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https://www.readbyqxmd.com/read/28544604/thymic-peripheral-crosstalk-in-lymphodepletion-therapy
#1
EDITORIAL
M E Snyder, D L Farber
T cell depletion is widely used as induction therapy in solid organ transplants and particularly in kidney transplantation, to reduce the episodes of acute cellular rejection. The resultant reduction in T cell numbers is usually temporary, as T cells are actively replenished due to thymic output and/or lymphopenia-induced proliferation of remaining, depletion-resistant T cells. However, the extent of T cell replenishment and the persistence of lymphopenia varies between individuals, with potential impacts on protective or pathogenic immune responses...
May 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28544474/breast-cancer-and-transplantation
#2
Germaine Wong, Eric Au, Sunil V Badve, Wai H Lim
Breast cancer is an important cancer among solid organ transplant recipients. While the incidence of breast cancer in solid organ transplant recipients is comparable to the age matched general population, the outcomes are generally poor. Interventions such as cancer screening which preclude the development of late stage disease through early detection are not well-studied, and clinical practice guidelines for cancer screening rely solely on recommendations from the general population. Among those with a prior breast cancer history, disease recurrence after transplantation is a rare but fearful event...
May 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28542111/clostridium-difficile-infection-in-solid-organ-transplant-recipients
#3
Deepa Nanayakkara, Neha Nanda
PURPOSE OF REVIEW: Clostridium difficile infection (CDI) is a major healthcare-associated infection that causes significant morbidity and an economic impact in the United States. In this review, we provide an overview of Clostridium difficile infection in solid organ transplant recipients with an emphasis on recent literature. RECENT FINDINGS: C. difficile in solid organ transplant population has unique risk factors. Fecal microbiota transplantation has shown favorable results in treatment of recurrent C...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28542109/application-and-interpretation-of-histocompatibility-data-in-pediatric-kidney-transplantation
#4
Hilda E Fernandez
PURPOSE OF REVIEW: Advances in technology to assess immunologic risk in solid organ transplant offer an opportunity to optimize the approach to pediatric deceased donor kidney transplant in the setting of a new allocation system in the United States. RECENT FINDINGS: Degree of human leukocyte antigen (HLA) mismatch, class II HLA mismatch, unacceptable antigens and donor-specific antibody (DSA) detected by solid-phase assays, and epitope matching pretransplant affect pediatric kidney transplant outcomes...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28542105/national-trends-and-in-hospital-outcomes-of-patients-with-solid-organ-transplant-undergoing-spinal-fusion
#5
Hiroyuki Yoshihara, Daisuke Yoneoka, Carl Paulino, Sanjeev Agarwal, Jose R Reyna, Kazuhiro Hasegawa
STUDY DESIGN: A retrospective analysis of population-based national hospital discharge data collected for the Nationwide Inpatient Sample (NIS) OBJECTIVES.: To examine the demographics and in-hospital outcomes of patients with solid organ transplant (SOT) undergoing spinal fusion on a national level SUMMARY OF BACKGROUND DATA.: Solid organ transplantation has become more common in recent years and some of these patients undergo spinal fusion surgery. However, there is little information regarding the trends and outcomes in such patients...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28542093/feasibility-and-applicability-of-antimicrobial-stewardship-in-immunocompromised-patients
#6
Elizabeth Robilotti, Marisa Holubar, Susan K Seo, Stan Deresinski
PURPOSE OF REVIEW: Antimicrobial stewardship is the primary intervention in the battle against antimicrobial resistance, but clinicians do not always apply many key antimicrobial stewardship principles to patients with significant immune defects due to lack of data and fear of bad outcomes. We review evidence regarding the application of stewardship principles to immunocompromised patients, with a focus on solid organ and hematopoietic stem cell transplant recipients. RECENT FINDINGS: Antimicrobial stewardship programs (ASPs), targeting immunocompromised patient populations such as oncology and transplant, are gaining traction...
May 24, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28542092/approach-to-skin-and-soft-tissue-infections-in-non-hiv-immunocompromised-hosts
#7
Victoria E Burke, Fred A Lopez
PURPOSE OF REVIEW: Skin and soft tissue infections are frequent contributors to morbidity and mortality in the immunocompromised host. This article reviews the changing epidemiology and clinical manifestations of the most common cutaneous pathogens in non-HIV immunocompromised hosts, including patients with solid organ transplants, stem cell transplants, solid tumors, hematologic malignancies, and receiving chronic immunosuppressive therapy for inflammatory disorders. RECENT FINDINGS: Defects in the innate or adaptive immune response can predispose the immunocompromised host to certain cutaneous infections in a predictive fashion...
