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Complications post transplantation

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https://www.readbyqxmd.com/read/28214296/abnormally-high-and-heterogeneous-bone-matrix-mineralization-after-childhood-solid-organ-transplantation-a-complex-pathology-of-low-bone-turnover-and-local-defects-in-mineralization
#1
Nadja Fratzl-Zelman, Helena Valta, Renata C Pereira, Barbara M Misof, Paul Roschger, Hannu Jalanko, Kathrine Wesseling-Perry, Klaus Klaushofer, Outi Mäkitie
Chronic renal, liver and heart failure in children associates with multiple skeletal complications. Increased fracture incidence often persists after transplantation and could be related to alterations in bone material properties. In the present cohort study we evaluated bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in 23 pediatric solid organ allograft recipients with suspected osteoporosis. We measured BMDD in the entire cross-sectional area of transiliac bone biopsies obtained from kidney (n = 9), liver (n = 9) and heart (n = 5) transplant recipients (aged 7...
February 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28210847/ethical-considerations-in-the-long-term-ventricular-assist-device-patient
#2
REVIEW
Amanda Cai, Howard J Eisen
PURPOSE OF REVIEW: As the heart failure population continues to age, the need for definitive therapies such as ventricular assist devices (VADs) to extend life and alleviate suffering from end-stage disease directly increases. The goal of this article is to examine the ethical principles of autonomy, beneficence, non-maleficence, and justice within the context of long-term VAD patients. RECENT FINDINGS: Survival rates in VAD-implanted patients have improved in parallel with modernization of device design and surgical technique, reaching that of cardiac transplantation at 1 year post-procedure...
February 16, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28209304/prognostic-value-of-the-nutritional-risk-index-in-heart-transplant-recipients
#3
Eduardo Barge-Caballero, Fernando García-López, Raquel Marzoa-Rivas, Gonzalo Barge-Caballero, David Couto-Mallón, María J Paniagua-Martín, Miguel Solla-Buceta, Carlos Velasco-Sierra, Francisco Pita-Gutiérrez, José M Herrera-Noreña, José J Cuenca-Castillo, José Manuel Vázquez-Rodríguez, María G Crespo-Leiro
INTRODUCTION AND OBJECTIVES: To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). METHODS: We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression...
February 10, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28208917/early-post-operative-coronary-thrombosis-following-repair-of-a-proximal-coronary-artery-fistula
#4
Yashasvi Chugh, Bryan Lau, Cynthia C Taub
Patients with aneurysmal coronary artery fistulas are often a treatment challenge. We hereby, report a case of aneurysmal left main coronary artery to coronary sinus fistula repair, complicated by an early post-operative thrombosis of the left main coronary artery, necessitating an orthotropic heart transplant. Routine use of peri-procedural and long-term anti-coagulation is usually not a standard recommendation in these cases; however, early institution of the same may prevent flow stasis, thrombus formation and unfavourable outcomes pre- or post-operatively...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205445/severe-hypertriglyceridemia-induced-by-sirolimus-treated-with-medical-management-without-plasmapheresis
#5
Kazuhiko Kido, Rickey A Evans, Anil Gopinath, Jeremy D Flynn
: Hypertriglyceridemia and hyperlipidemia are the most remarkable metabolic complications seen with long-term sirolimus therapy. We report the case of a 36-year-old woman status post bilateral lung transplantation on a maintenance immunosuppression regimen of sirolimus, tacrolimus, and prednisone who presented with status migrainosus, chest pain, abdominal discomfort, and triglyceride levels greater than 4425 mg/dL. In previously reported cases of severe hypertriglyceridemia that developed on maintenance sirolimus therapy, plasmapheresis has been utilized as an early strategy to rapidly lower triglycerides in order to minimize the risk of acute complications such as pancreatitis, but our case was managed medically without plasmapheresis...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28198960/quality-of-life-of-patients-with-graft-versus-host-disease-gvhd-post-hematopoietic-stem-cell-transplantation
#6
Sibéli de Fátima Ferraz Simão Proença, Celina Mattos Machado, Raquel de Castro Figueiredo Pereira Coelho, Leila Maria Mansano Sarquis, Paulo Ricardo Bittencourt Guimarães, Luciana Puchalski Kalinke
OBJECTIVE: Assessing the quality of life of adult patients with hematological cancer in the 100 days after transplantation of hematopoietic stem cells and verifying whether the variable graft-versus-host disease (GvHD) is predictive of worse results. METHOD: An observational correlational and quantitative study with 36 adult participants diagnosed with hematologic cancer who underwent hematopoietic stem cell transplantation from September 2013 to June 2015. RESULT: The mean age was 37 years, 52...
