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https://www.readbyqxmd.com/read/29769038/impact-of-new-daa-therapy-on-real-clinical-practice-a-multicenter-region-wide-cohort-study
#1
Simone Lanini, Paola Scognamiglio, Alessandra Mecozzi, Lorella Lombardozzi, Vincenzo Vullo, Mario Angelico, Antonio Gasbarrini, Gloria Taliani, Adolfo Francesco Attili, Carlo Federico Perno, Adriano De Santis, Vincenzo Puro, Fabio Cerqua, Gianpiero D'Offizi, Adriano Pellicelli, Orlando Armignacco, Francesco Saverio Mennini, Massimo Siciliano, Enrico Girardi, Vincenzo Panella, Giuseppe Ippolito
BACKGROUND: Management of chronic hepatitis C (CHC) has significantly accelerated in the last few years. Currently, second generation direct acting antivirals (DAAs) promise clearance of infection in most of patients. Here we present the results of the first analysis carried out on data of Lazio clinical network for DAAs. METHODS: The study was designed as a multicenter cohort: a) to assess the evolution of treatment during the first 24 months of the activity of the Clinical Network; b) to report overall efficacy of treatments; c) to analyze potential factors associated with lack of virological response at 12 weeks after therapy (SVR12); d) to evaluate the variation of ALT at baseline and 12 weeks after therapy in those who achieved SVR12 in comparison to those who did not...
May 16, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29754400/the-international-prevalence-and-variability-of-non-adherence-to-the-non-pharmacologic-treatment-regimen-after-heart-transplantation-findings-from-the-cross-sectional-bright-study
#2
Remon Helmy, Nathalie Duerinckx, Sabina De Geest, Kris Denhaerynck, Lut Berben, Cynthia L Russell, Johan Van Cleemput, Maria G Crespo-Leiro, Fabienne Dobbels
INTRODUCTION: Heart transplant (HTx) recipients need to follow a complex therapeutic regimen. We assessed the international prevalence and variability in non-adherence to six non-pharmacologic treatment components (physical activity, sun protection, diet, alcohol use, non-smoking, and outpatient follow-up visits). METHODS: We used self-report data of 1397 adult HTx recipients from the 36-HTx-center, 11-country, 4-continent, cross-sectional BRIGHT study (ClinicalTrials...
May 13, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29746495/tacrolimus-intra-patient-variability-is-not-associated-with-chronic-active-antibody-mediated-rejection
#3
Kasia A Sablik, Marian C Clahsen-van Groningen, Dennis A Hesselink, Teun van Gelder, Michiel G H Betjes
BACKGROUND: Chronic active antibody mediated rejection (c-aABMR) is a major cause of long-term kidney allograft loss. It is hypothesized that frequent sub-therapeutic exposure to immunosuppressive drugs, in particular tacrolimus (Tac), is a risk factor for the development of c-aABMR. The intra-patient variability (IPV) in Tac exposure may serve as a substitute biomarker for underexposure and/or non-adherence. In this study, the association between Tac IPV and the development of c-aABMR was investigated...
2018: PloS One
https://www.readbyqxmd.com/read/29723909/-psychological-foundations-of-pediatric-liver-transplantation
#4
Irene Petersen, Anna Sophie Dechow, Karl-Heinz Schulz
Liver transplantation (LTX) is an established therapy for pediatric patients with liver failure. In recent decades, survival rates have risen continuously. With increased life expectancy, there has been greater attention to children's and adolescents' quality of life following transplantation. This article provides an overview of the tasks of pediatric transplant psychology. We summarize the reviewed literature of research on health-related quality of life in pediatric liver transplant recipients. Furthermore, we present studies on fatigue, mental health, cognitive development and family strain...
