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https://www.readbyqxmd.com/read/28437790/utility-in-treating-kidney-failure-in-end-stage-liver-disease-with-simultaneous-liver-kidney-transplantation
#1
Xingxing S Cheng, Margaret R Stedman, Glenn M Chertow, W Ray Kim, Jane C Tan
BACKGROUND: Simultaneous liver-kidney (SLK) transplantation plays an important role in treating kidney failure in patients with end-stage liver disease. It used 5% of deceased donor kidney transplanted in 2015. We evaluated the utility, defined as posttransplant kidney allograft lifespan, of this practice. METHODS: Using data from the Scientific Registry of Transplant Recipients, we compared outcomes for all SLK transplants between January 1, 1995, and December 3, 2014, to their donor-matched kidney used in kidney-alone (Ki) or simultaneous pancreas kidney (SPK) transplants...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28397982/generation-of-chimeric-minipigs-by-aggregating-4-to-8-cell-stage-blastomeres-from-somatic-cell-nuclear-transfer-with-the-tracing-of-enhanced-green-fluorescent-protein
#2
Huili Ji, Chuan Long, Chong Feng, Ningning Shi, Yingdi Jiang, Guomin Zeng, Xirui Li, Jingjing Wu, Lin Lu, Shengsheng Lu, Dengke Pan
BACKGROUND: Blastocyst complementation is an important technique for generating chimeric organs in organ-deficient pigs, which holds great promise for solving the problem of a shortage of organs for human transplantation procedures. Porcine chimeras have been generated using embryonic germ cells, embryonic stem cells, and induced pluripotent stem cells; however, there are no authentic pluripotent stem cells for pigs. In previous studies, blastomeres from 4- to 8-cell-stage parthenogenetic embryos were able to generate chimeric fetuses efficiently, but the resulting fetuses did not produce live-born young...
April 11, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28361743/the-role-of-nutritional-assessment-and-early-enteral-nutrition-for-combined-pancreas-and-kidney-transplant-candidates
#3
Sally Finlay, Argiris Asderakis, Adel Ilham, Doruk Elker, Dawn Chapman, Elijah Ablorsu
BACKGROUND: Early post-operative enteral nutrition is an important part of perioperative management and is strongly supported by ESPEN Guidelines. However, there is limited evidence into the use of Early Enteral Nutrition (EEN) after combined Pancreas and Kidney Transplantation (PKT). We know malnutrition in type-1 diabetics with end stage renal failure (ESRF) is a common problem and a significant risk factor. Therefore, we introduced EEN in our patients. METHOD: We monitored and recorded nutritional data on 29 PKT recipients who underwent transplantation between Oct 2007 and Jan 2010 without a nutritional assessment or EEN [Monitored Group (MG)] and on 30 PKT recipients between Feb 2010 and Dec 2013 who received a nutritional assessment and EEN (Naso-jejunal feed or oral intake with supplementation, according to their nutritional status) [Fed Group (FG)]...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28349124/alemtuzumab-induction-and-delayed-acute-rejection-in-steroid-free-simultaneous-pancreas-kidney-transplant-recipients
#4
Jonna R Bank, Sebastiaan Heidt, Dirk Jan A R Moes, Dave L Roelen, Marko J K Mallat, Paul J M van der Boog, Manon Vergunst, Cornelia M Jol-van der Zijde, Robbert G M Bredius, Andries E Braat, Jan Ringers, Maarten J D van Tol, Frans H J Claas, Marlies E J Reinders, Johannes W de Fijter
BACKGROUND: The optimal immunosuppressive regimen in simultaneous pancreas-kidney transplant (SPKT) recipients that prevents acute rejection episodes (AREs) and allows optimal outcome remains elusive. METHODS: This cohort study assessed incidence and time to AREs in 73 consecutive SPKT recipients receiving alemtuzumab induction and steroid-free maintenance with tacrolimus and mycophenolate mofetil. A cohort with single high-dose antithymocyte globulin (ATG; n = 85) and triple therapy served as controls...
