantation-a-single-center-10-year-observational-cohort-study
#3
Erica Franceschini, Jessica Plessi, Stefano Zona, Antonella Santoro, Margherita Digaetano, Francesco Fontana, Gaetano Alfano, Giovanni Guaraldi, Patrizia Comoli, Francesca Facchini, Leonardo Potenza, William Gennari, Mauro Codeluppi, Mario Luppi, Gianni Cappelli, Inge C Gyssens, Cristina Mussini
BACKGROUND: Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. METHODS: Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706984/the-uk-national-registry-of-abo-and-hla-antibody-incompatible-renal-transplantation-pretransplant-factors-associated-with-outcome-in-879-transplants
#4
Laura Pankhurst, Alex Hudson, Lisa Mumford, Michelle Willicombe, Jack Galliford, Olivia Shaw, Raj Thuraisingham, Carmelo Puliatti, David Talbot, Sian Griffin, Nicholas Torpey, Simon Ball, Brendan Clark, David Briggs, Susan V Fuggle, Robert M Higgins
BACKGROUND: ABO and HLA antibody incompatible (HLAi) renal transplants (AIT) now comprise around 10% of living donor kidney transplants. However, the relationship between pretransplant factors and medium-term outcomes are not fully understood, especially in relation to factors that may vary between centers. METHODS: The comprehensive national registry of AIT in the United Kingdom was investigated to describe the donor, recipient and transplant characteristics of AIT...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706983/preimplantation-kidney-biopsies-of-extended-criteria-donors-have-a-heavier-inflammatory-burden-than-kidneys-from-standard-criteria-donors
#5
Camila M Mazeti-Felicio, Heloisa C Caldas, Ida M M Fernandes-Charpiot, Camila Z Dezotti, Maria A S F Baptista, Mario Abbud-Filho
BACKGROUND: Donors after brain death develop a systemic proinflammatory state that may predispose the kidneys to injury after transplantation. Because it is not known whether this inflammatory environment similarly affects the kidneys from expanded criteria donor (ECD) and standard criteria donors (SCD), we sought to evaluate differences in the gene expression of inflammatory cytokines in preimplantation biopsies (PIBx) from ECD and SCD kidneys. METHODS: Cytokines gene expression was measured in 80 PIBx (SCD, 52; ECD, 28) and associated with donor variables...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706982/preserving-the-pancreas-graft-outcomes-of-surgical-repair-of-duodenal-leaks-in-enterically-drained-pancreas-allografts
#6
David Al-Adra, Ian McGilvray, Nicolas Goldaracena, Vinzent Spetzler, Jerome Laurence, Andrea Norgate, Max Marquez, Paul Greig, Gonzalo Sapisochin, Jeffrey Schiff, Sunita Singh, Markus Selzner, Mark Cattral
BACKGROUND: Duodenal leak remains a major cause of morbidity and graft loss in pancreas transplant recipients. The role and efficacy of surgical and image-guided interventions to salvage enterically drained grafts with a duodenal leak has yet to be defined. METHODS: We investigated the incidence, treatment, and outcome of duodenal leak in 426 pancreas transplantation recipients from 2000 to 2015. RESULTS: Duodenal leak developed in 33 (7.8%) recipients after a median follow-up of 5...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706981/outcomes-of-liver-transplant-recipients-with-autoimmune-liver-disease-using-long-term-dual-immunosuppression-regimen-without-corticosteroid
#7
Sanjaya K Satapathy, Ollie D Jones, Jason M Vanatta, Faisal Kamal, Satish K Kedia, Yu Jiang, Satheesh P Nair, James D Eason
BACKGROUND: Liver transplant (LT) recipients with autoimmune liver disease (primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis) are at increased risk of developing acute cellular rejection (ACR), and in many cases graft failure due to recurrent disease. We describe our experience with dual immunosuppression without steroid maintenance and analyze its effect on disease recurrence; ACR; patient and graft survivals; and complications, such as sepsis and de novo malignancy...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706980/impact-of-cold-ischemia-time-in-kidney-transplants-from-donation-after-circulatory-death-donors
#8
Liise Kayler, Xia Yu, Carlos Cortes, Michelle Lubetzky, Patricia Friedmann
BACKGROUND: Deceased-donor kidneys are exposed to ischemic events from donor instability during the process of donation after circulatory death (DCD). Clinicians may be reluctant to transplant DCD kidneys with prolonged cold ischemia time (CIT) for fear of an additional deleterious effect. METHODS: We performed a retrospective cohort study examining US registry data between 1998 and 2013 of adult first-time kidney-only recipients of paired kidneys (derived from the same donor transplanted into different recipients) from DCD donors...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706979/the-optimization-of-short-term-hepatocyte-preservation-before-transplantation
#9
Kengo Fukuoka, Akiko Inagaki, Yasuhiro Nakamura, Muneyuki Matsumura, Satoru Yoshida, Takehiro Imura, Yasuhiro Igarashi, Shigehito Miyagi, Kazuo Ohashi, Shin Enosawa, Takashi Kamei, Michiaki Unno, Noriaki Ohuchi, Susumu Satomi, Masafumi Goto
BACKGROUND: No optimal methods for short-term hepatocyte preservation have been established. We have recently developed a prominent oxygen-permeable bag (Tohoku Device [TD]) for pancreatic islet culture and transplantation. In this study, we investigated whether TD is also effective for hepatocyte preservation and tried to optimize other conditions. METHODS: Hepatocytes were preserved in the following conditions, and their outcomes were observed. First, the effectiveness of TD was investigated...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706978/impact-of-conversion-from-advagraf-to-twice-daily-generic-tacrolimus-in-kidney-transplant-recipients-a-single-center-study-a-3-year-follow-up
#10
Iolanda Godinho, Maria João Melo, João Gonçalves, Marta Neves, Alice Santana, José Oliveira Guerra, António Gomes da Costa
No abstract text is available yet for this article.
