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Extended criteria grafts

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https://www.readbyqxmd.com/read/29792716/options-to-improve-the-quality-of-kidney-grafts-from-expanded-criteria-donors-experimental-study
#1
J Molacek, V Opatrný, V Treska, R Matejka, O Hes
INTRODUCTION: There is a worldwide discrepancy between the number of donors and the number of organs needed for transplantation, leading to certain expansion of criteria, resulting in acceptance of donor organs. This means that organs with worse parenchymal qualities may be harvested for transplantation. One possibility, how to ameliorate the quality of these organs, is to change the concept of their preservation during cold ischemia or even after sudden circulatory arrest, prior to the collection of the organ itself...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29786954/urinary-metabolites-predict-prolonged-duration-of-delayed-graft-function-in-dcd-kidney-transplant-recipients
#2
S Kostidis, J R Bank, D Soonawala, E Nevedomskaya, C van Kooten, O A Mayboroda, J W de Fijter
Extending kidney donor criteria, including donation after circulatory death (DCD), has resulted in increased rates of delayed graft function (DGF) and primary nonfunction. Here, we used Nuclear Magnetic Resonance (NMR) spectroscopy to analyze the urinary metabolome of DCD transplant recipients at multiple time points (days 10, 42, 180 and 360 after transplantation). The aim was to identify markers that predict prolonged duration of functional DGF (fDGF). Forty-seven metabolites were quantified and their levels were evaluated in relation to fDGF...
May 22, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29691119/ex-situ-liver-perfusion-organ-preservation-into-the-future
#3
REVIEW
Mariusz Bral, Boris Gala-Lopez, David L Bigam, Darren H Freed, A M James Shapiro
In recent years, remarkable progress has occurred in the development of technologies to support ex situ liver perfusion. Building upon extensive preclinical studies in large animal models, pilot and randomized clinical trials have been initiated, and preliminary outcomes suggest more optimal protection of both standard and extended criteria liver grafts. There currently exists an incredible opportunity and need to further refine this technology, determine appropriate viability measures to predict usable liver grafts, and to explore potent protective additive strategies to further optimize the quality of extended criteria organs...
April 5, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29687010/remaining-physiological-barriers-in-porcine-kidney-xenotransplantation-potential-pathways-behind-proteinuria-as-well-as-factors-related-to-growth-discrepancies-following-pig-to-kidney-xenotransplantation
#4
REVIEW
Jigesh A Shah, Miguel A Lanaspa, Tatsu Tanabe, Hironosuke Watanabe, Richard J Johnson, Kazuhiko Yamada
Considerable shortages in the supply of available organs continue to plague the field of solid organ transplantation. Despite changes in allocation, as well as the utilization of extended criteria and living donors, the number of patients waiting for organs continues to grow at an alarming pace. Xenotransplantation, cross-species solid organ transplantation, offers one potential solution to this dilemma. Previous extensive research dedicated to this field has allowed for resolution of xenograft failure due to acute rejection, leaving new areas of unresolved challenges as barriers to success in large animal models...
2018: Journal of Immunology Research
https://www.readbyqxmd.com/read/29682897/an-aseptically-processed-acellular-reticular-allogenic-human-dermis-improves-healing-in-diabetic-foot-ulcers-a-prospective-randomised-controlled-multicentre-follow-up-trial
#5
Charles M Zelen, Dennis P Orgill, Thomas E Serena, Robert E Galiano, Marissa J Carter, Lawrence A DiDomenico, Jennifer Keller, Jarrod P Kaufman, William W Li
Aseptically processed human reticular acellular dermal matrix (HR-ADM) has been previously shown to improve wound closure in 40 diabetic patients with non-healing foot ulcers. The study was extended to 40 additional patients (80 in total) to validate and extend the original findings. The entire cohort of 80 patients underwent appropriate offloading and standard of care (SOC) during a 2-week screening period and, after meeting eligibility criteria, were randomised to receive weekly applications of HR-ADM plus SOC or SOC alone for up to 12 weeks...
April 22, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29678647/post-mortem-retrieval-of-arterial-allografts-preliminary-results
#6
Dorian Verscheure, Julien Gaudric, Jérémie Jayet, Philippe Tresson, Mohamed Jarraya, Pierre Julia, Marc Coggia, Laurent Chiche, Fabien Koskas
OBJECTIVES: Cryopreserved arterial allografts are vascular substitutes used for arterial reconstructions in a septic field. Their use remains however limited by the shortage of donors. One of the possibilities to address this lack of grafts is to multiply the sources of retrieval. The objective of this preliminary study was the evaluation of the early clinical results and the microbiological safety of arterial grafts retrieved after death. MATERIAL AND METHODS: In addition to the standard conditions of arterial sampling the criteria of inclusion for postmortem retrieval comprised the refrigeration of the body of the donor within four hours following the death, a 24-hour time limit from the death, and the availability of an adapted place for retrieval (surgical unit or death chamber respecting the required aseptic conditions)...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29644030/proof-of-concept-liver-splitting-during-normothermic-machine-perfusion
#7
Barney T F Stephenson, Glenn K Bonney, Richard W Laing, Ricky H Bhogal, Francesca Marcon, Desley A H Neil, M Thamara P R Perera, Simon C Afford, Hynek Mergental, Darius F Mirza
Introduction: Despite utilizing extended criteria donors, there remains a shortage of livers for transplantation. No data exists on splitting donor livers with concurrent NMP-L. Methods: A liver recovered from a donor after circulatory death was subjected to NMP-L using a red cell based fluid. During NMP-L, a 'classical' left lateral + right trisegmentectomy split was performed using an integrated bipolar/ultrasonic device. After splitting, blood flow was confirmed using Doppler ultrasound in each lobe...
