Right Heart Failure in Left Ventricular Assist Device Patients
Abstract
1453 13963
Right Heart Failure in Left Ventricular Assist Device Patientsby
Abstract
Left ventricular assist devices (LVADs) improve quality of life in end-stage heart failure patients but a frequent complication is Right heart failure (RHF) causing significant morbidity and mortality. This review article discusses key issues that need to be considered in the assessment and clinical management of RHF in LVAD patients including the use of Right Ventricle (RV) support devices and off-label LVADs as temporary or permanent RV support. 1453 13963 |
Islet Autotransplantations for Total PancreatectomyAbstract
Total pancreatectomy (TP) is performed for not only malignant pancreatic diseases but also benign disease such as chronic pancreatitis or pancreatic injury. However, because this surgery involves removal of the whole pancreas, both exocrine and endocrine pancreatic functions are abolished, significantly impairing the nutritional statuses of patients as well as having other detrimental outcomes. Thus, especially in benign cases additional treatment to recover endocrine function is recommended, as permanent endocrine [...] 1084 8629 |
Secondary Antibody Deficiency in a Heart Recipient with Systemic AspergillosisAbstract
Secondary antibody deficiency has been associated with risk of invasive fungal infections in solid organ transplantation. Single center, multi-center and meta-analysis studies have tested this association. Therapy of these infectious complications in the presence of a secondary antibody deficiency after transplantation remain a challenge for transplant teams. Currently, there are no guidelines for the management of this combined clinical scenario. We report the case of a patient with severe secondary immunodeficien [...] 1381 8170 |
Prolonged and Resistant Cutaneous Infection in Newly Transplanted Renal Patientby
Abstract
Mucormycosis is an angioinvasive and potentially fatal fungal infection caused by ubiquitous filamentous fungi. Cutaneous mucormycosis is an emerging infection and potentially lethal. Our aim was to review the literature on cutaneous mucormycosis. We present a case of a renal transplant patient with a surgical wound infection 20 days after kidney transplant. This case is an example on how early diagnosis is crucial and, since culture is less sensitive, microscopic evaluation of the characteristic broad hyphae is th [...] 1114 7444 |
The Contribution of Psychotherapists to Patient Care in Multidisciplinary Heart Transplantation Care Teamsby
Abstract
Background: The participation of mental health professionals in multidisciplinary care teams for heart transplantation has become an international standard practice. The contribution of these professionals in this setting, which involves assessment and interventions, has not been the subject of systematic study. Methods: This paper explores how psychotherapists contribute to multidisciplinary decision making and care in transplant teams before, during, and after transplantation. To illustrate, it uses the case of a [...] 1497 9568 |
Islet Identity in Transplantation Procedures: The Intersection of Cellular Maturity and FunctionAbstract
Pancreatic islet transplantation holds promise for patients with insulin-dependent diabetes, but is severely limited by a shortage of cadaveric donor islets, and more so because of stringent inclusion criteria for organ donation including donor metabolic function, age, and comorbidities. The impact of these diverse factors on islet health has led to a broad investigation of global influences on islet biology, not least of all, characterization of mature, functional cellular identity and maintenance of appropriate e [...] 1638 9212 |
Role of Procalcitonin in Management of Infection in Solid Organ Transplantation Recipients: ReviewAbstract
Infections are a common cause of morbidity and mortality in solid organ transplantation (SOT) recipients. Procalcitonin (PCT) has garnered attention as an inflammatory marker that has been shown to be a valuable marker for early identification of systemic bacterial infection. However, interpretation of PCTs value in the different types of infections, transplanted organs, and post-operative courses can be challenging. We review the role of PCT in the management of infections in SOT recipients. First, the PCT level c [...] 1739 13200 |
Candida auris and Heart Transplantation. Preoperative Attitude.by
Abstract
In recent years, several agencies have issued warnings about the spread of Candida auris infections, a multidrug-resistant yeast that is associated with serious infections and with a mortality rate that can reach 70%. This problem is especially serious in transplant recipients receiving intense immunosupressive therapy. There are no established criteria on the relevance of this colonization or on when the transplant should be contraindicated in these cases. Five cases of colonization and two of candidemia have been [...] 1589 10899 |
Advances in Human Islet Processing: Manufacturing Steps to Achieve Predictable Islet Outcomes from Research PancreasesAbstract
Background: This presentation of a six-year study processing human islets for research and transplantation includes a review of multi-center transplant studies identifying key variables critical for successful islet processing and defines standardized processing procedures required to provide highly purified, functional Human Islets. Methods: Human islet processing methods are defined in detail with pancreas retrieval, shipping, trimming for processing, collagenase distension, controlled digestion by digestion/filt [...] 1913 14971 |
Aspiration of Gastrointestinal Material and Induction of Fibronectin Expression in Lung Transplant Recipients: Implications for Early Airway Remodelingby
Abstract
