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accommodation in transplant

Kenta Iwasaki, Yuko Miwa, Kazuharu Uchida, Yasuhiro Kodera, Takaaki Kobayashi
Donor-specific antibody (DSA), particularly against HLA class II, is a major cause of chronic antibody-mediated rejection (CAMR) after transplantation, although ABO-incompatible kidney transplantation has recently demonstrated favorable graft outcomes. The condition of no injury even in the presence of anti-donor antibody has been referred to as "accommodation", which would be one of the key factors for successful long-term graft survival. The purpose of this study was to analyze the beneficial effect of anti-blood group A/B antibody ligation on endothelial cells against HLA-DR antibody-mediated, complement-dependent cytotoxicity (CDC)...
December 23, 2016: Transplant Immunology
Vikram Kilambi, Sanjay Mehrotra
BACKGROUND: Geographic disparities persist in access to liver transplantation. Candidates with similar urgency experience varying opportunities for transplants across the US. Policymakers are poised to act and 1 proposal entails reorganizing the current OPTN of 11 regions into 8 districts. However, redistricting has the shortcomings that OPOs are disconnected from their immediate neighbors by district borders and that it is not easily responsive to uncertainty resulting from variability in donor and listing rates...
October 7, 2016: Transplantation
Tamir Miloh, Andrea Barton, Justin Wheeler, Yen Pham, Winston Hewitt, Tara Keegan, Christine Sanchez, Pinar Bulut, John Goss
Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression in children is generally more complex and can be challenging when compared to the use of these agents in adult liver transplant patients. Physiologic differences in children alter the pharmacokinetics of immunosuppressive agents, which affects absorption, distribution, metabolism and drug excretion...
November 22, 2016: Liver Transplantation
Sanusi Umar
: Hair transplantation involving patients with tightly curled Afro-textured hair using follicular unit extraction (FUE) employing conventional rotary punches frequently leads to unacceptably high transection rates. These patients are unsuitable candidates for FUE hair transplantation. Transection rates were observed during FUE in a case series of 18 patients with tightly curled Afro-textured hair using different punches. METHODS: Three different punches were sequentially used in patients to extract follicular units with several needle gauges until satisfactory transection rates occurred: conventional sharp and dull rotary punches, followed by a 2-pronged curved nonrotary punch...
September 2016: Plastic and Reconstructive Surgery. Global Open
Mark W Lowdell, Amy Thomas
Advanced therapy medicinal products (ATMPs) represent the current pinnacle of 'patient-specific medicines' and will change the nature of medicine in the near future. They fall into three categories; somatic cell-therapy products, gene therapy products and cells or tissues for regenerative medicine, which are termed 'tissue engineered' products. The term also incorporates 'combination products' where a human cell or tissue is combined with a medical device. Plainly, many of these new medicines share similarities with conventional haematological stem cell transplant products and donor lymphocyte infusions as well as solid organ grafts and yet ATMPs are regulated as medicines and their development has remained predominantly in academic settings and within specialist centres...
January 2017: British Journal of Haematology
Anton M Kolomeyer, Ken K Nischal, Ellen Mitchell
PURPOSE: To report a case of bilateral cavernous sinus thrombosis (CST) in a patient with tacrolimus-associated posttransplant thrombotic microangiopathy. METHODS: Case report. RESULTS: An 8-year-old boy with a medical history of orthotopic heart transplant, posttransplant lymphoproliferative disease, and recurrent infections was hospitalized for nausea, vomiting, and diarrhea. His ocular history included accommodative esotropia, hyperopia with astigmatism, Molluscum contagiosum lid lesions, and idiopathic intracranial hypertension...
October 13, 2016: European Journal of Ophthalmology
Eyal Katvan, Israel Doron, Tamar Ashkenazi, Hagai Boas, Michal Carmiel-Haggai, Michal Dranitzki Elhalel, Boaz Shnoor, Jacob Lavee
In 2013 the Israeli Ministry of Health appointed a public committee to examine the policy of placing an age limitation on candidates listed for organ transplantation. The committee rejected the use of an age limit criterion for listing candidates for transplantation and recommended to abolish it. However, opinions differed regarding the use of recipients' age in shaping a fair organ allocation policy. The committee's recommendations were adopted and put into force as of April 2014. This article unfolds the committee deliberations on accommodating values of formal equality for optimising the use of organ transplantation...
