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https://www.readbyqxmd.com/read/29775554/outcomes-and-predictors-of-early-infection-after-heart-transplantation
#1
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29769027/immune-monitoring-after-pediatric-liver-transplantation-the-prospective-chilsfree-cohort-study
#2
Imeke Goldschmidt, André Karch, Rafael Mikolajczyk, Frauke Mutschler, Norman Junge, Eva Doreen Pfister, Tamara Möhring, Lorenzo d'Antiga, Patrick McKiernan, Deirdre Kelly, Dominique Debray, Valérie McLin, Joanna Pawlowska, Loreto Hierro, Kerstin Daemen, Jana Keil, Christine Falk, Ulrich Baumann
BACKGROUND: Although trough levels of immunosuppressive drugs are largely used to monitor immunosuppressive therapy after solid organ transplantation, there is still no established tool that allows for a validated assessment of functional degree of immunosuppression or the identification of clinically relevant over- or under-immunosuppression, depending on graft homeostasis. Reliable non-invasive markers to predict biopsy proven acute rejection (BPAR) do not exist. Literature data suggest that longitudinal measurements of immune markers might be predictive of BPAR, but data in children are scarce...
May 16, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#3
Johan Noble, Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
Cornerstone immunosuppressive therapy currently relies on immediate-release tacrolimus, a calcineurin inhibitor (CNI) that is potentially nephrotoxic and is more diabetogenic than cyclosporine A. Two new formulations of tacrolimus have been launched: an extended-release formulation (Advagraf®/Astagraf XL®, Astellas company) and a long-lasting formulation (Envarsus®, Veloxis company). Area covered: Herein, we assess the efficacy of an extended-release formulation of tacrolimus (Advagraf®/Astagraf XL®) used in conjunction with or without an induction therapy (i...
May 14, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29754764/monitoring-of-early-humoral-immunity-to-identify-lung-recipients-at-risk-for-development-of-serious-infections-a-multicenter-prospective-study
#4
Elizabeth Sarmiento, Jose Cifrian, Leticia Calahorra, Carles Bravo, Sonia Lopez, Rosalia Laporta, Piedad Ussetti, Amparo Sole, Carmen Morales, Alicia de Pablos, Maria Jaramillo, Ikram Ezzahouri, Sandra García, Joaquin Navarro, Marcos Lopez-Hoyos, Javier Carbone
BACKGROUND: Infection is still a leading cause of death during the first year after lung transplantation. We performed a multicenter study among teaching hospitals to assess monitoring of early humoral immunity as a means of identifying lung recipients at risk of serious infections. METHODS: We prospectively analyzed 82 adult lung recipients at 5 centers in Spain. Data were collected before transplantation and at 7 and 30 days after transplantation. Biomarkers included IgG, IgM, IgA, complement factors C3 and C4, titers of antibodies to pneumococcal polysaccharide antigens (IgG, IgA, IgM) and antibodies to cytomegalovirus (IgG), and serum B-cell activating factor (BAFF) levels...
April 6, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#5
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29750317/mycophenolate-mofetil-for-sustained-remission-in-nephrotic-syndrome
#6
Uwe Querfeld, Lutz T Weber
The clinical application of mycophenolate mofetil (MMF) has significantly widened beyond the prophylaxis of acute and chronic rejections in solid organ transplantation. MMF has been recognized as an excellent treatment option in many immunologic glomerulopathies. For children with frequently relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS) experiencing steroid toxicity, MMF has been recommended as a steroid-sparing drug. Uncontrolled studies in patients with FRNS and SDSN have shown that many patients can achieve sustained remission of proteinuria with MMF monotherapy...
