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Extended criteria graft

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https://www.readbyqxmd.com/read/29325720/development-of-pancreatic-machine-perfusion-translational-steps-from-porcine-to-human-models
#1
Karim Hamaoui, Sally Gowers, Bynvant Sandhu, Natalie Vallant, Terry Cook, Martyn Boutelle, Daniel Casanova, Vassilios Papalois
BACKGROUND: Hypothermic machine perfusion (HMP) is increasingly being used for extended criteria kidney grafts. Pancreatic HMP is challenging because physiologically the pancreas is a low-flow organ susceptible to edema. We report the successful development of preclinical HMP models using porcine pancreases, as well as human pancreases unsuitable for clinical transplantation. METHODS: Ten porcine pancreases were used in the development of these perfusion models...
January 8, 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29316230/propensity-score-based-comparison-of-the-graft-failure-risk-between-kidney-transplant-recipients-of-standard-and-expanded-criteria-donor-grafts-towards-increasing-the-pool-of-marginal-donors
#2
A H Querard, F Le Borgne, A Dion, M Giral, G Mourad, V Garrigue, L Rostaing, N Kamar, A Loupy, C Legendre, E Morelon, F Buron, Y Foucher, E Dantan
From a prospective and multicentric French cohort, we proposed an external validation study for the Expanded Criteria Donor (ECD), based on 4833 kidney recipients transplanted for the first time between 2000 and 2014. We estimated the subject-specific effect from a multivariable Cox model. We confirmed a 1.75-fold (95%CI from 1.53 to 2.00, p<0.0001) increase in graft failure risk if a given patient received an ECD graft compared to a graft from a donor with standard criteria (SCD). Complementarily, we estimated the population-average effect using propensity scores...
January 9, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29314293/the-impact-of-donor-liver-allograft-fibrosis-on-patients-undergoing-liver-transplantation
#3
Vikram Wadhera, Norifumi Harimoto, Nir Lubezky, Ilias Gomatos, Matias Facciuto, David Gonzalez, Ashley Stueck, M Isabel Fiel, Thomas Schiano, Marcelo Facciuto
BACKGROUND: The utilization of extended criteria liver allografts (ECD) shortens time to transplantation. OBJECTIVE: To characterize the effect of liver allograft fibrosis on graft and patient survival after LT, with particular attention to fibrosis progression. METHODS: Retrospective database search of donor and recipient liver allograft histology of liver transplants performed between 2007 and 2011. Donor and patient characteristics were analyzed...
January 3, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29314286/the-impact-of-kidney-donor-profile-index-kdpi-on-delayed-graft-function-and-transplant-outcomes-a-single-center-analysis
#4
Tiffany J Zens, Juan S Danobeitia, Glen Leverson, Peter J Chlebeck, Laura J Zitur, Robert R Redfield, Anthony M D'Alessandro, Scott Odorico, Dixon B Kaufman, Luis A Fernandez
INTRODUCTION: Renal transplant outcomes result from a combination of factors. Traditionally, donor factors were summarized by classifying kidneys as extended criteria or standard criteria. In 2014, the nomenclature changed to describe donor factors with the kidney donor profile index (KDPI). We aim to evaluate the relationship between KDPI and delayed graft function, and the impact KDPI on transplant outcomes for both donor after cardiac death (DCD) and donor after brain death (DBD) ...
January 3, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29217537/characteristics-and-performance-of-unilateral-kidney-transplants-from-deceased-donors
#5
Syed Ali Husain, Mariana C Chiles, Samnang Lee, Stephen O Pastan, Rachel E Patzer, Bekir Tanriover, Lloyd E Ratner, Sumit Mohan
BACKGROUND AND OBJECTIVES: The fraction of kidneys procured for transplant that are discarded is rising in the United States. Identifying donors from whom only one kidney was discarded allows us to control for donor traits and better assess reasons for organ discard. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective cohort study using United Network for Organ Sharing Standard Transplant Analysis and Research file data to identify deceased donors from whom two kidneys were procured and at least one was transplanted...
