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https://www.readbyqxmd.com/read/29034718/the-prognostic-value-of-the-furosemide-stress-test-in-predicting-delayed-graft-function-following-deceased-donor-kidney-transplantation
#1
Blaithin A McMahon, Jay L Koyner, Tessa Novick, Steve Menez, Robert A Moran, Bonnie E Lonze, Niraj Desai, Sami Alasfar, Marvin Borja, William T Merritt, Promise Ariyo, Lakhmir S Chawla, Edward Kraus
OBJECTIVES AND METHODS: The Furosemide Stress Test (FST) is a novel dynamic assessment of tubular function that has been shown in preliminary studies to predict patients who will progress to advanced stage acute kidney injury, including those who receive renal replacement therapy (RRT). The aim of this study is to investigate if the urinary response to a single intraoperative dose of intravenous furosemide predicts delayed graft function (DGF) in patients undergoing deceased donor kidney transplant...
October 16, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29032588/clinical-significance-of-lactate-clearance-for-the-development-of-early-allograft-dysfunction-and-short-term-prognosis-in-deceased-donor-liver-transplantation
#2
Deok Gie Kim, Jee Youn Lee, Yoon Bin Jung, Seung Hwan Song, Jae Geun Lee, Han Dai Hoon, Dong Jin Joo, Man Ki Ju, Gi Hong Choi, Jin Sub Choi, Myoung Soo Kim, Soon Il Kim
This retrospective study evaluated lactate clearance (LC), measured at 6, 12, 18, and 24 hours after reperfusion, as a predictor of early allograft dysfunction (EAD) and short-term outcomes in patients receiving deceased donor liver transplantation. Of 181 transplant recipients, 44 (24.3%) developed EAD and had lower LCs than those who did not develop EAD. A receiver operating characteristic analysis showed that LC determined at 6 hours showed the highest area under curve value of 0.828 (95% confidence interval [CI]: 0...
October 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29026877/prolonged-delayed-renal-graft-function-secondary-to-venous-hypertension
#3
Suraj Mishra, Gaurav Gupta, I Moinuddin, Brian Strife, Uma Prasad, D Massey, Anne King, Dhiren Kumar, Chandra S Bhati
The case of a 39-year-old highly sensitized woman who underwent second renal transplantation after being on warfarin because of a history of frequent thromboses of her left femoral arteriovenous graft (AVG) is reported here. The patient received a flow cytometric positive crossmatch kidney transplant from a deceased donor. Her posttransplant course was complicated by prolonged delayed graft function (DGF) lasting for 9 months. Antibody-mediated rejection occurred in the immediate postoperative period. This resolved after treatment, and resolution was confirmed by repeat biopsy...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29026597/endoscopic-approach-for-management-of-biliary-strictures-in-liver-transplant-recipients-a-systematic-review-and-meta-analysis
#4
Dayse Pereira da Silva Aparício, José Pinhata Otoch, Edna Frasson de Souza Montero, Muhammad Ali Khan, Everson Luiz de Almeida Artifon
The most common biliary complication after liver transplantation is anastomotic stricture (AS) and it can occur isolated or in combination with other complications. Liver graft from a cadaveric donor or a living donor has an influence on the incidence of biliary strictures as well as on the response to endoscopic treatment. Endoscopic treatment using balloon dilation and insertion of biliary stents by endoscopic retrograde cholangiopancreatography (ERCP) is the initial approach to these complications. AIM: The aim of this article is to compare different endoscopic techniques to treat post-liver transplantation biliary strictures...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29025381/adenovirus-infection-as-a-cause-of-fever-of-unknown-origin-and-allograft-dysfunction-in-a-kidney-transplant-recipient
#5
Michelle Saliba, Hala Kfoury Assouf, Souodod Abbas, Pierre Abi Hanna, Gaby Kamel, Antoine Barbari
With the recent introduction of more potent modern immunosuppressive regimens in solid-organ transplant, new types of viral infections such as adenovirus are emerging as a potential cause for graft dysfunction and loss. We report a case of 41-year-old male patient with end-stage renal disease from recurrent kidney stones who underwent kidney transplant from a deceased 12-year-old female donor. He developed adenoviral infection with acute cystitis, microscopic hematuria, and necrotizing interstitial nephritis associated with graft dysfunction within the first month of the postoperative period...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29024048/the-impact-of-adult-to-adult-living-donor-liver-transplantation-on-transplant-center-outcomes-reporting
#6
John F Renz, Geraldine C Diaz
BACKGROUND: The Scientific Registry of Transplant Recipients (SRTR) has released a 5-tier performance ranking system based upon results of deceased-donor and living-donor liver transplantation. MATERIALS AND METHODS: An analysis of Spring 2017 SRTR Program Specific Reports for outcomes of adult living-donor and deceased-donor liver transplantation. RESULTS: Utilizing the current SRTR performance algorithm, living-donor liver transplant results may disproportionately affect transplant center performance ranking...