May 2018: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/29714147/epithelial-in-vitro-differentiation-of-mesenchymal-stem-cells
#5
Alvaro Sierra-Sanchez, Alexandra Ordonez-Luque, Olga Espinosa-Ibanez, Antonio Ruiz-Garcia, Salvador Arias-Santiago
Mesenchymal stem cells or mesenchymal stromal cells (MSCs) are non-hematopoietic stromal cells that reside in and have been isolated from a variety of adult or fetal tissues such as adipose tissue, bone marrow and umbilical cord Wharton's jelly, among others. Because they are a heterogeneous population, International Society for Cellular Therapy has established 3 minimum criteria to characterize MSCs in vitro: i) adherence to plastic, ii) differentiation potential (osteogenic, chondrogenic and adipogenic lineages) and iii) expression of specific surface antigens (CD73+, CD90+, CD105+, CD34-, CD45-, CD11b-, CD14-, CD19-, CD79a-, HLA-DR-)...
May 1, 2018: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29688849/cryptococcoma-of-a-transplanted-kidney-in-a-patient-presenting-with-recurrent-urinary-tract-infection-a-case-report
#6
Albert Z Muranda, Ludolf Greeff, Mike M Sathekge, Thabo Lengano, Victor O L Karusseit
BACKGROUND: Cryptococcosis is an important opportunistic infection of organ transplant recipients. It is the third most common fungal infection of transplant patients and occurs especially in kidney recipients. Cryptococcus neoformans is a ubiquitous fungus which infects humans by inhalation of spores. C. gattii has more recently been recognised as a pathogen. Infection commonly is disseminated affecting mainly the central nervous system and the lungs. Cryptococcoma, a localised form of the disease, has been described in various organs...
April 23, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29675688/everyone-has-a-donor-contribution-of-the-chinese-experience-to-global-practice-of-haploidentical-hematopoietic-stem-cell-transplantation
#7
REVIEW
Meng Lv, Yingjun Chang, Xiaojun Huang
Human leukocyte antigen (HLA)-matched donors for hematopoietic stem cell transplantation (HSCT) have long been scarce in China. Haploidentical (haplo) donors are available for the vast majority of patients, but toxicity has limited this approach. Three new approaches for haplo-HSCT originated from Italy, China, and USA in 1990 and have been developed to world-renowned system up to now. The Chinese approach have been greatly improved by implementing new individualized conditioning regimens, donor selection based on non-HLA systems, risk-directed strategies for graft-versus-host disease and relapse, and infection management...
April 19, 2018: Frontiers of Medicine
https://www.readbyqxmd.com/read/29542229/association-of-post-transplant-donor-specific-hla-antibody-with-liver-graft-fibrosis-during-long-term-follow-up-after-pediatric-liver-transplantation
#8
Kazuaki Tokodai, Shigehito Miyagi, Chikashi Nakanishi, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Keigo Murakami, Hironobu Sasano, Masafumi Goto, Michiaki Unno, Takashi Kamei
The aim of this study was to evaluate the significance of post-transplant DSA as a predictor of liver fibrosis during long-term follow-up after pediatric LT. We evaluated the histological findings in 18 LT recipients who underwent liver biopsy after DSA screening. Liver fibrosis was scored based on the METAVIR fibrosis staging. Patients were divided into 2 groups based on histological findings, and clinical characteristics among patients with liver fibrosis were assessed. Of 18 patients, 7 were included in the fibrosis group...
May 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29497386/psychosocial-variables-associated-with-immunosuppressive-medication-non-adherence-after-renal-transplantation
#9
Jennifer Felicia Scheel, Katharina Schieber, Sandra Reber, Lisa Stoessel, Elisabeth Waldmann, Sabine Jank, Kai-Uwe Eckardt, Franziska Grundmann, Frank Vitinius, Martina de Zwaan, Anna Bertram, Yesim Erim
Introduction: Non-adherence to immunosuppressive medication is regarded as an important factor for graft rejection and loss after successful renal transplantation. Yet, results on prevalence and relationship with psychosocial parameters are heterogeneous. The main aim of this study was to investigate the association of immunosuppressive medication non-adherence and psychosocial factors. Methods: In 330 adult renal transplant recipients (≥12 months posttransplantation), health-related quality of life, depression, anxiety, social support, and subjective medication experiences were assessed, and their associations with patient-reported non-adherence was evaluated...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29492382/current-state-of-pediatric-cardiac-transplantation
#10
REVIEW
Anne I Dipchand
Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29463231/prevalence-and-correlates-of-non-adherence-to-immunosuppressants-and-to-health-behaviours-in-patients-after-kidney-transplantation-in-brazil-the-adhere-brazil-multicentre-study-a-cross-sectional-study-protocol
#11
Helady Sanders-Pinheiro, Fernando Antonio Basile Colugnati, Elisa Oliveira Marsicano, Sabina De Geest, José Osmar Pestana Medina
BACKGROUND: Non-adherence to immunosuppressive therapy is a prevalent risk factor for poor clinical and after kidney transplantation (KT), and has contributed to the lack of improvement in long-term graft survival over the past decade. Understanding the multilevel correlates and risk factors of non-adherence is crucial to determine the optimal level for planning interventions, namely at the patient, health care provider, KT centre, and health care system level. Brazil, having the largest public transplantation program in the world and with regional differences regarding access to health services and service implementation, is in a unique position to study this multilevel approach...
