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Obesity and transplant

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https://www.readbyqxmd.com/read/28073162/refractory-subacute-steatohepatitis-after-biliopancreatic-diversion
#1
Sander Lefere, Anne Hoorens, Sarah Raevens, Roberto Troisi, Xavier Verhelst, Hans Van Vlierberghe, Anja Geerts
Steatohepatitis development after the biliopancreatic diversion (BPD) procedure for morbid obesity has rarely been reported. We present a case of fatal recurrent steatohepatitis post-PBD despite repeated liver transplantations. This article is protected by copyright. All rights reserved.
January 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28072757/organ-procurement-organization-survey-of-practices-and-beliefs-regarding-prerecovery-percutaneous-liver-biopsy-in-donation-after-neurologic-determination-of-death
#2
Joseph Benton Oliver, Andrea Fleisch Marcus, Mark Paster, Joseph Nespral, Advaith Bongu, George Dikdan, Lloyd Brown, Nikole Neidlinger, Baburao Koneru
BACKGROUND: Prerecovery liver biopsy (PLB) allows histological evaluation of the organ prior to procurement. The opinions and what factors might influence PLB use within Organ Procurement Organizations (OPOs) are unknown. METHODS: A survey instrument was distributed by the Association of OPOs to the clinical directors of all 58 OPOs. Descriptive statistics were calculated. Results were also stratified based on OPO characteristics. RESULTS: 84...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28069641/differential-impact-of-chronic-hyperglycemia-on-humoral-versus-cellular-primary-alloimmunity
#3
Nicholas H Bishop, Michelle K Nelsen, K Scott Beard, Ronald G Gill
Diabetes is prevalent among solid organ transplant recipients and is universal among islet transplant recipients. While diabetes is often considered to result in an immune compromised state, the impact of chronic hyperglycemia on host alloimmunity is not clear. Potential immune modifying effects of obesity, autoimmunity, or diabetogenic agents like streptozotocin may confound understanding alloimmunity in experimental models of diabetes. Therefore, we sought to determine the role of chronic hyperglycemia due to insulinopenia on alloimmunity using the non-autoimmune, spontaneously diabetic H-2(b)-expressing C57BL/6 Ins2(Akita) mice (Akita)...
January 9, 2017: Diabetes
https://www.readbyqxmd.com/read/28042926/the-potential-impact-of-gut-microbiota-on-your-health-current-status-and-future-challenges
#4
Stitaya Sirisinha
Our health and probably also our behaviors and mood depend not only on what we eat or what we do (lifestyle behaviors), but also on what we host. It is well established for decades that all vertebrates including humans are colonized by a wide array of bacteria, fungi, eukaryotic parasites and viruses, and that, at steady state (homeostasis), this community of microbes establishes a friendly mutual relationship with the host. The term microbiota was originally meant to represent an ecological community of commensals and potentially pathogenic microbes that live within our bodies, but it is now used interchangeably with the term microbiome which was initially meant to represent a collective genome of the microbiota...
December 2016: Asian Pacific Journal of Allergy and Immunology
https://www.readbyqxmd.com/read/28042242/perceptions-of-fecal-microbiota-transplantation-for-clostridium-difficile-infection-factors-that-predict-acceptance
#5
Leslie Park, Anjali Mone, Jennifer C Price, Demetrios Tzimas, Jacqueline Hirsh, Michael A Poles, Lisa Malter, Lea Ann Chen
BACKGROUND: Despite the effectiveness of fecal microbiota transplantation (FMT) for treating recurrent Clostridium difficile (C. difficile) infection, some patients are reluctant to accept this therapy. Our study examined attitudes towards FMT and factors that contribute to patients' acceptance of this treatment. METHODS: We distributed patient surveys at a Veterans Affairs hospital, a public hospital, and an academic faculty practice. Multivariable logistic regression was performed, adjusting for factors associated with FMT acceptance on univariate analysis and prior experience with C...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28042141/prolonged-unexplained-hypoxemia-as-initial-presentation-of-cirrhosis-a-case-report
#6
Anand Puttappa, Kumaraswamy Sheshadri, Aurelie Fabre, Georgina Imberger, John Boylan, Silke Ryan, Masood Iqbal, Niamh Conlon
BACKGROUND Hepatopulmonary syndrome (HPS) is a pulmonary complication of advanced liver disease with dyspnea as the predominant presenting symptom. The diagnosis of HPS can often be missed due to its nonspecific presentation and the presence of other comorbidities. CASE REPORT We present an interesting case of an obese 43-year-old man who presented with progressive, unexplained hypoxemia and shortness of breath in the absence of any symptoms or signs of chronic liver disease. After extensive cardiopulmonary investigations, he was diagnosed with severe HPS as a result of non-alcoholic steatohepatitis (NASH) leading to cirrhosis...