November 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28197149/treatment-of-infantile-inflammatory-bowel-disease-and-autoimmunity-by-allogeneic-stem-cell-transplantation-in-lps-responsive-beige-like-anchor-deficiency
#7
Shahrzad Bakhtiar, Laura Gámez-Díaz, Andrea Jarisch, Jan Soerensen, Bodo Grimbacher, Bernd Belohradsky, Klaus-Michael Keller, Christoph Rietschel, Thomas Klingebiel, Sibylle Koletzko, Michael H Albert, Peter Bader
Inflammatory bowel disease (IBD) in young children can be a clinical manifestation of various primary immunodeficiency syndromes. Poor clinical outcome is associated with poor quality of life and high morbidity from the complications of prolonged immunosuppressive treatment and malabsorption. In 2012, mutations in the lipopolysaccharide-responsive beige-like anchor (LRBA) gene were identified as the cause of an autoimmunity and immunodeficiency syndrome. Since then, several LRBA-deficient patients have been reported with a broad spectrum of clinical manifestations without reliable predictive prognostic markers...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28194493/oral-health-of-adult-patients-undergoing-hematopoietic-cell-transplantation-pre-transplant-assessment-and-care
#8
REVIEW
Agnieszka Bogusławska-Kapała, Kazimierz Hałaburda, Ewa Rusyan, Hubert Gołąbek, Izabela Strużycka
Hematopoietic cell transplantation (HCT) is now one of the frequent procedures used for treatment of malignant and non-malignant blood diseases, autoimmune disorders, and certain solid tumors. Despite improvements of therapeutic protocols, HCT still carries a high risk of non-relapse mortality due to early and late complications. Side effects of the therapy regimen frequently occur in the oral cavity and often significantly decrease the patients' quality of life. The complications may result from or may be exacerbated by improper oral preparation of the patient before transplantation...
February 13, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28191298/asymptomatic-epstein-barr-virus-shedding-in-the-urine-of-kidney-transplant-recipients-case-reports-and-review-of-the-literature
#9
Maryam Rahbar, Gholamreza Poormand, Masoud Karkhaneh Mahmoodi, Aboozar Jazayeri, Seyed Mohammad Jazayeri
Epstein-Barr virus (EBV) is associated with a wide range of malignancies and complications like post-transplant lymphoproliferative disorder (PTLD). To suppress active EBV infection in transplant recipients, who are at a heightened risk of developing PTLD, EBV DNAemia monitoring has been recommended. Quantitative multiplex real time polymerase chain reaction (QMRTPCR) offered the advantage of detection of more than one target in the same sample. We present four cases of kidney transplant recipient who were admitted for rising serum creatinine between 9 and 20 months post-transplant with a suspicion of BKV-associated nephropathy...
December 31, 2016: Infectious Disease Reports
https://www.readbyqxmd.com/read/28191012/application-of-modified-small-bladder-patch-to-bladder-double-layer-sutures-to-improve-renal-transplantation-in-mice
#10
Chen Wenwei, Yang Yirong, Katarzyna M Stevens, Michal Heger, Xia Peng
BACKGROUND: This study aimed to introduce an improved surgical procedure to reduce the incidence of urinary tract complications after renal transplantation in mice using a modified bladder patch-to-bladder anastomosis technique. METHODS: Renal isotransplantation was performed in 28 male C57BL/6 mice. The urinary tract was reconstructed with a ureteral anastomosis between the donor's small bladder patch and the recipient's bladder. The bladder patch was secured through a cystotomy in the recipient's bladder mucosa and seromuscular layers, which were sutured in a double-layer manner...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
https://www.readbyqxmd.com/read/28188678/prophylactic-ureteric-stents-in-renal-transplant-recipients-a-multicentre-randomised-controlled-trial-of-early-versus-late-removal
#11
Pareeta Patel, Irene Rebollo-Mesa, Elizabeth Ryan, Manish D Sinha, Stephen D Marks, Neal Banga, Iain C Macdougall, Michelle C Webb, Geoff Koffman, Jonathon Olsburgh
Prophylactic ureteric stenting in renal transplantation reduces major urological complications (MUCs). There is however morbidity related to the indwelling duration of a stent, we aimed to determine the optimal duration for stents in this clinical setting. Patients (aged 2-75 years) from 6 UK hospitals undergoing renal transplantation were recruited and randomly assigned, to either early stent removal at 5 days (without cystoscopy) or late at 6 weeks post-transplantation (with cystoscopy). The primary outcome was a composite of stent-related complications defined as pain, visible haematuria, migration, fragmentation, and urinary tract infections (UTIs) within 3 months of transplantation...
