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https://www.readbyqxmd.com/read/28640530/how-does-age-affect-the-outcome-of-kidney-transplantation-in-elderly-recipients
#1
Flavia Neri, Lucrezia Furian, Francesco Cavallin, Matteo Ravaioli, Cristina Silvestre, Paola Donato, Gaetano La Manna, Antonio Daniele Pinna, Paolo Rigotti
The aging of the on-dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aims to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all patients over 60 years, receiving a deceased-donor kidney transplantation from January 2004 to December 2014 in two north Italian Centers. We analyzed the correlation of recipient age with graft's and patient's survival, delayed graft function (DGF), acute cellular rejection (ACR), surgical complications, infections and glomerular filtration rate (GFR)...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28625537/the-developmental-stage-of-adult-human-stem-cell-derived-retinal-pigment-epithelium-cells-influences-transplant-efficacy-for-vision-rescue
#2
Richard J Davis, Nazia M Alam, Cuiping Zhao, Claudia Müller, Janmeet S Saini, Timothy A Blenkinsop, Francesca Mazzoni, Melissa Campbell, Susan M Borden, Carol J Charniga, Patty L Lederman, Vanessa Aguilar, Michael Naimark, Michael Fiske, Nathan Boles, Sally Temple, Silvia C Finnemann, Glen T Prusky, Jeffrey H Stern
Age-related macular degeneration (AMD) is a common cause of central visual loss in the elderly. Retinal pigment epithelial (RPE) cell loss occurs early in the course of AMD and RPE cell transplantation holds promise to slow disease progression. We report that subretinal transplantation of RPE stem cell (RPESC)-derived RPE cells (RPESC-RPE) preserved vision in a rat model of RPE cell dysfunction. Importantly, the stage of differentiation that RPESC-RPE acquired prior to transplantation influenced the efficacy of vision rescue...
June 13, 2017: Stem Cell Reports
https://www.readbyqxmd.com/read/28624109/the-use-of-old-donors-in-liver-transplantation
#3
REVIEW
Bobby V M Dasari, Andrea Schlegel, Hynek Mergental, M Thamara P R Perera
The process of ageing has an impact on the entire human body including the organ systems. In transplantation, professionals are daily faced with risk assessment of suitable donor offers , whether to accept a liver graft for a specific recipient. In this context, livers from elderly donors are more frequently accepted for transplantation, to increase the donor pool and compensate the high waiting list mortality. In the current practice it is not unusual to accept 60-year old donor livers for transplantation, as the donor demographics have significantly changed over the years...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28624031/lung-transplantation-with-lungs-from-older-donors-an-analysis-of-survival-in-elderly-recipients
#4
Jacob Katsnelson, Bryan A Whitson, Dmitry Tumin, Yazhini Ravi, Ahmet Kilic, Joseph D Tobias, Chittoor B Sai-Sudhakar, Don Hayes
BACKGROUND: The average ages of lung transplant (LTx) recipients and donors are increasing. With older recipients considered to be especially at high risk of posttransplant mortality, we sought to determine whether the use of allografts from older donors affects survival among older patients undergoing LTx. METHODS: The United Network for Organ Sharing registry was used to identify patients aged 65-80 y receiving a first-time LTx between 1987 and 2013. Survival analysis examined implications of a donor-recipient age difference >10 y using Cox proportional hazards regression...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28616498/xenotransplantation-a-special-case-of-one-health
#5
REVIEW
Joachim Denner
The chronic shortage of human transplants to treat tissue and organ failure has led to the development of xenotransplantation, the transplantation of cells, tissues and organs from another species to human recipients. For a number of reasons, pigs are best suited as donor animals. Successful, routine xenotransplantation would have an enormous impact on the health of the human population, including the young, who sometimes require a replacement organ or islet cells, but especially the elderly, who more often suffer the consequences of organ failure...
June 2017: One Health
https://www.readbyqxmd.com/read/28596252/success-in-bone-marrow-failure-novel-therapeutic-directions-based-on-the-immune-environment-of-myelodysplastic-syndromes
#6
REVIEW
Alyssa H Cull, Michael J Rauh
Myelodysplastic syndromes (MDS) are clonal neoplasms of aging that are associated with BM failure, related cytopenias, fatigue, susceptibility to infections, bruising, bleeding, a shortened lifespan, and a propensity for leukemic transformation. Most frail, elderly patients are not candidates for curative allogeneic BM transplantations and instead receive expectant management, supportive blood transfusions, or empirical, nontargeted therapy. It has been known for some time that MDS arises in an abnormal BM immune environment; however, connections have only recently been established with recurring MDS-associated mutations...
