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"Small bowel transplant"

Jamie Koo, David W Dawson, Sarah Dry, Samuel W French, Bita V Naini, Hanlin L Wang
In this study, we sought to determine the incidence of posttransplant complications including acute cellular rejection (ACR), infection, and posttransplant lymphoproliferative disease (PTLD) in mucosal allograft biopsies in patients with small bowel transplant at our institution. We retrospectively reviewed pathology reports from 5675 small bowel allograft biopsies from 99 patients and analyzed the following: indications for biopsy, frequency and grade of ACR, presence of infectious agents, results of work-up for potential PTLD, results of C4d immunohistochemistry (IHC), features of chronic mucosal injury, and findings in concurrent native bowel biopsies...
September 1, 2016: Clinical Transplantation
Frank A Schildberg, Bin Liu, Mamdouh Afify, Julia Steitz, Pascal Paschenda, Nico Schäfer, Jörg C Kalff, Thomas Minor, René H Tolba
BACKGROUND: The long-term outcome of intestinal transplantations is still not favorable, which is partly due to the intestinal susceptibility to ischemia. There are several indications that the inflammatory response to ischemia-reperfusion injury is mediated by cyclooxygenases and that their inhibition may be associated with improved organ function. The aim of this study was to analyze if COX inhibitors could improve the early posttransplant outcome after orthotopic small bowel transplantation (SBTx)...
July 29, 2016: Transplantation
Karen van Hoeve, Ilse Hoffman, Fabio Fusaro, Jacques Pirenne, Ann Vander Auwera, Anne-Marie Dieltjens, Gert De Hertogh, Diethard Monbaliu, Marc Miserez
BACKGROUND: Microvillus inclusion disease (MVID) is a known congenital cause of intractable diarrhea resulting in permanent intestinal failure. There is need for a lifelong total parenteral nutrition (TPN) from diagnosis and the prognosis is poor. Most patients die by the second decade of life as a result of complications of parenteral alimentation including liver failure or sepsis. The only available treatment at this moment is a small bowel transplantation. But before that moment, the patients often suffer from a persistent failure to thrive and electrolyte disturbances despite continuous TPN...
August 1, 2016: Acta Chirurgica Belgica
Martin W von Websky, Koji Kitamura, Isis Ludwig-Portugall, Christian Kurts, Maximilian von Laffert, Joel LeMaoult, Edgardo D Carosella, Kareem Abu-Elmagd, Joerg C Kalff, Nico Schäfer
The non-classical MHC I paralogue HLA-G is expressed by cytotrophoblast cells and implicated with fetomaternal tolerance by downregulating the maternal adaptive and innate immune response against the fetus. HLA-G expression correlates with favorable graft outcome in humans and recently promising immunosuppressive effects of therapeutic HLA-G in experimental transplantation (skin allograft acceptance) were shown. Consequently, we examined this novel therapeutic approach in solid organ transplantation. In this study, therapeutic recombinant HLA-G5 was evaluated for the first time in a solid organ model of acute rejection (ACR) after orthotopic intestinal transplantation (ITX)...
2016: PloS One
H Vollmer, E Harvey, G Barker, D Young
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
B Rao, S-M Jafri, M Kazimi, K Mullins, M Raoufi, M C Segovia
There is a higher incidence of acute cellular rejection (ACR) in small bowel transplantation (SBT) compared with transplantation of other solid organs. Although there are reports on the use of infliximab to successfully treat ACR refractory to other treatments, there are no reports, to our knowledge, regarding the use of adalimumab. We present a case of a female patient with a history of Crohn's disease who underwent an isolated SBT and developed an episode of severe ACR. She was initially treated with methylprednisolone, thymoglobulin, basiliximab, and a dosage adjustment of tacrolimus...
March 2016: Transplantation Proceedings
S Fujiwara, M Wada, H Kudo, S Yamaki, F Fujishima, K Ishida, M Nakamura, H Sasaki, T Kazama, H Tanaka, M Nio
BACKGROUND: A significant association between donor-specific antibody (DSA) and graft rejection has recently been documented. However, confirmed strategy has not been established for DSA-associated rejection after intestinal transplantation (ITx). CASE REPORT: A 20-year-old male patient with chronic intestinal obstruction caused by hypoganglionosis of the entire intestine underwent cadaveric donor ITx with grafting performed on 232 cm of the small intestine, cecum, and a part of the ascending colon...
