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Extended criteria grafts

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https://www.readbyqxmd.com/read/27915440/liver-steatosis-in-pre-transplant-liver-biopsies-can-be-quantified-rapidly-and-accurately-by-nuclear-magnetic-resonance-analysis
#1
Stefanie Bertram, Cathrin Myland, Sandra Swoboda, Anja Gallinat, Thomas Minor, Nils Lehmann, Michael Thie, Julia Kälsch, Leona Pott, Ali Canbay, Thomas Bajanowski, Henning Reis, Andreas Paul, Hideo A Baba
Donor livers marginally acceptable or acceptable according to extended criteria are more frequently transplanted due to the growing discrepancy between demand and availability of donor organs. One type of marginally acceptable graft is a steatotic donor liver, because it is more sensitive to ischemia-reperfusion injury. Thus, quantitative assessment of steatosis is crucial prior to liver transplantation. Extent of steatosis of 49 pre-reperfusion liver biopsies from patients who received orthotopic liver transplantation was assessed by three techniques: semi-quantitative histological evaluation, computerized histomorphometry, and NMR-based estimation of fat content...
December 3, 2016: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/27866861/outcomes-after-transplantation-of-lungs-preserved-for-more-than-12-h-a-retrospective-study
#2
Jonathan C Yeung, Thorsten Krueger, Kazuhiro Yasufuku, Marc de Perrot, Andrew F Pierre, Thomas K Waddell, Lianne G Singer, Shaf Keshavjee, Marcelo Cypel
BACKGROUND: Ex-vivo lung perfusion (EVLP) can be used to extend overall lung preservation time by splitting one long cold ischaemic time into two shorter ones and interposing an additional EVLP time. We assessed the outcomes after clinical transplantation of lungs with more than 12 h of preservation time. METHODS: For this retrospective study, we searched the Toronto Lung Transplant Program database for patients who had received at least one lung transplant between Jan 1, 2006, and April 30, 2015, at a single hospital in Toronto, Canada...
November 17, 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27860296/impact-of-subnormothermic-machine-perfusion-preservation-in-severely-steatotic-rat-livers-a-detailed-assessment-in-an-isolated-setting
#3
Y Okamura, K Hata, H Tanaka, H Hirao, T Kubota, O Inamoto, S Kageyama, I Tamaki, N Yermek, J Yoshikawa, S Uemoto
Current drastic shortage of donor organs has led to acceptance of extended-criteria donors for transplantation, despite higher risk of primary non-function. Here, we report the impact of subnormothermic machine perfusion (SMP) preservation on the protection of >50% macro-steatotic livers. Dietary hepatic steatosis was induced in Wistar rats via 2-day fasting and subsequent 3-day re-feeding with a fat-free, carbohydrate-rich diet. This protocol induces 50-60% macrovesicular steatosis, which should be discarded when preserved via cold storage (CS)...
November 10, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27857033/does-matching-donor-recipient-age-affect-long-term-survival-in-liver-transplantation
#4
Cristina Dopazo, Itxarone Bilbao, Lluis Castells, Mireia Caralt, Elena Fernández de Sevilla, José Luis Lázaro, Ramón Charco
BACKGROUND The characteristics of liver donors have changed over the last decade owing to the shortage of organs and high mortality on the waiting list, leading to wider use of extended-criteria donors, including older donors. The aim of this study was to evaluate the effect of matching donor-recipient age on morbidity at 1 year post-transplant and on long-term patient and graft survival. MATERIAL AND METHODS Retrospective study from a prospectively-obtained database including adult patients who had received a primary liver transplant (LT) from whole graft of brain-dead donors...
November 18, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27779800/the-expanded-criteria-donor-for-kidney-transplant-not-a-nearly-new-car
#5
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27721962/acute-rejection-in-renal-transplant-patients-of-a-hospital-in-bogota-colombia
#6
P García, M Huerfano, M Rodríguez, A Caicedo, F Berrío, C Gonzalez
BACKGROUND: Renal transplantation is the best treatment for end stage renal disease. Acute graft rejection is one of the main complications and may influence graft survival. OBJECTIVE: To determine the incidence and features of acute cellular rejection (ACR) episodes confirmed by biopsy. METHODS: We studied a cohort of 175 patients who underwent renal transplantation between 2004 and 2012 to determine the cumulative incidence of ACR confirmed by biopsy and to identify the associated risk factors using multivariate analysis...
