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Hand transplantation

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https://www.readbyqxmd.com/read/28210263/a-paradigm-shift-on-the-question-of-b-cells-in-transplantation-recent-insights-on-regulating-the-alloresponse
#1
REVIEW
Daniel J Firl, Gilles Benichou, James I Kim, Heidi Yeh
B lymphocytes contribute to acute and chronic allograft rejection through their production of donor-specific antibodies (DSAs). In addition, B cells present allopeptides bound to self-MHC class II molecules and provide costimulation signals to T cells, which are essential to their activation and differentiation into memory T cells. On the other hand, both in laboratory rodents and patients, the concept of effector T cell regulation by B cells is gaining traction in the field of transplantation. Specifically, clinical trials using anti-CD20 monoclonal antibodies to deplete B cells and reverse DSA had a deleterious effect on rates of acute cellular rejection; a peculiar finding that calls into question a central paradigm in transplantation...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28185062/decoupling-between-the-hand-territory-and-the-default-mode-network-after-bilateral-arm-transplantation-four-year-follow-up-case-study
#2
Carlos R Hernandez-Castillo, Jörn Diedrichsen, Erika Aguilar-Castañeda, Martin Iglesias
Several studies have suggested both a local and network reorganization of the sensorimotor system following amputation. Transplantation of a new limb results in a new shifting of cortical activity in the local territory of the transplanted limb. However, there is a lack of information about the reversibility of the abnormalities at the network level. The objective of this study was to characterize the functional connectivity changes between the cortical territory of the new hand and two intrinsic network of interest: the sensorimotor network (SMN) and the default mode network (DMN) of one patient whom received bilateral forearm transplants...
February 9, 2017: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/28179478/magnetic-resonance-spectroscopy-of-current-hand-amputees-reveals-evidence-for-neuronal-level-changes-in-former-sensorimotor-cortex
#3
Carmen M Cirstea, In-Young Choi, Phil Lee, Huiling Peng, Christina L Kaufman, Scott H Frey
Deafferentation is accompanied by large-scale functional reorganization of maps in the primary sensory and motor areas of the hemisphere contralateral to injury. Animal models of deafferentation suggest a variety of cellular-level structural changes including depression of neuronal metabolism and even neuronal death. Whether similar neuronal changes contribute to patterns of reorganization within the contralateral sensorimotor cortex of chronic human amputees is uncertain. We used a functional MRI-guided proton magnetic resonance spectroscopy (1H-MRS) to test the hypothesis that unilateral deafferentation is associated with lower absolute levels of N-acetylaspartate (NAA, a putative marker of neuronal integrity) in the sensorimotor hand territory located contralateral to the missing hand in chronic amputees (N=19) as compared to the analogous hand territory of age/sex-matched healthy controls (N=28)...
February 8, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28179049/promoting-hand-hygiene-compliance
#4
Thomas von Lengerke, Bettina Lutze, Christian Krauth, Karin Lange, Jona Theodor Stahmeyer, Iris Freya Chaberny
BACKGROUND: The German "Clean Hands Campaign" (an adaptation of the WHO "Clean Care is Safer Care" programme) to promote hand hygiene among hospital personnel at Hannover Medical School (MHH, Medizinische Hochschule Hannover), known as Aktion Saubere Hände (ASH), met with initial success. By 2013, however, compliance rates with hygienic hand disinfection in the hospital's ten intensive care units (ICUs) and two hematopoietic stem cell transplantation units (HSCTUs) had relapsed to their initial levels (physicians: 48%; nurses: 56%)...
January 20, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28178127/robotic-pancreas-transplantation-in-a-type-1-diabetic-patient-with-morbid-obesity-a-case-report
#5
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/28176947/silencing-of-foxp3-enhances-the-antitumor-efficacy-of-gm-csf-genetically-modified-tumor-cell-vaccine-against-b16-melanoma
#6
Antonio Miguel, Luis Sendra, Verónica Noé, Carles J Ciudad, Francisco Dasí, David Hervas, María José Herrero, Salvador F Aliño
The antitumor response after therapeutic vaccination has a limited effect and seems to be related to the presence of T regulatory cells (Treg), which express the immunoregulatory molecules CTLA4 and Foxp3. The blockage of CTLA4 using antibodies has shown an effective antitumor response conducing to the approval of the human anti-CTLA4 antibody ipilimumab by the US Food and Drug Administration. On the other hand, Foxp3 is crucial for Treg development. For this reason, it is an attractive target for cancer treatment...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28164637/clinical-implications-of-plasma-n-acetyl-seryl-aspartyl-lysyl-proline-level-in-stable-kidney-transplant-recipients
#7
Yosuke Suzuki, Fumihiko Katagiri, Fuminori Sato, Kanako Fujioka, Yukie Sato, Takashi Fujioka, Yuhki Sato, Hiromitsu Mimata, Hiroki Itoh
BACKGROUND: N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) is a natural inhibitor of pluripotent hematopoietic stem cell proliferation and is normally found in human plasma. Because AcSDKP is partially eliminated in urine, accumulation of AcSDKP due to chronic renal failure may cause anemia. However, the status of plasma AcSDKP level in stable kidney transplant recipients is unknown although some recipients develop anemia after kidney transplantation. In this study, we investigated the relationship between plasma AcSDKP-like immunoreactive substance (IS) level and clinical characteristics associated with renal anemia in stable kidney transplant recipients...