Background: Gastroesophageal reflux disease has been associated with the development of chronic lung allograft dysfunction following lung transplantation. While the mechanisms are unclear, it is postulated that microaspiration of gastrointestinal material (GIM) leads to inflammation and airway remodeling that culminates in obliterative bronchiolitis. As the expression of the matrix glycoprotein fibronectin has been shown to be an early marker of this fibroproliferative process, its induction could suggest a causal [...] 1292 8118 |
New Frontiers in Solid Organ Transplantation from Donors with Human Immunodeficiency Virus, Hepatitis C Virus Infection, and Multidrug Resistant Organismsby
Abstract
Despite the advances that have been made in the field of solid organ transplant (SOT), organ shortage remains a persistent problem. In addition, the donor pool has been changing with the ongoing opioid epidemic and increase in deaths related to drug overdose each year. More donors are meeting the 2013 United States (U.S.) Public Health Service criteria for increased risk donors (IRDs), or donors who are at higher risk for transmission of Human Immunodeficiency Virus (HIV), Hepatitis C virus (HCV), and other multidr [...] 1452 8275 |
Sex and Gender Issues in Heart Transplantation1546 9666 |
Tuberculosis Screening and Treatment in Solid Organ TransplantationAbstract
Background: Tuberculosis (TB) is a common infection with challenges in diagnosis and treatment. Management of TB in solid organ transplant (SOT) candidates and recipients poses unique challenges not seen in other populations. Questions and Recommendations: Latent TB infection (LTBI) is important to diagnose pre-transplant through history, physical examination, imaging, and laboratory tests. Tuberculin skin tests and interferon-gamma release assays are important tools but not sufficiently sensitive nor specific to d [...] 1452 11346 |
Challenges in Diagnosis and Management of Nontuberculous Mycobacteria in Solid Organ TransplantationAbstract
Nontuberculous mycobacteria (NTM) infections are relatively rare but carry significant morbidity in solid organ transplant (SOT) recipients. Given the rarity of disease and diagnostic limitations, a high index of suspicion is required for accurate diagnosis and initiation of appropriate treatment. We discuss the challenges in diagnosis and management of NTM infections specific to the SOT population. 1284 9250 |
Solid Organ Transplantation in Older Adults. Infectious and Other Age-Related ConsiderationsAbstract
In the U.S., older adults aged 65 or above comprise nearly one quarter of the solid organ transplant (SOT) waitlists, and the number of transplants performed in this age group continues to increase. There are no specific guidelines for the assessment and follow up of the older SOT candidate or recipient. Older adults are at increased risk of infectious complications after SOT. Despite these complications and even with the use of suboptimal donors, overall outcomes are favorable. We provide an overview to specific c [...] 1556 9616 |
Isolated Hepatic Mucormycosis in the Early Post-Transplant Period: A Case Report and Literature ReviewAbstract
Mucormycosis is a rare fungal infection associated with high morbidity and mortality that typically afflicts immunocompromised hosts. We present a case of isolated hepatic mucormycosis with Rhizopus spp. that developed in the early post-transplant period. Initial presentation was concerning for allograft rejection, but definitive diagnosis was made with histopathology and fungal culture. The patient had a favourable outcome with surgical resection, a course of liposomal amphotericin B combined with micafungin, and [...] 1287 9057 |
Innate Immune Determinants of Graft-Versus-Host Disease and Bidirectional Immune Tolerance in Allogeneic TransplantationAbstract
The success of tissue transplantation from a healthy donor to a diseased individual (allo-transplantation) is regulated by the immune systems of both donor and recipient. Developing a state of specific non‐reactivity between donor and recipient, while maintaining the salutary effects of immune function in the recipient, is called “immune (transplantation) tolerance”. In the classic early post‐transplant period, minimizing bidirectional donor ←→ recipient reactivity requires the administration [...] 1542 12700 |
Targeting Acute Islet Inflammation to Preserve Graft Mass and Long-Term FunctionAbstract
Islet transplantation is a minimally invasive cell based replacement therapy to prevent or reverse diabetes or hypoglycemia through natural hormonal responses to regulate blood glucose. However, extending the islet graft functional lifespan remains a challenge that prevents long-term success and widespread use of the procedure. Islets are subject to stress and damage and undergo immunological assault during transplantation procedures. Current treatments to prevent immune reactivity toward the graft come with toxic [...] 1311 10475 |
Where’s Waldo? Extrahepatic Site Options for Islet Transplantationby
Abstract
The current predominant location for allo- and auto-transplantation of islets is the liver. Despite the historical success of this site, recent studies have revealed multiple disadvantages. Portal hypertension, portal vein thrombosis, bleeding, low oxygen tension, instant blood mediated inflammatory reaction, inadequate alpha cell function, and delays in neovascularization are factors that continue to drive researchers to explore alternative sites for islet transplantation. Factors of an optimal site include: capac [...] 1442 10460 |
KAS Turns Four: The State of Deceased Donor Kidney Allocation in the U.S.Abstract
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 [...] 1800 17750 |
Parvovirus B19 Infection in Solid Organ Transplantation: Report of A Case and A ReviewAbstract
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 [...] 1681 13021 |
Chagas Disease, Leishmaniasis, and Malaria in Solid Organ Transplant Recipientsby
Abstract
