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https://www.readbyqxmd.com/read/28518214/immune-monitoring-as-prerequisite-for-transplantation-tolerance-trials
#1
REVIEW
Katayoun Behnam Sani, Birgit Sawitzki
Ever since its first application in clinical medicine, scientists have urged to induce tolerance towards foreign allogeneic transplants and thus avoid rejection by the recipient's immune system. This would circumvent chronic use of immunosuppressive drugs (IS) and thus avoid development of IS-induced side effects, which are contributing to the still unsatisfactory long-term graft and patient survival after solid organ transplantation. Although manifold strategies of tolerance induction have been described in preclinical models, only three therapeutic approaches have been successfully utilized in a still small number of patients...
May 18, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28513974/fecal-microbiota-transplantation-outcomes-in-immunocompetent-and-immunocompromised-patients-a-single-center-experience
#2
Sally Alrabaa, Ripal Jariwala, Kristen Zeitler, Jose Montero
BACKGROUND: Clostridium difficile infection (CDI) is a major infectious disease focus for which fecal microbiota transplantation (FMT) has been used with success in various patient populations. METHODS: We conducted a retrospective study of FMT in immunocompetent and immunocompromised patients to review outcomes at our center, with a focus on identifying risk factors for FMT failure in solid organ transplant (SOT) patients. FMT was conducted using universal banked frozen stool via naso-duodenal tube in patients with recurrent CDI of 3 or more episodes per our institutional protocol...
May 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#3
Jillian S Y S Y, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Richard A Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28511545/fosfomycin-tromethamine-for-the-treatment-of-cystitis-in-abdominal-solid-organ-transplant-recipients-with-renal-dysfunction
#4
Luiza Kerstenetzky, Margaret R Jorgenson, Jillian L Descourouez, Glen Leverson, Warren E Rose, Robert R Redfield, Jeannina A Smith
BACKGROUND: Urinary tract infection (UTI) after abdominal solid organ transplantation (SOT) is associated with significant morbidity and mortality. Fosfomycin tromethamine (FOS), a uroselective antibiotic, is FDA approved for uncomplicated UTIs in women and is used off-label for complicated UTIs and prostatitis in men. Literature supporting the use of FOS in the SOT population is limited, and efficacy is questioned in the setting of renal dysfunction. OBJECTIVE: To evaluate the success of FOS for the treatment of cystitis in SOT patients with renal dysfunction...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28509395/da-epoch-r-for-post-transplant-lymphoproliferative-disorders-ptld
#5
Christin B DeStefano, Vera Malkovska, Hind Rafei, Aarthi Shenoy, Kelly Fitzpatrick, Anita Aggarwal, Joseph P Catlett
Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous and potentially fatal group of neoplasms arising in an immunodeficient environment in the background of viral antigenic stimulation. PTLD is rare, with an incidence in solid organ transplant recipients typically less than 20% [1]. For aggressive, monomorphic cases, current guidelines recommend reduced immunosuppression in addition to chemoimmunotherapy, which generally consists of R-CHOP [1]. Nevertheless, prognosis is poor with 5-year overall survival (OS) rates of only 40-60% [1]...
May 16, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28507913/role-of-gastroesophageal-reflux-disease-in-lung-transplantation
#6
REVIEW
Kelly E Hathorn, Walter W Chan, Wai-Kit Lo
Lung transplantation is one of the highest risk solid organ transplant modalities. Recent studies have demonstrated a relationship between gastroesophageal reflux disease (GERD) and lung transplant outcomes, including acute and chronic rejection. The aim of this review is to discuss the pathophysiology, evaluation, and management of GERD in lung transplantation, as informed by the most recent publications in the field. The pathophysiology of reflux-induced lung injury includes the effects of aspiration and local immunomodulation in the development of pulmonary decline and histologic rejection, as reflective of allograft injury...
April 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28505159/infectious-disease-ward-admission-positively-influences-p-jiroveci-pneumonia-pjp-outcome-a-retrospective-analysis-of-116-hiv-positive-and-hiv-negative-immunocompromised-patients
#7
Alessandra Ricciardi, Elisa Gentilotti, Luigi Coppola, Gaetano Maffongelli, Carlotta Cerva, Vincenzo Malagnino, Alessia Mari, Ambra Di Veroli, Federica Berrilli, Fabiana Apice, Nicola Toschi, David Di Cave, Saverio Giuseppe Parisi, Massimo Andreoni, Loredana Sarmati
P. jiroveci (Pj) causes a potentially fatal pneumonia in immunocompromised patients and the factors associated with a bad outcome are poorly understood. A retrospective analysis on Pj pneumonia (PjP) cases occurring in Tor Vergata University Hospital, Italy, during the period 2011-2015. The patients' demographic, clinical and radiological characteristics and the Pj genotypes were considered. The study population included 116 patients, 37.9% of whom had haematological malignancy or underwent haematological stem cell transplantation (HSCT), 22...
