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https://www.readbyqxmd.com/read/29677070/heavy-alcohol-use-among-deceased-donors-does-not-impact-recipient-outcomes-after-liver-transplantation
#1
Sumant S Arora, Khushdeep S Chahal, Page Axley, Devin E Eckhoff, Yong-Fang Kuo, Sanjaya K Satapathy, Russell Wiesner, Ashwani K Singal
BACKGROUND: Data on liver transplant (LT) outcomes using deceased donors with heavy drinking (HD) (>2 drinks/day) are scanty. METHODS: Using the United Network for Organ Sharing database (2002-2014), we examined outcomes after LT in adults comparing deceased HD donors with not heavy drinking (ND) donors. RESULTS: Of 56 182 first LTs performed in the US for 10 common indications using deceased donors, 47 882 with available information on alcohol use were analyzed...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29677069/evolution-of-deceased-organ-donation-activity-vs-efficiency-over-a-15-year-period-an-international-comparison
#2
Julius Weiss, Andreas Elmer, Beatriz Mahíllo, Beatriz Domínguez-Gil, Danica Avsec, Alessandro Nanni Costa, Bernadette J J M Haase-Kromwijk, Karim Laouabdia, Franz F Immer
BACKGROUND: The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs. METHODS: This is a retrospective analysis of 2001-2015 deceased organ donation and mortality registry data...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29676390/receiving-hypertensive-donor-grafts-is-associated-with-inferior-prognosis-in-simultaneous-liver-kidney-transplantation-recipients
#3
Zebin Zhu, Shanzhou Huang, Qiang Zhao, Yunhua Tang, Zhiheng Zhang, Linhe Wang, Weiqiang Ju, Zhiyong Guo, Xiaoshun He
BACKGROUND The impact of hypertensive (HTN) donor grafts on the prognosis of simultaneous liver-kidney transplantation (SLKT) patient is not known, and an applicable risk scoring system for SLKT patient survival is lacking. This study aimed to evaluate the impact of donor HTN on patient survival of SLKT recipients and to identify independent risk factors. MATERIAL AND METHODS Data from 3844 adult SLKT recipients receiving deceased donor grafts from March 2002 to December 2014 in the Scientific Registry of Transplant Recipients (SRTR) database were retrospectively analyzed...
April 20, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29672442/more-than-just-wait-time-regional-differences-in-liver-transplant-outcomes-for-hepatocellular-carcinoma
#4
Rachel Hogen, Mary Lo, Joseph DiNorcia, Lingyun Ji, Yuri Genyk, Linda Sher, Kiran Dhanireddy
BACKGROUND: Regional allocation of deceased donor livers has led to variable wait times for HCC patients on the liver transplant list. The purpose of our study was to evaluate how regional differences in wait time affect outcomes for HCC patients. METHODS: A retrospective, observational study was performed using the OPTN database from 2/27/2002 to 9/25/2015. The cumulative incidences of transplant and waitlist death as well as intention-to-treat and posttransplant survival were evaluated for patients ≥ 18 years of age listed for DDLT with stage II HCC exception points in each UNOS region...
April 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29666020/geographic-variation-in-the-treatment-of-u-s-adult-heart-transplant-candidates
#5
William F Parker, Allen S Anderson, Donald Hedeker, Elbert S Huang, Edward R Garrity, Mark Siegler, Matthew M Churpek
BACKGROUND: The current U.S. priority ranking for heart candidates is based on treatment intensity, not objective markers of severity of illness. This system may encourage centers to overtreat candidates. OBJECTIVES: This study sought to describe national variation in the intensity of treatment of adult heart transplantation candidates and identify center-level predictors of potential overtreatment. METHODS: The registrations of all U.S. adult heart transplantation candidates from 2010 to 2015 were collected from the SRTR (Scientific Registry of Transplant Recipients)...
March 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29665840/effects-of-cyclosporine-a-pretreatment-of-deceased-organ-donors-on-kidney-graft-function-cis-a-rein-study-protocol-for-a-randomized-controlled-trial
#6
Jean-Christophe Orban, Eric Fontaine, Elisabeth Cassuto, Karine Baumstarck, Marc Leone, Jean-Michel Constantin, Carole Ichai
BACKGROUND: Renal transplantation represents the treatment of choice of end-stage kidney disease. Delayed graft function (DGF) remains the most frequent complication after this procedure, reaching more than 30%. Its prevention is essential as it impedes early- and long-term prognosis of transplantation. Numerous pharmacological interventions aiming to prevent ischemia-reperfusion injuries failed to reduce the rate of DGF. We hypothesize that cyclosporine as an early preconditioning procedure in donors would be associated with decreased DGF...