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 [...] 1792 9617 |
A Tale of Two Flaviviruses: West Nile Virus and Zika Virus in Solid Organ TransplantationAbstract
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 [...] 1634 10111 |
An Approach to Fungal Diagnostics in Solid Organ Transplantationby
Abstract
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 [...] 1441 10124 |
Chemical Strategies for Improving Islet Transplant Outcomesby
Abstract
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 [...] 1316 15865 |
Strongyloidiasis in Solid Organ Transplantationby
Abstract
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 [...] 1806 12676 |
Application of Microfluidic Biochips for Human Islet TransplantationAbstract
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 [...] 1512 10972 |
Alpha-1 Antitrypsin Deficiency and Lung Transplantation: A Clinical Caseby
Abstract
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 [...] 1166 9286 |
Changes in HLA-G Expression by Leucocyte Subsets Following Renal Transplantation and the Effect of Immunosuppressive Drugs on Leucocyte HLA-G Expression in Vitroby
Abstract
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 [...] 1311 9291 |
Cell based Therapy in TransplantationAbstract
One of the major hurdles still facing the field of transplantation is the management of immunosuppression and the morbidity that results from treatment. Due to toxicity and complications from a maintenance immunosuppression therapies, a necessary improvement in post-transplant immunosuppressive therapies must be the development of a low-side effect therapy. Cell-based therapies as an emerging candidate offer a novel approach to generating graft tolerance, and when utilized within a combination therapeutic strategy, [...] 1336 8027 |
Severe Passenger Lymphocyte Syndrome and Acute Rejection in ABO Compatible but non-Identical Liver Transplant Recipient from Hepatitis C Viremic Donorby
Abstract
Background: We performed a liver transplant (LT) with a graft from a 52-year-old donor of blood group O who was HCV viremic. The recipient was a 52-year-old male with blood group A, HCV-related cirrhosis and hepatocellular carcinoma. Methods: A liver biopsy performed on post-LT day 9 revealed acute T-cell-mediated rejection and the patient received three 1.0-g boluses of methylprednisolone. On day 9, the hemoglobin level dropped and the direct antiglobulin test became positive. Passenger lymphocyte syndrome (PLS) w [...] 1298 9450 |
The Impact of Allograft CXCL9 during Respiratory Infection on the Risk of Chronic Lung Allograft Dysfunctionby
Abstract
Background: The long term clinical significance of respiratory infections after lung transplantation remains uncertain. Methods: In this retrospective single-center cohort study of 441 lung transplant recipients, we formally evaluate the association between respiratory infection and chronic lung allograft dysfunction (CLAD). We furthermore hypothesized that bronchoalveolar lavage fluid (BALF) CXCL9 concentrations are augmented during respiratory infections, and that episodes of infection with elevated BALF CXCL9 ar [...] 1397 10259 |
Identifying Novel Biomarkers of Frailty in Cirrhosis: Results from an Unbiased Proteomics Search from the Functional Assessment in Liver Transplantation (FrAILT) StudyAbstract
Background: Patients with cirrhosis suffer not only from commonly-diagnosed portal hypertensive complications such as ascites and hepatic encephalopathy but also from more insidious effects of chronic liver failure including muscle wasting, under-nutrition, and functional decline. These manifestations of physical frailty have been demonstrated to predict mortality in patients with cirrhosis independently of liver disease severity, but objective biomarkers associated with physical frailty in cirrhosis are needed. Th [...] 1471 9603 |
Allogeneic Hematopoietic Cell Therapies to Induce Tolerance in Kidney TransplantationAbstract
This review summarizes the latest results from the interventional clinical trials for inducing clinical tolerance in the recipients of human leukocyte antigen (HLA)-matched or mismatched living donor kidney transplants via allogeneic hematopoietic stem cell (HSC)-based therapies. The protocols utilized by the three medical centers in the United States differ in degree of HLA-matching, relatedness or unrelatedness, donor cell composition of the hematopoietic stem cells transplant (HSCT), timing for infusion and cond [...] 1418 8782 |
The Conundrum of High Body Mass Index in Kidney Transplant PatientsAbstract
Obesity is on the rise and the number of end stage renal disease patients who are obese parallel this trend. There is no universally accepted guideline for wait-listing end stage renal disease obese patients in order to reduce surgical complications and improve survival of the kidney graft. Criteria for acceptance are variable among transplant centres, as do post-transplant policies. Careful risk assessment to maximise the benefits of the limited organ donor resource must be undertaken prior to waitlist an obese ki [...] 1204 8818 |
The Concerted Action of Multiple Mechanisms to Induce and Sustain Transplant Toleranceby
Abstract
Transplant tolerance has been achieved in experimental models using immune intervention strategies. Yet, their clinical translation remains unsuccessful and requires further optimization of immunotherapeutic regimens based on a deeper understanding of the cellular and molecular mechanisms at play in the induction and maintenance phases of immune tolerance. Intensive investigations have shed light on the tolerogenic networks underlying graft survival and have unraveled their complexity, which may depend on several p [...] 1298 7982 |
Evolution of Enzyme Requirements for Human Islet IsolationAbstract
