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Organ donor management

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https://www.readbyqxmd.com/read/29462353/predicition-models-for-delayed-graft-function-external-validation-on-the-dutch-prospective-renal-transplantation-registry
#1
Jesper Kers, Hessel Peters-Sengers, Martin B A Heemskerk, Stefan P Berger, Michiel G H Betjes, Arjan D van Zuilen, Luuk B Hilbrands, Johan W de Fijter, Azam S Nurmohamed, Maarten H Christiaans, Jaap J Homan van der Heide, Thomas P A Debray, Fréderike J Bemelman
Background: Delayed graft function (DGF) is a common complication after kidney transplantation in the era of accepting an equal number of brain- and circulatory-death donor kidneys in the Netherlands. To identify those cases with an increased risk of developing DGF, various multivariable algorithms have been proposed. The objective was to validate the reproducibility of four predictive algorithms by Irish et al. (A risk prediction model for delayed graft function in the current era of deceased donor renal transplantation...
February 16, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29461275/management-of-the-critically-ill-liver-failure-patient-surpassing-our-limitations-to-reach-transplantation
#2
Constance M Mobley, Ashish Saharia
PURPOSE OF REVIEW: Patients with liver failure and liver-related diseases are often critically ill. Here, we review advances in donor organ management, tools for patient selection and highlight ICU management of liver transplant (LT) recipients. A focused discussion on the impact each of these factors have on critical care management of liver failure patients is presented. RECENT FINDINGS: Artificial liver assist devices to increase donor organ utilization are broadening the potential for transplantation of critically ill patients...
February 15, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29457693/growth-yield-and-selection-of-nosz-clade-ii-types-in-a-continuous-enrichment-culture-of-n-2-o-respiring-bacteria
#3
Monica Conthe, Lea Wittorf, J Gijs Kuenen, Robbert Kleerebezem, Sara Hallin, Mark C M van Loosdrecht
Nitrous oxide (N2 O) reducing microorganisms may be key in the mitigation of N2 O emissions from managed ecosystems. However, there is still no clear understanding of the physiological and bioenergetic implications of microorganisms possessing either of the two N2 O reductase genes (nosZ), clade I and the more recently described clade II type nosZ. It has been suggested that organisms with nosZ clade II have higher growth yields and a lower affinity constant (Ks ) for N2 O. We compared N2 O reducing communities with different nosZI/nosZII ratios selected in chemostat enrichment cultures, inoculated with activated sludge, fed with N2 O as a sole electron acceptor and growth limiting factor, and acetate as electron donor...
February 19, 2018: Environmental Microbiology Reports
https://www.readbyqxmd.com/read/29452978/the-management-of-antibodies-in-heart-transplantation-an-ishlt-consensus-document
#4
Jon Kobashigawa, Monica Colvin, Luciano Potena, Duska Dragun, Maria G Crespo-Leiro, Juan F Delgado, Michael Olymbios, Jayan Parameshwar, Jignesh Patel, Elaine Reed, Nancy Reinsmoen, E Rene Rodriguez, Heather Ross, Randall C Starling, Dolly Tyan, Simon Urschel, Andreas Zuckermann
Despite the successes from refined peri-operative management techniques and immunosuppressive therapies, antibodies remain a serious cause of morbidity and mortality for patients both before and after heart transplantation. Patients awaiting transplant who possess antibodies against human leukocyte antigen are disadvantaged by having to wait longer to receive an organ from a suitably matched donor. The number of pre-sensitized patients has been increasing, a trend that is likely due to the increased use of mechanical circulatory support devices...
January 31, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29442469/brain-death-associated-pathological-events-and-therapeutic-options
#5
REVIEW
Paweł Chudoba, Wojciech Krajewski, Joanna Wojciechowska, Dorota Kamińska
BACKGROUND: At present, organ transplantation is the most efficient treatment of end-stage failure of various organs, including the heart, lungs, pancreas, intestines, kidney, and liver. Despite the efforts to use organs from living donors or from donors after circulatory death, most of the organs are recovered from brain dead (BD) donors. METHODS: The Medline and Web of Science databases were searched without time limit on November 2015 using the terms "brain dead donor" and "deceased donor" in conjunction with "transplantation", "graft", "organ", "hemodynamic", "hormonal", or "management"...
