MedWorm: Transplant Surgery

Blood Pressure Measurements and Left Ventricular Mass Index in Hemodialysis Patients

Artificial Organs — Mon, 06 Feb 2012 05:00:00 +0100

AbstractLeft ventricular hypertrophy (LVH) is the most frequent cardiac abnormality in hemodialysis (HD) patients. It is related to cardiovascular diseases and is an important risk factor for mortality in HD patients. Arterial hypertension is an established risk factor for LVH in HD patients. Inferior vena cava (IVC) diameter is a good indicator of circulating fluid volume; hypervolemia is an important pathogenetic factor of hypertension in HD patients. The purpose of our study was to evaluate possible association between LVH, IVC diameter, and different blood pressure (BP) measurements in HD patients. In the present study, 85 HD patients were included. BP was measured with a standard mercury sphygmomanometer before and after the HD session; the average 1‐monthly values of the routine BP...

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Fifty Years of Work on the Artificial Placenta: Milestones in the History of Extracorporeal Support of the Premature Newborn

Artificial Organs — Mon, 06 Feb 2012 05:00:00 +0100

AbstractThe concept of an artificial placenta has been pursued in experimental research since the early 1960s. The principle has yet to be successfully implemented in neonatal care despite the constant evolution in extracorporeal life support technology and advancements in neonatal intensive care in general. For more than three decades, the physical dimensions of the required equipment necessitated pump‐driven circuits; however, recent advances in oxygenator technology have allowed exploration of the simpler and physiologically preferable concept of pumpless arteriovenous oxygenation. We expect that further miniaturization of the extracorporeal circuit will allow the implementation of the concept into clinical application as an assist device. To this end, NeonatOx (Fig. 1), a custom‐...

Laryngeal transplantation in minipigs: early immunological outcomes.

Clinical and Developmental Immunology — Sun, 05 Feb 2012 16:24:12 +0100

Authors: Birchall MA, Ayling SM, Harley R, Murison PJ, Burt R, Mitchard L, Jones A, Macchiarini P, Stokes CR, Bailey M Abstract Despite recent tissue-engineering advances, there is no effective way of replacing all the functions of the larynx in those requiring laryngectomy. A recent clinical transplant was a success. Using quantitative immunofluorescence targeted at immunologically relevant molecules, we have studied the early (48 h and 1 week) immunological responses within larynxes transplantated between seven pairs of National Institutes of Health (NIH) minipigs fully homozygous at the major histocompatibility complex (MHC) locus. There were only small changes in expression of some molecules (relative to interindividual variation) and these were clearest in samples from the s...

For Kidney Disease Patients, Goals For Blood Pressure May Be Unrealistic

Health News from Medical News Today — Sat, 04 Feb 2012 08:00:00 +0100

An upward revision of the blood pressure numbers used to identify risk of end-stage renal disease (ESRD) might actually help doctors provide better care for their patients, said the authors of a study in patients with chronic kidney disease (CKD). The researchers found that systolic blood pressure - the "upper number" in a blood pressure reading - was the key variable. Current guidelines call for CKD patients to maintain a systolic pressure of 130/80 or lower in order to prevent ESRD, which is complete or almost complete kidney failure, leading to dialysis, kidney transplant, or death... (Source: Health News from Medical News Today)

Abercrombie to sign organ transplant funding bill into law

bizjournals.com Health Care:Hospitals headlines — Sat, 04 Feb 2012 00:50:56 +0100

Hawaii lawmakers on Friday passed legislation for about $1.8 million in emergency funds for kidney and liver transplants in the state. Gov. Neil Abercrombie plans to sign House Bill 608 into law on Saturday at The Queen's Medical Center. The law will appropriate emergency funds, subject to private matching funds, for the transplants, as well as to support a chronic kidney disease management program. Hawaii was left without an organ transplant center after the closure last month of Hawaii Medical Center East, which ran the state's only organ transplant program before it stopped taking patients in December... (Source: bizjournals.com Health Care:Hospitals headlines)

Six-Organ Transplant Girl Goes Home Today

Health News from Medical News Today — Fri, 03 Feb 2012 18:00:00 +0100

After 100 days in hospital and undergoing a complicated 6-organ transplant, 9-year-old Alannah Shevenell, from Maine, leaves Boston Children's Hospital today and goes home. Alannah has been treated for a rare form of cancer; an inflammatory myofibroblastic tumor continued to grow after all possible treatments failed, and was compromising her internal organs. A team of surgeons, led by Dr. Heung Bae Kim, the hospital's Pediatric Transplant Center director, performed the transplant procedure of Alannah's liver, spleen, pancreas, stomach, small intestine and esophagus... (Source: Health News from Medical News Today)

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Maine girl home after 6-organ transplant

Health News: CBSNews.com — Fri, 03 Feb 2012 15:05:11 +0100

Alannah Shevenell, 9, needed new stomach, liver, spleen, small intestine, pancreas, esophagus after all were squashed by tumor (Source: Health News: CBSNews.com)

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation.

The Tohoku Journal of Experimental Medicine — Thu, 02 Feb 2012 18:24:02 +0100

In conclusion, the examination and prevention of risk factors associated with atherosclerosis should be started at the beginning of renal failure. PMID: 22293651 [PubMed - in process] (Source: The Tohoku Journal of Experimental Medicine)

Medicare Pay Policy on Transplant Drugs Slammed

MedPage Today Geriatrics — Thu, 02 Feb 2012 16:32:58 +0100

(MedPage Today) -- Medicare's failure to provide lifelong coverage for immunosuppressive therapy after kidney transplant is bad for patients and for the system's finances, two researchers argued. (Source: MedPage Today Geriatrics)

Study: Volume matters in high-risk orthotopic heart transplant patients

Cardiovascular Business News — Thu, 02 Feb 2012 15:46:41 +0100

Undergoing orthotopic heart transplantation at high-volume centers (those who perform more than 15 procedures per year) leads to better outcomes, according to a study published in the January issue of the Journal of Thoracic and Cardiovascular Surgery. It was found that high-risk patients who undergo transplants at low-volume centers had “exceedingly high” mortality rates; however, center volume mattered less for lower risk patients. (Source: Cardiovascular Business News)

Ground-breaking six-organ transplant saves Alannah Shevenell, 9, from 'monster' tumour

the Mail online | Health — Thu, 02 Feb 2012 09:37:46 +0100

Alannah Shevenell, 9, is recovering at her home in Maine after a ground-breaking six-organ transplant which gave her a new esophagus, liver, stomach, spleen, pancreas and small intestine. (Source: the Mail online | Health)

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Geography Over Need Is Putting Sicker Patients Needing Lung Transplant At Higher Risk Of Dying

Health News from Medical News Today — Thu, 02 Feb 2012 08:00:00 +0100

The current system for allocating donated lungs based on proximity and not on need appears to decrease the potential benefits of lung transplantation and increase the number of patients who die waiting, researchers said at an annual meeting of thoracic surgeons in Fort Lauderdale, Fla... (Source: Health News from Medical News Today)

Evaluation of metabolic syndrome after hematopoietic stem cell transplantation in children and adolescents

Pediatric Blood and Cancer — Thu, 02 Feb 2012 05:00:00 +0100

ConclusionsThe prevalence of MS was 32%, which was significantly higher than in a healthy pediatric population. We recommend prolonged follow‐up for transplant recipients, coupled with enforcement of preventive measures, such as early diagnosis and encouragement of a healthy lifestyle. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc. (Source: Pediatric Blood and Cancer)

Early viral load and recipient IL28B rs12979860 genotype are predictors for progression of hepatitis C after liver transplantation

Liver Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

AbstractThere have been few studies of detailed viral kinetics following liver transplantation (LT) and conflicting data have been reported on viral load and severity of recurrent hepatitis C virus (HCV) disease. This long‐term study aimed to examine (1) the impact of HCV RNA levels at specific points in time within the first year and (2) the influence of IL28B genotype on patient outcome and severity of recurrent HCV disease. Viral load was measured at week 2, 4, 12, 24 and 48 following LT and recipient / donor IL28B genotypes of 164 patients were determined. Cox‐regression analysis showed that viral load at week 2 was an independent negative predictor of recipient outcome. A week 2 viral load of = 6.0 log10 IU/mL was significantly associated with reduced patient survival. After a mea...

Banff 2011 Meeting Report: New Concepts in Antibody‐Mediated Rejection

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

The 11th Banff meeting was held in Paris, France, from June 5 to 10, 2011, with a focus on refining diagnostic criteria for antibody‐mediated rejection (ABMR). The major outcome was the acknowledgment of C4d‐negative ABMR in kidney transplants. Diagnostic criteria for ABMR have also been revisited in other types of transplants. It was recognized that ABMR is associated with heterogeneous phenotypes even within the same type of transplant. This highlights the necessity of further refining the respective diagnostic criteria, and is of particular significance for the design of randomized clinical trials. A reliable phenotyping will allow for definition of robust end‐points. To address this unmet need and to allow for an evidence‐based refinement of the Banff classification, Banff Work...

Deleterious Effect of CTLA4‐Ig on a Treg‐Dependent Transplant Model

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

This study confirms the importance of the B7:CD28 pathway in Treg homeostasis in an in vivo transplant model and suggests that hCTLA4Ig therapy may be deleterious in circumstances where engraftment is dependent on Tregs. (Source: American Journal of Transplantation)

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A Common Peripheral Blood Gene Set for Diagnosis of Operational Tolerance in Pediatric and Adult Liver Transplantation

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

To identify biomarkers of operational tolerance in pediatric and adult liver transplant recipients, transcriptional profiles were examined from 300 samples by microarrays and Q‐PCR measurements of blood specimens from pediatric and adult liver transplant recipients and normal tissues. Tolerance‐specific genes were validated in independent samples across two different transplant programs and validated by Q‐PCR. A minimal set of 13 unique genes, highly expressed in natural killer cells (p = 0.03), were significantly expressed in both pediatric and adult liver tolerance, irrespective of different clinical and demographic confounders. The performance of this gene set by microarray in independent samples was 100% sensitivity and 83% specificity and the AUC was 0.988 for only three genes b...

Acquired Antithrombin Type IIb Deficiency After Liver Transplantation: A Case Report

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

A 3‐year‐old girl with multifocal hepatoblastoma was referred to our clinic for living‐donor liver transplantation, the patient's father being the donor. Pretransplant evaluation revealed that the father presented partial asymptomatic antithrombin (AT) deficiency, with no inherited AT deficiency found in the girl. The genetic testing showed an AT type IIb deficiency responsible for a defect in the heparin‐binding region of AT which is less thrombogenic but more common than the other AT qualitative defects. Her mother was ABO incompatible. Despite the thrombophilia on the father's side, transplantation was successfully performed under replacement therapy with intravenous AT concentrate and low‐molecular‐weight heparin thromboprophylaxis given to both the recipient and the donor....

A New Diagnostic Algorithm for Antibody‐Mediated Microcirculation Inflammation in Kidney Transplants

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

We studied the significance of microcirculation inflammation in kidney transplants, including 329 indication biopsies from 251 renal allograft recipients, who were mostly nonpresensitized (crossmatch negative). Glomerulitis (g) and peritubular capillaritis (ptc) were often associated with antibody‐mediated rejection (65% and 75%, respectively), but were also found in other diseases in the absence of donor‐specific antibody (DSA): T‐cell‐mediated rejection (ptc, g), glomerulonephritis (g) and acute tubular necrosis (ptc). To develop rules for reducing the nonspecificity of microcirculation inflammation and defining the best grading thresholds associated with DSA, we built and validated a decision tree to predict DSA. The decision tree revealed that g + ptc sum (addition of g‐score...

