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Liver, Renal & Pancreas transplantation

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https://www.readbyqxmd.com/read/29174777/cardiac-surgery-outcomes-in-abdominal-solid-organ-transplant-recipients
#1
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28844151/high-dose-acyclovir-for-cytomegalovirus-prophylaxis-in-seropositive-abdominal-transplant-recipients
#2
Margaret R Jorgenson, Jillian L Descourouez, Glen E Leverson, Erin K McCreary, Michael R Lucey, Jeannina A Smith, Robert R Redfield
BACKGROUND: Following abdominal solid organ transplant (aSOT), valganciclovir (VGC) is recommended for cytomegalovirus (CMV) prophylaxis. This agent is associated with efficacy concerns, toxicity, and emergence of ganciclovir resistance. OBJECTIVE: To evaluate the incidence of high-dose acyclovir (HD-A) prophylaxis failure in seropositive aSOT recipients (R+). METHODS: This was a retrospective, single-center study of R+ transplanted without lymphocyte-depleting induction between January 1, 2000, and June 30, 2013, discharged with 3 months of HD-A prophylaxis (800 mg 4 times daily)...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28655312/transplantation-of-human-fetal-pancreatic-progenitor-cells-ameliorates-renal-injury-in-streptozotocin-induced-diabetic-nephropathy
#3
Yongwei Jiang, Wenjian Zhang, Shiqing Xu, Hua Lin, Weiguo Sui, Honglin Liu, Liang Peng, Qing Fang, Li Chen, Jinning Lou
BACKGROUND: Diabetic nephropathy (DN) is a severe complication of diabetes mellitus (DM). Pancreas or islet transplantation has been reported to prevent the development of DN lesions and ameliorate or reverse existing glomerular lesions in animal models. Shortage of pancreas donor is a severe problem. Islets derived from stem cells may offer a potential solution to this problem. OBJECTIVE: To evaluate the effect of stem cell-derived islet transplantation on DN in a rat model of streptozotocin-induced DM...
June 27, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#4
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
November 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28538243/bk-virus-as-a-mediator-of-graft-dysfunction-following-kidney-transplantation
#5
Stephanie G Yi, Richard J Knight, Keri E Lunsford
PURPOSE OF REVIEW: BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients. RECENT FINDINGS: Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28481004/tips-and-pitfalls-in-direct-ligation-of-large-spontaneous-splenorenal-shunt-during-liver-transplantation
#6
Hyeyoung Kim, Kyung Chul Yoon, Kwang-Woong Lee, Nam-Joon Yi, Hae Won Lee, YoungRok Choi, Dongkyu Oh, Hyo-Sin Kim, Suk Kyun Hong, Sung Woo Ahn, Kyung-Suk Suh
Patients with large spontaneous splenorenal shunts (SRSs) prove challenging during liver transplantation (LT), regardless of organizing portal vein (PV) thrombosis. Here, we detail the clinical outcomes of 26 patients who underwent direct ligation of large SRSs during LT. Direct ligation of large SRS was applied in poor portal flow during LT. We performed temporary test clamping of the SRS before direct ligation and applied PV pressure monitoring in patients who showed signs of portal hypertension, such as bowel edema...
July 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28272287/risk-factors-and-outcomes-of-de-novo-cancers-excluding-nonmelanoma-skin-cancer-after-liver-transplantation-for-primary-sclerosing-cholangitis
#7
Mohamad A Mouchli, Siddharth Singh, Edward V Loftus, Lisa Boardman, Jayant Talwalkar, Charles B Rosen, Julie K Heimbach, Russell H Wiesner, Bashar Hasan, John J Poterucha, Watt D Kymberly
BACKGROUND: Patients with primary sclerosing cholangitis (PSC) may be at higher risk of malignancy after liver transplantation (LT) compared to other LT recipients. We aimed to determine the cumulative incidence of/risk factors for long-term cancer-related mortality in patients with PSC after LT. METHODS: All adult patients underwent LT for PSC without cholangiocarcinoma from 1984 to 2012, with follow-up through June 2015. We estimated cumulative incidence, risk factors, and mortality from de novo malignancies after LT...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28148909/en-bloc-transplant-of-the-liver-kidney-and-pancreas-experience-from-a-latin-american-transplant-center
#8
Luis A Caicedo, Jorge I Villegas, Oscar Serrano, Mauricio Millán, Mauricio Sepúlveda, Diego Jiménez, Jairo García, Juan G Posada, Liliana Mesa, Carlos Duran, Johanna Schweineberg, Diana Dávalos, Eliana Manzi, Angie Sabogal, Ana María Aristizabal, Gabriel J Echeverri
BACKGROUND En-bloc transplantation is a surgical procedure in which multiple organs are transplanted simultaneously. It has some similarities with multi-organ transplantation but offers certain advantages. This report highlights the experience of our interdisciplinary group regarding the treatment and follow-up of patients who received en-bloc transplantation, with the aim of encouraging the development of this surgical technique. CASE REPORT The first case is a 38-year-old patient with type 1 diabetes mellitus, liver cirrhosis, and chronic kidney failure who received an en-bloc transplant of the liver, pancreas, and kidney with no intraoperative complications...
