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Journal of Transplantation

Ehab E Abdel-Khalek, Alrefaey K Alrefaey, Amr M Yassen, Ahmed Monier, Hesham M Elgouhari, Mohamed Samy Habl, Gehad Tawfik, Thuraya Elzayat, Reham Adly Zayed, Mohamed Abdel-Wahab
Introduction. The possible risk factors for chronic kidney disease in transplant recipients have not been thoroughly investigated after living-donor liver transplantation. Material and Methods. A retrospective cohort study of consecutive adults who underwent living-donor liver transplantation between May 2004 and October 2016, in a single center, was conducted. Kidney function was investigated successively for all the patients throughout the study period, with 12 months being the shortest follow-up. Postoperative renal dysfunction was defined in accordance with the Chronic Kidney Disease Epidemiology Collaboration criteria...
2018: Journal of Transplantation
Nadia Iannino, Amine Nasri, Agnès Räkel, Anique Ducharme, Kim Lachance, Normand Racine, Simon de Denus, Maxime Tremblay-Gravel, Annik Fortier, Michel White
Background: Recent changes in the demographic of cardiac donors and recipients have modulated the rate and risk, associated with posttransplant diabetes mellitus (PTDM). We investigated the secular trends of the risk of PTDM at 1 year and 3 years after transplantation over 30 years and explored its effect on major outcomes. Methods: Three hundred and three nondiabetic patients were followed for a minimum of 36 months, after a first cardiac transplantation performed between 1983 and 2011...
2018: Journal of Transplantation
Sara Assadiasl, Mohammad Javad Mousavi, Aliakbar Amirzargar
Survivin, an antiapoptotic molecule from inhibitor of apoptosis protein (IAP) family, is most known for its implication in cancer as there are some efforts to apply it for diagnostic as well as therapeutic purposes in oncology. On the other hand, it could be a useful molecule to be positively targeted when trying to save tissue and promote cells viability. Since protecting the allograft from ischemia reperfusion injury and inflammation-induced damage is a considerable objective in transplantation, it is reasonable to take advantage from antiapoptotic agents like survivin in order to achieve this goal...
2018: Journal of Transplantation
Maryam Mozaffar, Shahrzad Shahidi, Marjan Mansourian, Shirinsadat Badri
Objective: Organ transplant recipients receive immunosuppressive regimens to prevent transplant rejection, which put them at increased risk for opportunistic infections like cytomegalovirus (CMV). Ganciclovir and Valganciclovir are mostly used to prevent or treat CMV. Any incorrect use of the drug may have serious consequences for patients. In this study, the outcome of transplant recipients was assessed in relation to the optimal or suboptimal use of Ganciclovir or Valganciclovir. Methods: This study was performed on 148 hospitalized patients who received Ganciclovir or Valganciclovir in the nephrology and kidney transplantation departments of our university hospitals, from March 2012 to December 2016...
2018: Journal of Transplantation
Edwin Jonathan Aslim, Fang Jann Lee, Valerie Huei Li Gan
Background: Near infrared light (NIR) fluorescence imaging with indocyanine green (ICG) has been used in various aspects of surgery, such as in the assessment of vascular anastomosis, tissue perfusion, and the identification of lymph nodes. In this study we evaluated the utility of NIR/ICG fluorescence imaging in kidney transplantation. Materials and Methods: NIR/ICG imaging was used to assess allograft perfusion in n=1 living donor (LDRT) and n=2 deceased donor (DDRT) renal transplantations, performed in February 2017...
2018: Journal of Transplantation
Kunal Das, Tanvi Khanna, Nitika Agrawal
The scope and application of hematopoietic stem cell transplantation are increasing. With advancement in science and close cooperation of health centers, HSCT units are coming up in new developing and underdeveloped countries. India hosts many HSCT units and often provides financially viable option for HSCT to foreign patients as well. Recently Indian Council of Medical Research (ICMR) issued a guideline about HSCT unit in India. This review article discusses establishment of new HSCT unit in resource limited setting...
2018: Journal of Transplantation
Muhammad Abdul Mabood Khalil, Muhammad Ashhad Ullah Khalil, Taqi F Taufeeq Khan, Jackson Tan
Drug-induced hematological cytopenia is common in kidney transplantation. Various cytopenia including leucopenia (neutropenia), thrombocytopenia, and anemia can occur in kidney transplant recipients. Persistent severe leucopenia or neutropenia can lead to opportunistic infections of various etiologies. On the contrary, reducing or stopping immunosuppressive medications in these events can provoke a rejection. Transplant clinicians are often faced with the delicate dilemma of balancing cytopenia and rejection from adjustments of immunosuppressive regimen...
