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Solid organ transplantation

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https://www.readbyqxmd.com/read/28231023/increasing-nocardia-incidence-associated-with-bronchiectasis-at-a-tertiary-care-center
#1
Michael H Woodworth, Jennifer L Saullo, Paul M Lantos, Gary M Cox, Jason E Stout
RATIONALE: Nocardia is a genus of pathogens that most commonly afflicts immunocompromised hosts, but may be an emerging infection among persons with bronchiectasis. OBJECTIVES: To examine the epidemiology and clinical presentation of adult patients with Nocardia and bronchiectasis relative to other patient groups. METHODS: We examined a retrospectively-assembled cohort of adults at Duke University Hospital in Durham, North Carolina with at least one positive culture from a bodily fluid or tissue specimen for Nocardia between January 1996 and December 2013...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230640/disparities-in-waitlist-and-posttransplantation-outcomes-in-liver-transplant-registrants-and-recipients-18-24-years-old-analysis-of-the-unos-database
#2
Noelle H Ebel, Evelyn K Hsu, Kristin Berry, Simon P Horslen, George N Ioannou
BACKGROUND: We evaluated liver transplantation waitlist and posttransplantation outcomes in 18-24 year olds compared to both younger (0-17 year old) and older (25-34 year old) registrants and recipients. METHODS: Utilizing national data from the United Network for Organ Sharing, competing risk, Cox regression and Kaplan-Meier analyses were performed on first-time liver transplant registrants (n=13,979) and recipients (n=8,718) ages 0-34 years old between 2002 to 2015...
February 22, 2017: Transplantation
https://www.readbyqxmd.com/read/28229376/the-pharmacogenetics-of-tacrolimus-in-corticosteroid-sparse-pediatric-and-adult-kidney-transplant-recipients
#3
Mads Juul Madsen, Troels K Bergmann, Kim Brøsen, Helle Charlotte Thiesson
INTRODUCTION: Tacrolimus is a calcineurin inhibitor used as an immunosuppressant drug in solid organ transplantation, and is mainly metabolized by cytochrome P450 (CYP) 3A4 and CYP3A5. Studies have shown an association between the CYP3A5 genotype and tacrolimus dose-adjusted trough concentrations. Variants in the genes PPARA, POR and CYP3A4 have recently been shown to influence tacrolimus metabolism. Furthermore, pharmacokinetic interaction between corticosteroid treatment and tacrolimus has been shown...
February 22, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28228429/two-faces-of-gamma-delta-mycosis-fungoides-before-and-after-renal-transplantation
#4
Knut Erich Prillinger, Franz Trautinger, Melitta Kitzwögerer, Johanna Eder
We describe a patient with a 30-year history of mycosis fungoides (MF) and renal transplantation performed 3 years before he presented with an ulcerated tumour in the lumbosacral area. Biopsy revealed a lymphatic infiltrate of medium-sized, pleomorphic T cells expressing the gamma-delta T-cell receptor. Radiological staging and bone marrow biopsy revealed no extracutaneous involvement. Despite reduction in systemic immunosuppressants, total skin electron beam radiotherapy and systemic chemotherapy, the disease followed a highly aggressive course and the patient died 31 years after initial diagnosis of MF...
February 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28227254/a-data-science-approach-for-quantifying-spatio-temporal-effects-to-graft-failures-in-organ-transplantation
#5
Diego Pinheiro, Farag Hamad, Martin Cadeiras, Ronaldo Menezes, Nezamoddin Nezamoddini-Kachouie, Diego Pinheiro, Farag Hamad, Martin Cadeiras, Ronaldo Menezes, Nezamoddin Nezamoddini-Kachouie, Farag Hamad, Martin Cadeiras, Diego Pinheiro, Ronaldo Menezes, Nezamoddin Nezamoddini-Kachouie
The transplantation of solid organs is one of the most important accomplishments of modern medicine. Yet, organ shortage is a major public health issue; 8,000 people died while waiting for an organ in 2014. Meanwhile, the allocation system currently implemented can lead to organs being discarded and the medical community still investigates factors that affects early graft failure such as distance and ischemic time. In this paper, we investigate early graft failure under a spatio-temporal perspective using a data science unified approach for all six organs that is based on complementary cumulative analysis of both distance and ischemic time...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223256/role-of-the-leukocyte-response-in-normal-and-immunocompromised-host-after-clostridium-difficile-infection
#6
Edwin Vargas, Senu Apewokin, Rajat Madan
Clostridium difficile is the leading cause of healthcare-associated infections in the United States. Clinically, C. difficile-associated disease can present as asymptomatic colonization, self-limited diarrheal illness or severe colitis (that may result in death). This variability in disease course and outcomes suggests that host factors play an important role as key determinants of disease severity. Currently, there are several scoring indices to estimate severity of C. difficile-associated disease. Leukocytosis and renal failure are considered to be the most important predictors of C...