December 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29185228/deceased-donor-liver-transplant-experience-from-a-public-sector-hospital-in-india
#6
Viniyendra Pamecha, Deeplaxmi Purushottam Borle, Senthil Kumar, Kishore Gurumoorthy Subramanya Bharathy, Piyush Kumar Sinha, Shridhar Vasantrao Sasturkar, Vibuti Sharma, Chandra Kant Pandey, Shiv Kumar Sarin
BACKGROUND: Deceased donor liver transplant (DDLT) is an uncommon procedure in India. We present our experience of DDLT from a public sector teaching hospital. METHODS: A retrospective analysis of all DDLT was performed from April 2012 till September 2016. Demographics, intraoperative, donor factors, morbidity, and outcome were analyzed. RESULTS: During the study period, 305 liver transplants were performed, of which 36 were DDLT (adult 32, pediatric 4; 35 grafts; 1 split)...
November 29, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29173815/-focusing-on-kidney-transplantation-in-the-elderly
#7
Mathilde Lemoine, Dominique Guerrot, Dominique Bertrand
Due to the increase in life expectancy and the ageing of end-stage renal disease patients, the number of patients older than 65 years receiving a kidney transplant has been continuously growing over the last fifteen years. The benefits of renal transplantation compared to dialysis in terms of survival and quality of life have been shown in selected recipients over 65, or 70 years. However, the age remains the main limiting factor for the access to the waiting list, and the reluctance of the clinicians can be explained by the multiple comorbidities of these candidates, their limited life expectancy or the shortage of grafts...
November 21, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29149973/hepatitis-c-virus-recurrence-occurs-earlier-in-patients-receiving-donation-after-circulatory-death-liver-transplant-grafts-compared-with-those-receiving-donation-after-brainstem-death-grafts
#8
S A Townsend, M A Monga, P Nightingale, D Mutimer, A M Elsharkawy, A Holt
INTRODUCTION: Hepatitis C virus (HCV)-related cirrhosis remains the commonest indication for liver transplantation worldwide, yet few studies have investigated the impact of donation after circulatory death (DCD) graft use on HCV recurrence and patient outcomes. DCD grafts have augmented the limited donor organ pool and reduced wait-list mortality, although concerns regarding graft longevity and patient outcome persist. METHODS: This was a single-center study of all HCV + adults who underwent DCD liver transplantation between 2004 and 2014...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29145515/male-kidney-allograft-recipients-at-risk-for-urinary-tract-infection
#9
Gerold Thölking, Katharina Schuette-Nuetgen, Thomas Vogl, Ulrich Dobrindt, Barbara C Kahl, Marcus Brand, Hermann Pavenstädt, Barbara Suwelack, Raphael Koch, Stefan Reuter
BACKGROUND: Urinary tract infection (UTI) is the most common infection after renal transplantation (RTx). Although female sex is a well-known risk factor for the development of UTI after RTx, the role of the donor sex in this context remains unclear. METHODS: In this case control study 6,763 RTx cases were screened for UTI when presenting at our transplant outpatient clinics. 102 different RTx patients fulfilled the inclusion criteria and were compared to 102 controls...