February 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28107792/noteworthy-literature-published-in-2016-for-abdominal-organ-transplant-anesthesiologists
#9
Jeron Zerillo, Sang Kim, Bryan Hill, Samuel DeMaria, Tetsuro Sakai
More than 400 peer-reviewed publications on the topic of pancreas transplantation, more than 400 on intestine transplantation, and more than 3000 on renal transplantation were published in 2016. This review will highlight the most pertinent literature for anesthesiologists caring for patients undergoing non-liver abdominal organ transplantation. This review is the second part in an annual series to review relevant contributions in the field of abdominal organ transplantation focusing on pancreas, intestine, and renal transplantation...
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27726195/the-use-of-robotic-surgery-in-abdominal-organ-transplantation-a-literature-review
#10
REVIEW
Giovanni B Levi Sandri, Edoardo de Werra, Gianluca Mascianà, Francesco Guerra, Gabriele Spoletini, Quirino Lai
Minimally invasive surgical approaches in transplantation are gaining increasing interest, and many centers are reporting their, mainly laparoscopic, experiences. Robotic surgery (RS) has some hypothetical advantages over traditional laparoscopy and has been successfully applied, although infrequently to organ transplantation. Our goal was to review and critique the publications reporting RS use in organ transplantation. Most of the RS experience has been with living renal donor organ procurement and, to a lesser extent, with RS procedures in the transplant recipient...
January 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/27569973/comparison-of-the-ovary-and-kidney-as-sites-for-islet-transplantation-in-diabetic-rats
#11
COMPARATIVE STUDY
M Karakose, F A Pinarli, M S Arslan, G Boyuk, B Boztok, A Albayrak, A T Ulus, E Cakal, T Delibasi
BACKGROUND: Currently, the most commonly used site for clinical islet transplantation is the liver although it is far from being an ideal site. Low oxygen tension and the induction of an inflammatory response impair islet implantation and lead to significant early loss of islet. The present study aimed to investigate and compare the efficacy of islet transplantation to the ovary and kidney subcapsule in diabetic rats. METHODS: The study was performed with 3 groups of rats (control, ovary, and kidney subcapsule) including 6 Sprague female rats each...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27380753/clinical-applications-of-high-intensity-focused-ultrasound
#12
REVIEW
W H She, T T Cheung, C R Jenkins, M G Irwin
Ultrasound has been developed for therapeutic use in addition to its diagnostic ability. The use of focused ultrasound energy can offer a non-invasive method for tissue ablation, and can therefore be used to treat various solid tumours. High-intensity focused ultrasound is being increasingly used in the treatment of both primary and metastatic tumours as these can be precisely located for ablation. It has been shown to be particularly useful in the treatment of uterine fibroids, and various solid tumours including those of the pancreas and liver...
August 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27203584/paid-living-donation-and-growth-of-deceased-donor-programs
#13
REVIEW
Nasrollah Ghahramani
Limited organ availability in all countries has stimulated discussion about incentives to increase donation. Since 1988, Iran has operated the only government-sponsored paid living donor (LD) kidney transplant program. This article reviews aspects of the Living Unrelated Donor program and development of deceased donation in Iran. Available evidence indicates that in the partially regulated Iranian Model, the direct negotiation between donors and recipients fosters direct monetary relationship with no safeguards against mutual exploitation...
June 2016: Transplantation
https://www.readbyqxmd.com/read/27067875/epico-3-0-antifungal-prophylaxis-in-solid-organ-transplant-recipients
#14
Rafael Zaragoza, José María Aguado, Ricard Ferrer, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Patricia Muñoz, Jesús Fortún, Mercedes Bouzada, Juan Carlos Del Pozo, Rafael León
BACKGROUND: Although over the past decade the management of invasive fungal infection has improved, considerable controversy persists regarding antifungal prophylaxis in solid organ transplant recipients. AIMS: To identify the key clinical knowledge and make by consensus the high level recommendations required for antifungal prophylaxis in solid organ transplant recipients. METHODS: Spanish prospective questionnaire, which measures consensus through the Delphi technique, was conducted anonymously and by e-mail with 30 national multidisciplinary experts, specialists in invasive fungal infections from six national scientific societies, including intensivists, anesthetists, microbiologists, pharmacologists and specialists in infectious diseases that responded to 12 questions prepared by the coordination group, after an exhaustive review of the literature in the last few years...