December 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29419693/organ-damage-mitigation-with-the-baskent-sickle-cell-medical-care-development-program-bascare
#6
Hakan Ozdogu, Can Boga, Suheyl Asma, Ilknur Kozanoglu, Cigdem Gereklioglu, Mahmut Yeral, Nurhilal Turgut Buyukkurt, Soner Solmaz, Aslı Korur, Pelin Aytan, Erkan Maytalman, Mutlu Kasar
The Eastern Mediterranean is among the regions where sickle cell disease (SCD) is common. The morbidity and mortality of this disease can be postponed to adulthood through therapies implemented in childhood. The present study focuses on the organ damage-reducing effects of the Baskent Sickle Cell Medical Care Development Program (BASCARE), which was developed by a team who lives in this region and has approximately 25 years of experience. The deliverables of the program included the development of an electronic health recording system (PRANA) and electronic vaccination system; the use of low citrate infusion in routine prophylactic automatic erythrocyte exchange (ARCE) programs including pregnant women; the use of leukocyte-filtered and irradiated blood for transfusion; the use of magnetic resonance imaging methods (T2) for the management of transfusion-related hemosiderosis; and the implementation of an allogeneic hematopoietic stem cell transplantation protocol for adult patients...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29381647/recommendations-for-management-of-endemic-diseases-and-travel-medicine-in-solid-organ-transplant-recipients-and-donors-latin-america
#7
Wanessa Trindade Clemente, Lígia Camera Pierrotti, Edson Abdala, Michele I Morris, Luiz S Azevedo, Rogelio López-Vélez, Manuel Cuenca-Estrella, Julian Torre-Cisneros, Eskild Petersen, Luis Fernando A Camargo, Alissa Jade Wright, Nicholas J Beeching, Eduardo Garcia Vilela, Guilherme Santoro-Lopes, Oscar Len, Raquel S B Stucchi, Oriol Manuel, Luciana Costa Faria, Hakan Leblebicioglu, Shirish Huprikar, Israel Molina, Paulo Henrique Orlandi Mourão, Camille N Kotton, José María Aguado
The Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America clinical practice guideline is intended to guide clinicians caring for solid-organ transplant (SOT) donors, candidates and recipients regarding infectious diseases (ID) issues related to this geographical region, mostly located in the tropics. These recommendations are based on both systematic reviews of relevant literature and expert opinion from both transplant ID and travel medicine specialists...
February 2018: Transplantation
https://www.readbyqxmd.com/read/29381582/recommendations-for-management-of-endemic-diseases-and-travel-medicine-in-solid-organ-transplant-recipients-and-donors-latin-america-map-gallery
#8
Paulo Henrique Orlandi Mourão, Joan Gavalda, Fernando Salvador, Israel Molina
No abstract text is available yet for this article.
February 2018: Transplantation
https://www.readbyqxmd.com/read/29380059/post-transplantation-development-of-food-allergies
#9
REVIEW
Erik N Newman, Rafael Firszt
PURPOSE OF REVIEW: The development of food allergies is increasingly being recognized as a post-solid organ transplant complication. In this article, we review the spectrum of post-transplant food allergy development and the proposed mechanisms for de novo food allergies and the clinical significance they pose. RECENT FINDINGS: The development of new food allergies is disproportionately associated with pediatric liver transplants, where it occurs in up to 38% of select populations...
January 29, 2018: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/29363441/severe-strongyloidiasis-in-solid-organ-transplant-recipients-should-we-preventively-treat-the-recipient-the-donor-or-both
#10
Gilles Eperon, Jerome Tourret, Oana Ailioaie, Luc Paris, Lucile Mercadal, Julien Mayaux, Eric Caumes, Benoit Barrou
Strongyloidiasis is caused by a soil-transmitted helminth that is endemic in tropical and subtropical countries. The parasite can complete its life cycle without leaving the host, allowing autoinfection and persistence. The risk of infection in travelers is low, but the disease may become lethal following immunosuppression. In case of solid organ transplantation, the risk of donor transmission has been suspected for several years. However, the management of live donors in this context has only recently been considered, and no guidelines exist for the management of deceased donors...