March 2016: Transplantation Proceedings
G E Gondolesi, G Mazariegos, T E Starzl
At the 14th International Small Bowel Transplant Symposium, (ISBTS2015) held in Buenos Aires, a session to recognize the pioneers that have dedicated their lives to make our current field possible was organized. Dr Thomas Starzl received the first Living Legend Award. A video interview was obtained at his office, edited, and later presented during the scientific meeting. More than 600 people saw Dr Starzl's interview, which captivated the audience for 40 minutes, before smiles, tears and the final applause erupted at the conclusion...
March 2016: Transplantation Proceedings
Gabriel E Gondolesi, Douglas G Farmer
No abstract text is available yet for this article.
March 2016: Transplantation Proceedings
Ane Miren Andres, Monica Santamaria, Francisco Hernandez-Oliveros, Laura Guerra, Sergio Lopez, Pablo Stringa, Maria Teresa Vallejo, Carlota Largo, Jose Luis Encinas, Maria Soledad Garcia de Las Heras, Manuel Lopez-Santamaria, Juan Antonio Tovar
Experimental small bowel transplantation (SBT) in rats has been proven to be a useful tool for the study of ischemia-reperfusion and immunological aspects related to solid organ transplantation. However, the model is not completely refined, specialized literature is scarce and complex technical details are typically omitted or confusing. Most studies related to acute rejection (AR) use the orthotopic standard, with small sample sizes due to its high mortality, whereas those studying chronic rejection (CR) use the heterotopic standard, which allows longer term survival but does not exactly reflect the human clinical scenario...
May 2016: Transplant Immunology
Geneviève Huard, Thomas Schiano, Marie I Fiel, Stephen C Ward, Jang Moon, Kishore Iyer
AIMS: To compare the diagnosis of acute cellular rejection (ACR) based on biopsies (Bx) performed simultaneously in the small bowel (SB) and colonic grafts (paired Bx) after intestinal transplantation (ITx). METHODS AND RESULTS: Retrospective study including all ITx with colon at Mount Sinai Hospital between 2009 and 2014. Paired Bx were reviewed blindly by two experienced gastrointestinal (GI) pathologists and were graded based on the VIII International Small Bowel Transplant Symposium Consensus criteria, with minor modifications for evaluation of colon biopsies...
October 2016: Histopathology
Helen M Craggs, Phoebe Jackson, Girish Gupte, Jane Hartley, Mona Abdel-Hady, Rachael Morton, Sue Beath, Lindsay Hogg
BACKGROUND: Small bowel transplant with or without a liver graft (SBTx ± LTx) for children with intestinal failure involves checking their immunity to a range of microorganisms, including hepatitis B virus (HBV), at the time of assessment. HBV vaccination in the United Kingdom is recommended for transplant candidates. The aim of this audit was to find out how many SBTx ± LTx candidates received HBV vaccination before transplantation and how the timing of vaccination influenced the development of immunity...
March 9, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Caroline Cruysmans, Marie-Gabrielle Ferneiny, Sylvie Fraitag, Pierre Frange, Christophe Chardot, Christine Bodemer, Olivier Goulet, Florence Lacaille
BACKGROUND: Severe skin problems are uncommon after small bowel transplantation. Differential diagnosis includes drug reactions, infections, graft-versus-host disease (GVHD), and mixed diseases. Early diagnosis and treatment are determinant for prognosis. METHODS AND RESULTS: We describe 6 patients with severe cutaneous complications after small bowel transplantation, the work-up, final diagnosis, and evolution. Two patients died from chronic GVHD or unrecognized drug rash with eosinophilia and systemic symptoms, the others recovered completely...