May 11, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29735782/an-overview-of-liver-transplant-pathology-data-from-a-tertiary-referral-centre-in-western-india
#7
Fiona Fonseca, Bijal Kulkarni, Meenal Hastak, Vinay Kumaran, Vibha Varma, Sorabh Kapoor
INTRODUCTION AND AIM: 1. Study of liver explants - Etiologic types of end-stage chronic liver disease (ESCLD) and acute liver failure (ALF) in adults and children. 2. Assessment of donor steatosis and incidental granulomas. 3. Post-transplant liver biopsies. MATERIAL AND METHODS: Specimens of 180 explant hepatectomies, 173 donor wedge and 30 core liver biopsies, and 58 post transplant liver biopsies received in our department from April 2013 to March 2017. RESULTS: 1...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29735031/endoscopic-follow-up-of-intestinal-transplant-recipients
#8
REVIEW
Robert E Carroll
The growing population of intestinal transplant recipients present a unique challenge to the gastroenterologists responsible for their support and evaluation. Improvements in patient and graft survival are largely attributed to surgical advancements, refined antirejection therapy, and enhanced endoscopic surveillance protocols that better perceive rejection and other complications. This article reviews the endoscopic management and interventions provided for transplant recipients at the University of Illinois Hospital with complications, such as acute rejection, ischemia, bleeding, fistula, post-transplant lymphoproliferative disorder, and gastroparesis...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29731098/efficacy-and-safety-of-induction-therapy-in-kidney-transplantation-a-network-meta-analysis
#9
S D Hwang, J H Lee, S W Lee, K-M Park, J K Kim, M-J Kim, J H Song
BACKGROUND: Rejection and infection can occur after kidney transplantation and are important factors in preserving graft kidney function. The use of immunosuppressant agents in transplantation is therefore important, and the question of which induction therapy should be used as an immunosuppressant is controversial. OBJECTIVE: The goal of this study was to assess the comparative benefits and harms of various maintenance immunosuppressive induction agents in adults undergoing kidney transplantation by using a network meta-analysis and to generate rankings of the different immunosuppressive regimens according to their safety and efficacy...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29722128/five-year-outcomes-in-kidney-transplant-patients-randomized-to-everolimus-with-cyclosporine-withdrawal-or-low-exposure-cyclosporine-versus-standard-therapy
#10
Claudia Sommerer, Michael Duerr, Oliver Witzke, Frank Lehner, Wolfgang Arns, Volker Kliem, Daniel Ackermann, Markus Guba, Johannes Jacobi, Ingeborg A Hauser, Rolf Stahl, Petra Reinke, Thomas Rath, Justyna Veit, Arianeb Mehrabi, Martina Porstner, Klemens Budde
HERAKLES was a one-year randomized, multicenter trial. Patients were randomized at three months after kidney transplantation to remain on cyclosporine-based therapy, switch to everolimus without a calcineurin inhibitor (CNI), or switch to everolimus with low-exposure cyclosporine. Overall, 417/497 (83.9%) patients from the core study entered a four-year extension study. The randomized regimen was continued to year 5 in 75.9%, 41.9% and 24.6% of patients in the standard-CNI, CNI-free and low-CNI groups, respectively...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29719210/cell-encapsulation-overcoming-barriers-in-cell-transplantation-in-diabetes-and-beyond
#11
Marco Farina, Jenolyn F Alexander, Usha Thekkedath, Mauro Ferrari, Alessandro Grattoni
Cell-based therapy is emerging as a promising strategy for treating a wide range of human diseases, such as diabetes, blood disorders, acute liver failure, spinal cord injury, and several types of cancer. Pancreatic islets, blood cells, hepatocytes, and stem cells are among the many cell types currently used for this strategy. The encapsulation of these "therapeutic" cells is under intense investigation to not only prevent immune rejection but also provide a controlled and supportive environment so they can function effectively...
April 29, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29713644/the-therapeutic-effects-after-transplantation-of-whole-layer-olfactory-mucosa-in-rats-with-optic-nerve-injury
#12
Shun Gong, Hai Jin, Danfeng Zhang, Wei Zou, Chunhui Wang, Zhenxing Li, Rongbin Chen, Yan Dong, Lijun Hou
Background: Existing evidence suggests the potential therapy of transplanting olfactory ensheathing cells (OEC) either alone or in combination with neurotrophic factors or other cell types in optic nerve injury (ONI). However, clinical use of autologous OEC in the acute stages of ONI is not possible. On the other hand, acute application of heterologous transplantation may bring the issue of immune rejection. The olfactory mucosa (OM) with OEC in the lamina propria layer is located in the upper region of the nasal cavity and is easy to dissect under nasal endoscopy, which makes it a candidate as autograft material in acute stages of ONI...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29709248/identifying-risk-profiles-in-liver-transplant-candidates-and-implications-for-induction-immunosuppression
#13
REVIEW
Umberto Cillo, Wolf O Bechstein, Gabriela Berlakovich, Philipp Dutkowski, Frank Lehner, Silvio Nadalin, Faouzi Saliba, Hans J Schlitt, Johann Pratschke
Changes in recipient and donor characteristics are redefining the role of induction in liver transplant recipients. Older recipients are more common, with greater concomitant comorbidity. Moderate or severe renal dysfunction is now estimated to affect 40% of liver transplant recipients. Donors are also becoming older, and other factors such as more frequent non-alcoholic fatty liver disease (NAFLD) compromise the quality of some grafts. Rejection rates are now relatively low (~10%) but some patients have a markedly increased risk such as younger recipients and those undergoing re-transplantation...
April 13, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29703119/individuals-experiences-with-brief-admission-during-the-implementation-of-the-brief-admission-sk%C3%A3-ne-rct-a-qualitative-study
#14
Marjolein Helleman, Lars-Gunnar Lundh, Sophie I Liljedahl, Daiva Daukantaité, Sofie Westling
BACKGROUND: Brief admission (BA) is an adjunctive treatment option for individuals with self-harming behavior, having traits of borderline personality disorder (BPD). It is offered alongside outpatient psychotherapy for the purpose of strengthening autonomy, self-reflection and self-care and to increase the likelihood of being able to stay in therapy by avoiding lengthy inpatient hospitalizations. AIMS: To investigate participants' experiences with BA during the pilot phase of the Brief Admission Skåne Randomized Controlled Trial (BASRCT), in order to detect possible strengths and limitations of the intervention and gain knowledge to facilitate implementation of BA at other treatment centers...