February 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28185887/fatal-disseminated-rasamsonia-infection-in-cystic-fibrosis-post-lung-transplantation
#12
Gina Hong, Marissa White, Noah Lechtzin, Natalie E West, Robin Avery, Heather Miller, Richard Lee, Robert J Lovari, Christian Massire, Lawrence B Blyn, Xinglun Liang, Deanna A Sutton, Jianmin Fu, Brian L Wickes, Nathan P Wiederhold, Sean X Zhang
BACKGROUND: Disseminated fungal infections are a known serious complication in individuals with cystic fibrosis (CF) following orthotopic lung transplantation. Aspergillus fumigatus and Scedosporium species are among the more common causes of invasive fungal infection in this population. However, it is also important for clinicians to be aware of other emerging fungal species which may require markedly different antifungal therapies. CASE SUMMARY: We describe the first laboratory-documented case of a fatal disseminated fungal infection caused by Rasamsonia aegroticola in a 21-year-old female CF patient status post-bilateral lung transplantation, which was only identified post-mortem...
February 6, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#13
REVIEW
Lani Shochet, John Kanellis, Ian Simpson, Joseph Ta, William Mulley
Thrombotic microangiopathy (TMA) is a well-recognised complication following transplantation, often due to an underlying genetic predisposition, medications or rejection. The use of eculizumab in these settings has been previously described, but its role still remains to be clarified. A 45-year-old man, with a history of type 1 diabetes mellitus and subsequent end-stage kidney failure, presented for a simultaneous pancreas-kidney transplant. Immunologically, he was well matched with the donor, and he received standard induction immunosuppression including tacrolimus...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28176387/bridge-with-a-left-ventricular-assist-device-to-a-simultaneous-heart-and-kidney-transplant-review-of-the-united-network-for-organ-sharing-database
#14
Ann C Gaffey, Carol W Chen, Jennifer Chung, Edward Wilson Grandin, Paige M Porrett, Michael A Acker, Pavan Atluri
BACKGROUND: Left ventricular assist device (LVAD) implantation as a bridge to cardiac transplantation (BTT) is an effective treatment for end-stage heart failure patients. Currently, there is an increasing number of patients with a LVAD who need a heart and kidney transplant (HKT). Little is known of the prognostic outcomes in these patients. This study was undertaken to determine whether an equivalent outcome would be present in HKTs as compared to a non-LVAD primary HKT cohort. METHODS: We reviewed the United Network for Organ Sharing database from 2004 to 2013...
February 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28173959/the-clinical-impact-of-cytomegalovirus-infection-following-allogeneic-hematopoietic-cell-transplantation-why-the-quest-for-meaningful-prophylaxis-still-matters
#15
REVIEW
Shawna T Chan, Aaron C Logan
Latent infection with human cytomegalovirus (CMV) is common. Functional immunity effectively contains such latent infections; however, CMV reactivation may cause significant complications in patients undergoing allogeneic hematopoietic cell transplantation (alloHCT). In spite of the universal implementation of post-transplant screening for CMV viremia and the institution of pre-emptive antiviral management, CMV disease still occurs in a small portion of patients. Moreover, interactions between CMV and the immune system have significant implications for the incidence of graft-versus-host disease, the recurrence of malignancy, and non-relapse mortality following alloHCT, even in the era of pre-emptive antiviral management...