February 20, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29446874/transplant-recipients-are-vulnerable-to-coverage-denial-under-medicare-part-d
#12
Lisa M Potter, Angela Q Maldonado, Krista L Lentine, Mark A Schnitzler, Zidong Zhang, Gregory P Hess, Edward Garrity, Bertram L Kasiske, David A Axelrod
Transplant immunosuppressants are often used off-label because of insufficient randomized prospective trial data to achieve organ-specific US Food and Drug Administration (FDA) approval. Transplant recipients who rely on Medicare Part D for immunosuppressant drug coverage are vulnerable to coverage denial for off-label prescriptions, unless use is supported by Centers for Medicare & Medicaid Services (CMS)-approved compendia. An integrated dataset including national transplant registry data and 3 years of dispensed pharmacy records was used to identify the prevalence of immunosuppression use that is both off-label and not supported by CMS-approved compendia...
February 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29439280/-adherence-to-immunosuppressive-medication-following-organ-transplantation
#13
Mariel Nöhre, Yesim Erim, Frank Vitinius, Felix Klewitz, Mario Schiffer, Martina de Zwaan
Organ transplantation is the best and to some extent only option for many patients with chronic organ failure. Usually after successful transplantation patients experience a significant improvement of their condition. Nevertheless, they are not cured but still chronically ill. Living with an organ transplant requires consequent immunosuppression intake, regular physician visits and following the recommendations regarding infection prevention. These factors are important to secure a long transplant survival...
May 2018: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/29427394/a-simplified-regimen-of-targeted-antifungal-prophylaxis-in-liver-transplant-recipients-a-single-center-experience
#14
B Lavezzo, D Patrono, F Tandoi, S Martini, F Fop, V Ballerini, C Stratta, S Skurzak, F Lupo, P Strignano, P P Donadio, M Salizzoni, R Romagnoli, F G De Rosa
BACKGROUND: Invasive fungal infection (IFI) is a severe complication of liver transplantation burdened by high mortality. Guidelines recommend targeted rather than universal antifungal prophylaxis based on tiers of risk. METHODS: We aimed to evaluate IFI incidence, risk factors, and outcome after implementation of a simplified two-tiered targeted prophylaxis regimen based on a single broad-spectrum antifungal drug (amphotericin B). Patients presenting 1 or more risk factors according to literature were administered prophylaxis...
April 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29405487/history-of-psychosis-and-mania-and-outcomes-after-kidney-transplantation-a-retrospective-study
#15
Miklos Z Molnar, James D Eason, Abduzhappar Gaipov, Manish Talwar, Praveen K Potukuchi, Kiran Joglekar, Adam Remport, Zoltan Mathe, Istvan Mucsi, Marta Novak, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
History of psychosis or mania, if uncontrolled, both represent relative contraindications for kidney transplantation. We examined 3680 US veterans who underwent kidney transplantation. The diagnosis of history of psychosis/mania was based on a validated algorithm. Measured confounders were used to create a propensity score-matched cohort (n = 442). Associations between pretransplantation psychosis/mania and death with functioning graft, all-cause death, graft loss, and rejection were examined in survival models and logistic regression models...
