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Complications post transplantation

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https://www.readbyqxmd.com/read/28432802/subsequent-malignancies-after-allogeneic-hematopoietic-stem-cell-transplantation
#1
Mehmet Gündüz, Mehmet Özen, Uğur Şahin, Selami Koçak Toprak, Sinem Civriz Bozdağ, Meltem Kurt Yüksel, Önder Arslan, Muhit Özcan, Taner Demirer, Meral Beksaç, Osman İlhan, Günhan Gürman, Pervin Topçuoğlu
We evaluated 979 patients for the development of post-transplant lymphoproliferative disease (PTLD) and solid malignancies after allogeneic hematopoietic stem cell transplantations (allo-HSCT) as a late complication. We found 15 (1.5%) subsequent malignancies; three of these malignancies were PTLD, and twelve were solid tumors. The median time from allo-HSCT to the development of PTLD was 9 (3-20) months and that from allo-HSCT to the development of solid tumors was 93 (6-316) months. The cumulative incidence of evolving subsequent malignancy in patients was 1...
April 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28432742/living-donor-uterus-transplantation-a-single-center-s-observations-and-lessons-learned-from-early-setbacks-to-technical-success
#2
G Testa, E C Koon, L Johannesson, G McKenna, T Anthony, G B Klintmalm, R T Gunby, A M Warren, J M Putman, G dePrisco, J M Mitchell, K Wallis, M Olausson
Uterus transplantation is a vascularized composite allograft transplantation. It allows women who do not have a uterus to become pregnant and deliver a baby. In this paper we analyze the first 5 cases of Living Donor Uterus Transplantation performed in the US. The first 3 recipients lost their uterus grafts at day 14, 12 and 6 after transplant. Vascular complications, related to both inflow and outflow problems, were identified as the primary reason for the graft losses. Two recipients, 6 and 3 months post-transplant have functioning grafts with regular menstrual cycles...
April 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28431019/identifying-cytomegalovirus-cmv-complications-using-the-quantiferon-cmv-assay-after-allogeneic-hematopoietic-stem-cell-transplantation
#3
Michelle K Yong, Paul U Cameron, Monica Slavin, C Orla Morrissey, Krystal Bergin, Andrew Spencer, David Ritchie, Allen C Cheng, Assia Samri, Guislaine Carcelain, Brigitte Autran, Sharon R Lewin
Background: Cytomegalovirus (CMV) reactivation and disease remain a major cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. A simple test to identify recovery of CMV-specific T-cell immunity could assist clinicians in managing CMV-related complications. Methods: In an observational multi-centre prospective study of 94 allogeneic HSCT recipients we evaluated CMV-specific T-cell immunity at baseline, 3, 6, 9 and 12 months post-transplant using the Quantiferon-CMV®, an ELISpot assay and in a subset, we also evaluated intracellular cytokine staining (ICS)...
April 18, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28428716/transition-after-pediatric-liver-transplantation-perceptions-of-adults-adolescents-and-parents
#4
Norman Junge, Katarina Migal, Imeke Goldschmidt, Ulrich Baumann
AIM: To develop a locally adapted, patient-focused transition-program, we evaluated the perceptions of adult and adolescent patients and parents regarding transition-programs and transfer. METHODS: We evaluated these perceptions by analyzing the responses of pre-transfer adolescents (n = 57), their parents (n = 57) and post-transfer adults (n = 138) from a cohort of pediatric-liver-transplant-patients using a self-designed questionnaire. Furthermore, we compared a responder group with a non-responder group as well as the provided answers with baseline characteristics and clinical outcomes to exclude selection bias, characterize high-risk patients for non-adherence and test for gender differences...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28427999/serpinb1-ameliorates-acute-lung-injury-in-liver-transplantation-through-erk1-2-mediated-stat3-dependent-ho-1-induction
#5
Weifeng Yao, Haobo Li, Gangjian Luo, Xiang Li, Chaojin Chen, Dongdong Yuan, Xinjin Chi, Zhengyuan Xia, Ziqing Hei
BACKGROUND: Postoperative acute lung injury(ALI) is a severe complication after liver transplantation, which severely affects postoperative patients' survival. The underlying mechanism is largely unknown and effective treatment limited. We explored the role of serpin protease inhibitor B1(SERPINB1), a potent inhibitor of neutrophil serine proteases, in ALI in liver transplantation and its interplay with signal transducer and activator of transcription 3(STAT3) and heme oxygenase-1(HO-1)...
