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Experimental and Clinical Transplantation

Juan José Araiz Burdio, Paula Ocabo Buil, Elena Lacruz Lopez, María Carmen Diaz Mele, Adrián Rodríguez García, Ana Pascual Bielsa, Begoña Zalba Etayo, Beatriz Virgós Señor, Lucia Marin Araiz, Miguel Ángel Suárez Pinilla
OBJECTIVES: Scarcity of liver grafts has led to the use of marginal donors, consequently increasing the number of complications posttransplant. To prevent this situation, several indicators have been developed. However, important differences remain among countries. Here, we compared an early-risk liver transplant indicator based on the Spanish Liver Transplant Registry, called the Graft Risk Index, versus the US donor risk index and the Eurotransplant donor risk index. MATERIALS AND METHODS: The new indicator was based on prospectively collected data from 600 adult liver transplants performed in our center...
May 14, 2019: Experimental and Clinical Transplantation
Helin Sahinturk, Aycan Ozdemirkan, Pinar Zeyneloglu, Adnan Torgay, Arash Pirat, Mehmet Haberal
OBJECTIVES: Duration of postoperative mechanical ventilation after pediatric liver transplant may influence pulmonary functions, and postoperative prolonged mechanical ventilation is associated with higher morbidity and mortality. Here, we determined its incidence and risk factors after pediatric liver transplant at our center. MATERIALS AND METHODS: We retrospectively analyzed the records of 121 children who underwent liver transplant between April 2007 and April 2017 (305 total liver transplant procedures were performed during this period)...
May 14, 2019: Experimental and Clinical Transplantation
Riccardo De Carlis, Enzo Andorno, Vincenzo Buscemi, Andrea Lauterio, Pietro Diviacco, Stefano Di Sandro, Luciano De Carlis
The shortage of organs has pushed transplant surgeons to accept liver grafts with extended criteria, but severe vascular abnormalities may still discourage the use of otherwise acceptable organs. We report herein the case of a liver graft with a 64-mm aneurysm of the proper hepatic artery extended to the origin of the right and left hepatic branches. The graft was deemed unsuitable for transplant by all other centers in the region. However, liver function tests were normal, and there was no evidence of compromised arterial supply...
May 14, 2019: Experimental and Clinical Transplantation
Shahad Farhan Alenazi, Ghada Mahaya Almutairi, Maha Ahmed Sheikho, Mona Ahmed Al Alshehri, Batool Mousa Alaskar, Abdullah Ahmed Al Sayyari
OBJECTIVES: We investigated the impact of nonimmuno-logic factors on patient and graft survival after deceased-donor kidney transplant. MATERIALS AND METHODS: All deceased-donor kidney transplants performed between January 2004 and December 2015 were included in our analyses. We used the independent t test to calculate significant differences between means above and below medians of various parameters. RESULTS: All study patients (N = 205; 58...
May 14, 2019: Experimental and Clinical Transplantation
Tevfik Tolga Sahin, Kemal Baris Sarici, Burak Kilci, Cemalettin Koc, Emrah Otan, Serdar Karakas, Koray Kutluturk, Cemalettin Aydin, Cuneyt Kayaalp, Sezai Yilmaz
OBJECTIVES: In irreversible acute liver failure, liver transplant is the only viable treatment option. In this study, our aim was to evaluate and determine the factors related to mortality in patients who received liver transplants in accordance with King's College criteria for acute liver failure in order to prevent futile operations. MATERIALS AND METHODS: Our study included 65 adult patients with acute liver failure who received liver transplant according to King's College criteria...
May 9, 2019: Experimental and Clinical Transplantation
Ali Ozer, Hikmet Aktas, Tonguc Utku Yilmaz, Meltem Guner Can, Ercument Gurluler, Isil Yildiz, Remzi Emiroglu
OBJECTIVES: Portal vein thrombosis is no longer a contraindication for liver transplantation. However, varied outcomes are still reported with regard to patients with complete portal vein thrombosis. MATERIALS AND METHODS: We analyzed data of 505 patients who underwent liver transplant between January 2014 and June 2017. Of 505 patients, 55 (10.9%) had portal vein thrombosis, which included 37 patients (67%) who had living-donor and 18 patients (33%) who had deceased-donor liver transplant...
May 8, 2019: Experimental and Clinical Transplantation
Nuretdin Suna, Mohammad Mahdi Mohammadi, Diğdem Özer Etik, Serkan Öcal, Haldun Selçuk
OBJECTIVES: Hepatocellular carcinoma is the most frequent primary malignant tumor of the liver and the third most common cause of all cancer-related mortalities. There is a need to develop new strategies to prevent hepatocellular carcinoma, as the incidence of this cancer continues to increase despite all advancements. In this study, our aim was to determine the effects of propranolol treatment on the incidence of hepatocellular carcinoma in cirrhotic patients waiting for liver transplant...