September 8, 2016: Age and Ageing
Jin Xiao, Wangzhen Xiang, Yan Chai, Joel Haywood, Jianxun Qi, Limin Ba, Peng Qi, Ming Wang, Jun Liu, George F Gao
Canines represent a crucial animal model for studying human diseases and organ transplantation, as well as the evolution of domestic animals. MHCs, with a central role in cellular immunity, are commonly used in the study of dog population genetics and genome evolution. However, the molecular basis for the peptide presentation of dog MHC remains largely unknown. In this study, peptide presentation by canine MHC class I DLA-88*50801 was structurally determined, revealing diversified anchoring modes of the binding peptides...
September 15, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Malka Gorfine, Yair Goldberg, Ya'acov Ritov
SummarySince survival data occur over time, often important covariates that we wish to consider also change over time. Such covariates are referred as time-dependent covariates. Quantile regression offers flexible modeling of survival data by allowing the covariates to vary with quantiles. This article provides a novel quantile regression model accommodating time-dependent covariates, for analyzing survival data subject to right censoring. Our simple estimation technique assumes the existence of instrumental variables...
August 2, 2016: Biostatistics
Rashad S Barsoum
Geographical, ecological, and genetic factors result in many similarities among the six main countries of the African Sahara, including the epidemiology of kidney disease. With an average incidence of 182 and prevalence of 522 patients with end-stage kidney disease (ESKD) per million population, North Africa (NA) spends $650 million on dialysis and transplantation despite an estimated annual loss of 600,000 life years. The health burden of ESKD is not limited to its directly-related morbidity and mortality but affects even more significantly other body systems, particularly the cardiovascular system...
2016: Clinical Nephrology
Paul W Bernhardt
We propose a flexible cure rate model that accommodates different censoring distributions for the cured and uncured groups and also allows for some individuals to be observed as cured when their survival time exceeds a known threshold. We model the survival times for the uncured group using an accelerated failure time model with errors distributed according to the seminonparametric distribution, potentially truncated at a known threshold. We suggest a straightforward extension of the usual expectation-maximization algorithm approach for obtaining estimates in cure rate models to accommodate the cure threshold and dependent censoring...
June 16, 2016: Statistics in Medicine
Allison Williams, Jac Kee Low, Elizabeth Manias, Kimberley Crawford
AIMS AND OBJECTIVES: To obtain an understanding of how health professionals support the kidney transplant patient to take their medications as prescribed long term. BACKGROUND: Kidney transplantation requires stringent adherence to complex medication regimens to prevent graft rejection and to maintain general well-being. Medication nonadherence is common in kidney transplantation, emerging in the first few months post-transplantation, leading to poor patient outcomes...
August 2016: Journal of Clinical Nursing
G V Ramesh Prasad
What determines the ownership of human body parts? In this paper, I argue that this question can be informed by an exploration of the cognitive distinction between property external to the human body such as houses, cars or land, and internal property such as organs that are located within anatomical body confines. Each type of property has distinct brain representations and possibly different effects on the sense of self. This distinction may help explain the divergence in post-donation outcomes seen in different kidney donor populations...
August 2016: Journal of Evaluation in Clinical Practice
Andrew R Pepper, Rena Pawlick, Antonio Bruni, Boris Gala-Lopez, John Wink, Yasmin Rafiei, Mariusz Bral, Nasser Abualhassan, A M James Shapiro
BACKGROUND: Islet transplantation is a successful β-cell replacement therapy for selected patients with type 1 diabetes mellitus. However, despite early insulin independence, long-term graft attrition gradually reverts recipients to exogenous insulin dependency. Undoubtedly, as insulin producing stem cell therapies progress, a transplant site that is retrievable is desirable. This prerequisite is currently incompatible with intrahepatic islet transplantation. Herein, we evaluate the functional capacity of a prevascularized subcutaneous site to accommodate marginal islet mass transplantation in mice...