April 27, 2018: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/29701351/heart-transplantation-early-results-of-two-different-regimes-of-immnunosuppression
#15
Carlos Branco, David Prieto, André Antunes, Manuel Batista, Manuel J Antunes
INTRODUCTION: The management of induction and maintenance immunosuppression therapy after heart transplantation (HT) remains a controversial issue. The dosage and the timing has been a changing target. We aimed at evaluate the incidence of acute cellular rejection (ACR) [≥1R grade], major infection and survival in first year after HT in patients receiving two different induction immunosuppression regimes and with a reduction in intensity of triple maintenance immunosuppression dose...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29694722/transplantation-of-hepatitis-c-virus-infected-kidneys-into-hepatitis-c-virus-uninfected-recipients
#16
REVIEW
Meghan E Sise, Donald F Chute, Jenna L Gustafson, David Wojciechowski, Nahel Elias, Raymond T Chung, Winfred W Williams
Long wait times for kidney transplant and the high risk of mortality on dialysis have prompted investigation into strategies to increase organ allocation and decrease discard rates of potentially viable kidneys. Organs from hepatitis C virus (HCV) antibody positive donors are often rejected; nearly 500 HCV-infected kidneys are discarded annually in the United States. Due the opioid epidemic, the number of HCV-infected donors has increased because of a rise in both new HCV infections and drug-related deaths...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29694721/hepatitis-c-virus-infection-in-kidney-transplantation-changing-paradigms-with-novel-agents
#17
REVIEW
Yuvaram N V Reddy, David Nunes, Vipul Chitalia, Craig E Gordon, Jean M Francis
Hepatitis C virus (HCV) is a common cause of increased morbidity and mortality in kidney transplant patients. It is associated with posttransplant glomerulonephritis, chronic allograft nephropathy, and New Onset Diabetes after Transplant (NODAT). In the past, HCV was difficult to treat due to the presence of interferon alpha-based therapies that were difficult to tolerate and were associated with adverse side-effects, such as the risk of rejection. With the advent of oral directly acting antiviral therapies, the landscape for HCV and transplantation has changed...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29693023/kidney-transplantation-the-challenge-of-human-leukocyte-antigen-and-its-therapeutic-strategies
#18
REVIEW
Tilahun Alelign, Momina M Ahmed, Kidist Bobosha, Yewondwossen Tadesse, Rawleigh Howe, Beyene Petros
Kidney transplantation remains the treatment of choice for end-stage renal failure. When the immune system of the recipient recognizes the transplanted kidney as a foreign object, graft rejection occurs. As part of the host immune defense mechanism, human leukocyte antigen (HLA) is a major challenge for graft rejection in transplantation therapy. The impact of HLA mismatches between the donor and the potential recipient prolongs the time for renal transplantation therapy, tethered to dialysis, latter reduces graft survival, and increases mortality...
2018: Journal of Immunology Research
https://www.readbyqxmd.com/read/29679515/the-influence-of-mtor-inhibitors-on-the-incidence-of-cmv-infection-in-high-risk-donor-positive-recipient-negative-d-r-kidney-transplant-recipients
#19
M P Cristelli, R M Esmeraldo, C Motta Pinto, T V Sandes-Freitas, C Felipe, C F Lobo, L Viana, J Mansur, S Stopa, D W C Santos, P C Grenzi, W F Aguiar, H Tedesco-Silva, J O Medina-Pestana
Several studies and meta-analysis suggest the mTOR inhibitors are associated with reduced incidence of CMV infection after kidney transplantation, although their effects on the high-risk population have not been investigated thoroughly. This retrospective cohort study investigates the association between immunosuppression and CMV infection in D+/R- kidney transplant recipients receiving preemptive therapy. All patients received rabbit anti-thymocyte globulin, tacrolimus, prednisone and azathioprine (AZA), mycophenolate (MPA) or everolimus (EVR)...
April 21, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29676031/treatment-of-recurrent-focal-segmental-glomerulosclerosis-post-kidney-transplantation-in-australian-and-new-zealand-children-a-retrospective-cohort-study
#20
Anna Francis, Madeleine Didsbury, Hugh McCarthy, Tonya Kara
Disease recurrence affects around a third of renal transplants for children with FSGS and is associated with poor graft outcomes. Unfortunately, there are no large trials guiding treatment for recurrent FSGS. We aimed to describe current therapies and treatment response for recurrent FSGS in 4 centres in Australia and New Zealand. Data were collected on children (age <18 years) with recurrent FSGS (1990-2015). We reviewed patient charts to obtain clinical information. Ethics approval was obtained from the relevant boards...
April 19, 2018: Pediatric Transplantation
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