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Obesity and transplant

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https://www.readbyqxmd.com/read/29239576/living-donor-kidney-transplantation
#1
Ilkka Helanterä, Eero Honkanen, Jutta Huhti, Helena Isoniemi, Hannu Jalanko, Marko Lempinen, Marja Miettinen, Arno Nordin, Risto Tertti, Satu Mäkelä
While the majority of kidney transplantations in Finland have been traditionally performed from deceased donors, the frequency of living donors should be increased. Kidney donation is a safe procedure for a carefully examined donor, and for the recipient living donation enables elective surgery and preemptive transplantation. Potential risks for the donor must be minimized, but according to current recommendations, mild hypertension or obesity are not absolute contraindications for donation. Guidelines for donor selection and examination have been updated to simplify the process for all parties...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29234200/nutrition-and-muscle-in-cirrhosis
#2
REVIEW
Anil C Anand
As the cirrhosis progresses, development of complication like ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma signify increasing risk of short term mortality. Malnutrition and muscle wasting (sarcopenia) is yet other complications that negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Conventionally, these are not routinely looked for, because nutritional assessment can be a difficult especially if there is associated fluid retention and/or obesity...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29226105/non-alcoholic-fatty-liver-disease-a-clinical-update
#3
REVIEW
Joseph M Pappachan, Shithu Babu, Babu Krishnan, Nishal C Ravindran
Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease in developed countries because of the obesity epidemic. The disease increases liver-related morbidity and mortality, and often increases the risk for other comorbidities, such as type 2 diabetes and cardiovascular disease. Insulin resistance related to metabolic syndrome is the main pathogenic trigger that, in association with adverse genetic, humoral, hormonal and lifestyle factors, precipitates development of NAFLD...
December 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29225163/impact-of-dose-adjusted-melphalan-in-obese-patients-undergoing-autologous-stem-cell-transplantation
#4
Kendall Shultes, Christopher Arp, Keith Stockerl-Goldstein, Kathryn Trinkaus, Sean DeFrates
BACKGROUND: Limited guidance exists for dosing melphalan (MEL) for autologous stem cell transplantation (ASCT) in the obese patient population as the current literature reports conflicting clinical outcomes between obese and non-obese patients. In 2014, the American Society for Blood and Marrow Transplantation published conditioning chemotherapy dosing guidelines for obese patients and recommended MEL be dosed utilizing actual body weight (ABW) in the body surface area calculation. Practice at Barnes-Jewish Hospital has consistently been to dose MEL using an adjusted body weight (AdBW) with a 20% correction when patients weigh greater than or equal to 120% their ideal body weight (IBW)...
December 7, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29224938/subclinical-atherosclerosis-in-pediatric-liver-transplant-recipients-carotid-and-aorta-intima-media-thickness-and-their-predictors
#5
Emily R Perito, Andrew Phelps, Tabitha Vase, Vickie A Feldstein, Robert H Lustig, Philip Rosenthal
OBJECTIVE: To investigate prevalence and predictors of cardiovascular risk in pediatric liver transplant recipients using noninvasive markers of subclinical atherosclerosis: carotid intima-media thickness (cIMT) and aorta intima-media thickness (aIMT). STUDY DESIGN: Cross-sectional study of 88 pediatric liver transplant recipients. The cIMT and aIMT were measured by ultrasound imaging using standardized protocol. RESULTS: Participants were 15...
December 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29223620/impact-of-obesity-on-modality-longevity-residual-kidney-function-peritonitis-and-survival-among-incident-peritoneal-dialysis-patients
#6
Yoshitsugu Obi, Elani Streja, Rajnish Mehrotra, Matthew B Rivara, Connie M Rhee, Melissa Soohoo, Daniel L Gillen, Wei-Ling Lau, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: The prevalence of severe obesity, often considered a contraindication to peritoneal dialysis (PD), has increased over time. However, mortality has decreased more rapidly in the PD population than the hemodialysis (HD) population in the United States. The association between obesity and clinical outcomes among patients with end-stage kidney disease remains unclear in the current era. STUDY DESIGN: Historical cohort study. SETTING & PARTICIPANTS: 15,573 incident PD patients from a large US dialysis organization (2007-2011)...
December 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29222858/obesity-lipid-profiles-and-oxidative-stress-in-children-after-liver-transplantation
#7
Piotr Czubkowski, Aldona Wierzbicka, Joanna Pawłowska, Irena Jankowska, Piotr Socha
PURPOSE: In adult liver transplant recipients, coronary artery disease and congestive heart failure are significant cause of morbidity and mortality. This may be attributed to the long-term immunosuppressive treatment, mostly with calcineurin inhibitors and steroids, which in long-term may be associated with hyperlipidemia, oxidative stress and cardiovascular complications. Since such data for children is sparse, the aim of this study was to assess the lipid and oxidative stress markers after pediatric liver transplantation (LTx)...