May 2, 2019: Experimental and Clinical Transplantation
Barbara Jeschke, Aline Gottlieb, Jan-Peter Sowa, Sebastian Jeschke, Jürgen-Walter Treckmann, Guido Gerken, Ali Canbay
OBJECTIVES: Budd-Chiari syndrome is a rare but critical condition that can progress to liver failure and death. For severe cases, orthotopic liver transplant remains the only curative option. The present study aimed to identify predictive parameters to assess outcomes of liver transplant. MATERIALS AND METHODS: Medical records of 33 individuals with Budd-Chiari syndrome who received orthotopic liver transplant were retrospectively assessed. Twenty-seven eligible patients were identified and grouped by outcome (survived/deceased) after transplant for Budd-Chiari syndrome...
May 2, 2019: Experimental and Clinical Transplantation
Senol Tonyali, Hakan Bahadir Haberal, Cenk Yucel Bilen, Fazil Tuncay Aki
OBJECTIVES: Our goal was to investigate the safety and efficacy of the Boari bladder flap procedure in patients who received either allogeneic or autotransplant of kidneys. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all patients with either allogeneic or autotransplant of kidneys who also underwent Boari bladder flap procedures between January 2007 and January 2018. Boari bladder flap was preferred in management of ureteral com-plications after allogeneic renal transplant or it was combined with renal autotransplant when ureteral length was not sufficient to allow ureterovesical anastomosis in patients with ureteral injury...
May 2, 2019: Experimental and Clinical Transplantation
Azita Talebzadeh Bonakdar, Mohammad Mahdi Mohammadi, Afshin Namdar, Pedram Ahmadpoor, Davood Jafari, Mir Saeed Yekaninejad, Ali Akbar Amirzargar
OBJECTIVES: A growing body of evidence has revealed the role of innate immune cells in transplantation; however, the nature of natural killer cell involvement in rejection is still elusive. Here, we aimed to determine the impact of natural killer cell activities in acute and chronic renal transplant rejection. MATERIALS AND METHODS: This preliminary case-control study included 63 participants: 19 were patients with kidney allograft rejection (8 patients with acute rejection and 11 patients with chronic rejection) and 44 comprised the control group (22 patients who had well-functioning grafts posttransplant and 22 healthy subjects)...
May 2, 2019: Experimental and Clinical Transplantation
Mohamed Adel Bakr, Ayman Maher Nagib, Mohamed Hamed Abbas, Ahmed Farouk Donia
OBJECTIVES: Adherence to immunosuppression and minimization of drug exposure are important con-siderations in preventing rejection and maximizing transplant outcomes. The once-daily tacrolimus protocol confers potential benefit by simplifying immunosuppressive regimens, thereby improving adherence among transplant recipients. Studies of stable transplant recipients have suggested that once-daily tacrolimus is bioequivalent to twice-daily tacrolimus and is noninferior to twice-daily tacrolimus with a concentration-dependent rejection risk...
May 2, 2019: Experimental and Clinical Transplantation
Dongyong Zhu, Qichao Zheng, Meng Wu
To allow improved quality of life, renal transplant has been regarded as the best therapeutic option for patients with end-stage renal disease. However, due to shortages of renal sources, annually, only a few patients with renal failure can receive transplants, with most patients requiring hemodialysis to maintain their life. With increasing imbalance of demands and supplies for donor organs, infant organ donors have become an important part of domestic and foreign transplant sources. It is of great importance to guarantee successful kidney transplant outcomes...
May 2, 2019: Experimental and Clinical Transplantation
Danko Mikulic, Ivan Stironja, Stipislav Jadrijevic, Anita Skrtic, Anna Mrzljak, Tajana Filipec Kanizaj, Branislav Kocman
Hepatocellular carcinoma is the fifth most common cancer in the world and the third leading cause of cancer-related death. It is currently one of the leading indications for liver transplant, with selected 5-year survival rates after liver transplant of about 70%. Despite excellent results of liver transplant for hepatocellular carcinoma, a number of patients develop metastases after transplant, and multifocal metastatic disease is the most frequent cause of death. In a large autopsy series of patients with hepatocellular carcinoma, adrenal glands were the third most common site of extrahepatic metastasis after lungs and bones...
