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Liver transplant tolerance

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https://www.readbyqxmd.com/read/28101345/%C3%AE-cell-function-prior-to-liver-transplantation-contributes-to-post-operative-diabetes
#1
Tatsuki Ichikawa, Naota Taura, Hisamitsu Miyaaki, Satoshi Miuma, Hidetaka Shibata, Takuya Honda, Masaaki Hidaka, Akihiko Soyama, Mitsuhisa Takatsuki, Susumu Eguchi, Kazuhiko Nakao
Liver cirrhosis and diabetes mellitus (DM) are closely associated. The present study aimed to determine whether liver transplantation (LT) may prevent/cure DM in patients with cirrhosis and whether the degree of glucose tolerance prior to transplantation is associated with the onset of DM after transplantation. Seventy-three patients who received a living donor LT at Nagasaki University Hospital (Nagasaki, Japan) between November 2005 and December 2012 were recruited. Among them, patients were considered diabetic if they had been prescribed diabetes medications or had impaired glucose tolerance, as evidenced by an oral glucose tolerance test (OGTT)...
December 2016: Biomedical Reports
https://www.readbyqxmd.com/read/28051797/%C3%A2-sofosbuvir-and-daclatasvir-in-mono-and-hiv-coinfected-patients-with-recurrent-hepatitis-c-after-liver-transplant
#2
Lluís Castells, Jordi Llaneras, Isabel Campos-Varela, Itxarone Bilbao, Manel Crespo, Oscar Len, Francisco Rodríguez-Frías, Ramon Charco, Teresa Salcedo, Juan Ignacio Esteban, Rafael Esteban-Mur
:  Background and aims. Pegylated interferon (Peg-INF) and ribavirin (RBV) based therapy is suboptimal and poorly tolerated. We evaluated the safety, tolerability and efficacy of a 24-week course of sofosbuvir plus daclatasvir without ribavirin for the treatment of hepatitis C virus (HCV) recurrence after liver transplantation (LT) in both HCV-monoinfected and human immunodeficiency virus (HIV)-HCV coinfected patients. MATERIAL AND METHODS: We retrospectively evaluated 22 consecutive adult LT recipients (16 monoinfected and 6 coinfected with HIV) who received a 24-week course of sofosbuvir plus daclatasvir treatment under an international compassionate access program...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28041666/prediabetes-in-pediatric-recipients-of-liver-transplant-mechanism-and-risk-factors
#3
Emily R Perito, Robert H Lustig, Philip Rosenthal
OBJECTIVE: To investigate the role of calcineurin inhibitor exposure and states of insulin resistance-obesity and adolescence-in prediabetes after pediatric liver transplant via oral glucose tolerance testing, which previously has not been done systematically in these at-risk youths. STUDY DESIGN: This was a cross-sectional study of 81 pediatric recipients of liver transplant. Prediabetes was defined as impaired glucose tolerance (IGT; glucose ≥140 mg/dL at 2 hours) or impaired fasting glucose (IFG, ≥100 mg/dL)...
December 29, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28039929/epstein-barr-virus-dna-monitoring-in-serum-and-whole-blood-in-pediatric-liver-transplant-recipients-who-do-or-do-not-discontinue-immunosuppressive-therapy
#4
C Kullberg-Lindh, R Saalman, M Olausson, G Herlenius, M Lindh
The rate of PTLD can be reduced by weaned IS guided by monitoring of EBV DNA. In this single-center retrospective case series study, we analyzed how reduction in IS influenced EBV DNA levels in whole blood and serum in 30 children during the first year after liver transplantation, and how these levels were related to symptoms putatively due to EBV. Primary and reactivated EBV infection was seen in 18 (60%) and eight patients (27%), respectively. Thirteen patients (42%) developed chronic high load the first year post-transplant...
