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Obesity and transplant

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https://www.readbyqxmd.com/read/28528269/bariatric-surgery-for-the-obese-patients-undergoing-liver-transplantation-the-case-for
#1
Anya Adair
The incidence of obesity is rising exponentially. This is having a direct impact on liver transplantation due to an increase in NAFLD disease and numbers of overweight and obese patients requiring transplantation. There is now evidence suggesting that obesity has a negative impact on both graft and patient survival. There remains an imbalance between number of donors available and patients requiring transplantation. We therefore need to ensure we make the best use of the organs available, optimizing graft and patient survival in those fortunate enough to receive an organ...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528267/using-mri-to-non-invasively-and-accurately-quantify-preoperative-hepatic-steatosis
#2
Callisia N Clarke, Haesun Choi, Ping Hou, Catherine H Davis, Jingfei Ma, Asif Rashid, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND: The obesity epidemic has significantly increased the incidence and severity of hepatic steatosis in liver surgery patients and liver donors, potentially impacting postoperative liver regeneration and function. Development of a non-invasive means to quantify hepatic steatosis would facilitate selection of candidates for liver resection and transplant donation. METHODS: An IRB-approved protocol prospectively enrolled 28 patients with liver tumors requiring hepatic resection...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28527810/hif-1%C3%AE-stabilizing-agent-fg-4997-rescues-human-cd34-cell-mobilization-in-response-to-g-csf-in-immuno-deficient-mice
#3
Bianca Nowlan, Katarzyna Futrega, Marion E Brunck, Gail Walkinshaw, Lee E Flippin, Michael R Doran, Jean-Pierre Levesque
Granulocyte colony-stimulating factor (G-CSF) is routinely used in the clinic to mobilize hematopoietic stem progenitor cells (HSPC) into the patient's blood for collection and subsequent transplantation. However a significant proportion of patients who have previously received chemotherapy or radiotherapy and requiring autologous HSPC transplantation, cannot mobilize the minimal threshold of mobilized HSPC to achieve rapid and successful hematopoietic reconstitution. Although several alternatives to the G-CSF regime have been tested, few are in use in the clinic...
May 17, 2017: Experimental Hematology
https://www.readbyqxmd.com/read/28521870/the-use-of-statins-alone-or-in-combination-with-pioglitazone-and-other-drugs-for-the-treatment-of-non-alcoholic-fatty-liver-disease-non-alcoholic-steatohepatitis-and-related-cardiovascular-risk-an-expert-panel-statement
#4
REVIEW
Vasilios G Athyros, Theodore K Alexandrides, Helen Bilianou, Evangelos Cholongitas, Michael Doumas, Emmanuel S Ganotakis, John Goudevenos, Moses S Elisaf, Georgios Germanidis, Olga Giouleme, Asterios Karagiannis, Charalambos Karvounis, Niki Katsiki, Vasilios Kotsis, Jannis Kountouras, Evangelos Liberopoulos, Christos Pitsavos, Stergios Polyzos, Loukianos S Rallidis, Dimitrios Richter, Apostolos G Tsapas, Alexandros D Tselepis, Konstantinos Tsioufis, Konstantinos Tziomalos, Themistoklis Tzotzas, Themistoklis G Vasiliadis, Charalambos Vlachopoulos, Dimitri P Mikhailidis, Christos Mantzoros
Non-alcoholic fatty liver disease (NAFLD), the most common liver disease, is characterized by accumulation of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. It is closely related to the epidemic of obesity, metabolic syndrome or type 2 diabetes mellitus (T2DM). NAFLD can cause liver inflammation and progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis or hepatocellular cancer (HCC). Nevertheless, cardiovascular disease (CVD) is the most common cause of death in NAFLD/NASH patients...
June 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28520574/orthotopic-liver-transplantation-changes-the-course-of-gastric-antral-vascular-ectasia-a-case-series-from-a-transplant-center
#5
Chaitanya Allamneni, Basem Alkurdi, Rehan Naseemuddin, Brendan M McGuire, Mohamed G Shoreibah, Devin E Eckhoff, Shajan Peter
BACKGROUND AND AIM: Gastric antral vascular ectasia (GAVE) is an important cause of upper gastrointestinal bleeding and anemia in patients with cirrhosis. The aim of our study was to evaluate the effect of orthotopic liver transplantation (OLT) on GAVE and associated anemia. PATIENTS AND METHODS: We performed a chart review and identified all cirrhotic patients with GAVE who underwent OLT at the University Of Alabama at Birmingham between 2005 and 2013. Population's demographics, etiology of cirrhosis, comorbidities, presentation and treatment modalities of GAVE, endoscopic and histopathologic reports, hemoglobin values before and after transplant, and immunosuppressive regimens were collected...
