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Obesity and transplant

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https://www.readbyqxmd.com/read/28320971/neuroendocrine-androgen-action-is-a-key-extraovarian-mediator-in-the-development-of-polycystic-ovary-syndrome
#1
Aimee S L Caldwell, Melissa C Edwards, Reena Desai, Mark Jimenez, Robert B Gilchrist, David J Handelsman, Kirsty A Walters
Polycystic ovary syndrome (PCOS) is a complex hormonal disorder characterized by reproductive, endocrine, and metabolic abnormalities. As the origins of PCOS remain unknown, mechanism-based treatments are not feasible and current management relies on treatment of symptoms. Hyperandrogenism is the most consistent PCOS characteristic; however, it is unclear whether androgen excess, which is treatable, is a cause or a consequence of PCOS. As androgens mediate their actions via the androgen receptor (AR), we combined a mouse model of dihydrotestosterone (DHT)-induced PCOS with global and cell-specific AR-resistant (ARKO) mice to investigate the locus of androgen actions that mediate the development of the PCOS phenotype...
March 20, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28315009/severe-underweight-decreases-the-survival-rate-in-adult-lung-transplantation
#2
Teruya Komatsu, Toyofumi F Chen-Yoshikawa, Ayako Oshima, Shin-Ichi Harashima, Akihiro Aoyama, Nobuya Inagaki, Hiroshi Date
PURPOSE: The body mass index (BMI) before lung transplantation (LT) is a benchmark of the post-LT survival. The aim of the study is to determine the BMI inadequate for the post-LT survival. METHODS: We examined the survival after LT in patients grouped into the following BMI categories: <18.5 kg/m(2) (underweight), 18.5-24.9 kg/m(2) (normal weight), 25-29.9 kg/m(2) (overweight), and ≥30.0 kg/m(2) (obese) according to the World Health Organization (WHO) criteria...
March 17, 2017: Surgery Today
https://www.readbyqxmd.com/read/28314081/delirium-after-lung-transplantation-association-with-recipient-characteristics-hospital-resource-utilization-and-mortality
#3
Yelizaveta Sher, Joshua Mooney, Gundeep Dhillon, Roy Lee, José R Maldonado
BACKGROUND: Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized. METHODS: The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS and one-year mortality...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#4
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T-cells were measured using an interferon-γ Elispot-assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28293093/clinical-features-and-natural-history-of-cryptogenic-cirrhosis-compared-to-hepatitis-c-virus-related-cirrhosis
#5
Luca Rinaldi, Fabio Nascimbeni, Mauro Giordano, Chiara Masetti, Barbara Guerrera, Annalisa Amelia, Maria Chiara Fascione, Stefano Ballestri, Dante Romagnoli, Rosa Zampino, Riccardo Nevola, Enrica Baldelli, Natalina Iuliano, Valerio Rosato, Amedeo Lonardo, Luigi Elio Adinolfi
AIM: To characterize natural history of cryptogenic cirrhosis (CC) and compare its clinical features and outcomes to those of hepatitis C virus (HCV)-related cirrhosis. METHODS: A prospective cohort of 102 consecutive patients at their first diagnosis of CC were enrolled in this study. The clinical data and outcomes were compared to an age- and Child-Pugh class-matched cohort of 110 patients with HCV-related cirrhosis. Diagnosis of cirrhosis was based on compatible clinical and laboratory parameters, ultrasound/endoscopic parameters and, whenever possible, on histological grounds and transient elastography...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28286571/we-are-not-alone-a-case-for-the-human-microbiome-in-extra-intestinal-diseases
#6
EDITORIAL
S Shivaji
BACKGROUND: "Dysbiosis" in the gut microbiome has been implicated in auto-immune diseases, in inflammatory diseases, in some cancers and mental disorders. The challenge is to unravel the cellular and molecular basis of dysbiosis so as to understand the disease manifestation. MAIN BODY: Next generation sequencing and genome enabled technologies have led to the establishment of the composition of gut microbiomes and established that "dysbiosis" is the cause of several diseases...
