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https://www.readbyqxmd.com/read/28921748/increased-risk-organ-transplantation-in-the-pediatric-population
#1
Sean M Wrenn, Peter W Callas, Trishul Kapoor, Alia F Aunchman, Adam N Paine, Jaime A Pineda, Carlos E Marroquin
IRD organs are classified by the Public Health Service to be at above-average risk for harboring human immunodeficiency virus, hepatitis C, and hepatitis B. Traditionally underutilized, there exists even greater reluctance for their use in pediatric patients. We performed a retrospective analysis via the United Network for Organ Sharing database of all pediatric renal and hepatic transplants performed from 2004 to 2008 in the United States. Primary outcomes were patient and graft survival. Proportional hazards regression was performed to control for potentially confounding factors...
September 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28921709/kidney-allograft-failure-in-the-steroid-free-immunosuppression-era-a-matched-case-control-study
#2
Mohamad M Alkadi, Jim Kim, Meredith J Aull, Joseph E Schwartz, John R Lee, Anthony Watkins, Jun B Lee, Darshana M Dadhania, Surya V Seshan, David Serur, Sandip Kapur, Manikkam Suthanthiran, Choli Hartono, Thangamani Muthukumar
We studied the causes and predictors of death-censored kidney allograft failure among 1670 kidney recipients transplanted at our center in the corticosteroid-free maintenance immunosuppression era. As of January 1, 2012, we identified 137 recipients with allograft failure; 130 of them (cases) were matched 1-1 for recipient age, calendar year of transplant and donor type with 130 recipients with functioning grafts (controls). Median time to allograft failure was 29 months (interquartile range 18-51). Physician validated and biopsy confirmed categories of allograft failure were: acute rejection (21%), glomerular disease (19%), transplant glomerulopathy (13%), interstitial fibrosis tubular atrophy (10%), and polyomavirus-associated nephropathy (7%)...
September 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28921638/graft-infiltrating-pd-l1-hi-cross-dressed-dendritic-cells-regulate-anti-donor-t-cell-responses-in-mouse-liver-transplant-tolerance
#3
Yoshihiro Ono, Angelica Perez-Gutierrez, Toshimasa Nakao, Helong Dai, Geoffrey Camirand, Osamu Yoshida, Shinichiro Yokota, Donna Beer Stolz, Mark A Ross, Adrian E Morelli, David A Geller, Angus W Thomson
While a key role of cross-dressing has been established in immunity to viral infection and more recently in the instigation of transplant rejection, its role in tolerance is unclear. Here, we investigated the role of intra-graft dendritic cells (DC) and cross-dressing in mouse major histocompatibility complex (MHC)-mismatched liver transplant tolerance that occurs without therapeutic immunosuppression. While donor interstitial DC diminished rapidly following transplantation, they were replaced in the liver by host DC that peaked on postoperative day (POD) 7 and persisted indefinitely...
September 16, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28920721/-changes-in-carbohydrate-metabolism-after-kidney-transplantation-and-their-effects-on-cardiovascular-risk
#4
Bernadett Borda, Edit Szederkényi, Zoltán Hódi, Aurél Ottlakán, Viktor Szabó, György Lázár
INTRODUCTION: Cardiovascular disease is the major cause of deaths after transplantation, with diabetes mellitus being the main risk factor in development. AIM: The aim of our study was to assess the prevalence of new onset diabetes mellitus in connection with the cardiovascular risk predicted by the HEART Score. METHOD: 44 patients were involved in our study; after overview of baseline data, OGTT was performed, followed by patient classification into the following groups: normal, impaired fasting glucose/impaired glucose tolerance, and new onset diabetes mellitus...
September 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28920719/-history-of-hand-transplantation-advancement-in-the-operative-technics-medications-and-the-survival-of-the-transplanted-hands-review-of-literature
#5
Vilmos Bíró
The author summarizes briefly the history of hand allograft transplantation, the basics of the operative technics, and the medicinal treatment of the immunosuppression. He establishes that this operation requires complicated team-work: many specialists must be united in the interest of the successful final outcome. The biggest problem is not the technical challenge of the complicated operation, but the ineffectiveness of immunosuppression, its complications; even though significant development has happened in this field and experimental results are also encouraging...
