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Louise Crowe, Vicki Anderson, Winita Hardikar, Avihu Boneh
Ornithine Trans-Carbamylase (OTC) deficiency is the most common disorder of the urea cycle. Cognitive impairments in skills such as attention and executive function have been reported in individuals with OTC deficiency who are managed with medication. In some cases, children undergo liver transplantation (LTx) to correct the metabolic defect. The metabolic and medical outcomes of LTx are generally good. However, little is known about the impacts on cognition. In this study, four children (three female) completed detailed neuropsychological batteries prior to (n = 6) and following LTx (n = 8 assessments)...
March 10, 2018: JIMD Reports
Anupong Tangaroonsanti, Augustine S Lee, Marcelo F Vela, Michael D Crowell, David Erasmus, Cesar Keller, Jorge Mallea, Francisco Alvarez, Cristina Almansa, Kenneth R DeVault, Lesley A Houghton
GOALS: To assess the effect of unilateral versus bilateral lung transplantation (LTx) on esophageal motility and gastroesophageal reflux, and the association with the development of obstructive chronic lung allograft dysfunction (o-CLAD). BACKGROUND: We have shown that esophagogastric junction outflow obstruction, incomplete bolus transit, and proximal reflux are all independent risk factors for the development of chronic allograft failure. However, it remains unclear whether these factors are influenced by the type of surgery and how this relates to allograft failure...
March 2, 2018: Journal of Clinical Gastroenterology
Qi Cheng, Kunal Patel, Biao Lei, Lindsay Rucker, D Patterson Allen, Peng Zhu, Chentha Vasu, Paulo N Martins, Martin Goddard, Satish N Nadig, Carl Atkinson
Donor brain death (BD) is an inherent part of lung transplantation (LTx) and a key contributor to ischemia-reperfusion injury (IRI). Complement activation occurs as a consequence of BD in other solid organ Tx and exacerbates IRI, but the role of complement in LTx has not been investigated. Here, we investigate the utility of delivering nebulized C3a receptor antagonist (C3aRA) pre-Transplant to BD donor lungs in order to reduce post-LTx IRI. BD was induced in Balb/c donors, and lungs nebulized with C3aRA or vehicle 30 minutes prior to lung procurement...
March 5, 2018: American Journal of Transplantation
Joseph T Brooks, Naoru Koizumi, Elizabeth Neglia, Bilel Gdoura, Tina W Wong, Chang Kwon, Tony E Smith, Jorge Ortiz
BACKGROUND: Share 35 prioritizes offers of deceased donor livers to regional candidates with Model for End-Stage Liver Disease (MELD) ≥35 over local candidates with lower MELD scores. Analysis of Share35 has shown that overall 1- or 2-year post-transplant (LTx) outcomes have been unchanged while waitlist mortality has been reduced. However, these studies exclude retransplant (reLTx) recipients. This study aims to investigate the outcomes of liver retransplants in evaluating the impact of the Share35 policy...
February 27, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Eduardo J Mortani Barbosa, Maarten Lanclus, Wim Vos, Cedric Van Holsbeke, William De Backer, Jan De Backer, James Lee
RATIONALE AND OBJECTIVES: Long-term survival after lung transplantation (LTx) is limited by bronchiolitis obliterans syndrome (BOS), defined as a sustained decline in forced expiratory volume in the first second (FEV1 ) not explained by other causes. We assessed whether machine learning (ML) utilizing quantitative computed tomography (qCT) metrics can predict eventual development of BOS. MATERIALS AND METHODS: Paired inspiratory-expiratory CT scans of 71 patients who underwent LTx were analyzed retrospectively (BOS [n = 41] versus non-BOS [n = 30]), using at least two different time points...
February 19, 2018: Academic Radiology
Yohei Yamada, Ken Hoshino, Yasushi Fuchimoto, Kentaro Matsubara, Taizo Hibi, Hiroshi Yagi, Yuta Abe, Masahiro Shinoda, Minoru Kitago, Hideaki Obara, Takahito Yagi, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto, Tatsuya Suzuki, Keiichi Kubota, Tomoharu Yoshizumi, Yoshihiko Maehara, Yukihiro Inomata, Yuko Kitagawa, Hiroto Egawa, Tatsuo Kuroda
Background: Multiple studies have failed to reveal an effective method for preventing the recurrence of primary sclerosing cholangitis (PSC) after liver transplantation (LTx). A national study conducted in Japan revealed several risk factors for the recurrence after living donor LTx (LDLTx); however, recipients of ABO-blood type incompatible (ABO-I) LTx were excluded from the previous analysis. In the present study, we investigated the efficacy of an immunosuppressive protocol in ABO-I LTx on the recurrence of PSC after LDLTx...