2016: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/27720135/-toward-a-customized-preservation-for-each-kidney-graft
#7
Thomas Kerforne, Frédéric Favreau, Raphaël Thuillier, Thierry Hauet, Michel Pinsard
The increased number of patients in waiting list for renal transplantation requires the establishment of recommendations regarding graft preservation techniques. The preservation method impacts graft function and survival particularly in case of extended criteria donors. Based on our experience, the aim of this review is to establish a decisional diagram to draw graft management to 5years in relation to donor type and graft quality. Novel biomarkers are necessary to evaluate graft quality. Nuclear magnetic resonance or transcriptomic analyses are promising...
October 3, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27714983/porcine-models-for-the-study-of-small-for-size-syndrome-and-portal-inflow-modulation-literature-review-and-proposal-for-a-standardized-nomenclature
#8
Kayvan Mohkam, Benjamin Darnis, Jean-Yves Mabrut
Porcine models of extended hepatectomy and liver transplantation (LT) of reduced graft have been widely used for studying the small-for-size (SFS) syndrome and the various modalities of portal inflow modulation (PIM). However, considerable heterogeneity exists among the studies and their results. The aim of this review was to assess the main advantages and drawbacks of the different porcine models of SFS LT and SFS hepatectomy, and propose a standardized anatomical nomenclature for the various models. The MEDLINE database was searched for articles reporting porcine models of reduced graft LT or hepatectomy of more than 65%...
October 6, 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27706895/benefits-of-temporary-portocaval-shunt-during-orthotopic-liver-transplantation-with-vena-cava-preservation-a-propensity-score-analysis
#9
M Rayar, G B Levi Sandri, C Cusumano, C Locher, P Houssel-Debry, C Camus, N Lombard, V Desfourneaux, M Lakehal, B Meunier, L Sulpice, K Boudjema
During orthotopic liver transplantation (OLT), clamping of the portal vein induces splanchnic venous congestion and accumulation of noxious compounds. These adverse effects could increase ischemia-reperfusion injury and subsequently the risk of graft dysfunction, especially for grafts harvested from extended criteria donors (ECD). Temporary portocaval shunt (TPCS) could prevent these complications. Between 2002 and 2013, all OLT performed in our center were retrospectively analyzed and a propensity score matching analysis was used to compare the effect of TPCS in 686 patients (343 in each group)...
October 5, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27672295/liver-grafts-from-hepatitis-b-surface-antigen-positive-donors-a-review-of-the-literature
#10
REVIEW
Elisabetta Loggi, Fabio Conti, Alessandro Cucchetti, Giorgio Ercolani, Antonio Daniele Pinna, Pietro Andreone
The scarcity of available organs and the gap between supply and demand continue to be the main limitations of liver transplantation. To relieve the organ shortage, current transplant strategies have implemented extended criteria, which include the use of liver from patients with signs of past or present hepatitis B virus (HBV) infection. While the use of liver grafts from donors with evidence of past HBV infection is quite limited, some data have been collected regarding the feasibility of transplanting a liver graft from a hepatitis B surface antigen (HBsAg) positive donor...
September 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27554622/the-role-of-extended-criteria-donors-in-liver-transplantation-for-nonalcoholic-steatohepatitis
#11
Francesca M Dimou, Hemalkumar B Mehta, Deepak Adhikari, Robert C Harland, Taylor S Riall, Yong-Fang Kuo
BACKGROUND: Nonalcoholic steatohepatitis is expected to become the leading indication for liver transplantation. Use of extended criteria donors (ECD) may help with donor allocation in these patients. The objective of this study was to determine the use of ECDs in patients with nonalcoholic steatohepatitis undergoing liver transplantation to stimulate a liver-specific predictive model for ECD use. METHODS: The United Network for Organ Sharing database was used to identify patients undergoing liver transplantation for nonalcoholic steatohepatitis (2002-2014)...
