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Complications post transplantation

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https://www.readbyqxmd.com/read/27904614/the-predictive-value-of-blood-neutrophil-lymphocyte-ratio-in-patients-with-end-stage-liver-cirrhosis-following-abo-incompatible-liver-transplantation
#1
Bingyi Lin, Lei Geng, Zhiyun Zheng, Junjun Jia, Tian Shen, Jing Zhang, Lin Zhou, Shusen Zheng
BACKGROUND: The study was designed to assess the role of preoperative neutrophil, lymphocyte, and neutrophil-lymphocyte ratio (NLR) in predicting survival outcomes of ABO-incompatible liver transplantation (LT). MATERIALS AND METHODS: We retrospectively collected the demographic and clinical characteristics of 71 patients with end-stage liver cirrhosis following ABO-incompatible LT in this study. Kaplan-Meier survival analysis and Cox multiple factors regression analysis were performed to determine the independent risk factors from preoperative blood parameters for poor prognosis...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27900791/robust-graft-survival-and-normalized-dopaminergic-innervation-does-not-obligate-recovery-in-a-pd-patient
#2
Jeffrey H Kordower, Christopher G Goetz, Yaping Chu, Glenda M Halliday, Daniel A Nicholson, Timothy Musial, David J Marmion, A Jon Stoessl, Vesna Sossi, Thomas B Freeman, C Warren Olanow
OBJECTIVE: The main goal of dopamine cell replacement therapy in Parkinson's disease (PD) is to provide clinical benefit mediated by graft survival with nigrostriatal reinnervation. We report a dichotomy between graft structure and clinical function in a patient dying sixteen years following fetal nigral grafting. METHODS: A 55-year-old levodopa-responsive woman with PD received bilateral putamenal fetal mesencephalic grafts as part of an NIH-sponsored double-blind sham-controlled trial...
November 30, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27900097/post-transplant-lymphoproliferative-disorder-presenting-with-skin-ulceration-in-a-renal-transplant-recipient-who-achieved-sustained-remission-with-rituximab-therapy-a-case-report
#3
Man Fai Law, Hay Nun Chan, Ho Kei Lai, Chung Yin Ha, Celia Ng, Yiu Ming Yeung, Sze Fai Yip
Post-transplant lymphoproliferative disorder (PTLD) is associated with a variety of clinical presentations, but rarely involves the skin. We herein report a case of PTLD presenting with skin ulceration in a renal transplant recipient. A biopsy of the ulcer confirmed the diagnosis of diffuse large B-cell lymphoma. The patient was initially treated with immunosuppression reduction, but the skin ulcer persisted. He was then treated with two courses of chemotherapy, but his condition was complicated with cryptococcal infection...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27899718/postoperative-delirium-after-liver-transplantation-is-associated-with-increased-length-of-stay-and-lower-survival-in-a-prospective-cohort
#4
Sonja Beckmann, Maria Schubert, Hanna Burkhalter, Philipp Dutkowski, Sabina De Geest
INTRODUCTION: Although postoperative delirium (POD) is a common in-hospital complication associated with negative outcomes, evidence in liver transplantation (LT) is scarce. OBJECTIVE: We examined the incidence and duration of POD, its impact on outcomes and health-care utilization, and described predisposing and precipitating factors favoring POD development. DESIGN: This prospective cohort study included adults undergoing transplantation in a tertiary hospital...
November 28, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27899297/validation-of-the-afp-model-as-a-predictor-of-hcc-recurrence-in-patients-with-viral-hepatitis-related-cirrhosis-who-had-received-a-liver-transplant-for-hcc
#5
Andrea Notarpaolo, Richard Layèse, Paolo Magistri, Maria Gambato, Michele Colledan, Giulia Magini, Lucia Miglioresi, Alessandro Vitale, Giovanni Vennarecci, Cecilia D Ambrosio, Patrizia Burra, Fabrizio Di Benedetto, Stefano Fagiuoli, Marco Colasanti, Giuseppe Maria Ettorre, Arnoldo Andreoli, Umberto Cillo, Alexis Laurent, Sandrine Katsahian, Etienne Audureau, Françoise Roudot-Thoraval, Christophe Duvoux
BACKGROUND AND AIMS: The AFP model was shown superior to Milan criteria for prediction of HCC recurrence after liver transplantation in a French population. Our aim was to test the AFP model in a non French, post-hepatitic cirrhosis-based population of HCC candidates. METHODS: 574 patients transplanted for HCC in 4 Italian centres were studied. AFP score was assessed at last evaluation before LT. Probabilities of recurrence and survival were estimated by the log rank test or competing risk analysis and compared according to the AFP model...