September 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28920046/the-effect-of-intraoperative-alkali-treatment-on-recovery-from-atracurium-induced-neuromuscular-blockade-in-renal-transplantation-a-randomized-trial
#6
Navid Noraee, Mohammad Fathi, Majid Golestani Eraghi, Ali Dabbagh, Nilofar Massoudi
BACKGROUND: Intraoperative care and anesthesia method in patients undergoing allograft renal transplantation surgery are very necessary. Acid-base imbalance can alter neuromuscular blockade and recovery time. OBJECTIVES: The aim of the present study was to investigate the effect of acid-base balance on atracurium blockade in renal transplantation. METHODS: In this randomized-controlled trial, 31 end-stage renal disease (ESRD) patients undergoing renal transplantation were randomly assigned into two equal groups...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28918589/isolated-pancreas-rejections-do-not-have-an-adverse-impact-on-kidney-graft-survival-whereas-kidney-rejections-are-associated-with-adverse-pancreas-graft-survival%C3%A2-in-simultaneous-pancreas-kidney-transplantation
#7
Irfan Moinuddin, Muhammad Sohail Yaqub, Tim Taber, John Powelson, Jonathan Fridell, Asif Sharfuddin
BACKGROUND AND OBJECTIVES: Diabetic Kidney Disease is associated with excessive mortality and morbidity. Simultaneous pancreas kidney transplantation (SPK) significantly improves quality of life and increases life expectancy of uremic diabetic patients. It is not known whether pancreas and kidney rejections in these transplant patients is concordant or discordant. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We analyzed clinical data on all SPK transplants performed between 2003 and 2014 at Indiana University to assess the impact of isolated or combined pancreas and kidney rejections on patient and allograft outcomes...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28918487/clinical-risk-stratification-of-paediatric-renal-transplant-recipients-using-c1q-and-c3d-fixing-of-de-novo-donor-specific-antibodies
#8
Jon Jin Kim, Olivia Shaw, Chloe Martin, George Michaelides, Ramnath Balasubramaniam, Neil J Sebire, Nizam Mamode, Anthony Dorling, Robert Vaughan, Stephen D Marks
INTRODUCTION: We have previously shown that children who developed de novo donor-specific human leukocyte antigen (HLA) antibodies (DSA) had greater decline in allograft function. We hypothesised that patients with complement-activating DSA would have poorer renal allograft outcomes. METHODS: A total of 75 children developed DSA in the original study. The first positive DSA sample was subsequently tested for C1q and C3d fixing. The primary event was defined as 50% reduction from baseline estimated glomerular filtration rate and was analysed using the Kaplan-Meier estimator...
September 16, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28916346/radiofrequency-ablation-of-t1a-renal-cell-carcinomas-within-renal-transplant-allografts-oncologic-outcomes-and-graft%C3%A2-viability
#9
Derek W Cool, John R Kachura
PURPOSE: To evaluate oncologic outcomes and graft viability after percutaneous RF ablation of renal cell carcinoma (RCC) developing within renal transplant allografts. MATERIALS AND METHODS: A single-institution, retrospective study reviewed all patients treated with RF ablation for RCC between February 2004 and May 2016. Ten patients were identified (age 49.6 y ± 12.6; 9 men, 1 woman) with 12 biopsy-confirmed RCC tumors within the allograft (all T1a, mean diameter 2...
September 13, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28914777/the-usefulness-of-contrast-enhanced-ultrasound-in-the-assessment-of-early-kidney-transplant-function-and-complications
#10
REVIEW
Sara Álvarez Rodríguez, Vital Hevia Palacios, Enrique Sanz Mayayo, Victoria Gómez Dos Santos, Víctor Díez Nicolás, María Dolores Sánchez Gallego, Javier Lorca Álvaro, Francisco Javier Burgos Revilla
OBJECTIVES: The routine diagnostic method for assessment of renal graft dysfunction is Doppler ultrasound. However, contrast-enhanced ultrasound (CEUS) may provide more information about parenchymal flow and vascular status of kidney allografts. The aim of the study was to assess the effectiveness of CEUS in the immediate post-transplant period, focusing on acute vascular complications. A brief review of available literature and a report of our initial experience is made. MATERIAL AND METHODS: 15 kidney transplant (KT) cases with clinical suspicion of acute surgical complication were assessed with CEUS and conventional Doppler ultrasound (US)...