January 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28342278/simultaneous-pancreas-and-kidney-transplantation-incidence-and-risk-factors-for-amputation-after-10-years-follow-up
#5
E MacCraith, N F Davis, C Browne, P Mohan, D Hickey
INTRODUCTION: The incidence of amputation after simultaneous pancreas and kidney (SPK) transplantation ranges from 9.5-23% after 5 years of follow-up. The objective of this study was to investigate the incidence and risk factors for amputation in SPK transplant patients after a minimum follow-up of 10 years. METHODS: An analysis was performed on a prospectively maintained database of 81 SPK transplants and 43 kidney transplantation alone (KTA) consecutively performed in one centre for insulin dependent diabetes mellitus between December 1992 and January 2006...
March 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28332959/de-novo-donor-specific-antibody-formation-in-tacrolimus-based-mycophenolate-versus-mammalian-target-of-rapamycin-immunosuppressive-regimens
#6
Zain Mithani, Jane Gralla, Oluwafisayo Adebiyi, Patrick Klem, James E Cooper, Alexander C Wiseman
OBJECTIVES: De novo donor-specific antibody formation posttransplant is associated with decreased graft survival. It is not known whether mammalian target of rapamycin inhibitors may be advantageous or detrimental compared with mycophenolate in the prevention of de novo donor-specific antibody formation. MATERIALS AND METHODS: We compared 66 kidney and kidney-pancreas transplant recipients who received tacrolimus, mammalian target of rapamycin inhibitor, and prednisone (group 1; 36 of whom received everolimus and 30 of whom received sirolimus) versus 132 patients who received tacrolimus, mycophenolate, and prednisone (group 2) matched for age, sex, race, and type/timing of transplant from 2007 to 2012...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28319322/an-analysis-of-the-survival-outcomes-of-simultaneous-pancreas-and-kidney-transplantation-compared-to-live-donor-kidney-transplantation-in-patients-with-type-1-diabetes-a-uk-transplant-registry-study
#7
Adam D Barlow, Kourosh Saeb-Parsy, Christopher J E Watson
BACKGROUND: Transplant options for patients with type 1 diabetes and end-stage renal disease (ESRD) include deceased donor kidney, live donor kidney (LDK) and simultaneous pancreas-kidney (SPK) transplantation. The aim of this study was to compare outcomes between LDK and SPK for patients with type 1 diabetes and ESRD in the UK. METHODS: Data on all SPK (n=1739) and LDK (n=385) transplants performed between January 2001 and December 2014 were obtained from the UK Transplant Registry...
March 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28295646/the-epidemiology-of-clostridium-difficile-infection-in-a-national-kidney-transplant-center
#8
Claire Kennedy, Carmel Waldron, Mairead Skally, Leah Gaughan, Colm Magee, Karen Burns, Fidelma Fitzpatrick
BACKGROUND: We aimed to describe the epidemiology and outcomes of CDI in a national kidney transplant center from 2008 to 2015. METHODS: Adult kidney and kidney-pancreas transplant recipients were included for analysis if they met the surveillance CDI case definition. Rates of new healthcare-associated CDI (HA-CDI) were expressed per 10 000 KTR/KTPR bed days used (BDU) to facilitate comparisons. RESULTS: Fifty-two cases of CDI were identified in 42 KTRs and KPTRs...