January 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28041666/prediabetes-in-pediatric-recipients-of-liver-transplant-mechanism-and-risk-factors
#7
Emily R Perito, Robert H Lustig, Philip Rosenthal
OBJECTIVE: To investigate the role of calcineurin inhibitor exposure and states of insulin resistance-obesity and adolescence-in prediabetes after pediatric liver transplant via oral glucose tolerance testing, which previously has not been done systematically in these at-risk youths. STUDY DESIGN: This was a cross-sectional study of 81 pediatric recipients of liver transplant. Prediabetes was defined as impaired glucose tolerance (IGT; glucose ≥140 mg/dL at 2 hours) or impaired fasting glucose (IFG, ≥100 mg/dL)...
December 29, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28040759/novel-application-of-a-percutaneous-left-ventricular-assist-device-as-a-bridge-to-transplant-in-a-paediatric-patient-with-severe-heart-failure-due-to-viral-myocarditis
#8
Paul Perry, Elizabeth David, Broadus Atkins, Gary Raff
A 13-year obese female with suspected viral myocarditis presented with acute decompensated heart failure. Due to her body habitus, she was a poor candidate for immediate heart transplantation. A peripherally inserted left ventricular assist device (LVAD) was implanted via the right axillary artery. Following device insertion the patient experienced rapid improvement in symptoms. The LVAD provided effective left ventricular unloading for 50 days, promoting myocardial recovery and maintaining excellent patient performance status...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040534/cardiovascular-risk-factors-in-survivors-of-childhood-hematopoietic-cell-transplantation-treated-with-total-body-irradiation-a-longitudinal-analysis
#9
Danielle Novetsky Friedman, Patrick Hilden, Chaya S Moskowitz, Maya Suzuki, Farid Boulad, Nancy Kernan, Suzanne Wolden, Kevin C Oeffinger, Charles A Sklar
Hematopoietic cell transplantation (HCT) survivors treated with total body irradiation (TBI) are known to be at increased risk for the development of cardiovascular risk factors (CVRF). We sought to characterize the incidence of CVRF in a TBI-exposed survivor cohort and describe prognostic indicators of their development. Retrospective analysis of CVRF in 1-year survivors of leukemia or lymphoma treated with TBI at Memorial Sloan Kettering from April 1987-May 2011. Eligible participants were≤ 21 years of age at TBI and were not on glucocorticoids at the time of entry to Long-Term Follow-Up...
December 28, 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28039914/the-metabolic-syndrome-and-its-components-in-pediatric-survivors-of-allogeneic-hematopoietic-stem-cell-transplantation
#10
Bella Bielorai, Yael Weintraub, Daphna Hutt, Rina Hemi, Hannah Kanety, Dalit Modan-Moses, Gal Goldstein, Dana Hadar, Liat Lerner-Geva, Amos Toren, Orit Pinhas-Hamiel
MetS is a known complication after HSCT that contributes to long-term morbidity. We assessed the prevalence of components of the MetS in pediatric survivors of allogeneic HSCT, and identified associated risk factors. Thirty-eight patients, median age at HSCT, 8.5 years, were evaluated at a median of 3.9 years post HSCT. Overweight or obesity were seen in 23.7% of the patients, 15.8% had hypertension, 15.8% had hypertriglyceridemia and 13% had low HDL-C levels according to age and gender. Four (10.5%) met the criteria of MetS, all were transplanted for malignant disease...
