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https://www.readbyqxmd.com/read/28239914/-d-10-meld-as-a-novel-predictor-of-patient-and-graft-survival-after-adult-to-adult-living-donor-liver-transplantation
#1
Arvinder Singh Soin, Sanjay Goja, Sanjay Kumar Yadav, Tseten Yonjen Tamang, Amit Rastogi, Prashant Bhangui, S Thiagrajan, Vikram Raut, Raghvendra Y Babu, Neeraj Saraf, Narendra Singh Chaudhary, Vijay Vohara
We modified the previously described DMELD score in deceased donor liver transplant, to (D+10)MELD to account for living donors being about 10 years younger than deceased donors, and tested it on living donor liver transplantation (LDLT) recipients. 500 consecutive LDLT, between July 2010 and December 2012 were retrospectively analyzed to see the effect of (D+10)MELD on patient and graft survival. Donor age alone did not influence survival. Recipients were divided into 6 classes on based on the (D+10)MELD score: Class 1 (0-399), Class 2 (400-799), Class 3 (800-1199), class 4 (1200-1599), Class 5 (1600-1999) and Class 6 (>2000)...
February 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28239909/ledipasvir-sofosbuvir-is-effective-and-well-tolerated-in-post-kidney-transplant-patients-with-chronic-hepatitis-c-virus
#2
Amilcar L Morales, Luz Liriano-Ward, Amber Tierney, Michelle Sang, Alexander Lalos, Mohamed Hassan, Vinay Nair, Thomas Schiano, Rohit Satoskar, Coleman Smith
Patients with end stage renal diseases on hemodialysis have a high prevalence of hepatitis C infection (HCV). In most patients treatment for HCV is delayed until post renal transplant. We assessed the effectiveness and tolerance of ledipasvir/sofosbuvir (LDV/SOF) in 32 post-kidney transplant patients infected with HCV. The group was composed predominantly of treatment naïve (75%) African American (68.75%) males (75%) infected with genotype 1a (62.5%). Most patients received a deceased donor kidney graft (78...
February 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28223731/risk-of-alcohol-use-relapse-after-liver-transplantation-for-alcoholic-liver-disease
#3
Yasuharu Onishi, Hiroyuki Kimura, Tomohide Hori, Shinichi Kishi, Hideya Kamei, Nobuhiko Kurata, Chisato Tsuboi, Naoko Yamaguchi, Mayu Takahashi, Saki Sunada, Mitsuaki Hirano, Hiroshige Fujishiro, Takashi Okada, Masatoshi Ishigami, Hidemi Goto, Norio Ozaki, Yasuhiro Ogura
AIM: To investigate factors, including psychosocial factors, associated with alcoholic use relapse after liver transplantation (LT) for alcoholic liver disease (ALD). METHODS: The clinical records of 102 patients with ALD who were referred to Nagoya University Hospital for LT between May 2003 and March 2015 were retrospectively evaluated. History of alcohol intake was obtained from their clinical records and scored according to the High-Risk Alcoholism Relapse scale, which includes duration of heavy drinking, types and amount of alcohol usually consumed, and previous inpatient treatment history for alcoholism...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28223040/red-blood-cell-exchange-as-an-approach-for-treating-a-case-of-severe-tacrolimus-overexposure
#4
Valentina Spallanzani, Lucia Bindi, Irene Bianco, Arianna Precisi, Paolo DeSimone, Alessandro Mazzoni, Gianni Biancofiore
Immunosuppressive medication dosing errors are not unfrequent and may present a number of challenges to transplant clinicians. Tacrolimus (TAC) is a widely used immunosuppressant with a narrow therapeutic index and potential severe side effects, including neurotoxicity and kidney injury. We herein report a case of 60-year-old woman who underwent deceased-donor liver transplantation at our center and due to inadvertent TAC overexposure was admitted to the Intensive Care Unit because of severe neurologic impairment, kidney injury and arterial hypotension...
