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Obesity and transplant

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https://www.readbyqxmd.com/read/29026064/the-effect-of-recipient-body-mass-index-and-its-extremes-on-survival-and-graft-vascular-and-biliary-complications-after-liver-transplantation-a-single-center-retrospective-study
#1
Emmanouil Giorgakis, Michele Tedeschi, Eliano Bonaccorsi-Riani, Shirin Elizabeth Khorsandi, Krishna Menon, Hector Vilca-Melendez, Wayel Jassem, Parthi Srinivasan, Andreas Prachalias, Nigel Heaton
BACKGROUND This is the largest UK-based study on the effect of recipient body mass index (BMI) and its extremes (BMI <18.5 and BMI ≥35 kg/m²) on liver transplant (LT) outcomes. Its purpose was to analyze the BMI effect on post-LT mortality, graft loss, primary non-function (PNF), and graft vascular and biliary complications. MATERIAL AND METHODS Data were retrieved from a single-center LT database of 2,115 consecutive patients receiving first LT during period February 2004 to September 2015. Survivals were compared across the BMI groups; the effects of recipient BMI on survival, PNF, and graft vascular and biliary complications were analyzed via regression...
October 13, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29024822/pubertally-initiated-high-fat-diet-promotes-mammary-tumorigenesis-in-obesity-prone-fvb-mice-similarly-to-obesity-resistant-balb-c-mice
#2
Yirong Zhu, Mark D Aupperlee, Sandra Z Haslam, Richard C Schwartz
Premenopausal breast cancer is associated with increased animal fat consumption among normal-weight but not overweight women. Our previous findings in obesity-resistant BALB/c mice showed that a diet high in saturated animal fat (HFD) promotes mammary tumorigenesis in both DMBA carcinogenesis and Trp53-null transplant models. Having made these observations in BALB/c mice, which have very modest HFD weight gain, we determined the effects of HFD in FVB mice, which gain significant weight on HFD. Three-week-old FVB mice fed a low-fat diet or HFD were subjected to 7,12-dimethylbenz[a]anthracene-induced carcinogenesis...
October 9, 2017: Translational Oncology
https://www.readbyqxmd.com/read/29019954/weight-loss-in-advanced-chronic-kidney-disease-should-we-consider-individualised-qualitative-ad-libitum-diets-a-narrative-review-and-case-study
#3
Capizzi Irene, Teta Luigi, Vigotti Federica Neve, Tognarelli Giuliana, Consiglio Valentina, Scognamiglio Stefania, Piccoli Giorgina Barbara
In advanced chronic kidney disease, obesity may bring a survival advantage, but many transplant centres demand weight loss before wait-listing for kidney graft. The case here described regards a 71-year-old man, with obesity-related glomerulopathy; referral data were: weight 110 kg, Body Mass Index (BMI) 37 kg/m², serum creatinine (sCr) 5 mg/dL, estimated glomerular filtration rate (eGFR) 23 mL/min, blood urea nitrogen (BUN) 75 mg/dL, proteinuria 2.3 g/day. A moderately restricted, low-protein diet allowed reduction in BUN (45-55 mg/dL) and good metabolic and kidney function stability, with a weight increase of 6 kg...
October 11, 2017: Nutrients
https://www.readbyqxmd.com/read/28990516/gut-microbiota-as-a-therapeutic-target-for-metabolic-disorders
#4
Hirofumi Okubo, Yusuke Nakatsu, Akifumi Kushiyama, Takeshi Yamamotoya, Yasuka Matsunaga, Masa-Ki Inoue, Midori Fujishiro, Hideaki Sakoda, Haruya Ohno, Masayasu Yoneda, Hiraku Ono, Tomoichiro Asano
The prevalence of metabolic disorders has been rising worldwide, making the identification of factors affecting metabolic control more important than ever. Gut microbiota play a vital role not only in the digestion and absorption of nutrients, but also in homeostatic maintenance of host immunity, metabolism and the gut barrier. It was recently suggested that gut microbiota alterations contribute to the pathogenesis of metabolic disorders such as obesity, diabetes mellitus and non-alcoholic fatty liver disease...
October 9, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28985892/laparoscopic-donor-nephrectomy-a-single-institution-minimally-invasive-general-surgeon-experience-1999-2013
#5
Benjamin Raber, Matthew Westmoreland, David Arnold, Butch Derek, Richard Lueking, Grace Lassiter, Elizabeth Nguyen
BACKGROUND: Laparoscopic donor nephrectomy (LDN) is the standard of care for donor nephrectomies. No large series reports have been published detailing the LDN experience of minimally invasive general surgeons. METHODS: A retrospective review of 526 LDNs performed by MIS general surgeons at Baylor University Medical Center between 1999 and 2013. Complications were graded on the Clavien scale. The learning curve was determined by procedure time. RESULTS: The complication rate was 3...