Role of Rapamycin‐Induced Autophagy in Pancreatic Islets

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

(Source: American Journal of Transplantation)

A Risk‐Prediction Model for In‐hospital Mortality After Heart Transplantation in US Children

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

We sought to develop and validate a quantitative risk‐prediction model for predicting the risk of posttransplant in‐hospital mortality in pediatric heart transplantation (HT). Children <18 years of age who underwent primary HT in the United States during 1999–2008 (n = 2707) were identified using Organ Procurement and Transplant Network data. A risk‐prediction model was developed using two‐thirds of the cohort (random sample), internally validated in the remaining one‐third, and independently validated in a cohort of 338 children transplanted during 2009–2010. The best predictive model had four categorical variables: hemodynamic support (ECMO, ventilator support, VAD support vs. medical therapy), cardiac diagnosis (repaired congenital heart disease [CHD], unrepaired CHD vs...

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The Presence of Autophagy in Mammal Cells Should Be Interpreted Carefully

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

(Source: American Journal of Transplantation)

Organ Donation and Moyamoya Disease

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

(Source: American Journal of Transplantation)

Impact of Sirolimus Duration on Hepatitis C Related Fibrosis Progression in Liver Transplant Recipients

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

(Source: American Journal of Transplantation)

Counting Small Hypointense Spots Confounds the Quantification of Functional Islet Mass Based on Islet MRI

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

Iron‐containing fragmented islets or free iron released from dying cells could confound the interpretation of MRI of iron nanoparticle‐labeled islets. Exclusion of small hypointense spots could be a useful strategy to avoid such artifact. We investigated whether this strategy could improve the estimation of functioning islet mass after islet transplantation. Using a rat syngeneic intraportal islet transplantation model, we quantitatively assessed the relationships between total area, number of hypointense spots on MRI that belong to each size quartile and glycemic control of the recipients. The total area of hypointense spots on MRI was greater in the recipients that achieved diabetes reversal (p = 0.002), whereas the total number of hypointense spots was not different (p = 0.757). Exc...

Diagnostic Pathology: Kidney Diseases, by Robert Colvin

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

(Source: American Journal of Transplantation)

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Endogenous Expansion of Regulatory T Cells Leads to Long‐Term Islet Graft Survival in Diabetic NOD Mice

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

Donor pancreatic lymph node cells (PLNC) protect islet transplants in Non‐obese diabetic (NOD) mice. We hypothesized that induced FoxP3+ regulatory T cells (Tregs) were required for long‐term islet engraftment. NOD or NOD.NON mice were treated with ALS (antilymphocyte serum) and transplanted with NOR islets +/–PLNC (5 × 107). In vivo proliferation and expansion of FoxP3+ Tregs was monitored in spleen and PLN from ALS‐ and ALS/PLNC‐treated recipient mice. Anti‐CD25 depletion was used to determine the necessity of Tregs for tolerance. FoxP3+ numbers significantly increased in ALS/PLNC‐treated recipients compared to ALS‐treated mice. In ALS/PLNC‐treated mice, recipient‐derived Tregs localized to the transplanted islets, and this was associated with intact, insulin‐produ...

Multivisceral Ex Vivo Surgery for Tumors Involving Celiac and Superior Mesenteric Arteries

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

Abdominal tumors involving both roots of the celiac and superior mesenteric artery are deemed unresectable by conventional surgical methods. We performed three cases of multivisceral ex vivo surgery involving temporary removal of the entire abdominal viscera followed by vascular reconstruction, ex vivo tumor resection and autotransplantation of excised organs. We achieved a complete tumor resection with negative margins in all cases. All patients have survived with no tumor recurrence to date at 17‐, 27‐ and 38‐month follow‐up. Postoperative complications included diarrhea, sphincter of Oddi dysfunction and arterial stenosis; all responded to directed treatments. Multivisceral ex vivo surgery applying techniques of deceased donor multivisceral transplantation is feasible in achievi...

Early Metabolic Markers that Anticipate Loss of Insulin Independence in Type 1 Diabetic Islet Allograft Recipients

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

In conclusion, AIRGLU is an early metabolic assay capable of anticipating loss of insulin independence at 1 year in T1D patients undergoing PIT and constitutes a valuable, simple and reliable method to follow patients after transplant. (Source: American Journal of Transplantation)

Role of Lentivirus‐Mediated Overexpression of Programmed Death‐Ligand 1 on Corneal Allograft Survival

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

To investigate the role of lentivirus‐mediated overexpression of programmed death‐ligand 1 (PD‐L1) on rat corneal allograft survival. A fully allogeneic rat cornea transplant model was used for in vivo studies. Lentiviral (LV) vectors are efficient tools for ex vivo genetic modification of cultured corneas. LV vector encoding for PD‐L1 (LV.PD‐L1) and LV vector encoding for eGFP (LV.eGFP, as control) were constructed and tested. PD‐L1 or eGFP expression was increased on corneal cells upon LV.PD‐L1 and LV.eGFP transduction, respectively. Both allogeneic controls and allogeneic LV.eGFP transduced corneas were uniformly rejected (MST: 13.8 ± 1.7 days and 12.3 ± 1.9 days, respectively). In contrast, allogeneic LV.PD‐L1 transduced corneas showed a high percentage (83%) of graft...

Donor Brain Death Inhibits Tolerance Induction in Miniature Swine Recipients of Fully MHC‐Disparate Pulmonary Allografts

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

We have previously shown that a short course of high‐dose tacrolimus induces long‐term tolerance to fully mismatched lung allografts procured from healthy MHC‐inbred miniature swine. Here, we investigate whether donor brain death affects tolerance induction. Four recipient swine were transplanted with fully mismatched lung grafts from donors that were rendered brain dead and mechanically ventilated for 4 h before procurement (Group 1). These recipients were compared to two control groups (Group 2: 4 h of donor ventilation without brain death [n = 5]; and Group 3: no donor brain death with <1 h of ventilation [n = 6]). All recipients were treated with a 12‐day course of tacrolimus. In contrast to both groups of control animals, the swine transplanted with lung allografts from bra...

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Three‐Year Outcomes From BENEFIT‐EXT: A Phase III Study of Belatacept Versus Cyclosporine in Recipients of Extended Criteria Donor Kidneys

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

In conclusion, at 3 years after transplantation, immunosuppression with belatacept resulted in similar patient survival, graft survival and acute rejection, with better renal function compared with cyclosporine. As previously reported, PTLD and tuberculosis were the principal safety findings associated with belatacept in this study population. (Source: American Journal of Transplantation)

Lung Transplantation in Patients with Prior Cardiothoracic Surgical Procedures

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

The full spectrum of prior cardiothoracic procedures in lung transplant candidates and the impact of prior procedures on outcomes after lung transplantation (LTx) remain unknown, though the impact is considered to be large. Patients transplanted at our institution from 2004 to 2009 were identified (n = 554) and divided into two groups: patients who had undergone cardiothoracic surgical (CTS) procedures prior to LTx (n = 238) and patients who had not (non‐CTS: n = 316). Our primary endpoint was survival. Secondary endpoints included allograft function and the incidence of major complications including reexploration due to bleeding, prolonged ventilation, renal insufficiency and primary graft dysfunction. Long‐term survival was not significantly different between the groups whereas posto...

Circulating Antibody Free Light Chains and Risk of Posttransplant Lymphoproliferative Disorder

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

Posttransplant lymphoproliferative disorder (PTLD) is a major complication of solid‐organ transplantation. With human immunodeficiency virus infection (an analogous immunosuppressive state), elevated kappa and lambda immunoglobulin free light chains (FLCs) in peripheral blood are associated with increased risk of lymphoma. To assess the role of B‐cell dysfunction in PTLD, we measured circulating FLCs among Canadian transplant recipients, including 29 individuals with PTLD and 57 matched transplant recipients who were PTLD‐free. Compared with controls, PTLD cases had higher kappa FLCs (median 1.53 vs. 1.07 times upper limit of normal) and lambda FLCs (1.03 vs. 0.68). Using samples obtained on average 3.5 months before PTLD diagnosis, cases were more likely to have polyclonal FLC eleva...

Multiple Hyperacute Rejections in the Absence  of Detectable Complement Activation in a Patient  with Endothelial Cell Reactive Antibody

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

This case involves a 54‐year‐old patient with polycystic kidney disease and a history of hyperacute allograft rejections. Two previous compatible live donor transplants functioned immediately but failed within the first 12 h due to antibody‐injury. This patient was referred for a third transplant due to decreased vascular access and progressive hypotension from uremic autonomic dysfunction. He was broadly sensitized to HLA; however, a live donor was identified through kidney paired donation for whom he had no donor‐specific HLA antibody (HLA‐DSA). This patient received one plasmapheresis (PP) and intravenous immunoglobulin (IVIg) treatment, anti‐CD25, and anti‐CD20 antibodies prior to transplant. The allograft functioned immediately but became anuric within 24 h. A biopsy rev...

With Respect to Elderly Patients: Finding Kidneys in the Context of New Allocation Concepts

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

The elderly have benefited from increased access to renal transplantation in recent years. New allocation concepts would shift distribution of kidneys to younger recipients, making expanded criteria and living donor kidneys more relevant for seniors. Current issues impacting expanded criteria donor kidney availability and living donor transplant opportunities for the elderly are explored. It is hoped that the kidney donor profile index will improve risk assessment and utilization of marginal kidneys. The usefulness of procurement biopsy remains controversial. Dual kidney transplantation and machine perfusion appear to be effective mechanisms to increase organ availability. “Old‐for‐old” allocation systems, donation service area variation and regulatory and reimbursement issues high...

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Differential Expression of MicroRNAs During Allograft Rejection

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

MicrorRNA are small noncoding RNA molecules that regulate the posttranscriptional expression of target genes. In addition to being involved in many biologic processes, microRNAs are important regulators in innate and adaptive immune responses. Distinct sets of expressed microRNAs are found in different cell types and tissues and aberrant expression of microRNAs is associated with many disease states. MicroRNA expression was examined in a model of heterotopic heart transplantation by microarray analyses and a unique profile was detected in rejecting allogeneic transplants (BALB/c → C57BL/6) as compared to syngeneic transplants (C57BL/6 → C57BL/6). The microRNA miR‐182 was significantly increased in rejecting cardiac allografts and in mononuclear cells that infiltrate the grafts. Forkh...

Transhilar Passage in Right Graft Live Donor Liver Transplantation: Intrahilar Anatomy and Its Impact on Operative Strategy

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

The passage through the hilar plate during right graft live donor liver transplantation (LDLT) can have dangerous consequences for both donors and recipients. The purpose of our study was to delineate hilar transection and biliary reconstruction strategies in right graft LDLT, with special consideration of central and peripheral hilar anatomical variants. A total of 71 consecutive donors underwent preoperative three‐dimensional (3D) CT reconstructions and virtual 3D hepatectomies. A three‐modal hilar passage strategy was applied, and its impact on operative strategy analyzed. In 68.4% of cases, type I and II anatomical configurations allowed for an en block hilar transection with simple anastomotic reconstructions. In 23.6% of cases, donors had “difficult” type II and types III/IV ...

Recipient IL28B Polymorphism Is an Important Independent Predictor of Posttransplant Diabetes Mellitus in Liver Transplant Patients with Chronic Hepatitis C

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

IL28B polymorphisms are strongly associated with response to treatment for HCV infection. IL28B acts on interferon‐stimulated genes via the JAK‐STAT pathway, which has been implicated in development of insulin resistance. We investigated whether IL28B polymorphisms are associated with posttransplant diabetes mellitus (DM). Consecutive HCV patients who underwent liver transplantation between 1–1995 and 1–2011 were studied. Genotyping of the polymorphism rs12979860 was performed on DNA collected from donors and recipients. Posttransplant DM was screened for by fasting blood glucoses every 1–3 months. Of 221 included patients, 69 developed posttransplant DM (31%). Twenty‐two patients with recipient IL28B genotype TT (48%), 25 with IL28B genotype CT (25%) and 22 with IL28B genotype...