March 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29629996/normothermic-liver-preservation-current-status-and-future-directions
#8
Danielle Detelich, James F Markmann
PURPOSE OF REVIEW: Normothermic machine perfusion (NMP) is an emerging technology for liver preservation. Early clinical results demonstrate beneficial effects in reconditioning high-risk grafts. This review discusses the role of normothermic perfusion as a tool to assess graft viability and as a platform for graft intervention and modification. RECENT FINDINGS: The potential benefits of NMP extend far beyond organ reconditioning. Recent pilot studies have identified clinically relevant viability criteria, which now require validation in large randomized control trials prior to implementation...
April 7, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29623266/the-potential-role-of-liver-transplantation-as-a-treatment-option-in-colorectal-liver-metastases
#9
REVIEW
Pål-Dag Line, Morten Hagness, Svein Dueland
Liver resection is the only potentially curative treatment option in patients with liver metastases from colorectal cancer, but only about 20% of the patients are resectable. Liver transplantation of patients with unresectable liver metastases was attempted in the early era but it was abandoned due to poor survival. During the last decade, several case reports, a controlled pilot study, and a retrospective cohort study indicated that prolonged disease-free survival and overall survival can be obtained in a proportion of these patients...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29617450/limb-remote-ischemic-conditioning-of-the-recipient-protects-the-liver-in-a-rat-model-of-arterialized-orthotopic-liver-transplantation
#10
Zoltan Czigany, Christian Bleilevens, Christian Beckers, Christian Stoppe, Michaela Möhring, Andras Fülöp, Attila Szijarto, Georg Lurje, Ulf P Neumann, René H Tolba
BACKGROUND: Ischemic-reperfusion (IR) injury still represents a major concern in clinical transplantation, especially in the era of extreme organ shortage and extended criteria donor organs. In the present study we aimed to investigate the hepatoprotective effects of remote ischemic conditioning (RIC) in a rat model of arterialized orthotopic liver transplantation (OLT). METHODS: Male Lewis rats were used (n = 144 / 72 OLT cases; 240-340g) as donors and recipients...
2018: PloS One
https://www.readbyqxmd.com/read/29603016/ischaemia-reperfusion-injury-mechanisms-of-progression-to-chronic-graft-dysfunction
#11
REVIEW
Gerhard R Situmorang, Neil S Sheerin
The increasing use of extended criteria organs to meet the demand for kidney transplantation raises an important question of how the severity of early ischaemic injury influences long-term outcomes. Significant acute ischaemic kidney injury is associated with delayed graft function, increased immune-associated events and, ultimately, earlier deterioration of graft function. A comprehensive understanding of immediate molecular events that ensue post-ischaemia and their potential long-term consequences are key to the discovery of novel therapeutic targets...
March 30, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29602202/renal-resistance-trend-during-hypothermic-machine-perfusion-is-more-predictive-of-postoperative-outcome-than-biopsy-score-preliminary-experience-in-35-consecutive-kidney-transplantations
#12
Massimiliano Bissolati, Paolo Giovanni Gazzetta, Rossana Caldara, Giovanni Guarneri, Olga Adamenko, Fabio Giannone, Michele Mazza, Giulia Maggi, Deborah Tomanin, Riccardo Rosati, Antonio Secchi, Carlo Socci
Hypothermic machine perfusion (HPM) grants a better postoperative outcome in transplantation of organs procured from extended criteria donors (ECDs) and donors after cardiac death (DCD). So far, the only available parameter for outcome prediction concerning those organs is pretransplant biopsy score. The aim of this study is to evaluate whether renal resistance (RR) trend during HPM may be used as a predictive marker for post-transplantation outcome. From December 2015 to present, HMP has been systematically applied to all organs from ECDs and DCD...
March 30, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29564206/hypothermic-machine-preservation-of-the-liver-state-of-the-art
#13
REVIEW
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
Purpose of Review: In this review, we highlight which livers may benefit from additional treatment before implantation and describe the concept of hypothermic machine liver perfusion. Furthermore, we explain why cold oxygenated perfusion concepts could potentially lead to a breakthrough in this challenging field of transplantation. Accordingly, we summarize recent clinical applications of different hypothermic perfusion approaches. Recent Findings: The impact of end-ischemic, hypothermic liver perfusion in liver transplantation is currently assessed by two multicenter, randomized controlled trials...