December 2016: Surgery
https://www.readbyqxmd.com/read/27543202/initial-poor-function-and-primary-nonfunction-in-deceased-donor-orthotopic-liver-transplantation-maintaining-short-cold-ischemic-time-what-is-the-influence-of-poor-donor-maintenance-notes-from-a-single-indian-center
#12
Somak Das, Sudeepta Kumar Swain, Pavan Kumar Addala, Ramakrishnan Balasubramaniam, C V Gopakumar, Dinesh Zirpe, Kirubakaran Renganathan, Harsha Kollu, Darshan Patel, Bipin B Vibhute, Prashantha S Rao, Elankumaran Krishnan, Mahesh Gopasetty, Anand K Khakhar, Anil Vaidya, Anand Ramamurthy
BACKGROUND: Nations with emerging deceased-donor liver transplantation programs, such as India, face problems associated with poor donor maintenance. Cold ischemic time (CIT) is typically maintained short by matching donor organ recovery and recipient hepatectomy to achieve maximum favorable outcome. We analyzed different extended criteria donor factors including donor acidosis, which may act as a surrogate marker of poor donor maintenance, to quantify the risk of primary nonfunction (PNF) or initial poor function (IPF)...
August 19, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27500266/results-of-the-top-study-prospectively-randomized-multicenter-trial-of-an-ex-vivo-tacrolimus-rinse-before-transplantation-in-edc-livers
#13
Sebastian Pratschke, Hannah Arnold, Alfred Zollner, Michael Heise, Andreas Pascher, Peter Schemmer, Marcus N Scherer, Andreas Bauer, Karl-Walter Jauch, Jens Werner, Markus Guba, Martin K Angele
BACKGROUND: Organ shortage results in the transplantation of extended donor criteria (EDC) livers which is associated with increased ischemia-reperfusion injury (IRI). Experimental studies indicate that an organ rinse with the calcineurin inhibitor tacrolimus before implantation protects against IRI. The tacrolimus organ perfusion study was initiated to examine the effects of ex vivo tacrolimus perfusion on IRI in transplantation of EDC livers. METHODS: A prospective randomized multicenter trial comparing ex vivo perfusion of marginal liver grafts (≥2 EDC according to Eurotransplant manual) with tacrolimus (20 ng/mL) or histidine-tryptophane-ketoglutarate solution (control) was carried out at 5 German liver transplant centers (Munich Ludwig-Maximilians University, Berlin, Heidelberg, Mainz, Regensburg) between October 2011 and July 2013...
June 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27497417/extended-cricotracheal-resection-with-posterior-costochondral-grafting-for-complex-pediatric-subglottic-stenosis
#14
Jaime Penchyna Grub, Enrique Ortíz Hernández, Gustavo Teyssier Morales, Ivan Rivas Rivera, Diego Preciado, Hiram Álvarez-Neri
BACKGROUND AND OBJECTIVE: Severe laryngotracheal stenosis in childhood poses a complex surgical challenge for specialists in airway surgery. Patients with severe subglottic stenosis with vocal cord involvement are particularly difficult to manage successfully. The goal of this work was to review our experience with extended CTR in a cohort of young children with severe SGS and determine which clinical parameters would be associated with surgical success. METHODS: Retrospective analysis of the outcome of consecutive patients with severe glottic-subglottic stenosis submitted to an extended double-stage CTR between 2004 and 2014 at a large tertiary referral center...
September 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27478630/intermediate-term-outcomes-of-dual-adult-versus-single-kidney-transplantation-evolution-of-a-surgical-technique
#15
Ana K Islam, Richard J Knight, Wesley A Mayer, Adam B Hollander, Samir Patel, Larry D Teeter, Edward A Graviss, Ashish Saharia, Hemangshu Podder, Emad H Asham, A Osama Gaber
Background. Acceptance of dual kidney transplantation (DKT) has proven difficult, due to surgical complexity and concerns regarding long-term outcomes. We herein present a standard technique for ipsilateral DKT and compare outcomes to single-kidney transplant (SKT) recipients. Methods. A retrospective single-center comparison of DKT and SKT performed between February 2007 and July 2013. Results. Of 516 deceased donor kidney transplants, 29 were DKT and 487 were SKT. Mean follow-up was 43 ± 67 months. DKT recipients were older and more likely than SKT recipients to receive an extended criteria graft (p < 0...
