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delayed graft function

Lauren Brasile, Nicholas Henry, Bart Stubenitsky
BACKGROUND: We have previously reported on a novel organ-specific immunomodifying therapy that provides protection from early allograft rejection in the absence of systemic immunosuppressive drugs. This novel therapy is a nano-barrier membrane called ImmunoCloak, consisting of a matrix of laminin, proteoglycans, fibronectin and collagens. The membrane "immunocloaks" the luminal surfaces within the renal vasculature by covering the point of contact between donor vascular endothelial cells and the recipient's immune cells; without adversely affecting renal function...
October 19, 2016: Transplantation
Joceline S Liu, Matthew I Bury, Natalie J Fuller, Renea M Sturm, Nida Ahmad, Arun K Sharma
Substitution urethroplasty for the treatment of male stricture disease is often accompanied by subsequent tissue fibrosis and secondary stricture formation. Patients with pre-existing morbidities are often at increased risk of urethral stricture recurrence brought upon in-part by delayed vascularization accompanied by overactive inflammatory responses following surgery. Within the context of this study, we demonstrate the functional utility of a cell/scaffold composite graft comprised of human bone marrow-derived mesenchymal stem cells (MSC) combined with CD34+ hematopoietic stem/progenitor cells (HSPC) to modulate inflammation and wound healing in a rodent model of substitution urethroplasty...
October 20, 2016: Scientific Reports
Rauf Shahbazov, Gumpei Yoshimatsu, Waqas Z Haque, Omar S Khan, Giovanna Saracino, Michael C Lawrence, Peter T Kim, Nicholas Onaca, Bashoo Naziruddin, Marlon F Levy
BACKGROUND: The impact of pylorus preserving procedures (PP) on total pancreatectomy with islet autotransplantation (TPIAT) has not been examined. This study aimed to investigate the clinical impact of the PP on TPIAT. METHODS: The Baylor Simmons Transplant Institute database was queried to identify seventy-three patients who underwent TPIAT from 2006 to 2014. All patients were investigated in postoperative complications, long-term nutritional status, and graft function...
October 8, 2016: American Journal of Surgery
Benjamin M Anderson, Jemma L Mytton, Felicity Evison, Charles J Ferro, Adnan Sharif
INTRODUCTION: Outcomes for weekend hospital admissions or emergency procedures have become a topical and controversial issue for the UK National Health Service (NHS). Deceased-donor kidney transplantation is frequently performed at weekends and evidence for its relative safety are lacking. METHODS: We undertook a population-based cohort analysis, obtaining data from every deceased-donor kidney-alone transplant procedure performed in England between January 2003 and December 2014...
October 17, 2016: Transplantation
Ahmer M Hameed, Henry C Pleass, Germaine Wong, Wayne J Hawthorne
BACKGROUND: The two main options for renal allograft preservation are static cold storage (CS) and machine perfusion (MP). There has been considerably increased interest in MP preservation of kidneys, however conflicting evidence regarding its efficacy and associated costs have impacted its scale of clinical uptake. Additionally, there is no clear consensus regarding oxygenation, and hypo- or normothermia, in conjunction with MP, and its mechanisms of action are also debated. The primary aims of this article were to elucidate the benefits of MP preservation with and without oxygenation, and/or under normothermic conditions, when compared with CS prior to deceased donor kidney transplantation...
October 2016: Medicine (Baltimore)
Sang Min Park, Haemin Jeong, Kyung-Soon Hong, Christopher Kim
BACKGROUND: In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age. CASE SUMMARY: A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year...
October 2016: Medicine (Baltimore)
I Lobb, J Jiang, D Lian, W Liu, A Haig, M N Saha, R Torregrossa, M E Wood, M Whiteman, A Sener
Ischemia-reperfusion injury (IRI) is unavoidably caused by loss and subsequent restoration of blood flow during organ procurement and prolonged IRI results in increased rates of delayed graft function and early graft loss. The endogenously produced gasotransmitter, hydrogen sulfide (H2 S), is a novel molecule that mitigates hypoxic tissue injury. The current study investigates the protective mitochondrial effects of H2 S during in vivo cold storage and subsequent renal transplantation (RTx) and in vitro cold hypoxic renal injury...
