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https://www.readbyqxmd.com/read/28900245/the-role-of-metronomic-capecitabine-for-treatment-of-recurrent-hepatocellular-carcinoma-after-liver-transplantation
#1
Matteo Ravaioli, Alessandro Cucchetti, Antonio Daniele Pinna, Vanessa De Pace, Flavia Neri, Maria Aurelia Barbera, Lorenzo Maroni, Giorgio Frega, Andrea Palloni, Stefania De Lorenzo, Maria Cristina Ripoli, Maria Abbondanza Pantaleo, Matteo Cescon, Massimo Del Gaudio, Giovanni Brandi
The management of recurrent hepatocellular carcinoma untreatable with surgical options is based on systemic therapy with sorafenib. Due to the high rates of adverse events connected to the therapy with sorafenib, metronomic capecitabine seems a promising strategy for these patients. We analyzed the data of 38 patients with hepatocellular carcinoma recurrent after liver transplantation performed at our center. We compared the outcome of 17 patients receiving metronomic capecitabine versus 20 patients experiencing best supportive care and versus the data of the literature about treatment with sorafenib...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28898563/direct-acting-antiviral-agents-based-regimen-for-hcv-recurrence-after-combined-liver-kidney-transplantation-results-from-the-anrs-co23-cupilt-study
#2
Sébastien Dharancy, Audrey Coilly, Claire Fougerou-Leurent, Christophe Duvoux, Nassim Kamar, Vincent Leroy, Albert Tran, Pauline Houssel-Debry, Valérie Canva, Christophe Moreno, Filoména Conti, Jérome Dumortier, Vincent Di Martino, Sylvie Radenne, Victor De Ledinghen, Louis D'Alteroche, Christine Silvain, Camille Besch, Philippe Perré, Danielle Botta-Fridlund, Claire Francoz, François Habersetzer, Hélène Montialoux, Armand Abergel, Maryline Debette-Gratien, Alexandra Rohel, Emilie Rossignol, Didier Samuel, Jean-Charles Duclos-Vallée, Georges-Philippe Pageaux
HCV infection is associated with reduced patient survival following combined liver-kidney transplantation (LKT). The aim of this study was to assess the efficacy and safety of second generation direct active antiviral (DAAs) in this difficult-to-treat population. The ANRS CO23 CUPILT study is a prospective cohort including transplant recipients with recurrent HCV treated with DAAs. The present work focused on recipients with recurrent HCV following LKT. The study population included 23 patients. All patients received at least one NS5B inhibitor (Sofosbuvir) in their antiviral regimen an average of 90 months after LKT...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28894081/eculizumab-in-renal-transplantation-a-2017-update
#3
Ryszard Grenda, Magdalena Durlik
Despite ongoing progress in renal transplantation, there are still emerging challenges in this field, including consequences of ischemia-reperfusion injury (IRI), pre-existing and produced de novo anti-HLA donor-specific antibodies (DSA), and acute/chronic humoral rejection (AMR), as well as the recurrence of atypical hemolytic-uremic syndrome (aHUS) in genetically predisposed patients. All these conditions are related to the prominent role of the complement system and are deleterious to the fate of the renal graft...
September 12, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28882367/defining-the-phenotype-of-antibody-mediated-rejection-in-kidney-transplantation-advances-in-diagnosis-of-antibody-injury
#4
REVIEW
Neetika Garg, Milagros D Samaniego, Dana Clark, Arjang Djamali
The diagnostic criteria for antibody-mediated rejection (ABMR) are constantly evolving in light of the evidence. Inclusion of C4d-negative ABMR has been one of the major advances in the Banff Classification in recent years. Currently Banff 2015 classification requires evidence of donor specific antibodies (DSA), interaction between DSA and the endothelium, and acute tissue injury (in the form of microvasculature injury (MVI); acute thrombotic microangiopathy; or acute tubular injury in the absence of other apparent cause)...
August 15, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28875861/therapeutic-monoclonal-antibodies-and-multiple-sclerosis-the-essentials
#5
Ioannis Heliopoulos, Athanasia Patousi
BACKGROUND: Monoclonal antibodies (mAbs) are now established as targeted therapies for malignancies, transplant rejection, autoimmune and infectious diseases. Two monoclonal antibodies are available for treatment and other antibodies are currently being tested in multiple sclerosis (MS) patients. OBJECTIVES: The purpose of the present review paper is to outline the antibody engineering technologies, the immunologic and pharmacologic concepts of mΑbs and the current status of treatment in MS with emphasis on clinical efficacy and safety...