2018: Current Transplantation Reports
https://www.readbyqxmd.com/read/29547544/bioactive-glasses-from-parent-45s5-composition-to-scaffold-assisted-tissue-healing-therapies
#14
REVIEW
Elisa Fiume, Jacopo Barberi, Enrica Verné, Francesco Baino
Nowadays, bioactive glasses (BGs) are mainly used to improve and support the healing process of osseous defects deriving from traumatic events, tumor removal, congenital pathologies, implant revisions, or infections. In the past, several approaches have been proposed in the replacement of extensive bone defects, each one with its own advantages and drawbacks. As a result, the need for synthetic bone grafts is still a remarkable clinical challenge since more than 1 million bone-graft surgical operations are annually performed worldwide...
March 16, 2018: Journal of Functional Biomaterials
https://www.readbyqxmd.com/read/29531641/results-of-kidney-transplantation-from-expanded-criteria-donors-a-single-center-experience
#15
B Palkoci, M Vojtko, J Fialová, D Osinová, M Lajčiaková
Background: Collection of kidneys from extended criteria donors (ECD) with diagnosed brain-death forms a part of the collection program that increases the number of transplantations. Objective: To compare the results of ECD with those of standard criteria donors (SCD). Methods: In a retrospective analysis in a group of 156 kidney donors, we identified ECD donors. We detected the basic parameters of the donors before kidney collection, and then evaluated the function of the graft, the survival of the graft, and the survival of the patients after 1, 3, and 5 years of transplantation...
2018: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/29523082/visual-quality-assessment-of-the-liver-graft-by-the-transplanting-surgeon-predicts-postreperfusion-syndrome-after-liver-transplantation-a-retrospective-cohort-study
#16
Felix Kork, Alexandra Rimek, Anne Andert, Niklas Jurek Becker, Christoph Heidenhain, Ulf P Neumann, Daniela Kroy, Anna B Roehl, Rolf Rossaint, Marc Hein
BACKGROUND: The discrepancy between demand and supply for liver transplants (LT) has led to an increased transplantation of organs from extended criteria donors (ECD). METHODS: In this single center retrospective analysis of 122 cadaveric LT recipients, we investigated predictors of postreperfusion syndrome (PRS) including transplant liver quality categorized by both histological assessment of steatosis and subjective visual assessment by the transplanting surgeon using multivariable regression analysis...
March 9, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29505674/outcomes-of-left-split-graft-transplantation-in-europe-report-from-the-european-liver-transplant-registry
#17
Roberta Angelico, Alessandra Nardi, René Adam, Silvio Nadalin, Wojciech G Polak, Vincent Karam, Roberto I Troisi, Paolo Muiesan
Split liver transplantation (SLT) has been widely adopted across Europe, resulting in remarkable reduction in the paediatric waiting-list mortality. Left split graft (LSG) is commonly used for paediatric recipients; however, deceased donor criteria selection are not universal. The aim of this study was to analyse the LSG outcome from the European Liver Transplant Registry and to identify risk factors for graft failure. Data from 1500 children transplanted in 2006-2014 with LSG from deceased donors were retrospectively analysed...
March 5, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29492384/current-approaches-in-retrieval-and-heart-preservation
#18
REVIEW
Maria Monteagudo Vela, Diana García Sáez, Andre R Simon
Fifty years after the first successful heart transplantation, despite multiple advances in the treatment of advanced acute and chronic heart failure, there is still no equivalent to heart transplantation as a long-term treatment for end-stage heart failure. Transplantation is, however, limited by the scarcity and quality of heart allografts. Donors are nowadays significantly older, particularly in European countries, and traumatic head injury as the cause of death has been replaced by intracerebral hemorrhage or hypoxic brain damage in the majority of cases...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29478259/maybe-ecd-kidneys-aren-t-as-bad-as-i-thought
#19
EDITORIAL
Michael J Englesbe
No abstract text is available yet for this article.
May 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29463396/-renal-transplantation
#20
L Rostaing
Renal transplantation is the best option for patients with end stage renal failure, since it significantly improves their duration and quality of life. The number of patients waiting for a kidney transplant continues to increase while the overall rate of organ procurement in France is stable. The graft shortage is worsening, as is the waiting time on list. Identifying the causes of this crisis and discussing the various options for addressing the kidney graft shortage is the aim of this talk. Among the solutions: (i) improving identification of potential donors through a national and hospitals policy to promulgate organ donation and understanding better the grounds for refusal; (ii) using infusion machines for all grafts with extended criteria; (iii) developing transplantation programs from deceased donors after cardiac arrest; (iv) developing transplantation programs from living donors...
June 2017: Néphrologie & Thérapeutique
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