2017: PloS One
https://www.readbyqxmd.com/read/29142490/postoperative-elevated-resistive-indices-do-not-predict-hepatic-artery-thrombosis-in-extended-criteria-donor-livers
#10
Eric J Siskind, Fauzia Vandermeer, Tamar R Siskind, David A Bruno, Samuel Sultan, Josue Alvarez-Casas, Arielle Stafford, Barton Lane, John C Lamattina, Rolf N Barth, Steven I Hanish
Postoperative transplant liver ultrasounds were analyzed in standard criteria donor (SCD), extended criteria donor (ECD), and donation after cardiac death (DCD) liver allografts to determine if elevated resistive indices (RIs) are consistently present and if they are pathological. Postoperative transplant liver ultrasounds were reviewed from 115 consecutive patients. Hepatic arterial RIs were stratified based on the type of donor: DCD, macrosteatosis (>30%), or standard criteria. In all patients with elevated RI, subsequent ultrasounds were reviewed to demonstrate RI normalization...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29045248/the-evolution-of-donation-after-circulatory-death-donor-kidney-repair-in-the-united-kingdom
#11
Sarah A Hosgood, Michael L Nicholson
PURPOSE OF REVIEW: The increasing reliance on marginal donors has driven research to investigate ways to repair and improve the quality of kidneys for transplantation. Normothermic perfusion technologies provide an opportunity for improved preservation, organ assessment and resuscitation/repair of damaged kidneys. This review describes the evolution of normothermic perfusion in kidney transplantation in the United Kingdom. RECENT FINDINGS: One hour of normothermic perfusion can be used to restore function and improve early graft function of extended criteria donor kidneys...
October 17, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29044682/systematic-review-and-meta-analysis-of-liver-transplantation-using-grafts-from-deceased-donors-aged-over-70-years
#12
REVIEW
B V Dasari, H Mergental, J R Isaac, P Muiesan, D F Mirza, M T P R Perera
INTRODUCTION: Due to the current organ shortage, nearly 20% of patients die waiting for a liver transplant (LT). The average donor age is on the rise, and grafts from elderly donors are offered as extended criteria grafts. METHODS: This is a meta-analysis comparing the outcome differences of adult patients undergoing LT using grafts from <70-year-old donors versus >70-year-old donors. The primary end-points were graft and patient survival. Secondary outcomes were biliary and vascular complications as well as graft function...
October 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29018070/hypothermic-oxygenated-machine-perfusion-hope-for-orthotopic-liver-transplantation-of-human-liver-allografts-from-extended-criteria-donors-ecd-in-donation-after-brain-death-dbd-a-prospective-multicentre-randomised-controlled-trial-hope-ecd-dbd
#13
Zoltan Czigany, Wenzel Schöning, Tom Florian Ulmer, Jan Bednarsch, Iakovos Amygdalos, Thorsten Cramer, Xavier Rogiers, Irinel Popescu, Florin Botea, Jiří Froněk, Daniela Kroy, Alexander Koch, Frank Tacke, Christian Trautwein, Rene H Tolba, Marc Hein, Ger H Koek, Cornelis H C Dejong, Ulf Peter Neumann, Georg Lurje
INTRODUCTION: Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28964417/continued-successful-evolution-of-extended-criteria-donor-lungs-for-transplantation
#14
Sakhee Kotecha, Jamie Hobson, Jeremy Fuller, Eldho Paul, Bronwyn J Levvey, Helen Whitford, Miranda Paraskeva, David McGiffin, Gregory I Snell, Glen P Westall
BACKGROUND: In an era of increasing ex vivo lung perfusion (EVLP) use, it remains important to describe what outcomes can be achieved without EVLP, by taking an aggressive approach to donor use to maximize lung transplantation. METHODS: Data for all lung transplant donor referrals to the Alfred Hospital in Melbourne, Australia were collected for 2012 to 2013. Donor variables were analyzed and calculated into a previously validated lung donor score. Lung transplant recipient outcome data included the following: primary graft dysfunction; duration of mechanical ventilation; need for cardiopulmonary bypass extracorporeal membrane oxygenation; intensive care and hospital length of stay; 30-day, 1-year, and 3- to 4-year survival rates; rates of acute rejection and chronic lung allograft dysfunction; and peak and 12-month lung function (forced expiratory volume in 1 second)...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28922301/hypothermic-liver-perfusion
#15
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
PURPOSE OF REVIEW: The review describes recent developments in hypothermic machine liver perfusion with a special focus on underlying protective mechanisms, and the role of this perfusion technique in high-risk donor-recipient combinations. RECENT FINDINGS: To maximize the number of transplantable donor livers, several centres are exploring new machine preservation techniques. In this context, hypothermic machine perfusion has been recently introduced into the clinical setting of human liver transplantation, and the effect of endischemic cold liver perfusion on posttransplant complications is currently under investigation in two multicentre, randomized controlled trials...