November 26, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27895419/acute-kidney-injury-and-post-reperfusion-syndrome-in-liver-transplantation
#6
REVIEW
Ilaria Umbro, Francesca Tinti, Irene Scalera, Felicity Evison, Bridget Gunson, Adnan Sharif, James Ferguson, Paolo Muiesan, Anna Paola Mitterhofer
In the past decades liver transplantation (LT) has become the treatment of choice for patients with end stage liver disease (ESLD). The chronic shortage of cadaveric organs for transplantation led to the utilization of a greater number of marginal donors such as older donors or donors after circulatory death (DCD). The improved survival of transplanted patients has increased the frequency of long-term complications, in particular chronic kidney disease (CKD). Acute kidney injury (AKI) post-LT has been recently recognized as an important risk factor for the occurrence of de novo CKD in the long-term outcome...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27894188/challenges-of-endoscopic-management-of-pancreaticobiliary-complications-in-surgically-altered-gastrointestinal-anatomy
#7
REVIEW
Tin Moe Wai, Eun Young Kim
Pancreaticobiliary complications following various surgical procedures, including liver transplantation, are not uncommon and are important causes of morbidity and mortality. Therapeutic endoscopy plays a substantial role in these patients and can help to avoid the need for reoperation. However, the endoscopic approach in patients with surgically altered gastrointestinal (GI) anatomy is technically challenging because of the difficulty in entering the enteral limb to reach the target orifice to manage pancreaticobiliary complications...
November 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27890707/novel-mutation-in-dock8-hies-with-severe-phenotype-and-successful-transplantation
#8
Latifa Al Shekaili, Farrukh Sheikh, Sulaiman Al Gazlan, Hasan Al Dhekri, Hamoud Al Mousa, Abdulaziz Al Ghonaium, Bander Al Saud, Saleh Al Mohsen, Agha M Rehan Khaliq, Safiah Al Sumayli, Mufarreh Al Zahrani, Anas Dababo, Ammar AlKawi, Abbas Hawwari, Rand Arnaout
BACKGROUND: Hyper-IgE syndrome (HIES) due to DOCK8 deficiency is an autosomal recessive (AR) primary combined immunodeficiency which results in significant morbidity and mortality at a young age. Different mutations in the DOCK8 gene can lead to variable severity of the disease. OBJECTIVE: We evaluated the genetic mutations in three related patients with severe clinical manifestations suggestive of AR HIES. We also explored whether treatment with stem cell transplantation could lead to complete disease resolution...
November 23, 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/27884502/the-role-of-arterial-conduits-for-revascularisation-in-adult-orthotopic-liver-transplantation
#9
REVIEW
Nikolaos A Chatzizacharias, Mohamed Aly, Raaj K Praseedom
The successful outcome in orthotopic liver transplantation (OLT) is critically dependent on the uncompromised hepatic graft blood inflow. Arterial conduits represent a good solution in cases where conventional revascularisation is not possible. The purpose of this systematic review is to analyse the published evidence on the use of arterial conduits in adult OLT. After review of the Pubmed and EMBASE databases, 19 relevant studies were identified and analysed. Even though patient survival was comparable, most large studies reported worse 1-, 3- and 5-year graft survival rates compared to grafts with standard arterial revascularisation...
November 4, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/27884235/hypertension-in-patients-with-cardiac-transplantation
#10
REVIEW
Amanda L Bennett, Hector O Ventura
Hypertension is a common complication among post cardiac transplant recipients affecting more than 95% of patients. Increased blood pressure poses a significant cardiovascular morbidity and mortality in these patients; it should be identified quickly and needs to be managed appropriately. Understanding the pathophysiology and contributing factors to this disease in these complex and unique patients is the key to appropriate treatment selection.