September 15, 2017: Diagnostics
https://www.readbyqxmd.com/read/28914208/a-systematic-review-of-clinical-studies-investigating-mesenchymal-stem-cells-for-fracture-non-union-and-bone-defects
#11
Kieran Killington, Reza Mafi, Pouya Mafi, Wasim Khan
Fracture non-union is a significant problem with a wide demographic and massive socioeconomic elements, as well as the clinical difficulties it presents. Conventional treatments with autograft and allograft bone grafting pose serious difficulties, thus, it is necessary to develop novel techniques with our ever increasing knowledge of bioengineering using natural materials. Papers were searched from a variety of sources, not limited to English-language studies or only published papers. Papers had to meet the definition of fracture non-union or bone defect and had to be clinical trials, using human MSCs...
September 15, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28914114/shining-dead-bone-cause-for-cautious-interpretation-of-18-f-naf-pet-scans
#12
Magnus Bernhardsson, Olof Sandberg, Marcus Ressner, Jacek Koziorowski, Jonas Malmquist, Per Aspenberg
Background and purpose - [(18)F]Fluoride ([(18)F]NaF) PET scan is frequently used for estimation of bone healing rate and extent in cases of bone allografting and fracture healing. Some authors claim that [(18)F]NaF uptake is a measure of osteoblastic activity, calcium metabolism, or bone turnover. Based on the known affinity of fluoride to hydroxyapatite, we challenged this view. Methods - 10 male rats received crushed, frozen allogeneic cortical bone fragments in a pouch in the abdominal wall on the right side, and hydroxyapatite granules on left side...
September 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28912844/triptolide-inhibits-cd4-memory-t-cell-mediated-acute-rejection-and-prolongs-cardiac-allograft-survival-in-mice
#13
Shuiwei Qiu, Dingliang Lv
There have been numerous investigations into the immunosuppressive effects of triptolide; however, its inhibitory effects on memory T cells remain to be elucidated. Using a cluster of differentiation (CD)4(+) memory T-cell transfer model, the aim of the present study was to determine the inhibitory effects of triptolide on CD4(+) memory T cell-mediated acute rejection and to determine the potential underlying mechanisms. At 4 weeks after skin transplantation, mouse cervical heart transplantation was performed following the transfer of CD4(+) memory T cells...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28912528/extracellular-vesicles-derived-from-t-regulatory-cells-suppress-t-cell-proliferation-and-prolong-allograft-survival
#14
Sistiana Aiello, Federica Rocchetta, Lorena Longaretti, Silvia Faravelli, Marta Todeschini, Linda Cassis, Francesca Pezzuto, Susanna Tomasoni, Nadia Azzollini, Marilena Mister, Caterina Mele, Sara Conti, Matteo Breno, Giuseppe Remuzzi, Marina Noris, Ariela Benigni
We have previously shown that rat allogeneic DC, made immature by adenoviral gene transfer of the dominant negative form of IKK2, gave rise in-vitro to a unique population of CD4(+)CD25(-) regulatory T cells (dnIKK2-Treg). These cells inhibited Tcell response in-vitro, without needing cell-to-cell contact, and induced kidney allograft survival prolongation in-vivo. Deep insight into the mechanisms behind dnIKK2-Treg-induced suppression of Tcell proliferation remained elusive. Here we document that dnIKK2-Treg release extracellular vesicles (EV) riched in exosomes, fully accounting for the cell-contact independent immunosuppressive activity of parent cells...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28911060/reduced-intensity-versus-reduced-toxicity-myeloablative-fludarabine-busulfan-based-conditioning-regimens-for-allografted-non-hodgkin-lymphoma-adult-patients-a-retrospective-study-on-behalf-of-the-soci%C3%A3-t%C3%A3-francophone-de-greffe-de-moelle-et-de-th%C3%A3-rapie-cellulaire
#15
A Le Bourgeois, M Labopin, D Blaise, P Ceballos, S Vigouroux, R Peffault de Latour, A Marçais, C E Bulabois, J O Bay, S Chantepie, E Deconinck, E Daguindau, N Contentin, I Yakoub-Agha, J Cornillon, M Mercier, P Turlure, A Charbonnier, P S Rorhlich, S N'Guyen, N Maillard, T Marchand, M Mohty, P Chevallier
Background: Fludarabine/busulfan-based conditioning regimens are widely used to perform allogeneic stem-cell transplantation (allo-SCT) in high-risk non-Hodgkin lymphoma (NHL) patients. The impact of the dose intensity of busulfan on outcomes has not been reported yet. Patients and methods: This was a retrospective with the aim to compare the outcomes of NHL patients who received before allo-SCT a fludarabine/busulfan conditioning regimen, either of reduced intensity (FB2, 2 days of busulfan at 4 mg/kg/day oral or 3...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28910821/vascular-disrupting-agent-in-pancreatic-and-hepatic-tumour-allografts-observations-of-location-dependent-efficacy-by-mri-microangiography-and-histomorphology
#16
Ting Yin, Yewei Liu, Ronald Peeters, Yuanbo Feng, Jie Yu, Uwe Himmelreich, Raymond Oyen, Yicheng Ni
BACKGROUND: Tumours growing in organs of different vascular environment could exhibit diverse responses to vascular disrupting agent (VDA). This study was aimed to identify in vivo imaging biomarkers for evaluation of pancreatic and hepatic tumours and comparison of their responses to a VDA Combretastatin A4 Phosphate (CA4P) using multiparametric MRI. METHODS: Male WAG/Rij rats were used for orthotopic pancreatic head tumour and hepatic tumour implantation; tumour growth was monitored by 3D isotropic MRI using a 3...