September 6, 2017: Medicinal Chemistry
https://www.readbyqxmd.com/read/28873970/immunosuppressive-agents-in-adult-kidney-transplantation-in-the-national-health-service-a-model-based-economic-evaluation
#6
Tristan M Snowsill, Jason Moore, Ruben E Mujica Mota, Jaime L Peters, Tracey L Jones-Hughes, Nicola J Huxley, Helen F Coelho, Marcela Haasova, Chris Cooper, Jenny A Lowe, Jo L Varley-Campbell, Louise Crathorne, Matt J Allwood, Rob Anderson
Background: Immunosuppression is required in kidney transplantation to prevent rejection and prolong graft survival. We conducted an economic evaluation to support England's National Institute for Health and Care Excellence in developing updated guidance on the use of immunosuppression, incorporating new immunosuppressive agents, and addressing changes in pricing and the evidence base. Methods: A discrete-time state transition model was developed to simulate adult kidney transplant patients over their lifetime...
July 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28873074/adipose-derived-cellular-therapies-in-solid-organ-and-vascularized-composite-allotransplantation
#7
Katlin B Stivers, Jason E Beare, Paula M Chilton, Stuart K Williams, Christina L Kaufman, James B Hoying
PURPOSE OF REVIEW: Controlling acute allograft rejection following vascularized composite allotransplantation requires strict adherence to courses of systemic immunosuppression. Discovering new methods to modulate the alloreactive immune response is essential for widespread application of vascularized composite allotransplantation. Here, we discuss how adipose-derived cellular therapies represent novel treatment options for immune modulation and tolerance induction in vascularized composite allotransplantation...
October 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28864749/wuzhi-tablet-schisandra-sphenanthera-extract-is-a-promising-tacrolimus-sparing-agent-for-renal-transplant-recipients-who-are-cyp3a5-expressers-a-two-phase-prospective-study
#8
Jia-Li Li, Siyang Chen, Xiaoling Qin, Qian Fu, Huichang Bi, Yu Zhang, Xueding Wang, Longshan Liu, Changxi Wang, Min Huang
Tacrolimus is a potent but expensive first-line immunosuppressant, thus solutions to reduce tacrolimus consumption while maintain therapeutic level are in urgent need. A two-phase prospective study was conducted to assess the efficacy of an ethanolic extraction preparation of Schisandra sphenanthera (Wuzhi tablet) as a tacrolimus-sparing agent in renal transplant recipients who were high-dose tacrolimus consumers (CYP3A5*1 allele carriers, CYP3A5 expressers). A total of twelve patients were included in the Part I study...
September 1, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28855128/inflammasome-activation-involved-in-early-inflammation-reaction-after-liver-transplantation
#9
Bao-Jian Hong, Hui Liu, Zhou-Han Wang, Yue-Xia Zhu, Li-Yun Su, Min-Xia Zhang, Ke Xu, Jian-Zhong Chen
Liver transplantation has emerged as a vital therapy for end-stage liver diseases. Acute -phase inflammation play an important role in liver graft injury.Recent studies have revealed that inflammasome are responsible for initiating inflammation in early stage of acute organ rejection in liver transplantation, however the underlying mechanism remains unclear. Here we explored to block inflammasome activation to see whether it can alleviate early inflammation reaction during rejection of allgrafts in a rat model and gain further insights into the mechanism of inhibiting inflammation in allografts...