February 18, 2017: Anaerobe
https://www.readbyqxmd.com/read/28221102/rhodococcus-infection-in-solid-organ-and-hematopoietic-stem-cell-transplant-recipients-1
#7
Pascalis Vergidis, Ella J Ariza-Heredia, Anoma Nellore, Camille N Kotton, Daniel R Kaul, Michele I Morris, Theodoros Kelesidis, Harshal Shah, Seo Young Park, M Hong Nguyen, Raymund R Razonable
We conducted a case-control study of 18 US transplant recipients with Rhodococcus infection and 36 matched controls. The predominant types of infection were pneumonia and bacteremia. Diabetes mellitus and recent opportunistic infection were independently associated with disease. Outcomes were generally favorable except for 1 relapse and 1 death.
March 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28220931/the-role-of-extracorporeal-photopheresis-in-the-management-of-cutaneous-t-cell-lymphoma-graft-versus-host-disease-and-organ-transplant-rejection-a-consensus-statement-update-from-the-uk-photopheresis-society
#8
Arun Alfred, Peter C Taylor, Fiona Dignan, Khaled El-Ghariani, James Griffin, Andrew R Gennery, Denise Bonney, Emma Das-Gupta, Sarah Lawson, Ram K Malladi, Kenneth W Douglas, Tracey Maher, Julie Guest, Laura Hartlett, Andrew J Fisher, Fiona Child, Julia J Scarisbrick
Extracorporeal photopheresis (ECP) has been used for over 35 years in the treatment of erythrodermic cutaneous T-cell lymphoma (CTCL) and over 20 years for chronic and acute graft-versus-host disease (GvHD) and solid organ transplant rejection. ECP for CTCL and GvHD is available at specialised centres across the UK. The lack of prospective randomised trials in ECP led to the development of UK Consensus Statements for patient selection, treatment schedules, monitoring protocols and patient assessment criteria for ECP...
February 21, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28219691/hepatitis-b-reactivation-associated-with-immune-suppressive-and-biological-modifier-therapies-current-concepts-management-strategies-and-future-directions
#9
REVIEW
Rohit Loomba, T Jake Liang
Hepatitis B reactivation associated with immune suppressive and biological therapies is emerging to be an important cause of morbidity and mortality in patients with current or prior exposure to hepatitis B virus infection. The population at risk for HBV reactivation includes those who are either currently infected with HBV or have past exposure to HBV. Since curative and eradicative therapy for HBV is not currently available, there is a large reservoir of individuals at risk for HBV reactivation in the general population...
February 17, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28219585/urinary-type-iii-procollagen-is-associated-with-chronic-allograft-dysfunction-and-predicts-graft-survival
#10
R Yılmaz, T Yıldırım, D E Baydar, B Altun, Y Erdem
BACKGROUND: Chronic allograft dysfunction (CAD) is the most important clinical problem in solid organ transplantation. Interstitial fibrosis and tubular atrophy contribute to long-term renal allograft failure. Urinary type III procollagen N-terminal propeptide (PIIINP), has been shown to associate fibrotic processes. METHODS: One hundred sixty patients with CAD who underwent allograft biopsies were evaluated, and 52 patients with chronic or sclerosing allograft nephropathy were enrolled in the study...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219273/noteworthy-literature-published-in-2016-for-thoracic-organ-transplantation-anesthesiologists
#11
Kathirvel Subramaniam, Soheyla Nazarnia
This article is first in the series to review the published literature on perioperative issues in patients undergoing thoracic solid organ transplantations. We present recent literature from 2016 on preoperative considerations, organ preservation, intraoperative anesthesia management, surgical techniques, postoperative complications, and the impact of perioperative management on short- and long-term outcomes that are pertinent to thoracic transplantation anesthesiologists.
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28215790/counterpoint-should-united-states-centers-transplant-solid-organs-into-international-recipients-no
#12
EDITORIAL
Vivek N Ahya
No abstract text is available yet for this article.
February 13, 2017: Chest
https://www.readbyqxmd.com/read/28215786/point-should-united-states-centers-transplant-solid-organs-into-international-recipients-yes
#13
EDITORIAL
Marie Budev
No abstract text is available yet for this article.
February 13, 2017: Chest
https://www.readbyqxmd.com/read/28214296/abnormally-high-and-heterogeneous-bone-matrix-mineralization-after-childhood-solid-organ-transplantation-a-complex-pathology-of-low-bone-turnover-and-local-defects-in-mineralization
#14
Nadja Fratzl-Zelman, Helena Valta, Renata C Pereira, Barbara M Misof, Paul Roschger, Hannu Jalanko, Kathrine Wesseling-Perry, Klaus Klaushofer, Outi Mäkitie
Chronic renal, liver and heart failure in children associates with multiple skeletal complications. Increased fracture incidence often persists after transplantation and could be related to alterations in bone material properties. In the present cohort study we evaluated bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in 23 pediatric solid organ allograft recipients with suspected osteoporosis. We measured BMDD in the entire cross-sectional area of transiliac bone biopsies obtained from kidney (n = 9), liver (n = 9) and heart (n = 5) transplant recipients (aged 7...