April 17, 2018: Trials
https://www.readbyqxmd.com/read/29665191/the-impact-of-donor-body-mass-index-on-outcomes-after-deceased-kidney-transplantation
#7
Adam Arshad, James Hodson, Imogen Chappelow, Nicholas G Inston, Andrew R Ready, Jay Nath, Adnan Sharif
The aim of this study was to determine the effect of donor body mass index (BMI) on deceased-donor kidney transplant outcomes. Data were collected from the UK Transplant Registry for all deceased-donor kidney transplant recipients between January 2003 and January 2015. Univariable and multivariable analyses were undertaken to assess the impact of donor BMI on a range of outcomes. Donor BMI (kg/m2 ) was stratified as <18.5 (n=380), 18.5-25.0 (n=6890), 25.1-30.0 (n=6669), 30.1-35.0 (n=2503) and >35.0 (n=1148)...
April 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29661469/successful-7-year-eculizumab-treatment-of-plasmapheresis-resistant-recurrent-atypical-hemolytic-uremic-syndrome-due-to-complement-factor-h-hybrid-gene-a-case-report
#8
K Vondrák, T Seeman
Atypical hemolytic-uremic syndrome (aHUS) is an extremely rare disease, and up to 70% of the patients have a genetic mutation in the encoding components of complement activation or anti-complement factor H autoantibodies. The risk of recurrence after kidney transplantation is 10% to 80%. Eculizumab, a monoclonal antibody that binds complement protein C5, has shown to be highly effective in patients with aHUS; however, there are only few reports on the efficacy and safety of long-term eculizumab treatment in children with recurrent aHUS...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661465/allograft-portacaval-shunt-in-small-for-size-liver-in-deceased-donor-liver-transplant
#9
J H Nguyen, D M Harnois
Portal hyperperfusion is detrimental to small-for-size livers (SFSLs) in liver transplantation. Surgical techniques modulating portal inflow provide the most effective approach to protect the SFSL. In this report, we describe a technique creating an allograft portacaval shunt that effectively attenuates portal inflow without a requirement of extensive surgical dissection in the recipient during the transplantation.
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661433/better-selection-criteria-with-prognostic-factors-for-liver-transplantation
#10
L S Nacif, R S Pinheiro, V Rocha-Santos, V M Barbosa, A P de Moura Dias, R B Martino, R A Macedo, L Ducatti, L Haddad, F Galvão, W Andraus, L Carneiro D' Albuquerque
BACKGROUND: Liver transplantation has evolved significantly in recent years, with each advancement part of the effort toward increasing patient and graft survival as well as quality of life. The objective of this study was to evaluate the prognostic factors and selection criteria for liver transplantation. METHODS: Our study was a statistical analysis, logistic regression, and survival evaluation of a total of 80 liver transplants that were performed between June 1, 2016 and September 24, 2016...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661426/delayed-graft-function-predictive-factors-and-7-year-outcome-of-deceased-donor-kidney-transplant-recipients-with-different-immunologic-profiles
#11
A H D S Quintella, M F Lasmar, R A Fabreti-Oliveira, E Nascimento
BACKGROUND: Delayed graft function (DGF) is the major post-transplant cause of deleterious effects to the allograft and is associated with poor allograft survival. The aim of this study was to report the outcomes of 236 kidney transplant recipients with different immunologic profiles. METHODS: All patients underwent transplantation (2008-2016) with a deceased donor at the University Hospital of the Faculty of Medical Science, Belo Horizonte, Minas Gerais, Brazil...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29660004/renal-transplant-outcomes-and-de-novo-donor-specific-anti-human-leukocyte-antigen-antibodies-a-systematic-review
#12
Ankit Sharma, Joshua R Lewis, Wai H Lim, Suetonia Palmer, Giovanni Strippoli, Jeremy R Chapman, Stephen I Alexander, Jonathan C Craig, Germaine Wong
Background: Pre-transplant donor-specific anti-human leukocyte antigen antibodies (DSAs) are known risk factors for acute rejection and reduced graft survival after kidney transplantation. DSAs may also develop de novo DSAs (dnDSAs) after transplantation but the clinical implications of these antibodies remain uncertain. Methods: We undertook a systematic review of observational studies that examined the association between dnDSAs and graft and patient outcomes (through August 2017) with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system of reporting used to assess the quality of evidence available...
April 11, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29652887/ethnicity-matching-and-outcomes-after-kidney-transplantation-in-the-united-kingdom
#13
Bhavini Pisavadia, Adam Arshad, Imogen Chappelow, Peter Nightingale, Benjamin Anderson, Jay Nath, Adnan Sharif
BACKGROUND: Kidneys from non-white donors have inferior outcomes, but it is unclear if ethnicity matching between donors and recipients achieves better post kidney transplant outcomes. METHODS: We undertook a retrospective, population cohort study utilising UK Transplant Registry data. The cohort comprised adult, kidney-alone, transplant recipients receiving their first kidney transplant between 2003-2015, with data censored at 1st October 2016. We included 27,970 recipients stratified into white (n = 23,215), black (n = 1,679) and south Asian (n = 3,076) ethnicity, with median post-transplant follow-up of 1,676 days (IQR 716-2,869 days)...