December 31, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28018115/dangerous-dietary-supplements-garcinia-cambogia-associated-hepatic-failure-requiring-transplantation
#11
Keri E Lunsford, Adam S Bodzin, Diego C Reino, Hanlin L Wang, Ronald W Busuttil
Commercial dietary supplements are marketed as a panacea for the morbidly obese seeking sustainable weight-loss. Unfortunately, many claims cited by supplements are unsupported and inadequately regulated. Most concerning, however, are the associated harmful side effects, often unrecognized by consumers. Garcinia cambogia extract and Garcinia cambogia containing products are some of the most popular dietary supplements currently marketed for weight loss. Here, we report the first known case of fulminant hepatic failure associated with this dietary supplement...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28009142/robotic-kidney-transplantation-current-status-and-future-perspectives
#12
Angelo Territo, Alex Mottrie, Ronney Abaza, Craig Rogers, Mani Menon, Mahendra Bhandari, Rajesh Ahlawat, Alberto Breda
INTRODUCTION: For the treatment of patients with end-stage renal disease, kidney transplantation is preferred to renal replacement modalities such as hemodialysis and peritoneal dialysis. Although open surgery remains the gold standard, minimally invasive approaches have recently been applied in transplant kidney surgery. Despite growing enthusiasm and potential benefits of robotic kidney transplant, many aspects of this novel technique remain controversial. Aim of this study was to analyze the current status and future developments in robotic-assisted surgery for kidney transplantation...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28008784/therapeutic-interventions-for-gut-dysbiosis-and-related-disorders-in-the-elderly-antibiotics-probiotics-or-faecal-microbiota-transplantation
#13
R C Vemuri, R Gundamaraju, T Shinde, R Eri
Ageing and physiological functions of the human body are inversely proportional to each other. The gut microbiota and host immune system co-evolve from infants to the elderly. Ageing is accompanied by a decline in gut microbial diversity, immunity and metabolism, which increases susceptibility to infections. Any compositional change in the gut is directly linked to gastrointestinal disorders, obesity and metabolic diseases. Increase in opportunistic pathogen invasion in the gut like Clostridium difficile leading to C...
December 23, 2016: Beneficial Microbes
https://www.readbyqxmd.com/read/28008650/evolution-of-body-weight-parameters-up-to-3-years-after-solid-organ-transplantation-the-prospective-swiss-transplant-cohort-study
#14
Sonja Beckmann, Nataša Nikolic, Kris Denhaerynck, Isabelle Binet, Michael Koller, Elsa Boely, Sabina De Geest
Obesity and weight gain are serious concerns after solid organ transplantation (Tx); however, no unbiased comparison regarding body weight parameter evolution across organ groups has yet been performed. Using data from the prospective nationwide Swiss Transplant Cohort Study, we compared the evolution of weight parameters up to 3 years post-Tx in 1359 adult kidney (58.3%), liver (21.7%), lung (11.6%), and heart (8.4%) recipients transplanted between May 2008 and May 2012. Changes in mean weight and body mass index (BMI) category were compared to reference values from 6 months post-Tx...
December 23, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28004036/the-microbial-hypothesis-contributions-of-adenovirus-infection-and-metabolic-endotoxaemia-to-the-pathogenesis-of-obesity
#15
REVIEW
Amos Tambo, Mohsin H K Roshan, Nikolai P Pace
The global obesity epidemic, dubbed "globesity" by the World Health Organisation, is a pressing public health issue. The aetiology of obesity is multifactorial incorporating both genetic and environmental factors. Recently, epidemiological studies have observed an association between microbes and obesity. Obesity-promoting microbiome and resultant gut barrier disintegration have been implicated as key factors facilitating metabolic endotoxaemia. This is an influx of bacterial endotoxins into the systemic circulation, believed to underpin obesity pathogenesis...