February 2, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28221244/hla-amino-acid-polymorphisms-and-kidney-allograft-survival
#5
Malek Kamoun, Keith P McCullough, Martin Maiers, Marcelo A Fernandez Vina, Hongzhe Li, Valerie Teal, Alan B Leichtman, Robert M Merion
BACKGROUND: The association of HLA mismatching with kidney allograft survival has been well established. We examined whether amino acid mismatches at the antigen recognition site of HLA molecules represent independent and incremental risk factors for kidney graft failure (GF) beyond those mismatches assessed at the antigenic (2-digit) specificity. METHODS: Data on 240,024 kidney transplants performed between 1987 and 2009 were obtained from the Scientific Registry of Transplant Recipients...
February 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28220747/three-cases-of-neurologic-syndrome-caused-by-donor-derived-microsporidiosis
#6
Rachel M Smith, Atis Muehlenbachs, Joanna Schaenmann, Sanjiv Baxi, Sophia Koo, Dianna Blau, Peter Chin-Hong, Anna R Thorner, Matthew J Kuehnert, Kristina Wheeler, Alexis Liakos, Jonathan W Jackson, Theresa Benedict, Alexandre J da Silva, Jana M Ritter, Dominique Rollin, Maureen Metcalfe, Cynthia S Goldsmith, Govinda S Visvesvara, Sridhar V Basavaraju, Sherif Zaki
In April 2014, a kidney transplant recipient in the United States experienced headache, diplopia, and confusion, followed by neurologic decline and death. An investigation to evaluate the possibility of donor-derived infection determined that 3 patients had received 4 organs (kidney, liver, heart/kidney) from the same donor. The liver recipient experienced tremor and gait instability; the heart/kidney and contralateral kidney recipients were hospitalized with encephalitis. None experienced gastrointestinal symptoms...
March 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28219583/risk-factors-affecting-graft-and-patient-survivals-after-transplantation-from-deceased-donors-in-a-developing-country-a-single-center-experience
#7
Y Ayar, A Ersoy, G Ocakoglu, A Yildiz, A Oruc, H Soyak, M Calapkulu, A B Sahin, N Bolca Topal, E Okeer, B Coskun, O Kaygisiz, Y Kordan, H Vuruskan
AIM: The aim of this study was to evaluate risk factors affecting graft and patient survival after transplantation from deceased donors. METHODS: We retrospectively analyzed the outcomes of 186 transplantations from deceased donors performed at our center between 2006 and 2014. The recipients were divided into two groups: Group I (141 recipients without graft loss) and Group II (45 recipients with graft loss). Kaplan-Meier, log-rank test, and Cox proportional hazard regressions were used...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28218989/liver-transplantation-from-donors-with-positive-blood-cultures-increased-risk-of-graft-failure-or-opportunity-to-expand-the-donor-pool
#8
Paolo Antonio Grossi
Organ transplantation is considered the therapy of choice for end-stage organ failure. However, the growing gap between the number of patients waiting for transplantation and available organs continue to be the number one issue facing the transplant community. As a consequence the major focus in liver transplantation has been developing strategies to increase available donors, including the use of live donor liver segments, splitting deceased donor grafts for two patients and the use of organs procured from donors after circulatory death (DCD)...
February 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28216707/combined-liver-and-kidney-transplantation-our-experience-and-review-of-literature
#9
Kusuma Ramachandra Halemani, N Bhadrinath
Increased awareness of organ donation has increased the availability of deceased donors, and it has boosted the opportunities for treating patients with multiple organ dysfunction. Simultaneously replacing two organs gives advantages of single surgery, lower immunosuppression dose and better survival than when one organ alone is transplanted. We present reports of management of three cases of combined liver and kidney transplantation (CLKT) from deceased donors. Based on management of these cases we discuss the importance of CLKT and anaesthetic concerns during such complex procedures...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28212159/liver-allocation-and-distribution-time-for-a-change
#10
Ranjit Deshpande, Ryutaro Hirose, David Mulligan
PURPOSE OF REVIEW: Liver allograft allocation has been a topic of hot debate for over a decade. New redistricting changes have been proposed by the Liver and Intestinal Transplant Committee to the existing United Network for Organ Sharing (UNOS) liver allocation policy. The basis of this new proposal is similar to the old one with an aim to distribute organs in a fair, efficient and equitable fashion. In this review, we plan to look in depth at the redistribution proposals thus far, their merits and how they may help patients who do not have adequate access to livers...