September 29, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28979783/obesity-and-listing-for-renal-transplantation-weighing-the-evidence-for-a-growing-problem
#6
Mohammed Hossain, Alexander Woywodt, Titus Augustine, Videha Sharma
A 56-year-old female patient was referred to the transplant assessment clinic in July 2016. She started haemodialysis in 2012 for renal failure due to urinary tract infections. She is doing very well on dialysis and has an excellent exercise tolerance without shortness of breath or angina. She has had no infections since starting dialysis and no other comorbidity, except well-controlled hypertension and hyperparathyroidism requiring treatment with cinacalcet. Clinical examination is essentially normal except for truncal obesity with height 167 cm and weight 121 kg, giving her a body mass index of 43...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28975090/chronic-dietary-oxalate-nephropathy-after-intensive-dietary-weight-loss-regimen
#7
Gebran Khneizer, Ahmad Al-Taee, Meher S Mallick, Bahar Bastani
BACKGROUND: Hyperoxaluria has been associated with nephrolithiasis as well as acute and chronic kidney disease. We present a case of end stage renal failure caused by excessive dietary oxalate intake in a dietary weight loss regimen. CASE PRESENTATION: A 51-year-old Caucasian male with the past medical history of type 2 diabetes mellitus, gout, hypertension and morbid obesity was referred to the primary care clinic after being found pale and easily fatigued. The patient had lost 36 kg over a 7-month period by implementing exercise and intense dietary measures that included 6 meals of spinach, kale, berries, and nuts...
July 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28973719/identification-of-differentially-expressed-genes-in-pathways-of-cerebral-neurotransmission-of-anovulatory-mice
#8
M A Azevedo, I D C G Silva
Polycystic ovary syndrome is the classic example of loss of functional cyclicity and anomalous feedback. In this case, the excessive extra-glandular production and conversion of androgens to estrogens are the pathophysiological basis of the chronic anovulation. The literature describes an experimental model of the polymicrocystic ovary in obese diabetic mice with insulin resistance. The fact that these animals exhibit obesity, insulin resistance, and infertility demonstrates their skill as an experimental model for polycystic ovary...
September 27, 2017: Genetics and Molecular Research: GMR
https://www.readbyqxmd.com/read/28965313/significant-liver-related-morbidity-after-bariatric-surgery-and-its-reversal-a-case-series
#9
Magdalena Eilenberg, Felix B Langer, Andrea Beer, Michael Trauner, Gerhard Prager, Katharina Staufer
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) occurs in up to 80% of patients with obesity. Current data suggest an improvement of NAFLD after established bariatric procedures. OBJECTIVES: This study investigated liver function impairment after Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB). SETTING: University Hospital, Bariatric Surgery Unit METHODS: In this single-center case series, consecutive in- and outpatients after bariatric surgery who presented with severe liver dysfunction from March 2014 to February 2017 were included and followed until March 2017...
September 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28964798/phenotypic-clusters-predict-outcomes-in-a-longitudinal-interstitial-lung-disease-cohort
#10
Ayodeji Adegunsoye, Justin M Oldham, Jonathan H Chung, Steven M Montner, Cathryn Lee, Leah J Witt, Danielle Stahlbaum, Rene S Bermea, Lena W Chen, Scully Hsu, Aliya N Husain, Imre Noth, Rekha Vij, Mary E Strek, Matthew Churpek
BACKGROUND: The current interstitial lung disease (ILD) classification has overlapping clinical presentations and outcomes. Cluster analysis modeling is a valuable tool in identifying distinct clinical phenotypes in heterogeneous diseases. However, this approach has yet to be implemented in ILD. METHODS: Using cluster analysis, we identified novel ILD phenotypes among subjects from a longitudinal ILD cohort and stratified outcomes by phenotypic clusters compared to subgroups by current American Thoracic Society (ATS)/European Respiratory Society (ERS) ILD classification criteria...
