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https://www.readbyqxmd.com/read/29916848/pancreas-transplantation-in-type-2-diabetes-expanding-the-criteria
#1
Talal M Al-Qaoud, Jon S Odorico, Robert R Redfield
PURPOSE OF REVIEW: Pancreas transplantation in type 2 diabetes mellitus (T2DM) candidates remains disproportionately lower than in type 1 diabetes mellitus (T1DM); however, outcomes in carefully selected patients mirrors that of T1DM. Despite the 2014 United Network for Organ Sharing (UNOS) eligibility criteria for simultaneous pancreas/kidney transplant (SPK) transplantation in T2DM patients, an expected increase in the number of transplants was not observed. RECENT FINDINGS: In an updated International Pancreas and Transplant Registry (IPTR) analysis, 1514 primary deceased donor pancreas transplants were performed in T2DM recipients [1995-2015, SPK 88%, pancreas after kidney (PAK) 9%, pancreas transplant alone (PTA) 3%]...
June 18, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29912046/changes-in-utilization-and-discard-of-hcv-antibody-positive-deceased-donor-kidneys-in-the-era-of-direct-acting-antiviral-therapy
#2
Mary G Bowring, Lauren M Kucirka, Allan B Massie, Tanveen Ishaque, Sunjae Bae, Ashton A Shaffer, Jacqueline Garonzik Wang, Mark Sulkowski, Niraj Desai, Dorry L Segev, Christine M Durand
BACKGROUND: The availability of direct-acting antiviral (DAA) therapy might have impacted use of HCV-infected (HCV+) deceased-donor kidneys for transplantation. METHODS: We used 2005-2018 SRTR data to identify 18 936 candidates willing to accept HCV+ kidneys and 3348 HCV+ recipients of HCV+ kidneys. We compared willingness to accept, utilization, discard, and posttransplant outcomes associated with HCV+ kidneys between 2 treatment eras (Interferon [IFN] era: 1/1/2005-12/5/2013 versus DAA era: 12/6/2013-8/2/2018)...
June 13, 2018: Transplantation
https://www.readbyqxmd.com/read/29905971/impact-of-insurance-type-on-eligibility-for-advanced-heart-failure-therapies-and-survival
#3
Sarah Streeter Hutcheson, Victoria Phillips, Rachel Patzer, Andrew Smith, J David Vega, Alanna A Morris
BACKGROUND: Medicaid insurance in Georgia provides limited reimbursement for heart transplant (HT) and left ventricular assist devices (LVAD). We examined whether insurance type affects eligibility for and survival after receipt of HT or LVAD. METHODS AND RESULTS: We retrospectively identified patients evaluated for HT/LVAD from 2012 to 2016. We used multivariable logistic and Cox proportional hazards regression to examine the association of insurance type on treatment eligibility and one year survival...
June 15, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29905497/synchronous-epstein-barr-virus-associated-skull-base-and-adrenal-smooth-muscle-tumors-in-an-8-year-old-girl-with-recent-epstein-barr-virus-infection
#4
Desmond A Brown, Nicholas L Deep, Colin L Driscoll, Michael J Link, Mark E Jentoft, David J Daniels
Epstein-Barr virus-associated smooth-muscle tumors are rare tumors seen in immunocompromised patients. Most cases occur in the context of AIDS and organ transplantation, and very rarely in the setting of congenital immunodeficiency, with only 5 case reports of the latter published so far in the literature. The authors report the case of a previously healthy 8-year-old girl with headaches and precocious puberty who was found to have a large skull base lesion. There was a synchronous left adrenal lesion. She underwent resection of the skull base lesion and a left adrenalectomy...
June 15, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29901589/quality-of-life-and-care-burden-in-primary-caregivers-of-liver-transplantation-recipients-in-china
#5
Linbo Wei, Juan Li, Yanpei Cao, Jianming Xu, Wei Qin, Huijuan Lu
So far, liver transplantation (LT) has become the most effective way to treat end-stage liver-related diseases. As we all know, a stable caregiver is crucial to LT recovery. However, compared with LT patients, few studies were focused on LT caregivers.This study aimed to describe the quality of life (QoL), care burden, and their related factors in caregivers of LT patients in Shanghai, China.We collected 225 liver transplanted patients and their corresponding caregivers' social demographic and medical information; meanwhile, we assessed 225 LT recipients' caregivers' life quality; by using Caregiver Quality of Life Index-Liver Transplantation in Chinese version (CQOLC-LT), Zarit caregiver burden inventory in Chinese version (ZBI) was used to access the care burden...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29899883/transfusion-medicine-and-molecular-genetic-methods
#6
REVIEW
Rozieyati Mohamed Saleh, Zulkafli Zefarina, Nor Fazila Che Mat, Geoffrey Keith Chambers, Hisham Atan Edinur
Transfusion procedures are always complicated by potential genetic mismatching between donor and recipient. Compatibility is determined by several major antigens, such as the ABO and Rhesus blood groups. Matching for other blood groups (Kell, Kidd, Duffy, and MNS), human platelet antigens, and human leukocyte antigens (HLAs) also contributes toward the successful transfusion outcomes, especially in multitransfused or highly immunized patients. All these antigens of tissue identity are highly polymorphic and thus present great challenges for finding suitable donors for transfusion patients...