December 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28922300/recent-advances-in-the-field-of-warm-ex-vivo-liver-perfusion
#16
Dagmar Kollmann, Markus Selzner
PURPOSE OF REVIEW: Organ shortage remains a major obstacle for liver transplantation, resulting in an increased mortality on the liver transplant waiting list. The usage of extended criteria donors (ECD) is a strategy to increase the number of available donor organs, however, with the risk of a higher rate of posttransplant graft dysfunction. Novel preservation strategies, such as warm ex-vivo liver perfusion, could improve the outcome of liver transplantation with ECD grafts. The present review summarizes the advances in the field of warm ex-vivo liver perfusion over the last 12 months...
December 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28885774/small-for-size-grafts-increase-recurrence-of-hepatocellular-carcinoma-in-liver-transplantation-beyond-milan-criteria
#17
Eung Chang Lee, Seong Hoon Kim, Jae Ryong Shim, Sang-Jae Park
BACKGROUND: Living donor liver transplantation (LDLT) has been reported to have high rates of hepatocellular carcinoma (HCC) recurrence compared to deceased donor liver transplant (DDLT). This has been assumed to be due to the frequent use of small-for-size grafts (SFSG) in LDLT rather than DDLT, but the relationship between graft size and prognosis remains controversial. This study aimed to clarify the effect of SFSG on the oncologic outcomes of patients with HCC who underwent LDLT. METHODS: Between January 2005 and December 2015, 597 consecutive patients underwent LDLT...
September 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28882367/defining-the-phenotype-of-antibody-mediated-rejection-in-kidney-transplantation-advances-in-diagnosis-of-antibody-injury
#18
REVIEW
Neetika Garg, Milagros D Samaniego, Dana Clark, Arjang Djamali
The diagnostic criteria for antibody-mediated rejection (ABMR) are constantly evolving in light of the evidence. Inclusion of C4d-negative ABMR has been one of the major advances in the Banff Classification in recent years. Currently Banff 2015 classification requires evidence of donor specific antibodies (DSA), interaction between DSA and the endothelium, and acute tissue injury (in the form of microvasculature injury (MVI); acute thrombotic microangiopathy; or acute tubular injury in the absence of other apparent cause)...
October 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28834072/a-severely-cholestatic-liver-graft-can-be-successfully-used-in-deceased-donor-liver-transplantation
#19
Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Soichi Narumoto, Toshihiro Kitajima, Rie Irie, Akinari Fukuda, Takako Yoshioka, Mureo Kasahara
The shortage of deceased organs is still a serious issue in Japan. A proactive approach to using liver grafts from extended criteria donors (ECDs) may be one way of expanding the donor pool; however, if it is recklessly attempted, a recipient receiving such a marginal graft can be at risk of mortality due to the primary non-function or a delayed graft function. We herein report the successful outcome of a recipient receiving a severely cholestatic graft that was considered transplantable because it lacked features characteristic of a long duration of "cholestasis" according to the precise interpretation of a donor biopsy...
August 18, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28771117/trends-in-deceased-donor-kidney-availability-and-utilization-in-the-kingdom-of-saudi-arabia
#20
Fayez Hejaili, Besher Attar, Faissal A M Shaheen
OBJECTIVES: We investigated trends in deceased donor kidney availability and utilization in Saudi Arabia, wait list changes, and recipient characteristics. MATERIALS AND METHODS: Ten-year registry data from the Saudi Center for Organ Transplantation were analyzed, including consent/discard rates, numbers of kidneys from deceased donors versus expanded criteria and standard criteria donors, wait list characteristics, dialysis characteristics, and causes of chronic kidney disease...
August 2017: Experimental and Clinical Transplantation
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