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Intestinal And Transplantation

Shenhai Gong, Zhengzheng Yan, Zhanguo Liu, Mengwei Niu, Heng Fang, Na Li, Chenyang Huang, Lei Li, Guiming Chen, Haihua Luo, Xiaojiao Chen, Hongwei Zhou, Jingjuan Hu, Wei Yang, Qiaobing Huang, Bernd Schnabl, Ping Chang, Timothy R Billiar, Yong Jiang, Peng Chen
Sepsis-induced liver injury is recognized as a key problem in intensive care units (ICUs). The gut microbiota has been touted as an important mediator of liver disease development; however, the precise roles of gut microbiota in regulating sepsis-induced liver injury are unknown. Here, we aimed to investigate the role of the gut microbiota in sepsis-induced liver injury and the underlying mechanism. Cecal ligation and puncture (CLP) was employed to induce polymicrobial sepsis and related liver injury. Fecal microbiota transplantation (FMT) was used to validate the roles of gut microbiota in these pathologies...
December 1, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Julius C Fischer, Chia-Ching Lin, Simon Heidegger, Alexander Wintges, Martin Schlapschy, Matthias Beudert, Stephanie E Combs, Florian Bassermann, Arne Skerra, Tobias Haas, Hendrik Poeck
PURPOSE: Type I interferon (IFN-I) and IL-22 modulate regeneration of the thymus and intestinal epithelial cells (IECs) after cytotoxic stress like irradiation. Radiation-induced damage to thymic tissues and IECs is a crucial aspect during the pathogenesis of inadequate immune reconstitution and acute graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with myeloablative total body irradiation (TBI), respectively. IL-22 and IFN-I reduce severity of acute GVHD after allo-HSCT with myeloablative TBI...
November 29, 2018: International Journal of Radiation Oncology, Biology, Physics
Jianing Fu, Julien Zuber, Mercedes Martinez, Brittany Shonts, Aleksandar Obradovic, Hui Wang, Sai-Ping Lau, Amy Xia, Elizabeth E Waffarn, Kristjana Frangaj, Thomas M Savage, Michael T Simpson, Suxiao Yang, Xinzheng V Guo, Michelle Miron, Takashi Senda, Kortney Rogers, Adeeb Rahman, Siu-Hong Ho, Yufeng Shen, Adam Griesemer, Donna L Farber, Tomoaki Kato, Megan Sykes
Human intestinal transplantation often results in long-term mixed chimerism of donor and recipient blood in transplant patients. We followed the phenotypes of chimeric peripheral blood cells in 21 patients receiving intestinal allografts over 5 years. Donor lymphocyte phenotypes suggested a contribution of hematopoietic stem and progenitor cells (HSPCs) from the graft. Surprisingly, we detected donor-derived HSPCs in intestinal mucosa, Peyer's patches, mesenteric lymph nodes, and liver. Human gut HSPCs are phenotypically similar to bone marrow HSPCs and have multilineage differentiation potential in vitro and in vivo...
November 21, 2018: Cell Stem Cell
Megan C Niederwerder
Fecal microbiota transplantation (FMT) is the process by which fecal microbiota are donated from a healthy individual and subsequently transplanted into a diseased or young individual. The mechanism by which FMT is effective is believed to be due to enhanced beneficial microbes, increased microbiome diversity, and restored normal flora. Beneficial gut microorganisms not only play a role in maintaining an intestinal barrier and metabolizing nutrients, but importantly, these microbes help regulate local and systemic immune function...
December 2018: Veterinary Immunology and Immunopathology
Aralia Leon-Coria, Manish Kumar, France Moreau, Kris Chadee
Amebiasis is caused by the protozoan parasite Entamoeba histolytica (Eh), a potentially fatal disease occurring mainly in developing countries. How Eh interacts with innate host factors in the gut is poorly understood. Eh resides and feed in/on the outer colonic mucus layer and thus share an ecological niche with indigenous microbiota. As gut microbiota regulates innate immune responses, in this study we characterized the cooperative roles that microbiota and the mucus layer play in Eh-induced pro-inflammatory responses in the colon...
November 2018: PLoS Pathogens
Riccardo Coletta, Antonino Morabito
Management of severe Short Bowel Syndrome (SBS) is still one of the largest challenges of the medicine. Vast majority of the short bowel patients are children, the conditions that lead to this possible outcome most often are necrotizing enterocolitis (NEC), small intestinal volvulus as a result of intestinal malrotation, gastroschisis and the "apple peel" syndrome. Therefore paediatricians and paediatric surgeons face this challenge most often. The non-surgical treatment appears to be effective using surgical procedure to increase absorptive surface and to reduce the transit time, but in some cases these procedure are enough to weaning of TPN...
