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https://www.readbyqxmd.com/read/29446874/transplant-recipients-are-vulnerable-under-the-medicare-part-d-benefit
#1
Lisa M Potter, Angela Q Maldonado, Krista L Lentine, Mark A Schnitzler, Zidong Zhang, Gregory P Hess, Edward Garrity, Bertram L Kasiske, David A Axelrod
Transplant immunosuppressants are often used off-label due to insufficient randomized prospective trial data to achieve organ-specific US Food and Drug Administration (FDA) approval. Transplant recipients who rely on Medicare Part D for immunosuppressant drug coverage are vulnerable to coverage denial for off-label prescriptions, unless use is supported by Centers for Medicare & Medicaid Services (CMS)-approved compendia. An integrated data set including national transplant registry data and 3 years of dispensed pharmacy records was used to identify the prevalence of immunosuppression use that is both off-label and not supported by CMS-approved compendia...
February 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29446212/free-dialysis-in-nepal-logistical-challenges-explored
#2
John Mcgee, Bimal Pandey, Abhishek Maskey, Tifany Frazer, Theodore Mackinney
Nepal's Ministry of Health began offering free lifetime hemodialysis (HD) in 2016. There has been a large growth in renal replacement therapy (RRT) services offered in Nepal since 2010, when the last known data on the subject was published. In 2016, 42 HD centers existed (223% increase since 2010) serving 1975 end stage renal disease patients (303% increase since 2010); 36 nephrologists were registered (200% increase since 2010), 12 were trained in transplantation, and 790 transplants had been performed to date...
February 15, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29446209/effect-of-the-ichoose-kidney-decision-aid-in-improving-knowledge-about-treatment-options-among-transplant-candidates-a-randomized-controlled-trial
#3
Rachel E Patzer, Laura McPherson, Mohua Basu, Sumit Mohan, Michael Wolf, Mariana Chiles, Allison Russell, Jennifer C Gander, John J Friedewald, Daniela Ladner, Christian P Larsen, Thomas Pearson, Stephen Pastan
We previously developed a mobile- and web-based decision aid (iChoose Kidney) that displays individualized risk estimates of survival and mortality, for the treatment modalities of dialysis versus kidney transplantation. We examined the effect of iChoose Kidney on change in transplant knowledge and access to transplant in a randomized controlled trial among patients presenting for evaluation in three transplant centers. A total of 470 patients were randomized to standard transplantation education (control) or standard education plus iChoose Kidney (intervention)...
February 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29444601/the-role-of-thoracic-surgery-in-extracorporeal-membrane-oxygenation-services
#4
Elliot Heward, Syed F Hashmi, Ignacio Malagon, Rajesh Shah, Julian Barker, Kandadai S Rammohan
Background Recent evidence surrounding the use of venovenous extracorporeal membrane oxygenation in treating acute respiratory failure has led to the expansion of extracorporeal membrane oxygenation services worldwide. The high rate of complications related to venovenous extracorporeal membrane oxygenation often requires intervention by specialist thoracic surgeons. This study aimed to investigate the role of specialist thoracic surgeons within the multidisciplinary team managing these high-risk patients. Methods We retrospectively reviewed 90 patients who received venovenous extracorporeal membrane oxygenation at our tertiary referral center between December 2011 and May 2015...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29443827/a-comparison-of-hla-molecular-mismatch-methods-to-determine-hla-immunogenicity
#5
C Wiebe, V Kosmoliaptsis, D Pochinco, C Taylor, P Nickerson
BACKGROUND: Antibody-mediated rejection is a major cause of premature graft loss in kidney transplantation. Multiple scoring systems are available to assess the HLA mismatch between donors and recipients at the molecular level, however, their correlation with the development of de novo donor-specific antibody (dnDSA) has not been compared in recipients on active immunosuppression. METHODS: HLA-DRβ1/3/4/5/DQα1β1 molecular mismatch was determined using eplet analysis, amino acid mismatch, and electrostatic mismatch for 596 renal transplant recipients and correlated with HLA-DR/DQ dnDSA development...
February 13, 2018: Transplantation
https://www.readbyqxmd.com/read/29443409/cellular-collection-by-apheresis
#6
REVIEW
Anand Padmanabhan
Cellular collection is an important and increasingly used apheresis procedure. These collections are performed by leukocytapheresis, a procedure involving the removal of a patient's or donor's white blood cells, and are used to collect hematopoietic progenitor cells, specific cell populations (such as T-lymphocytes), and granulocytes. Hematopoietic progenitor cell apheresis and T-lymphocyte collection are performed by procedures that enrich for mononuclear cells. Hematopoietic progenitor cells are used for autologous and allogeneic hematopoietic stem cell transplantation, whereas T-cell collection is being used increasingly in novel cellular therapy approaches and for donor lymphocyte infusions to induce graft-versus-leukemia effect...
