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Hepatitis c and organ donor

Yasir Waheed, Masood Siddiq, Zubia Jamil, Muzammil Hasan Najmi
Globally, over 300 million people are living with viral hepatitis with approximately 1.3 million deaths per year. In 2016, World Health Assembly adopted the Global Health Sector Strategy on viral hepatitis to eliminate hepatitis by 2030. Different World Health Organization member countries are working on hepatitis control strategies to achieve hepatitis elimination. So far, only 12 countries are on track to achieve hepatitis elimination targets. The aim of the study was to give an update about the progress and challenges to achieving hepatitis elimination by 2030...
November 28, 2018: World Journal of Gastroenterology: WJG
Koji Nanmoku, Yohei Owada, Yukio Oshiro, Akira Kurosawa, Taro Kubo, Takahiro Shinzato, Toshihiro Shimizu, Takaaki Kimura, Yasunaru Sakuma, Nobuo Ishikawa, Nobuhiro Ohkohchi, Hiroaki Okamoto, Takashi Yagisawa
BACKGROUND: Hepatitis E virus (HEV) infection can lead to chronic hepatitis in solid organ transplant recipients. To investigate whether HEV infection influences outcomes following kidney transplantation, we examined the prevalence of HEV infection and clinical characteristics of kidney transplant recipients in our hospital. METHODS: Our cross-sectional study included 184 kidney transplant recipients. Blood samples were obtained from all patients to detect anti-HEV immunoglobulin (Ig)A, IgM, and IgG by enzyme-linked immunosorbent assay and HEV RNA by reverse transcription-polymerase chain reaction...
November 27, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
David Goldberg, Peter P Reese
Utilization of kidneys from hepatitis C virus (HCV)-infected deceased donors has the potential to increase the number of kidney transplants by 500-1000 (or more) each year. This increase in the number of kidney transplants offers major opportunities to extend survival and improve quality of life for patients infected with HCV, as well as uninfected recipients. However, due to a lack of prospective safety and efficacy data on a sufficient number of HCV-negative recipients who received a kidney from a HCV-infected donor, as well as key logistical barriers, the practice of transplanting HCV-infected organs into uninfected recipients is not yet ready to be considered as standard of care...
November 26, 2018: Seminars in Dialysis
Nikhil Kapila, Gianina Flocco, Kawtar Al Khalloufi, Xaralambos B Zervos
Direct acting anti-viral drugs (DAA) have led to a paradigm shift in the approach to hepatitis C virus (HCV) positive organs. In this study, we report our experience with HCV viremic recipients undergoing kidney transplantation (KT) from HCV viremic donors, followed by the initiation of DAA therapy without ribavirin METHODS: We conducted a single center, retrospective review of patients who underwent deceased donor KT from March 2015 to February 2017. HCV viremic patients who received an HCV viremic kidney and were then treated with DAAs were included...
November 18, 2018: Journal of Viral Hepatitis
H Sasajima, S Miyagi, Y Kakizaki, T Kamei, M Unno, S Satomi, M Goto
BACKGROUND: Liver transplantation from donors after cardiac death (DCD) might increase the pool of available organs. Recently, some investigators reported the potential use of mesenchymal stem cells (MSCs) to improve the outcome of liver transplantation from DCD. The aim of this study was to evaluate the cytoprotective effects and safety of MSC transplantation on liver grafts from DCD. METHODS: Rats were divided into 4 groups (n = 5) as follows: 1. the heart-beating group, in which liver grafts were retrieved from heart-beating donors; 2...
November 2018: Transplantation Proceedings
H H Moon, T-S Kim, S Song, M Shin, Y J Chung, S Lee, G S Choi, J M Kim, C H D Kwon, S-K Lee, J Joh
BACKGROUND: East Asia is a known endemic area for hepatitis B, and living donor liver transplantation is mainly performed. Liver retransplantation (ReLT) is expected to become an increasing problem because of a shortage of organs. This study aimed to compare early and late ReLT with consideration of specific circumstances and disease background of East Asians. METHODS: Between October 1996 and January 2015, 51 patients underwent ReLT; we performed a retrospective analysis of data obtained from medical records of the patients...
November 2018: Transplantation Proceedings
M H Chung, C C Chuang, L F Liaw, C Y Chen, I M Chen, C P Hsu, N C Lin, C C Loong
BACKGROUND: The safety of the living donor in living-donor liver transplantation (LDLT) is always the first priority, meanwhile, the graft-to-recipient weight ratio (GRWR) and the anatomy of the liver allograft must also not be compromised in order to warrant tranplatation success. When it comes to the allograft of the right lobe of the liver without the middle hepatic vein (R-M), the outflow and adequate drainage for the territory of middle hepatic vein (MHV) is one critical concern...
