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Intestinal And Transplantation

Melissa R Laub, Stacy A Crow, Heather Personett, Ross Dierkhising, Barry Boilson, Raymund Razonable
Tacrolimus is a cornerstone of immunosuppression after transplantation but is highly susceptible to changes from interacting variables and has a narrow therapeutic index. Clotrimazole troches are commonly used as a non-systemic antifungal to prevent oral candidiasis. Studies suggest that clotrimazole troches, though minimally absorbed systemically, may affect tacrolimus concentrations by inhibition of metabolic enzyme activity in the intestines. However, the magnitude of the impact of clotrimazole on tacrolimus dosing requirements to maintain goal levels is not well described...
August 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Jens G Brockmann, Amir Butt, Hussa F Al Hussaini, Hadeel AlMana, Khaled AlSaad, Moheeb Al-Awwami, Dieter C Broering, Tariq Ali
BACKGROUND: Histological evaluation of the pancreas graft is usually done on demand resulting in significant delays. This analysis reports on endoscopic protocol duodenal graft biopsies at regular intervals to determine feasibility, safety and monitoring benefits. METHODS: Protocol duodenal graft biopsies in 27 18 consecutive pancreas transplants (10 simultaneous pancreas kidney [SPK], 17 pancreas after kidney [PAK]) with a follow-up of a minimum of 12 months were performed at days 14, 30, 90, 180, 360, 430...
August 15, 2018: Transplantation
Paloma Talayero, Esther Ramos Boluda, Elena Gómez Massa, María José Castro Panete, Gerardo Prieto Bozano, Jorge Calvo Pulido, Estela Paz-Artal, Esther Mancebo
Rejection is one of the most important drawbacks for graft and patient survival in intestinal and multivisceral transplantation. However, there is no consensus on the diagnostic criteria for humoral rejection and the literature about the role of donor specific antibodies (DSA) on the allograft outcome and the risk factors that contribute to their development is scant with contradictory results. The present study analyzes the role of DSA exclusively in a pediatric cohort of 43 transplants. Among our patients, 11...
August 16, 2018: Liver Transplantation
A Bond, M Taylor, A Abraham, A Teubner, M Soop, G Carlson, S Lal
INTRODUCTION: Short bowel syndrome (SBS) is a leading cause of intestinal failure (IF). Home parenteral nutrition (HPN) remains the standard treatment, with small intestinal transplantation reserved for cases with severe complications to HPN. There have recently been significant developments in growth factor therapy. We aimed to develop a greater contemporary understanding of our SBS-IF subset. METHOD: We performed a retrospective observational study of a prospectively maintained HPN audit database in October 2017...
August 15, 2018: European Journal of Clinical Nutrition
Dongchang Zhao, Yeung-Hyen Kim, Seihwan Jeong, Joel K Greenson, Mohammed S Chaudhry, Matthias Hoepting, Erik R Anderson, Marcel Rm van den Brink, Jonathan U Peled, Antonio Lc Gomes, Ann E Slingerland, Michael J Donovan, Andrew C Harris, John E Levine, Umut Özbek, Lora V Hooper, Thaddeus S Stappenbeck, Aaron M Ver Heul, Ta-Chiang Liu, Pavan Reddy, James Lm Ferrara
Graft-versus-host disease (GVHD) in the gastrointestinal (GI) tract remains the major cause of morbidity and non-relapse mortality after bone marrow transplantation (BMT). The Paneth cell protein, regenerating islet-derived 3-alpha (REG3α), is a biomarker specific for GI GVHD. REG3α serum levels rose in the systematic circulation as GVHD progressively destroyed Paneth cells and reduced GI epithelial barrier function. Paradoxically, GVHD suppressed intestinal REG3γ (the mouse homologue of human REG3α), and the absence of REG3γ in BMT recipients intensified GVHD but did not change the composition of the microbiome...
August 14, 2018: Journal of Clinical Investigation
Guo Chao Niu, Lei Liu, Libo Zheng, Hong Zhang, David Q Shih, Xiaolan Zhang
BACKGROUND: A variety of extra-intestinal manifestations (EIMs), including hepatobiliary complications, are associated with inflammatory bowel disease (IBD). Mesenchymal stem cells (MSCs) have been shown to play a potential role in the therapy of IBD. This study was designed to investigate the effect and mechanism of MSCs on chronic colitis-associated hepatobiliary complications using mouse chronic colitis models induced by dextran sulfate sodium (DSS). METHODS: DSS-induced mouse chronic colitis models were established and treated with MSCs...
August 13, 2018: BMC Gastroenterology
Michael Pignanelli, Chrysi Bogiatzi, Gregory Gloor, Emma Allen-Vercoe, Gregor Reid, Bradley L Urquhart, Kelsey N Ruetz, Thomas J Velenosi, J David Spence
OBJECTIVE: Toxic metabolites produced by the intestinal microbiome from animal proteins, carnitine (mainly from red meat), or phosphatidylcholine (mainly from egg yolk), have important adverse effects on cardiovascular disease. These are renally eliminated and may be termed gut-derived uremic toxins (GDUT). We hypothesized that even moderate renal impairment and intake of nutrient precursors would raise plasma levels of GDUT. DESIGN: A cohort study. SETTING: Academic medical center...
