Multidrug-Resistant Bacterial Infections before and after Liver Transplantation
Abstract
1596 10555
Multidrug-Resistant Bacterial Infections before and after Liver TransplantationAbstract
Bacterial infection represents a common event in the natural history of cirrhosis, especially in patients with end-stage liver disease. An episode of bacterial infection may significantly modify a patient’s outcome in the setting of liver transplantation (LT) by impairing hepatic and extrahepatic organ functions, both in pre-operative and post-operative phases. Infections caused by multidrug-resistant organisms (MDRO) are increasing in cirrhosis due to high antibiotic exposure and hospitalizations. This issue is pa [...] 1596 10555 |
Donor Age and Ischemia Time Are Independent Factors Affecting Graft Survival after En Bloc Kidney Transplantation from Donors Less than Three Years of Ageby
Abstract
This study aimed to investigate the outcomes of transplantation from donors aged less than three years in a single-center consecutive series. A total of 52 en bloc kidney graft transplantations were performed. In 22 cases, organs were procured from donors aged less than one year (group 1). In 30 cases, the age of donors varied from one to three years (group 2). After transplantation, renal function and graft and patient survival were evaluated retrospectively. No significant difference was observed between the grou [...] 1151 8389 |
Clinical Approach to the Management of Infections before and after Liver Transplantationby
Abstract
The infectious complications before and after liver transplant (LT) are affected by the severity of liver disease and immunosuppression intensity after transplantation. Both cirrhosis and immunosuppression contribute to dysfunction of defensive mechanisms of the host. When a patient is evaluated for transplantation, the opportunity arises to assess the individual’s risk for infection and how one may modify those risks through prophylactic and therapeutic strategies. Pretransplant infectious disease evaluation focus [...] 1839 14877 |
Genomic Biomarker Surveillance in the Care of Solid Organ Transplant Recipients: An Update for the General Clinician during the Coronavirus (CoVid-19) PandemicAbstract
Biomarker surveillance after solid organ transplant is an advancing field with promise for further elucidation through high-throughput analyses and “omics” technologies. To date, Gene Expression Profiling (GEP; AlloMapâ) is the only FDA-cleared genomic assay as surveillance for moderate-severe TCMR versus allograft quiescence after heart transplantation. Clinical validity and utility, however, have been recently established after kidney and heart transplantation, for analysis of donor-derived cell-free DNA in the a [...] 1907 11630 |
Pediatric Mixed Left Ventricular Non-Compaction and Restrictive Cardiomyopathy Bridged to Heart Transplant with Ventricular Assistby
Abstract
Left ventricular noncompaction cardiomyopathy (LVNC) is a rare form of heritable cardiomyopathy with wide genotypic variability, numerous phenotypic variations, and a wide spectrum of clinical disease from asymptomatic to end stage heart failure. Here, we present a case of a 2-year-old boy who presented to their pediatrician with a cough as a first clinical sign of heart failure, rapidly progressing to severe heart failure. He was found to have mixed LVNC with a restrictive phenotype, a rare phenotype of this form [...] 1518 9937 |
Medawar's Paradox and Immune Mechanisms of Fetomaternal ToleranceAbstract
Brazilian-born British biologist Dr. Peter Medawar played an integral role in developing the concepts of immunologic rejection and tolerance, which led to him receiving the Nobel Prize “for the discovery of acquired immunologic tolerance” and eventually made organ transplantation a reality. However, at the time of his early work in tolerance, a paradox to his theories was brought to his attention; how was pregnancy possible? Pregnancy resembles organ transplantation in that the fetus, possessing paterna [...] 2698 14112 |
Histoplasmosis in Liver Transplant Recipients: Case Reports and a Review of the LiteratureAbstract
We report two cases of histoplasmosis in orthotopic liver transplant (OLT) recipients to illustrate the variable presentations, complications encountered during treatment, the spectrum of diagnostic modalities, and case outcomes. Case 1 describes the insidious presentation of presumed gastrointestinal histoplasmosis 12 years after OLT, which was defined by months of intermittent diarrhea and focal colonic disease on colonoscopy. A diagnosis of Histoplasma capsulatum was ultimately made by broad range PCR performed [...] 1741 12811 |
Febrile Neutropenia in Children: Etiologies, Outcomes, and Risk Factors with Prolonged Feverby
Abstract
Most studies of children with prolonged fever and neutropenia (PFN) have focused on invasive fungal disease (IFD) as the etiology of fever and not on other causes. Data are lacking regarding risk factors and adverse outcomes in pediatric cancer patients with PFN compared with those whose fevers resolve more rapidly. Retrospective medical record review was performed for all cancer patients with febrile neutropenia (FN) in the pediatric oncology unit at University of Chicago Medicine Comer Children’s Hospital f [...] 1534 10325 |
Hematopoietic Stem Cell Transplantation in Refractory Celiac Disease: An Overview with Focus on Infectious Complicationsby
Abstract
Refractory celiac disease (RCD) is a rare condition in which a known celiac patient, usually an adult, suffers from persistence or recurrence of gluten-related symptomatology, laboratory abnormalities, and inflammatory enteropathy despite following an optimal dietary therapy with gluten-free diet (GFD). Arbitrarily, a duration of at least 12 months of GFD has been recommended prior to establishing such a diagnosis. Furthermore, exclusion of the other possible causes of non-celiac villous atrophy, particularly enter [...] 1503 10928 |
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