February 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28213954/human-herpes-virus-6-infection-in-pediatric-organ-transplant-patients
#15
Elisa Ylinen, Silja Lehtinen, Timo Jahnukainen, Teemu Karlsson, Raisa Loginov, Laura Mannonen, Irmeli Lautenschlager, Hannu Jalanko
Transplant patients need lifelong immunosuppressive medication, but this reduces their defense mechanisms, making them prone to viral infections and reactivations. We aimed to clarify the prevalence and clinical manifestations of the human herpes virus 6 (HHV-6) infection in children after pediatric solid organ transplants. Clinical findings and viral loads were compared between primary HHV-6 infections and reactivations. The study comprised 47 kidney, 25 liver, and 12 heart transplant patients who underwent surgery from 2009 to 2014...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28212150/desensitization-strategies-in-the-patient-awaiting-heart-transplantation
#16
David H Chang, Jon A Kobashigawa
PURPOSE OF REVIEW: The aim of this review is to discuss the impact of antibody sensitization on heart transplant recipients. RECENT FINDINGS: We will discuss the current state of antibody identification, antibody strength and potential antibody pathogenicity. The prevalence of antibody sensitization has increased with increased utilization of mechanical circulatory support (MCS). Data on MCS-related antibody sensitization are reviewed. Important considerations to minimize the prozone effect in antibody testing will be discussed...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28211090/development-of-proteinuria-and-focal-segmental-glomerulosclerosis-during-direct-acting-antiviral-therapy-for-hepatitis-c-virus-infection-hep-16-2474-r1
#17
Jonathan J Hogan, Mary Ann Lim, Matthew B Palmer, Roy D Bloom, Raymond T Chung, Meghan E Sise
Focal segmental glomerulosclerosis (FSGS) presents as proteinuric kidney disease and is associated with poor long-term renal outcomes. Here we describe three patients with solid organ transplants and normal baseline kidney function who developed FSGS during direct acting antiviral therapy for hepatitis C virus infection. This article is protected by copyright. All rights reserved.
February 17, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28207190/diaporthe-soft-tissue-infection-in-a-heart-transplant-patient
#18
Robert M Rakita, Kevin D O'Brien, Lori Bourassa
Infections caused by Diaporthe species are very uncommon. We describe a heart transplant recipient 14 years post transplant who developed a soft tissue fungal infection due to a Diaporthe species that responded well to surgical excision and posaconazole therapy. The Aspergillus galactomannan index was markedly elevated, and returned to normal following treatment. Solid organ transplant patients remain at risk of infection long after transplant and should be counseled about risk avoidance. This article is protected by copyright...
February 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28202188/rate-of-regional-nodal-metastases-of-cutaneous-squamous-cell-carcinoma-in-the-immunosuppressed-patient
#19
Eamon J McLaughlin, Lauren Miller, Thuzar M Shin, Joseph F Sobanko, Steven B Cannady, Christopher J Miller, Jason G Newman
PURPOSE: Immunosuppressed solid organ transplant recipients (SOTRs) have an increased risk of developing cutaneous squamous cell carcinomas (cSCCs) with metastatic potential. This study sought to determine the rate of regional lymph node involvement in a large cohort of solid organ transplant patients with cutaneous head and neck squamous cell carcinoma. MATERIALS AND METHODS: A retrospective chart review was performed on solid organ transplant patients with head and neck cutaneous squamous cell carcinoma treated at a tertiary academic medical center from 2005 to 2015...
February 4, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28199780/cytomegalovirus-responsive-cd8-t-cells-expand-after-solid-organ-transplantation-in-the-absence-of-cmv-disease
#20
Lauren E Higdon, Jennifer Trofe-Clark, Sai Liu, Kenneth B Margulies, Malaya K Sahoo, Emily Blumberg, Benjamin A Pinsky, Jonathan S Maltzman
Cytomegalovirus (CMV) is a major cause of morbidity and mortality in solid-organ transplant recipients. Approximately 60% of adults are CMV seropositive indicating previous exposure. Following resolution of primary infection, CMV remains in a latent state. Reactivation is controlled by memory T cells in healthy individuals; transplant recipients have reduced memory T cell function due to chronic immunosuppressive therapies. In this study, CD8(+) T cell responses to CMV polypeptides IE-1 and pp65 were analyzed in sixteen CMV seropositive renal and cardiac transplant recipients longitudinally pre- and post-transplant...
February 15, 2017: American Journal of Transplantation
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