Sirolimus Conversion for Renal Dysfunction in Liver Transplant Recipients: The Devil Really Is in the Details…

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

(Source: American Journal of Transplantation)

Mechanisms of Alloimmunization and Subsequent Bone Marrow Transplantation Rejection Induced by Platelet Transfusion in a Murine Model

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

For many nonmalignant hematological disorders, HLA‐matched bone marrow transplantation (BMT) is curative. However, due to lack of neoplasia, the toxicity of stringent conditioning regimens is difficult to justify, and reduced intensity conditioning is used. Unfortunately, current reduced intensity regimens have high rates of BMT rejection. We have recently reported in a murine model that mHAs on transfused platelet products induce subsequent BMT rejection. Most nonmalignant hematological disorders require transfusion support prior to BMT and the rate of BMT rejection in humans correlates with the number of transfusions given. Herein, we perform a mechanistic analysis of platelet transfusion‐induced BMT rejection and report that unlike exposure to alloantigens during transplantation, pl...

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Patient, Center and Geographic Characteristics  of Nationally Placed Livers

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

In conclusion, utilization of nationally placed livers is highly concentrated in very few centers, with no increased adjusted risk of graft loss. These findings provide the foundation for a more informed discussion about changing our current liver allocation and distribution policies. (Source: American Journal of Transplantation)

Donor‐Specific HLA Antibodies in a Cohort Comparing Everolimus with Cyclosporine After Kidney Transplantation

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

Donor‐specific HLA antibodies (DSA) have a negative impact on kidney graft survival. Therefore, we analyzed the occurrence of DSA and antibody‐mediated rejection (AMR) in patients from two prospective randomized trials in our center. At 3–4.5 months posttransplant 127 patients were randomized to continue cyclosporine or converted to everolimus therapy. The presence of DSA was prospectively assessed using Luminex assays. AMR was defined according to the Banff 2009 classification. Antibody screening was available in 126 patients with a median follow‐up of 1059 days. Seven out of 65 (10.8%) patients on cyclosporine developed DSA after a median of 991 days. In comparison, 14/61 patients (23.0%) randomized to everolimus developed DSA after 551 days (log‐rank: p = 0.048). Eight patient...

9-Year-Old Girl Heads Home After 6 Organ Transplant At Children’s Hospital

Wed, 01 Feb 2012 19:54:26 +0100

BOSTON (CBS) — A 9-year-old girl went back home to Maine Wednesday, three months after a groundbreaking multiple organ transplant at Children’s Hospital Boston. WBZ NewsRadio 1030′s Mark Katic reports Alannah Shevenell of Hollis underwent 14-and-a-half hours of surgery in October to remove an aggressive tumor and six organs – her stomach, pancreas, spleen, liver, small bowel and the esophagus. The tumor had twisted around the organs, so they all had to be transplanted. “They come together sort of as a cluster, so it’s almost like transplanting one big organ,” said Dr. Heung Bae Kim, the director of Children’s Pediatric Transplant Center. “The only way to take out this tumor was to remove all of the organs that were involved.” “It was like changing the wh...

Children’s becomes first hospital in New England to complete six organ transplant

Thrive, Children's Hospital Boston — Wed, 01 Feb 2012 15:57:55 +0100

The cover of today’s Boston Globe features the beaming face of Alannah Shevenell, a 9 year-old who will be heading home to Maine this morning after a three-month stay at Children’s Hospital Boston. For just under 100 days Alannah and her grandmother have been staying at Children’s while she received treatment for a rare and aggressive cancer that was compromising several of her internal organs. When all other treatments had failed, Heung Bae Kim, MD, director of Children’s Pediatric Transplant Center (PTC), suggested a multivisceral transplant that would remove Alannah’s tumor and replace the six organs that had been damaged by its presence. Under Kim’s guidance surgeons from Children’s PTC performed the 14-hour procedure. Once Alannah’s tumo...

9-Year-Old Girl Heading Home After 6 Organ Transplant At Children’s Hospital

Wed, 01 Feb 2012 13:14:26 +0100

BOSTON (AP) — A 9-year-old Maine girl is heading home after a groundbreaking multiple organ transplant at Children’s Hospital Boston. Alannah Shevenell of Hollis underwent 14 hours of surgery in October to remove an aggressive tumor and to undergo a transplant of her stomach, pancreas, spleen, liver, small bowel and esophagus. Hospital officials say it was the first known esophageal transplant in the world and the largest number of organs transplanted into a person at one time in New England. Alannah was diagnosed with a rare former of cancer when she was 4. The tumor snaked and twisted itself around her internal organs, choking the life out of them. It didn’t respond to chemotherapy or surgery to get rid of it. Even the transplant was risky. Alannah is scheduled to come Wedn...

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Improved Kidney Transplant Survival In Mice; New Agent Likely To Speed Replacement Of Other Organs

Health News from Medical News Today — Wed, 01 Feb 2012 09:00:00 +0100

New research published online in the FASEB Journal details a new antibody, called "OPN-305" that may significantly improve survival outcomes for those receiving donated kidneys and other organs. OPN-305 works by preventing inflammation triggered by oxygen deprivation in the donated organ, allowing for better recovery after transplantation. Specifically, it binds to sensors on transplant tissue, called "toll-like receptors" or "TLR-2," in the circulating blood and turns off signals that provoke inflammation... (Source: Health News from Medical News Today)

Salvaging kidneys with renal allograft compartment syndrome

Transplant International — Wed, 01 Feb 2012 05:00:00 +0100

SummaryRenal allograft compartment syndrome is an under recognized cause of early allograft dysfunction which can be reversed by early intervention. It occurs early after renal transplantation where closure of the anterior abdominal wall seems to compress the transplant in the limited retroperitoneal space. The literature about this syndrome in renal transplantation is sparse. Our report describes the diagnostic criteria and the management of two renal transplant recipients with this syndrome. Its diagnosis depends upon duplex vascular scan findings of reversed or absent diastolic flow in the renal vasculature in the absence of any perigraft collection or severe acute tubular necrosis. In our hands emergency laparotomy, decompression of the transplant and closure with interposition mesh sa...

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

(Source: The Journal of Heart and Lung Transplantation)

Editorial Board

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

(Source: The Journal of Heart and Lung Transplantation)

Combined heart and liver transplantation in an adult with familial heterozygous hypercholesterolemia and severe ischemic cardiomyopathy

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Familial hypercholesterolemia (FH) is an autosomal-dominant disorder caused by mutations in the low-density lipoprotein (LDL) receptor. The clinical manifestations of FH include severe atherosclerosis and premature heart disease. Liver transplantation restores defective LDL receptors and has been used for long-term treatment in homozygous FH. (Source: The Journal of Heart and Lung Transplantation)

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Altered progenitor cell and cytokine profiles in bronchiolitis obliterans syndrome

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Overall, altered progenitor cell profiles were found in patients who developed advanced BOS, which may be mediated by alterations in circulating cytokines. Ultimately, measurement of progenitor cell profiles may lead to further insight into the pathogenesis of airflow obstruction after lung transplantation. (Source: The Journal of Heart and Lung Transplantation)

Searching for novel molecular targets of chronic rejection in an orthotopic experimental lung transplantation model

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: This is the first experimental study performed in an orthotopic model of LT using DNA microarray analysis. The individual genes, biologic process and pathways identified may represent novel targets that could be manipulated and contribute to the development of treatments capable of providing protection from CR. (Source: The Journal of Heart and Lung Transplantation)

Construction of vascularized cardiac tissue from genetically modified mouse embryonic stem cells

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Using liquid collagen as scaffold, the enriched cardiomyocytes derived from genetically modified ESCs mixed with HUVECs and MEFs in 3-dimensional culture resulted in highly vascularized cardiac tissues. (Source: The Journal of Heart and Lung Transplantation)

Effect of simvastatin on development of obliterative airway disease: An experimental study

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Simvastatin treatment inhibited adaptive T-cell alloimmune activation as depicted by reduced expression of lymphocyte chemokine and pro-inflammatory cytokine mRNA and reduced allograft infiltration by inflammatory cells. Importantly, simvastatin inhibits the development of OAD and this effect is partially mediated by increased nitric oxide activity. These results suggest a role for simvastatin in the prevention of obliterative bronchiolitis. (Source: The Journal of Heart and Lung Transplantation)

Reconditioning of lungs donated after circulatory death with normothermic ex vivo lung perfusion

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Normothermic ex vivo lung perfusion could resuscitate DCD lungs injured by warm ischemia, and may ameliorate ischemia–reperfusion injury. (Source: The Journal of Heart and Lung Transplantation)

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Peripartum cardiomyopathy: Post-transplant outcomes from the united network for organ sharing database

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: This large report shows outcomes of graft failure and death are inferior for recipients with PPCM, which may be partly explained by younger age, higher allosensitization, higher pre-transplant acuity, and increased rejection. More research is needed to determine management strategies to improve outcomes in PPCM heart transplant recipients. (Source: The Journal of Heart and Lung Transplantation)

ABO-incompatible heart transplantation: Analysis of the Pediatric Heart Transplant Study (PHTS) database

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: In center and risk adjusted analysis, young children who received an ABOi transplant had equivalent one-year survival and freedom from rejection compared with those who received an ABOc transplant. In spite of the favorable outcome for ABOi recipients, many centers appear to reserve ABOi transplantation for sicker patients. These data mandate reexamination of the current United Network for Organ Sharing (UNOS) policy that gives priority to ABOc over ABOi transplantation in the United States. (Source: The Journal of Heart and Lung Transplantation)

Extremes of body mass index do not impact mid-term survival after continuous-flow left ventricular assist device implantation

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Background: Extremes of body mass index (BMI) are often considered contraindications to use of a left ventricular assist device (LVAD), but data regarding outcomes across the spectrum of BMI are limited. We sought to assess the association of BMI with survival and major morbidity after continuous-flow (CF) LVAD implantation. Methods: Patients (n = 896) enrolled in the HeartMate II LVAD bridge-to-transplantation and destination therapy trials were divided into 4 BMI groups: underweight ( (Source: The Journal of Heart and Lung Transplantation)

Evaluation of valganciclovir pharmacokinetics in lung transplant recipients

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: Valganciclovir at 900 mg/day resulted in the equivalent of a mean daily dose of 7.7 mg/kg intravenous ganciclovir. Higher systemic ganciclovir exposures occurred after 900 mg/day valganciclovir compared with intravenous 5 mg/kg/day ganciclovir. Valganciclovir therapeutic drug monitoring may be warranted in select lung transplant patients to avoid increased toxicity. (Source: The Journal of Heart and Lung Transplantation)

The Fourth INTERMACS Annual Report: 4,000 implants and counting

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

The Fourth Annual Report of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) summarizes and analyzes the first 5 years of patient and data collection. With more than 4,000 patients entered into the database, the evolution of pump technology, strategy at implant, and pre-implant patient profiles are chronicled. A risk factor analysis of the entire adult primary implant population is provided, and the recent composition of patient profiles is examined. Current actuarial survival with continuous-flow pumps exceeds 80% at 1 year and 70% at 2 years. (Source: The Journal of Heart and Lung Transplantation)

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The dawn of the ISHLT Mechanical Assisted Circulatory Support (IMACS) Registry: Fulfilling our mission

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

ISHLT Mission Statement: The International Society of Heart and Lung Transplantation is a multidisciplinary, professional organization dedicated to improving the care of patients with advanced heart or lung disease through transplantation, mechanical support, and innovative therapies via research, education, and advocacy. (Source: The Journal of Heart and Lung Transplantation)

Sinusoidal C4d deposits in liver allografts indicate an antibody mediated response: Diagnostic considerations in the evaluation of liver allografts

Liver Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

AbstractThere is a paucity of data concerning the correlation of C4d staining in liver allografts with antibody mediated rejection (AMR). Data regarding location and character of C4d deposits in native and allograft liver tissue are inconsistent. We performed C4d immunofluorescence (IF) on 141 fresh frozen liver allograft biopsies and native livers, documented the pattern of C4d IF staining and correlated the findings with the presence of donor specific antibodies (DSA). A linear/granular sinusoidal pattern of C4d IF was noted in 18 of 28 biopsies obtained post transplant in patients with positive crossmatch and detectable DSA (pos XM/DSA). In patients with negative XM/DSA none was C4d positive of 59 tested (p > 0.001). No significant association was found between positive XM/DSA and C4...