2017: PloS One
https://www.readbyqxmd.com/read/28505106/human-chorionic-gonadotropin-the-pregnancy-hormone-and-more
#8
REVIEW
Charalampos Theofanakis, Petros Drakakis, Alexandros Besharat, Dimitrios Loutradis
To thoroughly review the uses of human chorionic gonadotropin (hCG) related to the process of reproduction and also assess new, non-traditional theories. Review of the international literature and research studies. hCG and its receptor, LH/CGR, are expressed in numerous sites of the reproductive tract, both in gonadal and extra-goanadal tissues, promoting oocyte maturation, fertilization, implantation and early embryo development. Moreover, hCG seems to have a potential role as an anti-rejection agent in solid organ transplantation...
May 14, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28505025/a-rodent-model-of-cardiac-donation-after-circulatory-death-and-novel-biomarkers-of-cardiac-viability-during-ex-vivo-heart-perfusion
#9
Mark J Kearns, Sally Miller, Anson Cheung, Jamil Bashir, Stephanie Wong, Michael A Seidman, John H Boyd
BACKGROUND: Organ donation after circulatory death (DCD) is increasingly being used as a means of addressing the organ supply/demand mismatch in solid organ transplantation. There is reluctance to use DCD hearts, due to an inability to precisely identify hearts that have suffered irreversible injury. We investigated novel biomarkers and clinically relevant endpoints across a spectrum of warm ischemic times (WITs), prior to and during ex vivo heart perfusion (EVHP), to identify features associated with a non-viable cardiac phenotype...
May 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28504842/safety-and-efficacy-of-current-daa-regimens-in-kidney-and-liver-transplant-recipients-with-hepatitis-c-results-from-the-hcv-target-study
#10
Varun Saxena, Vandana Khungar, Elizabeth C Verna, Josh Levitsky, Robert S Brown, Mohamed A Hassan, Mark S Sulkowski, Jacqueline G O'Leary, Farrukh Koraishy, Joseph S Galati, Alexander A Kuo, Monika Vainorius, Lucy Akushevich, David R Nelson, Michael W Fried, Norah Terrault, K Rajender Reddy
BACKGROUND: Data outside of clinical trials with direct acting antiviral (DAA) regimens with or without ribavirin as treatment of chronic HCV in solid organ transplant recipients is limited. METHODS: Liver transplant (LT), kidney transplant (KT) and dual liver kidney (DLK) transplant recipients from the HCV-TARGET database, a multicenter, longitudinal clinical care treatment cohort, treated with DAA regimens between January 1 2014 and February 15, 2016 were included to assess safety and efficacy...
May 15, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28503959/emerging-drugs-for-prevention-of-t-cell-mediated-rejection-in-liver-and-kidney-transplantation
#11
Tiffany Cl Wong, Chung-Mau Lo, James Yy Fung
Acute and chronic graft rejection continues to be an important problem after solid organ transplantation. With the introduction of potent immunosuppressive agents such as calcineurin inhibitors, the risk of rejection has been significantly reduced. However, the adverse effects of life-long immunosuppression remain a concern, and there exist a fine balance between over-immunosuppression and risk of rejection. Areas covered. In this review, the current standard of care in immunosuppressive therapy, including the use of steroids, calcineurin inhibitors, mycophenolate prodrugs and mammalian target of rapamycin inhibitors, will be discussed...
May 15, 2017: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/28500792/changing-trends-in-the-aetiology-treatment-and-outcomes-of-bloodstream-infection-occurring-in-the-first-year-after-solid-organ-transplantation-a-single-centre-prospective-cohort-study
#12
Isabel Oriol, Núria Sabé, Antonella F Simonetti, Laura Lladó, Anna Manonelles, Jose González, Fe Tubau, Jordi Carratalà
To analyse trends in the aetiology, treatment and outcomes of BSI within the first year post-transplant over the last 10-year period, we prospectively recorded all episodes of BSI occurring in SOT recipients during the first year post-transplant from 2007 to 2016. Trends of factors were analysed by 2-year periods. Of 475 consecutive episodes of BSI, 218 occurred within a year of SOT in 178 SOT recipients. Gram-positive BSI decreased over time (40.5% to 2.2%). In contrast, there was a steady increase in Gram-negative bacilli (GNB) BSI (54...
May 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28500778/phaeohyphomycosis-due-to-exophiala-infections-in-solid-organ-transplant-recipients-case-report-and-literature-review
#13
Kate E Oberlin, Anna J Nichols, Rossana Rosa, Adriana Dejman, Adela Mattiazzi, Giselle Guerra, George W Elgart, Lilian M Abbo
This case report and literature review underscores the cutaneous presentations of phaeohyphomycosis in the solid organ transplant population. Increased cognizance with prompt identification is critical. The therapy and clinical outcomes of phaeohyphomycosis, caused by the Exophiala genus, in the solid organ transplant population is analyzed to examine optimal care. This review highlights the inherent difficulties in providing the appropriate duration of antifungal therapy to avoid relapsing infections in immunosuppressed patients...