May 2, 2019: Experimental and Clinical Transplantation
Anthony DeLeonibus, Graham Mitro, Joseph Brooks, Michael Rees, Jorge Ortiz
OBJECTIVES: Alemtuzumab (monoclonal anti-CD52 antibody) provides profound lymphocyte depletion and offers numerous advantages as an induction agent. Elderly recipients (> 65 years old) traditionally have inferior posttransplant outcomes versus younger recipients. We investigated short-term and long-term patient and graft survival rates following alemtuzumab induction in elderly recipients. MATERIALS AND METHODS: This retrospective analysis, which included 676 renal allograft transplant recipients with alemtuzumab induction, was conducted at the University of Toledo Medical Center between March 2006 and November 2015...
May 2, 2019: Experimental and Clinical Transplantation
Gerard Cortina, Violeta Ojinaga, Manuela Zlamy, Thomas Giner, Magdalena Riedl, Markus Rauchenzauner, Andreas Entenmann, Thomas Müller
OBJECTIVES: Vaccine-preventable diseases remain a major cause of morbidity and mortality in solid-organ transplant candidates and recipients. Newer recommendations include vaccination of all household members to create a herd immunity around the transplant recipient. This study evaluated the vaccination status of pediatric solid-organ transplant recipients and their household members. MATERIALS AND METHODS: We evaluated 30 pediatric solid-organ transplant recipients (14 kidney, 13 liver, 3 heart) and their household members (26 siblings, 30 parents) at time of transplant...
May 2, 2019: Experimental and Clinical Transplantation
Jasmine Sethi, Krishnan L Gupta, Tirthankar Mohanty, Shefali Gupta, Jasmina Ahluwalia, Harbir Singh Kohli
Histoplasmosis is a rare disease in nonendemic areas. We report a case of a 23-year-old male patient who presented with fever of unknown origin, cytopenias, organomegaly, and allograft dysfunction 4 months after renal transplant with father as donor. Bone marrow examination showed intracellular budding yeast cells, which was confirmed as histoplasmosis by culture of bone marrow biopsy sample. The patient was treated with intravenous liposomal amphotericin and responded well.
May 2, 2019: Experimental and Clinical Transplantation
Eliza W Beal, Clifford Akateh, Dmitry Tumin, Fabio Bagante, Sylvester M Black, Kenneth Washburn, Daniel Azouley, Timothy M Pawlik
OBJECTIVES: The benefits of transplant are shown as the difference in survival posttransplant versus that shown if the patient had remained on the wait list. Serum sodium was added to improve prediction. We sought to revisit the question of which Model for End-Stage Liver Disease-Sodium score threshold corresponded to a predicted benefit of liver transplant. MATERIALS AND METHODS: Data on adult patients (≥ 18 years old) were obtained from the United Network for Organ Sharing registry (date range of June 18, 2013 to December 2016)...
May 2, 2019: Experimental and Clinical Transplantation
Beyza Goncu, Emrah Yucesan, Erhan Aysan, Nur Ozten Kandas
OBJECTIVES: Tissue-specific immunogenicity can be characterized by the determination of human leukocyte antigens (HLA). Parathyroid hyperplasia tissue cells are presumed to have the ability to lose HLA class I expression profile during cultivation, whereas healthy parathyroid cells are presumed to already express HLA class I molecules at low levels. However, there are conflicting results about the expression of HLA class I antigens. In this study, our aim was to evaluate different patterns of HLA class I expression in different parathyroid tissue cells...
April 17, 2019: Experimental and Clinical Transplantation
Alexandra J Wenig, Naoru Koizumi, Mehdi Nayebpour, Jorge Ortiz
OBJECTIVES: Increasing living-donor kidney transplant procedures via kidney paired donations could help combat organ shortages. We examined whether a higher volume of kidney paired donation transplants would lead to increased center performance. MATERIALS AND METHODS: Kidney paired donation, living-donor, and deceased-donor transplant data from 165 centers between 2012 and 2016 were obtained from the UNOS OPTN database. The fixed-effects model was used for panel analysis based on Durbin-Wu-Hausman tests (P < ...
April 17, 2019: Experimental and Clinical Transplantation
Riccardo Pravisani, Akihiko Soyama, Mitsuhisa Takatsuki, Masaaki Hidaka, Tomohiko Adachi, Shinichiro Ono, Takanobu Hara, Takashi Hamada, Kengo Kanetaka, Susumu Eguchi
OBJECTIVES: Hepatic venous congestion is associated with impaired graft regeneration in living-donor liver transplant, and the management of middle hepatic vein tributaries in the right lobe graft represents an unresolved issue. In this study, we aimed to investigate the precise outflow pattern of segments 5 and 8 between the right hepatic vein and middle hepatic vein and the respective regeneration rates after living-donor liver transplant with right lobe graft, as available data on these relevant topics are scarce...
April 17, 2019: Experimental and Clinical Transplantation
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