2016: Journal of Transplantation
https://www.readbyqxmd.com/read/27468188/predictive-factors-of-short-term-outcome-after-liver-transplantation-a-review
#16
REVIEW
Giuliano Bolondi, Federico Mocchegiani, Roberto Montalti, Daniele Nicolini, Marco Vivarelli, Lesley De Pietri
Liver transplantation represents a fundamental therapeutic solution to end-stage liver disease. The need for liver allografts has extended the set of criteria for organ acceptability, increasing the risk of adverse outcomes. Little is known about the early postoperative parameters that can be used as valid predictive indices for early graft function, retransplantation or surgical reintervention, secondary complications, long intensive care unit stay or death. In this review, we present state-of-the-art knowledge regarding the early post-transplantation tests and scores that can be applied during the first postoperative week to predict liver allograft function and patient outcome, thereby guiding the therapeutic and surgical decisions of the medical staff...
July 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27429038/risk-avoidance-and-liver-transplantation-a-single-center-experience-in-a-national-network
#17
Matteo Ravaioli, Gennaro Grande, Paolo Di Gioia, Alessandro Cucchetti, Matteo Cescon, Giorgio Ercolani, Massimo Del Gaudio, Cristina Morelli, Antonio D Pinna
OBJECTIVES: To evaluate the risk avoidance policy at liver transplant centers. BACKGROUND: Transplant center improvements have extended the indications for the sickest patients and the use of extended criteria donors (ECD). This may result in lower survival, perhaps paradoxically discouraging transplant centers from these procedures. We evaluated the outcome of recipients or donors refused by other transplant centers and transplanted by our transplant unit without risk avoidance policy...
July 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27399412/133%C3%A2-the-development-of-human-embryonic-stem-cell-derived-dopamine-neurons-for-clinical-use-in-parkinson-disease
#18
Viviane S Tabar
INTRODUCTION: Parkinson disease (PD) is the second most common neurodegenerative disorder, affecting a million people in the United States alone. The advent of deep brain stimulation (DBS) has made a significant impact on the quality of life of a subset of patients. However, reconstruction of basal ganglia circuitry remains an ultimate goal that stands a better chance of addressing various aspects of the disease in a permanent and sustained manner. METHODS: Our team has developed robust protocols for the derivation of dopamine (DA) neurons from human embryonic stem cells (ES)...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27333617/-i-feel-stronger-and-younger-all-the-time-perspectives-of-elderly-kidney-transplant-recipients-thematic-synthesis-of-qualitative-research
#19
Jule Pinter, Camilla S Hanson, Jonathan C Craig, Jeremy R Chapman, Klemens Budde, Fabian Halleck, Allison Tong
BACKGROUND: Kidney transplantation offers improved survival and quality of life to an increasing number of elderly patients with end-stage kidney disease. However, elderly kidney transplant recipients may face unique challenges due to a higher burden of comorbidity, greater cumulative risk of immunosuppression-related complications and increasing frailty. We aimed to describe the perspectives of elderly kidney transplant recipients. METHODS: Electronic databases were searched to April 2015...
September 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27320596/regulated-oxygenation-of-rewarming-machine-perfusion-for-porcine-donation-after-cardiac-death-liver-transplantation
#20
N Morito, H Obara, N Matsuno, S Enosawa, K Watanabe, M Furukori, H Furukawa
INTRODUCTION: Machine perfusion (MP) is particularly expected to preserve and resuscitate an organ obtained from extended criteria donors or donation after cardiac death to expand the donated organ pool for organ transplantation. This method requires to be investigated an optimal preservation condition. The aim of this study is investigation of the optimal oxygenation conditions under rewarming MP (RMP). METHODS: Porcine livers were perfused with an RMP system developed by our research group...
May 2016: Transplantation Proceedings
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