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Complications post transplantation

Guido Kobbe, Thomas Schroeder, Rainer Haas, Ulrich Germing
Allogeneic blood stem cell transplantation (aBSCT) still is the only curative therapy for patients with myelodysplastic syndromes. While it carries the hope for cure for some patients, it may result in severe toxicity and death from complications or recurrent disease in others. Recent developments have improved patient and donor selection as well as technical aspects of the transplant procedure and post-transplant care, including early detection and treatment of relapse. Areas covered: This review will discuss current stratification tools to identify suitable patients, donors and transplant techniques...
March 16, 2018: Expert Review of Hematology
Dong Jae Shim, Gi-Young Ko, Kyu-Bo Sung, Dong Il Gwon, Heung Kyu Ko
PURPOSE: To evaluate the long-term efficacy of stent placement versus balloon angioplasty for portal vein (PV) stenosis in pediatric liver transplant (LT) recipients. MATERIALS AND METHODS: Fifty patients (<18 years old; median, 14 months) who underwent percutaneous transhepatic balloon angioplasty (n = 12), transhepatic stent placement (n = 18), or intraoperative transmesenteric stent placement (n = 20) between 1994 and 2015 were retrospectively analyzed...
March 13, 2018: Journal of Vascular and Interventional Radiology: JVIR
Michelle K Yong, Sharon R Lewin, Oriol Manuel
PURPOSE OF REVIEW: Immune monitoring to determine when and how the recovery of cytomegalovirus (CMV)-specific T-cells occurs post-transplantation may help clinicians to risk stratify individuals at risk of complications from CMV. We aimed to review all recent clinical studies using CMV immune monitoring in the pre- and post-transplant setting including the use of recently developed standardized assays (Quantiferon-CMV and the CMV ELISPOT) to better understand in whom, when, and how immune monitoring is best used...
March 14, 2018: Current Infectious Disease Reports
Tiong Y Lim, Enoka Gonsalkorala, Mary D Cannon, Stella Gabeta, Leonie Penna, Nigel D Heaton, Michael A Heneghan
BACKGROUND: Liver transplantation (LT) is a successful treatment for both acute liver failure and end-stage liver disease. The number of women of reproductive age undergoing LT is increasing. Pregnancy outcomes are favourable but there is still a lack of prognostic markers. We aimed to identify factors predictive of adverse pregnancy outcomes in LT recipients. METHODS: An analysis of all pregnancies occurring in LT recipients from 1989-2016 at King's College Hospital was performed...
March 14, 2018: Liver Transplantation
Marcus Weitz, Guido F Laube, Maria Schmidt, Kai Krupka, Luisa Murer, Dominik Müller, Bernd Hoppe, Anja Büscher, Jens König, Martin Pohl, Therese Jungraithmayr, Florian Thiel, Heiko Billing, Ryszard Grenda, Jacek Rubik, Michael M Kaabak, Fatos Yalcinkaya, Rezan Topaloglu, Nicholas Webb, Luca Dello Strologo, Lars Pape, Silvio Nadalin, Burkhard Tönshoff
BACKGROUND: Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx. METHODS: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry...
March 13, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Li Liu, Xuyan Zhang, Sizhou Feng
Epstein-Barr virus related post-transplant lymphoproliferative disorders (EBV-PTLDs) are rare but potentially fatal complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT), characterized by uncontrolled proliferation of EBV-infected lymphocytes. The most frequent risk factors include T cell depletion of graft, HLA mismatch, severe graft versus host disease (GVHD), EBV sero-mismatch (recipient-/donor+) and so on. EBV-PTLDs commonly manifest as fever and lymphadenopathy and may rapidly progress to multi-organ failure and even death...
March 9, 2018: Biology of Blood and Marrow Transplantation
Berk Hazır, Hakan Bahadır Haberal, Devrim Akıncı, Bülent Akdoğan
INTRODUCTION: A pelvic lymphocele is a collection of lymphatic fluid that develops after extensive lymphadenectomies in surgeries such as urological malignancies or renal transplantation. Pelvic lymphoceles may cause complications such as fever, abdominal pain, leg swelling, genital swelling and flank pain. This report summarizes the management of a pelvic lymphocele after open radical retropubic prostatectomy with bilateral lymphadenectomy. PRESENTATION OF CASE: Herein, we present a case in which a pelvic lymphocele developed seven months post-radical open retropubic prostatectomy and through this patient we discussed the lymphocele following radical prostatectomy...