2017: Gut Pathogens
https://www.readbyqxmd.com/read/28282006/a-nationwide-analysis-of-kidney-autotransplantation
#7
Zhobin Moghadamyeghaneh, Mark H Hanna, Reza Fazlalizadeh, Yoshitsugu Obi, Clarence E Foster, Michael J Stamos, Hirohito Ichii
There are limited data regarding outcomes of patients underwent kidney autotransplantation. This study aims to investigate outcomes of such patients. The nationwide inpatient sample database was used to identify patients underwent kidney autotransplantation during 2002 to 2012. Multivariate analyses using logistic regression were performed to investigate morbidity predictors. A total of 817 patients underwent kidney autotransplantation from 2002 to 2012. The most common indication of surgery was renal artery pathology (22...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28281236/simultaneous-liver-transplantation-and-sleeve-gastrectomy-prohibitive-combination-or-a-necessity
#8
Eviatar Nesher, Eytan Mor, Amir Shlomai, Michal Naftaly-Cohen, Renana Yemini, Alexander Yussim, Marius Brown, Andrei Keidar
Previously, many morbidly obese (MO) patients were denied liver transplantation (LT) because of the higher operative risk. However, nowadays, 5 and 10 years graft survival is the rule, and patients whose lives can be prolonged with LT are dying of obesity-related comorbidities. Recent experience suggests that weight reduction in MO liver transplant recipients would improve their long-term survival. The bariatric surgery before LT is contraindicated for patients with decompensated cirrhosis, while post-transplant intervention is associated with increased technical difficulty...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28276326/kidney-transplantation-in-patients-declined-by-other-centres
#9
N H P Glijn, J I Roodnat, F J Dor, M G Betjes, W C Zuidema, W Weimar, S P Berger
BACKGROUND: Transplant centres show considerable disagreement in the acceptance of transplant candidates with relative contraindications. The aim of this study is to investigate the outcomes of our patients who had been refused at other centres prior to transplantation at our centre. METHODS: We included patients who had been excluded from transplantation or wait-listing at other centres before referral to our centre. We scored the reasons for refusal at other centres, the type of transplantation procedure, postoperative and long-term complications, patient and graft survival and how these patients experienced the transplantation and quality of life at our centre...
March 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28262264/the-incidence-of-new-onset-diabetes-after-transplantation-and-related-factors-single-center-experience
#10
Ayse Sinangil, Vedat Celik, Soykan Barlas, Yener Koc, Taner Basturk, Tamer Sakaci, Emin Baris Akin, Tevfik Ecder
AIM: New-onset diabetes after transplantation (NODAT) is a frequent metabolic complication and is considered a risk factor for patients undergoing renal transplant. The aim of this study was to evaluate the incidence and developing duration of new-onset diabetes after transplant (NODAT) and influencing factors. METHODS: All patients' data was investigated retrospectively. Diabetics, follow-up period<6 months, age<18years were excluded. Demographic, clinical and laboratory data was recorded...
March 2, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28260464/incisional-hernia-after-liver-transplant
#11
Ebru H Ayvazoglu Soy, Mahir Kirnap, Sedat Yildirim, Gokhan Moray, Mehmet Haberal
OBJECTIVES: An incisional hernia seriously burdens the quality of life after liver transplant. The incidence of incisional hernia after liver transplant is reported to be 4% to 20%. Here, we evaluated incisional hernias that occurred after adult liver transplant and incisional hernias intentionally made in infant liver transplant procedures. MATERIALS AND METHODS: Between December 1988 and May 2016, we performed 536 liver transplant procedures in 515 patients. Demographic features, surgical outcomes, and predisposing factors were evaluated...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260459/bariatric-surgery-in-renal-transplant-patients
#12
Osama Gheith, Torki Al-Otaibi, Medhat A Halim, Tarek Mahmoud, Ahmed Mosaad, Jude Yagan, Zakaria Zakaria, Suzann Rida, Prasad Nair, Rashad Hassan
OBJECTIVES: The idea of transplanting organs is not new, nor is the disease of obesity. Obese transplant recipients have greater risk of early death than their cohorts, which is not due to increased rejection but due to obesity-related complications, including arterial hypertension, diabetes, and delayed graft function. Here, our aim was to evaluate the effects of bariatric surgery versus lifestyle changes on outcomes of moderate to severely obese renal transplant recipients. MATERIALS AND METHODS: Twenty-two morbidly obese patients with stable graft function who underwent bariatric surgery were compared with 44 obese patients on lifestyle management (control group)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260454/obesity-and-loss-of-kidney-function-two-complications-to-face-for-older-living-kidney-donors
#13
Demet Firat Kaya, Burak Sayin, Hatice Saglam, Bahar Gurlek Demirci, Turan Colak
OBJECTIVES: Although living kidney donors have a minimal lifetime risk of developing end-stage renal disease, long-term complications and physiologic and psychologic sequelae resulting from donation remain unclear because of lack of optimum follow-up after transplant. Here, we evaluated renal function, complications, and physical and mental performance of living kidney donors. MATERIALS AND METHODS: We evaluated 147 patients who donated living kidneys between 1981 and 2012 at Baskent University Hospital...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28259595/donor-recipient-size-matching-and-mortality-in-heart-transplantation-influence-of-body-mass-index-and-gender
#14
Henrik Bergenfeldt, Josef Stehlik, Peter Höglund, Bodil Andersson, Johan Nilsson
BACKGROUND: The International Society for Heart and Lung Transplantation (ISHLT) guidelines advise against inappropriate weight match (IWM) for heart transplant, defined as donor weight <70% of recipient's weight. Few studies have explored in detail this size-matching recommendation, especially with regard to body mass index (BMI) and gender matching. We aimed to determine whether any difference could be observed between size-matching in obese and non-obese recipients with regard to mortality after cardiac transplantation...
