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Liver transplant, kidney transplant, pancreas and intestinal transplant

Walter S Andrews, Bartholomew J Kane, Richard J Hendrickson
Pediatric transplant candidates include heart, lung, liver, pancreas, small intestine, and kidney. The purpose of this article is to review the history and current methods for determining priority of the above-mentioned transplantable organs. The methods used by the authors involved the review of historical and current manuscripts and UNOS policy documents. We summarized the findings in order to create a concise review of the current policies and wait times for transplantation in pediatric transplant patients...
August 2017: Seminars in Pediatric Surgery
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previously published reports suggest that these cases should be managed perioperatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of 67 isolated intestinal, intestinal-pancreas, and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
Michela Assalino, Karine Hadaya, Axel Andres, Thierry Berney
The article by Parajuli et al published in this issue of Transplant International is the latest, and perhaps the most convincing in a relatively small body of literature, to suggest that in a situation of simultaneous pancreas-kidney transplantation (SPK), in which both organs are from the same donor, one organ may be undergoing acute rejection independently from the other (1). The organ hierarchy in immunogeneicity and susceptibility to rejection is a long known biological phenomenon, with the liver at one end of the spectrum and the intestine the other...
August 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
Josef Finsterer, Marlies Frank
Mitochondrial disorders (MIDs) due to respiratory-chain defects or nonrespiratory chain defects are usually multisystem conditions [mitochondrial multiorgan disorder syndrome (MIMODS)] affecting the central nervous system (CNS), peripheral nervous system, eyes, ears, endocrine organs, heart, kidneys, bone marrow, lungs, arteries, and also the intestinal tract. Frequent gastrointestinal (GI) manifestations of MIDs include poor appetite, gastroesophageal sphincter dysfunction, constipation, dysphagia, vomiting, gastroparesis, GI pseudo-obstruction, diarrhea, or pancreatitis and hepatopathy...
January 2017: Therapeutic Advances in Gastroenterology
Carlo Castellani, Baroukh M Assael
Cystic fibrosis (CF), a monogenic disease caused by mutations in the CFTR gene on chromosome 7, is complex and greatly variable in clinical expression. Airways, pancreas, male genital system, intestine, liver, bone, and kidney are involved. The lack of CFTR or its impaired function causes fat malabsorption and chronic pulmonary infections leading to bronchiectasis and progressive lung damage. Previously considered lethal in infancy and childhood, CF has now attained median survivals of 50 years of age, mainly thanks to the early diagnosis through neonatal screening, recognition of mild forms, and an aggressive therapeutic attitude...
January 2017: Cellular and Molecular Life Sciences: CMLS
Stefan G Tullius, Bohdan Pomahac, Heung Bae Kim, Matthew J Carty, Simon G Talbot, Helen M Nelson, Francis L Delmonico
We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor...
October 2016: Transplantation
John P Donnelly, Jayme E Locke, Paul A MacLennan, Gerald McGwin, Roslyn B Mannon, Monika M Safford, John W Baddley, Paul Muntner, Henry E Wang
BACKGROUND: Solid organ transplant (SOT) recipients are at elevated risk of sepsis. The impact of SOT on outcomes following sepsis is unclear. METHODS: We performed a retrospective cohort study using data from University HealthSystem Consortium, a consortium of academic medical center affiliates. We examined the association between SOT and mortality among patients hospitalized with severe sepsis or explicitly coded sepsis in 2012-2014. We used International Classification of Diseases, Ninth Revision (ICD-9) codes to identify severe sepsis, explicitly coded sepsis, and SOT (kidney, liver, heart, lung, pancreas, or intestine transplants)...
July 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Megan L Troxell, Christian Lanciault
CONTEXT: -Immunohistochemical analysis of tissue biopsy specimens is a crucial tool in diagnosis of both rejection and infection in patients with solid organ transplants. In the past 15 years, the concept of antibody-mediated rejection has been refined, and diagnostic criteria have been codified in renal, heart, pancreas, and lung allografts (with studies ongoing in liver, small intestine, and composite grafts), all of which include immunoanalysis for the complement split product C4d...
