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arm transplant

Megan Sykes
The last 15 years or so have seen exciting progress in xenotransplantation, with porcine organ grafts surviving months or even years in non-human primates. These advances reflect the application of new scientific knowledge, improved immunosuppressive agents, and genetic engineering. The field has recently enjoyed a renaissance of interest and hope, largely due to the exponential increase in our capacity to genetically engineer porcine source animals. However, immune responses to xenografts are very powerful and widespread clinical application of xenotransplantation will depend on the ability to suppress these immune responses while preserving the capacity to protect both the recipient and the graft from infectious microorganisms...
May 2018: Xenotransplantation
Amber B Clemmons, Julianne Orr, Benjamin Andrick, Arpita Gandhi, Claude Sportes, David DeRemer
Evidence supports olanzapine for prophylaxis of chemotherapy-induced nausea/vomiting (CINV) for highly emetogenic chemotherapy (HEC); however, most studies focus on solid malignancies and single day regimens. A randomized, double-blinded, placebo-controlled trial was conducted to compare addition of olanzapine to triplet therapy (fosaprepitant, ondansetron, dexamethasone; FOND-O) versus triplet therapy alone (FOND) in preventing CINV in hematology patients receiving single and multi-day HEC and hematopoietic cell transplant (HCT) regimens (NCT02635984)...
June 12, 2018: Biology of Blood and Marrow Transplantation
Kathleen M Mullane, Drew J Winston, Ajay Nooka, Michele I Morris, Patrick Stiff, Michael J Dugan, Henry Holland, Kevin Gregg, Javier A Adachi, Steven A Pergam, Barbara D Alexander, Erik R Dubberke, Natalya Broyde, Sherwood L Gorbach, Pamela S Sears
Background: Clostridium difficile-associated diarrhea (CDAD) is common during hematopoietic stem-cell transplantation (HSCT) and is associated with increased morbidity and mortality. We evaluated fidaxomicin for prevention of CDAD in HSCT patients. Methods: In this double-blind study, subjects undergoing HSCT with fluoroquinolone prophylaxis stratified by transplant type (autologous/allogeneic) were randomized to once-daily oral fidaxomicin 200mg or matching placebo...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Robert Flisiak, Ewa Janczewska, Mariusz Łucejko, Ewa Karpińska, Dorota Zarębska-Michaluk, Khalil Nazzal, Beata Bolewska, Jolanta Białkowska, Hanna Berak, Katarzyna Fleischer-Stępniewska, Krzysztof Tomasiewicz, Kornelia Karwowska, Krzysztof Simon, Anna Piekarska, Olga Tronina, Ewelina Tuchendler, Aleksander Garlicki
We followed for 2 years patients treated with Direct Acting Agents (DAA) to assess long-term durability of virologic response, improvement of liver function, reduction of liver stiffness (LS), and risk of hepatocellular carcinoma (HCC).The study included patients from 16 hepatologic centers involved in the AMBER, investigators initiated study on treatment of chronic hepatitis C patients within a programme preceding EU registration of Ombitasvir/Paritaprevir/ritonavir±Dasabuvir±Ribavirin. A total of 204 patients among 209 from the primary study were enrolled; 200 with available testing at 2 years follow-up (2yFU) with undetectable HCV RNA (198 responders and 2 non-responders retreated)...
June 11, 2018: Journal of Viral Hepatitis
Youjin Wang, Weiyin Zhou, Blanche P Alter, Tao Wang, Stephen R Spellman, Michael Haagenson, Meredith Yeager, Stephanie J Lee, Stephen J Chanock, Sharon A Savage, Shahinaz M Gadalla
Studies of chromosomal aberrations in blood or bone marrow of patients with Fanconi anemia (FA) have focused on their associations with leukemic transformation. The role of such abnormalities on outcomes after hematopoietic cell transplantation (HCT) is unclear. We used genome-wide single nucleotide polymorphism (SNP) arrays to identify chromosomal aberrations in pre-HCT blood samples from 73 patients with FA who received unrelated donor HCT for severe aplastic anemia between 1991-2007. Outcome data and blood samples were available through the Center for International Blood and Marrow Transplant Research...
June 4, 2018: Biology of Blood and Marrow Transplantation
Jorge E Cortes, Martin S Tallman, Gary J Schiller, Denise Trone, Guy Gammon, Stuart L Goldberg, Alexander E Perl, Jean-Pierre Marie, Giovanni Martinelli, Hagop M Kantarjian, Mark J Levis
This randomized, open-label, phase 2b study (NCT01565668) evaluated efficacy and safety of two dosing regimens of quizartinib monotherapy in patients with relapsed/refractory (R/R) FLT3-internal tandem duplication (ITD)-mutated acute myeloid leukemia (AML) who previously underwent transplant or one second-line salvage therapy. Patients (N=76) were randomized to 30- or 60-mg/day doses (escalations to 60 or 90 mg/day, respectively, permitted for lack/loss of response) of single-agent oral quizartinib dihydrochloride...