Islet transplantation is becoming an established treatment option for managing a subset of adult patients who have type 1 diabetes mellitus. The success of this procedure is dependent upon the recovery of a sufficient number of functional human islets from donor organs for subsequent transplant. Here, the use of optimized bacterial collagenase-neutral protease enzyme mixtures has been shown to affect the yield and quality (defined by viability and glucose-stimulated insulin secretion) of islets recovered from human [...] 1481 22447 |
Bacterial Infections after Liver Transplantation: Updates in Post-Surgical Infections, Vancomycin-Resistant Enterococcus, and Multi-Drug Resistant EnterobacteriaceaeAbstract
Liver transplantation is a life-saving procedure available worldwide. Despite advances in its surgical and immunosuppressive strategies, infectious complications carry significant morbidity and mortality. Bacterial infections are the most common infective etiologies, and the majority are seen during the first four weeks post liver transplantation. Infectious complications are often intra-abdominal in origin, such as biliary complications and abdominal abscesses. Infections due to multi-drug resistant organisms are [...] 1299 10485 |
Early Nutrition during Critical Illness in Pediatric Patients Post-Hematopoietic Cell TransplantationAbstract
Background: Hematopoietic cell transplant (HCT) patients are a high-risk population for poor nutrition and decreased survival. There is little data on how nutrition in pediatric HCT patients affects need for critical care interventions and outcomes. Methods: We hypothesized that patients who did not meet goal nutrition by 72 hours post-admission to the pediatric intensive care unit (PICU) had increased in-hospital mortality and increased need for critical care interventions. We performed a retrospective cohort stud [...] 1432 7834 |
Infectious Complications in Liver Transplantation1014 6622 |
Ectopic Pelvic Kidney with Anomalous Vascular Supply during Deceased Organ Procurement – Case ReportAbstract
Even though renal ectopia is common, there have been very few reports of these kidneys being used for transplantation. The concerns with using such kidneys are subnormal function, ureteral anomalies and complications and anomalous arterial supply which makes arterial reconstruction challenging. Majority of reports are for use in living donor transplantation where good preoperative imaging is available. There is very scant literature reporting use of ectopic pelvic kidneys from deceased donors. We report a case of a [...] 1458 8627 |
Role of Automated Insulin Delivery (Artificial Pancreas) in Islet Transplantation: An In Silico AssessmentAbstract
Background: Human pancreatic islet transplantation is a minimally-invasive procedure that is gaining recognition for the treatment of type 1 diabetes (T1D). Selected patients with unstable T1D, hypoglycemia unawareness, history of severe hypoglycemia, and glycemic lability, not successfully stabilized with intensive insulin treatment, can be offered this alternative therapy that has been shown to provide long-term glycemic control with near-normalization of hemoglobin A1c in the absence of severe hypoglycemia. Toda [...] 1341 11144 |
The Holy Grail to Clinical Transplant Tolerance Is Paved with HLA EpitopesAbstract
The Holy Grail to Clinical Transplant Tolerance is Paved with HLA Epitopes 1014 7269 |
Acceptance of HPV Vaccination in Kidney Transplant Recipientsby
Abstract
Background: Human Papilloma virus (HPV) infections are an increasingly concerning etiology for post-transplantation viral-related malignancies. The nonavalent HPV vaccine (Gardasil 9) affords transplant recipients the best opportunity for malignancy prevention, but vaccine uptake remains low. Not previously reported for solid organ transplant recipients, we studied influential factors for HPV vaccine non-initiation. Methods: This survey, conducted from May to December 2017, examined influential factors for HPV vacc [...] 1406 10393 |
Intrapancreatic Parenchymal Cell Transplantation as a Possible Model for the Development of a Cell-based Therapy for Type I Diabetes MellitusAbstract
Background: Transplantation of isolated islets is one of the most powerful approaches to cure insulin-dependent (type I) diabetes mellitus (IDDM). Currently, the most widely used transplantation strategy is percutaneous perfusion into the liver via the portal vein. However, this approach has several drawbacks and is often limited by the large number of islets required and hypoxic damage to the grafts. Methods: In this article, we posit intrapancreatic parenchymal cell transplantation (IPPCT) as a promisin [...] 1210 9298 |
Case of Lung Transplantation in a Recipient with Emphysema: Importance of Determining Alpha 1-Antitrypsin Deficiency Status for Lung TransplantationAbstract
Here we present a case of a lung transplant recipient with alpha 1-antitrypsin deficiency as well as conducted a retrospective review of the United Network for Organ Sharing (UNOS) database from 1990 – 2016 specifically grouping patients with alpha-1 antitrypsin deficiency (A1ATD) and chronic obstructive pulmonary disease (COPD). 1304 8176 |
Autoimmunity in Autologous Islet Transplantationby
Abstract
Total pancreatectomy (TP) is increasingly being utilized for definitive treatment in patients with debilitating chronic pancreatitis (CP). In an effort to prevent surgical diabetes, the procedure can be performed in conjunction with transplantation of islets of Langerhans recovered from the patients’ own resected pancreas (autologous islet transplantation, AIT). Given that patients undergoing TP and AIT are traditionally assumed not to be at risk for the development of beta-cell autoimmunity, it is possible that th [...] 1545 9090 |
Regulation of Inflammatory Response in Islet Transplantationby
Abstract
