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Transplant International

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https://read.qxmd.com/read/31002407/epithelial-cell-death-markers-in-bronchoalveolar-lavage-correlate-with-chronic-lung-allograft-dysfunction-subtypes-and-survival-in-lung-transplant-recipients-a-single-center-retrospective-cohort-study
#1
Liran Levy, Alexander Tigert, Ella Huszti, Tomohito Saito, Mitsakakis Nicholas, Sajad Moshkelgosha, Betty Joe, Kristen Boonstra, Jussi M Tikkanen, Shaf Keshavjee, Stephen C Juvet, Tereza Martinu
BACKGROUND: Chronic lung allograft dysfunction (CLAD) remains the leading cause of late death after lung transplantation. Epithelial injury is thought to be a key event in the pathogenesis of CLAD. M30 and M65 are fragments of cytokeratin-18 released specifically during epithelial cell apoptosis and total cell death, respectively. We investigated whether M30 and M65 levels in bronchoalveolar lavage (BAL) correlate with CLAD subtypes: restrictive allograft syndrome (RAS) vs. bronchiolitis obliterans syndrome (BOS)...
April 19, 2019: Transplant International
https://read.qxmd.com/read/30983060/long-term-risk-for-kidney-donors-with-hypertension-at-donation-a-retrospective-cohort-study
#2
Anders Johan Haugen, Nina Elisabeth Langberg, Dag Olav Dahle, Hege Pihlstrøm, Kåre Inge Birkeland, Anna Reisaeter, Karsten Midtvedt, Anders Hartmann, Hallvard Holdaas, Geir Mjøen
In the general population, small increases in blood pressure are associated with increased mortality. In kidney donors this association is less certain. We therefore assessed long-term overall and cardiovascular mortality in donors who were hypertensive at the time of donation compared to normotensive donors. Hypertension was defined as blood pressure > 140/90 mmHg or use of antihypertensive drugs. Adequate records available in 2131 donors revealed that 140 were hypertensive and 1991 were normotensive. Multivariable regression analyses were performed for overall and cardiovascular mortality...
April 15, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30980772/the-future-of-organ-perfusion-and-re-conditioning
#3
REVIEW
A Weissenbacher, G Vrakas, D Nasralla, C D L Ceresa
Organ preservation and re-conditioning using machine perfusion technologies continue to generate promising results in terms of viability assessment, organ utilisation and improved initial graft function. Here, we summarise the latest findings and study the results of ex-vivo/ex-situ hypothermic (HMP) and normothermic machine perfusion (NMP) in the area of abdominal organ transplantation (kidney, liver, pancreas and intestine). We also consider the potential role of normothermic regional perfusion (NRP) to re-condition DCD organs before retrieval...
April 13, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30980556/allosensitization-after-transplant-failure-the-role-of-graft-nephrectomy-and-immunosuppression
#4
Gaetano Lucisano, Paul Brookes, Eva Santos-Nunez, Nicola Firmin, Nicola Gunby, Sevda Hassan, Alexander Gueret-Wardle, Paul Herbert, Vassilios Papalois, Michelle Willicombe, David Taube
There are conflicting data about the role of transplant nephrectomy and immunosuppression withdrawal on the development of allosensitization and the impact on re-transplantation. We divided 109 first graft recipients into two groups according to whether they underwent nephrectomy (NX+, n=61) or their graft was left in situ (NX-, n=48). Sera were assessed for HLA-A/B/Cw/DR/DQ antibodies at the time of NX/transplant failure and after 3, 6, 12, 24 months. The NX+ group showed a higher rate of donor specific antibody (DSA) and non-DSA HLA antibody production at all the time points...
April 13, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30972802/utility-or-futility-of-interleukin-2-receptor-antagonist-il2ra-induction-in-kidney-transplants-the-devil-is-in-the-detail
#5
Ajay Kher, Vijay Kher
Induction therapy is used routinely in kidney transplantation and has been recommended by the 2009 Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline as a level 1A recommendation (1) . However, which agent should be used for induction and in which patient remains a matter of debate. Induction agents currently in use include depleting (usually, polyclonal anti-thymocyte globulin derived from rabbit -rATG) or non depleting (Interleukin 2 receptor antagonists - IL2RA) agents. This article is protected by copyright...