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27882637/transplantation-associated-thrombotic-microangiopathy-isolated-to-a-congenital-anomaly-of-the-lung
#11
Rebecca T Kummen, Geoffrey D E Cuvelier, Camelia Stefanovici, Anamarija M Perry, Rick Higgins, Rochelle Yanofsky, Suyin A Lum Min, Donna A Wall
TA-TMA is a post-hematopoietic stem cell transplant complication with clinical features of hemolytic anemia and thrombocytopenia. A 26-month-old child who had had an allogeneic transplant for treatment of DBA developed severe TA-TMA with heavy red blood cell and platelet transfusion dependence. Incidentally, he was found to have a lung sequestration. TA-TMA resolved and transfusion dependence resolved after resection of the sequestration. The finding suggests the malformation vasculature was selectively vulnerable to the trigger of TA-TMA-raising perhaps a clue to basic pathophysiology of TA-TMA and/or vascular malformations...
November 24, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27882068/transplantation-of-deceased-donor-livers-with-elevated-levels-of-serum-transaminases-at-shiraz-transplant-center
#12
Nasir Fakhar, Saman Nikeghbalian, Kourosh Kazemi, Ali Reza Shamsayeefar, Siavash Gholami, Amir Kasraianfard, Seyed Ali Malek-Hosseini
BACKGROUND: The current organ shortage has prompted the use of marginal organs. We conducted this retrospective study to present our experience with transplanting deceased donor livers with elevated levels of serum transaminases and to explain whether elevated levels of serum transaminases in donors affect allograft function and survival of the recipients. METHODS: Data of deceased donor livers and patients, who underwent liver transplantation from March 2013 to March 2015 at Shiraz center for organ transplantation, was reviewed...
October 2016: Hepatitis Monthly
https://www.readbyqxmd.com/read/27878626/reducing-fluoroscopic-radiation-exposure-during-endomyocardial-biopsy-in-pediatric-transplant-recipients
#13
Jeffrey G Gossett, Christina L Sammet, Anya Agrawal, Karen Rychlik, David F Wax
Endomyocardial biopsy (EMB) with fluoroscopy is used for rejection surveillance in pediatric heart transplantation. Lowering frame rate may reduce radiation, but decreases temporal resolution and image quality. We undertook a quality initiative reducing frame rate from 10 frames per second (FPS) to 5 FPS. To assess whether lowering frame rate can reduce radiation exposure without compromising safety, data on EMBs from 9/2009 to 4/2013 without angiography or intervention were reviewed. Effective dose was calculated from dose area product (DAP) and fluoroscopy time...
November 23, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27876282/to-use-or-not-to-use-amiodarone-before-heart-transplantation
#14
Entela B Lushaj, Ravi Dhingra, Shahzad Chindhy, Shahab Akhter, Takushi Kohmoto, Susan Ulschmid, Satoru Osaki, Abbasali Badami, Lucian Lozonschi
BACKGROUND: Amiodarone frequently is used in patients with heart failure. Concerns still exist about possible complications related to its lingering effect during and after heart transplantation. METHODS: We selected all consecutive patients who received a heart transplant at our institution between January 2004 and December 2015 (n = 220) and compared the peri- and postoperative outcomes of patients who were taking amiodarone for at least 120 days before heart transplant (n = 127) with patients who did not take amiodarone prior to heart transplant (n = 93)...
November 19, 2016: Surgery
https://www.readbyqxmd.com/read/27875796/development-of-extensive-inferior-vena-cava-thrombosis-due-to-the-ligation-of-a-large-mesenteric-caval-shunt-during-liver-transplantation-a-case-report
#15
Hideya Kamei, Yasuharu Onishi, Masatoshi Ishigami, Yoji Ishizu, Kojiro Suzuki, Yasuhiro Ogura
INSTRUCTION: Inferior vena cava (IVC) thrombosis can be a life-threatening complication after liver transplantation (LT). Although this complication is usually related to technical problems associated with vascular anastomosis, we report a case of IVC thrombosis which developed from a ligated large mesenteric-caval shunt. PRESENTATION OF CASE: A 35-year-old man underwent LT from a brain-dead donor for primary sclerosing cholangitis. Enhanced computed tomography (CT) before LT showed a huge collateral vessel of the inferior mesenteric vein (IMV) draining into the infra-renal IVC directly...