February 2, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28170112/treatment-of-hepatitis-c-virus-infection-in-patients-with-cirrhosis-and-predictive-value-of-meld-analysis-of-data-from-the-hepa-c-registry
#16
Carlos Fernández Carrillo, Sabela Lens, Elba Llop, Juan Manuel Pascasio, Javier Crespo, Juan Arenas, Inmaculada Fernández, Carme Baliellas, José Antonio Carrión, Manuel de la Mata, Maria Buti, Lluís Castells, Agustín Albillos, Manuel Romero, Juan Turnes, Clara Pons, José María Moreno-Planas, José Javier Moreno-Palomares, Conrado Fernández-Rodriguez, Javier García-Samaniego, Martín Prieto, Miguel Fernández Bermejo, Javier Salmerón, Ester Badia, Magdalena Salcedo, José Ignacio Herrero, Rafael Granados, Michel Blé, Zoe Mariño, José Luis Calleja
Direct-acting antiviral agents (DAAs) are highly effective and well tolerated in patients with chronic hepatitis C virus (HCV) infection, including those with compensated cirrhosis. However, fewer data are available in patients with more advanced liver disease. Our retrospective, non-interventional, national, multi-center study in patients from the Spanish Hepa-C registry investigated the effectiveness and safety of interferon-free DAA regimens in patients with advanced liver disease, including those with decompensated cirrhosis, in routine practice (all currently approved regimens were registered)...
February 7, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28164015/post-traumatic-ventricular-septal-defect-a-rare-indication-for-extracorporeal-membrane-oxygenation-as-a-bridge-to-transplant
#17
María Alejandra Restrepo-Córdoba, Francisco José Hernández-Pérez, Manuel Francisco Gómez-Bueno, Juan Manuel Escudier-Villa, Evaristo Castedo, Javier Segovia, Luis Antonio Alonso-Pulpón
A ventricular septal defect (VSD) is a rare complication of blunt chest trauma. This report presents the case of a 44-year-old man who developed a VSD as a result of high-energy closed chest trauma. We describe the initial surgical and medical management of the cardiac rupture. After failed repair surgery, extracorporeal membrane oxygenation (ECMO) was used as a bridge to heart transplantation. We discuss the successful use of ECMO to improve the prognosis results in this rare and complex entity.
February 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28163356/comparing-three-data-mining-methods-to-predict-kidney-transplant-survival
#18
Leila Shahmoradi, Mostafa Langarizadeh, Gholamreza Pourmand, Ziba Aghsaei Fard, Alireza Borhani
INTRODUCTION: One of the most important complications of post-transplant is rejection. Analyzing survival is one of the areas of medical prognosis and data mining, as an effective approach, has the capacity of analyzing and estimating outcomes in advance through discovering appropriate models among data. The present study aims at comparing the effectiveness of C5.0 algorithms, neural network and C&RTree to predict kidney transplant survival before transplant. METHOD: To detect factors effective in predicting transplant survival, information needs analysis was performed via a researcher-made questionnaire...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28162932/multicenter-evaluation-of-a-national-organ-sharing-policy-for-highly-sensitized-patients-listed-for-heart-transplantation-in-canada
#19
Brian Clarke, Anique Ducharme, Nadia Giannetti, Daniel Kim, Michael McDonald, Peter Pflugfelder, Miroslaw Rajda, Mario Sénéchal, Ellie Stadnick, Mustafa Toma, Shelley Zieroth, Debra Isaac
BACKGROUND: Transplantation of sensitized recipients has been associated with increased risk of post-transplant complications. In 2010, the Canadian Cardiac Transplant Network (CCTN) created a unique status listing for highly sensitized heart transplant candidates. Status 4S listing requires calculated panel-reactive antibody (cPRA) level >80% as the sole listing criteria and enables geographic expansion of the donor pool by providing national access. In this study, we describe patient characteristics and outcomes of those transplanted as Status 4S in Canada...
January 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28160394/cardiovascular-morbidity-and-mortality-after-liver-transplantation-the-protective-role-of-mycophenolate-mofetil
#20
D D'Avola, V Cuervas-Mons, J Martí, J Ortiz de Urbina, L Lladó, C Jimenez, E Otero, F Suarez, J M Rodrigo, M A Gómez, E Fraga, P Lopez, T Serrano, A Rios, E Fábrega, J I Herrero
: Cardiovascular (CV) diseases are recognized long-term causes of death after liver transplantation (LT). The objective of this multicenter study was to analyse the prevalence and the evolution of CV risk factors and CV morbidity and mortality in 1819 liver transplant recipients along 5 years after LT. The influence of baseline variables on survival, morbidity and mortality was studied. There was a continuous and significant increase of the prevalence of all the CV risk factors (except smoking) after LT...
February 3, 2017: Liver Transplantation
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