June 6, 2018: Blood
Edoardo Dalla Pozza, Bahar Bassiri Gharb, Francis A Papay, Richard L Drake, Andrew Steckler, Antonio Rampazzo
BACKGROUND: Hand transplantation in patients with severe upper extremity burns can be associated with an increased risk of exposure of vessels, tendons and nerves because of extensive skin and soft tissue deficit. This study evaluated how to reliably transfer additional extended skin flaps with a standard hand allograft. METHODS: Twenty-five upper extremities were used. Sixteen were injected with latex to map the perforating branches of the brachial (BA), superior ulnar collateral (SUCA), radial (RA), ulnar (UA) and posterior interosseous (PIA) arteries...
May 19, 2018: Plastic and Reconstructive Surgery
Jorge Cortes, Alexander E Perl, Hartmut Döhner, Hagop Kantarjian, Giovanni Martinelli, Tibor Kovacsovics, Philippe Rousselot, Björn Steffen, Hervé Dombret, Elihu Estey, Stephen Strickland, Jessica K Altman, Claudia D Baldus, Alan Burnett, Alwin Krämer, Nigel Russell, Neil P Shah, Catherine C Smith, Eunice S Wang, Norbert Ifrah, Guy Gammon, Denise Trone, Deborah Lazzaretto, Mark Levis
BACKGROUND: Old age and FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutations in patients with acute myeloid leukaemia are associated with early relapse and poor survival. Quizartinib is an oral, highly potent, and selective next-generation FLT3 inhibitor with clinical antileukaemic activity in relapsed or refractory acute myeloid leukaemia. We aimed to assess the efficacy and safety of single-agent quizartinib in patients with relapsed or refractory acute myeloid leukaemia...
May 30, 2018: Lancet Oncology
A Nademanee, A Sureda, P Stiff, J Holowiecki, M Abidi, N N Hunder, M Pecsok, M Uttarwar, I Purevjal, J Sweetenham
The phase 3 AETHERA trial demonstrated brentuximab vedotin's (BV) efficacy as consolidation therapy in patients with classical Hodgkin lymphoma (HL) at high risk of relapse or progression following autologous hematopoietic stem cell transplant (auto-HSCT; hazard ratio [HR]=0.57; P<0.001). The objective of this analysis is to provide further detail on the most common and clinically important treatment-emergent adverse events (TEAEs) in the AETHERA BV arm including their occurrence and management. AEs of clinical importance occurring in patients who participated in AETHERA (BV + best supportive care [BSC], n=165; placebo + BSC, n=164) were evaluated for time to onset, manageability through dose modification, and resolution...
May 30, 2018: Biology of Blood and Marrow Transplantation
G Ianiro, L Masucci, G Quaranta, C Simonelli, L R Lopetuso, M Sanguinetti, A Gasbarrini, G Cammarota
BACKGROUND: Faecal microbiota transplantation (FMT) is a highly effective treatment against recurrent Clostridium difficile infection. Far less evidence exists on the efficacy of FMT in treating severe Clostridium difficile infection refractory to antibiotics. AIM: To compare the efficacy of two FMT-based protocols associated with vancomycin in curing subjects with severe Clostridium difficile infection refractory to antibiotics. METHODS: Subjects with severe Clostridium difficile infection refractory to antibiotics were randomly assigned to one of the two following treatment arms: (1) FMT-S, including a single faecal infusion via colonoscopy followed by a 14-day vancomycin course, (2) FMT-M, including multiple faecal infusions plus a 14-day vancomycin course...
May 30, 2018: Alimentary Pharmacology & Therapeutics
Mandeep R Mehra, Christopher Salerno, Joseph C Cleveland, Sean Pinney, Melana Yuzefpolskaya, Carmelo A Milano, Akinobu Itoh, Daniel J Goldstein, Nir Uriel, Sanjeev Gulati, Francis D Pagani, Ranjit John, Robert M Adamson, Roberta C Bogaev, Vinay Thohan, Joyce Chuang, Poornima Sood, Scott Goates, Scott C Silvestry
Background : MOMENTUM 3 compares the centrifugal HeartMate 3 (HM3) to the axial HeartMate II (HMII) continuous-flow Left Ventricular Assist System (LVAS) in patients with advanced heart failure, irrespective of the intended goal of therapy. The trial's 2-year clinical outcome (n=366), demonstrated superiority of the HM3 for the primary endpoint (survival free of a disabling stroke or reoperation to replace or remove a malfunctioning pump). This analysis evaluates health resource use and cost implications of the observed differences between the two devices while patients were enrolled in the trial...
May 27, 2018: Circulation
Daniele Lilleri, Paola Zelini, Chiara Fornara, Federica Zavaglio, Teresa Rampino, Laurent Perez, Elisa Gabanti, Giuseppe Gerna
Immune correlates of protection against human cytomegalovirus (HCMV) infection are still debated. This study aimed to investigate which arm of the immune response plays a major role in protection against HCMV infection in kidney (KTR, n=40) and heart transplant recipients (HTR, n= 12). Overall, patients were divided into two groups: one including 37 patients with low viral load (LVL), and the other including 15 patients with high viral load (HVL). All LVL patients resolved the infection spontaneously, whereas HVL patients were all treated with one or more courses of antivirals...
