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https://www.readbyqxmd.com/read/29723531/transplant-outcomes-for-congenital-heart-disease-patients-bridged-with-a-ventricular-assist-device
#1
Roosevelt Bryant, Raheel Rizwan, Chet R Villa, Farhan Zafar, Dennis Wells, Clifford Chin, Angela Lorts, David L Morales
BACKGROUND: Ventricular assist device (VAD) use as a bridge-to-transplant (BTT) for children with end-stage heart failure and congenital heart disease (CHD), although challenging, has increased but its impact on post-transplant outcome is unknown. This study describes post-transplant outcomes of CHD patients BTT with a VAD. METHODS: All heart transplants identified in UNOS database from 2006-2015 (N=21,865) were divided into four groups based on the diagnosis of CHD and VAD support at transplant: +CHD/+VAD, +CHD/-VAD, +VAD/-CHD and -VAD/-CHD...
April 30, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#2
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29643259/cerebrovascular-accidents-during-mechanical-circulatory-support-new-predictors-of-ischemic-and-hemorrhagic-strokes-and-outcome
#3
Saef Izzy, Daniel B Rubin, Firas S Ahmed, Feras Akbik, Simone Renault, Katelyn W Sylvester, Henrikas Vaitkevicius, Jennifer A Smallwood, Michael M Givertz, Steven K Feske
BACKGROUND AND PURPOSE: Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality...
May 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29505397/challenges-of-dealing-with-financial-concerns-during-life-threatening-illness-perspectives-of-health-care-practitioners
#4
Sally A Hageman, Anita J Tarzian, John Cagle
The costs of serious medical illness and end of life care are often a heavy burden for patients and families (Collins, Stepanczuk, Williams, & Rich, 2016 ; Kim, 2007 ; May et al., 2014 ; Zarit, 2004 ). Twenty-six practitioners, including social workers, managers/administrators, supervisors, and case managers from five health care settings, participated in qualitative semistructured interviews about financial challenges patients encountered. Seven practitioners took part in a focus group. Practitioners were recruited from hospice (n = 5), long-term care (n = 5), intensive care (n = 5), dialysis (n = 6), and oncology (n = 5)...
January 2018: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/29501401/one-year-outcomes-of-101-begraft-stent-grafts-used-as-bridging-stents-in-fenestrated-endovascular-repairs
#5
Rafaelle Spear, Jonathan Sobocinski, Adrien Hertault, Matthieu Delloye, Richard Azzauiu, Dominique Fabre, Stéphan Haulon
OBJECTIVES: To evaluate the outcomes of the second generation BeGraft balloon expandable covered stent Graft System (Bentley InnoMed, Hechingen, Germany) implanted as bridging stent grafts during fenestrated endovascular aortic repair (FEVAR) of complex aneurysms. DESIGN: This was a single centre prospective study including all consecutive patients treated by FEVAR performed with second generation BeGraft stent grafts as bridging stents. METHODS: Demographics of patients, diameter and length of the bridging stent grafts, technical success, re-interventions, occlusions, post-operative events, and imaging (Cone Beam CT and/or CT scan, and contrast enhanced ultrasound) were prospectively collected in an electronic database...
April 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29462206/cell-free-synthesis-of-functional-antibody-fragments-to-provide-a-structural-basis-for-antibody-antigen-interaction
#6
Takayoshi Matsuda, Takuhiro Ito, Chie Takemoto, Kazushige Katsura, Mariko Ikeda, Motoaki Wakiyama, Mutsuko Kukimoto-Niino, Shigeyuki Yokoyama, Yoshikazu Kurosawa, Mikako Shirouzu
Growing numbers of therapeutic antibodies offer excellent treatment strategies for many diseases. Elucidation of the interaction between a potential therapeutic antibody and its target protein by structural analysis reveals the mechanism of action and offers useful information for developing rational antibody designs for improved affinity. Here, we developed a rapid, high-yield cell-free system using dialysis mode to synthesize antibody fragments for the structural analysis of antibody-antigen complexes. Optimal synthesis conditions of fragments (Fv and Fab) of the anti-EGFR antibody 059-152 were rapidly determined in a day by using a 30-μl-scale unit...