May 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29391524/evaluation-of-infliximab-as-second-line-treatment-of-acute-graft-versus-host-disease-validating-response-on-day-7-and-28-as-predictors-of-survival
#16
Marietta Nygaard, Niels Smedegaard Andersen, Claus Ernst Moser, Gitte Olesen, Ida Marie Schjødt, Carsten Heilmann, Henrik Sengeløv
Several immunosuppressive drugs have been proposed for second-line treatment of steroid-refractory acute graft versus host disease (aGvHD) after allogeneic hematopoietic stem cell transplantation. However, the studies on these drugs are small, retrospective, uncontrolled and use different endpoints. Therefore, it remains unknown which treatment is superior. We retrospectively evaluated 68 consecutive patients treated with infliximab for aGvHD. We adhered to recently proposed guidelines for aGvHD trials and thus evaluated response on day 7 and 28...
February 1, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29388675/influenza-vaccines-in-immunosuppressed-adults-with-cancer
#17
REVIEW
Roni Bitterman, Noa Eliakim-Raz, Inbal Vinograd, Anca Zalmanovici Trestioreanu, Leonard Leibovici, Mical Paul
BACKGROUND: This is an update of the Cochrane review published in 2013, Issue 10.Immunosuppressed cancer patients are at increased risk of serious influenza-related complications. Guidelines, therefore, recommend influenza vaccination for these patients. However, data on vaccine effectiveness in this population are lacking, and the value of vaccination in this population remains unclear. OBJECTIVES: To assess the effectiveness of influenza vaccine in immunosuppressed adults with malignancies...
February 1, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29380445/self-reported-non-adherence-to-immunosuppressive-medication-in-adult-lung-transplant-recipients-a-single-center-cross-sectional-study
#18
Nora Drick, Benjamin Seeliger, Jan Fuge, Igor Tudorache, Mark Greer, Tobias Welte, Axel Haverich, Jens Gottlieb
BACKGROUND: Non-adherence to immunosuppressive treatment following solid organ transplantation is common and often associated with poorer outcomes. Non-adherence is difficult to assess, and barriers to adherence in lung transplant (LTx) recipients remain to be elucidated. METHODS: A single-center cross-sectional observational study of all LTx recipients attending our department between 07/2013 and 05/2014 was performed. Non-adherence was assessed using patient self-reporting, including Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) along with healthcare worker (HCW) judgment and reasons for non-adherence by the Immunosuppressive Therapy Barriers Scale...
January 29, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29356221/results-of-early-treatment-for-de-novo-donor-specific-antibodies-in-pediatric-kidney-transplant-recipients-in-a-cross-sectional-and-longitudinal-cohort
#19
Olga Charnaya, Shamir Tuchman, Asha Moudgil
The development of dnDSA anti-HLA antibodies has been shown to be a significant risk factor for graft failure. In 2008, we instituted a routine protocol of standardized monitoring and treatment of dnDSA in pediatric kidney transplant recipients. Of 67 first-time pediatric kidney transplant recipients, 26 (38%) developed dnDSA after 1.36 (IQ 1-2.14) years. Coefficient of variance of tacrolimus, a surrogate marker of non-adherence, was found to be the single most important risk factor for dnDSA development. Overall, there was a significant reduction in dnDSA with treatment in 19 (76%) children...
March 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29346567/epithelial-grafting-of-a-decellularized-whole-tracheal-segment-an-in-vivo-experimental-model
#20
Margot Den Hondt, Bart M Vanaudenaerde, Eric K Verbeken, Jan J Vranckx
OBJECTIVES: Prerequisites for successful trachea transplantation include the use of a biocompatible construct, submucosal vascularization and an epithelial covering. Implantation of non-epithelialized tracheal scaffolds may lead to stenosis. However, epithelial grafting or seeding can only be attempted onto a well-vascularized submucosal bed. Our aim was to investigate a method to prevent stenosis during prelamination of non-epithelialized, gently decellularized rabbit tracheae and to evaluate whether grafting of revascularized constructs with buccal mucosa is feasible...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
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