December 31, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/28027587/analysis-of-surgical-interruption-of-the-enterohepatic-circulation-as-a-treatment-for-pediatric-cholestasis
#5
Kasper S Wang, Greg Tiao, Lee M Bass, Paula M Hertel, Douglas Mogul, Nanda Kerkar, Matthew Clifton, Colleen Azen, Laura Bull, Philip Rosenthal, Dylan Stewart, Riccardo Superina, Ronen Arnon, Molly Bozic, Mary L Brandt, Patrick A Dillon, Annie Fecteau, Kishore Iyer, Binita Kamath, Saul Karpen, Frederick Karrer, Kathleen M Loomes, Cara Mack, Peter Mattei, Alexander Miethke, Kyle Soltys, Yumirle P Turmelle, Karen West, Jessica Zagory, Cat Goodhue, Benjamin L Shneider
: To evaluate the efficacy of non-transplant surgery for pediatric cholestasis, 58 clinically diagnosed children, including 20 Alagille syndrome (ALGS), 16 Familial Intrahepatic Cholestasis-1 (FIC1), 18 Bile Salt Export Pump (BSEP) disease, & 4 others with low γ-glutamyl transpeptidase disease (levels <100 U/L), were identified across 14 Childhood Liver Disease Research Network (ChiLDReN) centers. Data were collected retrospectively from individuals who collectively had 39 partial external biliary diversions (PEBD), 11 ileal exclusions (IE) and 7 gallbladder-to-colon diversion (GBC)...
December 27, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28024124/developing-therapies-to-treat-hepatitis-c-infection-in-post-liver-transplant-recipients
#6
Thomas R McCarty, Joseph K Lim
Currently, hepatitis C virus (HCV) infection remains the most common indication for liver transplant in the United States (US) with almost universal HCV recurrence in the post-liver transplant setting. Previous interferon (IFN)-related efficacy and tolerability concerns about worsening liver function have limited treatment options for many patients with HCV-associated decompensated liver disease and post-liver transplant recipients. However, the last decade has seen a seen a radical shift in the management of HCV with multiple direct-acting antiviral (DAA) treatments that provide more effective, all-oral, IFN-free alternatives...
December 26, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28012215/real-world-experience-with-daclatasvir-plus-sofosbuvir-%C3%A2-ribavirin-for-post-liver-transplant-hcv-recurrence-and-severe-liver-disease
#7
Kerstin Herzer, Tania M Welzel, Ulrich Spengler, Holger Hinrichsen, Hartwig Klinker, Thomas Berg, Peter Ferenci, Markus Peck-Radosavljevic, Akin Inderson, Yue Zhao, Maria Jesus Jimenez-Exposito, Stefan Zeuzem
Optimizing therapy of post-transplant HCV recurrence remains important, especially in advanced liver disease. We evaluated daclatasvir (DCV) plus sofosbuvir (SOF), with or without ribavirin (RBV), in patients with post-liver transplant recurrence in a real-world European cohort at high risk of decompensation or death within 12 months. Recommended treatment was DCV 60mg plus SOF 400mg once-daily for 24 weeks; RBV use/shorter treatment duration was at physicians' discretion. Patients (N=87) were 70% male, 93% white, and mostly infected with HCV genotypes 1b (48%), 1a (32%), or 3 (9%); 37 (43%) had cirrhosis (16 decompensated), five had fibrosing cholestatic hepatitis...
December 24, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28006874/sofosbuvir-ledipasvir-and-ribavirin-tolerability-and-efficacy-in-pediatric-liver-transplant-recipients
#8
Koen Huysentruyt, Xavier Stephenne, Sharat Varma, Isabelle Scheers, Gisèle Leclercq, Françoise Smets, Etienne Sokal
No abstract text is available yet for this article.
December 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28006867/differential-profile-of-activated-regulatory-t-cell-subsets-and-micrornas-in-tolerant-liver-transplant-recipients
#9
B Revilla-Nuin, A de Bejar, L Martínez-Alarcón, J I Herrero, C M Martínez-Cáceres, P Ramírez, A Baroja-Mazo, J A Pons
: Regulatory T cells (Tregs) play a potential role in operational tolerance in liver transplant patients, and microRNAs (miRNAs) are known to be involved in immunological responses and tolerance. Thus, we analyzed the implication of different peripheral blood Treg subsets and miRNAs on liver transplantation tolerance in 24 tolerant (Tol) and 23 non-tolerant (non-Tol) liver transplant recipients by cellular, genetic and epigenetic approximation. Non-Tol patients had a lower demethylation rate of the FOXP3 Treg-specific demethylated region (TSDR) than Tol patients that correlated with the frequency of circulating Tregs...