May 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28515845/diagnosis-of-morbid-obesity-may-not-impact-healthcare-utilization-for-orthotopic-liver-transplantation-a-propensity-matched-study
#6
Joshua R Peck, Nicholas Latchana, Anthony Michaels, Adam J Hanje, Alice Hinton, Elmahdi A Elkhammas, Sylvester M Black, Khalid Mumtaz
AIM: To study mortality, length of stay, and total charges in morbidly obese adults during index hospitalization for orthotopic liver transplantation. METHODS: The Nationwide Inpatient Sample was queried to obtain demographics, healthcare utilization, post orthotopic liver transplantation (OLT) complications, and short term outcomes of OLT performed from 2003 to 2011 (n = 46509). We divided patients into those with [body mass index (BMI) ≥ 40] and without (BMI < 40) morbid obesity...
April 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28501338/risk-factors-for-metabolic-syndrome-after-liver-transplantation-a-systematic-review-and-meta-analysis
#7
REVIEW
Line Buch Thoefner, Andreas Arendtsen Rostved, Hans-Christian Pommergaard, Allan Rasmussen
INTRODUCTION: Metabolic syndrome is associated with increased risk of cardiovascular events, which contributes to the elevated mortality rate among liver transplant recipients. The objective of this systematic review and meta-analysis was to assess the prevalence and risk factors for metabolic syndrome after liver transplantation. METHODS: The databases Medline and Scopus were searched for observational studies evaluating prevalence and risk factors for metabolic syndrome after liver transplantation...
April 23, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28500419/bariatric-surgery-as-a-bridge-to-renal-transplantation-in-patients-with-end-stage-renal-disease
#8
Shadi Al-Bahri, Tannous K Fakhry, John Paul Gonzalvo, Michel M Murr
BACKGROUND: Obesity is a relative contraindication to organ transplantation. Preliminary reports suggest that bariatric surgery may be used as a bridge to transplantation in patients who are not eligible for transplantation because of morbid obesity. SETTING: The Bariatric Center at Tampa General Hospital, University of South Florida, Tampa, Florida. METHODS: We reviewed the outcomes of 16 consecutive patients on hemodialysis for end-stage renal disease (ESRD) who underwent bariatric surgery from 1998 to 2016...
May 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28493926/obesity-and-access-to-kidney-transplantation-in-patients-starting-dialysis-a-prospective-cohort-study
#9
Mathilde Lassalle, Léopold K Fezeu, Cécile Couchoud, Thierry Hannedouche, Ziad A Massy, Sébastien Czernichow
BACKGROUND: Obesity has been linked to poor access to medical care. Although scientific evidence suggest that kidney transplantation improves survival and quality of life in obese patients with end-stage renal disease (ESRD), few data exist on the impact of obesity on access to kidney transplantation in this population. OBJECTIVES: We aimed to characterize the relationships between body mass index (BMI) at the start of dialysis, changes in BMI after the start of dialysis, and either access to kidney transplantation or overall mortality in dialysis or transplantation among ESRD patients...
2017: PloS One
https://www.readbyqxmd.com/read/28488418/systematic-review-with-meta-analysis-post-operative-complications-and-mortality-risk-in-liver-transplant-candidates-with-obesity
#10
REVIEW
M Barone, M T Viggiani, G Losurdo, M Principi, G Leandro, A Di Leo
BACKGROUND: International guidelines rate class III (morbid) obesity (body mass index [BMI]≥40 kg/m(2) ) as a relative contraindication for liver transplantation (LT) requiring further research. Moreover, data on the mortality risk in candidates with a BMI: 30-34.9 and 35-39.9 kg/m(2) (class I and class II obesity, respectively) are weak. AIM: Herein, we compared post-operative complications and mortality risks in all obese candidates vs candidates with a BMI: 18...