2018: PloS One
https://www.readbyqxmd.com/read/29421806/taking-warfarin-with-heparin-replacement-and-direct-oral-anticoagulant-is-a-risk-factor-for-bleeding-after-endoscopic-submucosal-dissection-for-early-gastric-cancer
#7
Yoji Sanomura, Shiro Oka, Shinji Tanaka, Naoki Yorita, Kazutaka Kuroki, Mio Kurihara, Takeshi Mizumoto, Yoshikazu Yoshifuku, Kazuaki Chayama
BACKGROUND: Although bleeding after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) remains problematic, especially in patients taking anticoagulants, there are differing views on the ideal and optimal management for these patients. This study investigated the risk of bleeding after ESD in patients taking anticoagulants. METHODS: We enrolled 61 consecutive patients taking anticoagulants (anticoagulant group) and 968 patients taking no antithrombotic agents (non-antithrombotic group) treated with ESD for EGC between December 2010 and October 2016...
2018: Digestion
https://www.readbyqxmd.com/read/29419536/extracorporeal-membrane-oxygenation-in-a-patient-with-biliary-atresia-case-and-review-of-extracorporeal-life-support-organization-data
#8
Inna N Lobeck, Alexander Bondoc, Heather Nolan, Jason S Frischer, Kathleen M Campbell, Thomas D Ryan, Stuart L Goldstein, Jaimie D Nathan, Maria H Alonso, Greg M Tiao
Biliary atresia is a newborn cholangiopathy that may lead to portopulmonary hypertension and cirrhosis-induced cardiomyopathy while awaiting liver transplantation. Extracorporeal life support and hepatic toxin filtration are life-saving interventions that provide cardiopulmonary support and hepatic dialysis to allow resolution of a child's illness. We utilized a combination of these extreme measures to bridge an infant with biliary atresia to transplantation. We reviewed cases of extracorporeal life support utilization in transplantation recipients in the Extracorporeal Life Support Organization database and determined that ours was the only use of pretransplant extracorporeal life support in biliary atresia...
February 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29390238/-infrequent-and-incremental-dialysis-differences-and-definitions
#9
EDITORIAL
Piergiorgio Bolasco, Stefano Murtas
The purpose of this review is to give dignity at the Incremental Dialysis, which cannot be confused with the term and the therapeutic choice defined as Infrequent Dialysis. The Infrequent Dialysis is defined by each and every hemodialytic therapeutic choice like rhythms below thrice-weekly-hemodialytic treatments. Nonetheless, Infrequent Dialysis is a choice of replacement hemodialysis therapy with pays more special clinical attentions and nutritional monitoring and should also be accompanied by a slightly hypoproteic controlled nutrition...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29311195/peritoneal-dialysis-is-feasible-as-a-bridge-to-combined-liver-kidney-transplant
#10
Ruth Ellen Jones, Yun Liang, Malcolm MacConmara, Christine Hwang, Ramesh Saxena
Patients with combined liver and kidney failure may remain on dialysis for years while awaiting simultaneous liver-kidney transplantation (SLKT). The role of peritoneal dialysis (PD) in patients with advanced liver and kidney failure awaiting SLKT remains to be defined. We present our single-institution experience with PD in cirrhotics, 3 of whom went on to receive successful SLKT. Patients initiated in our PD program between 2006 and 2016 who had both liver and kidney failure were identified. Medical and dialysis records were reviewed retrospectively...