April 17, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28427382/splenectomy-before-adult-liver-transplantation-a-retrospective-study
#6
LingXiang Kong, Ming Li, Lei Li, Li Jiang, Jiayin Yang, Lvnan Yan
BACKGROUND: A considerable number of patients with portal hypertension (PHT) have to undergo splenectomy because they do not meet the requirements for liver transplantation (LT) or cannot find a suitable liver donor. However, it is not known whether pre-transplantation splenectomy may create occult difficulties for patients who require LT in future. METHODS: We analyzed 1059 consecutive patients who underwent adult liver transplantation (ADLT). Patients with pre-transplantation splenectomy Sp(+) and without splenectomy Sp(-) were compared using a propensity score analysis to create the best match between groups...
April 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#7
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Model for End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28420433/umbilical-cord-derived-mesenchymal-stem-cells-on-scaffolds-facilitate-collagen-degradation-via-upregulation-of-mmp-9-in-rat-uterine-scars
#8
Lu Xu, Lijun Ding, Lei Wang, Yun Cao, Hui Zhu, Jingjie Lu, Xin'an Li, Tianran Song, Yali Hu, Jianwu Dai
BACKGROUND: Severe injuries of the uterus may trigger uterine scar formation, ultimately leading to infertility or obstetrical complications. To date, few methods have adequately solved the problem of collagen deposition in uterine scars. Umbilical cord-derived mesenchymal stem cells (UC-MSCs) have shown great promise in clinical applications. The objective of this study was to investigate the effect of a scaffold/UC-MSCs construct on collagen degradation and functional regeneration in rat uterine scars following full-thickness excision of uterine walls...
April 18, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28420067/kidney-transplantation-for-end-stage-renal-disease-in-lupus-nephritis-a-very-safe-procedure-a-single-latin-american-transplant-center-experience
#9
J Naranjo-Escobar, E Manzi, J G Posada, L Mesa, G J Echeverri, C Duran, J Schweneiberg, L A Caicedo, J I Villegas, G J Tobón
Background Lupus nephritis (LN) is one of the most frequent complications of SLE and occurs in up to 50% of cases depending on the studied population. Of these, approximately 20% progress to end-stage renal disease (ESRD), with the treatment of choice being a kidney transplant. Objective The objective of this study was to describe the clinical outcome of patients transplanted due to LN, compared with patients transplanted for other causes, in a Latin American population from the Fundación Valle del Lili in Cali, Colombia...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28417421/a-review-of-infectious-complications-after-haploidentical-hematopoietic-stem-cell-transplantations
#10
REVIEW
Erden Atilla, Pinar Ataca Atilla, Sinem Civriz Bozdağ, Taner Demirer
BACKGROUND: Allogeneic hematopoietic stem cell transplantation from haploidentical donor is a feasible option for patients with hematological diseases who lack a suitable HLA-matched donor, but viral and fungal infections are still the most common causes of morbidity and mortality in haploidentical transplantation setting because of delayed immune reconstitution, increased risk of graft vs host disease (GvHD) or systemic steroid use. Therefore, this review will focus on the infectious complications after haploidentical hematopoietic stem cell transplantation (HSCT)...