October 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29023920/the-rise-of-the-opioid-epidemic-and-hepatitis-c-positive-organs-a-new-era-in-liver-transplantation
#7
REVIEW
Stevan A Gonzalez, James F Trotter
The use of hepatitis C virus (HCV) positive organs in liver transplantation has increased in the era of direct-acting antiviral therapy. A rising demand for organs, the ability to effectively treat HCV infection in the transplant setting, and an unprecedented increase in HCV positive donors have all contributed to this trend. A recent abrupt rise in opioid use in the US has resulted in a surge of injection drug use, transmission of HCV, and opioid-related overdose deaths. Geographic areas most affected by the opioid epidemic have experienced a rapid increase in recovery and utilization of HCV positive donor organs, in which the proportion of deceased donor liver transplants in the US from donors who are HCV positive has increased nearly two-fold within the last three years...
October 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29022123/assessment-of-a-closed-wash-system-developed-for-processing-living-donor-femoral-heads
#8
M J Eagle, J Man, P Rooney, T A McQuillan, G Galea, J N Kearney
NHS Blood and Transplant Tissue and Eye Services (TES) and Scottish National Blood Transfusion Services Tissues and Cells Directorate (TCD) currently bank whole, frozen femoral head bone from living donors who are undergoing primary hip replacement surgery. When required, the bone is issued to a surgeon still frozen on dry ice (- 79 °C). Consequently, the femoral head bone is not processed, is not sterilised and at the time of issue, it contains donor blood, bone marrow and associated cells. We have previously shown that, cut, shaped and washed bone from deceased donors can be processed to remove up to 99...
October 11, 2017: Cell and Tissue Banking
https://www.readbyqxmd.com/read/29020665/high-serum-soluble-cd40l-levels-previously-to-liver-transplantation-in-patients-with-hepatocellular-carcinoma-are-associated-with-mortality-at-one-year
#9
Leonardo Lorente, Sergio T Rodriguez, Pablo Sanz, Antonia Pérez-Cejas, Javier Padilla, Dácil Díaz, Antonio González, María M Martín, Alejandro Jiménez, Manuel A Barrera
PURPOSE: CD40L and its soluble form (sCD40L) are proteins of the tumor necrosis factor superfamily (TNFSF) that exhibit prothrombotic and proinflammatory properties when binding to CD40, which is a cell surface receptor of the tumor necrosis factor receptor superfamily (TNFRSF). High circulating levels of sCD40L have been associated with poor prognosis in patients with hepatocellular carcinoma (HCC). However, it is unknown whether there is an association between circulating sCD40L levels and survival in patients with HCC underwent to liver transplantation (LT), and this was the objective of that study...
September 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29019539/evaluation-of-the-treatment-of-the-hepatocarcinoma-nodules-in-the-patients-in-waiting-list-for-liver-transplant
#10
Gustavo Pilotto Domingues Sá, Jorge Roberto Marcante Carlotto, Fernando Pompeu Piza Vicentine, Luiz Romero, Dario Fernandes Perdomo Tejada, Alcides Augusto Salzedas, Gaspar de Jesus Lopes, Adriano Miziara Gonzalez
OBJECTIVE: to compare the outcome of liver transplantation for hepatocarcinoma in submitted or not to locoregional treatment and downstaging regarding survival and risk of recurrence in transplant waiting list patients. METHODS: retrospective study of patients with hepatocarcinoma undergoing liver transplantation in the metropolitan region of São Paulo, between January 2007 and December 2011, from a deceased donor. The sample consisted of 414 patients. Of these, 29 patients were included in the list by downstaging...