Comparison of seven liver allocation models with respect to lives saved among patients on the liver transplant waiting list

Transplant International — Wed, 01 Feb 2012 05:00:00 +0100

SummaryThe patients with end‐stage liver disease (ESLD) on the liver transplant waiting list are prioritized for transplant based on the model for end‐stage liver disease (MELD) score. We developed and used an innovative approach to compare MELD to six proposed alternatives with respect to waiting list mortality. Our analysis was based on United Network for Organ Sharing data of patients with ESLD on the waiting list between January 2006 and June 2009. We compared six allocation models to MELD. Two models were based on reweighting the variables used by MELD: an “updated” MELD, and ReFit MELD. Four models also included serum sodium: MESO, MeldNa, UKELD, and ReFit MELDNa. We estimated that UKELD and the updated MELD would result in significantly fewer lives saved. There were no signi...

Regulatory T Cells Exhibit Decreased Proliferation  but Enhanced Suppression After Pulsing with Sirolimus

American Journal of Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Although regulatory T cells (Tregs) suppress allo‐immunity, difficulties in their large‐scale production and in maintaining their suppressive function after expansion have thus far limited their clinical applicability. Here we have used our nonhuman primate model to demonstrate that significant ex vivo Treg expansion with potent suppressive capacity can be achieved and that Treg suppressive capacity can be further enhanced by their exposure to a short pulse of sirolimus. Both unpulsed and sirolimus‐pulsed Tregs (SPTs) are capable of inhibiting proliferation of multiple T‐cell subpopulations, including CD4+ and CD8+ T cells, as well as antigen‐experienced CD28+CD95+ memory and CD28−CD95+ effector subpopulations. We further show that Tregs can be combined in vitro with CTLA4‐Ig...

Prevalence and subtypes of BK virus in pediatric renal transplant recipients in Russia

Pediatric Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

The objective of our study was to determine the prevalence of BKV infection in consecutive pediatric kidney transplant recipients at our center. Fifty‐eight pediatric kidney transplant recipients were studied. The mean age at screening was 9.4 ± 2.8 yr, and samples were obtained at a median of 2.4 ± 1.4 yr after transplantation. BKV‐DNA was analyzed in urine and plasma by quantitative PCR. Occurrences of BK‐DNAuria and BK‐DNAemia did not change in the first two yr after transplantation in children and amounted to 21–23% and 7–8%, respectively (p > 0.05). In the third year, the occurrences of BK‐DNAuria and BK‐DNAemia increased insignificantly to 27% and 9% in the pediatric patients. We also determined the subtypes and subgroups of BK virus isolated fr...

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Mitochondrial haplogroups associated with end-stage heart failure and coronary allograft vasculopathy in heart transplant patients

European Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions Mitochondrial haplogroups behave like risk factors for the progress to end-stage HF in a Spanish cardiac transplant population. Mitochondrial DNA variants may have some influence on the appearance of cardiac transplant complications. (Source: European Heart Journal)

Many children with liver transplants from parents can safely stop using anti-rejection drugs

EurekAlert! - Medicine and Health — Wed, 01 Feb 2012 05:00:00 +0100

(New York- Presbyterian Hospital/Columbia University Medical Center) Physicians at three transplant centers have found in a pilot study that a majority of children who receive liver tissue from a parent can eventually stop using immunosuppression (anti-rejection) medications safely. These drugs, which tamp down natural immune function, have been linked to a bevy of complications, including cancer, diabetes, hypertension and kidney failure. (Source: EurekAlert! - Medicine and Health)

Lungs clothed in fresh cells offer new hope for transplant patients

EurekAlert! - Medicine and Health — Wed, 01 Feb 2012 05:00:00 +0100

(Arizona State University) Now Daniel Weiss at the Vermont Lung Center in collaboration with Cheryl Nickerson and her colleagues at the Biodesign Institute at Arizona State University are exploring a radically new approach for developing viable lung tissue suitable for transplantation. (Source: EurekAlert! - Medicine and Health)

When the isolated lung runs out of air

EurekAlert! - Medicine and Health — Wed, 01 Feb 2012 05:00:00 +0100

(Ludwig-Maximilians-Universität München) A lung transplant is the only treatment option for patients faced with imminent pulmonary failure. But suitable donor organs are highly susceptible to damage in transit. A team of researchers based at LMU's Walther Straub Institute has now discovered why this is so, and suggest ways of avoiding it. (Source: EurekAlert! - Medicine and Health)

Amelia Rivera, 3, in struggle for kidney transplant over disability

Health News: CBSNews.com — Tue, 31 Jan 2012 19:06:32 +0100

Controversy sparked in January when Riveras said prominent hospital denied daughter kidney transplant because of disability (Source: Health News: CBSNews.com)

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Outcomes of living‐donor liver transplantation in patients with preoperative type‐1 hepatorenal syndrome and acute hepatic decompensation

Liver Transplantation — Tue, 31 Jan 2012 18:57:13 +0100

In conclusion, HRS patients, compared with non‐HRS patients, had worse postoperative renal function and overall survival. However, their five‐year overall survival rate was still nearly 80%, which is satisfactory. Therefore, living‐donor liver transplantation can be considered for patients who have acute hepatic decompensation with or without HRS. © 2012 American Association for the Study of Liver Diseases (Source: Liver Transplantation)

Incidence, kinetics, and risk factors of Epstein–Barr virus viremia in pediatric patients after allogeneic stem cell transplantation

Pediatric Transplantation — Tue, 31 Jan 2012 18:43:29 +0100

Bordon V, Padalko E, Benoit Y, Dhooge C, Laureys G. Incidence, kinetics, and risk factors of Epstein–Barr virus viremia in pediatric patients after allogeneic stem cell transplantation.  Pediatr Transplantation 2012. © 2012 John Wiley & Sons A/S.Abstract: After allogeneic hematopoietic stem‐cell transplantation (allo‐HSCT), EBV infections can be potentially dangerous and even life threatening. We evaluated the EBV viremia in 80 consecutive allo‐HSCT with quantitative EBV‐PCR every 2 weeks during the first 3 months and monthly thereafter until 1 yr after allo‐HSCT or until death. We found a significantly more frequent viremia in patients who had in vivo T‐cell depletion in which 23 out of 51 (45%) had EBV‐PCR positivity. The EBV virus load was also significan...

Transplant possible for Amelia Rivera

USATODAY.com Health — Tue, 31 Jan 2012 16:53:00 +0100

The parents of Amelia Rivera still do not know if she will be eligible for a kidney transplant. The case has inspired intense online reactio ... (Source: USATODAY.com Health)

Complications of kidney transplantation with grafts from expanded criteria donors

World Journal of Urology — Tue, 31 Jan 2012 07:06:01 +0100

Conclusions Transplantation of kidneys from expanded criteria donors is associated with a significant higher risk of medical and surgical complications than kidneys from non-expanded criteria donors. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00345-012-0831-3Authors Javier Barba, Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008 Pamplona, SpainJuan Javier Zudaire, Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008 Pamplona, SpainJosé Enrique Robles, Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008 Pamplona, SpainDavid Rosell, Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008 Pamplona, SpainJosé María Berian, Department of Urology, Univers...

Sirolimus – Moving toward the mainstream in pediatric heart transplantation?

Pediatric Transplantation — Tue, 31 Jan 2012 05:00:00 +0100

(Source: Pediatric Transplantation)

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New agent improves kidney transplant survival in mice, likely to speed replacement of other organs

EurekAlert! - Medicine and Health — Tue, 31 Jan 2012 05:00:00 +0100

(Federation of American Societies for Experimental Biology) New research published online in the FASEB Journal details a new antibody, called "OPN-305" that may significantly improve survival outcomes for those receiving donated kidneys and other organs. (Source: EurekAlert! - Medicine and Health)

Iatrogenic atrial septal defect and aortoatrial fistula in a patient with endovascular prosthesis in the inferior vena cava.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:13:34 +0100

We report the case of a liver transplant patient with a stenosis in the anastomosis of the suprahepatic veins to inferior vena cava, treated by self-expanding prosthesis, who developed an aorto-right atrial fistula and an atrial septal defect. Open heart surgery was performed to correct the defects. Transthoracic echocardiogram 1 year later revealed no evidence of residual shunt. PMID: 22269763 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Teenager given days to live has life-saving lung transplant after spending 10 YEARS in hospital and planning her own funeral

the Mail online | Health — Mon, 30 Jan 2012 17:38:07 +0100

Casey Blunstone, from Walgherton, Cheshire East, was told by doctors that she had just days to live as cystic fibrosis has caused her lung function to drop to dangerous levels. (Source: the Mail online | Health)

Study: Stopping Steroids Safe After Kidney Transplant (CME/CE)

MedPage Today Nephrology — Mon, 30 Jan 2012 15:13:08 +0100

(MedPage Today) -- Patients who stopped taking the immunosuppressant prednisone soon after a kidney transplant avoided steroid-related side effects without putting their new organs at risk, according to a decade-long study. (Source: MedPage Today Nephrology)

Prednisone 'unnecessary' after kidney transplant

Pharmacy Europe — Mon, 30 Jan 2012 12:09:00 +0100

Stopping immunosuppression soon after transplantation may prevent side-effects (Source: Pharmacy Europe)

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In Development - System To Deliver Organ Transplant Drug Without Harmful Side Effects

Health News from Medical News Today — Mon, 30 Jan 2012 08:00:00 +0100

A new system for delivering a drug to organ transplant patients, which could avoid the risk of harmful side effects, is being developed by scientists at the University of Strathclyde in Glasgow. The drug, cyclosporine (CsA), is widely used in transplant operations and helps prevent the patient's body rejecting the organ but it can cause adverse drug reactions, of which the most serious problems are kidney and liver damage, in the doses which are currently administered in the long term... (Source: Health News from Medical News Today)

Anidulafungin for the treatment of candidaemia/invasive candidiasis in selected critically ill patients

Clinical Microbiology and Infection — Mon, 30 Jan 2012 05:00:00 +0100

AbstractA prospective, multicentre, phase IIIb study with an exploratory, open‐label design was conducted to evaluate efficacy and safety of anidulafungin for the treatment of candidaemia/invasive candidiasis (C/IC) in specific ICU patient populations. Adult ICU patients with confirmed C/IC meeting ≥1 of the following criteria were enrolled: postabdominal surgery, solid tumour, renal/hepatic insufficiency, solid organ transplant, neutropaenia, age ≥65 years. Patients received anidulafungin (200 mg on day 1, 100 mg/day thereafter) for 10–42 days, optionally followed by oral voriconazole/fluconazole. The primary efficacy endpoint was global (clinical and microbiologic) response at the end of all therapy (EOT). Secondary endpoints included global response at the end of intravenous the...