February 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28211259/liver-transplantation-from-a-deceased-donor-with-%C3%AE-thalassemia-intermedia-is-not-contraindicated-a-case-report
#11
Ersin Gumus, Osman Abbasoglu, Cahit Tanyel, Fatma Gumruk, Hasan Ozen, Aysel Yuce
The use of extended criteria donors who might have previously been deemed unsuitable is an option to increase the organ supply for transplantation. This report presents a pediatric case of a successful liver transplantation from a donor with β-thalassemia intermedia. A patient, 6-year-old female, with a diagnosis of cryptogenic liver cirrhosis underwent deceased donor liver transplantation from a thalassemic donor. Extreme hyperferritinemia was detected shortly after transplantation. The most probable cause of hyperferritinemia was iron overload secondary to transplantation of a hemosiderotic liver...
February 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28208936/supra-hepatic-inferior-vena-cava-thrombosis-surgical-challenges
#12
Senthil Muthuraman, Anand Ramamurthy, Mahesh Gopashetty, Cuddalore Sadasivam Vijayshankar, Anand Khakhar
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a chronic affliction characterized by numerous liver and kidney cysts. There is a gradual but progressive renal and liver impairment which may require combined liver-kidney transplantation. Compression of the retrohepatic Inferior Vena Cava (IVC) by an enlarged polycystic liver may impede clear visualization on pre-operative imaging and miss an underlying thrombosis or obliteration. This may result in an intra-operative surprise. Management can be challenging requiring modification of conventional surgical approach...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207635/kidney-transplantation-rates-across-glomerulonephritis-subtypes-in-the-united-states
#13
Michelle M O'Shaughnessy, Sai Liu, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
BACKGROUND: Whether kidney transplantation rates differ by glomerulonephritis (GN) subtype remains largely unknown. METHODS: Using the US Renal Data System, we identified all adult patients with ESRD attributed to 1 of 6 GN subtypes who initiated dialysis in the US (1996-2013). Patients with diabetic nephropathy (DN) and autosomal-dominant polycystic kidney disease (ADPKD) served as "external" non-GN comparators. Using Cox proportional hazards regression, with death considered a competing risk, we estimated hazard ratios [HRs (95% confidence intervals)] for first kidney transplantation, controlling for year, demographics, comorbidities, socioeconomic factors, and Organ Procurement Organization (OPO)...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28206695/graft-quality-matters-survival-after-simultaneous-liver-kidney-transplant-according-to-kdpi
#14
Colleen Jay, Jacqueline Pugh, Glenn Halff, Greg Abrahamian, Francisco Cigarroa, Ken Washburn
BACKGROUND: Poor renal function is associated with higher mortality after liver transplantation. Our aim was to understand the impact of kidney graft quality according to kidney donor profile index (KDPI) score on survival after simultaneous liver-kidney (SLK) transplantation. METHODS: Using United Network of Organ Sharing data from 2002-2013 for adult deceased donor SLK recipients, we compared survival and renal graft outcomes according to KDPI. RESULTS: Of 4,207 SLK transplants, 6% were from KDPI >85% donors...
February 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28203455/risk-balancing-of-cold-ischemic-time-against-night-shift-surgery-possibly-reduces-rates-of-reoperation-and-perioperative-graft-loss
#15
Nikos Emmanouilidis, Julius Boeckler, Bastian P Ringe, Alexander Kaltenborn, Frank Lehner, Hans Friedrich Koch, Jürgen Klempnauer, Harald Schrem
Background. This retrospective cohort study evaluates the advantages of risk balancing between prolonged cold ischemic time (CIT) and late night surgery. Methods. 1262 deceased donor kidney transplantations were analyzed. Multivariable regression was used to determine odds ratios (ORs) for reoperation, graft loss, delayed graft function (DGF), and discharge on dialysis. CIT was categorized according to a forward stepwise pattern ≤1h/>1h, ≤2h/>2h, ≤3h/>3h,…, ≤nh/>nh. ORs for DGF were plotted against CIT and a nonlinear regression function with best R(2) was identified...