August 9, 2018: Journal of Renal Nutrition
Jean-Frederic Colombel, Andrea Shin, Peter R Gibson
DESCRIPTION: The purpose of this clinical practice update review is to describe key principles in the diagnosis and management of functional gastrointestinal (GI) symptoms in patients with inflammatory bowel disease (IBD). METHODS: The evidence and best practices summarized in this manuscript are based on relevant scientific publications, systematic reviews, and expert opinion where applicable. BEST PRACTICE ADVICE 1: A stepwise approach to rule-out ongoing inflammatory activity should be followed in IBD patients with persistent GI symptoms (measurement of fecal calprotectin, endoscopy with biopsy, cross-sectional imaging)...
August 9, 2018: Clinical Gastroenterology and Hepatology
Vannarut Satitpitakul, Zhongmou Sun, Kunal Suri, Afsaneh Amouzegar, Kishore R Katikireddy, Ula V Jurkunas, Ahmad Kheirkhah, Reza Dana
Corneal transplantation is the most prevalent form of tissue transplantation. The success of corneal transplantation mainly relies on the integrity of corneal endothelial cells (CEnCs), which maintain graft transparency. CEnC density decreases significantly after corneal transplantation even in the absence of graft rejection. To date, different strategies have been used to enhance CEnC survival. The neuropeptide vasoactive intestinal peptide (VIP) improves CEnC integrity during donor cornea tissue storage and protects CEnCs against oxidative stress-induced apoptosis...
August 7, 2018: American Journal of Pathology
Mihaela Filip, Valentina Tzaneva, Dan L Dumitrascu
Background and aim: Fecal transplantation or fecal material transplantation (FMT) became a hot topic in gastroenterology in recent years. Therefore it is important to disseminate the up-to-date information on FMT. The aim of the paper is to review the knowledge on FMT and its clinical applications. Methods: An extensive review of the literature was carried out. Titles from Pubmed were searched and analyzed. A narrative review has been written with emphasis on indications of FMT in different conditions...
July 2018: Clujul Medical (1957)
Wida S Cherikh, Linda C Cendales, Christopher L Wholley, Jennifer Wainright, Vijay S Gorantla, David K Klassen, Sue McDiarmid, L Scott Levin
On July 3, 2014, the Organ Procurement and Transplantation Network/United Network for Organ Sharing was charged with the oversight of Vascularized Composite Allograft (VCA) procurement and transplantation in the U.S. As of December 31, 2017, 61 VCA programs at 27 centers were approved in the U.S. Fifty candidates have been added to the waiting list at 15 centers. Twenty-eight VCA transplants have been performed at 14 programs (10 upper limb, 10 uterus, 5 craniofacial, 1 scalp, 1 abdominal wall, and 1 penile)...
August 9, 2018: American Journal of Transplantation
Brandon Chatani, Jennifer Garcia, Chiara Biaggi, Thiago Beduschi, Akin Tekin, Rodrigo Vianna, Kristopher Arheart, Ivan A Gonzalez
BIs are ubiquitous among the pediatric intestinal transplant patient population. Personalizing postoperative prophylaxis antibiotic regimens may improve outcomes in this population. A retrospective analysis of all pediatric patients who underwent intestinal transplantation was evaluated to compare standardized and tailored regimens of antibiotics provided as prophylaxis postoperatively. Patients in the standard group have both shorter time to and higher rate of BIs, which was statistically significant (P < 0...
August 9, 2018: Pediatric Transplantation
Giovanni Frongia, Ali Majlesara, Arash Saffari, Dezfouli Sepher Abbasi, Negin Gharabaghi, Jürgen Günther Okun, Christian Thiel, Patrick Günther, Rodrigo Vianna, Arianeb Mehrabi
BACKGROUND: Small bowel transplantation (SBTX) in children receiving larger grafts from adults can be challenging because of size mismatch. The aim of the present study was to assess whether a simultaneous serial transverse enteroplasty (STEP) can address the problem of size mismatch. METHODS: Three different size ratio groups between donors and recipients were compared in a porcine model with a 14-day follow-up. The groups were size matched, size mismatched (1:3...
August 8, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Linda Chia-Hui Yu, Shu-Chen Wei, Yen-Hsuan Ni
A role of gut microbiota in colorectal cancer (CRC) growth was first suggested in germ-free rats almost 50 years ago, and the existence of disease-associated bacteria (termed pathobionts) had becoming increasingly evident from experimental data of fecal transplantation, and microbial gavage or monoassociation. Altered bacterial compositions in fecal and mucosal specimens were observed in CRC patients compared to healthy subjects. Microbial fluctuations were found at various cancer stages; an increase of bacterial diversity was noted in the adenoma specimens, while a reduction of bacterial richness was documented in CRC samples...