July 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28992338/the-association-of-donor-and-recipient-age-with-graft-survival-in-paediatric-renal-transplant-recipients-in-a-european-society-for-paediatric-nephrology-european-renal-association-european-dialysis-and-transplantation-association-registry-study
#11
Nicholas C Chesnaye, Karlijn J van Stralen, Marjolein Bonthuis, Jaap W Groothoff, Jérôme Harambat, Franz Schaefer, Nur Canpolat, Arnaud Garnier, James Heaf, Huib de Jong, Søren Schwartz Sørensen, Burkhard Tönshoff, Kitty J Jager
Background: The impact of donor age in paediatric kidney transplantation is unclear. We therefore examined the association of donor-recipient age combinations with graft survival in children. Methods: Data for 4686 first kidney transplantations performed in 13 countries in 1990-2013 were extracted from the ESPN/ERA-EDTA Registry. The effect of donor and recipient age combinations on 5-year graft-failure risk, stratified by donor source, was estimated using Kaplan-Meier survival curves and Cox regression, while adjusting for sex, primary renal diseases with a high risk of recurrence, pre-emptive transplantation, year of transplantation and country...
September 15, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28992075/does-kidney-donor-risk-index-implementation-lead-to-the-transplantation-of-more-and-higher-quality-donor-kidneys
#12
Ester Philipse, Alison P K Lee, Bart Bracke, Vera Hartman, Thierry Chapelle, Geert Roeyen, Kathleen de Greef, Dirk K Ysebaert, Gerda van Beeumen, Marie-Madeleine Couttenye, Amaryllis H Van Craenenbroeck, Rachel Hellemans, Jean-Louis Bosmans, Daniel Abramowicz
Background: The Kidney Donor Risk Index (KDRI) is a quantitative evaluation of the quality of donor organs and is implemented in the US allocation system. This single-centre study investigates whether the implementation of the KDRI in our decision-making process to accept or decline an offered deceased donor kidney, increases our acceptance rate. Methods: From April 2015 until December 2016, we prospectively calculated the KDRI for all deceased donor kidney offers allocated by Eurotransplant to our centre...
August 21, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28987015/center-practice-drives-variation-in-choice-of-u-s-kidney-transplant-induction-therapy-a-retrospective-analysis-of-contemporary-practice
#13
V R Dharnidharka, A S Naik, D A Axelrod, M A Schnitzler, Z Zhang, S Bae, D L Segev, D C Brennan, T Alhamad, R Ouseph, N N Lam, M Nazzal, H Randall, B L Kasiske, M McAdams-Demarco, K L Lentine
To assess factors that influence the choice of induction regimen in contemporary kidney transplantation, we examined center-identified, national transplant registry data for 166,776 US recipients (2005-2014). Bi-level hierarchical models were constructed, wherein use of each regimen was compared pairwise with use of interleukin-2 receptor blocking antibodies (IL2rAb). Overall, 81.8% of patients received induction, including thymoglobulin (TMG, 46.0%), IL2rAb (21.9%), alemtuzumab (ALEM, 12.5%), and other agents (1...
October 7, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28983074/use-of-hepatitis-c-positive-deceased-liver-donors-in-response-to-the-organ-shortage-in-an-endemic-area
#14
Duilio Pagano, Aurelio Seidida, Alessandro Tropea, Giada Pietrosi, Fabrizio di Francesco, Giovanni Battista Vizzini, Angelo Luca, Salvatore Gruttadauria
The region of Sicily, Italy, is witnessing a chronic organ shortage. Thus, to face this critical issue, the use of marginal donors has increased over time. An example of marginal donor expansion is the use of liver donors who are positive for the hepatitis C antibody (HCV+) for HCV+ patients requiring liver transplantation (LT). In view of new advances in HCV therapy, including direct-acting agents (DAAs) to treat HCV in the post-transplant setting, our study focused on a monocentric experience in a series of consecutive LTs performed in adult patients receiving HCV+ liver donor allografts...
October 6, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28980391/the-duration-of-asystolic-ischemia-time-determines-the-risk-of-graft-failure-after-circulatory-dead-donor-kidney-transplantation-a-eurotransplant-cohort-study
#15
L Heylen, I Jochmans, U Samuel, I Tieken, M Naesens, J Pirenne, B Sprangers
Circulatory death donor (DCD) kidney transplantations are steadily increasing. Consensus reports recommend to limit donor warm ischemia time (DWIT) in DCD donation, although an independent effect on graft outcome has not been demonstrated. We investigated death-censored graft survival in 18,065 recipients of deceased-donor kidney transplants in the Eurotransplant region: 1,059 DCD and 17,006 brain-dead donor (DBD) kidney recipients. DWIT was defined as time from circulatory arrest until cold flush. DCD donation was an independent risk factor for graft failure (adjusted HR 1...