2018: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29895662/acute-lymphoblastic-leukemia-in-adolescent-and-young-adults-treat-as-adults-or-as-children
#7
Nicolas Boissel, André Baruchel
Adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) are recognized as a unique population with specific characteristics and needs. In adolescents aged 15-20 years old, the use of full pediatric protocols is supported by many comparative studies of pediatric and adult cooperative groups. In young adults, growing evidence suggests that pediatric-inspired or even fully pediatric approaches may also dramatically improve outcomes, leading to long-term survival rates of almost 70%, despite diminishing indications of hematopoietic stem cell transplantation...
June 12, 2018: Blood
https://www.readbyqxmd.com/read/29886220/removal-of-non-infected-arteriovenous-fistulae-following-kidney-transplantation-is-a-safe-and-beneficial-management-strategy-for-unused-dialysis-access
#8
Charles D Fraser, Joshua C Grimm, Rui Han Liu, Russell N Wesson, Faris Azar, Robert J Beaulieu, Thomas Reifsnyder
INTRODUCTION: Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This study evaluates the indications for, and safety of, arteriovenous fistula (AVF) removal in patients following successful renal transplantation. METHODS: All patients that underwent AVF excision at a single institution from 2006-2016 were retrospectively reviewed...
June 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29884929/correction-to-scaling-safe-access-to-fecal-microbiota-transplantation-past-present-and-future
#9
Pratik Panchal, Shrish Budree, Alex Scheeler, Geraldine Medina, Monica Seng, Wing Fei Wong, Ryan Elliott, Thomas Mitchell, Zain Kassam, Jessica R Allegretti, Majdi Osman
In the original version of this article, author Ryan Elliott's name was misspelled as Ryan Eliott. The correct spelling of the name is Ryan Elliott.
June 8, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29880053/indications-and-complications-of-inpatient-parenteral-nutrition-prescribed-to-children-in-a-large-tertiary-referral-hospital
#10
C Mantegazza, N Landy, G V Zuccotti, J Köglmeier
BACKGROUND: Parenteral Nutrition (PN) is prescribed to children with intestinal failure. Although life saving, complications are common. Recommendations for indications and constituents of PN are made in the 2005 guidelines by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). The aim of this study was to establish if the indications for prescribing PN in a tertiary children's hospital were appropriate, and to identify complications encountered. Data were compared to those published by the National Confidential Enquiry into patient outcome and death (NCEPOD) carried out in the United Kingdom in 2010...
June 8, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29878578/and-equal-access-for-all-the-future-of-deceased-donor-kidney-allocation
#11
EDITORIAL
Richard N Formica
End stage renal disease (ESRD) and it co-morbidities do not affect patients differently based upon where they live. However access, referring to both referral for evaluation for kidney transplantation and equitable allocation of organs to those on the list, is very different depending on place of residence.(1) This is a complicated problem with many facets including regional differences in the prevalence of kidney disease, access to healthcare, availability of suitable deceased donor organs and the organ acceptance practices of transplant centers...
June 7, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29875179/planning-vascular-access-in-peritoneal-dialysis-defining-high-risk-patients
#12
Hugo Ferreira, Ana T Nunes, Ana Oliveira, Ana Beco, Joana Santos, Manuel Pestana
BACKGROUND: Peritoneal dialysis (PD) is an effective renal replacement technique. However, every year a considerable number of patients are transferred to hemodialysis (HD). Our aim was to identify those at risk, in order to place an arteriovenous fistula (AVF). METHODS: Case-control study enrolling all prevalent patients in 2014 and 2015 in our clinic. Groups: 72 case patients who were transferred definitively to HD, 111 control patients (remaining on PD, transplanted, recovered renal function, or deceased)...
June 6, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29873895/defibrotide-for-the-treatment-of-hepatic-veno-occlusive-disease-sinusoidal-obstruction-syndrome-following-nontransplant-associated-chemotherapy-final-results-from-a-post-hoc-analysis-of-data-from-an-expanded-access-program
#13
Nancy A Kernan, Paul G Richardson, Angela R Smith, Brandon M Triplett, Joseph H Antin, Leslie Lehmann, Yoav Messinger, Wei Liang, Robin Hume, William Tappe, Robert J Soiffer, Stephan A Grupp
BACKGROUND: Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a potentially fatal complication of conditioning for hematopoietic stem cell transplantation (HSCT) but can occur after nontransplant-associated chemotherapy. Following HSCT, VOD/SOS with multi-organ dysfunction (MOD) may be associated with >80% mortality. Defibrotide is approved to treat severe hepatic VOD/SOS post-HSCT in patients aged >1 month in the European Union and hepatic VOD/SOS with renal or pulmonary dysfunction post-HSCT in the United States...