September 5, 2017: Immunology Letters
https://www.readbyqxmd.com/read/28841655/lower-frequency-routine-surveillance-endomyocardial-biopsies-after-heart-transplantation
#10
Ludwig T Weckbach, Ulrich Maurer, Rene Schramm, Bruno C Huber, Korbinian Lackermair, Max Weiss, Bruno Meiser, Christian Hagl, Steffen Massberg, Sandra Eifert, Ulrich Grabmaier
In heart transplantation (HTx) patients, routine surveillance endomyocardial biopsies (rsEMB) are recommended for the detection of early cardiac allograft rejection. However, there is no consensus on the optimal frequency of rsEMB. Frequent rsEMB have shown a low diagnostic yield in the new era of potent immunosuppressive regimen. Efficacy and safety of lower frequency rsEMB have not been investigated so far. In this retrospective, single centre, observational study we evaluated 282 patients transplanted between 2004 and 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28838454/acute-graft-rejection-and-formation-of-de-novo-donor-specific-antibodies-triggered-by-low-cyclosporine-levels-and-interferon-therapy-for-recurrent-hepatitis-c-infection-after-liver-transplantation-a-case-report
#11
R Nakano, M Ohira, K Ishiyama, K Ide, T Kobayashi, H Tahara, S Shimizu, K Arihiro, M Imamura, K Chayama, Y Tanaka, H Ohdan
BACKGROUND: We report a case of acute rejection of a liver graft, together with the occurrence of de novo donor-specific antibodies (DSAs), in a 53-year-old Japanese man who had undergone deceased-donor liver transplantation. METHODS: The graft rejection was triggered by low cyclosporine levels and pegylated interferon treatment for the recurrence of hepatitis C virus (HCV) infection 18 months after transplantation. Although the graft was ABO-compatible, pre-formed DSA B51 was detected; therefore, total plasma exchange was performed and intravenous rituximab (500 mg/body) was administered before transplantation...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838437/urgent-lung-transplantation-in-severe-acute-respiratory-failure-based-on-rapidly-progressive-interstitial-lung-disease-a-case-report
#12
I Madurka, J Elek, N Schönauer, T Bartók, K Kormosói-Tóth, É Zöllei, Á Ghimessy, G Lang, W Klepetko, F Rényi-Vámos
Lung transplantation (LUTX) became a worldwide accepted standard therapy for certain well-defined chronic end-stage lung diseases. Until recently, patients on mechanical ventilation or extracorporeal life support techniques were hardly eligible for LUTX because of the inferior short-term results. However, a paradigm shift has occurred, and now these techniques represent bridging options to LUTX for listed patients. In the current practice, transplantation from the intensive care unit (ICU) is not extraordinary in patients on the waiting list...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28832451/induction-therapy-rejection-and-graft-outcomes-in-pediatric-and-adolescent-kidney-transplant-recipients
#13
Christine Marie Mincham, Germaine Wong, Armando Teixeira-Pinto, Sean Kennedy, Stephen Alexander, Nicholas Larkins, Wai H Lim
BACKGROUND: Although the clinical benefit of interleukin-2-receptor antibody (IL-2RAb) induction in reducing the risk of acute rejection in adult kidney transplant recipients is well established, a similar benefit in pediatric recipients remains controversial. The aim of this study is to evaluate the efficacy of IL-2RAb in reducing acute rejection in pediatric and adolescent recipients aged 21 years or younger using Australia and New Zealand Dialysis and Transplant registry. METHODS: The association between IL-2RAb induction and risk of acute rejection was examined using adjusted logistic regression and propensity score analyses, whereby the associations between induction, graft loss, and incident cancer were examined using adjusted Cox regression analysis...
September 2017: Transplantation
https://www.readbyqxmd.com/read/28828166/is-early-conversion-to-mtor-inhibitors-represent-a-suitable-choice-in-renal-transplant-recipients-a-systemic-review-of-medium-term-outcomes
#14
REVIEW
J Kumar, I Reccia, T Kusano
BACKGROUND: Immunosuppressive therapies are important parts of renal transplantation. OBJECTIVE: To assess the present literature on the effectiveness of early introduction of mTOR inhibitors with or without calcineurin inhibitors (CNI) in renal transplant recipients in terms of renal functioning and graft survival. METHODS: The current literature was reviewed following PROSPERO approval, assessing the role of immunosuppressive agent, mTOR inhibitors as an alternative to CNI within 6 months of renal transplantation by searching PubMed, EMBASE, Cochrane, Crossref, and Scopus...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28821363/living-donor-kidney-transplantation-in-atypical-hemolytic-uremic-syndrome-a-case-series
#15
Caroline Duineveld, Jacobien C Verhave, Stefan P Berger, Nicole C A J van de Kar, Jack F M Wetzels
BACKGROUND: The development of complement inhibitors has greatly improved the outcome of patients with atypical hemolytic uremic syndrome (aHUS), making kidney transplantation a more feasible option. Although prophylactic eculizumab therapy may prevent recurrent disease after transplantation, its necessity for all transplant recipients is debated. STUDY DESIGN: A case series. SETTING & PARTICIPANTS: Patients with aHUS who underwent living donor kidney transplantation after 2011 at 2 university centers, prospectively followed up with a protocol of eculizumab therapy limited to only recipients with documented posttransplantation recurrent thrombotic microangiopathy...
