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https://www.readbyqxmd.com/read/27920725/controlled-reperfusion-strategies-improve-cardiac-hemodynamic-recovery-after-warm-global-ischemia-in-an-isolated-working-rat-heart-model-of-donation-after-circulatory-death-dcd
#1
Emilie Farine, Petra Niederberger, Rahel K Wyss, Natalia Méndez-Carmona, Brigitta Gahl, Georg M Fiedler, Thierry P Carrel, Hendrik T Tevaearai Stahel, Sarah L Longnus
Aims: Donation after circulatory death (DCD) could improve cardiac graft availability, which is currently insufficient to meet transplant demand. However, DCD organs undergo an inevitable period of warm ischemia and most cardioprotective approaches can only be applied at reperfusion (procurement) for ethical reasons. We investigated whether modifying physical conditions at reperfusion, using four different strategies, effectively improves hemodynamic recovery after warm ischemia. Methods and Results: Isolated hearts of male Wistar rats were perfused in working-mode for 20 min, subjected to 27 min global ischemia (37°C), and 60 min reperfusion (n = 43)...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27919635/a-critical-assessment-on-kidney-allocation-systems
#2
REVIEW
Richard N Formica
The kidney allocation system that took effect on December 4, 2014 represents a significant improvement over the prior approach. It seeks to improve outcomes by longevity matching - pairing kidneys expected to function the longest with recipients expected to live the longest. It addresses the biological barriers faced by highly sensitized patients in an evidence based fashion and it begins to introduce the concept of medical need into kidney allocation by crediting time from the starting dialysis to a patient's waiting time...
October 8, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/27919372/does-extended-cpoe-use-reduce-patient-length-of-stay
#3
Darryl Romanow, Arun Rai, Mark Keil, Steven Luxenberg
OBJECTIVE: This study compares use of Computerized Provider Order Entry (CPOE) and related clinical systems (i.e., extended CPOE) across 796 clinical teams caring for five distinct patient conditions. Our focus is the relationship between clinical teams' extended CPOE use and extent of prolonged stay (EPS), defined as the deviation in patients' observed length of stay from expected risk-adjusted length of stay. MATERIALS AND METHODS: Using archival data from two affiliated hospitals in the Southeastern United States, we focused on five different patient conditions of varying mortality risk (vaginal birth, knee/hip replacement, cardiovascular surgery, organ transplant and pneumonia)...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27918349/soft-palate-ulcer-an-unusual-presentation-of-a-posttransplant-lymphoproliferative-disorder
#4
Maryam Bahmanyar, Nader Shakibazad, Mohammad Hadi Imanieh, Seyed Mohsen Dehghani
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation. It has several clinical manifestations, including infectious mononucleosis-like syndrome, lymphadenopathy, and other organ involvement. Soft palate ulcer is a rare manifestation of PTLD. The aim of this study is to present a 17-year-old girl with liver transplantation due to metastatic liver disease. After transplantation, she presented with a painful whitish ulcerative lesion accompanied by central necrosis in the right soft palate area measuring about 3 cm×3...
December 1, 2016: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27918103/identifying-opportunities-to-increase-organ-donation-after-brain-death-an-observational-study-in-sweden-2009-2014
#5
T Nolin, C Mårdh, G Karlström, S M Walther
BACKGROUND: There is a wide gap between the number of organ donors and patients on waiting lists for transplantation. The purpose of this Swedish nationwide study of the critical pathway for organ donation after brain death (DBD) was to identify missed opportunities for organ donation. METHODS: We performed a prospective, observational study of all ICU deaths in Sweden from Jan 1, 2009 to Dec 31, 2014. The protocol structure followed the critical pathway for organ donation, which was developed and tested during 2008...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#6
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27916175/state-of-the-art-bridging-to-lung-transplantation-using-artificial-organ-support-technologies
#7
Keshava Rajagopal, Marius M Hoeper
Lung transplantation increasingly is being performed in recipients of higher risk and acuity. A subset of these patients has severely abnormal gas exchange and/or right ventricular dysfunction, such that artificial organ support strategies are required to bridge patients to lung transplantation. We review the rationales and currently used and potential strategies for bridging to lung transplantation and characterize bridging outcomes. Based on physiologic reasoning and a study of the existing literature, we provide a working strategy for bridging to lung transplantation...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27916032/-lung-transplantation-for-phase-%C3%A2-silicosis-a-series-of-32-cases
#8
W J Mao, J Y Chen, M F Zheng, R Chen, Y J He, F Liu, S G Ye, R G Lu
Objective: To evaluate the effect of lung transplantation for phase Ⅲ silicosis. Methods: From September 2002 to September 2015, 32 patients with end-stage silicosis underwent lung transplantation at Department of Thoracic Surgery, Affiliated Wuxi People's Hospital, Nanjing Medical University. There were 29 male and 3 female patients aged from 24 to 63 years. Thirty-two patients were diagnosed as phase Ⅲ silicosis by the local occupational disease prevention and control center. Fifteen patients were type Ⅰ respiratory failure and 17 patients were type Ⅱ...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27916030/-short-term-outcomes-of-lung-transplant-recipients-using-organs-from-brain-death-donors