March 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28286566/gastrointestinal-manifestations-of-mitochondrial-disorders-a-systematic-review
#9
REVIEW
Josef Finsterer, Marlies Frank
Mitochondrial disorders (MIDs) due to respiratory-chain defects or nonrespiratory chain defects are usually multisystem conditions [mitochondrial multiorgan disorder syndrome (MIMODS)] affecting the central nervous system (CNS), peripheral nervous system, eyes, ears, endocrine organs, heart, kidneys, bone marrow, lungs, arteries, and also the intestinal tract. Frequent gastrointestinal (GI) manifestations of MIDs include poor appetite, gastroesophageal sphincter dysfunction, constipation, dysphagia, vomiting, gastroparesis, GI pseudo-obstruction, diarrhea, or pancreatitis and hepatopathy...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28273393/a-retrospective-study-to-describe-the-epidemiology-and-outcomes-of-opportunistic-infections-after-abdominal-organ-transplantation
#10
Mia Helfrich, Peter Dorschner, Kathryn Thomas, Valentina Stosor, Michael G Ison
BACKGROUND: Most epidemiologic studies of opportunistic infections (OI) following abdominal organ transplant (AOT) are derived prior to the era of contemporary immunosuppression and prophylaxis. These studies suggest that most OI occur within the first 6 months post transplant. METHOD: In this single-center, retrospective cohort study, we describe the epidemiology of OI in 359 consecutive AOT recipients, in the era of contemporary prophylaxis practices and alemtuzumab induction in kidney and simultaneous pancreas-kidney transplant recipients...
March 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28267898/laparoscopic-biopsies-in-pancreas-transplantation
#11
P D Uva, J S Odorico, A Giunippero, I C Cabrera, A Gallo, L R Leon, E Minue, F Toniolo, I Gonzalez, E Chuluyan, D H Casadei
As there is no precise laboratory test or imaging study for detection of pancreas allograft rejection, there is increasing interest in obtaining pancreas tissue for diagnosis. Pancreas allograft biopsies are most commonly performed percutaneously, transcystoscopically, or endoscopically, yet pancreas transplant surgeons often lack the skills to perform these types of biopsies. We have performed 160 laparoscopic pancreas biopsies in 95 patients. There were 146 simultaneous kidney-pancreas biopsies and 14 pancreas-only biopsies due to pancreas alone, kidney loss, or extraperitoneal kidney...
March 7, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28266040/ex-vivo-porcine-organ-perfusion-models-as-a-suitable-platform-for-translational-transplant-research
#12
Rohan Kumar, Wen Yuan Chung, Ashley Robert Dennison, Giuseppe Garcea
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies...
March 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28265591/tubulovillous-adenoma-in-the-bladder-in-a-dual-pancreas-kidney-transplant-patient
#13
Taylor Remondini, Stephan Van Zyl, Tarek A Bismar, Serdar Yilmaz, M Eric Hyndman
Background: A rare report of a tubulovillous adenoma arising in the setting of a dual pancreas-kidney transplant patient. Case Presentation: This adenoma was discovered in a 60-year-old male with a dual pancreas-kidney transplant that presented with urinary retention and gross hematuria. Management of this patient required both transurethral resection of the tumor as well as a laparotomy after recurrence. Follow-up with cystoscopy has shown no further recurrence of the tumor. Conclusion: This case adds to the few cases documented of adenomas arising in bladders augmented with gastrointestinal tract tissue...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/28260427/annual-data-for-kidney-transplant-services-in-kuwait-2015
#14
Yahya M Makkeyah, Turki Al-Otaibi, Narayanan Nampoory, Prasad Nair, Mostafa Al-Mousawi, Mahmoud Samhan, Alaa Gawish, Tarek Said, Medhat A Halim, Osama Gheith
OBJECTIVES: Renal transplant services have been provided by the Hamed Al-Essa Organ Transplant Center in Ibn Sina Hospital since 1979 for Kuwaitis and non-Kuwaiti citizens residing in Kuwait. We aimed to monitor the activity and outcome of annual renal transplants in 2015. MATERIALS AND METHODS: Data on transplant patients were collected from hospital records from January 1, 2015, through December 31, 2015, at Ibn Sina Hospital. RESULTS: Eighty-one patients underwent a renal transplant in Kuwait in 2015; 46 patients (56...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28255902/imaging-spectrum-of-central-nervous-system-complications-of-hematopoietic-stem-cell-and-solid-organ-transplantation
#15
REVIEW
Andrés Server, Nuria Bargalló, Yngvar Fløisand, Jon Sponheim, Francesc Graus, John K Hald
Neurologic complications are common after hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) and affect 30-60% of transplant recipients. The aim of this article is to provide a practical imaging approach based on the timeline and etiology of CNS abnormalities, and neurologic complications related to transplantation of specific organs. The lesions will be classified based upon the interval from HSCT procedure: pre-engraftment period <30 days, early post-engraftment period 30-100 days, late post-engraftment period >100 days, and the interval from SOT procedure: postoperative phase 1-4 weeks, early posttransplant syndromes 1-6 months, late posttransplant syndromes >6 months...