September 2016: Archives of Pathology & Laboratory Medicine
María Guadalupe Moreno-Treviño, Gerardo Rivera-Silva
Transplants are one of the most important advances of modern medicine; in the last 50 years in our country there have been more than fifty thousand transplants, which makes it clear that this is one of the most sought-after medical practices not only in Mexico but worldwide. In life, it is possible for a person to donate a kidney, a lung or a liver segment. When brain death occurs it is possible for a person to donate kidneys, heart, liver, pancreas, intestines, lungs, blood, hematopoietic cells, bone marrow, bones, corneas, heart valves, tendons, and arteries...
November 2015: Revista Médica del Instituto Mexicano del Seguro Social
Milan Kuman
Solid organ transplantation (heart, lung, liver, kidney, pancreas, small interesting and their combinations) are standard therapy of terminal organ failure. Czech Republic belongs to the states with developed transplantation program. The results correspond with current knowledge and results of leading centers in the world, as demostrated in this article. Organ donor shortage is major factor limiting development of organ transplantations as elsewhere in the Europe or in the world.
July 2015: Vnitr̆ní Lékar̆ství
Ted Welman, Sebastian Michel, Nicholas Segaren, Kumaran Shanmugarajah
Organ transplantation can offer a curative option for patients with end stage organ failure. Unfortunately the treatment is severely limited by the availability of donor organs. Organ bioengineering could provide a solution to the worldwide critical organ shortage. The majority of protocols to date have employed the use of decellularization-recellularization technology of naturally occurring tissues and organs with promising results in heart, lung, liver, pancreas, intestine and kidney engineering. Successful decellularization has provided researchers with suitable scaffolds to attempt cell reseeding...
2015: Bioengineered
L Raffini, C Witmer
There has been extraordinary progress over the last half-century in the field of medical transplantation in which tissue, organs, or body parts from one human are placed into another. Solid organ transplants have allowed thousands of children with otherwise devastating inherited or acquired disorders to survive. Depending upon the clinical situation, there are many specific peri-transplant issues that must be carefully addressed to optimize outcomes. Although surgical, immunologic, and infectious concerns are usually in the forefront, important aspects regarding hemostasis frequently arise...
June 2015: Journal of Thrombosis and Haemostasis: JTH
G Low, J L Jaremko, D J Lomas
A variety of transplants have been performed in the abdomen including liver, kidney, pancreas and islet, bowel, and multivisceral transplants. Imaging plays an important role in graft surveillance particularly to exclude post-transplant complications. When complications occur, therapeutic image-guided interventions are invaluable as these may be graft-saving and even life-saving. Vascular complications following transplantation have been extensively reported in recent reviews. The focus of this review is to discuss post-transplant complications that are primarily extravascular in location...
August 2015: Clinical Radiology
Suresh Paudel, Ioannis M Zacharioudakis, Fainareti N Zervou, Panayiotis D Ziakas, Eleftherios Mylonakis
Several factors including antibiotic use, immunosuppression and frequent hospitalizations make solid organ transplant (SOT) recipients vulnerable to Clostridium difficile infection (CDI). We conducted a meta-analysis of published studies from 1991-2014 to estimate the prevalence of CDI in this patient population. We searched PubMed, EMBASE and Google Scholar databases. Among the 75,940 retrieved citations, we found 30 studies coded from 35 articles that were relevant to our study. Based on these studies, we estimated the prevalence of CDI among 21,683 patients who underwent transplantation of kidney, liver, lungs, heart, pancreas, intestine or more than one organ and stratified each study based on the type of transplanted organ, place of the study conduction, and size of patient population...
2015: PloS One
Joohyun Kim, Michael A Zimmerman
PURPOSE OF REVIEW: This article reviews current strategies for living-donor organ procurement in liver, kidney, pancreas, and intestinal transplant. RECENT FINDINGS: Here we summarize current open and laparoscopic approaches to living donation of abdominal organs. SUMMARY: Living donation strategies expand the organ pool in the setting of a significant organ shortage.