February 2018: Transfusion
https://www.readbyqxmd.com/read/29442420/a-liver-for-a-kidney-ethics-of-trans-organ-paired-exchange
#7
Benjamin Samstein, Inmaculada de Melo-Martin, Sandip Kapur, Lloyd Ratner, Jean Emond
Living donation provides important access to organ transplantation, which is the optimal therapy for patients with end-stage liver or kidney failure. Paired exchanges have facilitated thousands of kidney transplants and enable transplantation when the donor and recipient are incompatible. However, frequently willing and otherwise healthy donors have contraindications to donation of the organ that their recipient needs. Trans-organ paired exchanges would enable a donor associated with a kidney recipient to donate a lobe of liver and a donor associated with a liver recipient to donate a kidney...
February 14, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29439263/what-we-do-and-do-not-know-about-women-and-kidney-diseases-questions-unanswered-and-answers-unquestioned-reflection-on-world-kidney-day-and-international-women-s-day
#8
Giorgina B Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin
Chronic kidney disease affects approximately 10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women's health and specifically their kidney health, on the community and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly...
February 13, 2018: Nephron
https://www.readbyqxmd.com/read/29435267/women-and-kidney-disease-reflections-on-world-kidney-day-2018
#9
Giorgina B Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin
Chronic kidney disease affects ∼10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women's health, and specifically their kidney health, to the community and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women, so that we may apply those learnings more broadly...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29433495/presentation-of-laboratory-test-results-in-patient-portals-influence-of-interface-design-on-risk-interpretation-and-visual-search-behaviour
#10
Paolo Fraccaro, Markel Vigo, Panagiotis Balatsoukas, Sabine N van der Veer, Lamiece Hassan, Richard Williams, Grahame Wood, Smeeta Sinha, Iain Buchan, Niels Peek
BACKGROUND: Patient portals are considered valuable instruments for self-management of long term conditions, however, there are concerns over how patients might interpret and act on the clinical information they access. We hypothesized that visual cues improve patients' abilities to correctly interpret laboratory test results presented through patient portals. We also assessed, by applying eye-tracking methods, the relationship between risk interpretation and visual search behaviour. METHODS: We conducted a controlled study with 20 kidney transplant patients...
February 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29432664/the-impact-of-cold-ischemia-time-cit-at-the-higher-end-of-the-kdpi-spectrum-what-is-the-risk
#11
David D Lee, Hani M Wadei
On December 4, 2014, the new kidney allocation system (KAS) was implemented to reduce extreme longevity mismatches between kidney allograft and recipient life expectancy, increase the highly sensitized patients' access to transplantation through prioritization, broaden access for disadvantaged candidates by counting dialysis time towards wait-list time, and potentially increase the utilization of "marginal kidneys" through broader allocation at the local and regional level. In the first year after implementation, the early results of KAS suggested that the new policies were successful in meeting many of these goals 1 ...
February 12, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29432654/eccrine-sweat-glands-associate-with-the-human-hair-follicle-within-a-defined-compartment-of-dermal-white-adipose-tissue
#12
E Poblet, F Jimenez-Acosta, E Escario-Travesedo, J A Hardman, I Hernández-Hernández, J L Agudo-Mena, J J Cabrera-Galvan, C Nicu, R Paus
BACKGROUND: Eccrine sweat glands (ESGs) are critical for thermoregulation and involved in wound healing. ESGs have traditionally been considered as separate skin appendages without connection to the pilosebaceous unit (PSU). However, recent preliminary evidence has encouraged the hypothesis that PSU and ESG are more interconnected than previously thought. OBJECTIVE: To reevaluate the morphology of human skin adnexa with an integrated 3D perspective in order to explore the possible interconnections that the PSU and the ESG may form...
February 12, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29432583/the-clinical-utility-of-pgd-with-hla-matching-a-collaborative-multi-centre-eshre-study
#13
G Kakourou, S Kahraman, G C Ekmekci, H A Tac, G Kourlaba, E Kourkouni, A Cervero Sanz, J Martin, H Malmgren, C Giménez, V Gold, F Carvalho, C Billi, J F C Chow, X Vendrell, G Kokkali, J Liss, J Steffann, J Traeger-Synodinos
STUDY QUESTION: Has PGD-HLA been successful relative to diagnostic and clinical efficacy? SUMMARY ANSWER: The diagnostic efficacy of PGD-HLA protocols was found lower in this study in comparison to published PGD-HLA protocols and to that reported for general PGD by ESHRE (78.5 vs 94.1% and vs 92.6%, respectively), while the clinical efficacy has proven very difficult to assess due to inadequate follow-up of both the ART/PGD and HSCT procedure outcomes. WHAT IS KNOWN ALREADY: The first clinical cases for PGD-HLA were reported in 2001...