October 5, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28979784/seventy-seven-kidney-paired-donation-transplantations-at-a-single-transplant-centre-in-india-led-to-an-increase-in-living-donor-kidney-transplantations-in-2015
#16
Vivek B Kute, Himanshu V Patel, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Priya S Shah, Umesh T Varyani, Pavan S Wakhare, Saiprasad G Shinde, Vijay A Ghodela, Varsha B Trivedi, Minaxi H Patel, Hargovind L Trivedi
BACKGROUND: To ascertain the validity of kidney paired donations (KPDs) as an alternative strategy for increasing living donor kidney transplantations (LDKTs) in an LDKT-dominated transplant programme since directed kidney transplantation, ABO-incompatible or crossmatch-positive pairs are not feasible due to costs and infectious complications. METHODS: This was a prospective single-centre study of 77 KPD transplantations (25 two-way, 7 three-way and 1 six-way exchange) from 1 January 2015 to 1 January 2016 of 158 registered donor recipient pairs...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28977005/renal-cold-storage-followed-by-transplantation-impairs-expression-of-key-mitochondrial-fission-and-fusion-proteins
#17
Nirmala Parajuli, Stephen Shrum, Julia Tobacyk, Alex Harb, John M Arthur, Lee Ann MacMillan-Crow
BACKGROUND: The majority of transplanted kidneys are procured from deceased donors which all require exposure to cold storage (CS) for successful transplantation. Unfortunately, this CS leads to renal and mitochondrial damage but, specific mitochondrial targets affected by CS remain largely unknown. The goal of this study is to determine whether pathways involved with mitochondrial fusion or fission, are disrupted during renal CS. METHODS: Male Lewis rat kidneys were exposed to cold storage (CS) alone or cold storage combined with transplantation (CS/Tx)...
2017: PloS One
https://www.readbyqxmd.com/read/28974434/graft-immunologic-events-in-deceased-donor-kidney-transplant-recipients-with-preformed-hla-donor-specific-antibodies
#18
Xicohténcatl Ixtlapale-Carmona, Adriana Arvizu, Adrian De-Santiago, Norma González-Tableros, Mayra López, Natalia Castelán, Lluvia A Marino, Norma O Uribe-Uribe, Alan G Contreras, Mario Vilatobá, Luis E Morales-Buenrostro, Josefina Alberú
INTRODUCTION: Pretransplant donor-specific HLA alloantibodies detected with the Single Antigen Bead (SAB) assay reflect an increased risk for acute antibody-mediated rejection (AMR). We herein report the incidence of both acute AMR and acute cellular rejection (ACR) during the first year posttransplantation, in a cohort of kidney transplant recipients (KTR) of deceased donor (DD) grafts, according to their DSA status. Pretransplant DSA do not preclude DD-KT in negative CDC-XM recipients at our center...
September 30, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28972946/recent-advances-in-decellularization-and-recellularization-for-tissue-engineered-liver-grafts
#19
Yujia Wang, Clara T Nicolas, Harvey S Chen, Jeffery J Ross, Silvana B De Lorenzo, Scott L Nyberg
Liver transplantation from deceased or living human donors remains the only proven option for patients with end-stage liver disease. However, the shortage of donor organs is a significant clinical concern that has led to the pursuit of tissue-engineered liver grafts generated from decellularized liver extracellular matrix and functional cells. Investigative efforts on optimizing both liver decellularization and recellularization protocols have been made in recent decades. In the current review, we briefly summarize these advances, including the generation of high-quality liver extracellular matrix scaffolds, evaluation criteria for quality control, modification of matrix for enhanced properties, and reseeding strategies...
2017: Cells, Tissues, Organs
https://www.readbyqxmd.com/read/28972665/impact-of-machine-perfusion-after-long-static-cold-storage-on-delayed-graft-function-incidence-and-duration-and-time-to-hospital-discharge
#20
Ana Cristina Carvalho Matos, Lúcio Roberto Requiao Moura, Milton Borrelli, Mario Nogueira, Gabriela Clarizia, Paula Ongaro, Marcelino Souza Durao, Alvaro Pacheco-Silva
Delayed graft function (DGF) is very high in our center (70-80%), we usually receive a kidney for transplant after more than 22 hours of static cold ischemia time (CIT). Also, there is an inadequate care of the donors contributing to a high rate of delayed graft function (DGF). We decided to test whether machine perfusion (MP) after a cold ischemic time (CIT) improved the outcome of our transplant patients. We analyzed the incidence of DGF, its duration and the length of hospital stay (LOS) in patients who received a kidney preserved with MP after a CIT (Hybrid Perfusion - HP)...
October 3, 2017: Clinical Transplantation
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