July 2018: Intestinal Research
Antonella Gagliardi, Valentina Totino, Fatima Cacciotti, Valerio Iebba, Bruna Neroni, Giulia Bonfiglio, Maria Trancassini, Claudio Passariello, Fabrizio Pantanella, Serena Schippa
A microbial ecosystem in which bacteria no longer live in a mutualistic association is called dysbiotic. Gut microbiota dysbiosis is a condition related with the pathogenesis of intestinal illnesses (irritable bowel syndrome, celiac disease, and inflammatory bowel disease) and extra-intestinal illnesses (obesity, metabolic disorder, cardiovascular syndrome, allergy, and asthma). Dysbiosis status has been related to various important pathologies, and many therapeutic strategies aimed at restoring the balance of the intestinal ecosystem have been implemented...
August 7, 2018: International Journal of Environmental Research and Public Health
Ujjala Ghoshal, Prabhat Ranjan, Asmita Dey, Uday Chand Ghoshal
Context: Cryptosporidiosis is intestinal opportunistic infection commonly occurring in immunocompromised patients including renal transplant (RT) recipients receiving continuous immunosuppressive therapy. Knowledge about species of Cryptosporidium-infecting RT recipients is necessary to know about mode of its transmission (anthroponotic or zoonotic). Various genes such as small subunit rRNA (SSU rRNA) and Cryptosporidium oocyst wall protein (COWP) genes may help in species identification though their sensitivity and specificity are highly variable...
April 2018: Indian Journal of Medical Microbiology
Leon M T Dicks, Lasse S Mikkelsen, Erik Brandsborg, Harold Marcotte
Clostridium difficile is normally present in low numbers in a healthy adult gastro-intestinal tract (GIT). Drastic changes in the microbial population, e.g., dysbiosis caused by extensive treatment with antibiotics, stimulates the growth of resistant strains and the onset of C. difficile infection (CDI). Symptoms of infection varies from mild diarrhea to colitis (associated with dehydration and bleeding), pseudomembranous colitis with yellow ulcerations in the mucosa of the colon, to fulminant colitis (perforation of the gut membrane), and multiple organ failure...
August 6, 2018: Current Microbiology
Nicolas Gürtler, Patricia Hirt-Minkowski, Simon S Brunner, Katrin König, Katharina Glatz, David Reichenstein, Stefano Bassetti, Michael Osthoff
BACKGROUND Hemorrhagic duodenitis is an exceptionally rare adverse event of sodium polystyrene sulfonate (SPS) treatment and is a common manifestation of cytomegalovirus (CMV) reactivation. SPS is known to cause marked inflammation in the lower gastrointestinal tract, including colonic necrosis, whereas involvement of the small bowel is uncommon. Although its effectiveness and safety has been disputed since its introduction, SPS remains widely used due to lack of alternatives. CMV infection and reactivation are well-known complications after solid-organ transplantation, particularly in seronegative recipients receiving organs from seropositive donors, and is associated with significant morbidity and mortality...
August 3, 2018: American Journal of Case Reports
Alexander R Cortez, Holly M Poling, Nicole E Brown, Akaljot Singh, Maxime M Mahe, Michael A Helmrath
BACKGROUND: We previously described the development of human intestinal organoids from pluripotent stem cells, as well as their in vivo maturation when transplanted into the mouse kidney capsule. While sufficient for certain aspects of study, this model has limitations. Herein, we describe an alternative model of human intestinal organoids transplantation into the mouse mesentery. We hypothesize that efficient engraftment and marked differentiation of human intestinal organoids will be similar to our kidney model yet in a more anatomically appropriate location allowing for improved in vivo modeling...
July 30, 2018: Surgery
De-Bin Guo, Xiang-Qing Zhu, Qing-Qing Li, Gao-Mi-Yang Liu, Guang-Ping Ruan, Rong-Qing Pang, Yu-Hao Chen, Qiang Wang, Jin-Xiang Wang, Ju-Fen Liu, Qiang Chen, Xing-Hua Pan
Umbilical cord mesenchymal stem cells (UC-MSCs) exert strong immunomodulatory effects and can repair organs. However, their roles in radiation injury remain unclear. We show that in tree shrews with acute radiation injury, injected UC-MSCs significantly improved survival rates, reduced lung inflammation and apoptosis, prevented pulmonary fibrotic processes, recovered hematopoiesis, and increased blood counts. A protein microarray analysis showed that serum levels of the anti-inflammatory cytokines IL-10 and IL-13 and the growth factors BMP-5, BMP-7, HGF, insulin, NT-4, VEGFR3, and SCF were significantly higher, while those of the inflammatory cytokines IL-2, TIMP-2, TNF-α, IFN-γ, IL-1ra, and IL-8 and the fibrosis-related factors PDGF-BB, PDGF-AA, TGF-β1, IGFBP-2, and IGFBP-4 were significantly lower in UC-MSC-injected animals...
July 31, 2018: Cytotechnology
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