December 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28002876/outcomes-of-treatment-with-daclatasvir-and-asunaprevir-for-recurrent-hepatitis-c-after-liver-transplantation
#10
Masaki Honda, Yasuhiko Sugawara, Takehisa Watanabe, Masakuni Tateyama, Motohiko Tanaka, Koushi Uchida, Seiichi Kawabata, Daiki Yoshii, Kouhei Miura, Kaori Isono, Shintaro Hayashida, Yuki Ohya, Hidekazu Yamamoto, Yutaka Sasaki, Yukihiro Inomata
AIM: The development of direct - acting oral agents has dramatically changed the treatment strategy of hepatitis C virus (HCV) infection. Here we aimed to reveal the efficacy and safety of daclatasvir (DCV) and asunaprevir (ASV) for recurrent HCV genotype 1 infection after liver transplantation (LT). METHODS: A retrospective study was conducted on 9 patients [5 men; 4 had failed peg-interferon/ribavirin, 2 had failed simeprevir/peg-interferon/ribavirin, 1 had the resistance-associated variant (RAV) Y93H in the NS5A region, 1 underwent maintenance dialysis ] who underwent a 24 -week DCV/ASV treatment regimen for recurrent HCV genotype 1 infection...
December 21, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28002655/optimal-dosage-regimen-for-rituximab-in-abo-incompatible-living-donor-liver-transplantation
#11
Hiroto Egawa, Koji Umeshita, Shinji Uemoto
BACKGROUND: Rituximab has greatly improved the outcomes of ABO-incompatible living donor liver transplantation (ABO-I LDLT). To clarify the optimal regimen for rituximab in adult ABO-I LDLT, a multicenter study was conducted in Japan. METHODS: Clinical data of 33 adult patients undergoing ABO-I LDLT at 15 centers in 2013 were retrospectively corrected. RESULTS: The targeted blood type was A1 in 18, B in 14, and AB in 1 patient. Rituximab was administered at 7 to 48 days before LT, at a dose of 375 mg/m(2) in 12 patients, 500 mg in 15 patients, 300 mg in 5 patients, and 100 mg in 1 patient...
December 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27984276/mechanisms-of-liver-induced-tolerance
#12
Demetrios Moris, Lina Lu, Shiguang Qian
PURPOSE OF REVIEW: To highlight the results of the ongoing research on the mechanisms of liver-induced tolerance focusing on results from the last year. RECENT FINDINGS: The liver is exposed to a massive antigenic burden of dietary and commensal products from the gastrointestinal tract via portal vein, most of which are necessary for survival. To prevent the immune system from destroying these foreign yet beneficial elements, the liver has developed unique mechanisms to suppress immune responses...
February 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27982034/a-tlr9-agonist-promotes-il-22-dependent-pancreatic-islet-allograft-survival-in-type-1-diabetic-mice
#13
Deepak Tripathi, Sambasivan Venkatasubramanian, Satyanarayana S Cheekatla, Padmaja Paidipally, Elwyn Welch, Amy R Tvinnereim, Ramakrishna Vankayalapati
Pancreatic islet transplantation is a promising potential cure for type 1 diabetes (T1D). Islet allografts can survive long term in the liver parenchyma. Here we show that liver NK1.1(+) cells induce allograft tolerance in a T1D mouse model. The tolerogenic effects of NK1.1(+) cells are mediated through IL-22 production, which enhances allograft survival and increases insulin secretion. Increased expression of NKG2A by liver NK1.1(+) cells in islet allograft-transplanted mice is involved in the production of IL-22 and in the reduced inflammatory response to allografts...
December 16, 2016: Nature Communications
https://www.readbyqxmd.com/read/27943153/phase-i-ii-randomized-trial-of-sorafenib-and-bevacizumab-as-first-line-therapy-in-patients-with-locally-advanced-or-metastatic-hepatocellular-carcinoma-north-central-cancer-treatment-group-trial-n0745-alliance
#14
Joleen M Hubbard, Michelle R Mahoney, William S Loui, Lewis R Roberts, Thomas C Smyrk, Zoran Gatalica, Mitesh Borad, Shaji Kumar, Steven R Alberts
BACKGROUND: Angiogenesis has been a major target of novel drug development in hepatocellular carcinoma (HCC). It is hypothesized that the combination of two antiangiogenic agents, sorafenib and bevacizumab, will provide greater blockade of angiogenesis. OBJECTIVE: To determine the optimal dose, safety, and effectiveness of dual anti-angiogenic therapy with sorafenib and bevacizumab in patients with advanced HCC. PATIENTS AND METHODS: Patients with locally advanced or metastatic HCC not amenable for surgery or liver transplant were eligible...