September 27, 2017: Chest
https://www.readbyqxmd.com/read/28961576/nonalcoholic-steatohepatitis-is-the-most-rapidly-increasing-indication-for-liver-transplantation-in-young-adults-in-the-united-states
#11
Iliana Doycheva, Danny Issa, Kymberly D Watt, Rocio Lopez, Ghassoub Rifai, Naim Alkhouri
GOALS: To analyze the frequency and trend of liver transplantation (LT) for nonalcoholic steatohepatitis (NASH) cirrhosis in young adults aged 18 to 40 years and to assess post-LT outcomes in this age group. BACKGROUND: NASH is currently the fastest-growing indication for LT in US adults. It is believed that NASH is a rare indication for LT among young adults. STUDY: Using the United Network for Organ Sharing database, we performed a retrospective cohort analysis of all LTs in young adults between 2002 and 2012...
September 28, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28955032/clinical-responses-to-adoptive-t-cell-transfer-can-be-modeled-in-an-autologous-immune-humanized-mouse-model
#12
Henrik Jespersen, Mattias F Lindberg, Marco Donia, Elin M V Söderberg, Rikke Andersen, Ulrich Keller, Lars Ny, Inge Marie Svane, Lisa M Nilsson, Jonas A Nilsson
Immune checkpoint inhibitors and adoptive cell transfer (ACT) of autologous tumor-infiltrating T cells have shown durable responses in patients with melanoma. To study ACT and immunotherapies in a humanized model, we have developed PDXv2.0 - a melanoma PDX model where tumor cells and tumor-infiltrating T cells from the same patient are transplanted sequentially in non-obese diabetic/severe combined immune-deficient/common gamma chain (NOG/NSG) knockout mouse. Key to T-cell survival/effect in this model is the continuous presence of interleukin-2 (IL-2)...
September 27, 2017: Nature Communications
https://www.readbyqxmd.com/read/28951657/sleeve-gastrectomy-and-left-ventricular-assist-device-for-heart-transplant
#13
Joseph Greene, Tung Tran, Timothy Shope
BACKGROUND AND OBJECTIVES: Heart failure (HF) is a severe obesity-related comorbidity. Many patients with end-stage HF eventually require cardiac transplantation for long-term survival. These patients may be precluded from enrollment in heart transplant programs secondary to morbid obesity. We propose a pathway involving sleeve gastrectomy (SG) for patients with morbid obesity and HF to afford cardiac transplantation eligibility. METHODS: Three patients with HF and morbid obesity underwent implantation of a left ventricular assist device (LVAD) and SG at an academic tertiary care institution in Washington, DC...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28949096/temporal-trends-center-level-variation-and-the-impact-of-prevalent-state-obesity-rates-on-acceptance-of-obese-living-kidney-donors
#14
Abhijit S Naik, Diane M Cibrik, Ankit Sakhuja, Milagros Samaniego, Yee Lu, Vahakn Shahinian, Silas P Norman, Mark A Schnitzler, Bertram L Kasiske, Dorry L Segev, Krista L Lentine
The impact of predonation obesity on long-term outcomes of living kidney donors remains controversial. Published guidelines offer varying recommendations regarding body mass index (BMI, kg/m(2) ) thresholds for donor acceptance. We examined temporal and center-level variation in BMI of accepted donors across US transplant centers. Using national transplant registry data, we performed multivariate hierarchical logistic regression modeling using pairwise comparisons (overweight, BMI 25-29.9; mildly obese, BMI 30-34...
September 26, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28942920/adipose-tissue-macrophage-derived-exosomal-mirnas-can-modulate-in%C3%A2-vivo-and-in%C3%A2-vitro-insulin-sensitivity
#15
Wei Ying, Matthew Riopel, Gautam Bandyopadhyay, Yi Dong, Amanda Birmingham, Jong Bae Seo, Jachelle M Ofrecio, Joshua Wollam, Angelina Hernandez-Carretero, Wenxian Fu, Pingping Li, Jerrold M Olefsky
MiRNAs are regulatory molecules that can be packaged into exosomes and secreted from cells. Here, we show that adipose tissue macrophages (ATMs) in obese mice secrete miRNA-containing exosomes (Exos), which cause glucose intolerance and insulin resistance when administered to lean mice. Conversely, ATM Exos obtained from lean mice improve glucose tolerance and insulin sensitivity when administered to obese recipients. miR-155 is one of the miRNAs overexpressed in obese ATM Exos, and earlier studies have shown that PPARγ is a miR-155 target...