March 6, 2018: International Journal of Surgery Case Reports
Yejun Hu, Jisheng Ran, Zefeng Zheng, Zhangchu Jin, Xiao Chen, Zi Yin, Chenqi Tang, Yangwu Chen, Jiayun Huang, Huihui Le, Ruijian Yan, Ting Zhu, Junjuan Wang, Junxin Lin, Kan Xu, Yiting Zhou, Wei Zhang, Youzhi Cai, Pioletti Dominique, Boon Chin Heng, Weishan Chen, Weiliang Shen, Hong-Wei Ouyang
Anterior cruciate ligament (ACL) is one of the most difficult tissues to heal once injured. Ligament regeneration and tendon-bone junction healing are two major goals of ACL reconstruction. This study aimed to investigate the synergistic therapeutic effects of Stromal cell-derived factor 1(SDF-1)-releasing collagen-silk (CSF) scaffold combined with intra-articular injection of ligament-derived stem/progenitor cells (LSPCs) for ACL regeneration and the amelioration in the long-term complication of osteoarthritis (OA)...
March 7, 2018: Acta Biomaterialia
Emilie Jean-St-Michel, James M Meza, Jonathon Maguire, John Coles, Brian W McCrindle
Ventricular dysfunction affects survival in patients with single right ventricle (RV), and remains one of the primary indications for heart transplantation. Since it is challenging to predict the capacity of patients with ventricular dysfunction to proceed to the stage II procedure, we sought to identify factors that would be associated with death or heart transplantation without achieving stage II for single RV patients with ventricular dysfunction after Norwood procedure. The Single Ventricle Reconstruction (SVR) trial public-use database was used...
March 8, 2018: Pediatric Cardiology
Raphael Steiner, Robert Kridel, Emiliano Giostra, Thomas McKee, Rita Achermann, Nicolas Mueller, Oriol Manuel, Michael Dickenmann, Macé M Schuurmans, Laurence de Leval, Thomas Fehr, Marianne Tinguely, Isabelle Binet, Sergio Cogliatti, Eugenia Haralamvieva, Michael Koller, The Swiss Transplant Cohort Study Stcs, Pierre-Yves Dietrich
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a potentially life-threatening complication of transplantation occurring in the setting of immunosuppression and oncogenic viral infections. However, little is known about the cumulative incidence, histological subtypes, risk determinants and outcome of PTLD in solid organ transplant (SOT) recipients in Switzerland. METHODS: This retrospective observational study investigated adult SOT recipients from two sequential cohorts, the pre-SCTS (Swiss Transplant Cohort Study) series, with data collected from January 1986 to April 2008, and the STCS series, with data collected from May 2008 to December 2014 in Switzerland...
March 8, 2018: Swiss Medical Weekly
Ramzy C Khabbaz, R Peter Lokken, Yi-Fan Chen, Andrew J Lipnik, James T Bui, Charles E Ray, Ron C Gaba
PURPOSE: To evaluate the capability of albumin-bilirubin (ALBI) and platelet-albumin-bilirubin (PALBI) grades in predicting transplant-free survival (TFS) in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: This single-center retrospective study included 342 ALBI and 337 PALBI patients (62% men; age 53-54 years) with cirrhosis (median MELD 15) and portal hypertension complications (variceal bleeding, 55%; ascites, 35%; other, 10%) who underwent TIPS between 1998 and 2017...
March 7, 2018: Cardiovascular and Interventional Radiology
Frank Friedersdorff, Therese-Marie Koch, Beatriz Banuelos-Marco, Ricardo Gonzalez, Tom Florian Fuller, Stefanie von Mechow, Dominik Müller, Anja Lingnau
INTRODUCTION: To evaluate graft- and patient survival after paediatric kidney transplantation and detecting influence factors, which affect the post-transplant time. MATERIALS AND METHODS: We analysed long-term survival rates and complications after paediatric kidney transplantation and searched for predictive parameters for graft function. RESULTS: In 132 patients, 143 kidney transplantations were performed. Graft failure occurred in 25%...