November 2018: Transplantation Proceedings
Hiroyuki Kato, Sergio Duarte, Mary G Miller, Ronald W Busuttil, Ana J Coito
he purpose of this study was to assess the significance of tenascin-C (Tnc) expression in steatotic liver ischemia and reperfusion injury (IRI). The critical shortage in donor organs has led to the use of steatotic livers in transplantation regardless of their elevated susceptibility to hepatic IRI. Tnc is an endogenous danger signal extracellular matrix (ECM) molecule involved in various aspects of immunity and tissue injury. In the current study, mice were fed with a steatosis-inducing diet and developed approximately 50% hepatic steatosis, predominantly macrovesicular, before being subjected to hepatic IRI...
October 24, 2018: Liver Transplantation
María Trapero-Marugán, Ester Coelho Little, Marina Berenguer
Given the high waiting list mortality, there is a clear need to identify strategies to increase the number of livers for transplantation. Some strategies require policy changes, whereas others depend on a better understanding of available opportunities. We divided the strategies to increase the number of livers for transplantation into two categories-those aiming to increase the use of organs considered to be of suboptimal quality, and those aiming to increase the use of organs considered to be of suboptimal size...
November 2018: Lancet. Gastroenterology & Hepatology
Azin Jafari, Hanno Matthaei, Vittorio Branchi, Edwin Bölke, Rene H Tolba, Jörg C Kalff, Steffen Manekeller
BACKGROUND: The ever growing demand for liver transplantation inevitably necessitates an expansion of the donor pool. Utilization of "shock organs" is considered suboptimal to date while the associated outcome has hardly been investigated. MATERIALS AND METHODS: Male Wistar rats underwent a period of 30 min of hypovolemic shock. After 24 h livers were explanted and prior to reperfusion underwent either 18 h of cold storage (CS; N = 6) or 17 h of CS followed by 60 min venous systemic oxygen persufflation (VSOP; N = 6)...
October 23, 2018: European Journal of Medical Research
Wei Tang, Ren Guo, Shi-Jun Shen, Yang Zheng, Yu-Ting Lu, Meng-Meng Jiang, Xue Cui, Ci-Zhong Jiang, Xin Xie
Human liver or hepatocyte transplantation is limited by a severe shortage of donor organs. Direct reprogramming of other adult cells into hepatic cells may offer a solution to this problem. In a previous study, we have generated hepatocyte-like cells from mouse fibroblasts using only one transcription factor (TF) plus a chemical cocktail. Here, we show that human urine-derived epithelial-like cells (hUCs) can also be transdifferentiated into human hepatocyte-like cells (hiHeps) using one TF (Foxa3, Hnf1α, or Hnf4α) plus the same chemical cocktail CRVPTD (C, CHIR99021; R, RepSox; V, VPA; P, Parnate; T, TTNPB; and D, Dznep)...
October 12, 2018: Acta Pharmacologica Sinica
Alanna Carla da Costa, José Damião da Silva Filho, Eduardo Arrais Rocha, Mônica Coelho Andrade, Arduina Sofia Ortet de Barros Vasconcelos Fidalgo, Eliana Régia Barbosa Almeida, Carlos Eduardo Menezes Viana, Erlane Chaves Freitas, Ivo Castelo Branco Coelho, Maria de Fátima Oliveira
INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015...
September 2018: Revista da Sociedade Brasileira de Medicina Tropical
Pierluigi Toniutto, Davide Bitetto, Ezio Fornasiere, Elisa Fumolo
Liver transplantation (LT) has become the treatment of choice for a wide range of liver diseases in both adult and pediatric patients. Until recently, the largest proportion of LT in adults, were performed in patients with hepatitis C (HCV) related cirrhosis. The recent availability of safe and effective direct antiviral agents to cure HCV infection in almost all patients whatever the HCV genotype and severity of liver disease, will reduce the need for LT in this category of recipients. Thus, it is presumed that in the next 1 to 2 decades HCV related liver disease will diminish substantially, whereas non-alcoholic steato-hepatitis (NASH) will correspondingly escalate as an indication for LT...