May 24, 2018: Journal of Medical Virology
Jennifer M Knight, Stephanie A Kerswill, Parameswaran Hari, Steve W Cole, Brent R Logan, Anita D'Souza, Nirav N Shah, Mary M Horowitz, Melinda R Stolley, Erica K Sloan, Karen E Giles, Erin S Costanzo, Mehdi Hamadani, Saurabh Chhabra, Binod Dhakal, J Douglas Rizzo
BACKGROUND: Repurposing existing medications for antineoplastic purposes can provide a safe, cost-effective, and efficacious means to further augment available cancer care. Clinical and preclinical studies suggest a role for the ß-adrenergic antagonist (ß-blocker) propranolol in reducing rates of tumor progression in both solid and hematologic malignancies. In patients undergoing hematopoietic cell transplantation (HCT), the peri-transplant period is a time of increased activity of the ß-adrenergically-mediated stress response...
May 24, 2018: BMC Cancer
William J Lane, Connie M Westhoff, Nicholas S Gleadall, Maria Aguad, Robin Smeland-Wagman, Sunitha Vege, Daimon P Simmons, Helen H Mah, Matthew S Lebo, Klaudia Walter, Nicole Soranzo, Emanuele Di Angelantonio, John Danesh, David J Roberts, Nick A Watkins, Willem H Ouwehand, Adam S Butterworth, Richard M Kaufman, Heidi L Rehm, Leslie E Silberstein, Robert C Green
BACKGROUND: There are more than 300 known red blood cell (RBC) antigens and 33 platelet antigens that differ between individuals. Sensitisation to antigens is a serious complication that can occur in prenatal medicine and after blood transfusion, particularly for patients who require multiple transfusions. Although pre-transfusion compatibility testing largely relies on serological methods, reagents are not available for many antigens. Methods based on single-nucleotide polymorphism (SNP) arrays have been used, but typing for ABO and Rh-the most important blood groups-cannot be done with SNP typing alone...
May 17, 2018: Lancet Haematology
W P Andrew Lee, Jaimie T Shores, Gerald Brandacher
AIM:  To achieve a favorable risk-benefit balance for hand transplantation, an immunomodulatory protocol was developed in the laboratory and translated to clinical application. METHODS:  Following donor bone marrow infusion into transplant recipients, hand and arm allografts have been maintained on low-dose tacrolimus monotherapy. RESULTS:  Good-to-excellent functional recovery has been achieved in patients compliant with medication and therapy, thus restoring autonomous and productive lives...
May 18, 2018: Journal of Reconstructive Microsurgery
Julieta García De Alba Verduzco, Erika Fabiola Hurtado López, Consuelo Pontón Vázquez, Adriana de la Torre Serrano, Enrique Romero Velarde, Edgar Manuel Vásquez Garibay
OBJECTIVE: The objective of the study was to demonstrate that there are differences in the factors associated with anthropometric indicators of nutritional status, with particular emphasis on arm indicators, in children with end-stage kidney disease undergoing peritoneal dialysis (PD), hemodialysis (HD), and after kidney transplant (KT). METHODS: An analytical cross-sectional study of consecutive cases included 130 children and adolescents with end-stage kidney disease undergoing substitutive treatment: 49 patients who underwent KT, 33 undergoing PD, and 47 undergoing HD...
May 11, 2018: Journal of Renal Nutrition
İsmail Okan Yildirim, Turgut Pişkin, Enes Duman, Ali Firat, Murat Dogan, Hülya Taskapan, Idris Sahin, Kaya Sarac
BACKGROUND: We aimed to evaluate the efficacy of percutaneous embolization following lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. METHODS: Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele following renal transplant were included. The mean age of the patients was 56...
May 11, 2018: Transplantation
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
Roman Chmel, Marta Novackova, Zlatko Pastor, Jiri Fronek
STUDY OBJECTIVE: The goal of this study was to assess a group of Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) women with surgically created neovaginas in the interest of uterus transplantation (UTx) and to recruit the first group of applicants for a uterus transplant trial. DESIGN: and Setting: This is an original prospective study using semistructured interviews. PARTICIPANTS: A study group of 50 MRKH syndrome women with Vecchietti neovaginas was recruited by letter of invitation...
May 8, 2018: Journal of Pediatric and Adolescent Gynecology
Daniel Böhringer, Birgit Grotejohann, Gabriele Ihorst, Helga Reinshagen, Eric Spierings, Thomas Reinhard
BACKGROUND: Graft rejection. Twenty to thirty percent of patients with corneal transplants experience at least one rejection episode in the first 5 years after transplantation. Prophylaxis through matching for human leukocyte antigens (HLA) is controversial. We herein report the results of the Functional ANtigen matChing in keratoplastY (FANCY) trial. METHODS: FANCY was a randomized, double-blind, multicenter clinical trial. The primary objective was to evaluate superiority of HLA matching versus random graft assignment...
April 13, 2018: Deutsches Ärzteblatt International
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