March 7, 2018: Urologia Internationalis
W A Werbel, M G Ison, M P Angarone, A Yang, V Stosor
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) affected 5-15% of solid organ transplant (SOT) recipients prior to universal prophylaxis, classically with trimethoprim-sulfamethoxazole (TMP-SMX). Guidelines generally recommend 6-12 months of prophylaxis post SOT, yet optimal duration and robust PJP risk stratification have not been established. METHODS: A retrospective, single-center, case-control study of PJP among SOT recipients from January 1998 to December 2013 was conducted...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Geraldine Miller, Heidi Schaefer, Sandra Yoder, Rachel Miller, Patricia Winokur, Karen Kotloff, David Klassen, Michael Wierzbicki, Cyrille Amegashie, Kathryn Edwards
BACKGROUND: Solid organ transplant recipients are at increased risk for reactivation of herpes zoster, or shingles, and have a higher frequency of serious complications including post-herpetic neuralgia. A live, attenuated shingles vaccine is effective and approved for individuals 50 years and older. The vaccine is contraindicated following transplantation but may be used in patients with renal failure. Utilization of the vaccine has been poor in patients with end-stage renal disease, including those awaiting transplant, due to concerns for safety, efficacy, and potential sensitization prior to transplant...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Mehmet Sarıer, İbrahim Duman, Meltem Demir, Yücel Yüksel, Mestan Emek, Erdal Kukul
Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods: Between February 2009 and March 2016, 38 male patients underwent TURP/TUIP due to BOO within the first 30 days of renal transplantation...
March 2018: Turkish Journal of Urology
Federica Vernuccio, Raj Gondalia, Susan Churchill, Mustafa R Bashir, Daniele Marin
Proper pre- and post-transplant diagnostic imaging work-up is fundamental in ensuring a successful outcome for renal transplantation. Despite exposure to ionizing radiation, CT has high spatial resolution and is a widely available and fast imaging technique. CT is performed routinely to delineate the anatomy of the kidney, relevant vasculature, and urinary collecting system in the living donor, to assess the iliac vessels in potential recipients prior to surgery, and to assess early and late-term post-transplant complications...
March 5, 2018: Abdominal Radiology
Jenny H C Chen, David W Johnson, Carmel Hawley, Neil Boudville, Wai H Lim
Technique failure is a frequent complication of peritoneal dialysis (PD), but the association between causes of death-censored technique failure and mortality remains unclear. Using Australian and New Zealand Dialysis and Transplant (ANZDATA) registry data, we examined the associations between technique failure causes and mortality in all incident PD patients who experienced technique failure between 1989-2014. Of 4663 patients, 2415 experienced technique failure attributed to infection, 883 to inadequate dialysis, 836 to mechanical failure and 529 to social reasons...
March 5, 2018: Scientific Reports
Sung-Yeon Cho, Hyeon-Jeong Lee, Dong-Gun Lee
Hematopoietic stem cell transplantation (HSCT) is a treatment for hematologic malignancies, immune deficiencies, or genetic diseases, ect. Recently, the number of HSCTs performed in Korea has increased and the outcomes have improved. However, infectious complications account for most of the morbidity and mortality after HSCT. Post-HSCT infectious complications are usually classified according to the time after HSCT: pre-engraftment, immediate post-engraftment, and late post-engraftment period. In addition, the types and risk factors of infectious complications differ according to the stem cell source, donor type, conditioning intensity, region, prophylaxis strategy, and comorbidities, such as graft-versushost disease and invasive fungal infection...
March 2018: Korean Journal of Internal Medicine
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. There were 52 patients who underwent IT during the study period. Among these patients, 4% developed a postoperative abscess, one developed an enteric fistula (2%), and one had an enteric or anastomotic leak (2%)...
March 2, 2018: Pediatric Transplantation
M Cecilia Bahit, Ajar Kochar, Christopher B Granger
Heart failure (HF) complicating myocardial infarction (MI) is common and may be present at admission or develop during the hospitalization. Among patients with MI, there is a strong relationship between degree of HF and mortality. The optimal management of the patient with HF complicating MI varies according to time since the onset of infarction. Medical therapy for HF after MI includes early (within 24 h) initiation of angiotensin-converting enzyme inhibitors and early (within 7 days) use of aldosterone antagonists...
March 2018: JACC. Heart Failure
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