February 8, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29430739/racial-disparities-in-kidney-transplant-waitlist-appearance-in-chicago-is-it-race-or-place
#14
Robert B Peng, Haena Lee, Zheng T Ke, Milda R Saunders
BACKGROUND: Prior work has demonstrated how neighborhood poverty and racial composition impact racial disparities in access to the deceased donor kidney transplant waitlist, both nationally and regionally. We examined the association between neighborhood characteristics and racial disparities in time to transplant waitlist in Chicago, a diverse city with continued neighborhood segregation. METHODS: Using data from the United States Renal Data System (USRDS) and the US Census, we investigated time from dialysis initiation to kidney transplant waitlisting for African American and white patients in Chicago using cause-specific proportional hazards analyses, adjusting for individual sociodemographic and clinical characteristics, as well as neighborhood poverty and racial composition...
February 11, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29423194/women-and-renal-replacement-therapy-in-europe-lower-incidence-equal-access-to-transplantation-longer-survival-than-men
#15
Raul Fernandez-Prado, Beatriz Fernandez-Fernandez, Alberto Ortiz
In 2018, World Kidney Day (WKD) and International Women's Day coincide. The WKD editorial focuses on women's kidney health. The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2015 summary provides an excellent snapshot of renal replacement therapy (RRT) epidemiology and women in Europe. The WKD editorial reports a lower incidence of RRT in women in major registries and potential limitations to women's access to transplantation. What is the situation in Europe? In Europe, the incidence of RRT is also lower in women: 38% of incident RRT patients are women...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29421958/treating-childhood-traumatic-brain-injury-with-autologous-stem-cell-therapy
#16
Shyam Dewan, Samantha Schimmel, Cesar V Borlongan
Neonatal traumatic brain injury (TBI) is a significant cause of developmental disorders. Autologous stem cell therapy may enhance neonatal brain plasticity towards repair of the injured neonatal brain. Areas Covered: The endogenous neonatal anti-inflammatory response can be enhanced by biological treatments. Stem cell therapy stands as a robust approach for sequestering the inflammation-induced cell death in the injured brain. Here, we discuss the use of umbilical cord blood cells and bone marrow stromal cells for acute and chronic treatment of experimental neonatal TBI...
February 9, 2018: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29421860/-face-transplantation-current-status-and-future-developments
#17
REVIEW
Sotirios Tasigiorgos, Branislav Kollar, Nicco Krezdorn, Ericka M Bueno, Stefan G Tullius, Bohdan Pomahac
More than thirty-five facial allograft transplantations (FAT) have been reported worldwide since the pioneering case performed in France in the year 2005. FAT has received tremendous interest by the medical field and the general public while gaining strong support from multiple disciplines as a solution for reconstructing complex facial defects not amenable/responsive to conventional methods. FAT has expanded the frontiers of reconstructive microsurgery, immunology and transplantation, and established its place in the cross section of multiple disciplines...
February 8, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29420218/neighborhood-socioeconomic-status-and-outcomes-following-the-norwood-procedure-an-analysis-of-the-pediatric-heart-network-single-ventricle-reconstruction-trial-public-data-set
#18
Emily M Bucholz, Lynn A Sleeper, Jane W Newburger
BACKGROUND: Children with single ventricle heart disease require frequent interventions and follow-up. Low socioeconomic status (SES) may limit access to high-quality care and place these children at risk for poor long-term outcomes. METHODS AND RESULTS: Data from the SVR (Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use) data set were used to examine the relationship of US neighborhood SES with 30-day and 1-year mortality or cardiac transplantation and length of stay among neonates undergoing the Norwood procedure (n=525)...
February 2, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29415705/resource-allocations-and-disparities-in-the-brazilian-health-care-system-insights-from-organ-transplantation-services
#19
Eduardo J Gómez, Sven Jungmann, Agnaldo Soares Lima
BACKGROUND: To date, few studies have assessed how Brazil's universal healthcare system's (SUS, Sistema Único de Saúde) systemic, infrastructural, and geographical challenges affect individuals' abilities to access organ transplantation services and receive quality treatment. DISCUSSION: In this article we evaluated the existing literature to examine the impact that SUS has had on an increasingly important healthcare sector: organ transplantation services. We assess how equity challenges within the transplantation system can be explained by wider problems within SUS...
February 7, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29411990/diagnosis-and-management-of-hepatic-encephalopathy
#20
Debbie L Shawcross
Overt and covert hepatic encephalopathy (HE) are debilitating complications of cirrhosis. HE results in a poor quality of life for patients and their caregivers and, unless there is access to liver transplantation, the prognosis is poor. The development of overt HE is often unpredictable, and its management, particularly in the ward, remains challenging. There is an urgent need for novel approaches to treat HE. Until recently, therapies for this complication were disappointing, with frequently intolerable side effects such as diarrhoea and faecal incontinence...
February 7, 2018: British Journal of Nursing: BJN
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