January 22, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29343286/diagnosis-and-management-of-transthyretin-familial-amyloid-polyneuropathy-in-japan-red-flag-symptom-clusters-and-treatment-algorithm
#11
REVIEW
Yoshiki Sekijima, Mitsuharu Ueda, Haruki Koike, Sonoko Misawa, Tomonori Ishii, Yukio Ando
Hereditary ATTR (ATTRm) amyloidosis (also called transthyretin-type familial amyloid polyneuropathy [ATTR-FAP]) is an autosomal-dominant, adult-onset, rare systemic disorder predominantly characterized by irreversible, progressive, and persistent peripheral nerve damage. TTR gene mutations (e.g. replacement of valine with methionine at position 30 [Val30Met (p.Val50Met)]) lead to destabilization and dissociation of TTR tetramers into variant TTR monomers, which form amyloid fibrils that deposit in peripheral nerves and various organs, giving rise to peripheral and autonomic neuropathy and several non-disease specific symptoms...
January 17, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29338388/novel-fusion-protein-targeting-mitochondrial-dna-improves-pancreatic-islet-functional-potency-and-islet-transplantation-outcomes
#12
Juan S Danobeitia, Peter J Chlebeck, Inna Shokolenko, Xiaobo Ma, Glenn Wilson, Luis A Fernandez
Long-term graft survival is an ongoing challenge in the field of islet transplantation. With the growing demand for transplantable organs, therapies to improve organ quality and reduce the incidence of graft dysfunction are of paramount importance. We evaluated the protective role of a recombinant DNA repair protein targeted to mitochondria (Exscien I-III), as a therapeutic agent using a rodent model of pancreatic islet transplantation. We first investigated the effect of therapy on isolated rat islets cultured with pro-inflammatory cytokines (interleukin-1 β, interferon γ, and tumor necrosis factor α) for 48 h and documented a significant reduction in apoptosis by flow cytometry, improved viability by immunofluorescence, and conserved functional potency in vitro and in vivo in Exscien I-III-treated islets...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29337122/lung-focused-resuscitation-at-a-specialized-donor-care-facility-improves-lung-procurement-rates
#13
Stephanie H Chang, Daniel Kreisel, Gary F Marklin, Lindsey Cook, Ramsey Hachem, Benjamin D Kozower, Keki R Balsara, Jennifer M Bell, Christine Frederiksen, Bryan F Meyers, G Alexander Patterson, Varun Puri
BACKGROUND: Lung procurement for transplantation occurs in about 20% of brain dead donors and is a major impediment to wider application of lung transplantation. We investigated the impact of lung protective management at a specialized donor care facility on lung procurement rates from brain dead donors. METHODS: Our local organ procurement organization instituted a protocol of lung protective management at a freestanding specialized donor care facility in 2008...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29331874/thyroid-hormone-resuscitation-after-brain-death-in-potential-organ-donors-a-primer-for-neurocritical-care-providers-and-narrative-review-of-the-literature
#14
REVIEW
Ian A Buchanan, Vivek A Mehta
Solid organ transplantation has become a mainstay in the contemporary management of end-stage organ failures fueled by advances in immunosuppression, intensive care and surgical technology. Every year, a vast number of transplantable organs is lost on account of hemodynamic instability in potential brain-dead organ donors. Because of a growing organ shortage, measures that increase total donor supply pools are desperately needed. Thyroid hormone has been identified as an adjunctive therapy in donor management due to its potential for increasing organ supply and is currently endorsed by transplant organizations such as United Network for Organ Sharing (UNOS)...