June 8, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28586309/italian-real-life-experience-with-brentuximab-vedotin-results-of-a-large-observational-study-on-234-relapsed-refractory-hodgkin-s-lymphoma
#7
Cinzia Pellegrini, Alessandro Broccoli, Alessandro Pulsoni, Luigi Rigacci, Caterina Patti, Guido Gini, Donato Mannina, Monica Tani, Chiara Rusconi, Alessandra Romano, Anna Vanazzi, Barbara Botto, Armando Santoro, Stefan Hoaus, Gian Matteo Rigolin, Pellegrino Musto, Patrizio Mazza, Stefano Molica, Paolo Corradini, Angelo Fama, Francesco Gaudio, Michele Merli, Fioravante Ronconi, Giuseppe Gritti, Daniele Vallisa, Patrizia Tosi, Anna Marina Liberati, Antonello Pinto, Vincenzo Pavone, Filippo Gherlinzoni, Maria Paola Bianchi, Stefano Volpetti, Livio Trentin, Maria Cecilia Goldaniga, Maurizio Bonfichi, Amalia De Renzo, Corrado Schiavotto, Michele Spina, Angelo Michele Carella, Vittorio Stefoni, Lisa Argnani, Pier Luigi Zinzani
A large Italian multicenter observational retrospective study was conducted on the use of brentuximab vedotin (BV) for patients with relapsed Hodgkin's lymphoma (HL) to check if clinical trial results are confirmed even in a real life context. 234 CD30+ HL patients were enrolled. Best response was observed after a median of 4 cycles in 140 patients (59.8%): 74 (31.6%) patients obtained a complete response (CR) and 66 (28.2%) achieved a partial response (PR); overall response rate at the end of the treatment was 48...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28583573/kidney-transplantation-in-korean-patients-with-end-stage-renal-disease-aged-65-and-older-a-single-center-experience
#8
S S Kang, W Y Park, K Jin, S B Park, S Han
BACKGROUND: The mean age of patients starting dialysis in Korea has increased to older than 60 years and the proportion of patients aged 65 and older exceeded 40% in 2014. Although the number of elderly dialysis patients is increasing rapidly, percentages of elderly patients undergoing kidney transplantation (KT) are very low. METHODS: We retrospectively reviewed the medical records of patients who underwent KT at Keimyung University Dongsan Medical Center between 1982 and 2016...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28583528/human-polyomavirus-is-associated-with-earlier-onset-of-upper-urinary-tract-urothelial-carcinoma-in-patients-after-kidney-transplantation
#9
H L Luo, Y T Chen, S C Huang, T C Chen, P H Chiang, S S Lin, Y T Cheng
OBJECTIVES: Polyomavirus has been reported to be oncogenic due to viral integration into the human genome. A relatively high prevalence of upper urinary tract urothelial carcinoma (UTUC) was noted after kidney transplantation (KT) in Taiwan. However, little was known about the impact of polyomavirus on the urothelial cancer behavior. Therefore, the aim of this study is to analyze the characteristics of polyomavirus-related UTUC after KT. METHODS: From 2005 to 2014, 27 patients were found to have UTUCs after KT...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28573892/acute-myeloid-leukemia-in-the-elderly-therapeutic-options-and-choice
#10
Jonathan A Webster, Keith W Pratz
Acute myeloid leukemia (AML) therapies are rapidly evolving with novel targeted therapies showing high-level responses in a notoriously difficult to treat group of patients - the elderly and unfit. This review will examine the outcomes of older AML patients (>60 years old) with conventional induction strategies, and published literature on risks of pursuit of induction. Low-intensity combination therapy response rates appear to be approaching that of induction regimens, and with lower toxicity, low-intensity therapy likely represents the future standard approach in this age group...