November 29, 2018: Current Pediatric Reviews
Jacob de Boer, Andries Braat, Hein Putter, Erwin de Vries, Christian H Strassburg, Zoltán Máthé, Bart van Hoek, Felix Braun, Aad van den Berg, Danko Mikulic, Peter Michielsen, Blaz Trotovsek, Heinz Zoller, Jan de Boer, Marieke van Rosmalen, Undine Samuel, Gabriela Berlakovich, Markus Guba
BACKGROUND: About 15% of liver transplantations in Eurotransplant are currently performed in patients with a high-urgency (HU) status. Patients that have acute liver failure or require an acute retransplantation can apply for this status. This study aims to evaluate the efficacy of this prioritization. METHODS: Patients that were listed for liver transplantation with HU status from 01.01.2007 up to 31.12.2015 were included. Waiting list and posttransplantation outcomes were evaluated and compared with a reference group of patients with labMELD scores ≥40 (MELD 40+)...
November 21, 2018: Transplantation
Amanda Cheung, Sajal Tanna, Michael G Ison
Infections remain a leading cause of morbidity and mortality among patients with liver failure. A number of factors, including relative immune dysfunction and systemic inflammation, bacterial translocation, gut dysbiosis, small intestine bacterial overgrowth, altered bile acid pools, and changes in pH due to acid suppression, contribute to the high rates of infection in this population. Though a range of infections can complicate the course of cirrhotic patients, spontaneous bacterial peritonitis (SBP), cholangitis, and cholecystitis in addition to other infections (i...
October 2018: Seminars in Respiratory and Critical Care Medicine
Konstantin Kazankov, Simon Mark Dahl Jørgensen, Karen Louise Thomsen, Holger Jon Møller, Hendrik Vilstrup, Jacob George, Detlef Schuppan, Henning Grønbæk
Nonalcoholic fatty liver disease (NAFLD) and its inflammatory and often progressive subtype nonalcoholic steatohepatitis (NASH) are becoming the leading cause of liver-related morbidity and mortality worldwide, and a primary indication for liver transplantation. The pathophysiology of NASH is multifactorial and not yet completely understood; however, innate immunity is a major contributing factor in which liver-resident macrophages (Kupffer cells) and recruited macrophages play a central part in disease progression...
November 27, 2018: Nature Reviews. Gastroenterology & Hepatology
Sreeja Biswas Roy, Paul Banks, Matthew Kunz, Taylor R Ipsen, Takahiro Masuda, Sumeet K Mittal, Michael A Smith, Ross M Bremner
BACKGROUND: Barrett's esophagus (BE)-intestinal metaplasia in the esophagus-may progress to low-grade dysplasia (LGD), high-grade dysplasia (HGD), and ultimately, invasive esophageal adenocarcinoma (EAC). The course of BE in immunosuppressed lung transplant recipients is unknown. METHODS: We retrospectively reviewed the records of patients who underwent lung transplant at our center between 01/01/2010 and 10/31/2016. We analyzed pre-transplant esophagram, esophagogastroduodenoscopy, 24-hour pH monitoring, high-resolution manometry, and gastric emptying studies...
November 24, 2018: Annals of Thoracic Surgery
Rajiv Mehta, Mayank Kabrawala, Subhash Nandwani, Parika Kalra, Chintan Patel, Pankaj Desai, Krishna Parekh
Experimental studies demonstrated that fecal microbiota transplant (FMT) may reverse intestinal microbial dysbiosis. In this retrospective case series, we share our experience of treating recurrent overt hepatic encephalopathy (HE) with single FMT treatment. A total of 10 patients, age ranged from 25 to 65 years, were treated with single FMT through colonoscopy using fecal material received from rigorously screened patient-identified donors. There was sustained clinical response with single FMT treatment in 6 patients at post-treatment week 20...
November 26, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Zhujiang Dai, Jingqiu Zhang, Qi Wu, Juan Chen, Jun Liu, Lu Wang, Chaowu Chen, Jiaming Xu, Hongpeng Zhang, Chunfeng Shi, Zhen Li, Huiwen Fang, Chaobiao Lin, Dong Tang, Daorong Wang
Colorectal cancer is the third largest cancer in worldwide and has been proven to be closely related to the intestinal microbiota. Many reports and clinical studies have shown that intestinal microbial behavior may lead to pathological changes in the host intestines. The changes can be divided into epigenetic changes and carcinogenic changes at the gene level, which ultimately promote the production and development of colorectal cancer. This article reviews the pathways of microbial signaling in the intestinal epithelial barrier, the role of microbiota in inflammatory colorectal tumors, and typical microbial carcinogenesis...
November 26, 2018: International Journal of Cancer. Journal International du Cancer
Merel M Tielemans, Gerben A J van Boekel, Teun van Gelder, Eric T Tjwa, Luuk B Hilbrands
Gastrointestinal (GI) discomfort is common after renal transplantation and can be caused by the use of various immunosuppressive drugs. GI symptoms affect the quality of life, lead to an impaired graft survival and an increased mortality. Moreover, diseases and disturbances of the GI tract also affect the pharmacokinetics of immunosuppressive drugs. This review addresses the interaction between immunosuppressive agents and GI disorders. The GI tract is involved in the metabolism of several immunosuppressive drugs...