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706977/acute-rejection-after-kidney-transplantation-associates-with-circulating-micrornas-and-vascular-injury
#11
Roel Bijkerk, Barend W Florijn, Meriem Khairoun, Jacques M G J Duijs, Gurbey Ocak, Aiko P J de Vries, Alexander F Schaapherder, Marko J K Mallat, Johan W de Fijter, Ton J Rabelink, Anton Jan van Zonneveld, Marlies E J Reinders
BACKGROUND: Acute rejection (AR) of kidney transplants is associated with the loss of endothelial integrity, microvascular rarefaction and, ultimately, graft dysfunction. Circulating angiogenic microRNAs (miRNAs) may serve as markers for microvascular injury. Here, we investigated the short- and long-term effects of AR after kidney transplantation on systemic vascular injury and the associated circulating miRNA profile. METHODS: Systemic vascular injury was determined by measuring capillary tortuosity and density within the oral mucosa as well as by assessing circulating levels of angiopoietin-2/angiopoietin-1 ratio, vascular endothelial growth factor and soluble thrombomodulin...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706976/donor-diabetes-and-prolonged-cold-ischemia-time-synergistically-increase-the-risk-of-graft-failure-after-liver-transplantation
#12
Isabel M A Brüggenwirth, Natasha H Dolgin, Robert J Porte, Adel Bozorgzadeh, Paulo N A Martins
BACKGROUND: Both prolonged cold ischemia time (CIT) and donor history of diabetes mellitus (DM) are associated with reduced graft survival after liver transplantation. However, it is unknown whether the adverse effect of prolonged CIT on posttransplant graft survival is more pronounced after transplant with DM versus non-DM donor grafts. METHODS: The study sample included 58 226 liver transplant recipients (2002-2015) from the Scientific Registry of Transplant Recipients...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706975/reexamining-the-association-of-body-mass-index-with-overall-survival-outcomes-after-liver-transplantation
#13
Su-Hsin Chang, Xiaoyan Liu, Nils P Carlsson, Yikyung Park, Graham A Colditz, Jacqueline M Garonzik-Wang, William C Chapman, Jason R Wellen, Maria B Doyle, Tarek Alhamad
BACKGROUND: Several studies have shown that obese patients undergoing liver transplantation (LT) have an increased risk of mortality regardless of Model of End Stage Liver Disease (MELD) scores. The purpose of this study is to identify the range of body mass index (BMI) at LT associated with the lowest risks of posttransplant mortality by MELD category. METHODS: A retrospective cohort of patients aged 18 years or older from the Organ Procurement and Transplantation Network database undergoing LT between February 27, 2002, and December 31, 2013, was identified and followed up through March 14, 2014...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706974/sirolimus-increases-t-cell-abundance-in-the-sun-exposed-skin-of-kidney-transplant-recipients
#14
Michael Thomas Burke, Lauren C Sambira Nahum, Nicole M Isbel, Robert P Carroll, Hans Peter Soyer, Ross Francis, Jennifer Anne Bridge, Carmel Hawley, Kimberly Oliver, Christine E Staatz, James William Wells
BACKGROUND: Kidney transplant recipients (KTRs) receiving the mammalian target of rapamycin inhibitor sirolimus may display a reduced risk of skin cancer development compared to KTRs receiving calcineurin inhibitors. Despite studies investigating the effects of these 2 drug classes on T cells in patient blood, the effect these drugs may have in patient skin is not yet known. METHODS: Fifteen patients with chronic kidney disease (not recipients of immunosuppressive drugs), and 30 KTRs (15 receiving a calcineurin inhibitor, and 15 receiving sirolimus) provided matched samples of blood, sun exposed (SE) and non-SE skin...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706973/splenocyte-infusion-and-whole-body-irradiation-for-induction-of-peripheral-tolerance-in-porcine-lung-transplantation-modifications-of-the-preconditioning-regime-for-improved-clinical-feasibility
#15
Katharina Jansson, Karla Dreckmann, Wiebke Sommer, Murat Avsar, Jawad Salman, Thierry Siemeni, Ann-Kathrin Knöfel, Linda Pauksch, Jens Gottlieb, Jörg Frühauf, Martin Werner, Danny Jonigk, Martin Strüber, Axel Haverich, Gregor Warnecke
BACKGROUND: Preoperative low-dose whole-body irradiation (IRR) with 1.5 and 7 Gy thymic IRR of the recipient, combined with a perioperative donor splenocyte infusion lead to reliable donor specific peripheral tolerance in our allogeneic porcine lung transplantation model. To reduce the toxicity of this preconditioning regime, modifications of the IRR protocol and their impact on allograft survival were assessed. METHODS: Left-sided single lung transplantation from major histocompatibility complex and sex mismatched donors was performed in 14 adult female minipigs...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706972/fever-and-pancytopenia-in-a-liver-transplant-recipient-going-against-the-rules-of-occam-s-razor