Islet cell transplantation is a developing treatment for patients suffering from severe Type-1 diabetes. The long-term insulin independence after islet cell transplantation has been difficult to achieve, and this has been linked to several factors. One of the major cause of poor long-term outcome is inflammation surrounding the islets. Inflammation in islets is caused at several stages, donor induced, during organ preservation, islet isolation stress, peri-transplant inflammation or instant blood mediated inflammat [...] 1599 11511 |
MicroRNAs as Potential Markers for Advantageous Perfusion in a Preclinical Donation after Cardiac Death Animal Model of Oxygenated Hypothermic Machine Perfusion (HOPE)by
Abstract
Background: Extended criteria donors and donation after cardiac death donors provide organs which tend to be more sensitive to the stress of preservation. There is a lack of evidence about the potential role of oxygen in preservation techniques, and literature comparing oxygenated and non-oxygenated techniques is very limited. The aim of the study was to compare HMP with oxygen versus HMP without oxygen in a pig model of kidney auto-transplantation (KT) reproducing conditions of DCD. We have also set up miRNAs expr [...] 1299 9381 |
Delayed Clinically Significant Portal Hypertension after Total Pancreatectomy-Islet Auto-TransplantationAbstract
Portal hypertension often occurs transiently with injection of islet cells into the portal system during total pancreatectomy-islet autotransplantation (TPIAT). We describe a TPIAT patient with non-cirrhotic portal hypertension (NCPH) two years after surgery initially identified with esophageal varices on upper endoscopy. The underlying mechanism for the development of NCPH after TPIAT is unclear but infectious and immune-related pathways have been proposed. Management of NCPH is primarily treatment of complication [...] 1482 10137 |
Stem Cell Strategies to Promote Islet Transplantation Outcomesby
Abstract
Pancreas or islet transplantation is the only reliable cure for Type 1 Diabetes. However, shortage of donor tissue supply, longitudinal graft attrition due to innate and adaptive immunity and the recurrence of autoimmunity, as well as the harmful side-effects of chronic immunosuppressive therapy limit the wide-spread acceptance of islet transplantation as a mainstream cure for autoimmune diabetes. Herein, preclinical and clinical stem-cells based research approaches aimed at obtaining large quantities of islets for [...] 1625 9727 |
Evolution in the Management of Invasive Fungal Infections in Liver Transplant RecipientsAbstract
Invasive fungal infections (IFI) remain an important cause of morbidity and mortality, especially in hospitalized and immunocompromised or critically ill patients. The incidence of IFIs has been declining in liver transplant recipients (LTR). This is likely due to the evolving immunosuppressive drug regimens, improved surgical techniques and targeted antifungal prophylaxis. However, IFI still contribute to high mortality and are associated with high economic burden due to consumption of costly newer antifungal agen [...] 1510 9547 |
Islet Xenotransplantation for the Treatment of Type 1 DiabetesAbstract
More than 10 million people worldwide suffer from type 1 diabetes mellitus (T1DM). Allogeneic islet transplantation has been established to prevent severe hypoglycemia in unstable T1DM patients although there is a serious shortage of donors. Islet xenotransplantation using porcine islets is a promising solution to this issue. Porcine islets offer several advantages over human islets, including unlimited and on-demand supplies, a higher quality of islets from healthy donors, greater safety with designated pathogen-f [...] 1621 11216 |
Cardiac Allograft Vasculopathy: A Review of Risk Factors and Pathogenesisby
Abstract
Heart transplant remains the gold standard therapy for patients with end stage heart disease and offers improved survival and quality of life. Significant progress has been achieved in improving one-year mortality after heart transplantation. Nonetheless, long-term graft survival has not changed significantly over the past few decades. Long term survival of heart transplant recipients is limited by chronic rejection, cardiac allograft vasculopathy (CAV), and malignancy. CAV is a major contributor for graft failure [...] 1550 13107 |
Management of Cardiac Allograft VasculopathyAbstract
Cardiac allograft vasculopathy is one of the leading causes of death following the first 5 years after orthotopic heart transplantation along with late graft failure, likely secondary to undiagnosed CAV. Currently there is no single medical treatment available for this condition except modification of risk factors and immunosuppression. Retrasplantation remains the hope for this entity with some limitations. 1352 8853 |
Malignancy in the Lung Transplant Populationby
Abstract
The risk for developing a variety of malignancies is significantly elevated in the setting of lung transplantation. Malignancy remains among the three major causes of death in post-transplant recipients, and the relatively high risk of cancer development as well as metastatic aggression pose special threats to this population due to the need for continued immunosuppression. A variety of risks such as tobacco use and inflammatory lung diseases that led to the lung pathology prompting lung transplantation, in additio [...] 1114 8604 |
IVIG Replacement for Hypogammaglobulinemia in Lung Transplant PatientsAbstract
After lung transplant, infection is a leading contributor to morbidity and mortality, and hypogammaglobulinemia (HGG) may be an important risk factor for many of these infections. Some reports suggest that HGG not only increases the risk of various infections, but also worsens survival. The incidence of HGG has been shown to increase after lung transplant, and may be as high as 70%. In order to mitigate this risk, intravenous immunoglobulin G (IVIG) replacement for the treatment of HGG has been utilized. However, t [...] 1513 15492 |
Anti-HLA Antibodies in Lung TransplantationAbstract
