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Primary graft dysfunction

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https://www.readbyqxmd.com/read/29334530/antegrade-arterial-and-portal-flushing-versus-portal-flushing-only-for-right-lobe-live-donor-liver-transplantation-a-randomized-control-trial
#1
Viniyendra Pamecha, Rommel Sandhyav, Piyush Kumar Sinha, Kishore Gurumoorthy Subramanya Bharathy, Shridhar Sasturkar
INTRODUCTION: In live donor liver transplantation (LDLT) portal flush only of the graft is done on the bench. There is no data on antegrade arterial flush along with portal flush of the graft. METHODS: Consecutive patients undergoing elective right lobe LDLT were block-randomized to receive either portal flush only or both portal and antegrade arterial flush. The primary objectives were safety, rate of early allograft dysfunction (EAD), and impact on vascular and biliary complications RESULTS: After randomization there were 40 patients in each group...
January 12, 2018: Transplantation
https://www.readbyqxmd.com/read/29319724/evaluation-of-the-efficacy-and-safety-of-endovascular-management-for-transplant-renal-artery-stenosis
#2
Leonardo G M Valle, Rafael N Cavalcante, Joaquim M Motta-Leal-Filho, Breno B Affonso, Francisco L Galastri, Marisa P Doher, Nadia K Guimarães-Souza, Ana K N Cavalcanti, Rodrigo G Garcia, Álvaro Pacheco-Silva, Felipe Nasser
OBJECTIVES: To evaluate the safety and efficacy of endovascular intervention with angioplasty and stent placement in patients with transplant renal artery stenosis. METHODS: All patients diagnosed with transplant renal artery stenosis and graft dysfunction or resistant systemic hypertension who underwent endovascular treatment with stenting from February 2011 to April 2016 were included in this study. The primary endpoint was clinical success, and the secondary endpoints were technical success, complication rate and stent patency...
December 2017: Clinics
https://www.readbyqxmd.com/read/29304176/prediction-of-delayed-graft-function-and-long-term-graft-survival-by-serum-and-urinary-neutrophil-gelatinase-associated-lipocalin-during-the-early-postoperative-phase-after-kidney-transplantation
#3
Herbert Thomas Maier, Muhammad Imtiaz Ashraf, Christian Denecke, Sascha Weiss, Florian Augustin, Franka Messner, Natalie Vallant, Matthias Böcklein, Christian Margreiter, Georg Göbel, Johann Pratschke, Dietmar Öfner-Velano, Felix Aigner
Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as an early marker protein for kidney dysfunction in various clinical settings. In this prospective study we evaluated serial changes of serum and urinary NGAL within the first 7 days after kidney transplantation in 170 consecutive recipients. The main focus of this study was to assess the performance of serum and urinary NGAL in the prediction of delayed graft function (DGF) and two-year graft and patient survival. Serum and urine samples of 170 patients undergoing primary kidney transplantation from October 2010 to December 2012 were prospectively collected from day 0 to 7...
2018: PloS One
https://www.readbyqxmd.com/read/29261831/evaluation-of-early-allograft-function-using-the-liver-graft-assessment-following-transplantation-risk-score-model
#4
Vatche G Agopian, Michael P Harlander-Locke, Daniela Markovic, Wethit Dumronggittigule, Victor Xia, Fady M Kaldas, Ali Zarrinpar, Hasan Yersiz, Douglas G Farmer, Jonathan R Hiatt, Ronald W Busuttil
Importance: Early allograft dysfunction (EAD) following a liver transplant (LT) unequivocally portends adverse graft and patient outcomes, but a widely accepted classification or grading system is lacking. Objective: To develop a model for individualized risk estimation of graft failure after LT and then compare the model's prognostic performance with the existing binary EAD definition (bilirubin level of ≥10 mg/dL on postoperative day 7, international normalized ratio of ≥1...
December 20, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29240608/metabolic-profile-of-ex-vivo-lung-perfusate-yields-biomarkers-for-lung-transplant-outcomes
#5
Michael K Hsin, Ricardo Zamel, Marcelo Cypel, David Wishart, Beomsoo Han, Shaf Keshavjee, Mingyao Liu
OBJECTIVE: To identify potential biomarkers during ex vivo lung perfusion (EVLP) using metabolomics approach. SUMMARY BACKGROUND DATA: EVLP increases the number of usable donor lungs for lung transplantation (LTx) by physiologic assessment of explanted marginal lungs. The underlying paradigm of EVLP is the normothermic perfusion of cadaveric lungs previously flushed and stored in hypothermic preservation fluid, which allows the resumption of active cellular metabolism and respiratory function...
January 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29236548/budesonide-instillation-immediately-after-reperfusion-ameliorates-ischemia-reperfusion-induced-injury-in-the-transplanted-lung-of-rat
#6
Wei Gao, Qiu-Ming Meng, Xiao-Guang Cui
PURPOSE: Lung ischemia-reperfusion injury (LIRI) after lung transplantation can lead to primary graft dysfunction. Budesonide can improve endothelial function to reduce lung injury. This study was aimed to examine the effects of budesonide on LIRI and potential mechanisms. METHODS: Wistar rats were randomized and transplanted with syngeneic left lung or received the sham surgery. The recipients were instilled with saline or budesonide immediately after reperfusion...