#16
Lionel Hon Wai Lum, Fei Wen Chen, Louise Jackett, Simone I Strasser, Rebecca J Davis
The syndrome of fever and pancytopenia is not infrequently encountered postliver transplant, and a broad differential list of infectious and noninfectious aetiologies can be invoked. A transplant patient is susceptible to more than 1 opportunistic infection or disease process. We described the diagnostic conundrums in managing our patient who ran a complex protracted course postliver transplant. He was diagnosed to have both disseminated tuberculosis and graft-versus-host disease, a rare complication after solid organ transplantation...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706971/a-donor-age-based-and-graft-volume-based-analysis-for-living-donor-liver-transplantation-in-elderly-recipients
#17
Hajime Imamura, Masaaki Hidaka, Akihiko Soyama, Amane Kitasato, Tomohiko Adachi, Shinichiro Ono, Koji Natsuda, Takanobu Hara, Tota Kugiyama, Zhassulan Baimakhanov, Satomi Okada, Fumihiko Fujita, Kengo Kanetaka, Mitsuhisa Takatsuki, Tamotsu Kuroki, Susumu Eguchi
BACKGROUND: Given the expected increase in the number of elderly recipients, details regarding how clinical factors influence the outcome in living donor liver transplantation (LDLT) for the elderly remain unclear. We examined the survival outcomes according to the results of donor age-based and graft volume-based analyses and assessed the impact of prognostic factors on the survival after LDLT for elderly recipients. METHODS: The 198 adult recipients were classified into 2 groups: an elderly group (n = 70, E group; ≥ 60 years of age) and a younger group (n = 128, Y group; <60 years of age)...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706970/reversibility-of-frailty-after-bridge-to-transplant-ventricular-assist-device-implantation-or-heart-transplantation
#18
Sunita R Jha, Malin K Hannu, Phillip J Newton, Kay Wilhelm, Christopher S Hayward, Andrew Jabbour, Eugene Kotlyar, Anne Keogh, Kumud Dhital, Emily Granger, Mark Connellan, Paul Jansz, Phillip M Spratt, Elyn Montgomery, Angela Smith, Michelle Harkess, Peta Tunicliff, Patricia M Davidson, Peter S Macdonald
BACKGROUND: We recently reported that frailty is independently predictive of increased mortality in patients with advanced heart failure referred for heart transplantation (HTx). The aim of this study was to assess the impact of frailty on short-term outcomes after bridge-to-transplant ventricular assist device (BTT-VAD) implantation and/or HTx and to determine if frailty is reversible after these procedures. METHODS: Between August 2013 and August 2016, 100 of 126 consecutive patients underwent frailty assessment using Fried's Frailty Phenotype before surgical intervention: 40 (21 nonfrail, 19 frail) BTT-VAD and 77 (60 nonfrail, 17 frail) HTx-including 17 of the 40 BTT-VAD supported patients...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28620650/graft-function-and-intermediate-term-outcomes-of-kidney-transplants-improved-in-the-last-decade-analysis-of-the-united-states-kidney-transplant-database
#19
Douglas Scott Keith, Gayle Vranic, Angie Nishio-Lucar
BACKGROUND: Previous analyses of the United States transplant database regarding long-term outcomes in kidney transplantation have shown minimal improvement in the rate of long-term graft loss. This study sought to analyze intermediate-term outcomes and graft function at 6 months in kidney transplantation in adult living and deceased donor recipients in the last decade. METHODS: Survival analysis was performed based on the year of transplant between 6 months and 3 years' posttransplant...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28620649/hepatoblastoma-transplant-versus-resection-experience-in-a-latin-american-transplant-center
#20
Luis A Caicedo, Angie Sabogal, Oscar Serrano, Jorge I Villegas, Verónica Botero, María T Agudelo, Viviana Lotero, Diana Dávalos, Eliana Manzi, Ana M Aristizabal, Catalina Gomez, Gabriel J Echeverri
BACKGROUND: Hepatoblastoma is the most common primary malignant liver tumor in children and is usually diagnosed during the first 3 years of life. Overall survival has increased 50% due to chemotherapeutic schemes, expertise surgery centers, and liver transplantation. METHODS: A retrospective collection of data was performed from pediatric patients with diagnosis of hepatoblastoma. Variables included demographic, diagnostic tools and histological classification; chemotherapy and surgical treatment; and outcomes and patient survival...
June 2017: Transplantation Direct
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