June 2, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28573420/identifying-independent-risk-factors-for-graft-loss-after-primary-liver-transplantation
#11
Jill Gwiasda, Harald Schrem, Jürgen Klempnauer, Alexander Kaltenborn
PURPOSE: The aim of the study is the identification of independent risk factors for re-transplantation after primary liver transplantation beyond the occurrence of hepatic artery thrombosis. METHODS: Eight hundred thirty-four adult patients undergoing primary liver transplantation were analyzed. A propensity score was developed using multivariable binary logistic regression with hepatic artery thrombosis as the dependent variable. The logit link function of the propensity score was included into multivariable Cox regression analysis for graft survival to adjust the study population...
June 1, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28562519/epigenetic-combination-therapy-for-children-with-secondary-myelodysplastic-syndrome-mds-acute-myeloid-leukemia-aml-and-concurrent-solid-tumor-relapse
#12
Chana L Glasser, Alice Lee, Don Eslin, Lianna Marks, Shakeel Modak, Julia L Glade Bender
Secondary myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) is a rare but devastating complication of solid tumor treatment involving high-dose topoisomerase II inhibitor and alkylator chemotherapy. For relapsed or elderly MDS and AML patients ineligible for hematopoietic stem cell transplantation, epigenetic therapies, including DNA methyltransferase inhibitors and histone deacetylase inhibitors, have been utilized as palliative therapy, offering a well-tolerated approach to disease stabilization, prolonged survival, and quality of life...
May 29, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28561667/myeloma-in-elderly-patients-when-less-is-more-and-more-is-more
#13
Ashley Rosko, Sergio Giralt, Maria-Victoria Mateos, Angela Dispenzieri
Multiple myeloma is a plasma cell malignancy that occurs among older adults and accounts for 15% of all hematologic malignancies in the United States. Thirty-five percent of patients are diagnosed at age 75 or older. Novel therapeutics and routine use of autologous stem cell transplantation (ASCT) have led to substantial improvements in patient survival, although improvements have been more impressive among patients younger than age 65. Finding the balance between under- and overtreating elderly patients is one of the biggest challenges specific to them as a subgroup of patients with MM...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28549531/targeting-the-akt-gsk-3-bcl-2-axis-in-acute-myeloid-leukemia
#14
REVIEW
Maria Rosaria Ricciardi, Simone Mirabilii, Roberto Licchetta, Monica Piedimonte, Agostino Tafuri
Over the last few decades, there has been significant progress in the understanding of the pathogenetic mechanisms of the Acute Myeloid Leukemia (AML). However, despite important advances in elucidating molecular mechanisms, the treatment of AML has not improved significantly, remaining anchored at the standard chemotherapy regimen "3 + 7", with the prognosis of patients remaining severe, especially for the elderly and for those not eligible for transplant procedures. The biological and clinical heterogeneity of AML represents the major obstacle that hinders the improvement of prognosis and the identification of new effective therapeutic approaches...
May 19, 2017: Advances in Biological Regulation
https://www.readbyqxmd.com/read/28549011/use-of-elderly-donors-in-liver-transplantation-a-paired-match-analysis-at-a-single-center
#15
Davide Ghinolfi, Quirino Lai, Daniele Pezzati, Paolo De Simone, Erion Rreka, Franco Filipponi
OBJECTIVE: To evaluate the use of elderly donors in liver transplantation (LT) and identify risk factors associated with a worse outcome. SUMMARY BACKGROUND DATA: Use of livers from very old donors could expand the donor pool but is not universally implemented. METHODS: This is a retrospective, single-center medical record review. From January 2001 to December 2014, 1354 LTs were performed. After exclusion of donors <18 years, ABO-incompatible LT, re-LT and UNOS 1 status patients, LT recipients were stratified into 2 groups based on donor age: 18-69 (n=692) vs...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28546942/magnetic-nanoparticles-conjugated-with-rpe-cell-mcp-1-antibody-vegf-antibody-compounds-for-the-targeted-therapy-of-age-related-macular-degeneration-a-hypothesis
#16
Zhao-Jiang Du, Peng Li, Li Wang
Age-related macular degeneration (AMD) is the leading cause of vision loss in the elderly throughout the world. Treatment of AMD utilizing retinal pigment epithelium (RPE) transplantation represents a promising therapy. However, simplex RPE transplantation can only replace the diseased RPE cells, but has no abilities to stop the development of AMD. It has been indicated that oxidization triggers the development of AMD by inducing the dysfunction and degeneration of RPE cells, which results in the upregulation of local monocyte chemotactic protein-1 (MCP-1) expression...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28538512/necrotizing-ulcer-after-bcg-vaccination-in-a-girl-with-leukocyte-adhesion-deficiency-type-1
#17
Hidemitsu Kurosawa, Tomoyuki Mizukami, Hiroyuki Nunoi, Masaya Kato, Yuya Sato, Mayuko Okuya, Keitaro Fukushima, Yoshihiko Katsuyama, Osamu Arisaka
Leukocyte-adhesion deficiency-1 is a recessively inherited disorder associated with recurrent bacterial infections, severe periodontitis, peripheral leukocytosis, and impaired wound healing. We diagnosed moderate-type leukocyte-adhesion deficiency-1 in a 7-year-old girl who developed a necrotizing ulcer after Bacillus Calmette-Guerin vaccination. The patient showed moderate expression of CD18 in neutrophils with a homozygous splice mutation with c.41_c.58+2dup20 of ITGB2 and experienced recurrent severe infections complicated with systemic lupus erythematosus...
