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Transplantation Direct

Daisuke Ueda, Atsushi Yoshizawa, Masakatsu Kaneshiro, Yoshihiro Hirata, Shintaro Yagi, Koichiro Hata, Hideaki Okajima, Hiroto Egawa, Shinji Uemoto
Background: The ABO blood-type barrier in kidney and liver transplantation has been overcome by aggressive treatments such as B cell depletion using rituximab. However, the long-term effects of ABO-incompatible liver transplantation (ABO-I LTx) on immunological status have not previously been studied. Here, we assessed whether long-term immune hyporesponsiveness against ABO blood-group antigens was retained. Methods: We recruited 81 patients, 75 patients who had survived ABO-I LTx without retransplantation and 6 patients who had survived after retransplantation using blood type-compatible grafts...
January 2019: Transplantation Direct
Ute Eisenberger, Justa Friebus-Kardash, Hana Guberina, Andreas Kribben, Oliver Witzke, Katharina Willuweit, Guido Gerken, Kerstin Herzer
Background: Direct-acing antiviral agents are highly efficient treatment options for chronic hepatitis C virus (HCV) infection after renal allograft transplantation. Treatment options for patients with impaired graft function remain limited. Therefore, we assessed the effectiveness and safety of grazoprevir/elbasvir therapy for patients with chronic HCV infection and impaired renal allograft function. Methods: Eleven renal allograft recipients with therapy-naïve HCV genotype (GT) 1a, 1b, or 4 were treated with the fixed-dose combination of elbasvir/grazoprevir without ribavirin for 12 weeks...
January 2019: Transplantation Direct
Marieke van der Zwan, Carla C Baan, Robert B Colvin, Rex N Smith, Rebecca A White, Dorothy Ndishabandi, Alex L Nigg, Thierry P P van den Bosch, Gretchen N de Graav, Marian C Clahsen-van Groningen, Dennis A Hesselink
Background: Belatacept-based therapy in kidney transplant recipient has been shown to increase long-term renal allograft and patient survival compared with calcineurin inhibitor-based therapy, however, with an increased risk of acute T cell-mediated rejection (aTCMR). An improved understanding of costimulation blockade-resistant rejections could lead to a more personalized approach to belatacept therapy. Here, immunomic profiles of aTCMR biopsies of patients treated with either tacrolimus or belatacept were compared...
January 2019: Transplantation Direct
Luís Mendonça, Hugo Diniz, José Silvano, Sofia Marques, Susana Sampaio, Manuel Pestana
Introduction: Prolonged-release tacrolimus (PR-TAC) was associated with improved renal function after transplantation when compared to immediate-release tacrolimus (IR-TAC) although evidence is still scarce. This study aimed to compare clinical outcomes and treatment costs in patients who converted from IR-TAC to PR-TAC during the first year after renal transplantation (RT) (early converters [EC]) or after that period (late converters [LC]). Methods: We performed a retrospective study including 79 patients (EC, 39; LC, 41) which were followed up over 60 months...
January 2019: Transplantation Direct
Sarah L White, William Rawlinson, Peter Boan, Vicky Sheppeard, Germaine Wong, Karen Waller, Helen Opdam, John Kaldor, Michael Fink, Deborah Verran, Angela Webster, Kate Wyburn, Lindsay Grayson, Allan Glanville, Nick Cross, Ashley Irish, Toby Coates, Anthony Griffin, Greg Snell, Stephen I Alexander, Scott Campbell, Steven Chadban, Peter Macdonald, Paul Manley, Eva Mehakovic, Vidya Ramachandran, Alicia Mitchell, Michael Ison
In 2016, the Transplantation Society of Australia and New Zealand, with the support of the Australian Government Organ and Tissue authority, commissioned a literature review on the topic of infectious disease transmission from deceased donors to recipients of solid organ transplants. The purpose of this review was to synthesize evidence on transmission risks, diagnostic test characteristics, and recipient management to inform best-practice clinical guidelines. The final review, presented as a special supplement in Transplantation Direct, collates case reports of transmission events and other peer-reviewed literature, and summarizes current (as of June 2017) international guidelines on donor screening and recipient management...