October 15, 2016: American Journal of Transplantation
S H Song, J G Lee, J Lee, K H Huh, M S Kim, S I Kim, Y S Kim
The effects of pretransplantation dialysis modality on graft function are key issues in end-stage renal disease patients. The aim of this study was to evaluate post-transplantation outcomes according to pretransplantation renal replacement therapy modality in deceased-donor kidney transplantation. Among 444 deceased-donor kidney transplant recipients in Severance Hospital between April 1993 and Dec 2014, 275 who maintained a unique dialysis modality (hemodialysis [HD; n = 178] or peritoneal dialysis [PD; n = 97]) until transplantation were enrolled...
September 2016: Transplantation Proceedings
J H Kang, B H Choi, K M Moon, Y M Park, K H Yang, J H Ryu, C W Chu
It is well known that the quality of organs retrieved from brain-dead donors (DBDs) is better than those retrieved from circulatory death donors. However, in situations of organ retrieval from marginal DBDs, who are unstable despite intensive care, transplantation outcomes are not good. Organ ischemia is the most important determining factor in decreased organ quality in circulatory death donors and in some DBDs. Extracorporeal membrane oxygenation (ECMO) for management of DBDs can be an emergency countermeasure...
September 2016: Transplantation Proceedings
L V Kroth, F F Barreiro, D Saitovitch, M A Traesel, D O L d'Avila, C E Poli-de-Figueiredo
BACKGROUND: Solid organ transplant recipients are susceptible to antibiotic-resistant infections and carbapenem-resistant Acinetobacter baumannii (CRAB) has recently been recognized as a serious complication in solid organ recipients. High mortality rates have been described. METHODS: We retrospectively analyzed 807 transplantations and detected 10 patients who died 24 hours after the diagnosis of septicemia, all with CRAB-positive blood cultures. Recipients were followed up for at least 1 year and were stratified into the following groups: Group 1, patients alive; Group 2, patients that died due to other causes except Acinetobacter infection; and Group 3, patients who died within 24 hours of CRAB diagnosis...
September 2016: Transplantation Proceedings
F Salazar Meira, J Zemiacki, A E Figueiredo, L Viliano Kroth, D Saute Kochhann, D O d'Avila, M Traesel, D Saitovitch, C E Poli-de-Figueiredo
BACKGROUND: One of the main postoperative complications of kidney transplant is delayed graft function (DGF), which means absence of graft function after transplant or the need for dialysis during the first week post procedure. The occurrence of DGF currently in our hospital is high and has been attributed to a combination of many factors. The aim of this study was to evaluate the factors associated to DGF and their influence in the outcome of kidney transplants. METHODS: Historical cohort of 150 patients transplanted with live or deceased donor kidneys from 2011 to 2013...
September 2016: Transplantation Proceedings
H Si Nga, H M Takase, A M Bravin, P D Garcia, M M Contti, C A Kojima, L G M de Andrade
BACKGROUND: With the increased demand for kidney transplants and the short supply of organs, it is necessary to have a better strategy to evaluate the available organs, especially from donors with acute kidney injury (AKI), because these organs are often rejected for transplantation. METHODS: We evaluated patients undergoing transplantation with kidneys from deceased donors with AKI. The cases were divided into AKI stages according to the Acute Kidney Injury Network (AKIN) criteria...
September 2016: Transplantation Proceedings
Luana Soriano Mota, Claudia Maria Costa de Oliveira, Francisco Martho Leal Pinheiro, Larissa Costa de Oliveira Santos, Danilo Gonçalves Nóbrega, Paula Fbc Fernandes, Alda Angélica de Melo Costa, Sônia Leite da Silva
Introduction: Kidney transplants with expanded criteria donor have been associated with improved patient survival compared to those who remain on dialysis. Objective: To compare renal function and survival of the kidney graft of deceased donor with expanded criteria and standard criteria over a year in a single transplant center. Methods: 255 kidney transplant recipients with deceased donor were included in the study between the years 2011 to 2013 and they were separated into two groups according to the type of donor (expanded criteria donor - ECD - and standard criteria donor - SCD)...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Hessel Peters-Sengers, Stefan P Berger, Martin B A Heemskerk, Doaa Al Arashi, Jaap J Homan van der Heide, Aline C Hemke, Ineke J M Ten Berge, Mirza M Idu, Michiel G H Betjes, Arjan D van Zuilen, Luuk B Hilbrands, Aiko P J de Vries, Azam S Nurmohamed, Maarten H Christiaans, L W Ernest van Heurn, Johan W de Fijter, Frederike J Bemelman
An increasing number of elderly patients (≥65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation Registry, we selected 3597 recipients (≥18 years) who received a first DBD or DCD kidney during 2002-2012, and categorized them as young or elderly recipients receiving a graft from either a young or elderly donor, stratified by donor type...