April 10, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30968472/cultural-barriers-to-organ-donation-among-chinese-and-korean-individuals-in-the-united-states-a-systematic-review
#6
REVIEW
Miah T Li, Grace C Hillyer, S Ali Husain, Sumit Mohan
Asian Americans have the lowest organ donation registration rates in the United States, and the reason for this is incompletely understood. Aiming to understand the reasons for low organ donation registration rate among Asian Americans, more specifically Chinese and Korean Americans, we conducted a systematic search of databases, websites, and gray literature. Altogether, 34 papers were retained after assessment of relevance and quality. Commonly reported barriers to organ donation registration among Chinese and Koreans in the literature included lack of knowledge about organ donation, distrust of health care and allocation system, cultural avoidance of discussion of death related topics, and desire for intact body mainly stemming from the Confucian concept of filial piety...
April 9, 2019: Transplant International
https://read.qxmd.com/read/30963624/combined-liver-kidney-transplantation-two-for-the-price-of-one
#7
R C Minnee, S Darwish Murad, W G Polak, H J Metselaar
In 1983 the first combined liver and kidney transplantation (CLKT) was performed by Margreiter et al and the first CLKT from a living related donor was carried out in Turkey in 1992. The indications for CLKT can be divided into three categories: I) end-stage liver disease with chronic kidney failure, II) end-stage liver disease with acute kidney failure, and III) metabolic disorders. This article is protected by copyright. All rights reserved.
April 8, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30963618/measuring-physiologic-shunt-fraction-during-normothermic-ex-vivo-lung-perfusion-to-assess-transplantability-of-questionable-donor-lungs
#8
Dirk Van Raemdonck, Arne Neyrinck
Lung transplantation as a live-saving treatment for selected patients with end-stage lung disease still suffers from a shortage of suitable lung donors [1]. The process of accepting donor lungs is often based on a subjective decision following a short-term macroscopic evaluation of the pulmonary graft by bronchoscopy, palpation, and inspection inside the donors' chest at the time of multi-organ retrieval [2]. P/F ratio defined as partial pressure of oxygen measured in a systemic artery (PaO2 ) / fraction of inspired oxygen (FiO2 ) is the historic clinical gold standard to assess gas exchange of donor lungs in vivo as an estimate of post-transplant pulmonary function...
April 8, 2019: Transplant International
https://read.qxmd.com/read/30955215/the-therapeutic-challenge-of-late-antibody-mediated-kidney-allograft-rejection
#9
REVIEW
Georg A Böhmig, Farsad Eskandary, Konstantin Doberer, Philip F Halloran
Late antibody-mediated rejection (ABMR) is a cardinal cause of kidney allograft failure, manifesting as a continuous and, in contrast to early rejection, often clinically silent alloimmune process. While significant progress has been made towards an improved understanding of its molecular mechanisms and the definition of diagnostic criteria, there is still no approved effective treatment. In recent small randomized controlled trials, therapeutic strategies with promising results in observational studies, such as proteasome inhibitor bortezomib, anti-C5 antibody eculizumab, or high dose intravenous immunoglobulin plus rituximab, had no significant impact in late and/or chronic ABMR...
April 7, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30924562/efficacy-of-the-natural-oxygen-transporter-hemo2life-%C3%A2-in-cold-preservation-in-a-preclinical-porcine-model-of-donation-after-cardiac-death
#10
Jacques Kaminski, Patrick Hannaert, Abdesalam Kasil, Raphael Thuillier, Elisabeth Leize, Eric Delpy, Clara Steichen, Jean Michel Goujon, Franck Zal, Thierry Hauet
The growing use of marginal organs for transplantation pushes current preservation methods towards their limits, and the need for improvement is pressing. We previously demonstrated the benefits of M101, a natural extracellular oxygen carrier compatible with hypothermia, for the preservation of healthy renal grafts in a porcine model of auto-transplantation. Herein, we use a variant of this pre-clinical model to evaluate M101 potential benefits both in static storage (CS) and in machine perfusion (MP) preservation in the transplantation outcomes for marginal kidneys...