July 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28159115/william-hunter-harridge-lecture-the-changing-face-of-short-gut-syndrome-management
#8
REVIEW
John J Fung
The evolution of managing short gut syndrome optimizes management and decision making of intestinal failure by way of a multidisciplinary team utilizing the latest advances in therapeutic options. Only the minority of patients referred for small bowel transplantation will actually need a transplant. Many of these patients can be rehabilitated without the need for transplant, by way of early referral, and thus the likelihood of medical therapy increases. On the other hand, in those patients with little likelihood of success with medical therapy, early referral decreases the morbidity and mortality associated with long-term total parenteral nutrition and associated complications and will improve their overall survival outcomes...
January 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28151807/the-impact-of-antibodies-and-virtual-crossmatching-on-intestinal-transplant-outcomes
#9
Elaine Y Cheng, Bernard J DuBray, Douglas G Farmer
PURPOSE OF REVIEW: Sensitization to human leukocyte antigens (HLAs) limits access to potential donors and contributes to inferior graft survival after transplantation. In this article, we will review the effects of HLA-specific antibodies on intestinal transplant outcomes, and discuss considerations in the monitoring and treatment of anti-HLA antibodies. RECENT FINDINGS: Only a handful of studies has investigated the effects of donor-specific anti-HLA antibodies (DSAs) on intestinal allograft outcomes...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28149225/case-report-35-year-follow-up-for-nonvascularized-toe-phalangeal-transfer-for-multiple-digit-symbrachydactyly
#10
Sanjay Naran, Joseph E Imbriglia
Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28149213/using-decision-analysis-to-understand-the-indications-for-unilateral-hand-transplantation
#11
Brett McClelland, Christine B Novak, Steven Hanna, Steven J McCabe
Background: Upper extremity transplantation has been performed to improve quality of life, the benefit which must be traded off for the risk created by life-long immunosuppression. We believe the process of decision analysis is well suited to improve our understanding of these trade-offs. Method: We created a decision tree to include a branch point to illustrate the expected recovery of useful function in the transplant, using the best estimates for utility and probability that exist. Results: Our model revealed that when the probability of achieving a good result, graded as Chen level one or two is greater than 73%, transplantation is preferred over no transplantation...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28147375/fecal-microbiota-transplantation-in-inflammatory-bowel-disease
#12
Walter Reinisch
The etiology of inflammatory bowel disease (IBD) is unknown, but it is thought to arise from an aberrant immune response to a change in colonic environment in a genetically susceptible individual. The intestinal microbiota are located at the complex interface of the epithelial barrier and are sensitive to changes in environmental factors, such as diets, drugs or smoking and signals derived from the intestinal immune system and the gut-brain axis. In patients with IBD, an imbalance in the structural and/or functional configuration of the intestinal microbiota leading to the disruption of the host-microorganism homeostasis (dysbiosis) has been reproducibly reported...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28147371/crohn-s-disease-and-intestinal-transplantation
#13
Pavel Drastich, Martin Oliverius
BACKGROUND: Most patients with Crohn's disease (CD) require one or more operations during their lifetime. Repeated resections and surgical complications may result in short gut in a subset of patients, typically those with extensive small bowel disease or a penetrating CD phenotype. The effects of short bowel syndrome (SBS) can range in seriousness from mild to life-threatening advanced intestinal failure. Worldwide, CD is the second leading indication for intestinal transplantation (ITx) in SBS, but the overall incidence of ITx is quite low...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28119823/pilot-study-of-the-safety-and-effect-of-adalimumab-on-pain-physical-function-and-musculoskeletal-disease-in-mucopolysaccharidosis-types-i-and-ii
#14
Lynda E Polgreen, Alicia Kunin-Batson, Kyle Rudser, Richard K Vehe, Jeanine J Utz, Chester B Whitley, Patricia Dickson
Mucopolysaccharidosis I and II are lysosomal storage disorders that, despite treatment with hematopoietic cell transplantation (HCT) and/or enzyme replacement therapy (ERT), continue to cause significant skeletal abnormalities leading to pain, stiffness, physical dysfunction, and short stature. Tumor necrosis factor - alpha (TNF-α) is elevated in individuals with MPS I and II and associated with pain and physical dysfunction. Therefore, we evaluated the safety and effects of the TNF-α inhibitor adalimumab in patients with MPS I and II in a 32-week, randomized, double blind, placebo-controlled, crossover study of adalimumab at a dose of 20 mg (weight 15-<30 kg) or 40 mg (weight ≥ 30 kg) administered subcutaneously every other week or saline placebo for 16 weeks...