January 2019: Transplantation Direct
A Justin Rucker, Kevin L Anderson, Michael S Mulvihill, Babatunde A Yerokun, Andrew S Barbas, Matthew G Hartwig
Background: Simultaneous heart-liver (SHL) transplantation is an efficacious therapeutic modality for patients with combined heart and liver failure. However, the extent to which heart transplantation followed by sequential liver transplantation (LAH) can match the benefit of simultaneous transplantation has not previously been examined. Our objective was to determine if LAH offers comparable survival to SHL. Methods: The Organ Procurement and Transplantation Network/United Network for Organ Sharing Standard Transplant Analysis and Research file was queried for adult recipients waitlisted for both heart and liver transplantation...
January 2019: Transplantation Direct
Amanda Jean Vinson, Bryce A Kiberd, Roger B Davis, Karthik K Tennankore
Background: In kidney transplantation, nonimmunologic donor-recipient (D-R) pairing is generally not given the same consideration as immunologic matching. The aim of this study was to determine how nonimmunologic D-R pairing relates to independent donor and recipient factors, and to immunologic HLA match for predicting graft loss. Methods: Seven D-R pairings (race, sex, age, weight, height, cytomegalovirus serostatus, and HLA match) were assessed for their association with the composite outcome of death or kidney graft loss using a Cox regression-based forward stepwise selection model...
January 2019: Transplantation Direct
Keisha Bonner, Gaurang Joshi, Rachel Seibert, Liise K Kayler
Background: There is no mechanism that matches hard-to-place kidneys with the most appropriate candidate. Thus, unwanted kidney offers are typically to recipients with long renal replacement time (vintage) which is a strong risk factor for mortality and graft failure, and in combination with prolonged cold ischemia time (CIT), may promote interactive effects on outcomes. Methods: Consecutive adult isolated kidney transplants between October 2015 and December 2017 were stratified by vintage younger than 1 year and CIT longer than 30 hours...
January 2019: Transplantation Direct
Dina Abdelwahab Elhamahmi, Thomas Chaly, Guo Wei, Isaac E Hall
Background: Deceased-donor kidney discard rates vary by region, but it is unknown whether discard rates and transplant outcomes vary during the American Transplant Congress (ATC) each year. Methods: Using national registry data, we determined rates of kidney discard, delayed graft function, graft failure, and mortality from December 31, 1999, through December 30, 2015, during ATC dates and compared these rates with those on the same days of the week during the 2 weeks before and after the ATC (non-ATC)...
January 2019: Transplantation Direct
Gabriel M Cohen, Arielle L Langer, Hamid Sima, Charissa Chang, Kevin Troy, Sarah Taimur
Human herpesvirus-8 (HHV-8) remains best known as an oncogenic virus, but nonneoplastic disease manifestations, such as bone marrow failure or hemophagocytic lymphohistiocytosis (HLH) have gained greater recognition in recent years. In organ transplantation, HHV-8 infection commonly occurs with reactivation of latent virus among recipients from endemic regions of the world or due to transmission from the organ donor. We describe a case of HHV-8-associated HLH in a liver transplant recipient at increased risk for primary infection...
December 2018: Transplantation Direct
Tanya Papaz, Upton Allen, Tom Blydt-Hansen, Patricia E Birk, Sandar Min, Lorraine Hamiwka, Veronique Phan, Tal Schechter, Donna A Wall, Simon Urschel, Bethany J Foster, Seema Mital
Background: Despite age-related differences in biology, physiology, and behavior, transplant immunosuppression is not tailored by age. This likely contributes to high graft failure and posttransplant complications. We present the aims, design, and methods of the Pediatric Outcomes in Transplant: PersOnaliSing Immunosuppression To ImproVe Efficacy Study aimed at personalizing posttransplant immunosuppression in children and young adults. Methods: In this prospective observational cohort study, we recruited pediatric and young adult solid organ transplant, pediatric allogeneic hematopoietic stem cell transplant recipients, and matched living and deceased organ donors from 14 transplant centers across Canada...
December 2018: Transplantation Direct
Ailish M S A Nimmo, Sophie McIntyre, David M Turner, Lorna K Henderson, Richard K Battle
Background: The development of HLA antibodies towards a failing renal allograft is a barrier to retransplantation. This study aimed to compare the formation of HLA donor-specific antibodies (DSA) in patients undergoing graft nephrectomy and in those with a failed graft left in situ who had maintenance immunosuppression (IS) stopped, and assess the relative impact of IS cessation and graft nephrectomy on future relative chance of transplant (R-CoT). Methods: A single-center retrospective study of patients with failed grafts between 2005 and 2015 was performed...