(1) Background: Lung transplantation is an increasingly utilized treatment for end-stage lung disease. Scarcity of organ donors limiting transplantation underscores the importance of optimal histocompatibility testing approaches to facilitate organ allocation and avoid immunologic rejection. Significant data has emerged over the past decade to define the role of alloantibodies against HLA in the pathogenesis of post-lung transplant complications. (2) Methods: Medical literature from 1996–2016 related to search term [...] 1451 10175 |
The Role of Artificial Intelligence in Microplastic Pollution Studies and ManagementAbstract
Artificial intelligence (AI) is reshaping microplastic research by enabling faster, more accurate, and scalable detection, characterization, and modeling. Deep learning automates the identification and classification of microplastics from microscopy images, while machine learning accelerates the recognition of polymers from Raman and infrared spectra. AI-based clustering and segmentation improve the analysis of complex samples, and source-apportionment models learn morphological and chemical features to trace emiss [...] 349 2074 |
A Systematic Literature Review for the Development of a Consolidated Method for DLCAAbstract
Dynamic Life Cycle Assessment (DLCA) is an emerging approach in the construction industry it is. Yet, current research is often limited, overlooks operational patterns, and relies on generic case studies, highlighting the need for an extended method to apply these analyses in the built environment. This study conducts a Systematic Literature Review to evaluate the current state of DLCA research and identify key steps toward developing a unified and globally applicable methodology. Using the PRISMA protocol, 69 peer [...] 566 3162 |
Importance of SLAPE Solar Panels, Electrochemical CO2 Reduction, Alkaline Electrolyzers and Alkaline Fuel Cells Development to Achieve United Nations Sustainable Development Goalsby
Abstract
The United Nations Organization (UNO) in the year 2015 formulated seventeen sustainable development goals (UNO’s 17 SDGs) to be achieved by the end of the year 2030. The so far achieved progress indicates that none of these UNO’s 17 SDGs can be achieved before the deadline. In fact, all these goals can be achieved by developing suitable technologies to fully capture and utilize all the renewable energy resources available on earth to meet all the energy needs of society without any backup from fossil fu [...] 550 3896 |
Lanthanum Uptake and Distribution in Agricultural and Wild Plants: Insights from Greenhouse and Field Studies in Uncontaminated SoilsAbstract
Lanthanum (La) is widely used in various fields. As a consequence, it can accumulate in soil and thus pose a potential hazard to the environment, including a decrease of plant biomass and chlorophyll content. To date, most experimental studies on the biogeochemistry of La have focused on toxic effects resulting from its accumulation in plants growing in La-contaminated areas, while the behavior of La in plants growing in uncontaminated soils has been the subject of much less research. The primary objectives of this [...] 626 3472 |
Modeling the Mesoscopic-Scale Spatial Evolution of the Epileptic Pre-Ictal and Ictal PhasesAbstract
The spatial evolution of the epileptiform regime in neural networks can be alternatively described in terms of a statistical approach, dealing with average smooth, differentiable fields rather than discrete neural elements. After a brief review of mathematical methods for modeling epilepsy (the condensed matter vs. the neural mass models) together with their pros and cons, we introduce our continuous-space model for the pre-ictal scalar field and the ictal epileptiform vector flux in the form of the diffusion equat [...] 608 3045 |
Entropy and War, Toy ModelsAbstract
This study investigates the relationship between entropy and societal dynamics, with a particular focus on the origins and implications of war. By using entropy as a measure of uncertainty and inequality, the research examines societal stability through patterns of stratification and wealth distribution. Employing simplified models of various wealth distributions, the study explores their effects on social stratification and the potential for conflict. Drawing on historical and contemporary examples, it delves into [...] 559 5164 |
Simulation Software in the Design and AI-Driven Automation of All-Terrain Farm Vehicles and Implements for Precision AgricultureAbstract
Precision agriculture depends on the automation and mechanization of agricultural equipment and vehicles in a variety of terrains, which increases productivity and sustainability. This review presents a comparative analysis of significant simulation software used in designing and developing automated agricultural systems, emphasizing their methodologies and significance in advancing farm technology. Artificial intelligence (AI) and machine learning (ML) methods are modeled, optimized, and integrated using key techn [...] 2196 17195 |
Machine Learning Analysis of the Impact of Increasing the Minimum Wage on Income Inequality in Spain from 2001 to 2021Abstract
The main aim of this work is to analyze the impact of the National Minimum Wage (NMW) on wealth redistribution in Spain during the 2001-2021 period. This research addresses a fundamental question: Does increasing the minimum wage effectively reduce income inequality and contribute to a more equitable wealth distribution without negatively impacting overall economic growth and employment? Using a complete statistical census provided by the Spanish Tax Administration Agency, this study examines how the increase in th [...] 916 5584 |
Impacts of Carbon Capture and Storage (CCS) Technology on the Sustainability of Coal-Based Power Generation Pathwaysby
Abstract