May 24, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28540499/cell-based-therapies-with-t-regulatory-cells
#8
REVIEW
Mateusz Gliwiński, Dorota Iwaszkiewicz-Grześ, Piotr Trzonkowski
CD4(+)CD25(high)FoxP3(+) T regulatory cells (Tregs) are immunodominant suppressors in the immune system. Tregs use various mechanisms to control immune responses. Preclinical data from animal models have confirmed the huge therapeutic potential of Tregs in many immune-mediated diseases. Hence, these cells are now on the road to translation to cell therapy in the clinic as the first clinical trials are accomplished. To date, clinical research has involved mainly hematopoietic stem cell transplantations, solid organ transplantations, and autoimmunity...
May 24, 2017: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/28539698/solid-organ-transplant-recipients-opinions-of-pre-and-post-transplant-supervised-exercise-programmes-a-brief-report
#9
Emma Schoo, Tanya Gustaw, Colleen Barbalinardo, Nicole Rodrigues, Yalda Zameni, Sunita Mathur, Tania Janaudis-Ferreira
Purpose: Access to pre- and post-transplant supervised exercise programmes in Canada is not consistent across organ types. The opinions of solid organ transplant (SOT) recipients can contribute to the discussion among stakeholders regarding increasing the availability of supervised exercise programmes. The objective of the study was to determine Canadian SOT recipients' opinions of pre- and post-transplant supervised exercise programmes and the factors that influenced their participation. Method: An Internet-based questionnaire was distributed to members of the Canadian Transplant Association...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/28538243/bk-virus-as-a-mediator-of-graft-dysfunction-following-kidney-transplantation
#10
Stephanie G Yi, Richard J Knight, Keri E Lunsford
PURPOSE OF REVIEW: BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients. RECENT FINDINGS: Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy...
May 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28538045/donor-derived-infections-in-solid-organ-transplant-patients-toward-a-holistic-approach
#11
Esther Benamu, Cameron R Wolfe, Jose G Montoya
PURPOSE OF REVIEW: Solid organ demand far exceeds organ supply. Strategies to increase the donor pool include the liberalization of selection criteria without increasing the risk of unexpected donor-derived infection (DDI), a rare complication of transplantation carrying high morbidity and mortality. We review the challenging aspects in the prevention of DDI, focusing on the complexities of data sharing and efficient communication and the role infectious diseases specialists play in the process...
May 19, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28536366/advances-in-the-use-of-regulatory-t-cells-for-the-prevention-and-therapy-of-graft-vs-host-disease
#12
REVIEW
Reshma Ramlal, Gerhard C Hildebrandt
Regulatory T (Tregs) cells play a crucial role in immunoregulation and promotion of immunological tolerance. Adoptive transfer of these cells has therefore been of interest in the field of bone marrow and solid organ transplantation, autoimmune diseases and allergy medicine. In bone marrow transplantation, Tregs play a pivotal role in the prevention of graft-verus-host disease (GvHD). This has generated interest in using adoptive Treg cellular therapy in the prevention and treatment of GvHD. There have been several barriers to the feasibility of Treg cellular therapy in the setting of hematopoietic stem cell transplantation (HSCT) which include low Treg concentration in peripheral blood, requiring expansion of the Treg population; instability of the expanded product with loss of FoxP3 expression; and issues related to the purity of the expanded product...
May 16, 2017: Biomedicines
https://www.readbyqxmd.com/read/28533197/incomplete-antibodies-may-reduce-abo-cross-match-incompatibility-a-pilot-study
#13
Mehmet Özen, Soner Yılmaz, Tülin Özkan, Yeşim Özer, Aliye Aysel Pekel, Asuman Sunguroğlu, Günhan Gürman, Önder Arslan
OBJECTIVE: Any erythrocyte transfusion among humans having type A or B blood groups is impossible due to antibodies causing fatal transfusion complications. A cross-match test is performed to prevent immune transfusion complications before transfusion. Our hypothesis is that the Fragment antibody (Fab) part of antibody (incomplete antibody) may be used to prevent an immune stimulus related to complete antibody. Therefore, we designed a pilot study to evaluate the effectiveness of these incomplete antibodies with using cross-match tests...
May 23, 2017: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/28530643/danger-signals-in-regulating-the-immune-response-to-solid-organ-transplantation
#14
Jamie L Todd, Scott M Palmer
Endogenous danger signals, or damage-associated molecular patterns (DAMPs), are generated in response to cell stress and activate innate immunity to provide a pivotal mechanism by which an organism can respond to damaged self. Accumulating experimental and clinical data have established the importance of DAMPs, which signal through innate pattern recognition receptors (PRRs) or DAMP-specific receptors, in regulating the alloresponse to solid organ transplantation (SOT). Moreover, DAMPs may incite distinct downstream cellular responses that could specifically contribute to the development of allograft fibrosis and chronic graft dysfunction...