August 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28817400/liver-xenotransplantation
#16
Madhukar S Patel, Nathan Louras, Parsia A Vagefi
PURPOSE OF REVIEW: There continues to be an inadequate organ supply and lack of effective temporary support, for patients with liver failure. The purpose of this review is to discuss recent progress in the field of orthotopic pig-to-nonhuman primate (NHP) liver xenotransplantation (LXT). RECENT FINDINGS: From 1968 to 2012, survival in pig-to-NHP LXT was limited to 9 days, initially due to hyperacute rejection which has been ameliorated through use of genetically engineered donor organs, but ultimately because of profound thrombocytopenia, thrombotic microangiopathy, and bleeding...
August 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28798289/prolonged-administration-of-twice-daily-bolus-intravenous-tacrolimus-in-the-early-phase-after-lung-transplantation
#17
Yutaka Hirano, Seiichiro Sugimoto, Toshifumi Mano, Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Masaomi Yamane, Motomu Kobayashi, Shinichiro Miyoshi, Takahiro Oto
BACKGROUND Although administration of tacrolimus, whether by the enteric, sublingual, or continuous intravenous routes, has some limitations, twice-daily bolus intravenous tacrolimus administration has been shown to be beneficial in optimizing efficacy and safety after lung transplantation. However, at present, the duration of bolus intravenous tacrolimus administration is limited, and the effects of prolonged bolus intravenous tacrolimus administration remain unknown. Our study was aimed at assessing the safety and efficacy of prolonged twice-daily bolus intravenous tacrolimus administration in the early phase after lung transplantation...
August 11, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28792635/favorable-results-in-abo-incompatible-renal-transplantation-without-b-cell-targeted-therapy-advantages-and-disadvantages-of-rituximab-pretreatment
#18
Manabu Okada, Yoshihiko Watarai, Kenta Iwasaki, Kenta Murotani, Kenta Futamura, Takayuki Yamamoto, Takahisa Hiramitsu, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Asami Takeda, Kunio Morozumi, Kazuharu Uchida, Takaaki Kobayashi
The effectiveness of desensitization with rituximab in ABO-incompatible renal transplantation (ABO-I) has been widely reported. However, ABO-I outcomes are still worse than those of ABO-identical or ABO-compatible renal transplantation (ABO-Id/C). We retrospectively examined the outcomes in consecutive living donor ABO-Id/C (n = 412) and ABO-I (n = 205) cases to elucidate the causes of inferiority in ABO-I. ABO-I cases included recipients treated with rituximab (RIT, n = 131), splenectomy (SPX, n = 21), or neither because of low anti-A/B antibody titers (NoR/S, n = 53)...
August 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28772237/low-intensity-laser-therapy-efficacy-evaluation-in-mice-subjected-to-acute-arthritis-condition
#19
Bianca F Trawitzki, Lothar Lilge, Fellipe A T de Figueiredo, Ana Paula Macedo, João Paulo M Issa
Acute arthritis is an inflammation that affects many joints. The principal treatment options comprise drugs (corticosteroids), invasive and painful surgery. The objective of this study was to evaluate the efficacy of low intensity laser therapy (LILT), a non-invasive treatment, in a murine model of acute inflammation model. 48 mice received a synovial injection of Zymosan A into one knee. Mice were treated with LILT by three different wavelengths, either as a single (S) or dual (D) application immediately after the injury or after 24h following initiation of an inflammatory response...
July 26, 2017: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/28766066/outcome-of-kidney-transplantation-in-pediatric-patients-with-anca-associated-glomerulonephritis-a-single-center-experience
#20
Damien Noone, Rae S M Yeung, Diane Hebert
OBJECTIVES: Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our experience of kidney transplantation in pediatric ANCA GN patients. METHODS: We performed a retrospective review of patients with ANCA GN who developed ESRD and were transplanted at a single center between the years 2000 and 2014...
August 1, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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