February 2018: Transplantation Direct
D K Daphnee, Sheila John, P Rajalakshmi, Anil Vaidya, Anand Khakhar, S Bhuvaneshwari, Anand Ramamurthy
BACKGROUND AND AIM: Nutritional therapy is an integral part of care in all phases of liver transplantation (LTx). However, there are several factors that make it a challenge to manage malnutrition in these patients including, but not limited to, loss of appetite, dietary restrictions and dietary habits. Dietary habits are guided by personal choice, social, cultural and regional background with diversity ranging from veganism to vegetarianism with the latter predominant in Indian population...
February 2018: Clinical Nutrition ESPEN
Yohei Yamada, Ken Hoshino, Takayuki Oyanagi, Ryohei Gatayama, Jun Maeda, Nobuyuki Katori, Yasushi Fuchimoto, Taizo Hibi, Masahiro Shinoda, Kentaro Matsubara, Hideaki Obara, Ryo Aeba, Yuko Kitagawa, Hiroyuki Yamagishi, Tatsuo Kuroda
Children with single ventricle physiology have complete mixing of the pulmonary and systemic circulations, requiring staged procedures to achieve a separation of these circulations, or Fontan circulation. The single ventricle physiology significantly increases the risk of mortality in children undergoing non-cardiac surgery. As liver transplantation for patients with single ventricle physiology is particularly challenging, only a few reports have been published. We herein report a case of successful LDLTx for an 8-month-old pediatric patient with biliary atresia, heterotaxy, and complex heart disease of single ventricle physiology...
February 19, 2018: Pediatric Transplantation
Christian Murer, Lars Christian Huber, Thomas Kurowski, Astrid Hirt, Cécile A Robinson, Urs Bürgi, Christian Benden
AIMS OF THE STUDY: Cystic fibrosis is the most common genetic disorder in Caucasians. The combination of the cystic fibrosis transmembrane conductance regulator (CFTR) corrector lumacaftor / potentiator ivacaftor (LUM/IVA) has been shown to increase forced expiratory volume in 1 second (FEV1) moderately, but predominantly reduce acute exacerbation rate (AER) in Phe508del homozygous cystic fibrosis patients; however, patients with FEV1 <40% predicted were excluded from studies. We used LUM/IVA on a "compassionate use" basis in cystic fibrosis patients with end-stage pulmonary disease...
February 16, 2018: Swiss Medical Weekly
Constanza Ciriza de Los Ríos, Fernando Canga Rodríguez-Valcárcel, Alicia de Pablo Gafas, Isabel Castel de Lucas, David Lora Pablos, Gregorio Castellano Tortajada
BACKGROUND: lung transplantation (LTx) is a viable option for most patients with end-stage lung diseases. Esophageal motor disorders (EMD) are frequent in candidates for LTx, but there is very little data about changes in esophageal motility post-LTx. AIM: the aim of our study was to assess esophageal motor disorders by high resolution manometry (HRM) both pre-LTx and six months post-LTx in patients with and without organ rejection. STUDY: HRM (Manoscan®) was performed in 57 patients both pre-LTx and six months post-LTx...
February 9, 2018: Revista Española de Enfermedades Digestivas
A Tangaroonsanti, M F Vela, M D Crowell, K R DeVault, L A Houghton
BACKGROUND: Proximal reflux and incomplete transit of boluses swallowed are risk factors for obstructive chronic lung allograft dysfunction (o-CLAD) post-lung transplantation (LTx). Likewise, so is esophagogastric junction outflow obstruction (EGJOO), but not hypo-contractility, when diagnosed using Chicago Classification (CC) v3.0. Given, peristaltic breaks as defined using CCv2.0 can prolong esophageal clearance, both swallowed and refluxed, but which are deemed within normality using CCv3...
February 7, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Nora Drick, Benjamin Seeliger, Jan Fuge, Igor Tudorache, Mark Greer, Tobias Welte, Axel Haverich, Jens Gottlieb
BACKGROUND: Non-adherence to immunosuppressive treatment following solid organ transplantation is common and often associated with poorer outcomes. Non-adherence is difficult to assess and barriers to adherence in lung transplant (LTx) recipients remain to be elucidated. METHODS: A single center cross-sectional observational study of all LTx recipients attending our department between 07/2013 - 05/2014 was performed. Non-adherence was assessed using patient self-reporting, including Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) along with health care worker (HCW) judgement and reasons for non-adherence by the Immunosuppressive Therapy Barriers Scale...