October 2016: Transplantation
Mingxiao Guo, Chunlei Lu, Ying Gao, Haifeng Zhang, Dongfeng Chen, Yousheng Li
Background and Objectives. The intestinal mucosa is extremely sensitive to ischemia. Better intestinal preservation is the first step to improve the results of intestinal transplantation. The aim of the study is to investigate the effect of cold Lifor solution on preservation of swine small bowel. Methods. Swine ileum segments (200 cm) were allotransplanted heterotopically after 9-hour cold storage with UW solution (group 1, n = 6), with Lifor solution (group 2, n = 6), or without storage (group 3, n = 6), respectively...
2016: Gastroenterology Research and Practice
Berkeley N Limketkai, Alyssa M Parian, Neha D Shah, Jean-Frédéric Colombel
Crohn's disease is a chronic and progressive inflammatory disorder of the gastrointestinal tract. Despite the availability of powerful immunosuppressants, many patients with Crohn's disease still require one or more intestinal resections throughout the course of their disease. Multiple resections and a progressive reduction in bowel length can lead to the development of short bowel syndrome, a form of intestinal failure that compromises fluid, electrolyte, and nutrient absorption. The pathophysiology of short bowel syndrome involves a reduction in intestinal surface area, alteration in the enteric hormonal feedback, dysmotility, and related comorbidities...
May 2016: Inflammatory Bowel Diseases
U A Gerlach, G Vrakas, B Sawitzki, R Macedo, S Reddy, P J Friend, H Giele, A Vaidya
Abdominal wall transplantation (AWTX) has revolutionized difficult abdominal closure after intestinal transplantation (ITX). More important, the skin of the transplanted abdominal wall (AW) may serve as an immunological tool for differential diagnosis of bowel dysfunction after transplant. Between August 2008 and October 2014, 29 small bowel transplantations were performed in 28 patients (16 male, 12 female; aged 41 ± 13 years). Two groups were identified: the solid organ transplant (SOT) group (n = 15; 12 ITX and 3 modified multivisceral transplantation [MMVTX]) and the SOT-AWTX group (n = 14; 12 ITX and 2 MMVTX), with the latter including one ITX-AWTX retransplantation...
June 2016: American Journal of Transplantation
L R Mathews, J M Lott, K Isse, A Lesniak, D Landsittel, A J Demetris, Y Sun, D F Mercer, S A Webber, A Zeevi, R T Fischer, B Feingold, H R Turnquist
Elevated serum soluble (s) suppressor of tumorigenicity-2 is observed during cardiovascular and inflammatory bowel diseases. To ascertain whether modulated ST2 levels signify heart (HTx) or small bowel transplant (SBTx) rejection, we quantified sST2 in serially obtained pediatric HTx (n = 41) and SBTx recipient (n = 18) sera. At times of biopsy-diagnosed HTx rejection (cellular and/or antibody-mediated), serum sST2 was elevated compared to rejection-free time points (1714 ± 329 vs. 546.5 ± 141.6 pg/mL; p = 0...
March 2016: American Journal of Transplantation
Hugh Thomas
No abstract text is available yet for this article.
January 2016: Nature Reviews. Gastroenterology & Hepatology
Derek Hirschman, Joselin Tacastacas, Peter L Rady, Stephen K Tyring, Kevin Cooper, Kord Honda
A 3-year-old African American girl taking sirolimus and tacrolimus for a small bowel transplantation presented with hypopigmented macules and papules throughout her trunk. A biopsy diagnosed epidermodysplasia verruciformis (EV) that was found to be associated with human papillomavirus (HPV) type 14 according to polymerase chain reaction analysis. There are few cases of acquired EV in the setting of organ transplantation. Although there is no standardized treatment for acquired EV, prevention and surveillance for transformation to squamous cell carcinoma are primary concerns...
January 2016: Pediatric Dermatology
Edwin J van Adrichem, Marion J Siebelink, Bart L Rottier, Janneke M Dilling, Greetje Kuiken, Cees P van der Schans, Erik A M Verschuuren
BACKGROUND: It is generally unknown to what extent organ transplant recipients can be physically challenged. During an expedition to Mount Kilimanjaro, the tolerance for strenuous physical activity and high-altitude of organ transplant recipients after various types of transplantation was compared to non-transplanted controls. METHODS: Twelve organ transplant recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic stem cell- and 1 small bowel-transplantation)...
2015: PloS One
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