Activation of cyclic adenosine monophosphate‐dependent protein kinase a signaling prevents liver ischemia/reperfusion injury in mice

Liver Transplantation — Mon, 30 Jan 2012 05:00:00 +0100

AbstractHepatic ischemia and reperfusion injury (IRI) occurs in multiple clinical settings including liver transplantation. Cyclic adenosine monophosphate (cAMP)‐dependent protein kinase A (PKA) pathway inhibits hepatocellular apoptosis and regulates TLR4‐triggered inflammation responses in vitro. Here, we examined the function and therapeutic potential of cAMP‐PKA activation in a murine (C57/BL6) model of liver warm ischemia (90 min) followed by reperfusion. Liver IRI triggered cAMP‐PKA activation, whereas administration of its specific inhibitor, H‐89, exacerbated hepatocellular damage. Conversely, Forskolin therapy, which activates PKA by elevating cAMP levels, protected livers from IRI, evidenced by diminished serum ALT and well‐preserved tissue architecture. Liver protecti...

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Liver Transplantation — Mon, 30 Jan 2012 05:00:00 +0100

(Source: Liver Transplantation)

Predictors of pre‐transplant dropout and post‐transplant recurrence in patients with perihilar cholangiocarcinoma

Hepatology — Mon, 30 Jan 2012 05:00:00 +0100

Conclusion: Outcome following neoadjuvant chemoradiation and liver transplantation for perihilar CCA is excellent. Risk of dropout is related to patient and tumor characteristics and this can be used to guide patient counseling prior to enrolment. Recurrence risk is mostly associated with presence of residual cancer on explant. PSC patients do not have an independent survival advantage over de‐novo patients, but present with more favorable tumor characteristics. (HEPATOLOGY 2012.) (Source: Hepatology)

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Integrity of the Oral Tissues in Patients with Solid-Organ Transplants

Advances in Pharmacological Sciences — Sun, 29 Jan 2012 18:41:46 +0100

The objective of this study was to determine the state of oral tissue integrity in renal, heart, and liver transplant patients who are on continuous medical and dental control. Forty patients of both sexes were clinically evaluated at the Clinical Hospital of the University of Chile to identify pathologies of oral mucosa, gingival enlargement (GE), decayed, missing, filled teeth (DMFT) index, and salivary flow. The average age of the transplant subjects was 49.4 years, and the age range was 19 to 69 years. Most subjects maintained a good level of oral hygiene, and the rate mean of DMFT was 14.7. The degree of involvement of the oral mucosa and GE was low (10%). Unlike other studies, the frequency of oral mucosal diseases and GE was low despite the fact that these patients were immunosu...

Respiratory Syncytial Virus Pneumonia Treated with Lower-Dose Palivizumab in a Heart Transplant Recipient

Anesthesiology Research and Practice — Sun, 29 Jan 2012 12:15:47 +0100

Respiratory syncytial virus (RSV) is an important community-acquired pathogen that can cause significant morbidity and mortality in patients who have compromised pulmonary function, are elderly, or are immunosuppressed. This paper describes a 70-year-old man with a remote history of heart transplantation who presented with signs and symptoms of pneumonia. Chest computed tomography (CT) imaging demonstrated new patchy ground glass infiltrates throughout the upper and lower lobes of the left lung, and the RSV direct fluorescence antibody (DFA) was positive. The patient received aerosolized ribavirin, one dose of intravenous immunoglobulin, and one dose of palivizumab. After two months of followup, the patient had improved infiltrates on chest CT, improved pulmonary function testing, and no e...

Pretransplant Fasting Glucose Predicts New-Onset Diabetes after Liver Transplantation

Clinical and Developmental Immunology — Sun, 29 Jan 2012 11:22:18 +0100

New-onset diabetes after transplantation (NODAT) is common after liver transplant and associated with poorer outcomes. The aim of this study was to identify risk factors for NODAT in liver transplant recipients off corticosteroids. In 225 adult nondiabetic liver transplant recipients, the mean age was 51.7 years, the majority were men (71%), and half had HCV (49%). The mean calculated MELD score at transplantation was 18.7, and 19% underwent living-donor transplant (LDLT). One year after transplantation, 17% developed NODAT, and an additional 16% had impaired fasting glucose. The incidence of NODAT in patients with HCV was 26%. In multivariate analysis, HCV, pretransplant FPG, and LDLT were significant. Each 10 mg/dL increase in pretransplant FPG was associat...

A risk score for early cytomegalovirus reactivation after allogeneic stem cell transplantation identifies low‐, intermediate‐, and high‐risk groups: reactivation risk is increased by graft‐versus‐host disease only in the intermediate‐risk group

Transplant Infectious Disease — Sun, 29 Jan 2012 05:00:00 +0100

ConclusionsIdentification of these 3 risk groups in association with the presence or absence of GVHD will help transplant units to make pre‐transplant policy decisions about prophylactic, pre‐emptive, or experimental CMV prevention strategies in groups of patients undergoing HSCT, as well as in those developing GVHD post transplant. (Source: Transplant Infectious Disease)

Chryseobacterium indologenes subcutaneous port‐related bacteremia in a liver transplant patient

Transplant Infectious Disease — Sun, 29 Jan 2012 05:00:00 +0100

We report the first case, to our knowledge, of C. indologenes subcutaneous port‐related bacteremia in a liver transplant recipient. The isolates were resistant to antibiotics previously reported as active, and device removal was required for treatment success. (Source: Transplant Infectious Disease)

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The deceased organ donor with an “open abdomen”: proceed with caution

Transplant Infectious Disease — Sun, 29 Jan 2012 05:00:00 +0100

AbstractIn solid organ transplantation, the disparity between donor supply and patients awaiting transplant continues to increase. The organ shortage has led to relaxation of historic contraindications to organ donation. A large percentage of deceased organ donors have been subjected to traumatic injuries, which can often result in intervention that leads to abdominal packing and intensive care unit resuscitation. The donor with this “open abdomen” (OA) presents a situation in which the risk of organ utilization is difficult to quantify. There exists a concern for the potential of a higher risk for both bacterial and fungal infections, including multidrug‐resistant (MDR) pathogens because of the prevalence of antibiotic use and critical illness in this population. No recommendations ...

The impact of hepatitis C virus donor and recipient status on long‐term kidney transplant outcomes: University of Wisconsin experience

Clinical Transplantation — Sun, 29 Jan 2012 05:00:00 +0100

Singh N, Neidlinger N, Djamali A, Leverson G, Voss B, Sollinger HW, Pirsch JD. The impact of hepatitis C virus donor and recipient status on long‐term kidney transplant outcomes: University of Wisconsin experience.  Clin Transplant 2012 DOI: 10.1111/j.1399‐0012.2011.01583.x.  © 2012 John Wiley & Sons A/S.Abstract: The survival benefit of transplanting hepatitis C (HCV)‐positive donor kidneys into HCV‐positive recipients remains uncertain. The purpose of this study was to assess the effect of HCV‐status of the donor (D) kidney on the long‐term outcomes in kidney transplant recipients (R). We evaluated 2169 consecutive recipients of deceased‐donor kidney transplants performed between 1991 and 2007. The following HCV cohorts were identified: D−/R− (n = 1897),...

Peritransplant kidney biopsies: comparison of pathologic interpretations and practice patterns of organ procurement organizations

Clinical Transplantation — Sun, 29 Jan 2012 05:00:00 +0100

Singh P, Farber JL, Doria C, Francos GC, Gulati R, Ramirez CB, Maley WR, Frank AM. Peritransplant kidney biopsies: comparison of pathologic interpretations and practice patterns of organ procurement organizations.  Clin Transplant 2012 DOI: 10.1111/j.1399‐0012.2011.01584.x.  © 2012 John Wiley & Sons A/S.Abstract: The preimplantation kidney biopsy affects utilization by diagnosing glomerulosclerosis, interstitial fibrosis (IF), arteriosclerosis, and arteriolar hyalinosis. Organ procurement organizations (OPOs) determine whether a donor warrants this biopsy and the donor hospital pathologists (DHPs) report on an OPO‐specific pathology interpretation form. Biopsy slides from 40 deceased donor kidneys transplanted at our institution were used to compare interpretations between ...

The effect of combination treatment with aliskiren and blockers of the renin-angiotensin system on hyperkalaemia and acute kidney injury: systematic review and meta-analysis

Nephrology Now — Sat, 28 Jan 2012 08:31:32 +0100

In the wake of the termination of the Altitude study, this meta-analysis identifies an increase risk of hyperkalemia but not acute kidney injury in the combination of aliskiren and angiotensin converting enzyme inhibitors or angiotensin receptor blockers. : Treatment of Kidney Transplant Recipients With ACEi/ARB and Risk of Respiratory Tract Cancer: A Collaborative Transplant Study Report Novartis announces termination of ALTITUDE study Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial (Source: Nephrology Now)

The PROMISE Study: A Phase 2b Multicenter Study of Voclosporin (ISA247) Versus Tacrolimus in De Novo Kidney Transplantation

Nephrology Now — Sat, 28 Jan 2012 08:25:59 +0100

Voclosporin is a new calcineurin inhibitor being assessed for transplantation. In this dose-ranging non-inferiority trial, three therapeutic levels of voclosporin were compared to tacrolimus in new renal transplant recipients. The incidence of acute rejection was similar in all voclosporin groups compared to tacrolimus. The incidence of diabetes increased in the higher-dose voclosporin group. Further studies will be needed to show whether voclosporin is an improvement over tacrolimus. : Reduced Exposure to Calcineurin Inhibitors in Renal Transplantation Everolimus with Very Low-Exposure Cyclosporine A in De Novo Kidney Transplantation: A Multicenter, Randomized, Controlled Trial The ORION Study: Comparison of Two Sirolimus-Based Regimens versus Tacrolimus and Mycophenolate Mofetil in Rena...

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Specificity of Histological Markers of Long-Term CNI Nephrotoxicity in Kidney-Transplant Recipients Under Low-Dose Cyclosporine Therapy

Nephrology Now — Sat, 28 Jan 2012 08:24:58 +0100

Arteriolar hyalinosis has been considered as the hallmark of calcineurin-inhibitor toxicity. In this retrospective study, renal biopsies were compared between patients who did and did not receive cyclosporine. No histologic lesion, including arteriolar hyalinosis, was seen exclusively in cyclosporine-treated patients. The accompanying editorial discusses the need to develop specific markers of calcineurin-inhibitor toxicity. : Everolimus with Very Low-Exposure Cyclosporine A in De Novo Kidney Transplantation: A Multicenter, Randomized, Controlled Trial Everolimus Plus Reduced-Exposure CsA versus Mycophenolic Acid Plus Standard-Exposure CsA in Renal-Transplant Recipients A Phase III Study of Belatacept-based Immunosuppression Regimens versus Cyclosporine in Renal Transplant Recipients (BEN...

Infectious complications in kidney-transplant recipients desensitized with rituximab and intravenous immunoglobulin

Nephrology Now — Sat, 28 Jan 2012 08:23:37 +0100

Patients who are desensitized prior to renal transplant require more intensive immunosuppression compared to average-risk patients. In this single-centre, non-randomized study, the use of rituximab was not associated with an increased risk of bacterial, viral or fungal infections. : Incidence and Predictive Factors for Infectious Disease after Rituximab Therapy in Kidney-Transplant Patients Troponin I is a Predictor of Acute Cardiac Events in the Immediate Postoperative Renal Transplant Period Similar Outcomes for Canadian Renal Transplant Recipients Followed Up in Transplant Centers and Satellite Clinics (Source: Nephrology Now)

Impact of Early Conversion From Tacrolimus to Sirolimus on Chronic Allograft Changes in Kidney Recipients on Rapid Steroid Withdrawal

Nephrology Now — Sat, 28 Jan 2012 08:21:27 +0100

This randomized controlled trial assessed the effect of conversion from tacrolimus to sirolimus at one month post-transplant. In comparison to other such trials of early conversion to an mTOR inhibitor, this trial was notable for including protocol biopsies. Conversion to sirolimus did not affect the frequency of chronic changes seen on biopsy at one year post-transplant. : The ORION Study: Comparison of Two Sirolimus-Based Regimens versus Tacrolimus and Mycophenolate Mofetil in Renal Allograft Recipients Subclinical Rejection in Stable Positive Crossmatch Kidney Transplant Patients: Incidence and Correlations Everolimus with Very Low-Exposure Cyclosporine A in De Novo Kidney Transplantation: A Multicenter, Randomized, Controlled Trial (Source: Nephrology Now)

Stopping Immunosuppressive Prednisone Soon After Transplantation Found To Be Safe

Health News from Medical News Today — Sat, 28 Jan 2012 08:00:00 +0100

Rapid discontinuation of the immunosuppressive steroid prednisone after a kidney transplant can help prevent serious side effects, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). Also, doing so does not appear to jeopardize the long-term survival of transplant patients and their new organs. Historically, most kidney transplant patients have taken large doses of the immunosuppressive steroid prednisone to help keep their bodies from rejecting their new organ... (Source: Health News from Medical News Today)

Embryonic hepatocyte transplantation for hepatic cirrhosis: Efficacy and mechanism of action.