December 10, 2017: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/29207219/-donor-and-recipient-selection-in-living-donor-kidney-transplantation-eligibility
#8
REVIEW
Marilena Gregorini, Eleonora Francesca Pattonieri, Gianluca Fasoli, Mauro Valente, Edoardo La Porta, Michele Canevari, Fulvia Erasmi, Teresa Rampino
This review is intended to be a guide for the physician to evaluate and prepare a donor / recipient couple for living kidney transplantation. Although it is intended to be exhaustive, it will not be able to respond at all possible and different cases, but it may apply at most of them. Renal transplantation is considered the choice treatment for patients with chronic renal failure and if the kidney transplant is performed pre-emptive it is associated with better organ and patient survival. The main aim of the program is to evaluate the risks of donor and recipient and to ensure the donor safety and well-being...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29198562/disease-burden-and-costs-from-excess-alcohol-consumption-obesity-and-viral-hepatitis-fourth-report-of-the-lancet-standing-commission-on-liver-disease-in-the-uk
#9
REVIEW
Roger Williams, Graeme Alexander, Iain Armstrong, Alastair Baker, Neeraj Bhala, Ginny Camps-Walsh, Matthew E Cramp, Simon de Lusignan, Natalie Day, Anil Dhawan, John Dillon, Colin Drummond, Jessica Dyson, Graham Foster, Ian Gilmore, Mark Hudson, Deirdre Kelly, Andrew Langford, Neil McDougall, Petra Meier, Kieran Moriarty, Philip Newsome, John O'Grady, Rachel Pryke, Liz Rolfe, Peter Rice, Harry Rutter, Nick Sheron, Alison Taylor, Jeremy Thompson, Douglas Thorburn, Julia Verne, John Wass, Andrew Yeoman
This report contains new and follow-up metric data relating to the eight main recommendations of the Lancet Standing Commission on Liver Disease in the UK, which aim to reduce the unacceptable harmful consequences of excess alcohol consumption, obesity, and viral hepatitis. For alcohol, we provide data on alcohol dependence, damage to families, and the documented increase in alcohol consumption since removal of the above-inflation alcohol duty escalator. Alcoholic liver disease will shortly overtake ischaemic heart disease with regard to years of working life lost...
November 28, 2017: Lancet
https://www.readbyqxmd.com/read/29197678/adipokines-inflammation-and-adiposity-in-hematopoietic-cell-transplant-survivors
#10
Tyler G Ketterl, Eric J Chow, Wendy M Leisenring, Pam Goodman, Ildi H Koves, Anna Petryk, Julia Steinberger, K Scott Baker
Adult survivors of acute leukemia in childhood have a higher than expected frequency of obesity, an increased risk for metabolic syndrome and early mortality from cardiovascular disease (CVD). Adipose tissue has been recognized as an endocrine and paracrine organ that secretes various adipokines involved in metabolic regulation and inflammatory processes. Examine inflammatory factors [IL-6 and TNF-] and adipokines (adiponectin, leptin) in addition to body composition and adiposity in cancer survivors who underwent hematopoietic cell transplantation (HCT) during childhood in comparison to sibling controls...
November 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29189286/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#11
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
November 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29173979/-dose-adaptation-of-the-drugs-used-for-hematopoietic-stem-cell-transplantation-in-patients-with-comorbidity-obesity-chronic-renal-disease-or-hepatopathy-guidelines-from-the-francophone-society-of-bone-marrow-transplantation-and-cellular-therapy-sfgm-tc
#12
Nicolas Simon, Valérie Coiteux, Bénédicte Bruno, Sophie Taque, Amandine Charbonnier, Laetitia Souchet, Laure Vincent, Ibrahim Yakoub-Agha, Yves Chalandon
In September 2016 in Lille, France, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organized the 7th Allogeneic Stem Cell Transplantation Clinical Practices Harmonization Workshop Series. Our work group focused on chemotherapy drug dose adaptation for hematopoietic stem cell transplantation patients presenting a comorbidity. The purpose of this workshop was to provide recommendations on chemotherapy drug dose adaptation for patient populations receiving hematopoietic stem cell transplantation who also had the following comorbidities: obesity, chronic kidney disease and hepatopathy...
November 22, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29161082/gut-microbiome-and-obesity-how-to-prove-causality
#13
Philippe Gérard
In recent years, the gut microbiota (the microorganisms that live in our digestive tract) has become an area of great interest. Indeed, this intestinal microbial community performs essential functions in maintaining our health, and has been proven to influence host physiology and metabolism. Thereby, dysregulation of this gut microbiota may be implicated in the development of various diseases, including obesity. However, studies rarely assess causality, which requires the use of germ-free animals and microbiota transplant...
November 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29157127/modulation-of-the-gut-microbiota-by-metformin-improves-metabolic-profiles-in-aged-obese-mice
#14
Heetae Lee, Youngjoo Lee, Jiyeon Kim, Jinho An, Sungwon Lee, Hyunseok Kong, Youngcheon Song, Chong-Kil Lee, Kyungjae Kim
The gut microbiota is a contributing factor in obesity-related metabolic disorders. The effect of metformin on the gut microbiota has been reported; however, the relationship between the gut microbiota and the mechanism of action of metformin in elderly individuals is unclear. In this study, the effect of metformin on the gut microbiota was investigated in aged obese mice. The abundance of the genera Akkermansia, Bacteroides, Butyricimonas, and Parabacteroides was significantly increased by metformin in mice fed a high-fat diet...