May 22, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28523327/complicated-diverticulitis-in-a-de-novo-kidney-transplanted-patient
#18
Liliana Ana TuŢă, Mădălina Boşoteanu, Eugen Dumitru, Mariana Deacu
Diverticular disease is frequent amongst the elderly and immunosuppressed patients. It mainly presents as sigmoid diverticulitis, but severe complications, like bleedings, infections and colon perforation may occur, frequently due to immunosuppressive therapy. Moreover, antibiotherapy and hemostatics may not efficiently control evolution in such cases. Early diagnose and adequate treatment of colonic diverticulosis complicated with lower gastrointestinal bleeding and diverticulitis in immunocompromised patients...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28522345/allogeneic-hematopoietic-cell-transplantation-for-older-patients-prognosis-determined-by-disease-risk-index
#19
Fiona He, Qing Cao, Aleksandr Lazaryan, Claudio Brunstein, Shernan Holtan, Erica Warlick, Celalettin Ustun, Brian McClune, Mukta Arora, Armin Rashidi, Craig Eckfeldt, Daniel J Weisdorf, Nelli Bejanyan
The treatment of elderly patients with advanced hematological malignancies has expanded to include reduced-intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (alloHCT) as a potentially curative option. We studied the association between Disease Risk Index (DRI) and clinical outcomes of 196 elderly patients (median age, 64.8; range, 60 to 75 years) with hematological malignancies receiving RIC alloHCT (2000 to 2014). Donors were related and unrelated adults (n = 100, 51.1%) or umbilical cord blood (n = 96, 48...
May 15, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28498784/depth-of-response-in-multiple-myeloma-a-pooled-analysis-of-three-pethema-gem-clinical-trials
#20
Juan-Jose Lahuerta, Bruno Paiva, Maria-Belen Vidriales, Lourdes Cordón, Maria-Teresa Cedena, Noemi Puig, Joaquin Martinez-Lopez, Laura Rosiñol, Norma C Gutierrez, María-Luisa Martín-Ramos, Albert Oriol, Ana-Isabel Teruel, María-Asunción Echeveste, Raquel de Paz, Felipe de Arriba, Miguel T Hernandez, Luis Palomera, Rafael Martinez, Alejandro Martin, Adrian Alegre, Javier De la Rubia, Alberto Orfao, María-Victoria Mateos, Joan Blade, Jesus F San-Miguel
Purpose To perform a critical analysis on the impact of depth of response in newly diagnosed multiple myeloma (MM). Patients and Methods Data were analyzed from 609 patients who were enrolled in the GEM (Grupo Español de Mieloma) 2000 and GEM2005MENOS65 studies for transplant-eligible MM and the GEM2010MAS65 clinical trial for elderly patients with MM who had minimal residual disease (MRD) assessments 9 months after study enrollment. Median follow-up of the series was 71 months. Results Achievement of complete remission (CR) in the absence of MRD negativity was not associated with prolonged progression-free survival (PFS) and overall survival (OS) compared with near-CR or partial response (median PFS, 27, 27, and 29 months, respectively; median OS, 59, 64, and 65 months, respectively)...
May 12, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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