World Journal of Gastroenterology : WJG — Sat, 28 Jan 2012 05:00:00 +0100

CONCLUSION: Transplantation of embryonic hepatocytes in rats has therapeutic effects on cirrhosis. The described treatment may significantly reduce the expression of STAP and ET-1. PMID: 22294837 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

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To split or not to split: That is the question

Liver Transplantation — Sat, 28 Jan 2012 05:00:00 +0100

(Source: Liver Transplantation)

Development of organ‐specific donor risk indices

Liver Transplantation — Sat, 28 Jan 2012 05:00:00 +0100

AbstractDue to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ‐specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C‐positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease...

Immunosuppression with budesonide for liver transplant recipients with severe infections

Liver Transplantation — Sat, 28 Jan 2012 00:45:30 +0100

(Source: Liver Transplantation)

Repeated transplantation of hepatocytes prevents fulminant hepatitis in a rat model of Wilson's disease

Liver Transplantation — Sat, 28 Jan 2012 00:45:27 +0100

AbstractThe outcome of consecutive hepatocyte transplants was explored in a rat model of Wilson's disease before the onset of fulminant hepatitis without preconditioning regimens. Rats received a high‐copper diet in order to induce a rapid induction of liver failure. Sham‐operated rats (15/15) developed jaundice and fulminant hepatitis, and they died within 4 weeks of first transplantation. Despite the continuation of a high dietary copper challenge, long‐term survival was observed for a notable proportion of the transplanted animals (7/18). All survivors displayed normalized levels of hepatitis‐associated serum markers and ceruloplasmin oxidase activity by posttransplant days 50 and 98, respectively. The liver copper concentrations, the liver histology, and the expression of marke...

Efficient human fetal liver cell isolation protocol based on vascular perfusion for liver cell–based therapy and case report on cell transplantation

Liver Transplantation — Sat, 28 Jan 2012 00:45:24 +0100

In conclusion, this human FL cell isolation protocol may be of interest for further clinical translation work on the development of liver cell–based therapies. Liver Transpl 18:226–237, 2012. © 2011 AASLD. (Source: Liver Transplantation)

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Impact of venous systemic oxygen persufflation supplemented with nitric oxide gas on cold‐stored, warm ischemia–damaged experimental liver grafts

Liver Transplantation — Sat, 28 Jan 2012 00:45:23 +0100

In conclusion, the resuscitation of livers after 30 minutes of WI to a level comparable to that of nonischemically damaged livers is possible with VSOP supplemented with NO gas. Moreover, the application of VSOP with NO minimizes the extent of injuries caused by oxygen free radicals during preservation. Liver Transpl 18:219–225, 2012. © 2011 AASLD. (Source: Liver Transplantation)

Transjugular intrahepatic portosystemic shunt for the treatment of sinusoidal obstruction syndrome in a liver transplant recipient and review of the literature

Liver Transplantation — Sat, 28 Jan 2012 00:45:20 +0100

We describe a patient with SOS after LT who was successfully treated by the placement of a transjugular intrahepatic portosystemic shunt (TIPS). Although information on this approach is scarce because of the low incidence of SOS in LT patients, we review the available literature on treating this condition with a TIPS. On the basis of the reported information and our patient's outcome, we suggest that prompt TIPS placement can be considered for SOS when medical treatment fails. Nonetheless, a formal assessment and prospective studies are needed to confidently indicate TIPS placement in this situation. Liver Transpl 18:201–205, 2012. © 2011 AASLD. (Source: Liver Transplantation)

Early use of mammalian target of rapamycin inhibitors is an independent risk factor for incisional hernia development after liver transplantation

Liver Transplantation — Sat, 28 Jan 2012 00:45:17 +0100

In conclusion, immunosuppressive therapy with mTOR inhibitors is an important independent risk factor for IH development after LT. To reduce the incidence of IHs, mTOR inhibitors should be avoided until the fourth month after LT unless their use is deemed to be strictly necessary. Liver Transpl 18:188–194, 2012. © 2011 AASLD. (Source: Liver Transplantation)

Outcome of post–liver transplant ischemic and nonischemic biliary stenoses treated with percutaneous interventions: The bologna experience

Liver Transplantation — Sat, 28 Jan 2012 00:45:16 +0100

In conclusion, a percutaneous approach is highly effective for the treatment of post‐LT BSs, and the best results are obtained for patients with simple, nonischemic BSs (technical success rate = 94%, 3‐year primary patency rate = 81%, 3‐year secondary patency rate = 75%). For patients with ischemic BSs, closer follow‐up and retreatment are more frequently needed to achieve secondary patency rates comparable to (or even better than) those for patients with nonischemic stenoses. Liver Transpl 18:177–187, 2012. © 2011 AASLD. (Source: Liver Transplantation)

Abnormal Finding on a Screening Endomyocardial Biopsy

American Journal of Transplantation — Sat, 28 Jan 2012 00:36:17 +0100

(Source: American Journal of Transplantation)

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Notes From the Field: Transplant‐Transmitted Hepatitis B Virus—United States, 2010

American Journal of Transplantation — Sat, 28 Jan 2012 00:36:13 +0100

Hepatitis B was transmitted to three of five organ recipients from a donor at increased risk for hepatitis B whose infection was detectable only by nucleic acid virus testing, which revealed extremely low‐level viremia. (Source: American Journal of Transplantation)

LITERATURE Watch Implications for transplantation

American Journal of Transplantation — Sat, 28 Jan 2012 00:35:17 +0100

The innate immune response is mediated through engagement of cellular receptors recognizing conserved molecular patterns of pathogens. This month, Robert Fairchild and Jonathan Bromberg discuss how pattern recognition receptors on dendritic cells influence antigen processing and presentation, and the body's response to inflammation, pointing out that it remains unclear how states of so‐called sterile inflammation evoke signals provoking the priming of T cells. (Source: American Journal of Transplantation)

The AJT Report News and issues that affect organ and tissue transplantation

American Journal of Transplantation — Sat, 28 Jan 2012 00:35:15 +0100

Many ESRD patients, a disproportionate number of whom are African American, are not told about transplantation as a treatment option (Source: American Journal of Transplantation)

Selecting lung transplant candidates: where do current guidelines fall short?

Expert Review of Respiratory Medicine — Fri, 27 Jan 2012 17:40:19 +0100

Expert Review of Respiratory Medicine , February 2012, Vol. 6, No. 1, Pages 51-61. (Source: Expert Review of Respiratory Medicine)

Live Liver Donations Confirmed As Safe

Health News from Medical News Today — Fri, 27 Jan 2012 17:00:00 +0100

According to Johns Hopkins researchers, individuals who donate a portion of their liver for live transplantation usually recover safely from the procedure and can expect to live long, healthy lives. The study is published in the February issue of the journal Gastroenterology. Dorry L. Segev, M.D., Ph.D., lead author of the study, a transplant surgeon, and an associate professor of surgery and epidemiology at the Johns Hopkins University School of Medicine explains: "The donor process is safer than some have previously thought... (Source: Health News from Medical News Today)

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Guidelines for potential multiple organ donors (adult). Part III: organ-specific recommendations

Revista Brasileira de Terapia Intensiva — Fri, 27 Jan 2012 15:57:11 +0100

A morte encefálica induz várias alterações fisiopatológicas que podem causar lesões em rins, pulmões, coração e fígado. Portanto, a atuação do intensivista durante a manutenção do potencial doador falecido exige cuidados específicos com estes órgãos visando sua maior viabilidade para transplantes. O manejo hemodinâmico cuidadoso, os cuidados ventilatórios e de higiene brônquica minimizam a perda de rins e pulmões para o transplante. A avaliação da condição morfológica e funcional do coração auxilia na avaliação do potencial transplantável deste órgão. Por fim, a avaliação da função hepática, assim como o controle metabólico e a realização de sorologias virais são fundamentais para a orientação das equipes transplantadoras na seleção do órgão ...

Hepatocellular Carcinoma Confirmation, Treatment, and Survival in Surveillance, Epidemiology, and End Results Registries, 1992‐2008

Hepatology — Fri, 27 Jan 2012 14:20:21 +0100

Conclusion: HCC survival is improving, because more cases are diagnosed and treated at early stages. Additional progress may be possible with continued use of clinical surveillance to follow individuals at risk for HCC, enabling early intervention. (HEPATOLOGY 2012;) (Source: Hepatology)

A First For Ontario: Cardiac Stem Cell Transplant Performed At The Peter Munk Cardiac Centre

Health News from Medical News Today — Fri, 27 Jan 2012 10:00:00 +0100

Heart failure is a leading cause of death in Canada. As part of the ongoing IMPACT-CABG clinical trial to treat advanced heart failure, physicians at the Peter Munk Cardiac Centre performed the first cardiac stem cell transplant in Ontario last week using stem cells derived from the patient's own bone marrow, isolated completely within the operating room, and implanted into the heart at the time of coronary bypass surgery. Researchers hope that stem cell therapy may be developed into a novel treatment for the 50,000 Canadians diagnosed each year with advanced heart failure... (Source: Health News from Medical News Today)

Can we direct organ allocation based on predicted outcome? Hepatocellular carcinoma outside of UCSF criteria or retransplant?

Langenbeck's Archives of Surgery — Fri, 27 Jan 2012 06:51:56 +0100

Conclusion These two very different but high risk patient populations have very different survival rates. At a time where regulatory agencies demand more and more with regards to transplant outcomes, we think the transplant community has to reflect on whether allocation justice and fair access to transplant are respected if we start allocating organs based on outcomes. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00423-012-0910-3Authors Caroline Rochon, Transplant Center of Excellence, Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, USAPatricia Sheiner, Transplant Center of Excellence, Westchester Medical Center, 100 Woods Road, Valhalla, NY 10595, USABasant Mahadevappa, Transplant Center of Excellence, Westchester Medic...

Supervised versus uncontrolled rehabilitation of patients after rotator cuff repair-clinical and neurophysiological comparative study.

The International Journal of Artificial Organs — Fri, 27 Jan 2012 05:00:00 +0100

Conclusion: The supervised exercise therapy is more effective than uncontrolled one after the rotator cuff surgical reconstruction. PMID: 22287203 [PubMed - as supplied by publisher] (Source: The International Journal of Artificial Organs)

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Treatment of septic shock with continuous HDF using 2 PMMA hemofilters for enhanced intensity.

