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World Journal of Transplantation

Yuri L Boteon, Simon C Afford
Longstanding research describes the mechanisms whereby the restoration of blood flow and reoxygenation (reperfusion) aggravates the ischaemic injury caused by a period of anoxia to a donor liver. This phenomenon, called ischaemia-reperfusion injury (IRI), leads to parenchymal cell death, microcirculatory failure, and inflammatory immune response. Clinically, IRI is the main factor responsible for the occurrence of posttransplant graft dysfunction and ischaemic-type biliary lesions. While extended criteria donor livers are more vulnerable to IRI, their utilisation is required to address the shortfall in donor organs...
January 16, 2019: World Journal of Transplantation
Swati Arora, Gretchen Kipp, Nitin Bhanot, Kalathil K Sureshkumar
Vaccine preventable diseases account for a significant proportion of morbidity and mortality in transplant recipients and cause adverse outcomes to the patient and allograft. Patients should be screened for vaccination history at the time of pre-transplant evaluation and vaccinated at least four weeks prior to transplantation. For non-immune patients, dead-vaccines can be administered starting at six months post-transplant. Live attenuated vaccines are contraindicated after transplant due to concern for infectious complications from the vaccine and every effort should be made to vaccinate prior to transplant...
January 16, 2019: World Journal of Transplantation
Moussab Damlaj, Mohammad Snnallah, Ayman Alhejazi, Samer Ghazi, Bader Alahmari, Ahmed Alaskar, Mohsen Al-Zahrani
AIM: To examine the outcome and prognostic factors for high risk patients with acute lymphoblastic leukemia/lymphoma (ALL/LBL) who underwent allogeneic hematopoietic stem cell transplantation (HCT) at our center during the period of 2010-2017. METHODS: After due institutional review board approval, patients with high risk ALL/LBL post HCT were identified and included. All records were retrospectively collected. Time to event analysis was calculated from the date of HCT until event of interest or last follow up with Kaplan-Meir means...
November 30, 2018: World Journal of Transplantation
Emmanouil Giorgakis, Amit K Mathur, Harini A Chakkera, Kunam S Reddy, Adyr A Moss, Andrew L Singer
Pancreas transplant has evolved significantly in recent years. It has now become a viable treatment option on type 1 diabetic patients with poorly controlled diabetes on conventional treatment, insulin intolerance, hypoglycaemia unawareness, brittle diabetes and/ or end-stage kidney disease. The purpose of this review is to provide an overview of pancreas transplant historical origins and current barriers to broader utilization of pancreata for transplant, with a focus on areas for future improvement to better pancreas transplant care...
November 30, 2018: World Journal of Transplantation
Yazin Marie, Avneesh Kumar, Sarah Hinchliffe, Simon Curran, Peter Brown, Douglas Turner, Badri Shrestha
Transplant renal artery (TRA) pseudoaneurysm can result in bleeding, infection, graft dysfunction and graft loss. We report the management of a renal transplant recipient who presented five months after renal transplantation with deterioration of renal function, who was found to have TRA pseudoaneurysm and TRA stenosis. Both were treated radiologically by using expandable hydrogel coils (EHC) in combination with stenting. Improvement in clinical, biochemical and radiological parameters were observed after the intervention...
October 22, 2018: World Journal of Transplantation
Yuri L Boteon, Amanda Pcs Boteon, Joseph Attard, Lorraine Wallace, Ricky H Bhogal, Simon C Afford
AIM: To review the clinical impact of machine perfusion (MP) of the liver on biliary complications post-transplantation, particularly ischaemic-type biliary lesions (ITBL). METHODS: This systematic review was performed in accordance with the Preferred Reporting Systematic Reviews and Meta-Analysis (PRISMA) protocol. The following databases were searched: PubMed, MEDLINE and Scopus. The keyword "liver transplantation" was used in combination with the free term "machine perfusion"...
October 22, 2018: World Journal of Transplantation
Fedaey Abbas, Mohsen El Kossi, Jon Jin Kim, Ihab Sakr Shaheen, Ajay Sharma, Ahmed Halawa
For decades, kidney diseases related to inappropriate complement activity, such as atypical hemolytic uremic syndrome and C3 glomerulopathy (a subtype of membranoproliferative glomerulonephritis), have mostly been complicated by worsened prognoses and rapid progression to end-stage renal failure. Alternative complement pathway dysregulation, whether congenital or acquired, is well-recognized as the main driver of the disease process in these patients. The list of triggers include: surgery, infection, immunologic factors, pregnancy and medications...