April 17, 2017: Infection
https://www.readbyqxmd.com/read/28416166/two-year-outcomes-of-balloon-occluded-retrograde-transvenous-obliteration-of-gastric-varices-in-liver-transplant-recipients-a-multi-institutional-study
#11
W E Saad, J F B Chick, R N Srinivasa, N Saad, S Kim, A Fischman, G Frey, A Al-Osaimi, S Caldwell
PURPOSE: To assess the 2-year effectiveness and safety of balloon-occluded retrograde transvenous obliteration (BRTO) for gastric varices (GVs) in liver transplant recipients. MATERIALS AND METHODS: Eleven liver transplant recipients underwent consecutive BRTO for GVs at four institutions. Patients included eight (73%) men and three (27%) women with mean age of 56 years±12 (SD) (range: 26-67 years). Underlying cause of liver transplantation was hepatitis C virus (HCV)-related cirrhosis in five (45%), alcohol- and HCV-related cirrhosis in three (27%), primary biliary cirrhosis in two (18%), and alcoholic cirrhosis in one (9%)...
April 13, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28415168/an-update-on-endoscopic-management-of-post-liver-transplant-biliary-complications
#12
Hyun Woo Lee, Najmul Hassan Shah, Sung Koo Lee
Biliary complications are the most common post-liver transplant (LT) complications with an incidence of 15%-45%. Furthermore, such complications are reported more frequently in patients who undergo a living-donor LT (LDLT) compared to a deceased-donor LT (DDLT). Most post-LT biliary complications involve biliary strictures, bile leakage, and biliary stones, although many rarer events, such as hemobilia and foreign bodies, contribute to a long list of related conditions. Endoscopic treatment of post-LT biliary complications has evolved rapidly, with new and effective tools improving both outcomes and success rates; in fact, the latter now consistently reach up to 80%...
April 17, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#13
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412517/challenges-around-access-to-and-cost-of-life-saving-medications-after-allogeneic-hematopoietic-cell-transplantation-for-medicare-patients
#14
Stephanie Farnia, Alex Ganetsky, Alicia Silver, Theresa Hwee, Jaime Preussler, Joan Griffin, Nandita Khera
Hematopoietic cell transplantation (HCT) is an expensive, medically complicated and potentially life-threatening therapy for multiple hematologic and non-hematologic disorders with a prolonged trajectory of recovery. Similar to financial issues in other cancer treatments, adverse financial consequences of HCT are emerging as an important issue, and may be associated with poor quality of life (QOL) and increased distress in HCT survivors. Prescription medicine coverage for HCT for Medicare and some Medicaid beneficiaries, especially in the long-term remains suboptimal due to inadequate payer formularies or prohibitive co-pays...
April 12, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28411099/robot-assisted-transplanted-ureteral-stricture-management
#15
H M Abdul-Muhsin, S B McAdams, R N Nuñez, N N Katariya, E P Castle
OBJECTIVE: To assess the feasibility of robot assisted transplanted ureteral reimplantation as a minimally invasive alternative to open surgery. MATERIAL AND METHODS: Between August 2015 and March 2016, five patients presented with transplanted ureteral strictures after failure of previous endoscopic management. All patients underwent robot assisted ureteral reimplantation. Patients' demographics, perioperative outcomes and complications are reported. RESULTS: All patients presented with deterioration of kidney function with or without recurrent urinary tract infection...
April 11, 2017: Urology
https://www.readbyqxmd.com/read/28410362/joint-assessment-of-donor-and-recipient-htert-gene-polymorphism-provides-additional-information-for-early-kidney-transplantation-outcomes
#16
Karolina Kłoda, Artur Mierzecki, Leszek Domański, Ewa Borowiecka, Krzysztof Safranow, Andrzej Ciechanowicz, Kazimierz Ciechanowski
BACKGROUND There are several genes and genetic loci affecting telomere length, including hTERT gene and BICD1 gene as well as polymorphisms within chromosome 18. It has been demonstrated that the age of the donor is a negative factor associated with long-term kidney allograft function, and that post-transplant complications accelerate transplanted organ aging, thus contributing to estimated glomerular filtration rate (eGFR) decreases. The aim of this study was a joint assessment of donors' and recipients' hTERT and BICD1 genes as well as chromosome 18 polymorphisms with regard to early kidney transplantation outcomes...