February 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29324293/biofilms-active-substrata-and-me
#15
REVIEW
Bruce E Rittmann
Having worked with biofilms since the 1970s, I know that they are ubiquitous in nature, of great value in water technology, and scientifically fascinating. Biofilms are naturally able to remove BOD, transform N, generate methane, and biodegrade micropollutants. What I also discovered is that biofilms can do a lot more for us in terms of providing environmental services if we give them a bit of help. Here, I explore how we can use active substrata to enable our biofilm partners to provide particularly challenging environmental services...
December 28, 2017: Water Research
https://www.readbyqxmd.com/read/29319565/left-ventricular-assist-device-as-destination-therapy-for-end-stage-heart-failure-the-right-time-for-the-right-patients
#16
Naoto Fukunaga, Vivek Rao
PURPOSE OF REVIEW: Cardiac transplantation is the gold standard treatment for patients with end-stage heart failure. Unfortunately, the demand for donor organs far outstrips the number of available hearts. Therefore, not all patients who can benefit from this therapy are even listed for transplant. Once destination therapy was approved for the long-term support of nontransplant eligible patients, it was felt that the number of durable ventricular assist device (VAD) implants would increase...
March 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29316778/role-of-liver-transplantation-in-severe-alcoholic-hepatitis
#17
Ravi Daswani, Ashish Kumar, Praveen Sharma, Vikas Singla, Naresh Bansal, Anil Arora
Severe alcoholic hepatitis has very high short term mortality and corticosteroids have been the mainstay of treatment for decades. Patients with Lille score >0.45 are considered non-responders to steroids and have poor outcome. Recently Orthotopic Liver Transplantation (OLT) is being increasingly used as rescue treatment for these patients, without waiting for 6 months of abstinence. Liver transplant is the only rescue treatment which can potentially provide long term benefit for patients who are steroid non-responders...
January 10, 2018: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/29314617/increased-risk-donors-a-bird-in-the-hand
#18
EDITORIAL
Daniel R Kaul
Unexpected donor-derived infections (DDI) are relatively uncommon events complicating less than 1% of solid organ transplants (1). Disease can be severe, however, with malignancies and agents that infect the central nervous system carrying a particularly high risk of adverse outcomes (2). In most cases, this risk is managed by a combination of clinical assessment and pre-procurement donor testing. This article is protected by copyright. All rights reserved.
January 4, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29299892/cytomegalovirus-infection-after-renal-transplantation-occurrence-clinical-features-and-the-cutoff-for-antigenemia-in-a-university-hospital-in-brazil
#19
Sócrates Bezerra de Matos, Roberto Meyer, Fernanda Washington de Mendonça Lima
BACKGROUND: Cytomegalovirus (CMV) is the main infectious agent causative of morbidity and mortality in transplant recipients. This study aimed to describe the occurrence and clinical features of CMV infection, and the optimum antigenemia assay cutoff associated with symptomatic infection. MATERIALS AND METHODS: This was a cohort study that investigated 87 patients undergoing renal transplantation. The patients were monitored with the CMV antigenemia assay performed weekly for the first 3 months post-transplantation and subsequently, when CMV infection was suspected clinically...
December 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29277435/assessment-of-potential-heart-donors-a-statement-from-the-french-heart-transplant-community
#20
Richard Dorent, Estelle Gandjbakhch, Céline Goéminne, Fabrice Ivanes, Laurent Sebbag, Fabrice Bauer, Eric Epailly, Pascale Boissonnat, Karine Nubret, Julien Amour, Emmanuelle Vermes, Phalla Ou, Soulef Guendouz, Philippe Chevalier, Guillaume Lebreton, Erwan Flecher, Jean-François Obadia, Damien Logeart, Pascal de Groote
Assessment of potential donors is an essential part of heart transplantation. Despite the shortage of donor hearts, donor heart procurement from brain-dead organ donors remains low in France, which may be explained by the increasing proportion of high-risk donors, as well as the mismatch between donor assessment and the transplant team's expectations. Improving donor and donor heart assessment is essential to improve the low utilization rate of available donor hearts without increasing post-transplant recipient mortality...
December 22, 2017: Archives of Cardiovascular Diseases
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