October 22, 2018: World Journal of Transplantation
Ignazio R Marino, Augusto Lauro
Short bowel syndrome (SBS) is due to a massive loss of small bowel: the reduction of gut function is below the minimum necessary to maintain health (in adults) and growth (in children) so intravenous supplementation is required. Parenteral nutrition represents the milestone of treatment and surgical attempts should be limited only when the residual bowel is sufficient to increase absorption, reducing diarrhea and slowing the transit time of nutrients, water and electrolytes. The surgical techniques lengthen the bowel (tapering it) or reverse a segment of it: developed in children, nowadays are popular also among adults...
October 22, 2018: World Journal of Transplantation
Katrine Rolid, Arne K Andreassen, Marianne Yardley, Elisabeth Bjørkelund, Kristjan Karason, Julia P Wigh, Christian H Dall, Finn Gustafsson, Lars Gullestad, Kari Nytrøen
AIM: To study exercise capacity and determinants of early peak oxygen consumption (VO2peak ) in a cohort of de novo heart transplant (HTx) recipients. METHODS: To determine possible central (chronotropic responses, cardiopulmonary and hemodynamic function) and peripheral factors (muscular exercise capacity and body composition) predictive of VO2peak , a number of different measurements and tests were performed, as follows: Cardiopulmonary exercise testing (CPET) was performed mean 11 wk after surgery in 81 HTx recipients > 18 years and was measured with breath by breath gas exchange on a treadmill or bicycle ergometer...
September 10, 2018: World Journal of Transplantation
Alberto Mella, Ester Gallo, Maria Messina, Cristiana Caorsi, Antonio Amoroso, Paolo Gontero, Aldo Verri, Francesca Maletta, Antonella Barreca, Fabrizio Fop, Luigi Biancone
AIM: To evaluate the role of a therapeutic regimen with plasma exchange, intravenous immunoglobulins and rituximab in chronic-active antibody-mediated rejection (cAMR) settings. METHODS: We compared 21 kidney transplant recipients (KTRs) with a diagnosis of cAMR in a retrospective case-control analysis: nine KTRs treated with plasmapheresis, intravenous immunoglobulins and rituximab (PE-IVIG-RTX group) vs 12 patients (control group) not treated with antibody-targeted therapies...
September 10, 2018: World Journal of Transplantation
Subhashini Ayloo, Sri Ram Pentakota, Michele Molinari
AIM: To compare trends in donor/recipient characteristics and outcomes using four period cohorts of liver transplant recipients from 1990 to 2009. METHODS: Seventy thousand three hundred and seventy-seven adult first-time recipients of whole-organ deceased-donor liver grafts from 1990 to 2009 were followed up until September 2013. Four periods based on transplantation dates were considered to account for developments in transplantation. Descriptive statistics were used to describe donor/recipient characteristics and transplant outcomes...
September 10, 2018: World Journal of Transplantation
Petra E de Ruiter, Yashna Gadjradj, Robert J de Knegt, Herold J Metselaar, Jan Nm Ijzermans, Luc Jw van der Laan
AIM: To investigate the specific effects of immunosuppressants on the antiviral action of daclatasvir and asunaprevir. METHODS: The antiviral activity of daclatasvir (DCV) and asunaprevir (ASV) combined with immunosuppressants was tested using two in vitro models for hepatitis C virus (HCV) infection. RESULTS: Tacrolimus, rapamycin and cyclosporine did not negatively affect the antiviral action of DCV or ASV. Mycophenolic acid (MPA) showed additive antiviral effects combined with these direct acting antivirals (DAAs)...
September 10, 2018: World Journal of Transplantation
Junji Uchida, Tomoaki Iwai, Tatsuya Nakatani
This minireview focuses on the current knowledge about the introduction of everolimus (EVL), a mammalian target of rapamycin inhibitor, with calcineurin inhibitor (CNI) elimination or minimization in kidney transplant recipients at a late posttransplant stage. Within, we have summarized two major clinical trials, ASCERTAIN and APOLLO, and seven other retrospective or nonrandomized studies. In the open-label multicenter ASCERTAIN study, the estimated glomerular filtration rate (eGFR) at 24 mo after conversion was not significantly different between three groups-EVL with CNI elimination, CNI minimization and continued CNI unchanged-at a mean of 5...