2018: Journal of Transplantation
Lluís Guirado
Delayed graft function (DGF) increases the risk of graft loss by up to 40%, and recent developments in kidney donation have increased the risk of its occurrence. Lowering the risk of DGF, however, is challenging due to a complicated etiology in which ischemia-reperfusion injury (IRI) leads to acute tubular necrosis. Among various strategies explored, the choice of induction therapy is one consideration. Rabbit antithymocyte globulin (rATG [Thymoglobuline]) has complex immunomodulatory effects that are relevant to DGF...
2018: Journal of Transplantation
Ihab A Ibrahim, Ehab A Hassan, Abdelrahman M Alkhan, Mohamed A Hussein, Ahmed F Alhabashi, Tariq Z Ali, Yasir Z Shah, Ibrahim S Alahmadi, Mohamed S Abdelsalam, Mohamed E Rashwan, Ammar Abdulbaki, Dieter C Broering, Hassan A Aleid
Background: Fasting during the lunar month of Ramadan is mandatory to all healthy adult Muslims. Renal transplant recipients are often worried about the impact of fluid and electrolyte deprivation during fasting on the function of their allograft. We aimed to examine the effect of fasting Ramadan on the graft function in renal transplant recipients. Methods: This retrospective cohort study included patients who underwent kidney transplantation in our tertiary referral center...
2018: Journal of Transplantation
Costanza Casati, Valeriana Giuseppina Colombo, Marialuisa Perrino, Ornella Marina Rossetti, Marialuisa Querques, Alessandro Giacomoni, Agnese Binaggia, Giacomo Colussi
Background: Grafts from elderly donors (ECD) are increasingly allocated to single (SKT) or dual (DKT) kidney transplantation according to biopsy score. Indications and benefits of either procedure lack universal agreement. Methods: A total of 302 ECD-transplants in period from Jan 1, 2000, to Dec 31, 2015, were allocated to SKT (SKTpre ) on clinical grounds alone (before Dec 2010, pre-DKT era, n = 170) or according to a clinical-histological protocol (after Dec 2010, DKT era, n = 132) to DKT ( n = 48), SKT biopsy-based protocol ("high-risk", SKThr , n = 51), or SKT clinically based protocol ("low-risk", SKTlr , n = 33)...
2018: Journal of Transplantation
Shruti Gupta, Ivy Rosales, David Wojciechowski
Background: Calcineurin inhibitors are associated with chronic nephrotoxicity, manifesting as interstitial fibrosis/tubular atrophy (IF/TA) and arteriolar hyalinosis. Conversion from tacrolimus to belatacept may be one strategy to preserve renal function. Methods: We conducted a retrospective review of renal transplant patients followed at our institution who were converted to belatacept and found to have chronic tacrolimus toxicity on biopsy. The primary outcome was eGFR at conversion as compared to eGFR at 3, 6, 12, and 24 months after conversion...
2018: Journal of Transplantation
Maria Cristina Ribeiro de Castro, Erick A Barbosa, Renata P Souza, Fabiana Agena, Patrícia S de Souza, Gabriella Maciel, Hélcio Rodrigues, Nicolas Panajotopoulos, Daísa S David, Flávio J de Paula, Elias David-Neto
The impact of the kinetics of the anti-HLA antibodies after KTx on the occurrence of acute rejection as well as the better time-point to monitor anti-HLA Abs after transplantation is not completely defined. This prospective study followed 150 patients over 12 months after transplantation. Serum IgG anti-HLA Abs were detected by single antigen beads after typing donors and recipients for loci A, B, C, DR, and DQ. Before KTx, 89 patients did not present anti-HLA Abs and 2% developed "de novo" Abs during the 1st year, 39 patients were sensitized without DSAs, and 13% developed DSA after surgery; all of them presented ABMR...
2018: Journal of Transplantation
Akihito Sannomiya, Toru Murakami, Ichiro Koyama, Kosaku Nitta, Ichiro Nakajima, Shohei Fuchinoue
Background: Focal segmental glomerulosclerosis (FSGS) often develops rapidly and frequently progresses to renal failure, while the recurrence rate after kidney transplantation is 20-50%. We performed low-density lipoprotein (LDL) apheresis before kidney transplantation in FSGS patients to prevent recurrence. Methods: Five adult patients with chronic renal failure due to FSGS undergoing living related donor kidney transplantation were investigated retrospectively...
2018: Journal of Transplantation
Sourabh Sharma, Debabrata Mukherjee, Ranjith K Nair, Bhaskar Datt, Ananth Rao
Background: Since the introduction of direct antiviral agents (DAAs), morbidity of HCV has considerably decreased but still no guidelines have been formulated in renal transplant recipients (RTRs). We studied efficacy and tolerability of direct antiviral agents in RTRs. Methods: This prospective observational study was conducted at Army Hospital Research & Referral, Delhi, from June 2016 to May 2017. Forty-five HCV infected RTRs with stable graft function were included...