May 22, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28529646/peptide-vaccination-in-the-presence-of-adjuvants-in-patients-after-hematopoietic-stem-cell-transplantation-with-cd4-t-cell-reconstitution-elicits-consistent-cd8-t-cell-responses
#15
Michael Schmitt, Anita Schmitt, Markus Wiesneth, Angela Hückelhoven, Zeguang Wu, Jürgen Kuball, Lei Wang, Peter Schauwecker, Susanne Hofmann, Marlies Götz, Birgit Michels, Birgit Maccari, Patrick Wuchter, Volker Eckstein, Thomas Mertens, Paul Schnitzler, Hartmut Döhner, Anthony D Ho, Donald W Bunjes, Peter Dreger, Hubert Schrezenmeier, Jochen Greiner
Rationale: Patients receiving an allogeneic stem cell graft from cytomegalovirus (CMV) seronegative donors are particularly prone to CMV reactivation with a high risk of disease and mortality. Therefore we developed and manufactured a novel vaccine and initiated a clinical phase I trial with a CMV phosphoprotein 65 (CMVpp65)-derived peptide. Methods: Ten patients after allogeneic stem cell transplantation received four vaccinations at a biweekly interval. All patients were monitored for CMVpp65 antigenemia...
2017: Theranostics
https://www.readbyqxmd.com/read/28518214/immune-monitoring-as-prerequisite-for-transplantation-tolerance-trials
#16
REVIEW
Katayoun Behnam Sani, Birgit Sawitzki
Ever since its first application in clinical medicine, scientists have urged to induce tolerance towards foreign allogeneic transplants and thus avoid rejection by the recipient's immune system. This would circumvent chronic use of immunosuppressive drugs (IS) and thus avoid development of IS-induced side effects, which are contributing to the still unsatisfactory long-term graft and patient survival after solid organ transplantation. Although manifold strategies of tolerance induction have been described in preclinical models, only three therapeutic approaches have been successfully utilized in a still small number of patients...
May 18, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28513974/fecal-microbiota-transplantation-outcomes-in-immunocompetent-and-immunocompromised-patients-a-single-center-experience
#17
Sally Alrabaa, Ripal Jariwala, Kristen Zeitler, Jose Montero
BACKGROUND: Clostridium difficile infection (CDI) is a major infectious disease focus for which fecal microbiota transplantation (FMT) has been used with success in various patient populations. METHODS: We conducted a retrospective study of FMT in immunocompetent and immunocompromised patients to review outcomes at our center, with a focus on identifying risk factors for FMT failure in solid organ transplant (SOT) patients. FMT was conducted using universal banked frozen stool via naso-duodenal tube in patients with recurrent CDI of 3 or more episodes per our institutional protocol...
May 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#18
Jillian S Y S Y, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Richard A Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28511545/fosfomycin-tromethamine-for-the-treatment-of-cystitis-in-abdominal-solid-organ-transplant-recipients-with-renal-dysfunction
#19
Luiza Kerstenetzky, Margaret R Jorgenson, Jillian L Descourouez, Glen Leverson, Warren E Rose, Robert R Redfield, Jeannina A Smith
BACKGROUND: Urinary tract infection (UTI) after abdominal solid organ transplantation (SOT) is associated with significant morbidity and mortality. Fosfomycin tromethamine (FOS), a uroselective antibiotic, is FDA approved for uncomplicated UTIs in women and is used off-label for complicated UTIs and prostatitis in men. Literature supporting the use of FOS in the SOT population is limited, and efficacy is questioned in the setting of renal dysfunction. OBJECTIVE: To evaluate the success of FOS for the treatment of cystitis in SOT patients with renal dysfunction...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28509395/da-epoch-r-for-post-transplant-lymphoproliferative-disorders-ptld
#20
Christin B DeStefano, Vera Malkovska, Hind Rafei, Aarthi Shenoy, Kelly Fitzpatrick, Anita Aggarwal, Joseph P Catlett
Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous and potentially fatal group of neoplasms arising in an immunodeficient environment in the background of viral antigenic stimulation. PTLD is rare, with an incidence in solid organ transplant recipients typically less than 20% [1]. For aggressive, monomorphic cases, current guidelines recommend reduced immunosuppression in addition to chemoimmunotherapy, which generally consists of R-CHOP [1]. Nevertheless, prognosis is poor with 5-year overall survival (OS) rates of only 40-60% [1]...
May 16, 2017: European Journal of Haematology
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