2016: International Journal of Chronic Diseases
https://www.readbyqxmd.com/read/27939909/liver-failure-after-long-limb-gastric-bypass
#16
Mike Ralki, David Cassiman, Jurgen Van Dongen, Michel Ferrante, Lode Van Overbeke
Liver failure is reported with increasing frequency in patients who underwent bariatric surgery for morbid obesity. In most cases, liver transplantation is the only possible treatment to avoid fatal outcome. Although most cases are observed after older bariatric surgery techniques characterized by high malabsorption rates, we report on a 38-year-old woman who developed liver failure seven months after long-limb gastric bypass.
December 8, 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/27935413/stable-core-virome-despite-variable-microbiome-after-fecal-transfer
#17
Felix Broecker, Giancarlo Russo, Jochen Klumpp, Karin Moelling
We recently described the 4.5-year time course of the enteric bacterial microbiota and virome of a patient cured from recurrent Clostridium difficile infection (rCDI) by fecal microbiota transplantation (FMT). Here, we extended the virome analyses and found the patient's phage population to exhibit highly donor-similar characteristics following FMT, which remained stable for the whole period tested (up to 7 months). Moreover, the detected viral populations of donor and patient exhibited comparable diversity and richness...
December 9, 2016: Gut Microbes
https://www.readbyqxmd.com/read/27932135/influence-of-body-mass-index-on-venous-thrombotic-complications-of-liver-transplants
#18
A R Molina, A R Vílchez, M B Domínguez, A N García, C M San Miguel, A R R González, Y S Fundora
OBJECTIVE: To analyze venous thrombotic complications in transplanted patients as a function of their body mass index (BMI). MATERIALS AND METHODS: This single-center, observational retrospective study of individuals undergoing liver transplantation between January 2008 and December 2014 analyzed the frequency of pretransplant portal thrombosis, post-transplant venous complications (early and late portal thrombosis), deep vein thrombosis, pulmonary thromboembolism and the survival outcomes as a function of World Health Organization BMI class...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932133/metabolic-syndrome-after-liver-transplantation-five-year-prevalence-and-risk-factors
#19
F García-Pajares, I Peñas-Herrero, R Sánchez-Ocaña, R Torrres-Yuste, M Cimavilla-Román, A Carbajo-López, C Almohalla-Alvarez, B Pérez-Saborido, E Muñoz-Conejero, M Gonzalez-Sagrado, A Caro-Patón, G Sánchez-Antolín
Survival after orthotopic liver transplantation (OLT) has increased over the last decades, focusing on the metabolic complications that contribute to patient morbidity and mortality. The aim of our study was to describe the prevalence of metabolic syndrome (MS), its components, and its associated factors in patients who underwent OLT in a hospital in Spain. From November 2001 to January 2014, we performed 415 transplantations in 386 patients. We analyzed 204 patients with a minimum follow-up of 1 year (77.6% were male and the mean age was 54...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931582/liver-transplantation-for-hepatitis-b-in-early-adulthood-analysis-of-the-united-network-for-organ-sharing-database
#20
G Rifai, A Anani, I A Hanouneh, B Mohamad, A Matloob, R Lopez, N N Zein, N Alkhouri
BACKGROUND: Chronic hepatitis B virus (HBV) infection has a mild course in most children that may delay initiation of treatment even when indicated. Unfortunately, a small number of cases can progress rapidly to cirrhosis, which may require liver transplantation (LT) in early adulthood. The aim of this study was to assess the characteristics of HBV-positive young adults who received LT and to evaluate post-transplant outcomes including patient and graft survival and differences between pre- and post-implementation of Model for End-stage Liver Disease (MELD) prioritization...
December 2016: Transplantation Proceedings
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