March 29, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30924559/health-related-quality-of-life-in-liver-transplantation-another-step-forward
#11
Patrizia Burra, Alberto Ferrarese
In the field of liver transplantation (LT), satisfactory results have been achieved in recent years in terms of graft and patient survival, but improving patients' health-related quality of life (HRQoL) remains an issue. It is well known that the HRQoL of patients with end-stage liver disease is impaired due to the life-threatening complications of portal hypertension, frequent hospitalizations, and limitations on their social life. This article is protected by copyright. All rights reserved.
March 29, 2019: Transplant International
https://read.qxmd.com/read/30920681/reclaiming-missed-opportunities-a-strategy-of-targeted-direct-acting-antiviral-prophylaxis-for-hcv-seronegative-recipients-of-hcv-seropositive-donor-kidneys
#12
Christine M Durand, Jacqueline Garonzik-Wang, Niraj M Desai
Direct acting antivirals (DAAs) have cured millions of individuals living with chronic hepatitis C virus (HCV) infection. They have also been shown to be effective and tolerable in transplant recipients, with good outcomes using HCV-infected (HCV+) donor organs for HCV+ recipients. Despite these advances, HCV+ donor organs continue to be discarded in the face of a severe organ shortage. This article is protected by copyright. All rights reserved.
March 28, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30920056/emerging-technologies-in-organ-preservation-tissue-engineering-and-regenerative-medicine-a-blessing-or-curse-for-transplantation
#13
REVIEW
Franka Messner, Yinan Guo, Joanna W Etra, Gerald Brandacher
Since the beginning of transplant medicine in the 1950's, advances in surgical technique and immunosuppressive therapy have created the success story of modern organ transplantation. However, today more than ever, we are facing a huge discrepancy between organ supply and demand, limiting the potential for transplantation to save and improve the lives of millions. To address current limitations and shortcomings, a variety of emerging new technologies focusing on either maximizing the availability of organs or on generating new organs and organ sources hold great potential to eventully overcoming these hurdles...
March 28, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30903722/increased-risk-of-rejection-after-basiliximab-induction-in-sensitized-kidney-transplant-recipients-without-pre-existing-donor-specific-antibodies-a-retrospective-study
#14
Annabelle Goumard, Bénédicte Sautenet, Elodie Bailly, Elodie Miquelestorena-Standley, Barbara Proust, Hélène Longuet, Lise Binet, Christophe Baron, Jean-Michel Halimi, Matthias Büchler, Philippe Gatault
Depleting induction therapy is recommended in sensitized kidney transplant recipients (KTRs), though the detrimental effect of non-donor-specific anti-HLA antibodies is not undeniable. We compared the efficacy and safety of basiliximab and rabbit anti-thymocyte globulin (rATG) in sensitized KTRs without pre-existing donor-specific antibodies (DSAs). This monocentric retrospective study involved all sensitized KTR adults without pre-existing DSAs (n=218) who underwent transplantation after June 2007. Patients with basiliximab and rATG therapy were compared for risk of biopsy-proven acute rejection (BPAR) and a composite end-point (BPAR, graft loss and death) by univariate and multivariate analysis...
March 23, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30903673/evaluation-of-donor-kidneys-prior-to-transplantation-an-update-of-current-and-emerging-methods
#15
REVIEW
Beat Moeckli, Pamela Sun, François Lazeyras, Philippe Morel, Solange Moll, Manuel Pascual, Léo H Bühler
The lack of suitable kidney donor organs has led to rising numbers of patients with end stage renal disease waiting for kidney transplantation. Despite decades of clinical experience and research, no evaluation process that can reliably predict the outcome of an organ has yet been established. This review is an overview of current methods and emerging techniques in the field of donor kidney evaluation prior to transplantation. Established techniques like histological evaluation, clinical scores, and machine perfusion systems offer relatively reliable predictions of delayed graft function but are unable to consistently predict graft survival...