October 5, 2018: Minerva Gastroenterologica e Dietologica
Jessica Lindemann, Leigh Anne Dageforde, Diane Brockmeier, Neeta Vachharajani, Meranda Scherer, William Chapman, Maria B Majella Doyle
Abdominal organ transplantation faces several challenges: burnout, limited pipeline of future surgeons, changes in liver allocation potentially impacting organ procurement travel, and travel safety. The organ procurement center (OPC) model may be one way to mitigate these issues. Liver transplants from 2009 to 2016 were reviewed. There were 755 liver transplants performed with 525 OPC and 230 in-hospital procurements. The majority of transplants (87.4%) were started during daytime hours (5 am-7 pm). Transplants with any portion occurring after-hours were more likely to have procurements in-hospital (P < ...
September 24, 2018: American Journal of Transplantation
Joris J Blok, Hein Putter, Herold J Metselaar, Robert J Porte, Federica Gonella, Jeroen de Jonge, Aad P van den Berg, Josephine van der Zande, Jacob D de Boer, Bart van Hoek, Andries E Braat
Background: Outcome after liver transplantation (LT) is determined by donor, transplant and recipient risk factors. These factors may have different impact on either patient or graft survival (outcome type). In the literature, there is wide variation in the use of outcome types and points in time (short term or long term). Objective of this study is to analyze the predictive capacity of risk factors and risk models in LT and how they vary over time and per outcome type. Methods: All LTs performed in the Netherlands from January 1, 2002, to December 31, 2011, were analyzed with multivariate analyses at 3-month, 1-year, and 5-year for patient and (non-)death-censored graft survival...
September 2018: Transplantation Direct
Mohamed Abdulkadir Hassan-Kadle, Mugtaba Sulaiman Osman, Pavel Petrovich Ogurtsov
AIM: To provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia. METHODS: A systematic review and meta-analysis was conducted as Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African Index Medicus and the Africa Journals Online databases, as well as on the Ministry of Health website...
September 14, 2018: World Journal of Gastroenterology: WJG
Nicholas Wettersten, Hao Tran, Kristin Mekeel, Victor Pretorius, Eric Adler, Saima Aslam
Every year the number of patients waiting for a heart transplant increases faster than the number of available donor organs. Some potential donor organs are from donors with active communicable diseases, including hepatitis C virus (HCV), potentially making donation prohibitive. The advent of direct-acting antiviral agents for HCV has drastically changed the treatment of HCV. Recently, these agents have been used to treat HCV in organ donor recipients who acquired the disease from the donor organ. We report a case of heart-kidney transplantation from an HCV viremic donor to HCV negative recipient with successful treatment and sustained virologic response...
September 17, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Jessica M Ruck, Dorry L Segev
PURPOSE OF REVIEW: Due to the organ shortage, which prevents over 90 000 individuals in the United States from receiving life-saving transplants, the transplant community has begun to critically reevaluate whether organ sources that were previously considered too risky provide a survival benefit to waitlist candidates. RECENT FINDINGS: Organs that many providers were previously unwilling to use for transplantation, including kidneys with a high Kidney Donor Profile Index or from increased risk donors who have risk factors for window period hepatitis C virus (HCV) and HIV infection, have been shown to provide a survival benefit to transplant waitlist candidates compared with remaining on dialysis...
November 2018: Current Opinion in Nephrology and Hypertension
Elizaveta Padalko, Katrien Lagrou, Marie-Luce Delforge, Hilde Jansens, Nadine Ectors, Jean-Paul Pirnay, Johan Klykens, Etienne Sokal, Ludo Muylle, Agnes Libois, Alain Vanderkelen, Gilbert Verbeken, Conny Matthys, Dominique Goossens, Geert Hanssens, Muriel Baltes, Hilde Beele
This paper on the biological tests carried out on serum/plasma samples from donors of human body material (HBM) is the result of a project of the working Group of Superior Health Council of Belgium formed with experts in the field of HBM and infectious serology. Indeed, uncertainty about the interpretation of biological test results currently leads to the sometimes unjustified cancelling of planned donations or the rejection of harvested HBM, whilst more sophisticated diagnostic algorithms would still allow the use of organs or HBM that would otherwise have been rejected...
August 29, 2018: Cell and Tissue Banking
Elizabeth Buganza-Torio, Karen Elizabeth Doucette
With potent nucleos(t)ide analogue (NA) therapy, hepatitis B virus (HBV) is now an uncommon indication for liver transplant (LT) in North America. NA therapy, with or without hepatitis B immunoglobulin, results in low recurrence rates and excellent outcomes after LT. Direct-acting antiviral therapy for hepatitis C virus (HCV), results in cure in most patients, either before or after transplant. There are now descriptions of good clinical outcomes of transplant from HBV and HCV infected donors, as treatments are so effective and well tolerated...
September 2018: Infectious Disease Clinics of North America
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