January 29, 2018: Clinical Transplantation
Hans-Christian Pommergaard, Andreas Arendtsen Rostved, René Adam, Lau Caspar Thygesen, Mauro Salizzoni, Miguel Angel Gómez Bravo, Daniel Cherqui, Paolo De Simone, Karim Boudjema, Vincenzo Mazzaferro, Olivier Soubrane, Juan Carlos García-Valdecasas, Joan Fabregat Prous, Antonio D Pinna, John O'Grady, Vincent Karam, Christophe Duvoux, Allan Rasmussen
Locoregional treatment while on the waiting list for liver transplantation (Ltx) for hepatocellular carcinoma (HCC) has been shown to improve survival. However, the effect of treatment type has not been investigated. We investigate the effect of locoregional treatment type on survival after Ltx for HCC. We investigated patients registered in the European Liver Transplant Registry database using multivariate Cox regression survival analysis. Information on locoregional therapy was registered for 4978 of 23 124 patients and was associated with improved overall survival [hazard ratio (HR) 0...
January 30, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Hubert P J van der Doef, Patrick F van Rheenen, M van Rosmalen, Xavier Rogiers, Henkjan J Verkade
INTRODUCTION: Liver transplantation (LTx) is the standard treatment for biliary atresia (BA) patients with end-stage liver disease. The prognosis after LTx has steadily improved, but overall prognosis of BA-patients is also determined by mortality before LTx. We aimed to quantify mortality in young BA-patients on the Eurotransplant waiting list and to determine the effect of disease severity and age at time of listing on pretransplant mortality. METHODS: We used a cohort study design, which incorporated data from the Eurotransplant registry...
January 29, 2018: Liver Transplantation
Jessica Rademacher, Jan Fuge, Tobias Welte, Jens Gottlieb, Hendrik Suhling
BACKGROUND: The risk of transmission of infections in partnerships between two transplant recipients is unknown. The aim of this study was to evaluate transmission in such couples. METHODS: In this single centre study, lung transplant (LTx) couples were identified among outpatients between 1988 and 2016. Infection rates per year and survival were compared to matched LTx-recipients not living in a transplant partnership. RESULTS: Twelve transplant couples were analysed with cumulative 65 years of relationship...
January 29, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Louise M Fuller, Doa El-Ansary, Brenda Button, Janet Bondarenko, Silvana Marasco, Greg Snell, Anne E Holland
A surgical incision for bilateral sequential lung transplantation (BSLTX) is the "clam shell" (CSI) approach via bilateral anterior thoracotomies and a transverse sternotomy to allow for sequential replacement of the lungs. This can be associated with significant post-operative pain, bony overriding or sternal instability. The sternal instability scale (SIS) is a non-invasive manual assessment tool that can be used to detect early bony non-union or instability following CSI; however, its reliability is unknown...
January 25, 2018: Physiotherapy Theory and Practice
Nicholas R Hess, Stephen A Esper, Marie Tuft, Matthew Morrell, Jonathan D'Cunha
INTRODUCTION: Patient foramen ovale (PFO) is a common and often incidental intraoperative finding during lung transplantation (LTx). We sought to characterize the potential outcomes related to the decision-making of whether the PFO was repaired or left unrepaired. METHODS: We retrospectively evaluated bilateral LTx recipients between 2005 and 2015 from our prospective database. Incidence of postoperative stoke, 90-day mortality, and overall survival was compared between the PFO-positive and PFO-negative groups, and secondly compared between repaired PFO (rPFO) and non-repaired PFO (nrPFO) groups...
January 19, 2018: Clinical Transplantation
Uta Herden, Lutz Fischer, Martina Sterneck, Enke Grabhorn, Bjoern Nashan
INTRODUCTION: Full-split liver transplantation (LTX) offers the possibility to expand the donor pool by utilization of one liver for two adults. The aim of our study was to analyse the long-term outcome in a large series and its applicability in the recent transplant era. METHODS: We performed a retrospective analysis of all full-split LTX from deceased donors (1999-2015). Additionally, the potential of full-split LTX was retrospectively analysed in all whole organ LTX recipients between 2006 and 2015 (after introduction of the MELD allocation)...
January 18, 2018: Clinical Transplantation
Amel Ben Lagha, Geneviève LeBel, Daniel Grenier
BACKGROUND: The highbush blueberry (Vaccinium corymbosum) has a beneficial effect on several aspects of human health. The present study investigated the effects of highbush blueberry proanthocyanidins (PACs) on the virulence properties of Aggregatibacter actinomycetemcomitans and macrophage-associated inflammatory responses. METHODS: PACs were isolated from frozen highbush blueberries using solid-phase chromatography. A microplate dilution assay was performed to determine the effect of highbush blueberry PACs on A...
January 10, 2018: BMC Complementary and Alternative Medicine
Anke Van Herck, Stijn E Verleden, Bart M Vanaudenaerde, Geert M Verleden, Robin Vos
Long-term survival after lung transplantation (LTx) is limited by chronic rejection (CR). Therapeutic strategies for CR have been largely unsuccessful, making prevention of CR an important and challenging therapeutic approach. In the current review, we will discuss current clinical evidence regarding prevention of CR after LTx.
December 2017: Journal of Thoracic Disease
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