May 10, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28473444/role-of-adipose-tissue-endothelial-adam17-in-age-related-coronary-microvascular-dysfunction
#11
Huijuan Dou, Attila Feher, Alec C Davila, Maritza J Romero, Vijay S Patel, Vinayak M Kamath, Monika Beck Gooz, R Daniel Rudic, Rudolf Lucas, David J Fulton, Neal L Weintraub, Zsolt Bagi
OBJECTIVE: A disintegrin and metalloproteinase ADAM17 (tumor necrosis factor-α [TNF]-converting enzyme) regulates soluble TNF levels. We tested the hypothesis that aging-induced activation in adipose tissue (AT)-expressed ADAM17 contributes to the development of remote coronary microvascular dysfunction in obesity. APPROACH AND RESULTS: Coronary arterioles (CAs, ≈90 µm) from right atrial appendages and mediastinal AT were examined in patients (aged: 69±11 years, BMI: 30...
May 4, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28473440/deficiency-of-lrp1-in-mature-adipocytes-promotes-diet-induced-inflammation-and-atherosclerosis-brief-report
#12
Eddy S Konaniah, David G Kuhel, Joshua E Basford, Neal L Weintraub, David Y Hui
OBJECTIVE: Mice with adipocyte-specific inactivation of low-density lipoprotein receptor-related protein-1 (LRP1) are resistant to diet-induced obesity and hyperglycemia because of compensatory thermogenic response by muscle. However, the physiological function of LRP1 in mature adipocytes and its role in cardiovascular disease modulation are unknown. This study compared perivascular adipose tissues (PVAT) from wild-type (adLrp1(+/+)) and adipocyte-specific LRP1 knockout (adLrp1(-/-)) mice in modulation of atherosclerosis progression...
June 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28473066/acr-appropriateness-criteria-%C3%A2-chronic-liver%C3%A2-disease
#13
Jeanne M Horowitz, Ihab R Kamel, Hina Arif-Tiwari, Sumeet K Asrani, Nicole M Hindman, Harmeet Kaur, Michelle M McNamara, Richard B Noto, Aliya Qayyum, Tasneem Lalani
Because liver fibrosis can be treated, it is important to diagnose liver fibrosis noninvasively and monitor response to treatment. Although ultrasound (grayscale and Doppler) can diagnose cirrhosis, it does so unreliably using morphologic and sonographic features and cannot diagnose the earlier, treatable stages of hepatic fibrosis. Transient elastography, ultrasound elastography with acoustic radiation force impulse, and MR elastography are modalities that can assess for hepatic fibrosis. Although all international organizations recommend ultrasound for screening for hepatocellular carcinoma, ultrasound is particularly limited for identifying hepatocellular carcinoma in patients with obesity, nonalcoholic fatty liver disease, and nodular cirrhotic livers...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28469809/hepatocellular-carcinoma-in-non-alcoholic-steatohepatitis-current-knowledge-and-implications-for-management
#14
REVIEW
George Cholankeril, Ronak Patel, Sandeep Khurana, Sanjaya K Satapathy
With the prevalence of hepatitis C virus expected to decline, the proportion of hepatocellular carcinoma (HCC) related to non-alcoholic steatohepatitis (NASH) is anticipated to increase exponentially due to the growing epidemic of obesity and diabetes. The annual incidence rate of developing HCC in patients with NASH-related cirrhosis is not clearly understood with rates ranging from 2.6%-12.8%. While multiple new mechanisms have been implicated in the development of HCC in NASH; further prospective long-term studies are needed to validate these findings...
April 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28469071/tetrahydrobiopterin-activates-brown-adipose-tissue-and-regulates-systemic-energy-metabolism
#15
Yasuo Oguri, Yoshihito Fujita, Abulizi Abudukadier, Akiko Ohashi, Tsuyoshi Goto, Futoshi Furuya, Akio Obara, Toru Fukushima, Naomi Matsuo, Minji Kim, Masaya Hosokawa, Teruo Kawada, Hiroyuki Hasegawa, Nobuya Inagaki
Brown adipose tissue (BAT) is a central organ that acts to increase energy expenditure; its regulatory factors could be clinically useful in the treatment of obesity. Tetrahydrobiopterin (BH4) is an essential cofactor of tyrosine hydroxylase and nitric oxide synthase (NOS). Although BH4 regulates the known regulatory factors of BAT, such as noradrenaline (NA) and NO, participation of BH4 in BAT function remains unclear. In the present study, we investigate the role of BH4 in the regulation of BAT. Hph-1 mice, a mouse model of BH4 deficiency, exhibit obesity, adiposity, glucose intolerance, insulin resistance, and impaired BAT function...