Carbon capture and storage (CCS) technology mitigates greenhouse gas (GHG) emissions. However, comprehensive studies assessing the sustainability of coal-based power generation (CBPG) with CCS remain limited. This study focuses on developing comparative sustainability indicators across the entire life cycle of CBPG integrated with CCS technology. Sixty-six pathways were analyzed after establishing five sustainability indicators for each. These indicators were standardized per megawatt-hour (MWh) of energy, encompas [...] 848 5509 |
Computer-Aided Study on Metal Complexes with Benzohydrazide Schiff Base as Potential Bacterial and Fungi Inhibitorsby
Abstract
The biochemical properties of metal complexes containing benzo hydrazide Schiff base have been reported by numerous researchers worldwide in various ways. In this work, the evaluation of biochemical roles of the metal complexes with benzo hydrazide Schiff base activity as anti-gram positive and gram-negative bacteria, as well as antifungal agents, were observed. The use of various techniques, including the induced fit docking methodology, the density functional theory method, and pharmacokinetics investigations wit [...] 837 3983 |
A Fuel Cell Control System for Performance Improvement under Variable Atmospheric Pressure ConditionsAbstract
This work focuses on designing a control unit for improving Proton Exchange Membrane Fuel Cell (PEMFC) performance powering electric vehicles when operating in variable atmospheric pressure conditions, a current situation in mountainous countries with sudden changes in road altitude. The paper studies and analyzes the PEM fuel cell behavior working with hydrogen supply from a pressurized tank and oxygen input from atmospheric air supply in journeys with continuous variation of road level due to the orography. The w [...] 858 5090 |
Occurrence of Multidrug Resistant Escherichia coli & Escherichia coli O157:H7 in Raw Cow Milk from Dhaka, Bangladeshby
Abstract
Enteropathogenic strains of Escherichia coli, like the serotype O157:H7, can cause significant health issues if consumed. Milk and dairy products can serve as a reservoir for the bacteria. Dissemination of multidrug-resistant E. coli through dairy products can become a potential health hazard if consumed. The present study investigates the occurrence of multidrug-resistant E. coli O157:H7 in raw milk obtained from farms and markets around Dhaka, Bangladesh. A Total of 50 milk samples were collected in this study fr [...] 33 222 |
Clinical Trials Characterizing the Serum 25-Hydroxyvitamin D Response to Vitamin D Supplementation in Children: A Systematic Review and Meta-AnalysisAbstract
Recommendations for vitamin D supplementation are essential for the prevention and therapy of vitamin D deficiency. However, reliable data remain lacking for children, as most intake recommendations are based on individual studies. This work aimed to obtain reliable data that allow health authorities to re-evaluate recommendations for oral vitamin D uptake in children. We conducted a systematic literature search in MEDLINE/PubMed on vitamin D supplementation in children. All randomized controlled trials (RCTs) publ [...] 349 2357 |
Impact of Heavy Metals as Trace Elements on the Ecosystem and HealthAbstract
Heavy metals are integral parts of our environment, originating initially from the universe and used in the industry, which may contribute to pollution. This book chapter aims to address the impact of heavy metals on the ecosystem and human health. Among the 32 heavy metals, eight belong to the group of essential ones: cobalt, copper, iron, manganese, molybdenum, nickel, selenium, and zinc. They were necessary in physiological amounts for the evolution of flora and fauna, including humans on earth, and are still ne [...] 598 4835 |
The Impact of Vitamin D on Type 2 Diabetes Mellitus: Exploring Its Role in Glucose Metabolism and Insulin SensitivityAbstract
Vitamin D, a fat-soluble secosteroid, plays a pivotal role beyond its functions in calcium and bone homeostasis. Emerging evidence suggests its involvement in glucose metabolism and insulin sensitivity, thus influencing the pathophysiology of Type 2 Diabetes Mellitus (T2DM). For the current review, a search was conducted across four major databases: PubMed, Embase, Google Scholar, and Web of Science. The aim was to identify relevant studies and clinical trials, published in English, reporting the mechanistic insigh [...] 558 4424 |
Preliminary Comparative Sodium Analysis of Different Tempeh Types in Indonesia and Its Benefits for HemodialysisAbstract
Hemodialysis patients require a diet rich in protein that is easily digestible, such as tempeh. Tempeh is a local Indonesian food product that can be purchased at a low price. Tempeh has a low sodium content, but there has never been an analysis related to the difference in sodium content in local Indonesian soybean tempeh products and imported soybean tempeh. This study was to compare the sodium analysis of different tempeh types in Indonesia as a preliminary study for the subsequent research to fulfill a high-pro [...] 346 2293 |
Therapeutic Carbohydrate Reduction for Lipedema: Guidelines for a Patient-Centered, Holistic ApproachAbstract
Lipedema is a chronic, often misdiagnosed disease characterized by painful, disproportionate fat accumulation in the extremities. Commonly mistaken for obesity or lymphedema, lipedema primarily affects women and has long been thought to be resistant to dietary intervention, a belief originating from its initial description by Allen and Hines at the Mayo Clinic in 1940. However, emerging research challenges this notion, revealing that individuals with lipedema often respond positively to therapeutic carbohydrate (CH [...] 2010 20186 |
Engaging with an Industrial Pandemic: Drivers of and Responses to the Expansion of Ultra-Processed Foods in East and Southern AfricaAbstract