2018: Journal of Transplantation
N Thao Galván, Kayla Kumm, Michael Kueht, Cindy P Ha, Dor Yoeli, Ronald T Cotton, Abbas Rana, Christine A O'Mahony, Glenn Halff, John A Goss
Stress-induced heart failure, also known as Broken Heart Syndrome or Takotsubo Syndrome, is a phenomenon characterized as rare but well described in the literature, with increasing incidence. While more commonly associated with postmenopausal women with psychiatric disorders, this entity is found in the postoperative patient. The nonischemic cardiogenic shock manifests as biventricular failure with significant decreases in ejection fraction and cardiac function. In a review of over 3000 kidney and liver transplantations over the course of 17 years within two transplant centers, we describe a series of 7 patients with Takotsubo Syndrome after solid organ transplantation...
2018: Journal of Transplantation
David A Baran, Cheryl Rosenfeld, Mark J Zucker
Background: Despite earlier studies describing the feasibility of steroid weaning in heart transplant patients, the majority of patients are maintained on steroid therapy for life. We examined a strategy based on a single morning serum cortisol measurement. Methods: We assigned stable posttransplant patients, who were maintained on tacrolimus, mycophenolate mofetil, and corticosteroids, into one of two groups based on a screening morning cortisol level. Patients with a cortisol < 8 micrograms/deciliter were assigned to a "maintenance" group and the others were assigned to the weaning group and steroids were tapered off over 4-6 weeks...
2018: Journal of Transplantation
Matthew G Cehic, Nishant Nundall, Jerry R Greenfield, Peter S Macdonald
Posttransplant diabetes mellitus (PTDM) is a well-recognized complication of heart transplantation and is associated with increased morbidity and mortality. Previous studies have yielded wide ranging estimates in the incidence of PTDM due in part to variable definitions applied. In addition, there is a limited published data on the management of PTDM after heart transplantation and a paucity of studies examining the effects of newer classes of hypoglycaemic drug therapies. In this review, we discuss the role of established glucose-lowering therapies and the rationale and emerging clinical evidence that supports the role of incretin-based therapies (glucagon like peptide- (GLP-) 1 agonists and dipeptidyl peptidase- (DPP-) 4 inhibitors) and sodium-glucose cotransporter 2 (SGLT2) inhibitors in the management of PTDM after heart transplantation...
2018: Journal of Transplantation
Rajvir Singh, Tulika Mehta Agarwal, Hassan Al-Thani, Yousuf Al Maslamani, Ayman El-Menyar
Objective: To validate a questionnaire for measuring factors influencing organ donation and transplant. Methods: The constructed questionnaire was based on the theory of planned behavior by Ajzen Icek and had 45 questions including general inquiry and demographic information. Four experts on the topic, Arabic culture, and the Arabic and English languages established content validity through review. It was quantified by content validity index (CVI). Construct validity was established by principal component analysis (PCA), whereas internal consistency was checked by Cronbach's Alpha and intraclass correlation coefficient (ICC)...
2018: Journal of Transplantation
Alfonso H Santos, Michael J Casey, Karl L Womer
We studied registry data of 12,944 adult kidney retransplant recipients categorized by induction regimen received into antithymocyte globulin (ATG) ( N = 9120), alemtuzumab ( N = 1687), and basiliximab ( N = 2137) cohorts. We analyzed risk factors for 1-year acute rejection (AR) and 5-year death-censored graft loss (DCGL) and patient death. Compared with the reference, basiliximab: (1) one-year AR risk was lower with ATG in retransplant recipients of expanded criteria deceased-donor kidneys (HR = 0.56, 95% CI = 0...
2017: Journal of Transplantation
Habib Mawad, Hugues Bouchard, Duy Tran, Denis Ouimet, Jean-Philippe Lafrance, Robert Zoël Bell, Sarah Bezzaoucha, Anne Boucher, Suzon Collette, Vincent Pichette, Lynne Senécal, Michel Vallée
Objectives. The primary objective of this study is to evaluate the use of cinacalcet in the management of hyperparathyroidism in kidney transplant recipients. The secondary objective is to identify baseline factors that predict cinacalcet use after transplantation. Methods. In this single-center retrospective study, we conducted a chart review of all patients having been transplanted from 2003 to 2012 and having received cinacalcet up to kidney transplantation and/or thereafter. Results. Twenty-seven patients were included with a mean follow-up of 2...
2017: Journal of Transplantation
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