October 5, 2017: Cell
https://www.readbyqxmd.com/read/28938312/long-cold-ischemia-times-in-same-hospital-deceased-donor-transplants
#16
Eric Kh Chow, Sandra DiBrito, Xun Luo, Corey Wickliffe, Allan B Massie, Jayme E Locke, Sommer E Gentry, Jacqueline Garonzik-Wang, Dorry L Segev
BACKGROUND: Recent changes in deceased donor organ allocation for livers (Share-35) and kidneys (KAS) have resulted in broader sharing of organs and increased cold ischemia time (CIT). Broader organ sharing however is not the only cause of increased CIT. METHODS: This was a retrospective registry study of CIT in same-hospital liver transplants (SHLT, n=4,347) and kidney transplants (SHKT, n=9,707) between 2004 and 2014. RESULTS: In SHLT, median (IQR) CIT was 5...
September 20, 2017: Transplantation
https://www.readbyqxmd.com/read/28935200/benefit-risk-of-intraoperative-liver-biopsy-during-bariatric-surgery-review-and-perspectives
#17
REVIEW
Sandrine Barbois, Catherine Arvieux, Vincent Leroy, Fabian Reche, Nathalie Stürm, Anne-Laure Borel
Nonalcoholic fatty liver disease (NAFLD) is a metabolic complication of obesity that encompasses a spectrum of conditions, including hepatic steatosis, nonalcoholic steatohepatitis (NASH), cirrhosis, and end-stage liver disease. Screening for NAFLD is important to limit progression, allow early detection of carcinoma, and follow the need for liver transplantation. Although noninvasive markers exist, hepatic histologic evaluation remains the gold standard for diagnosis. To reduce the risk of complications after liver biopsy but increase the accuracy of NAFLD diagnosis, hepatic tissue can be sampled during bariatric surgery...
August 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28935188/liver-transplantation-for-nash-cirrhosis-is-not-performed-at-the-expense-of-major-post-operative-morbidity
#18
Eline H van den Berg, Rianne M Douwes, Vincent E de Meijer, Tim C M A Schreuder, Hans Blokzijl
BACKGROUND: Non-alcoholic steatohepatitis (NASH) is an emerging indication for liver transplantation (LT) and coexists with multiple comorbidities. Obese and cirrhotic patients experience more perioperative complications. Limited data exist about short-term complications after LT for NASH cirrhosis. AIM: Investigate short-term complications in patients transplanted for NASH cirrhosis. METHODS: Single center retrospective cohort study including patients >18years who underwent LT between 2009-2015...
August 12, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28930104/liver-transplantation-in-the-obese-cirrhotic-patient
#19
REVIEW
Erin K Spengler, Jacqueline G O'Leary, Helen S Te, Shari Rogal, Anjana A Pillai, Abdullah Al-Osaimi, Archita Desai, James N Fleming, Daniel Ganger, Anil Seetharam, Georgios Tsoulfas, Martin Montenovo, Jennifer C Lai
Despite the rapidly increasing prevalence of obesity in the transplant population, the optimal management of obese liver transplant candidates remains undefined. Setting strict body mass index cutoffs for transplant candidacy remains controversial, with limited data to guide this practice. Body mass index is an imperfect measure of surgical risk in this population, partly due to volume overload and variable visceral adiposity. Weight loss before transplantation may be beneficial, but it remains important to avoid protein calorie malnutrition and sarcopenia...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28926375/early-effects-of-renal-replacement-therapy-on-cardiovascular-comorbidity-in-children-with-end-stage-kidney-disease-findings-from-the-4c-t-study
#20
Bernhard M W Schmidt, Rizky I Sugianto, Daniela Thurn, Karolis Azukaitis, Aysun K Bayazit, Nur Canpolat, Ayse Guler Eroglu, Salim Caliskan, Anke Doyon, Ali Duzova, Tevfik Karagoz, Ali Anarat, Murat Deveci, Sevgi Mir, Bruno Ranchin, Rukshana Shroff, Esra Baskin, Mieczyslaw Litwin, Z Birsin Özcakar, Rainer Büscher, Oguz Soylemezoglu, Jiri Dusek, Markus Kemper, Maria C Matteucci, Sandra Habbig, Guido Laube, Elke Wühl, Uwe Querfeld, Anja Sander, Franz Schaefer, Anette Melk
BACKGROUND: The early impact of renal transplantation on subclinical cardiovascular measures in pediatric patients has not been widely investigated. This analysis is performed for pediatric patients participating in the prospective 4C study and focuses on the early effects of RRT modality on cardiovascular comorbidity in patients receiving a preemptive transplant or started on dialysis. METHODS: We compared measures indicating subclinical cardiovascular organ damage (aortal pulse wave velocity, carotid intima media thickness, left ventricular mass index) and evaluated cardiovascular risk factors in 166 pediatric patients before and 6 to 18 months after start of RRT (n=76 transplantation, n=90 dialysis)...
September 18, 2017: Transplantation
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