November 14, 2018: Transplantation Reviews
Nadia Saïdani, Jean-Christophe Lagier, Nadim Cassir, Matthieu Million, Sophie Baron, Grégory Dubourg, Carole Eldin, Jad Kerbaj, Camille Valles, Didier Raoult, Philippe Brouqui
BACKGROUND: Colonization with carbapenemase producing Enterobacteriaceae or Acinetobacter (CPE/A) is associated with complex medical care requiring implementation of specific isolation policies and limitation of patient discharge to other medical facilities. Fecal Microbiota Transplantation (FMT) has been proposed in order to reduce the duration of gut colonization. OBJECTIVES: We investigated whether a dedicated protocol of FMT could reduce the negativation time of CPE/A intestinal carriage in patients whose medical care has been delayed due to such colonization...
November 22, 2018: International Journal of Antimicrobial Agents
Samuel Kesseli, Debra Sudan
Intestinal and multivisceral transplants are complex technical procedures that present unique challenges in the field of solid organ transplantation. This review aims to highlight the indications, techniques, outcomes, and complications specific to intestinal transplantation.
February 2019: Surgical Clinics of North America
Maura Faraci, Maria Grazia Calevo, Stefano Giardino, Massimiliano Leoni, Erica Ricci, Elio Castagnola, Edoardo Lanino
INTRODUCTION: Corticosteroids are the standard of care for first line treatment of patients who develop grades II-IV of acute Graft-versus-Host Disease (a-GvHD), but the optimal second-line treatment has not been determined yet. We prospectively evaluated the use of anti-TNFα monoclonal antibody Etanercept (ET) as second line treatment in children with steroid-refractory a-GvHD. MATERIALS AND METHODS: Twenty-five children with either malignant or non malignant diseases experiencing grade II-IV steroid-refractory (SR)-a-GvHD received ET as second line treatment...
November 21, 2018: Biology of Blood and Marrow Transplantation
Dominik Langgartner, Carolyn A Vaihinger, Melanie Haffner-Luntzer, Julia F Kunze, Anna-Lena J Weiss, Sandra Foertsch, Stephanie Bergdolt, Anita Ignatius, Stefan O Reber
Chronic psychosocial stress is a risk factor for the development of physical and mental disorders accompanied or driven by an activated immune system. Given that chronic stress-induced systemic immune activation is lacking in germ-free and antibiotics-treated mice, a causal role of the gut microbiome in the development of stress-related disorders is likely. To address this hypothesis in the current study we employed the chronic subordinate colony housing (CSC, 19 days) paradigm, a pre-clinically validated mouse model for chronic psychosocial stress, known to alter the gut microbial signature and to induce systemic low-grade inflammation, as well as physical and mental abnormalities...
2018: Frontiers in Behavioral Neuroscience
Eleonora De Martin, Amelia Hessheimer, Ryan Chadha, Gokhan Kabacam, Jeremy Raganayagam, Varvara Kirchner, Marit Kalisvaart, Irene Scalera, Mamatha Bhat, Alan Contreras, Prashant Bhangui
The 24 Joint Annual Congress of the International Liver Transplantation Society (ILTS) in association with European Liver and Intestine Transplant Association (ELITA) and Liver Intensive Care Group of Europe (LICAGE) was held in Lisbon, Portugal from May 23-26, 2018. More than 1200 participants from over 60 countries including surgeons, hepatologists, anesthesiologists and critical care intensivists, radiologists, pathologists, organ procurement personnel and research scientists, came together with the common aim of improving care and outcomes for liver transplant recipients...
November 19, 2018: Transplantation
Danfeng Chen, Jingyi Wu, Duochen Jin, Bangmao Wang, Hailong Cao
The human gut is home to a large and diverse microbial community, comprising about 1000 bacterial species. The gut microbiota exists in a symbiotic relationship with its host, playing a decisive role in the host's nutrition, immunity, and metabolism. Accumulating studies have revealed the associations between gut dysbiosis or some special bacteria and various cancers. Emerging data suggest that gut microbiota can modulate the effectiveness of cancer therapies, especially immunotherapy. Manipulating the microbial populations with therapeutic intent has become a hot topic of cancer research, and the most dramatic manipulation of gut microbiota refers to fecal microbiota transplantation (FMT) from healthy individuals to patients...
November 20, 2018: International Journal of Cancer. Journal International du Cancer
Tadashi Ohara, Tatsuo Suzutani
We have presented the first case report of FMT therapy for a patient with chronic intractable constipation. This therapy resulted in good, medium-term outcomes. Follow-up analysis of the intestinal flora suggested that transplanted microbes from the donor, particularly Bifidobacterium and Clostridium cluster IX, may have been incorporated into the recipient.
November 2018: Clinical Case Reports
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