June 6, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29870434/assessment-of-human-leukocyte-antigen-immunogenicity-current-methods-challenges-and-opportunities
#14
Hannah C Copley, Madhivanan Elango, Vasilis Kosmoliaptsis
PURPOSE OF REVIEW: Donor-recipient human leukocyte antigen (HLA) matching improves outcomes after solid-organ transplantation, but current assessment of HLA incompatibility is inadequate as it does not consider the relative immunogenicity of individual HLA mismatches. In this article, we review existing strategies for assessing HLA immunogenicity and discuss current challenges and future opportunities in this field. RECENT FINDINGS: Current HLA immunogenicity algorithms focus primarily on the humoral component of the alloimmune response and aim to determine a measure of 'dissimilarity' between donor and recipient HLA...
June 4, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29870114/emerging-trends-in-clinical-research-with-implications-for-population-health-and-health-policy
#15
Benjamin Chin-Yee, S V Subramanian, Amol A Verma, Andreas Laupacis, Fahad Razak
Policy Points: Significant advances in clinical medicine that have broader societal relevance may be less accessible to population health researchers and policymakers because of increased specialization within fields. We describe important recent clinical advances and discuss their broader societal impact. These advances include more expansive strategies for disease prevention, the rise of precision medicine, applications of human microbiome research, and new and highly successful treatments for hepatitis C infection...
June 2018: Milbank Quarterly
https://www.readbyqxmd.com/read/29869841/laparoscopic-donor-hepatectomy
#16
REVIEW
Kuo-Hsin Chen, Tiing Foong Siow, U-Chon Chio, Jiann-Ming Wu, Kuo-Shyang Jeng
Laparoscopic liver resection has been applied to treat most indications for liver resection during the past two decades. According to the literature, patient numbers have increased exponentially as a result, and surgical difficulty has increased as well. In expert centers, laparoscopic anatomical hemihepatectomy and major liver resection more than 3 segments have become the acceptable treatment. Moreover, with surgical innovations and accumulated experience, living donor liver transplantation has become an established treatment choice for patients on the transplant waiting list...
May 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29868400/fresh-femoral-head-osteochondral-allograft-transplantation-for-treating-osteochondritis-dissecans-of-the-femoral-head
#17
David R Maldonado, Brian H Mu, Austin W Chen, Victor Ortiz-Declet, Itay Perets, Leslie C Yuen, Benjamin G Domb
Treatment options for the management of osteochondritis dissecans (OCD) lesions of the femoral head are limited. Although arthroscopic surgery of the hip can treat a variety of intra- and extra-articular pathologies, an OCD lesion located at the superior and medial zone of the femoral head is often difficult to access and cannot be adequately treated arthroscopically. The use of fresh-stored osteochondral allograft allows surgeons to both avoid donor-site morbidity and treat lesions of a larger surface area...
April 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29867982/renal-involvement-in-antiphospholipid-syndrome
#18
REVIEW
Alonso Turrent-Carriles, Juan Pablo Herrera-Félix, Mary-Carmen Amigo
Antiphospholipid syndrome is a complex autoimmune disease, characterized by the presence of vascular thrombosis, obstetric, hematologic, cutaneous, and cardiac manifestations. Renal disease in patients with antiphospholipid syndrome was not recognized in the first descriptions of the disease, but later on, the renal manifestations of the syndrome have been investigated widely. Renal manifestations of antiphospholipid syndrome conform a wide spectrum of diverse renal syndromes. Hypertension is one of the most frequent, but less commonly recognized renal alteration...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29867981/non-invasive-multiphoton-imaging-of-islets-transplanted-into-the-pinna-of-the-nod-mouse-ear-reveals-the-immediate-effect-of-anti-cd3-treatment-in-autoimmune-diabetes
#19
Robert A Benson, Fabien Garcon, Asha Recino, John R Ferdinand, Menna R Clatworthy, Herman Waldmann, James M Brewer, Klaus Okkenhaug, Anne Cooke, Paul Garside, Maja Wållberg
We present a novel and readily accessible method facilitating cellular time-resolved imaging of transplanted pancreatic islets. Grafting of islets to the mouse ear pinna allows non-invasive, in vivo longitudinal imaging of events in the islets and enables improved acquisition of experimental data and use of fewer experimental animals than is possible using invasive techniques, as the same mouse can be assessed for the presence of islet infiltrating cells before and after immune intervention. We have applied this method to investigating therapeutic protection of beta cells through the well-established use of anti-CD3 injection, and have acquired unprecedented data on the nature and rapidity of the effect on the islet infiltrating T cells...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29863580/the-relationships-between-cold-ischemia-time-kidney-transplant-length-of-stay-and-transplant-related-costs
#20
Oscar K Serrano, David M Vock, Srinath Chinnakotla, Ty B Dunn, Raja Kandaswamy, Timothy L Pruett, Roger Feldman, Arthur J Matas, Erik B Finger
BACKGROUND: Recent changes in policies guiding allocation of transplant kidneys are predicted to increase sharing between distant geographic regions. The potential exists for an increase in cold ischemia time (CIT) with resulting increases in delayed graft function (DGF) and transplant-related costs (TRC). We sought to explore the impact of CIT on metrics that may influence TRC. METHODS: Between 2006 and 2014, 81,945 adult solitary deceased donor kidney transplants (KT) were performed in the United States; 477 (0...
May 31, 2018: Transplantation
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