December 13, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29229257/factors-related-to-the-severity-of-early-postoperative-infection-after-heart-transplantation-in-patients-surviving-prolonged-mechanical-support-periods-experience-at-a-single-university
#7
Ryuichiro Abe, Sho C Shibata, Shunsuke Saito, Yasumasa Tsukamoto, Koichi Toda, Akinori Uchiyama, Yasushi Sakata, Yoshiki Sawa, Kazunori Tomono, Yuji Fujino
OBJECTIVE: The authors examined the effect of prolonged support with continuous-flow ventricular assist devices (CF-VADs) and other related factors on the severity of infections within 30 days of heart transplantation (HTx). DESIGN: A retrospective analysis of consecutive HTx procedures. SETTING: University hospital, between 2010 and 2016. PARTICIPANTS: A cohort of 53 heart transplantation recipients (median age, 38...
July 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29229171/special-considerations-in-pediatric-kidney-transplantation
#8
REVIEW
Sean A Hebert, Rita D Swinford, David R Hall, Jason K Au, John S Bynon
Universally accepted as the treatment of choice for children needing renal replacement therapy, kidney transplantation affords children the opportunity for an improved quality of life over dialysis therapy. Immunologic and surgical advances over the last 15 years have improved the pediatric patient and kidney graft survival. Unique to pediatrics, congenital genitourinary anomalies are the most common primary diseases leading to kidney failure, many with urological issues. Early urological evaluation for post-transplant bladder dysfunction and emphasis on immunization adherence are the mainstays of pediatric pretransplant and post-transplant evaluations...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29224818/reconstruction-after-salvage-laryngectomy
#9
David H Yeh, Axel Sahovaler, Kevin Fung
Both early and advanced stage laryngeal cancers are treated with organ-preserving strategies including radiation alone or concurrent chemoradiotherapy. While organ-preserving modalities have proven effective in eradicating cancer while also preserving laryngeal function, there remains a proportion of cases where residual or recurrent cancer prevails, or conversely, where radiotherapy renders a larynx dysfunctional. In these circumstances, salvage total laryngectomy is often the surgical treatment. The effects of radiotherapy to the neck, amplified by chemotherapy, can create an inhospitable surgical environment, making the salvage laryngectomy an operation fraught with the potential for major complications such as the dreaded pharyngocutaneous fistula...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29216795/oxidative-stress-and-prolidase-enzyme-activity-in-the-pathogenesis-of-primary-varicose-veins
#10
İlker Akar, İlker İnce, Cemal Aslan, İsmail Benli, Osman Demir, Nuray Altındeger, Abdullah Dogan, Mehmet Ceber
Objectives Vascular endothelial dysfunction leads to the emerging of free oxygen radicals, deficiency of antioxidant system, forming of oxidative stress, inflammatory processes and release of proinflammatory cytokines. These things play big role in the development of primary varicose veins. Prolidase has been reported as an indicator of oxidative stress in diabetes, diabetic neuropathy, non-ulcerous dyspepsia, osteoporosis, polycystic over syndrome and many other diseases. The aim of this study is to evaluate the oxidative stress at venous insufficiency and to provide preliminary knowledge about the role of prolidase enzyme in varicose vein formation...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29211941/impact-of-aberrant-left-hepatic-artery-ligation-on-the-outcome-of-liver-transplantation
#11
Roberto Montalti, Andrea Benedetti Cacciaguerra, Daniele Nicolini, Emad Alì Ahmed, Martina Coletta, Lesley De Pietri, Andrea Risaliti, Roberto Ivan Troisi, Federico Mocchegiani, Marco Vivarelli
BACKGROUND: The preservation of a graft's aberrant left hepatic artery (LHA) during liver transplantation (LT) ensures optimal vascularization of the left liver but can also be considered a risk factor for hepatic artery thrombosis. In contrast, ligation of an aberrant LHA may lead to hepatic ischaemia with the potential risk of graft dysfunction and biliary complications. The aim of this study was to prospectively analyse the impact on the surgical strategy for LT of 5 tests performed to establish whether an aberrant LHA was an accessory or a replaced artery, thus leading to the design of a decisional algorithm...
December 6, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#12
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29198929/racial-differences-in-the-development-of-de-novo-donor-specific-antibodies-and-treated-antibody-mediated-rejection-after-heart-transplantation
#13
Robert Townsend Cole, Jonathan Gandhi, Robert A Bray, Howard M Gebel, Michael Yin, Nikolaz Shekiladze, An Young, Aubrey Grant, Ian Mahoney, S Raja Laskar, Divya Gupta, Kunal Bhatt, Wendy Book, Andrew Smith, Duc Nguyen, J David Vega, Alanna A Morris
BACKGROUND: Despite improvements in outcomes after heart transplantation, black recipients have worse survival compared with non-black recipients. The source of such disparate outcomes remains largely unknown. We hypothesize that a propensity to generate de-novo donor-specific antibodies (dnDSA) and subsequent antibody-mediated rejection (AMR) may account for racial differences in sub-optimal outcomes after heart transplant. In this study we aimed to determine the role of dnDSA and AMR in racial disparities in post-transplant outcomes...