May 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28499512/the-organ-transplant-imperative
#14
REVIEW
Wil L Santivasi, Jacob J Strand, Paul S Mueller, Thomas J Beckman
More than 120,000 US patients were listed for solid organ transplants in 2016. Although data are scarce, we suspect that many of these patients will die while awaiting transplant and without engaging in goals-of-care discussions with their physicians. The challenges of addressing goals of care in patients with malignancy, end-stage renal disease, and heart failure have been studied. However, there is sparse literature on addressing goals of care throughout the dynamic process of transplant assessment and listing...
May 10, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28492295/elderly-versus-non-elderly-patients-with-intra-abdominal-candidiasis-in-the-icu
#15
George Dimopoulos, Dimitrios K Matthaiou, Elda Righi, Maria Merelli, Matteo Bassetti
BACKGROUND: Intra-abdominal candidiasis (IAC) has a considerable cost in terms of mortality and morbidity. We sought to study the epidemiology, characteristics and outcome of elderly (>75 years old) versus non-elderly patients with IAC and risk factors for mortality in elderly patients. METHODS: Post-hoc analysis of a retrospective multinational cohort study over a 3- year period (2011-2013). RESULTS: Of 482 patients, 124 (25.7%) were elderly and 358 (74...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28489277/pancreas-after-islet-pai-transplantation-in-non-uremic-type-1-diabetes-a-strategy-for-restoring-durable-insulin-independence
#16
S A Wisel, J M Gardner, G R Roll, J Harbell, C E Freise, S Feng, S M Kang, R Hirose, D B Kaufman, A Posselt, P G Stock
Islet transplantation offers a minimally-invasive approach for beta cell replacement in diabetic patients with hypoglycemic unawareness. Attempts at insulin independence may require multiple islet re-infusions from distinct donors, thus increasing the risk for allogeneic sensitization. Currently, solid organ pancreas transplant is the only remaining surgical option following failed islet transplantation in the US. However, the immunologic impact of repeated exposure to donor antigens on subsequent pancreas transplantation is unclear...
May 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28485086/uptake-of-cancer-screening-tests-among-recipients-of-solid-organ-transplantation
#17
S A Acuna, R Sutradhar, X Camacho, C Daly, M E Del Giudice, S J Kim, N N Baxter
Population-based cancer screening recommendations are also suggested for solid organ transplant recipients (SOTR); however, recommendation adherence is unknown. In a population-based cohort of SOTR in Ontario between 1997 and 2010, we determined the uptake of breast, cervical, and colorectal cancer screening tests and identified factors associated with up-to-date screening using recurrent event analysis. We identified 4436 SOTR eligible for colorectal, 2252 for cervical, and 1551 for breast cancer screening...
May 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28484450/il-2-mediated-in-vivo-expansion-of-regulatory-t-cells-combined-with-cd154-cd40-co-stimulation-blockade-but-not-ctla-4-ig-prolongs-allograft-survival-in-naive-and-sensitized-mice
#18
Lerisa Govender, Jean-Christophe Wyss, Rajesh Kumar, Manuel Pascual, Dela Golshayan
In recent years, regulatory T cells (Treg)-based immunotherapy has emerged as a promising strategy to promote operational tolerance after solid organ transplantation (SOT). However, a main hurdle for the therapeutic use of Treg in transplantation is their low frequency, particularly in non-lymphopenic hosts. We aimed to expand Treg directly in vivo and determine their efficacy in promoting donor-specific tolerance, using a stringent experimental model. Administration of the IL-2/JES6-1 immune complex at the time of transplantation resulted in significant expansion of donor-specific Treg, which suppressed alloreactive T cells...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28480540/pharmacological-modulation-of-cell-death-in-organ-transplantation
#19
REVIEW
Pietro E Cippà, Thomas Fehr
New options to pharmacologically modulate fundamental mechanisms of regulated cell death are rapidly evolving and found first clinical applications in cancer therapy. Here we present an overview on how the recent advances in the understanding of the biology and pharmacology of cell death might influence research and clinical practice in solid organ transplantation. Of particular interest are the novel opportunities related to organ preservation and immunomodulation, which might contribute to promote organ repair and to develop more selective ways to modulate allogeneic immune responses to prevent rejection and induce immunological tolerance...
May 8, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28480277/epidemiology-of-cryptococcosis-and-cryptococcal-meningitis-in-a-large-retrospective-cohort-of-patients-after-solid-organ-transplantation
#20
Ige A George, Carlos A Q Santos, Margaret A Olsen, William G Powderly
BACKGROUND: Cryptococcosis is the third most common invasive fungal infection in solid organ transplant (SOT) recipients. There are no nationally representative data describing the incidence, risk factors, and outcomes of cryptococcosis after SOT. METHODS: We assembled a large cohort of adult SOT recipients using Classification of Diseases, Ninth Revision, Clinical Modification billing data from Healthcare Cost and Utilization Project State Inpatient Databases of Florida (2006-2012), New York (2006-2011), and California (2004-2010)...
2017: Open Forum Infectious Diseases
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