October 2016: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/26823089/sleeve-gastrectomy-surgery-in-obese-patients-post-organ-transplantation
#15
Enrique F Elli, Raquel Gonzalez-Heredia, Lisa Sanchez-Johnsen, Neil Patel, Raquel Garcia-Roca, Jose Oberholzer
BACKGROUND: Among organ transplant recipients, a common side effect of immunosuppressive therapy is the development of obesity, which affects a third of the patients within 3 years after transplantation. Bariatric surgery represents a possible surgical option for weight loss among posttransplant patients. OBJECTIVES: The aim of this study was to examine percent excess weight loss (%EWL), and percent weight loss (%WL) and perioperative and postoperative complications in posttransplant obese patients after sleeve gastrectomy (SG) compared with nontransplant patients...
March 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/26784269/en-bloc-multiorgan-transplant-liver-pancreas-and-kidney-for-acute-liver-and-renal-failure-in-a-patient-with-wolcott-rallison-syndrome
#16
LETTER
Erilia Rivera, Sameer Gupta, Blanche Chavers, Laura Quinones, Megan Rooney Berger, Sarah Jane Schwarzenberg, Timothy Pruett, Priya Verghese, Srinath Chinnakotla
No abstract text is available yet for this article.
March 2016: Liver Transplantation
https://www.readbyqxmd.com/read/26759930/practical-applications-in-immunohistochemistry-evaluation-of-rejection-and-infection-in-organ-transplantation
#17
REVIEW
Megan L Troxell, Christian Lanciault
CONTEXT: -Immunohistochemical analysis of tissue biopsy specimens is a crucial tool in diagnosis of both rejection and infection in patients with solid organ transplants. In the past 15 years, the concept of antibody-mediated rejection has been refined, and diagnostic criteria have been codified in renal, heart, pancreas, and lung allografts (with studies ongoing in liver, small intestine, and composite grafts), all of which include immunoanalysis for the complement split product C4d...
September 2016: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/26722644/preservation-solutions-used-during-abdominal-transplantation-current-status-and-outcomes
#18
REVIEW
Nicholas Latchana, Joshua R Peck, Bryan A Whitson, Mitchell L Henry, Elmahdi A Elkhammas, Sylvester M Black
Organ preservation remains an important contributing factor to graft and patient outcomes. During donor organ procurement and transportation, cellular injury is mitigated through the use of preservation solutions in conjunction with hypothermia. Various preservation solutions and protocols exist with widespread variability among transplant centers. In this review of abdominal organ preservation solutions, evolution of transplantation and graft preservation are discussed followed by classification of preservation solutions according to the composition of electrolytes, impermeants, buffers, antioxidants, and energy precursors...
December 24, 2015: World Journal of Transplantation
https://www.readbyqxmd.com/read/26555949/calcineurin-inhibitors-downregulate-hnf-1%C3%AE-and-may-affect-the-outcome-of-hnf1b-patients-after-renal-transplantation
#19
MULTICENTER STUDY
Stanislas Faguer, Laure Esposito, Audrey Casemayou, Yves Pirson, Stéphane Decramer, Claire Cartery, Marc Hazzan, Valérie Garrigue, Gwenaelle Roussey, Olivier Cointault, Thien Ho, Pierre Merville, Olivier Devuyst, Pierre Gourdy, Nicolas Chassaing, Jean-Loup Bascands, Nassim Kamar, Joost-Peter Schanstra, Lionel Rostaing, Dominique Chauveau
BACKGROUND: Patients with HNF1B mutations develop progressive chronic renal failure, diabetes mellitus (40-50%), and liver tests abnormalities (40-70%). In HNF1B patients who reach end-stage renal disease, single kidney transplantation (SKT) or combined kidney-pancreas transplantation can be considered. METHODS: A retrospective multicenter study including 18 HNF1B patients receiving SKT or kidney-pancreas transplantation, and in vitro experiments including the characterization of the HNF1B expression after calcineurin inhibitor (CNI) exposure...
September 2016: Transplantation
https://www.readbyqxmd.com/read/26520471/outcomes-of-cardiac-surgery-in-patients-with-previous-solid-organ-transplantation-kidney-liver-and-pancreas
#20
MULTICENTER STUDY
Patrick R Vargo, Nicholas K Schiltz, Douglas R Johnston, Nicholas G Smedira, Nader Moazami, Eugene H Blackstone, Edward G Soltesz
A growing number of solid organ transplant survivors require surgery for cardiac disease. We examined the effect of having a previous transplant on outcomes after cardiac surgery in these patients from a population-based perspective. Of 1,709,735 patients who underwent coronary artery bypass grafting, valve, or thoracic aorta surgery from 2004 to 2008 in the Nationwide Inpatient Sample, 3,535 patients (0.21%) had a previous organ transplant (2,712 kidney, 738 liver, 300 pancreas). Multivariate logistic regression analysis and propensity score matching were used to determine the effect of a previous solid organ transplant on outcomes...
December 15, 2015: American Journal of Cardiology
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