March 23, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30903630/transplant-center-characteristics-associated-with-living-donor-kidney-transplantation-a-cohort-study-with-a-hierarchical-modeling-approach
#16
Valérie Châtelet, Philippe Gatault, Marc Hazzan, Dany Anglicheau, Guy Launoy, Thierry Lobbedez, Bruno Moulin
Transplant center organization, that is a modifiable factor, may affect the access to living-donor kidney transplantation (LDKT). The objective of this study was to identify the center characteristics associated with LDKT using a hierarchical analysis. This was a retrospective multicenter observational study of 8701 patients who received a first renal graft between 2010 and 2014 in 32 transplantation centers of France. Hierarchical modeling was used to estimate the center effect and organization associated with LDKT...
March 22, 2019: Transplant International
https://read.qxmd.com/read/30901502/effects-of-immunoadsorption-combined-with-membrane-filtration-on-complement-markers-results-of-a-randomized-controlled-crossover-study
#17
Federica Defendi, Paolo Malvezzi, Farsad Eskandary, Jean-Yves Cesbron, Lionel Rostaing, Georg A Böhmig, Chantal Dumestre-Pérard
The complement system has been implicated in several kidney diseases, such as antibody-mediated rejection after kidney transplantation. Antibody-depletion techniques allow successful ABO- and/or HLA-incompatible transplantation. Considering the IgG removal, the use of semi-selective immunoadsorption (IA) has been advocated. However, because of results on incomplete IgM depletion, the adjunctive use of membrane filtration (MF) has been proposed to enhance the removal of macromolecules and to interfere with complement activation...
March 22, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30891833/a-novel-concept-for-evaluation-of-pulmonary-function-utilizing-pao-2-fio-2-difference-at-the-distinctive-fio-2-in-cellular-ex-vivo-lung-perfusion
#18
Hiromichi Niikawa, Toshihiro Okamoto, Kamal S Ayyat, Yoshifumi Itoda, Carol F Farver, J Steven Hata, Kenneth R McCurry
BACKGROUND: For more accurate lung evaluation in ex vivo lung perfusion (EVLP), we have devised a new parameter, PaO2 /FiO2 ratio difference (PFD); PFD1-0.4 = P/F ratio at FiO2 1.0 - P/F ratio at FiO2 0.4. The aim of this study is to compare PFD and transplant suitability, and physiological parameters utilized in cellular EVLP. METHODS: Thirty-nine human donor lungs were perfused. At 2 hours EVLP, PFD1-0.4 was compared with transplant suitability and physiological parameters...
March 20, 2019: Transplant International
https://read.qxmd.com/read/30891814/pushing-the-envelope-for-obese-kidney-donor-candidates
#19
A Seth Waits, S Randall Sung
Obesity has become a landmark issue in the field of transplantation. In 2013, kidney donors with a body mass index (BMI) greater than thirty represented 25% of all living kidney donors in the United States. This stands in stark contrast to the 1970's, when 8% of donors had a BMI above thirty(1). Advances in technology and metabolic screening have allowed us to stretch the acceptable limit for BMI while minimizing risk, but we have yet to fully understand and optimize how obese donors can be best managed. This article is protected by copyright...
March 19, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
https://read.qxmd.com/read/30883970/il-10-specific-autoantibodies-predict-major-adverse-cardiovascular-events-in-kidney-transplanted-patients-a-retrospective-cohort-study
#20
Kit Peiter Lund, Jakob Hjorth von Stemann, Frank Eriksson, Morten Bagge Hansen, Bente Klarlund Pedersen, Søren Schwartz Sørensen, Helle Bruunsgaard
End-stage renal failure is associated with persistent systemic inflammation. The aim of this study was to investigate if systemic inflammation at the time of kidney transplantation is linked to poor graft survival, major adverse cardiovascular events (MACE), and increased mortality, and if these processes are modulated by naturally occurring cytokine-specific autoantibodies (c-aAbs), which have been shown to regulate cytokine activity in vitro. Serum levels of cytokines, high-sensitivity C-reactive protein (hsCRP) and c-aAbs specific for interleukin (IL)-1α, tumor necrosis factor (TNF)-α, IL-6, and IL-10 were measured at the time of transplantation in a retrospective cohort study of 619 kidney transplanted patients with a median follow-up of 4...
March 18, 2019: Transplant International: Official Journal of the European Society for Organ Transplantation
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