April 14, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28409358/added-value-of-gadoxetic-acid-enhanced-t1-weighted-magnetic-resonance-cholangiography-for-the-diagnosis-of-post-transplant-biliary-complications
#17
Sonja Kinner, Tilman B Schubert, Adnan Said, Joshua D Mezrich, Scott B Reeder
OBJECTIVES: Biliary complications after liver transplantation (LT) are common. This study aimed to ascertain the value of gadoxetic acid-enhanced T1-weighted (T1w) magnetic resonance cholangiography (MRC) to evaluate anastomotic strictures (AS), non-anastomotic strictures (NAS) and biliary casts (BC). METHODS: Sixty liver-transplanted patients with suspicion of biliary complications and T2w-MRCP and T1w-MRC followed by endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) were analysed...
April 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28403842/outcomes-of-autologous-bone-marrow-mononuclear-cells-for-cerebral-palsy-an-open-label-uncontrolled-clinical-trial
#18
Liem Thanh Nguyen, Anh Tuan Nguyen, Chinh Duy Vu, Doan V Ngo, Anh V Bui
BACKGROUND: Stem cell therapy has emerged as a promising method for improving motor function of patients with cerebral palsy. The aim of this study is to assess the safety and effectiveness of autologous bone marrow mononuclear stem cell transplantation in patients with cerebral palsy related to oxygen deprivation. METHODS: An open label uncontrolled clinical trial was carried out at Vinmec International Hospital. The intervention consisted of two administrations of stem cells, the first at baseline and the second 3 months later...
April 12, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28403531/short-term-effects-of-extracorporeal-graft-rinse-versus-circulatory-graft-rinse-in-living-donor-liver-transplantation-a-prospective-randomized-controlled-trial
#19
Amr M Yassen, Waleed R Elsarraf, Mohamed A Elmorshedi, Mohamed Abdel Wahab, Tarek Salah, Ahmed M Sultan, Ahmed N Elghawalby, Mohamed M Elshobari, Mohamed Elsadany, Khaled Zalata, Usama Shiha
BACKGROUND: Living donor liver transplantation has shorter cold ischemia time, less preservative volume and lower metabolic load compared to transplantation from deceased donors. We investigated the impact of rinsing the graft contents into the systemic circulation on operative course and post-operative outcomes. PATIENTS AND METHODS: Donors had right hepatectomy and grafts were preserved with cold Histidine-Tryptophan-Ketoglutarate solution. On ending portal vein anastomosis, grafts were flushed by patient's portal blood; either through incompletely anastomosed hepatic vein (Extracorporeal Rinse group, EcRg, n=40) or into systemic circulation (Circulatory Rinse group, CRg, n=40)...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28400115/thymus-transplantation-for-complete-digeorge-syndrome-european-experience
#20
E Graham Davies, Melissa Cheung, Kimberly Gilmour, Jesmeen Maimaris, Joe Curry, Anna Furmanski, Neil Sebire, Neil Halliday, Konstantinos Mengrelis, Stuart Adams, Jolanta Bernatoniene, Ronald Bremner, Michael Browning, Blythe Devlin, Hans Christian Erichsen, H Bobby Gaspar, Lizzie Hutchison, Winnie Ip, Marianne Ifversen, T Ronan Leahy, Elizabeth McCarthy, Despina Moshous, Kim Neuling, Malgorzata Pac, Alina Papadopol, Kathryn L Parsley, Luigi Poliani, Ida Ricciardelli, David M Sansom, Tiia Voor, Austen Worth, Tessa Crompton, M Louise Markert, Adrian J Thrasher
BACKGROUND: Thymus transplantation is a promising strategy for the treatment of athymic complete DiGeorge syndrome (cDGS). METHODS: Twelve patients with cDGS were transplanted with allogeneic cultured thymus. OBJECTIVE: To confirm and extend the results previously obtained in a single centre. RESULTS: Two patients died of pre-existing viral infections without developing thymopoeisis and one late death occurred from autoimmune thrombocytopaenia...
April 8, 2017: Journal of Allergy and Clinical Immunology
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