September 14, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28905454/management-considerations-in-the-failing-renal-allograft
#17
REVIEW
Tom Lea-Henry, Bobby Chacko
Patients with a failed or failing renal transplant are increasing in number. Graft failure resulting in dialysis re-initiation is not uncommon, yet there are limited data to guide management of these patients. Physician practices vary regarding timing of dialysis initiation and the timing and extent of immunosuppression withdrawal. The risks of immunosuppression withdrawal need to be carefully balanced against the benefits of continuing low-dose therapy. The latter helps minimise the risk of sensitisation and has been proposed to possibly slow the loss of residual renal function; however, the use of common immunosuppressive agents may contribute to cardiovascular disease, malignancy, and infection, the major causes of death following the loss of a renal transplant...
September 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28904437/cryptococcal-infection-in-transplant-kidney-manifesting-as-chronic-allograft-dysfunction
#18
C Agrawal, V Sood, A Kumar, V Raghavan
Invasive fungal infections (IFIs) are a significant cause of morbidity in solid organ transplant (SOT) recipients. Common causes among them are Aspergillus, Candida, and Cryptococcus. Antifungal prophylaxis has led to decrease in overall incidence of IFI; however, there is very little decline in the incidence of Cryptococcal infections of SOT recipients because effective prophylaxis is not available against this infectious agent. Spectrum of manifestation of Cryptococcal infection varies in immunocompetent and immunocompromised host with subclinical and self-limiting with lungs being the primary site in immunocompetent and central nervous system as the most common site in an immunocompromised host...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28904433/risk-factors-for-urinary-tract-infections-in-renal-allograft-recipients-experience-of-a-tertiary-care-center-in-hyderabad-south-india
#19
M V N L R Mohan, M Neeraja, S Sudhaharan, S B Raju, T Gangadhar, V Lakshmi
Renal transplantation is an effective and commonly performed procedure for end-stage renal disease. Urinary tract infections are a major cause of morbidity and mortality in renal transplant patients. As data on postrenal transplant urinary tract infections from the Indian subcontinent are limited, the present study was conducted to estimate the burden of urinary tract infections in this vulnerable group of patients. This was a prospective study on patients undergoing renal transplantation in 2014 at our tertiary hospital in South India with a follow-up of 2 years to evaluate the risk factors for urinary tract infections...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28904429/correlation-of-pretransplant-donor-specific-antibody-assay-using-luminex-crossmatch-with-graft-outcome-in-renal-transplant-patients
#20
M Vimal, M P Chacko, G Basu, D Daniel
The significance of pretransplant anti-human leukocyte antigen antibody levels that are detectable by more sensitive platforms (including the Luminex platform) yet undetected by complement-dependent cytotoxicity (CDC) assay remains unclear. The aim of this study was to determine the clinical significance of the donor-specific antibody (DSA) assay Luminex crossmatch and its impact on short-term renal graft outcome such as acute rejections, graft survival, and graft function. The results of pretransplant DSA-lymphocyte crossmatching (LCXM) assay in 126 renal allograft recipients whose CDCs crossmatches were negative were retrospectively analyzed for correlation with posttransplant outcomes...
September 2017: Indian Journal of Nephrology
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