January 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#11
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
February 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29201024/involvement-of-the-transcriptional-coactivator-thmbf1-in-the-biocontrol-activity-of-trichoderma-harzianum
#12
M Belén Rubio, Alonso J Pardal, Rosa E Cardoza, Santiago Gutiérrez, Enrique Monte, Rosa Hermosa
Trichoderma harzianum is a filamentous fungus well adapted to different ecological niches. Owing to its ability to antagonize a wide range of plant pathogens, it is used as a biological control agent in agriculture. Selected strains of T. harzianum are also able to increase the tolerance of plants to biotic and abiotic stresses. However, little is known about the regulatory elements of the T. harzianum transcriptional machinery and their role in the biocontrol by this species. We had previously reported the involvement of the transcription factor THCTF1 in the T...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#13
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29029567/more-than-20-years-experience-of-left-ventricular-assist-device-implantation-at-a-non-transplant-centre
#14
COMPARATIVE STUDY
Erica Holmberg, Henrik Ahn, Bengt Peterzén
OBJECTIVES: Over recent decades implantable left ventricular assist devices (LVAD) have increased the possibility of improved survival in patients with advanced heart failure who also benefit from a better quality of life. The aim of this retrospective survey was to review the clinical results of LVAD implantation at a low-volume non-transplant centre (Linköping, Sweden) between 1993 and 2016. Our aim was also to assess the mortality and morbidity rates associated with implantation of three LVAD versions at our centre, and to compare our results with those from transplant centres...
December 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28930049/experience-with-the-syncardia-total-artificial-heart-in-a-canadian-centre
#15
Anthony Nguyen, Michel Pellerin, Louis P Perrault, Michel White, Anique Ducharme, Normand Racine, Michel Carrier
BACKGROUND: The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. METHODS: We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. RESULTS: From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%)...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28885379/risk-stratification-of-patients-with-current-generation-continuous-flow-left-ventricular-assist-devices-being-bridged-to-heart-transplantation
#16
Ashrith Guha, Duc Nguyen, Ana S Cruz-Solbes, Javier Amione-Guerra, Robert C Schutt, Arvind Bhimaraj, Barry H Trachtenberg, Myung H Park, Edward A Graviss, Osama Gaber, Erik Suarez, Eva Montane, Guillermo Torre-Amione, Jerry D Estep
Patients bridged to transplant (BTT) with continuous-flow left ventricular assist devices (CF-LVADs) have increased in the past decade. Decision support tools for these patients are limited. We developed a risk score to estimate prognosis and guide decision-making. We included heart transplant recipients bridged with CF-LVADs from the United Network for Organ Sharing (UNOS) database and divided them into development (2,522 patients) and validation cohorts (1,681 patients). Univariate and multivariate Cox proportional hazards models were performed...
March 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28792165/acute-stylet-peritoneal-dialysis-in-acute-kidney-injury-the-soul-never-dies
#17
Amith Vijay Leon D'Souza, Nishad Raveendran, Rajendra Singh Tanwar, Piyush Kimmatkar, Pankaj Beniwal, Dhananjai Agarwal, Vinay Vinay
BACKGROUND: Acute Kidney Injury (AKI) has a significant mortality rate. In developing countries, mortality due to AKI is high due to lack of access to dialysis facilities and related cost. The main goal of International Society of Nephrology (ISN) 0 by 25 initiative is to eliminate deaths due to AKI. Peritoneal dialysis is an underutilized modality in such a scenario. The aim of this study was to look into effectiveness of starting Acute stylet Peritoneal Dialysis (PD) in a resource constraint settings...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#18
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28651783/optimal-timing-of-heart-transplant-after-heartmate-ii-left-ventricular-assist-device-implantation
#19
COMPARATIVE STUDY
Robert J Steffen, Eugene H Blackstone, Nicholas G Smedira, Edward G Soltesz, Katherine J Hoercher, Lucy Thuita, Randall C Starling, Maria Mountis, Nader Moazami
BACKGROUND: Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. METHODS: A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28589209/bioengineering-in-renal-transplantation-technological-advances-and-novel-options
#20
REVIEW
Wee-Song Yeo, Yao-Chun Zhang
End-stage kidney disease (ESKD) is one of the most prevalent diseases in the world with significant morbidity and mortality. Current modes of renal replacement therapy include dialysis and renal transplantation. Although dialysis is an acceptable mode of renal replacement therapy, it does have its shortcomings, which include poorer life expectancy compared with renal transplantation, risk of infections and vascular thrombosis, lack of vascular access and absence of biosynthetic functions of the kidney. Renal transplantation, in contrast, is the preferred option of renal replacement therapy, with improved morbidity and mortality rates and quality of life, compared with dialysis...
June 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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