July 2016: Transplantation
Bruce Motyka, Nella Fisicaro, Szu-I Wang, Annetta Kratochvil, Katrina Labonte, Kesheng Tao, Jean Pearcey, Thuraya Marshall, Michael Mengel, Banu Sis, Xiaohu Fan, Anthony J F dʼApice, Peter J Cowan, Lori J West
BACKGROUND: ABO-incompatible (ABOi) organ transplantation is performed owing to unremitting donor shortages. Defining mechanisms of antibody-mediated rejection, accommodation, and tolerance of ABOi grafts is limited by lack of a suitable animal model. We report generation and characterization of a murine model to enable study of immunobiology in the setting of ABOi transplantation. METHODS: Transgenesis of a construct containing human A1- and H-transferases under control of the ICAM-2 promoter was performed in C57BL/6 (B6) mice...
June 2016: Transplantation
Kelly A Lombard
PURPOSE: To describe physical therapy (PT) examination and intervention during rehabilitation for a child poststroke with an implanted left ventricular assist device (LVAD). KEY POINTS: A 10-year-old boy with a history of congenital heart disease awaiting heart transplant was admitted to a pediatric rehabilitation hospital with right hemiplegia, and an external, portable LVAD. This child participated in standard PT examination procedures and interventions with accommodations for the LVAD...
2016: Pediatric Physical Therapy
Fa-Ming Chen, Xiaohua Liu
Biomaterials have played an increasingly prominent role in the success of biomedical devices and in the development of tissue engineering, which seeks to unlock the regenerative potential innate to human tissues/organs in a state of deterioration and to restore or reestablish normal bodily function. Advances in our understanding of regenerative biomaterials and their roles in new tissue formation can potentially open a new frontier in the fast-growing field of regenerative medicine. Taking inspiration from the role and multi-component construction of native extracellular matrices (ECMs) for cell accommodation, the synthetic biomaterials produced today routinely incorporate biologically active components to define an artificial in vivo milieu with complex and dynamic interactions that foster and regulate stem cells, similar to the events occurring in a natural cellular microenvironment...
February 1, 2016: Progress in Polymer Science
Mohamed Y Rady, Joseph L Verheijde
Brain death is a novel construct of death for the procurement of transplantable organs. Many authoritative Islamic organizations and governments have endorsed brain death as true death for organ donation. Many commentators have reiterated the misconception that the Quranic text does not define death. We respond by clarifying: (1) the Quran does define death as biologic disintegration and clearly distinguishes it from the dying process, (2) brain death belongs scientifically within the spectrum of neurologic disorders of consciousness and should not be confused with death, and (3) religious and legal discord about brain death has grown in jurisdictions worldwide...
August 2016: Journal of Religion and Health
Brian T Freeman, Jangwook P Jung, Brenda M Ogle
Fusion of donor mesenchymal stem cells with parenchymal cells of the recipient can occur in the brain, liver, intestine and heart following transplantation. The therapeutic benefit or detriment of resultant hybrids is unknown. Here we sought a global view of phenotypic diversification of mesenchymal stem cell-cardiomyocyte hybrids and associated time course. Using single-cell RNA-seq, we found hybrids consistently increase ribosome components and decrease genes associated with the cell cycle suggesting an increase in protein production and decrease in proliferation to accommodate the fused state...
March 21, 2016: Scientific Reports
Esme I Dijke, Jeffrey L Platt, Paul Blair, Menna R Clatworthy, Jignesh K Patel, A G Kfoury, Marilia Cascalho
B cell responses underlie the most vexing immunological barriers to organ transplantation. Much has been learned about the molecular mechanisms of B cell responses to antigen and new therapeutic agents that specifically target B cells or suppress their functions are available. Yet, despite recent advances, there remains an incomplete understanding about how B cell functions determine the fate of organ transplants and how, whether or when potent new therapeutics should optimally be used. This gap in understanding reflects in part the realization that besides producing antibodies, B cells can also regulate cellular immunity, contribute to the genesis of tolerance and induce accommodation...
June 2016: Journal of Heart and Lung Transplantation
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