December 2018: Transplantation Direct
Numan Kutaiba, Zaid Ardalan, Kurvi Patwala, Eddie Lau, Mark Goodwin, Paul Gow
Background: The purpose of this study was to review the value of bone scans (BS) in the assessment of bone metastases from early-stage hepatocellular carcinoma (HCC) in patients assessed or waiting for liver transplant (LTx). Methods: We reviewed BS studies performed at our center for patients with early-stage HCC either being assessed for LTx, or on the waiting list for LTx, from January 2010 to May 2017. The BS findings were classified as positive, equivocal, or negative...
December 2018: Transplantation Direct
Mariya L Samoylova, Andrew S Barbas, Kadiyala V Ravindra, Debra L Sudan, Deepak S Vikraman
No abstract text is available yet for this article.
December 2018: Transplantation Direct
Jay Nath, Kamlesh Patel, Melanie Field, James Hodson, Adnan Sharif, Nicholas G Inston, Andrew R Ready
Background: Increasing numbers of patients with end-stage renal failure are receiving kidneys from nondirected kidney donors (NKDs), also known as altruistic donors. Transplant outcomes for recipients of such kidneys are largely inferred from studies on specified kidney donors (SKDs), which may be inaccurate due to differences in donor, recipient and transplant specific factors. We report the outcomes for recipients of NKD in the United Kingdom. Methods: Outcomes for 6861 patients receiving a living donor kidney transplant between January 2007 and December 2014 were analyzed using both the National Health Service Blood and Transplant and the UK Renal Registry datasets...
December 2018: Transplantation Direct
Eric J Charles, J Hunter Mehaffey, Mary E Huerter, Ashish K Sharma, Mark H Stoler, Mark E Roeser, Dustin M Walters, Curtis G Tribble, Irving L Kron, Victor E Laubach
Background: Increased utilization of donation after circulatory death (DCD) lungs may help alleviate the supply/demand mismatch between available donor organs and lung transplant candidates. Using an established porcine DCD model, we sought to determine the effect of increasing warm ischemia time (WIT) after circulatory arrest on lung function during ex vivo lung perfusion (EVLP). Methods: Porcine donors (n = 15) underwent hypoxic cardiac arrest, followed by 60, 90, or 120 minutes of WIT before procurement and 4 hours of normothermic EVLP...
December 2018: Transplantation Direct
Dewei Ren, Thomas S Kaleekal, Edward A Graviss, Duc T Nguyen, Neeraj Sinha, Amad Goodarzi, Isioma Agboli, Erik E Suarez, Matthias Loebe, Scott A Scheinin, Brian A Bruckner
Background: With the increase of primary lung transplantation across major centers worldwide, over the last several years the need of lung retransplant (ReTX) is likely to increase. Therefore, characterization of ReTX patients is prudent and necessary. Our study aimed to investigate and characterize the covariates and outcomes associated with lung ReTX survival in a single large U.S. transplant center. Methods: Demographic, clinical diagnoses, and comorbidities were analyzed...
November 2018: Transplantation Direct
Thomas A Verbeek, Jonathan G Stine, Fuat H Saner, Dmitri Bezinover
In this review, we analyze the epidemiology of thromboses related to end-stage liver disease (ESLD), discuss causes of hypercoagulability, describe susceptible populations, and critically evaluate proposed prophylaxis and treatment of thromboses. Classically, ESLD has been regarded as a model for coagulopathy, and patients were deemed to be at high risk for bleeding complications. Patients with ESLD are not auto-anticoagulated, and they do not have a lower risk of portal vein thrombosis, intracardiac thrombus formation, pulmonary embolism or hepatic artery thrombosis...
November 2018: Transplantation Direct
Cathy Richardson, Aimee Williams, Jill McCready, Khalid Khalil, Felicity Evison, Adnan Sharif
Background: The aim of this study was to analyze the impact of clinic nonattendance within the first year after kidney transplantation on graft-related outcomes. Methods: Our retrospective analysis included all patients receiving their transplant (2007-2017) and receiving their long-term follow up at our center. Clinic nonattendance was extracted from electronic patient records and informatics systems, with highest clinic nonattenders stratified at the 75th percentile...
November 2018: Transplantation Direct
Melissa H Lee, Glenn M Ward, Richard J MacIsaac, Kathy Howe, D Jane Holmes-Walker, Patricia Anderson, Toni Radford, P Toby Coates, Thomas W Kay, Philip J O'Connell, David J Goodman
No abstract text is available yet for this article.
November 2018: Transplantation Direct
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