May 4, 2017: JCI Insight
https://www.readbyqxmd.com/read/28458462/partial-lipodystrophy-in-patients-who-have-undergone-hematopoietic-stem-cell-transplantation-during-childhood-an-institutional-cross-sectional-survey
#16
Masanori Adachi, Yuji Oto, Koji Muroya, Junko Hanakawa, Yumi Asakura, Hiroaki Goto
Partial lipodystrophy (PD), a condition similar to metabolic syndrome without obesity, is one of the late complications of hematopoietic stem cell transplantation (HSCT) performed during childhood. We aimed to investigate the prevalence and risk factors of PD. A cross-sectional survey was performed in a children's hospital, targeting patients treated for a malignancy or hematological disorder, and who were disease-free for > 24 mo. PD was defined as gluteal lipoatrophy and lipohypertrophy of the cheeks or neck associated with diabetes and/or fatty liver disease...
2017: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
https://www.readbyqxmd.com/read/28457422/co-transplantation-of-xenogeneic-bone-marrow-derived-mesenchymal-stem-cells-alleviates-rejection-of-pancreatic-islets-in-non-obese-diabetic-mice
#17
C Corradi-Perini, T M Santos, N O S Camara, M C Riella, C A M Aita
Bone marrow-mesenchymal stem cells (BM-MSCs) have generated a great perspective in the field of regenerative medicine, and also in the treatment of inflammatory and autoimmune diseases in the past decade due to their immunomodulatory and anti-inflammatory properties. Here, we investigated the effect of xenogeneic BM-MSCs and pancreatic islets co-transplantation obtained from Wistar rats in preventing rejection or inducing tolerance to islet transplantation in non-obese diabetic mice. Non-obese diabetic mice were treated with co-transplantation of pancreatic islets and BM-MSCs (islet + MSCs group) or pancreatic islets only (islet group)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457403/surgical-complications-in-early-post-transplant-kidney-recipients
#18
H Pinto, R Leal, L Rodrigues, L Santos, C Romãozinho, F Macário, R Alves, C Bastos, A Roseiro, F Costa, M Campos, A Mota, A Figueiredo
BACKGROUND: The purpose of this study was to determine the incidence of early surgical complications of kidney transplantation in our institution and its association with donor and recipient factors, as well as patient and transplant outcome. METHODS: A retrospective cohort study of all kidney transplants performed during 2015 was made. We evaluated the incidence of surgical complications and the outcome of patients and grafts at a 3-month follow-up interval. RESULTS: During the study period, 141 kidney transplants occurred...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457383/kidney-transplantation-in-alstr%C3%A3-m-syndrome-case-report
#19
L Poli, G Arroyo, M Garofalo, E Choppin de Janvry, G Intini, A Saracino, R Pretagostini, F Della Pietra, P B Berloco
The Alström syndrome is a rare genetic disorder, inherited in an autosomal recessive manner. It has recently been classified as a ciliopathic disorder. Alström syndrome is a multiorgan pathology characterized by cone-rod dystrophy, hearing loss, childhood truncal obesity, insulin resistance and hyperinsulinemia, type 2 diabetes mellitus, dyslipidemia, short stature in adulthood, hypothyroidism, hypogonadism, dilated or restrictive cardiomyopathy, and progressive pulmonary, hepatic, and renal dysfunction. End-stage renal disease can occur as early as the late teens and is the leading cause of death...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457364/bariatric-surgery-to-target-obesity-in-the-renal-transplant-population-preliminary-experience-in-a-single-center
#20
P G Gazzetta, M Bissolati, A Saibene, C G A Ghidini, G Guarneri, F Giannone, O Adamenko, A Secchi, R Rosati, C Socci
During the last century, obesity has become a global epidemic. The effect of obesity on renal transplantation may occur in perioperative complications and impairment of organ function. Obese patients have metabolic derangements that can be exacerbated after transplantation and obesity directly impacts most transplantation outcomes. These recipients are more likely to develop adverse graft events, such as delayed graft function and early graft loss. Furthermore, obesity is synergic to some immunosuppressive agents in triggering diabetes and hypertension...
May 2017: Transplantation Proceedings
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