2017: Journal of Transplantation
https://www.readbyqxmd.com/read/28197992/study-of-the-association-between-human-leukocyte-antigens-hla-and-pemphigus-vulgaris-in-brazilian-patients
#16
Julio M Gil, Raimar Weber, Claudia B Rosales, Helcio Rodrigues, Luiz U Sennes, Jorge Kalil, Azis Chagury, Ivan D Miziara
BACKGROUND: Pemphigus vulgaris is a mucocutaneous blistering autoimmune disease that manifests as painful blisters or erosions on the skin and/or mucosal surfaces. IgG autoantibodies target desmoglein, playing a major role in disease pathogenesis. Genetic predisposal to pemphigus vulgaris, especially the HLA DR and DQ alleles, has been known since the 1980s. The unique constitution of the Brazilian population favors exploratory genetic studies. METHODS: The study group included 51 patients with a confirmed diagnosis of pemphigus vulgaris from a tertiary hospital in Sao Paulo city, Sao Paulo, southeast Brazil...
February 15, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28197039/surgical-illustration-of-en-bloc-dual-kidney-transplant-from-a-16-month-old-brain-dead-donor-to-an-adult-recipient
#17
Vikas Jain, Saurabh Jain, Paras Singhal, Suman Lata Nayak, Rajendra P Mathur
Transplantable organs from pediatric donors have been contributing significantly to donor pool worldwide. Pediatric donors are excellent resources that should be procured whenever available, and with the recent increase in deceased donations in India, more pediatric donors will be available for organ harvesting. We share a rare instance of multi-organ harvesting from a 16-month old brain dead donor and implanting both kidneys en-bloc in an adult male, while liver went to a 4-year old child. The report provides the surgical illustration of salient steps of transplanting both kidneys from pediatric donor into an adult, in an en-bloc manner...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28196987/living-donor-liver-transplantation-eliminating-the-wait-for-death-in-end-stage-liver-disease
#18
REVIEW
Robert A Fisher
Adult-to-adult living donor liver transplantation (A2ALDLT), outside of Asia, remains an important yet underutilized gift of life. For patients with end-stage liver disease, A2ALDLT is a proven transplantation option, with lower waiting list mortality and suffering, and equivalent or better allograft and patient survival than deceased-donor liver transplantation (DDLT). The risks to living donors and the benefit to their recipients have been carefully defined with long-term level 1 and 2 evidence-based study...
February 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28183854/linguistic-isolation-and-access-to-the-active-kidney-transplant-waiting-list-in-the-united-states
#19
Efrain Talamantes, Keith C Norris, Carol M Mangione, Gerardo Moreno, Amy D Waterman, John D Peipert, Suphamai Bunnapradist, Edmund Huang
BACKGROUND AND OBJECTIVES: Waitlist inactivity is a barrier to transplantation, because inactive candidates cannot receive deceased donor organ offers. We hypothesized that temporarily inactive kidney transplant candidates living in linguistically isolated communities would be less likely to achieve active waitlist status. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We merged Organ Procurement and Transplantation Network/United Network for Organ Sharing data with five-digit zip code socioeconomic data from the 2000 US Census...
February 9, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28182043/deceased-donor-renal-transplantation-a-single-center-experience
#20
N Gopalakrishnan, T Dineshkumar, J Dhanapriya, R Sakthirajan, T Balasubramaniyan, N D Srinivasa Prasad, K Thirumalvalavan, S Murugananth, K Kawaskar
Deceased donor renal transplantation (DDRT) constitutes less than 5% of all kidney transplantats in India. A retrospective analysis of 173 deceased donor renal transplants performed in a public funded government hospital was done. Mean age of the recipients was 36 years (male:female ratio 2.4:1), and that of the donors was 32.3 years (male:female ratio 6:1). The cold ischemic time was 340 ± 170 minutes. Mean follow-up period was 36 months. Forty one patients died, 75% of them in the first post - transplant year...
January 2017: Indian Journal of Nephrology
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