April 2015: Current Opinion in Organ Transplantation
Abbas Rana, Angelika Gruessner, Vatche G Agopian, Zain Khalpey, Irbaz B Riaz, Bruce Kaplan, Karim J Halazun, Ronald W Busuttil, Rainer W G Gruessner
IMPORTANCE: The field of transplantation has made tremendous progress since the first successful kidney transplant in 1954. OBJECTIVE: To determine the survival benefit of solid-organ transplant as recorded during a 25-year study period in the United Network for Organ Sharing (UNOS) database and the Social Security Administration Death Master File. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective analysis of UNOS data for solid-organ transplant during a 25-year period (September 1, 1987, through December 31, 2012), we reviewed the records of 1,112,835 patients: 533,329 recipients who underwent a transplant and 579 506 patients who were placed on the waiting list but did not undergo a transplant...
March 1, 2015: JAMA Surgery
P A Farinelli, J M Padin, J C Troncoso, A Bertolotti, M Lenz, N Sanchez, R Fortunato, E Caravello, N Imperiali, M Dip, R Sanchez Claria, M Arriola, J De Arteaga, G Pujol Soler, L Bisigniano, O Gil, L McCormack, E Botta, O Inventarza, L Gaite, S H Hyon, P Raffaele, G Illanes, E de Santibañez, R Favaloro, G Gondolesi
BACKGROUND: The development of intestinal transplant (Tx) programs introduces thymoglobulin donor treatment as well as an almost complete warm dissection of the abdominal organs to allocate them to different recipients. Our aim is to assess the reproducibility and feasibility of the surgical technique of multi-organ procurement with the use of thymoglobulin donor pre-treatment and report the short- and long-term outcomes of every graft harvested as part of multi-organ procurement (MTOp), including the intestine...
July 2014: Transplantation Proceedings
C W N Spearman, M I McCulloch
Transplantation is the accepted mode of treatment for patients with end-stage organ disease affecting the heart, lungs, kidney, pancreas, liver and intestine. Long-term outcomes have significantly improved and the aim of management is no longer only long-term survival, but also focuses on quality of life especially in children. Transplantation in Africa faces a number of challenges including wide socioeconomic disparity, lack of legislation around brain death and organ donation in many countries, shortage of skilled medical personnel and facilities, infectious disease burden and insecure access to and monitoring of immunosuppression...
November 2014: Pediatric Transplantation
N Zacharias, M H Gallichio, D J Conti
Graft-versus-host disease (GVHD) is a rare complication after solid organ transplantation and consists of a reaction of donor derived immune cells directed against host tissues. The vast majority of cases reported in the literature involve liver, small intestine and pancreas transplantation. We report a case of GVHD in a 48-year-old man after living-unrelated kidney transplantation at another center. Six months postoperatively he developed a skin rash, anorexia, and diarrhea that resulted in malnutrition and a 90 pound weight loss...
2014: Case Reports in Transplantation
Constantinos Nastos, Konstantinos Kalimeris, Nikolaos Papoutsidakis, Marios-Konstantinos Tasoulis, Panagis M Lykoudis, Kassiani Theodoraki, Despoina Nastou, Vassilios Smyrniotis, Nikolaos Arkadopoulos
Liver ischemia/reperfusion injury has been extensively studied during the last decades and has been implicated in the pathophysiology of many clinical entities following hepatic surgery and transplantation. Apart from its pivotal role in the pathogenesis of the organ's post reperfusion injury, it has also been proposed as an underlying mechanism responsible for the dysfunction and injury of other organs as well. It seems that liver ischemia and reperfusion represent an event with "global" consequences that influence the function of many remote organs including the lung, kidney, intestine, pancreas, adrenals, and myocardium among others...
2014: Oxidative Medicine and Cellular Longevity
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