October 11, 2016: Journal of the American Society of Nephrology: JASN
Pietro Felice, Giovanni Zucchelli, Gioacchino Cannizzaro, Carlo Barausse, Michele Diazzi, Anna Trullenque-Eriksson, Marco Esposito
PURPOSE: To compare the clinical outcome of single implants placed immediately after tooth extraction with implants placed 6 weeks after tooth extraction (immediate-delayed placement), and with implants placed after 4 months of extraction and socket healing (delayed placement). MATERIALS AND METHODS: Two hundred and ten patients requiring a single implant-supported crown to replace a tooth to be extracted were randomised to receive immediate post-extractive implants (70 patients), immediate-delayed implants at 6 weeks (70 patients), and delayed implants after 4 months of healing (70 patients), according to a parallel group design...
2016: European Journal of Oral Implantology
Coco de Koning, Stefan Nierkens, Jaap Jan Boelens
T-cell immune reconstitution (IR) after allogeneic hematopoietic cell transplantation (allo-HCT) is highly variable between patients and may take several months to even years. Patients with delayed or unbalanced T-cell IR have a higher probability of developing transplantation-related-morbidity, -mortality, and relapse of disease. Hence, there is a need for strategies to better predict and improve IR to reduce these limitations of allo-HCT. In this review, we provide an update of current and in near-future clinically relevant strategies before, during, and after transplantation to achieve successful T-cell IR...
October 3, 2016: Blood
Nicoline Valentina Krogstrup, Mihai Oltean, Gertrude J Nieuwenhuijs-Moeke, Frank J M F Dor, Ulla Møldrup, Søren Palmelund Krag, Bo Martin Bibby, Henrik Birn, Bente Jespersen
Delayed graft function is a frequent complication following deceased donor renal transplantation, and is closely related to ischaemia-reperfusion injury. Experimental and clinical studies have shown protection by remote ischaemic conditioning (RIC). We hypothesised that recipient RIC before kidney graft reperfusion reduces the time to graft recovery. This multicentre, blinded, randomised, controlled clinical trial included 225 adult recipients of renal transplants from deceased donors at four transplantation centres in Denmark, Sweden and the Netherlands...
October 3, 2016: American Journal of Transplantation
Kevin R Stone, Jonathan R Pelsis, Kellen Na, Ann W Walgenbach, Thomas J Turek
PURPOSE: The purpose of this study is to evaluate the clinical outcomes of the articular cartilage paste graft procedure at a minimum of 10 years from surgery. It is hypothesized that articular cartilage paste grafting can provide patients with a durable repair of severe full-thickness osteochondral injuries, measured by persistence of procedure-induced benefit and subjective outcome scores at 10 or more years. METHODS: Seventy-four patients undergoing paste grafting at a mean age of 45...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jean-Yves Jenny, Xavier Clement
PURPOSE: The purpose of the study was to report the functional outcome following anterior cruciate ligament (ACL) reconstruction in patients who decide when to resume work and normal sporting activity post-operatively. The hypothesis tested was that patient-based decision to return to work and sport was possible without compromising functional outcome and increased the rate of repeat rupture in comparison with the existing literature. METHODS: This was a monocentric, retrospective study...
September 26, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Rongsheng E Wang, Ying Wang, Yuhan Zhang, Chase Gabrelow, Yong Zhang, Victor Chi, Qiangwei Fu, Xiaozhou Luo, Danling Wang, Sean Joseph, Kristen Johnson, Arnab K Chatterjee, Timothy M Wright, Vân T B Nguyen-Tran, John Teijaro, Argyrios N Theofilopoulos, Peter G Schultz, Feng Wang
A variable region fusion strategy was used to generate an immunosuppressive antibody based on a novel "stalk-knob" structural motif in the ultralong complementary-determining region (CDR) of a bovine antibody. The potent Kv1.3 channel inhibitory peptides Moka1-toxin and Vm24-toxin were grafted into different CDRs of the humanized antibodies BVK and Synagis (Syn) using both β-sheet and coiled-coil linkers. Structure-activity relationship efforts led to generation of the fusion protein Syn-Vm24-CDR3L, which demonstrated excellent selectivity and potency against effector human memory T cells (subnanomolar to picomolar EC50 values)...
October 11, 2016: Proceedings of the National Academy of Sciences of the United States of America
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