September 10, 2018: World Journal of Transplantation
Jesmar Buttigieg, Andrei Agius-Anastasi, Ajay Sharma, Ahmed Halawa
Urological complications, especially urine leaks, remain the most common type of surgical complication in the early post-transplant period. Despite major advances in the field of transplantation, a small minority of kidney transplants are still being lost due to urological problems. Many of these complications can be traced back to the time of retrieval and implantation. Serial ultrasound examination of the transplanted graft in the early post-operative period is of key importance for early detection. The prognosis is generally excellent if recognized and managed in a timely fashion...
September 10, 2018: World Journal of Transplantation
Fedaey Abbas, Mohsen El Kossi, Jon Jin Kim, Ajay Sharma, Ahmed Halawa
Thrombotic microangiopathy (TMA) is one of the most devastating sequalae of kidney transplantation. A number of published articles have covered either de novo or recurrent TMA in an isolated manner. We have, hereby, in this article endeavored to address both types of TMA in a comparative mode. We appreciate that de novo TMA is more common and its prognosis is poorer than recurrent TMA; the latter has a genetic background, with mutations that impact disease behavior and, consequently, allograft and patient survival...
September 10, 2018: World Journal of Transplantation
Giacomo Colussi, Costanza Casati, Valeriana Giuseppina Colombo, Mario Livio Pietro Camozzi, Fabio Rosario Salerno
AIM: To compare survival of kidney transplants from deceased extended criteria donors (ECD) according to: (1) donor graft histological score; and (2) allocation of high score grafts either to single (SKT) or dual (DKT) transplant. METHODS: Renal biopsy was performed as part of either a newly adopted DKT protocol, or of surveillance protocol in the past. A total 185 ECD graft recipients were categorized according to pre-implantation graft biopsy into 3 groups: SKT with graft score 1 to 4 [SKT(1-4) , n = 102]; SKT with donor graft score 5 to 8 [SKT(> 4) , n = 30]; DKT with donor graft score 5 to 7 (DKT, n = 53)...
August 9, 2018: World Journal of Transplantation
Bhavna Chopra, Kalathil K Sureshkumar
AIM: To evaluate the outcomes of transplanting marginal kidneys preemptively compared to better-quality kidneys after varying dialysis vintage in older recipients. METHODS: Using OPTN/United Network for Organ Sharing database from 2001-2015, we identified deceased donor kidney (DDK) transplant recipients > 60 years of age who either underwent preemptive transplantation of kidneys with kidney donor profile index (KDPI) ≥ 85% (marginal kidneys) or received kidneys with KDPI of 35%-84% (better quality kidneys that older wait-listed patients would likely receive if waited longer) after being on dialysis for either 1-4 or 4-8 years...
August 9, 2018: World Journal of Transplantation
Francis E Dailey, Erica P Turse, Maliha Naseer, Jack D Bragg, Veysel Tahan
Those patients with perianal Crohn's disease or ulcerative colitis experience a difficult to treat disease process with a delayed state and often inability to heal despite current therapies. The approaches currently used to treat these patients with corticosteroids, antibiotics, immunomodulators, anti-tumor necrosis factor-α drug, and surgical repair are limited in their healing ability. This review presents all current literature since emergence in the early 2000s of stem cell therapy for patients with perianal inflammatory bowel disease and analyzes the efficacy, outcomes and safety within these studies...
August 9, 2018: World Journal of Transplantation
Maurizio Salvadori, Aris Tsalouchos
Data from World Health Organization estimates that the hepatitis C virus (HCV) prevalence is 3% and approximately 71 million persons are infected worldwide. HCV infection is particularly frequent among patients affected by renal diseases and among those in dialysis treatment. In addition to produce a higher rate of any cause of death, HCV in renal patients and in renal transplanted patients produce a deterioration of liver disease and is a recognized cause of transplant glomerulopathy, new onset diabetes mellitus and lymphoproliferative disorders...
August 9, 2018: World Journal of Transplantation
Ahmed Aref, Tariq Zayan, Ajay Sharma, Ahmed Halawa
Adequate intravenous fluid therapy is essential in renal transplant recipients to ensure a good allograft perfusion. Central venous pressure (CVP) has been considered the cornerstone to guide the fluid therapy for decades; it was the only available simple tool worldwide. However, the revolutionary advances in assessing the dynamic preload variables together with the availability of new equipment to precisely measure the effect of intravenous fluids on the cardiac output had created a question mark on the future role of CVP...
June 28, 2018: World Journal of Transplantation
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