#9
W X He, C Jiang, X G Liu, W Huang, C Chen, L Jiang, B Yang, K Wu, Q K Chen, Y Yang, Y M Yu, G N Jiang
Objective: To assess short-term outcomes after lung transplantation with organs procured following brain death. Methods: Between April 2015 and July 2016, all 17 recipients after lung transplantation using organs from brain death donors (DBD) at Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine were enrolled in this study. All patients were male, aging (60±7) years, including 11 chronic obstructive pulmonary disease, 5 idiopathic pulmonary fibrosis, 1 silicosis...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27915968/peripheral-t-cell-lymphoma-a-posttransplant-lymphoproliferative-disorder-presenting-as-a-jejunal-mass-in-a-renal-transplant-recipient
#10
Aanchal Kakkar, Immanuel Pradeep, Geetika Singh, Amit Dinda, Sanjay K Agarwal
Posttransplant lymphoproliferative disorders are a spectrum of lymphoproliferative disorders seen in recipients of solid-organ, bone marrow, and stem cell allografts. They include polyclonal early lesions mimicking infectious mononucleosis and monoclonal proliferations of B and T cells, indistinguishable from lymphomas occurring in immunocompetent individuals. Although most posttransplant lymphoproliferative disorders are B-cell neoplasms, T-cell posttransplant lymphoproliferative disorders are very rare. Among solid-organ transplants, renal allografts have low risk for development of posttransplant lymphoproliferative disorders...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27915963/kidney-transplant-recipients-requiring-critical-care-admission-within-one-year-of-transplant
#11
Okechukwu O Okidi, David Van Dellen, Cassandra Sobajo, Angela Summers, John R Greer, Titus Augustine
OBJECTIVES: Kidney transplant is the gold standard for treatment of renal failure. With the increasing age of the recipient population, which carries significant comorbidities, and the use of more marginal organs, there is potential for increased critical care admissions. In this study, we investigated the incidence, indications, and outcomes of patients admitted to critical care within 1 year of transplant. We also aimed to identify any precipitating factors or events that may trigger these admissions, as well as establish variables that could affect mortality...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27915440/liver-steatosis-in-pre-transplant-liver-biopsies-can-be-quantified-rapidly-and-accurately-by-nuclear-magnetic-resonance-analysis
#12
Stefanie Bertram, Cathrin Myland, Sandra Swoboda, Anja Gallinat, Thomas Minor, Nils Lehmann, Michael Thie, Julia Kälsch, Leona Pott, Ali Canbay, Thomas Bajanowski, Henning Reis, Andreas Paul, Hideo A Baba
Donor livers marginally acceptable or acceptable according to extended criteria are more frequently transplanted due to the growing discrepancy between demand and availability of donor organs. One type of marginally acceptable graft is a steatotic donor liver, because it is more sensitive to ischemia-reperfusion injury. Thus, quantitative assessment of steatosis is crucial prior to liver transplantation. Extent of steatosis of 49 pre-reperfusion liver biopsies from patients who received orthotopic liver transplantation was assessed by three techniques: semi-quantitative histological evaluation, computerized histomorphometry, and NMR-based estimation of fat content...
December 3, 2016: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/27914967/survival-advantage-and-comparable-toxicity-in-reduced-toxicity-treosulfan-based-vs-reduced-intensity-busulfan-based-conditioning-regimen-in-mds-and-aml-patients-post-allogeneic-hematopoietic-cell-transplantation
#13
Ioanna Sakellari, Despina Mallouri, Eleni Gavriilaki, Ioannis Batsis, Maria Kaliou, Varnavas Constantinou, Apostolia Papalexandri, Chrysavgi Lalayanni, Chrysanthi Vadikolia, Anastasia Athanasiadou, Evangelia Yannaki, Damianos Sotiropoulos, Christos Smias, Achilles Anagnostopoulos
Treosulfan has been incorporated in conditioning regimens for sustained remissions without substantial toxicity and treatment related mortality (TRM). We aimed to analyze the safety and efficacy of FluTreo conditioning regimen (fludarabine 150mg/m(2), treosulfan 42g/m(2)) in medically infirm patients. Patients' outcome was compared with a similar historical group treated with FluBuATG (fludarabine 150-180mg/m(2), busulfex 6.4mg/Kg, thymoglobulin-ATG 5-7.5mg/kg). Thirty one consecutive patients suffering from AML (21), MDS (6) or treatment-related AML (4) received FluTreo conditioning...
November 30, 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27914923/alloantigen-gene-transfer-to-hepatocytes-promotes-tolerance-to-pancreatic-islet-graft-by-inducing-cd8-regulatory-t-cells
#14
Valentin Le Guen, Jean-Paul Judor, Françoise Boeffard, Vanessa Gauttier, Nicolas Ferry, Jean-Paul Soulillou, Sophie Brouard, Sophie Conchon
BACKGROUND & AIM: Induction of donor-specific immune tolerance is a good alternative to chronic life-long immunosuppression for transplant patients. Donor major histocompatibility complex (MHC) molecules represent the main targets of the allogeneic immune response of transplant recipients. Liver-targeted gene transfer with viral vectors induces tolerance toward the encoded antigen. The aim of this work was to determine whether alloantigen gene transfer to hepatocytes induces tolerance and promotes graft acceptance...