November 15, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27875636/evaluation-of-coronary-artery-disease-in-potential-liver-transplant-recipients
#16
REVIEW
Brian J Hogan, Enoka Gonsalkorala, Michael A Heneghan
Improvements in the management of patients undergoing Liver Transplantation (LT) have resulted in a significant increase in survival over recent years. Cardiac disease is now the leading cause of early mortality and the stress of major surgery, haemodynamic shifts, the possibility of haemorrhage or reperfusion syndrome require the recipient to have good baseline cardiac function. The prevalence of coronary artery disease (CAD) is increasing in liver transplant candidates, especially in those with Non-Alcohol related Fatty Liver Disease (NAFLD)...
November 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27874253/combined-delivery-of-fgf-2-tgf-%C3%AE-1-and-adipose-derived-stem-cells-from-an-engineered-periosteum-to-a-critical-sized-mouse-femur-defect
#17
Raimundo Romero, John K Travers, Emilie Asbury, Attie Pennybaker, Laura Chubb, Ruth Rose, Nicole P Ehrhart, Matt J Kipper
Critical-sized long bone defects suffer from complications including impaired healing and non-union due to substandard healing and integration of devitalized bone allograft. Removal of the periosteum contributes to the limited healing of bone allografts. Restoring a periosteum on bone allografts may provide improved allograft healing and integration. This article reports a polysaccharide-based tissue engineered periosteum that delivers basic fibroblast growth factor (FGF-2), transforming growth factor-β1 (TGF-β1), and adipose-derived mesenchymal stem cells (ASCs) to a critical-sized mouse femur defect...
November 22, 2016: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/27872748/hemothorax-following-lung-transplantation-incidence-risk-factors-and-effect-on-morbidity-and-mortality
#18
Aria Hong, Christopher S King, A Whitney Walter Brown, Shahzad Ahmad, Oksana A Shlobin, Sandeep Khandhar, Linda Bogar, Anthony Rongione, Steven D Nathan
BACKGROUND: Hemothorax after lung transplantation may result in increased post-operative morbidity and mortality. Risk factors for developing hemothorax and the outcomes of patients who develop hemothorax have not been well studied. METHODS: A retrospective chart review was performed on all patients who underwent lung transplantation at a single center between March 2009 and July 2014. Comparison was made between patients with and without hemothorax post-transplant...
2016: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/27872731/infectious-complications-after-umbilical-cord-blood-transplantation-from-unrelated-donors
#19
REVIEW
Juan Montoro, José Luis Piñana, Federico Moscardó, Jaime Sanz
Umbilical cord-blood (UCB) is a well-recognized alternative source of stem cells for unrelated donor hematopoietic stem cell transplantation (HSCT). As compared with other stem cell sources from adult donors, it has the advantages of immediate availability of cells, absence of risk to the donor and reduced risk of graft-versus-host disease despite donor-recipient HLA disparity. However, the use of UCB is limited by the delayed post-transplant hematologic recovery due, at least in part, to the reduced number of hematopoietic cells in the graft and the delayed or incomplete immune reconstitution...
2016: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/27871893/clinical-effects-of-pre-transplant-serum-25-hydroxyvitamin-d-level-on-post-transplant-immunologic-and-non-immunologic-outcomes-in-kidney-transplant-recipients
#20
Tae Hyun Ban, Jeong Ho Kim, Han Beol Jang, Yoon Seo Lee, Bum Soon Choi, Cheol Whee Park, Chul Woo Yang, Yong-Soo Kim, Byung Ha Chung
BACKGROUND: The aim of this study was to investigate the effects of pre-transplant serum 25-hydroxyvitamin D (25(OH)D) level on non-immunologic and immunologic aspects of post-transplant clinical outcomes in kidney transplant recipients (KTRs). METHODS: We investigated 174 KTRs with low immunologic risk at baseline. We divided the patients into three groups according to baseline serum 25(OH)D level and compared the post-transplant clinical outcomes of acute rejection, infectious complications, and osteoporosis among the groups...
November 18, 2016: Transplant Immunology
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