2018: PloS One
https://www.readbyqxmd.com/read/29650438/hepatitis-e-virus-infection-mimicking-acute-graft-rejection-in-a-liver-transplant-recipient
#14
M Allaire, C Bazille, J Selves, E Salamé, M Altieri
INTRODUCTION: In liver transplant (LT) patients, hepatitis E virus (HEV) can lead to acute liver failure, chronic hepatitis and graft cirrhosis. Few data on graft rejection associated with HEV are available and are subject to discussion. CASE REPORT: Here we report the case of a 58-year-old male patient who underwent LT in July 2015 for cirrhosis due to NASH and chronic alcohol intake complicated by hepatocellular carcinoma. LT was performed with a deceased donor isogroup and a mismatch CMV (donor+ and recipient-)...
April 10, 2018: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29644073/first-uk-case-report-of-kidney-transplantation-from-an-hiv-infected-deceased-donor-to-two-hiv-infected-recipients
#15
Eileen Nolan, Nikolaos Karydis, Martin Drage, Rachel Hilton
Kidney transplantation is now considered the treatment of choice for many human immunodeficiency virus (HIV)-infected patients with end-stage renal disease (ESRD). Graft survival rates using HIV-negative donors and carefully selected HIV-positive ESRD patients are similar to those observed in HIV-uninfected kidney transplant recipients. To address the relative shortfall in donated organs it has been proposed that organs from HIV-infected deceased donors might be allocated to HIV-infected patients on the transplant waiting list...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29622763/esophageal-mucosal-calcinosis-a-rare-site-of-gastrointestinal-mucosal-calcinosis
#16
Aaron R Huber, Brandon S Sprung, John Miller, Jennifer J Findeis-Hosey
BACKGROUND Gastrointestinal tract mucosal calcinosis (MC) tends to affect the gastric mucosa, while esophageal involvement is rare. Gastric MC may be seen with solid organ transplantation, use of aluminum-containing antacids or sucralfate, malignancy, and chronic renal failure. While the incidence of gastric MC in renal transplant patients undergoing gastric biopsy is common (between 15-29%), to our knowledge esophageal MC has only been previously reported 3 times. CASE REPORT A 68-year-old male dialysis-dependent end stage renal disease status-post deceased donor kidney transplant underwent an esophagogastroduodenoscopy (EGD) for dysphagia and diffuse esophageal wall thickening seen on imaging studies...
April 6, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29620613/incidence-risk-factors-and-outcomes-of-clostridium-difficile-infections-in-kidney-transplant-recipients
#17
George Li, Justin Trac, Shahid Husain, Olusegun Famure, Yanhong Li, S Joseph Kim
BACKGROUND: Kidney transplant recipients (KTR) may be at increased risk for Clostridium difficile infections (CDI) but risk factors and outcomes in this population have not been well studied. METHODS: An observational cohort study was conducted to determine the incidence, risk factors, and outcomes of CDI in KTR. A total of 1,816 KTR transplanted between 2000 and 2013 at Toronto General Hospital were included. Sixty-eight patients developed CDI. Controls were selected at a 4:1 ratio using risk-set sampling and risk factors were explored using conditional logistic regression models...
April 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29616522/further-options-and-survival-results-after-failure-following-ecls-implantation
#18
Leopold Rupprecht, Daniele Camboni, Alois Philipp, Dirk Lunz, Thomas Müller, Christof Schmid, Andreas Keyser
BACKGROUND: A retrospective study was designed to analyze the outcome of patients with extracorporeal life support (ECLS) who needed a consecutive cardiac or pulmonary support system. METHODS: From 2006 to 2016, 93 out of 587 patients with their age ranging from 2.4 to 77.3 years required an exchange of an ECLS by another mechanical support system. Sixty- one patients were inhospital cases, 39 patients were referred with ECLS from other institutions by ambulance car (n=15) or helicopter (n=24)...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29611277/renal-transplantation-outcome-and-social-deprivation-in-the-french-health-care-system-a-cohort-study-using-the-european-deprivation-index
#19
Valérie Châtelet, Sahar Bayat-Makoei, Cécile Vigneau, Guy Launoy, Thierry Lobbedez
BACKGROUND: The study objective was to estimate the effect of social deprivation estimated by the European Deprivation Index (EDI) on the risk of death and graft failure on renal transplantation in France. PATIENTS AND METHODS: EDI was calculated for 8701/9205 patients receiving a first renal transplantation between 2010 and 2014. Patients were separated in EDI quintiles of the general population. A Cox model (cs-HR: cause specific hazard of death or graft failure) and a Fine and Gray model (sd-HR: sub-distribution hazard of death and graft failure) were used for the analysis...
April 2, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29605022/posttransplant-complications-in-adult-recipients-of-intestine-grafts-without-bowel-decontamination
#20
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Selective digestive decontamination is commonly used to decrease lumenal bacterial flora. Preoperative bowel decontamination may be associated with a lower wound infection rate but has not been shown to decrease risk of intra-abdominal abscess or lower leak rate for enteric anastomoses. Alternatively, the decontamination disrupts the normal flora of the gastrointestinal tract and may affect normal physiology, including immunologic function. This study reports complication rates of an intestine transplant program that has never used bowel decontamination...
May 2018: Journal of Surgical Research
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