November 30, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27914916/-cytotoxicity-of-natural-anti-hla-antibodies-in-moroccan-patients-awaiting-for-kidney-transplantation
#15
Nadia Benseffaj, Sanae Ouadghiri, Asmaa Drissi Bourhanbour, Asmae Noor Zerrouki, Malika Essakalli
: The presence of anti-HLA antibodies in the serum of a patient result from an immune response produced during an immunizing event as transfusion, pregnancy or graft. These antibodies can be cytotoxic by activating the complement pathway via C1q and may cause organ rejection during the transplant. Some male patients awaiting kidney transplantation are seropositive for anti-HLA antibodies when they have no immunizing antecedent event. These antibodies are qualified as natural antibodies...
November 30, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27914702/renal-xenotransplantation-experimental-progress-and-clinical-prospects
#16
Martin Wijkstrom, Hayato Iwase, Wayne Paris, Hidetaka Hara, Mohamed Ezzelarab, David K C Cooper
There are >100,000 patients waiting for kidney transplants in the United States and a vast need worldwide. Xenotransplantation, in the form of the transplantation of kidneys from genetically engineered pigs, offers the possibility of overcoming the chronic shortage of deceased and living human donors. These genetic manipulations can take the form of (i) knockout of pig genes that are responsible for the expression of antigens against which the primate (human or nonhuman primate) has natural "preformed" antibodies that bind and initiate complement-mediated destruction or (ii) the insertion of human transgenes that provide protection against the human complement, coagulation, or inflammatory responses...
November 30, 2016: Kidney International
https://www.readbyqxmd.com/read/27914462/recombinant-mhc-tetramers-for-isolation-of-virus-specific-cd8-cells-from-healthy-donors-potential-approach-for-cell-therapy-of-posttransplant-cytomegalovirus-infection
#17
A S Vdovin, S Y Filkin, P R Yefimova, S A Sheetikov, N M Kapranov, Y O Davydova, E S Egorov, E G Khamaganova, M Y Drokov, L A Kuzmina, E N Parovichnikova, G A Efimov, V G Savchenko
Patients undergoing allogeneic hematopoietic stem cell transplantation have a high risk of cytomegalovirus reactivation, which in the absence of T-cell immunity can result in the development of an acute inflammatory reaction and damage of internal organs. Transfusion of the virus-specific donor T-lymphocytes represents an alternative to a highly toxic and often ineffective antiviral therapy. Potentially promising cell therapy approach comprises transfusion of cytotoxic T-lymphocytes, specific to the viral antigens, immediately after their isolation from the donor's blood circulation without any in vitro expansion...
November 2016: Biochemistry. Biokhimii︠a︡
https://www.readbyqxmd.com/read/27913812/association-between-cytokines-and-their-receptor-antagonist-gene-polymorphisms-and-clinical-risk-factors-and-acute-rejection-following-renal-transplantation
#18
SIqing Ding, Jianfei Xie, Qiquan Wan
BACKGROUND Acute rejection (AR) after renal transplantation affects both patient and graft survival. There is growing evidence of the genetic association between cytokine or its receptor antagonist and AR in solid organ transplantation. The objectives of this study were to investigate the role of recipient TNF β, IL-10, IL-1β, and IL-1 receptor antagonist (ra) gene polymorphism, as well as traditional clinical variables such as panel-reactive antibody (PRA) levels, donor type, and HLA mismatches in AR following renal transplantation...
December 3, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27913799/involvement-of-recipient-transplant-coordinators-in-transplant-outpatient-clinics-in-japan-current-status-and-transplant-physician-s-thoughts-on-follow-up-clinics
#19
Kuniko Hagiwara, Natsuko Seto, Yasuko Shimizu, Shiro Takahara
CONTEXT: Transplant recipients require long-term immunosuppressive therapy, so continued medical follow-up is necessary for long-term survival. OBJECTIVE: To investigate the current role of recipient transplant coordinators (RTCs) in the outpatient care of organ transplant recipients in Japan. METHODS: We sent a questionnaire survey to doctors in transplant facilities affiliated with the Japan Society for Transplantation probing attitudes on the role of RTCs in outpatient clinics...
December 2, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27913515/cellular-immune-responses-in-red-blood-cell-alloimmunization
#20
James C Zimring, Krystalyn E Hudson
In excess of 340 blood group antigens have now been described that vary between individuals. Thus, any unit of blood that is nonautologous represents a significant dose of alloantigen. Most blood group antigens are proteins, which differ by a single amino acid between donors and recipients. Approximately 1 out of every 70 individuals are transfused each year (in the United States alone), which leads to antibody responses to red blood cell (RBC) alloantigens in some transfusion recipients. When alloantibodies are formed, in many cases, RBCs expressing the antigen in question can no longer be safely transfused...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
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