March 2, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28215709/superior-mesenteric-artery-pseudoaneurysm-fistulised-to-the-small-intestine-in-a-pancreas-kidney-transplant-recipient-can-it-be-detected-by-capsule-endoscopy
#16
Hugo I Uchima, Isis K Araujo, Joana Ferrer, Marta Burrell, Alejandro Sotomayor, Ángeles García-Criado, Faust Feu, M J Ricart, Josep Llach, Begoña González-Suárez
No abstract text is available yet for this article.
February 16, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28201960/hypoglycemia-and-glucocorticoid-free-immunosuppression-are-related-with-low-dehydroepiandrosterone-sulfate-level
#17
Martina Zahradnicka, Frantisek Saudek, Kvetoslav Lipar, Jelena Skibova
BACKGROUND: Low dehydroepiandrosterone sulfate (DHEAS) levels and a high cortisol/DHEAS ratio are associated with higher mortality in elderly, dialyzed, and immunocompromised patients. The role of these hormones in patients with hypoglycemia unawareness (hypo) or in pancreas or islet recipients treated by glucocorticoid-free immunosuppressive regimen (IS) has not been studied. OBJECTIVE: The aim of this study was to determine the effects of IS and of recurrent hypoglycemia on DHEAS and adrenocorticotropic hormone (ACTH) levels in patients with type-1 diabetes (T1DM)...
February 13, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28188676/hemoglobin-based-oxygen-carrier-rescues-double-transplant-patient-from-life-threatening-anemia
#18
M F Gomez, O Aljure, G Ciancio, M Lynn
This case describes a 46-year-old male recipient of a kidney-pancreas transplant who is Jehovah's Witness. Early in the postoperative period, he was found to have splenic vein thrombosis requiring heparin infusion. Two days later, he developed severe symptomatic anemia (hemoglobin <6 g/dL). Standard medical therapy for bloodless surgical patients with severe anemia was instituted. Nevertheless, the patient's hemoglobin concentration continued to decline to critical levels (2 g/dL). Because he was Jehovah's Witness, transfusion of allogeneic blood products was not an option, prompting use of a hemoglobin-based oxygen carrier (HBOC)...
February 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28178127/robotic-pancreas-transplantation-in-a-type-1-diabetic-patient-with-morbid-obesity-a-case-report
#19
Chun Chieh Yeh, Mario Spaggiari, Ivo Tzvetanov, José Oberholzer
RATIONALE: Obesity is considered a relative contraindication to pancreas transplantation due to increased risks of wound-related complications. Robotic surgeries have never been applied for pancreas transplantation in obese recipients though robotic kidney transplantation did and already proved its value in reducing wound-related complications in obese recipients. PATIENT CONCERNS & DIAGNOSES: We performed the first robotic pancreas after kidney transplantation for a 34-year-old Hispanic type 1 diabetic male with class III obesity (BMI = 41 kg/m)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#20
REVIEW
Lani Shochet, John Kanellis, Ian Simpson, Joseph Ta, William Mulley
Thrombotic microangiopathy (TMA) is a well-recognised complication following transplantation, often due to an underlying genetic predisposition, medications or rejection. The use of eculizumab in these settings has been previously described, but its role still remains to be clarified. A 45-year-old man, with a history of type 1 diabetes mellitus and subsequent end-stage kidney failure, presented for a simultaneous pancreas-kidney transplant. Immunologically, he was well matched with the donor, and he received standard induction immunosuppression including tacrolimus...
February 2017: Nephrology
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