The International Journal of Artificial Organs — Fri, 27 Jan 2012 05:00:00 +0100

Conclusion: Enhanced intensity PMMA-CHDF may improve hemodynamics and survival rate in patients with refractory septic shock. PMID: 22287204 [PubMed - as supplied by publisher] (Source: The International Journal of Artificial Organs)

Immune response to an adjuvanted influenza A H1N1 vaccine (Pandemrix(R)) in renal transplant recipients

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. These data suggest that Pandemrix® does not provide a protective immune response in the majority of kidney transplant recipients. Therefore, for new vaccines, efficacy as well as safety profiles should be evaluated in this subgroup of patients. (Source: Nephrology Dialysis Transplantation)

Renin-angiotensin system blockade and kidney transplantation: a longitudinal cohort study

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusion. ACEI/ARB prescription may be suggested as beneficial among multiple medications for reducing mortality in kidney transplant recipients, but its use was not associated with longer graft survival. (Source: Nephrology Dialysis Transplantation)

Sirolimus-based regimen is associated with decreased expression of glomerular vascular endothelial growth factor

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. There is emerging evidence that the VEGF system can play either a beneficial or a detrimental role depending on the specific pathologic situations. Therefore, modulating the renal VEGF axis by using an SRL-based regimen may influence the evolution of kidney injury associated with renal transplantation. (Source: Nephrology Dialysis Transplantation)

Renal transplant recipients have elevated frequencies of circulating myeloid-derived suppressor cells

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. RTRs, CKD patients and ICI-SCCPos have increased MDSC frequencies and MDSC/DC ratios. These changes may impact on cancer immunosurveillance. Therefore, MDSC represent both a potential therapeutic target and prognostic marker in these patients, with respect to the development of SCC and other malignancies. (Source: Nephrology Dialysis Transplantation)

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Pharmacists' interventions in the management of patients with chronic kidney disease: a systematic review

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. The evidence of pharmacists’ interventions in patients with chronic kidney disease is sparse, of variable quality and with heterogeneous outcomes. On the basis of best available evidence, pharmacists’ interventions may have a positive impact on outcomes of patients with chronic kidney disease. (Source: Nephrology Dialysis Transplantation)

Liver Transplant Using Donor Organs With High Liver EnzymesLiver Transplant Using Donor Organs With High Liver Enzymes

Medscape Today Headlines — Fri, 27 Jan 2012 04:00:00 +0100

How safe are liver transplants with organs from elderly donors? How old is too old? Liver International (Source: Medscape Today Headlines)

Temple’s heart and lung transplant program reactivated

bizjournals.com Health Care:Pharmaceuticals headlines — Thu, 26 Jan 2012 21:02:28 +0100

Temple University Hospital has reactivated its heart, lung, and heart/lung transplant programs, effective immediately. The reactivation follows the hospital’s receipt of interim approval, from the United Network of Organ Sharing, to reactive the programs. “The reactivation of these transplant programs gives Temple the opportunity once again to bring a full range of sophisticated, lifesaving care to patients with end-stage lung and heart disease – from effective medical therapy to bridge-to- transplant procedures to solid-organ transplantation,” said Larry R... (Source: bizjournals.com Health Care:Pharmaceuticals headlines)

Pediatric Renal Transplantation in a Highly Sensitised Child—8 Years On

Advances in Pharmacological Sciences — Thu, 26 Jan 2012 18:56:20 +0100

Highly sensitised children have markedly reduced chances of receiving a successful deceased donor renal transplant, increased risk of rejection, and decreased graft survival. There is limited experience with the long-term followup of children who have undergone desensitization. Following 2 failed transplants, our patient was highly sensitised. She had some immunological response to intravenous immunoglobulin (IVIg) but this was not sustained. We developed a protocol involving sequential therapies with rituximab, IVIg, and plasma exchange. Immunosuppressant therapy at transplantation consisted of basiliximab, tacrolimus, mycophenolate mofetil, and steroids. At the time of transplantation, historical crossmatch was ignored. Current CDC crossmatch was negative, but T and B cell flow crossmatc...

Silent Ischemia: Clinical Relevance

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:10 +0100

Myocardial ischemia can occur without overt symptoms. In fact, asymptomatic (or silent) ST-segment depression during ambulatory electrocardiogram monitoring occurs more often than symptomatic ST-segment depression in patients with coronary artery disease. Initial studies documented that silent ischemia provided independent prediction of adverse outcomes in patients with known and unknown coronary artery disease. The ACIP (Asymptomatic Cardiac Ischemia Pilot Study) enrolled patients in the 1990s and found that revascularization was better than medical therapy in reducing silent ischemic episodes and possibly cardiovascular (CV) events. However, the more recent COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial found similar CV event rates between pa...

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Long-Term Kidney Allograft Function and Survival in Prednisone-Free Regimens: Tacrolimus/Mycophenolate Mofetil versus Tacrolimus/Sirolimus.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionsThis study shows that, in a prednisone-free immunosuppressive regimen, long-term renal graft survival and function are significantly worse in the tacrolimus/sirolimus group than the tacrolimus/mycophenolate mofetil group. The synergistic nephrotoxic effect and higher acute rejection rates in the tacrolimus/sirolimus compared with the tacrolimus/mycophenolate mofetil group adversely affect graft survival. PMID: 22282478 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Ten-Year Outcome after Rapid Discontinuation of Prednisone in Adult Primary Kidney Transplantation.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionsPrednisone-related side effects can be minimized in a protocol incorporating rapid discontinuation of prednisone for maintenance immunosuppression. Ten-year patient and graft outcomes remain acceptable. PMID: 22282482 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Experience of heart transplantation from hemodynamically unstable brain‐dead donors with extracorporeal support

Clinical Transplantation — Thu, 26 Jan 2012 05:00:00 +0100

Yang H‐Y, Lin C‐Y, Tsai Y‐T, Lee C‐Y, Tsai C‐S. Experience of heart transplantation from hemodynamically unstable brain‐dead donors with extracorporeal support.  Clin Transplant 2012 DOI: 10.1111/j.1399‐0012.2011.01585.x.  © 2012 John Wiley & Sons A/S.Abstract: The shortage of organ donors remains a major problem for transplantation worldwide. Potential donors after brain death may become hemodynamically unstable, despite maximal medical management, which ultimately leads to failure of organ procurement. We reviewed the medical records of five brain‐dead potential donors who presented with hemodynamic instability despite maximal medical management that were supported by extracorporeal circulation membrane oxygenation (ECMO). The outcomes of heart recipients were...

Ontario's first cardiac stem cell transplant performed last week at the Peter Munk Cardiac Centre

EurekAlert! - Medicine and Health — Thu, 26 Jan 2012 05:00:00 +0100

(University Health Network) Peter Munk Cardiac Centre physicians performed the first cardiac stem cell transplant in Ontario, part of the IMPACT-CABG clinical trial, to treat advanced heart failure, using stem cells derived from the patient's bone marrow, isolated within the operating room, and implanted into the heart at the time of coronary bypass surgery. Researchers hope that stem cell therapy may be developed into a novel treatment for the 50,000 Canadians diagnosed each year with advanced heart failure. (Source: EurekAlert! - Medicine and Health)

Teen to meet 11 strangers who saved his life by donating blood, platelets

UCLA Newsroom: Health Sciences — Wed, 25 Jan 2012 23:00:00 +0100

WHAT: Due to confidentiality laws, most blood donors never know who receives their blood. Similarly, patients never learn the identities of the people who donated their time and blood to save their lives. But a rare reunion organized by the UCLA Blood and Platelet Center will change that. A teenage boy who underwent a heart transplant at Mattel Children's Hospital UCLA will meet 11 blood and platelet donors who sustained his life with their generous donations. WHO: RECIPIENT Donovan Ho Ho, 17, of Orange, Calif., will express his gratitude for the 72 units of donated blood, plasma and platelets that helped make his 2010 organ transplant successful after his heart failed. Accompanied by his 10-year-old brother, parents, grandparents and great-grandmo...

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Patient with dropped heart leaves hospital after successful transplant

Health News: CBSNews.com — Wed, 25 Jan 2012 21:48:17 +0100

Erika Hernandez doing well after transplant, but she doesn't know heart was dropped, doctor said. (Source: Health News: CBSNews.com)

Effectiveness of rhGH treatment on final height of renal-transplant recipients in childhood

Pediatric Nephrology — Wed, 25 Jan 2012 18:13:56 +0100

Conclusion Our findings confirm that rhGH is effective to improve FH in CKD RTx patients, without affecting kidney function. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00467-011-2090-8Authors Silvia Gil, Department of Endocrinology, Hospital de Pediatria Garrahan, Buenos Aires, ArgentinaElisa Vaiani, Department of Endocrinology, Hospital de Pediatria Garrahan, Buenos Aires, ArgentinaGabriela Guercio, Department of Endocrinology, Hospital de Pediatria Garrahan, Buenos Aires, ArgentinaMarta Ciaccio, Department of Endocrinology, Hospital de Pediatria Garrahan, Buenos Aires, ArgentinaAmalia Turconi, Department of Nephrology, Hospital de Pediatria Garrahan, Buenos Aires, ArgentinaNorma Delgado, Department of Nephrology, Hospital de Pediatria G...

Does the use of extended criteria donors influence early and long-term results of lung transplantation?

Interactive CardioVascular and Thoracic Surgery — Wed, 25 Jan 2012 05:00:00 +0100

A best evidence topic was constructed according to a structured protocol. The question addressed was whether the presence of extended criteria donors influences the early and long-term results in patients referred for lung transplantation. Of the 30 papers found using a report search, 14 presented the best evidence to answer the clinical question. The authors, journal, date, country of publication, study type, group studied, relevant outcomes and results of these papers are given. In total, we recorded 10 retrospective studies that considered all the donor criteria for comparing marginal donors (MDs) and standard donors. On the one hand, six of them showed no difference between the two groups in terms of early and long-term results. On the other hand, four studies demonstrated a negative i...

Early transcriptional programming links progression to hepatitis C virus‐induced severe liver disease in transplant patients

Hepatology — Wed, 25 Jan 2012 05:00:00 +0100

AbstractLiver failure due to chronic hepatitis C virus infection is a major cause for liver transplantation worldwide. Recurrent infection of the graft is universal in HCV patients following transplant and results in rapid progression to severe fibrosis and end‐stage liver disease in one‐third of all patients. No single clinical variable, or combination thereof, has so far proven accurate in identifying patients at risk of hepatic decompensation in the transplant setting. A combination of longitudinal, dimensionality reduction, and categorical analysis of the transcriptome from 111 liver biopsy specimens taken from 57 HCV‐infected patients over time identified a molecular signature of gene expression of patients at risk of developing severe fibrosis. Significantly, alterations in gen...

http://www.D‐MELD.com, the Italian survival calculator to optimize donor to recipient matching and to identify the unsustainable matches in liver transplantation

Transplant International — Wed, 25 Jan 2012 00:59:36 +0100

SummaryOptimization of donor‐recipient match is one of the exciting challenges in liver transplantation. Using algorithms obtained by the Italian D‐MELD study (5256 liver transplants, 21 Centers, 2002–2009 period), a web‐based survival calculator was developed. The calculator is available online at the URL http://www.D‐MELD.com. The access is free. Registration and authentication are required. The website was developed using PHP scripting language on HTML platform and it is hosted by the web provider Aruba.it. For a given donor (expressed by donor age) and for three potential recipients (expressed by values of bilirubin, creatinine, INR, and by recipient age, HCV, HBV, portal thrombosis, re‐transplant status), the website calculates the patient survival at 90 days, 1 year, ...

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Hospital closings put new focus on Hawaii health care

bizjournals.com Health Care:Hospitals headlines — Tue, 24 Jan 2012 22:22:46 +0100

The shutdown of the two Hawaii Medical Center hospitals earlier this month caused a new wave of uncertainty for an already-burdened Hawaii health-care industry — but it has at least put a spotlight on the industry’s longtime woes. State lawmakers are fast-tracking legislation that would provide approximately $1.8 million in emergency funding for a new kidney and liver transplant facility, which will be located at The Queen’s Medical Center. Queen’s, the state’s largest acute-care hospital, is waiting on federal approval to establish its own organ transplant facility, allowing it to take over from Hawaii Medical Center East, which ran Hawaii’s only such center for decades before it stopped taking patients in December ahead of the shutdown... (Source: bizjournals.com Health Car...