March 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28117792/murine-full-thickness-skin-transplantation
#15
Chih-Hsien Cheng, Chen-Fang Lee, Madeline Fryer, Georg J Furtmüller, Byoungchol Oh, Jonathan D Powell, Gerald Brandacher
Murine full-thickness skin transplantation is a well-established in vivo model to study alloimmune response and graft rejection. Despite its limited application to humans, skin transplantation in mice has been widely employed for transplantation research. The procedure is easy to learn and perform, and it does not require delicate microsurgical techniques nor extensive training. Moreover, graft rejection in this model occurs in a very reproducible immunological reaction and is easily monitored by direct inspection and palpation...
January 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28114582/evaluation-of-the-surgical-device-and-procedure-for-extracellular-matrix-scaffold-supported-human-ipsc-derived-retinal-pigment-epithelium-cell-sheet-transplantation
#16
Hiroyuki Kamao, Michiko Mandai, Wataru Ohashi, Yasuhiko Hirami, Yasuo Kurimoto, Junichi Kiryu, Masayo Takahashi
Purpose: To develop a clinically applicable transplantation device and surgical procedure for extracellular matrix-scaffold-supported human-induced pluripotent stem cell-derived retinal pigment epithelium (hiPSC-RPE) cell sheet transplantation for clinical use. Methods: The developed surgical device consisted of a custom-designed hand piece and a cannula. The subretinal transplantation of hiPSC-RPE cell sheets was performed in 12 rabbits. The results evaluated were the graft condition (damage or fold), side (front or back), position (center, near, far), and direction (anterior, posterior, right, left) immediately after surgery and the graft condition (shrinking or fold) 2 weeks after surgery...
January 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28114144/hepatitis-c-treatment-in-chronic-kidney-disease-patients-the-kidney-disease-improving-global-outcomes-perspective
#17
Michel Jadoul, Paul Martin
BACKGROUND: Hepatitis C virus (HCV) infection is a very common infection found among hemodialysis (HD) and kidney transplant patients. It is associated with substantial morbidity and mortality. Direct-acting antiviral agents (DAAs) have much better efficacy (sustained viral response (SVR)) and tolerance than interferon-based regimens. Very recent studies extend this breakthrough finding to chronic kidney disease (CKD) populations. SUMMARY: CKD patients with an estimated glomerular filtration rate (eGFR) >30 ml/min/1...
January 24, 2017: Blood Purification
https://www.readbyqxmd.com/read/28109687/-ocular-graft-versus-host-disease-an-often-misdiagnosed-etiology-of-dry-eye-syndrome
#18
L Moyal, R Adam, J Akesbi, F T Rodallec, J-P Nordmann
PURPOSE: To report a case of severe ocular graft-versus-host disease (GVHD) after cataract surgery. METHODS: Observational case report. RESULTS: We describe the case of a 59-year-old man with postoperative corneal ulcer on his only functional eye. His past history reported allogenic bone marrow transplant. His visual acuity (VA) was limited to hand motions. Slit lamp examination revealed diffuse conjunctival hyperemia, severe blepharitis, Meibomian dysfunction, total corneal opacification with epithelial and stromal keratitis and neovascular invasion...
January 18, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28107607/epidemiology-update-for-hepatitis-c-virus-and-hepatitis-b-virus-in-end-stage-renal-disease-in-france-r%C3%A3-seau-epid%C3%A3-miologique-et-information-en-n%C3%A3-phrologie-registry
#19
Corinne Isnard Bagnis, Cécile Couchoud, Marc Bowens, Ayman Sarraj, Gilbert Deray, Jérôme Tourret, Patrice Cacoub, Sophie Tezenas du Montcel
BACKGROUND AND AIMS: Risk for HCV/HBV infection is increased in ESRD patients. We generate updated epidemiological data. METHODS: Based on the National French registry for ESRD, we extracted data for patients who started dialysis or preemptive transplantation between January, 2005 and December, 2013. A positive serum HBs Ag and/or a positive HCV RNA defined HBV and HCV infections, respectively. RESULTS: 72,948 patients were included among which 62...
January 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28104126/analysis-of-donor-factors-for-non-heart-beating-donors-with-regard-to-cadaveric-kidney-transplantation-in-the-western-region-of-japan
#20
N Nakamura, M Tanaka, M Tsukamoto, Y Shimano, M Yasuhira, J Ashikari
BACKGROUND: Kidneys from non-heart-beating donors are thought to be marginal, and careful evaluation is required. Mass analyzed data are limited, and each transplant surgeon must evaluate these organs on the basis of their own experience. METHODS: We analyzed the data of 589 kidneys used for kidney transplantation from 304 non-heart-beating donors from January 2002 through December 2013 at the Japan Organ Transplant Network West Japan Division. The age of the donors, cause of death, and total ischemic time of more than 24 hours were factors that influenced the graft survival of the organs...
January 2017: Transplantation Proceedings
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