February 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28256569/aggressive-non-alcoholic-steatohepatitis-following-rapid-weight-loss-and-or-malnutrition
#15
Jia-Huei Tsai, Linda D Ferrell, Vivian Tan, Matthew M Yeh, Monika Sarkar, Ryan M Gill
While non-alcoholic steatohepatitis is a slowly progressive disease, patients may rarely present in acute liver failure. We describe six patients who developed severe hepatic dysfunction following rapid weight loss or malnutrition. Rapid weight loss (18 to 91 kg) occurred after Roux-en-Y gastric bypass in four patients and starvation-like dieting or hypoalbuminemia was noted in two patients. Four patients either died or received an urgent liver transplant. Pathologic findings were characterized by advanced alcoholic steatohepatitis-like features, including extensive/circumferential centrizonal pericellular fibrosis, central scar with perivenular sclerosis/veno-occlusion with superimposed hepatocellular dropout, abundant/prominent hepatocellular balloons, and numerous Mallory-Denk bodies, but there was no history of excess alcohol consumption...
March 3, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28255978/the-effect-of-bmi-serum-leptin-and-adiponectin-levels-on-prognosis-in-patients-with-non-ischaemic-dilated-cardiomyopathy
#16
Celina Wojciechowska, Wojciech Jacheć, Ewa Romuk, Ewa Nowalany-Kozielska, Andrzej Tomasik, Lucyna Siemińska
INTRODUCTION: The recent studies demonstrated that obese heart failure patients have better prognosis - "obesity paradox". The aim of the study was to evaluate the relationship between body mass index (BMI), leptin and adiponectin concentrations and prognosis in patients with heart failure due to non ischeamic dilated cardiomyopathy (NIDCM). MATERIAL AND METHODS: 128 patients with NIDCM were included and followed-up for three years. Leptin and adiponectin were measured at baseline using commercially available ELISA tests...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28254844/vegf-a-expressing-adipose-tissue-shows-rapid-beiging-enhanced-survival-after-transplantation-and-confers-il4-independent-metabolic-improvements
#17
Jiyoung Park, Min Kim, Kai Sun, Yu Aaron An, Xue Gu, Philipp E Scherer
Adipocyte-derived VEGF-A plays a crucial role in angiogenesis and contributes to adipocyte function and systemic metabolism, such as insulin resistance, chronic inflammation and beigeing of subcutaneous adipose tissue. Utilizing a doxycycline (Dox)-inducible adipocyte-specific VEGF-A overexpressing mouse model, we investigated the dynamics of local VEGF-A effects on tissue beiging of adipose tissue transplants. VEGF-A overexpression in adipocytes triggers angiogenesis. We also observe a rapid appearance of beige fat cells in subcutaneous white adipose tissue (sWATs) within as early as 2 days post induction of VEGF-A...
March 2, 2017: Diabetes
https://www.readbyqxmd.com/read/28241825/non-alcoholic-fatty-liver-disease
#18
REVIEW
Brent A Neuschwander-Tetri
Non-alcoholic fatty liver disease has emerged a major challenge because of it prevalence, difficulties in diagnosis, complex pathogenesis, and lack of approved therapies. As the burden of hepatitis C abates over the next decade, non-alcoholic fatty liver disease will become the major form of chronic liver disease in adults and children and could become the leading indication for liver transplantation. This overview briefly summarizes the most recent data on the pathophysiology, diagnosis, and treatment of non-alcoholic fatty liver disease...
February 28, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28240264/overexpressing-the-novel-autocrine-endocrine-adipokine-wisp2-induces-hyperplasia-of-the-heart-white-and-brown-adipose-tissues-and-prevents-insulin-resistance
#19
John R Grünberg, Jenny M Hoffmann, Shahram Hedjazifar, Annika Nerstedt, Lachmi Jenndahl, Johannes Elvin, John Castellot, Lan Wei, Sofia Movérare-Skrtic, Claes Ohlsson, Louise Mannerås Holm, Fredrik Bäckhed, Ismail Syed, Fatima Bosch, Alan Saghatelian, Barbara B Kahn, Ann Hammarstedt, Ulf Smith
WISP2 is a novel adipokine, most highly expressed in the adipose tissue and primarily in undifferentiated mesenchymal cells. As a secreted protein, it is an autocrine/paracrine activator of canonical WNT signaling and, as an intracellular protein, it helps to maintain precursor cells undifferentiated. To examine effects of increased WISP2 in vivo, we generated an aP2-WISP2 transgenic (Tg) mouse. These mice had increased serum levels of WISP2, increased lean body mass and whole body energy expenditure, hyperplastic brown/white adipose tissues and larger hyperplastic hearts...
February 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28235986/-fecal-microbiota-transplantation
#20
C Lübbert, B Salzberger, J Mössner
The human intestinal microbiome has important metabolic and immunological functions for the host and is part of the defense against pathogens in the gastrointestinal tract. Antibiotics, probiotics, dietary measures, such as prebiotics, and the relatively newly established method of fecal microbiota transplantation (FMT, also known as fecal microbiome transfer) all influence the intestinal microbiome. The FMT procedure comprises the transmission of fecal microorganisms from a healthy donor into the gastrointestinal tract of a patient...
February 24, 2017: Der Internist
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