by Darren E. Stewart  , Amber R. Wilk  and David K. Klassen

Received: 14 December 2018;  Published: 22 January 2019;  doi: 10.21926/obm.transplant.1901041

Background: This study examines very recent trends in deceased donor kidney transplantation to assess the performance of the kidney allocation system (KAS), implemented December 4, 2014, and whether bolus effects associated with KAS have stabilized nearly four years after implementation. Methods: The overall number of deceased donor kidney transplants, as well as the proportion of transplants by recipient and transplant characteristics, were calculated monthly from December 2013 through September 2018 and examined [...]

by Margaret E. Newman  , Kenneth Pursell  and David Pitrak

Received: 05 November 2018;  Published: 20 January 2019;  doi: 10.21926/obm.transplant.1901040

Infection with parvovirus B19 is common, with up to 55% of adults showing seropositive evidence of prior infection. Clinical disease can occur due to acute infection, chronic persistent viremia, rarely secondary infection, or possibly viral reactivation of latent virus. The clinical presentation of primary infection depends on age, the presence of a hematologic condition, and immune status. We report a renal transplant recipient who developed transfusion dependent anemia refractory to erythropoietin that responded [...]

by Spinello Antinori  and Laura Milazzo

Received: 28 October 2018;  Published: 15 January 2019;  doi: 10.21926/obm.transplant.1901039

Solid organ transplantation (SOT) is increasingly employed worldwide to treat several diseases causing both acute and chronic organ failure. Recipients of SOT are at an increased risk to develop infections as a consequence of immunosuppressive therapy. Sometimes such infections may be acquired by the transplanted organ or by reactivation of a previously acquired latent infection. The globalization and the increase of international travel poses a risk for exposure to infections such as Chagas disease (CD), leishmani [...]

by Makeda L. Robinson  , Kyle Enriquez  and Dora Y. Ho

Received: 02 November 2018;  Published: 08 January 2019;  doi: 10.21926/obm.transplant.1901038

Flaviviruses can cause epidemics and endemics with substantial public health threat and economic impacts. In the last few decades, many flaviviruses have re-emerged or expanded their territories to new regions or continents, including West Nile virus (WNV) which has become endemic in the US since its arrival in 1999 and Zika virus (ZIKV) which recently spread across the Americas. These events demonstrate the speed with which a vector-borne pathogen can disseminate when introduced into a susceptible population with [...]

by David C. Gaston  and Marwan M. Azar

Received: 14 November 2018;  Published: 29 December 2018;  doi: 10.21926/obm.transplant.1804037

The approach to diagnosing fungal infections following solid organ transplantation (SOT) is patient-specific. An assessment of an individual’s risk for particular infections, also understood as the pre-test probability, should guide appropriate diagnostic testing whereas diagnostic stewardship is needed to produce interpretable, actionable and cost-sensitive results. This review provides a cognitive framework for practitioners aiming to diagnose fungal infections in recipients of SOT, taking into consideration the [...]

by Jeremy M. Quintana  , Alexandra L. Stinchcomb  , Jessica H. Kostyo  , Blair M. Robichaud  , Michael A. Plunk  and Robert R. Kane

Received: 08 October 2018;  Published: 28 December 2018;  doi: 10.21926/obm.transplant.1804036

Islet transplantation has proven to be a viable treatment for individuals suffering from both Type 1 Diabetes Mellitus (T1D) and chronic pancreatitis. However, a variety of challenges limit the effectiveness of this procedure by reducing the number of islets that survive the harvesting and transplantation processes. Increasing islet survival would increase the long-term effectiveness of the procedure and allow this technique to be used in more patients. A number of factors have been shown to improve the outcomes of [...]

by Ashrit Multani  and Stanley Deresinski

Received: 31 October 2018;  Published: 27 December 2018;  doi: 10.21926/obm.transplant.1804035

Strongyloides stercoralis, an intestinal parasitic nematode (roundworm), infects more than 100 million people worldwide. While most infected immunocompetent persons are either asymptomatic or experience only mild, intermittent symptoms, immunosuppressed individuals, including those undergoing solid organ transplantation, are at increased risk for developing the frequently fatal hyperinfection syndrome. Donor-derived strongyloidiasis has recently become increasingly recognized and reported but current donor screenin [...]

by Julianna Holzer  , John Wu  , Yi He  , Mingyang Ma  , Yuan Xing  , Jose Oberholzer  and Yong Wang

Received: 08 November 2018;  Published: 21 December 2018;  doi: 10.21926/obm.transplant.1804034

In this review, we discuss the application of microfluidic devices in studying the physiology and pathophysiology of human islets and beta-cells, especially its application for human islet transplantation. Human islet transplantation is a promising therapy for Type I diabetes; however, the islet transplant outcomes for achieving complete insulin independence are far from perfect and face many challenges. This review focuses on the microfluidic devices developed in our laboratory, which can address these challenges [...]

by Victoria Lorenzetti  , Elena Bargagli  , Antonella Fossi  , David Bennett  , Paolo Cameli  and Paola Rottoli

Received: 30 August 2018;  Published: 18 December 2018;  doi: 10.21926/obm.transplant.1804033

Background: Alpha-1-antitrypsin (AAT) deficiency is the most common hereditary disorder in adults and is associated with an increased risk of developing lung emphysema. Methods:Here, we report the case of a 54-year-old man, who underwent bilateral lung transplantation due to AAT deficiency emphysema in the general hospital of Siena, Italy. Results:The patient was diagnosed with partial AAT deficiency (189 mg/dL) associated with the PIMZ genotype; although he quit smoking, his lung disease progressed to chronic resp [...]

by Zaid Albayati  , Sally Heyworth  , Jane Moberly  , Derek Middleton  , Brian Flanagan  , Abdul Hammad  and Stephen E Christmas

Received: 10 October 2018;  Published: 14 December 2018;  doi: 10.21926/obm.transplant.1804032

Background:HLA-G is an immunosuppressive molecule with a potential role in allograft acceptance. Methods:Expression of HLA-G on leucocyte subpopulations was studied in a group of 21 renal transplant patients immediately prior to and 2 months post-transplantation. Results:Significant increases in proportions of total HLA-G+CD4+ T cells were seen (0.5+/-0.1% to 7.9+/-3.2%; p<0.01) and also for CD45RA+, CD45RO+ and CD69+ subsets. Increases in proportions of HLA-G+ cells were also seen in CD8+ T cells and their [...]