November 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29198870/targeting-resolution-of-pulmonary-edema-in-primary-graft-dysfunction-after-lung-transplantation-is-inhaled-ap301-the-answer
#14
EDITORIAL
Lorraine B Ware
No abstract text is available yet for this article.
November 16, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29198660/utility-of-oxford-classification-in-post-transplant-immunoglobulin-a-nephropathy
#15
V Agrawal, A Singh, A Kaul, R Verma, M Jain, R Pandey
BACKGROUND: With increasing graft survival, post-transplant immunoglobulin A nephropathy (IgAN) has emerged as an important cause of chronic graft dysfunction in renal allograft recipients. We studied the clinico-pathological features of post-transplant IgAN regardless of the primary disease. The aim was to study the usefulness of the Oxford classification in predicting survival. METHODS: Indication graft biopsy specimens (n = 915) were received during a 10-year period; 27 biopsy specimens from 22 patients were diagnosed as IgAN...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29191301/incremental-value-of-deformation-imaging%C3%A2-and-hemodynamics-following%C3%A2-heart-transplantation-insights-from-graft%C3%A2-function-profiling
#16
Yukari Kobayashi, Naga Lakshmi Sudini, June-Wha Rhee, Marie Aymami, Kegan J Moneghetti, Sara Bouajila, Yuhei Kobayashi, Juyong B Kim, Ingela Schnittger, Jeffery J Teuteberg, Kiran K Khush, William F Fearon, Francois Haddad
OBJECTIVES: This study investigated to define graft dysfunction and to determine its incremental association with long-term outcome after heart transplantation (HT). BACKGROUND: Although graft failure is an established cause of late mortality after HT, few studies have analyzed the prognostic value of graft dysfunction at 1- and 5-year follow-up of HT. METHODS: Patients who underwent HT and completed their first annual evaluation with right heart catheterization and echocardiography at Stanford University between January 1999 and December 2011 were included in the study...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29191293/cardiac-transplantation-current-outcomes-and-contemporary-controversies
#17
REVIEW
Michelle M Kittleson, Jon A Kobashigawa
Despite advances in pharmacologic and device treatment of chronic heart failure, long-term morbidity and mortality remain high, and many patients progress to end-stage heart failure. Over the last 5 decades, heart transplantation (HTx) has become the preferred therapy for select patients with end-stage heart disease. However, although HTx has become standard of care for the management of end-stage heart failure, challenges continue to exist. The number of patients with end-stage heart failure is increasing, whereas the number of donor organs remains constant and a limiting factor in HTx...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29153000/coronary-bypass-in-left-ventricular-dysfunction-and-differential-cardiac-recovery
#18
Lucian Lozonschi, Takushi Kohmoto, Satoru Osaki, Nilto C De Oliveira, Ravi Dhingra, Shahab A Akhter, Paul C Tang
Background We aimed to examine the efficacy of surgical revascularization with respect to improvement in ventricular function and survival in patients with ischemic cardiomyopathy and poor left ventricular function. Methods We retrospectively analyzed the data of 429 patients (median age 64.6 years, 81.1% male) with ejection fractions <40% undergoing isolated primary coronary artery bypass grafting from 2000 to 2016. Techniques included on-pump cardioplegic arrest ( n = 312), off-pump ( n = 75), and on-pump beating heart ( n = 42)...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29152498/extracorporeal-life-support-in-preoperative-and-postoperative-heart-transplant-management
#19
REVIEW
Christian A Bermudez, D Michael McMullan
Increased experience with extracorporeal life support (ECLS) as a mode of cardiac support has expanded its use to diverse patient populations including patients requiring a bridge to heart transplantation and patients requiring posttransplant support for primary graft dysfunction (PGD). The use of ECLS is associated with acceptable outcomes in well-selected patients. While outcomes with the use of extracorporeal membrane oxygenation (ECMO) as a bridge to heart transplant have been variable, several series have confirmed the safe use of ECLS to stabilize patients prior to left ventricular assist device (LVAD) implantation...
October 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29136325/primary-graft-dysfunction-after-heart-transplantation-incidence-trends-and-associated-risk-factors
#20
Alina Nicoara, David Ruffin, Mary Cooter, Chetan B Patel, Annemarie Thompson, Jacob Schroeder, Mani A Daneshmand, Adrian F Hernandez, Joseph G Rogers, Mihai V Podgoreanu, Madhav Swaminathan, Adam Kretzer, Mark Stafford-Smith, Carmelo A Milano, Raquel R Bartz
Changes in heart transplant (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, and associated risk factors by analyzing consecutive adult patients who underwent HT between January 2009 and December 2014 at our institution. Patients were categorized as having PGD using the International Society of Heart and Lung Transplantation defined criteria. Variables, including clinical and demographic characteristics of donors and recipients, were selected to assess their independent association with PGD...
November 14, 2017: American Journal of Transplantation
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