November 20, 2017: Gut Microbes
https://www.readbyqxmd.com/read/29156003/chronic-respiratory-disease-an-unrecognized-risk-factor-in-dialysis
#15
Cécile Couchoud, Clémence Béchade, Abdelkader Bemrah, Jean-Christophe Delarozière, Guillaume Jean
Background: Few studies have analysed the impact of chronic respiratory disease (CRD) on outcomes in dialysis. We therefore sought to describe patients with CRD and end-stage renal disease and their outcomes after dialysis start, compared with patients without CRD, focusing especially on causes of death, access to renal transplantation and causes of hospital admissions. Methods: The study included 52 797 adults aged 18 years and older who began dialysis from 2008 to 2013 and are recorded in the French national REIN registry...
May 30, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29152478/changes-in-dietary-patterns-and-body-composition-within-12-months-of-liver-transplantation
#16
Simone M McCoy, Katrina L Campbell, Annie-Claude M Lassemillante, Matthew P Wallen, Jonathan Fawcett, Maree Jarrett, Graeme A Macdonald, Ingrid J Hickman
Background: Cardiometabolic risk factors are increasing in liver transplant recipients (LTR). Influencing dietary factors have not been assessed. The aim of this observational study was to assess changes in weight, metabolic function, dietary intake and eating behaviours in the first year after orthotopic liver transplantation (OLT). Methods: Consecutive recruitment of 17 patients (14 males) awaiting OLT at a single tertiary hospital. Dietary intake, food behaviours and anthropometry were recorded at baseline, and 6 and 12 months post-transplant...
October 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29151569/what-kind-of-incision-should-be-made-to-reduce-the-risk-of-incisional-hernia-in-kidney-transplantation
#17
Ihsan Yildız, Yavuz Savas Koca
BACKGROUND The incidence of incisional hernia following renal transplantation is 1.1% to 3.8%. The risk factors are immunosuppressive medications, impaired tissue quality, neuromuscular trauma due to the operation, and denervation. The incidence has been decreasing based on the shift from hockey-stick incision method to inguinal oblique incision method. The aim of this study was to minimize the development of incisional hernias due to renal transplantation. MATERIAL AND METHODS Twenty-four patients who underwent renal transplantation in 2015-2017 were retrospectively examined...
November 20, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29149954/preoperative-risk-factors-associated-with-urinary-complications-after-kidney-transplantation
#18
T Bessede, Y Hammoudi, D Bedretdinova, B Parier, H Francois, A Durrbach, G Benoit
BACKGROUND: Only surgically irrelevant risk factors including sex, African-American ancestry, or exceptional U-stitch anastomosis have been identified to associate with urinary complications after kidney transplantation. The objective was to identify modifiable and nonmodifiable risk factors associated with urinary complications after kidney transplantation. METHODS: A single-center study of 3,129 kidney transplants performed over 40 years was conducted to identify independent risk factors using χ(2) tests and logistic regression analysis...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29146891/heart-transplantation-and-risk-of-cardiac-vasculopathy-development-what-factors-are-important
#19
Małgorzata Sobieszczańska-Małek, Jerzy Korewicki, Krzysztof Komuda, Małgorzata Karczmarz, Sylwia Szymańska, Alicja Cicha-Mikołajczyk, Paweł Bekta, Adam Parulski, Maciej Pronicki, Wiesława Grajkowska, Grzegorz Małek, Przemysław Leszek, Maria Kaczorowska, Mariusz Kuśmierczyk, Tomasz Zieliński
BACKGROUND The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL AND METHODS There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest)...
November 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29146734/humanized-mice-in-studying-efficacy-and-mechanisms-of-pd-1-targeted-cancer-immunotherapy
#20
Minan Wang, Li-Chin Yao, Mingshan Cheng, Danying Cai, Jan Martinek, Chong-Xian Pan, Wei Shi, Ai-Hong Ma, Ralph W De Vere White, Susan Airhart, Edison T Liu, Jacques Banchereau, Michael A Brehm, Dale L Greiner, Leonard D Shultz, Karolina Palucka, James G Keck
Establishment of an in vivo small animal model of human tumor and human immune system interaction would enable preclinical investigations into the mechanisms underlying cancer immunotherapy. To this end, non-obese diabetic (NOD).Cg-Prkdc(scid)IL2rg(tm1Wjl) /Sz (null; NSG) mice were transplanted with human (h)CD34(+) hematopoietic progenitor and stem cells, which leads to the development of human hematopoietic and immune systems [humanized NSG (HuNSG)]. HuNSG mice received human leukocyte antigen partially matched tumor implants from patient-derived xenografts [PDX; nonsmall cell lung cancer (NSCLC), sarcoma, bladder cancer, and triple-negative breast cancer (TNBC)] or from a TNBC cell line-derived xenograft (CDX)...
November 16, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
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