Therapeutic Liposomal Dry Powder Inhalation Aerosols for Targeted Lung Delivery

Lung — Tue, 24 Jan 2012 18:14:14 +0100

Abstract Therapeutic liposomal powders (i.e., lipospheres and proliposomes) for dry powder inhalation aerosol delivery, formulated with phospholipids similar to endogenous lung surfactant, offer unique opportunities in pulmonary nanomedicine while offering controlled release and enhanced stability. Many pulmonary diseases such as lung cancer, tuberculosis (TB), cystic fibrosis (CF), bacterial and fungal lung infections, asthma, and chronic obstructive pulmonary disease (COPD) could greatly benefit from this type of pulmonary nanomedicine approach that can be delivered in a targeted manner by dry powder inhalers (DPIs). These delivery systems may require smaller doses for efficacy, exhibit reduced toxicity, fewer side effects, controlled drug release over a prolonged time p...

Performance of the Japanese GFR equation in potential kidney donors

Clinical and Experimental Nephrology — Tue, 24 Jan 2012 07:30:47 +0100

Conclusion The Japanese GFR equation underestimated GFR in potential kidney donors. Higher creatinine generation compared with CKD subjects may contribute to the underestimation of GFR by the Japanese GFR equation in potential kidney donors. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s10157-012-0586-6Authors Masaru Horio, Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, JapanYoshinari Yasuda, Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, JapanJyunya Kaimori, Departments of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Osaka, JapanNaotsugu Ichimaru, Department of Specific Organ Regulation, Osaka Universit...

Development of a new quantitative real-time HHV-6-PCR and monitoring of HHV-6 DNAaemia after liver transplantation.

Journal of Virological Methods — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Karlsson T, Mannonen L, Loginov R, Lappalainen M, Höckerstedt K, Lautenschlager I Abstract A quantitative HHV-6 PCR (qPCR) assay was developed and compared to an "in-house" qualitative PCR and to the commercial quantitative Argene CMV, HHV6, 7, 8 R-gene™ test. Clinical specimens consisting of 127 whole blood and 57 cerebrospinal fluid (CSF) specimens were tested using the two qPCRs and the qualitative PCR in parallel. When the qualitative PCR was used as a "gold standard," the sensitivities of the qPCRs for the blood samples were 86% for the "in-house" qPCR and 76% for the Argene's test and the specificities were 96% and 92%, respectively. With CSF specimens the sensitivities were 92% and 80% and the specificities 98% and 82%, respectively. Furthermore, the two qPCRs we...

Improved Survival but Marginal Allograft Function in Patients Treated With Extracorporeal Membrane Oxygenation After Lung Transplantation [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Advances in ECMO technology, particularly VV ECMO, have greatly improved the ability to support patients with severe PGD after lung transplantation. VV ECMO is an important tool in the armamentarium of any lung transplant program to optimize patient outcomes; however, strategies to improve lung allograft function in patients experiencing severe PGD are still needed. (Source: The Annals of Thoracic Surgery)

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Iatrogenic Atrial Septal Defect and Aortoatrial Fistula in a Patient With Endovascular Prosthesis in the Inferior Vena Cava [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

We report the case of a liver transplant patient with a stenosis in the anastomosis of the suprahepatic veins to inferior vena cava, treated by self-expanding prosthesis, who developed an aorto–right atrial fistula and an atrial septal defect. Open heart surgery was performed to correct the defects. Transthoracic echocardiogram 1 year later revealed no evidence of residual shunt. (Source: The Annals of Thoracic Surgery)

Roundup: limb transplants, stressed cities

USATODAY.com Health — Mon, 23 Jan 2012 14:52:13 +0100

Part of triple limb transplant fails, some lung cancer patients keep smoking and the "sunshine state" may be misnamed. (Source: USATODAY.com Health)

Organ donation: Best man donates life-saving kidney to bride

the Mail online | Health — Mon, 23 Jan 2012 13:31:00 +0100

Leanne Stefanovic, 31, of Hull, East Yorks, is recovering from a successful transplant after her husband's best friend Stuart Kilgannon, 39 was found to be a match. (Source: the Mail online | Health)

'Awake ECMO' May Boost Survival After Lung Transplant (CME/CE)

MedPage Today Allergy — Mon, 23 Jan 2012 10:13:00 +0100

(MedPage Today) -- Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation increased survival compared with mechanical ventilation in awake, spontaneously breathing patients, according to a retrospective study. (Source: MedPage Today Allergy)

MedWorm: Transplant Surgery

Blood Pressure Measurements and Left Ventricular Mass Index in Hemodialysis Patients

Fifty Years of Work on the Artificial Placenta: Milestones in the History of Extracorporeal Support of the Premature Newborn

Laryngeal transplantation in minipigs: early immunological outcomes.

For Kidney Disease Patients, Goals For Blood Pressure May Be Unrealistic

Abercrombie to sign organ transplant funding bill into law

Six-Organ Transplant Girl Goes Home Today

Maine girl home after 6-organ transplant

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation.

Medicare Pay Policy on Transplant Drugs Slammed

Study: Volume matters in high-risk orthotopic heart transplant patients

Ground-breaking six-organ transplant saves Alannah Shevenell, 9, from 'monster' tumour

Geography Over Need Is Putting Sicker Patients Needing Lung Transplant At Higher Risk Of Dying

Evaluation of metabolic syndrome after hematopoietic stem cell transplantation in children and adolescents

Early viral load and recipient IL28B rs12979860 genotype are predictors for progression of hepatitis C after liver transplantation

Banff 2011 Meeting Report: New Concepts in Antibody‐Mediated Rejection

Deleterious Effect of CTLA4‐Ig on a Treg‐Dependent Transplant Model

A Common Peripheral Blood Gene Set for Diagnosis of Operational Tolerance in Pediatric and Adult Liver Transplantation

Acquired Antithrombin Type IIb Deficiency After Liver Transplantation: A Case Report

A New Diagnostic Algorithm for Antibody‐Mediated Microcirculation Inflammation in Kidney Transplants

Role of Rapamycin‐Induced Autophagy in Pancreatic Islets

A Risk‐Prediction Model for In‐hospital Mortality After Heart Transplantation in US Children

The Presence of Autophagy in Mammal Cells Should Be Interpreted Carefully

Organ Donation and Moyamoya Disease

Impact of Sirolimus Duration on Hepatitis C Related Fibrosis Progression in Liver Transplant Recipients

Counting Small Hypointense Spots Confounds the Quantification of Functional Islet Mass Based on Islet MRI

Diagnostic Pathology: Kidney Diseases, by Robert Colvin

Endogenous Expansion of Regulatory T Cells Leads to Long‐Term Islet Graft Survival in Diabetic NOD Mice

Multivisceral Ex Vivo Surgery for Tumors Involving Celiac and Superior Mesenteric Arteries

Early Metabolic Markers that Anticipate Loss of Insulin Independence in Type 1 Diabetic Islet Allograft Recipients

Role of Lentivirus‐Mediated Overexpression of Programmed Death‐Ligand 1 on Corneal Allograft Survival

Donor Brain Death Inhibits Tolerance Induction in Miniature Swine Recipients of Fully MHC‐Disparate Pulmonary Allografts

Three‐Year Outcomes From BENEFIT‐EXT: A Phase III Study of Belatacept Versus Cyclosporine in Recipients of Extended Criteria Donor Kidneys

Lung Transplantation in Patients with Prior Cardiothoracic Surgical Procedures

Circulating Antibody Free Light Chains and Risk of Posttransplant Lymphoproliferative Disorder

Multiple Hyperacute Rejections in the Absence of Detectable Complement Activation in a Patient with Endothelial Cell Reactive Antibody

With Respect to Elderly Patients: Finding Kidneys in the Context of New Allocation Concepts

Differential Expression of MicroRNAs During Allograft Rejection

Transhilar Passage in Right Graft Live Donor Liver Transplantation: Intrahilar Anatomy and Its Impact on Operative Strategy

Recipient IL28B Polymorphism Is an Important Independent Predictor of Posttransplant Diabetes Mellitus in Liver Transplant Patients with Chronic Hepatitis C

Sirolimus Conversion for Renal Dysfunction in Liver Transplant Recipients: The Devil Really Is in the Details…

Mechanisms of Alloimmunization and Subsequent Bone Marrow Transplantation Rejection Induced by Platelet Transfusion in a Murine Model

Patient, Center and Geographic Characteristics of Nationally Placed Livers

Donor‐Specific HLA Antibodies in a Cohort Comparing Everolimus with Cyclosporine After Kidney Transplantation

9-Year-Old Girl Heads Home After 6 Organ Transplant At Children’s Hospital

Children’s becomes first hospital in New England to complete six organ transplant

9-Year-Old Girl Heading Home After 6 Organ Transplant At Children’s Hospital

Improved Kidney Transplant Survival In Mice; New Agent Likely To Speed Replacement Of Other Organs

Salvaging kidneys with renal allograft compartment syndrome

Contents

Editorial Board

Combined heart and liver transplantation in an adult with familial heterozygous hypercholesterolemia and severe ischemic cardiomyopathy

Altered progenitor cell and cytokine profiles in bronchiolitis obliterans syndrome

Searching for novel molecular targets of chronic rejection in an orthotopic experimental lung transplantation model

Construction of vascularized cardiac tissue from genetically modified mouse embryonic stem cells

Effect of simvastatin on development of obliterative airway disease: An experimental study

Reconditioning of lungs donated after circulatory death with normothermic ex vivo lung perfusion

Peripartum cardiomyopathy: Post-transplant outcomes from the united network for organ sharing database

ABO-incompatible heart transplantation: Analysis of the Pediatric Heart Transplant Study (PHTS) database

Extremes of body mass index do not impact mid-term survival after continuous-flow left ventricular assist device implantation

Evaluation of valganciclovir pharmacokinetics in lung transplant recipients

The Fourth INTERMACS Annual Report: 4,000 implants and counting

The dawn of the ISHLT Mechanical Assisted Circulatory Support (IMACS) Registry: Fulfilling our mission

Sinusoidal C4d deposits in liver allografts indicate an antibody mediated response: Diagnostic considerations in the evaluation of liver allografts

Comparison of seven liver allocation models with respect to lives saved among patients on the liver transplant waiting list

Regulatory T Cells Exhibit Decreased Proliferation but Enhanced Suppression After Pulsing with Sirolimus

Prevalence and subtypes of BK virus in pediatric renal transplant recipients in Russia

Mitochondrial haplogroups associated with end-stage heart failure and coronary allograft vasculopathy in heart transplant patients

Many children with liver transplants from parents can safely stop using anti-rejection drugs

Lungs clothed in fresh cells offer new hope for transplant patients

When the isolated lung runs out of air

Amelia Rivera, 3, in struggle for kidney transplant over disability

Outcomes of living‐donor liver transplantation in patients with preoperative type‐1 hepatorenal syndrome and acute hepatic decompensation

Incidence, kinetics, and risk factors of Epstein–Barr virus viremia in pediatric patients after allogeneic stem cell transplantation

Transplant possible for Amelia Rivera

Complications of kidney transplantation with grafts from expanded criteria donors

Sirolimus – Moving toward the mainstream in pediatric heart transplantation?

New agent improves kidney transplant survival in mice, likely to speed replacement of other organs

Iatrogenic atrial septal defect and aortoatrial fistula in a patient with endovascular prosthesis in the inferior vena cava.

Teenager given days to live has life-saving lung transplant after spending 10 YEARS in hospital and planning her own funeral

Multiple Hyperacute Rejections in the Absence  of Detectable Complement Activation in a Patient  with Endothelial Cell Reactive Antibody

Patient, Center and Geographic Characteristics  of Nationally Placed Livers

Regulatory T Cells Exhibit Decreased Proliferation  but Enhanced Suppression After Pulsing with Sirolimus