December 9, 2016: Targeted Oncology
https://www.readbyqxmd.com/read/27932171/recurrence-of-progressive-familial-intrahepatic-cholestasis-type-2-phenotype-after-living-donor-liver-transplantation-a-case-report
#15
K Masahata, S Uehara, S Ibuka, K Nakahata, Y Hasegawa, H Kondou, R Kubitz, T Ueno
BACKGROUND: Progressive familial intrahepatic cholestasis 2 (PFIC2) is the result of mutations in the ABCB11, which encodes for bile salt export pump (BSEP). An absence of BSEP in the canalicular membrane causes cholestasis and leads to the development of end-stage liver disease in the first decade of life. Liver transplantation (LT) has been considered curative for BSEP disease. However, patients with PFIC2 having undergone LT have recently been reported to develop recurrence of cholestasis together with the clinical and histological features of primary BSEP disease...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932161/sofosbuvir-monotherapy-for-asymptomatic-and-noncirrhotic-hepatitis-c-infection-in-a-renal-retransplantation-recipient-a-case-report
#16
G Deng, J Ma, S Shen, Q Li, L Peng, S Meng, J Zhou, J Wu, D Liu
Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to cirrhosis, end-stage liver diseases, and hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with proteinuria, transplant glomerulopathy, HCV-associated glomerulonephritis, and chronic rejection. Previous therapy involving interferon alfa and ribavirin led to treatment complications, including toxicity, anemia, sepsis, and drug-drug interactions with calcineurin inhibitors, as well as reduced tolerability and efficacy...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932123/serum-levels-of-interleukin-34-during-acute-rejection-in-liver-transplantation
#17
D San Segundo, P Ruiz, J Irure, M T Arias-Loste, A Cuadrado, A Puente, F Casafont, M López-Hoyos, J Crespo, E Fábrega
INTRODUCTION: Accumulating evidence indicates that interleukin (IL)-34 participates in T-cell homeostasis and tolerance due to the ability of IL-34 to trigger apoptosis of Th1, Th17, and Tc1 cells, but spare Th2 cells and Treg. In addition, IL-34 exerts anti-inflammatory effects by impairing leukocyte adhesion and transendothelial migration, and reducing the secretion of proinflammatory cytokines. The aim of our study was to investigate the time course of serum levels of IL-34 during hepatic allograft rejection...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932113/hepatitis-c-treatment-with-direct-acting-antivirals-in-kidney-transplant-preliminary-results-from-a-multicenter-study
#18
M A Gentil, C González-Corvillo, M Perelló, S Zarraga, C Jiménez-Martín, L R Lauzurica, A Alonso, A Franco, D Hernández-Marrero, A Sánchez-Fructuoso
Hepatitis C (HC) is a very relevant negative prognosis factor for graft and transplant recipient survival. New direct-acting antivirals (DAAs) allow us to solve this problem in an effective way. It is crucial to understand their real impact in our daily practice. We analyzed treatment results with DAA, free of interferon, in kidney transplant recipients (KTRs) from 15 Spanish hospitals (Grupo Español de Actualización en Trasplante), regarding effectiveness, tolerance, and impact on immunosuppression, renal function-proteinuria, and diabetes...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931584/evaluation-of-pregnancy-outcomes-after-liver-transplantation
#19
M Akarsu, T Unek, A Avcu, M Ozbilgin, T Egeli, I Astarcioglu
Liver transplantation is increasing worldwide. Pregnancy after liver transplantation is considered to be well tolerated with favorable neonatal outcomes in cases of stable and sufficient graft function. In this study, our aim was to determine pregnancy and neonatal outcomes of patients after liver transplantation. Data for patients who had been followed-up by the liver transplantation clinic at the Dokuz Eylül University Medical Faculty Hospital, Turkey, between 2002 and 2016, and who had pregnancy after the transplantation were evaluated retrospectively...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27917261/anti-hepatitis-c-virus-drugs-and-kidney
#20
REVIEW
Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Denis Sautereau, Annick Rousseau, Pierre Marquet, Jérémie Jacques, Véronique Loustaud-Ratti
Hepatitis C virus (HCV) mainly targets the liver but can also induce extrahepatic manifestations. The kidney may be impacted via an immune mediated mechanism or a cytopathic effect. HCV patients are clearly at a greater risk of chronic kidney disease (CKD) than uninfected patients are, and the presence of CKD increases mortality. Interferon-based therapies and ribavirin are difficult to manage and are poorly effective in end-stage renal disease and hemodialysis. These patients should be given priority treatment with new direct anti-viral agents (DAAs) while avoiding peginterferon and ribavirin...
November 18, 2016: World Journal of Hepatology
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