Intensified marketing and expanding consumption of ultra-processed foods (UPFs) that contain high sugar, salt, trans-fats and other additives and sugar sweetened beverages in Sub-Saharan Africa (SSA) are associated with rising obesogenic environments and non-communicable diseases, termed by some an ‘industrial pandemic’ due to its commercial drivers and cross border nature. This review paper addresses the question of how far SSA, positioned at an early point of a rising wave, is controlling this growing health chal [...] 559 3166 |
An Interview with Prof. Rosita GabbianelliAbstract
An Interview with Prof. Rosita Gabbianelli 280 1731 |
Physiological Impact of Milk on Multiple Health Outcomes in HumanAbstract
Milk is best known as a nutrient-rich fluid produced by the mammary glands of mammals, designed primarily to feed young. In the human diet, cow milk is most prevalent, but milk of other mammals and plant milk are common too. This study aims to investigate milk's nutritional value in various age groups and review opposing evidence of its effect on cardiovascular diseases in adults. It is a literature-based strategy to synthesize information from observational and meta-analytic studies. The milk content—macronutrient [...] 1324 6490 |
Germination-Induced Starch Influence on Structural Characteristics of Water-Soluble Extracts from Purple Pericarp Creole Cornby
Abstract
Germination is a viable, cost-effective, and environmentally friendly biotechnological process that enhances the industrial applications of cereals. This study evaluated the impact of germination (86 hours at 30°C) on soluble solids, proximate composition, and total phenolic compounds (TPC) in water-soluble extracts. It also included imaging analyses using scanning electron microscopy (SEM), X-ray diffraction (XRD), apparent amylose content, and starch pasting properties of purple pericarp Creole corn (PPCC) fr [...] 572 3014 |
Attenuation of Blood Glucose by the Ketone Monoester (R)-3-betahydroxybutyrate Glyceride in Healthy Male Sprague Dawley Rats in Response to a Standard Oral Glucose Tolerance Testby
Abstract
Efficient glucose uptake by peripheral tissue is important for individuals who desire to maintain optimal wellbeing. Various methods to regulate postprandial blood glucose have been reported in the research literature, however, few have examined the effect of ketone esters on blood glucose levels. The present study evaluated blood glucose following the administration of an oral glucose tolerance test, with and without ketone esters delivered at two different dosages, in a sample of healthy Sprague-Dawley rats. We h [...] 646 3998 |
Physicochemical Characterization of Fresh and Powdered Tomato in Arba Minch, EthiopiaAbstract
Tomato (Solanum lycopersicum L.) is the largest vegetable crop produced and consumed in the world. Tomatoes are a top source of Vitamin A and C, contain more dietary fibre, beta-carotene, iron, lycopene, magnesium, niacin, potassium, phosphorus, riboflavin, and thiamine. Tomatoes have a limited shelf life in ambient conditions and are highly perishable. It creates glut during the production season and becomes scanty during the off-season. Short shelf life, coupled with inadequate processing facilities results in he [...] 919 5874 |
The Importance of Specialized Inpatient Medical Stabilization for Weight Restoration of Individuals with Extreme Eating DisordersAbstract
Inpatient care is a significant contributor to the health-care costs associated with the treatment of individuals with eating disorders (EDs). This study seeks to better understand the treatment outcomes of individuals with extreme EDs requiring inpatient medical stabilization at specialized medical versus nonspecialized medical units. Patients transferred via air ambulance to ACUTE Center for Eating Disorders and Severe Malnutrition (specialized care) from an outside hospital (nonspecialized care) between January [...] 565 6020 |
The Contribution of Dietary Fatty Acids to Prediction of All-Cause Mortality in a Cohort of Middle-Aged Men Followed-Up for 61 Years Until ExtinctionAbstract
To describe the contribution of three classes of dietary fatty acids to all-cause mortality and age at death among middle-aged men followed up for 61 years until extinction. The cohort comprised 1712 men aged 40-59 years at entry examination in 1960, belonging to the Italian Rural Areas of the Seven Countries Study of Cardiovascular Diseases. A dietary survey allowed to estimate dietary fatty acids [saturated (SAFA), mono-unsaturated (MUFA), poly-unsaturated (PUFA) and their ratios (M/S, P/S)] that were fed as poss [...] 584 3117 |
Exclusive Enteral Nutrition as an Effective Treatment in Inflammatory Bowel DiseaseAbstract
In recent years, the incidence of Inflammatory Bowel Disease (IBD) has risen significantly in the Western population, pointing toward the potential influence of environmental and dietary factors. In order to explain this, some research on nutritional therapy identifies exclusive enteral nutrition (EEN) as a highly effective approach for managing IBD in children. This treatment achieves high remission rates; more specifically, some clinical trials have reported remission rates from 70% to 100%. EEN not only facilita [...] 820 15180 |
Location, Season and Source Effects on Gross Composition of Raw Cow’s Milk Across Khartoum State, SudanAbstract
This study was conducted to investigate the effect of sources. locations and seasons (late summer and winter) on the chemical composition of cow milk collected from Khartoum State. The samples were collected randomly in the morning or the evening. Two hundred and seventy milk samples were collected from farms (90 samples), groceries (90 samples) and vendors (90 samples) in Khartoum State during the late summer and winter seasons, 135 samples each. The milk samples were kept in cool cracked ice and transported immed [...] 552 4640 |
The Crucial Role of Vitamin D in Regulating Gut Microbiota in Inflammatory Bowel DiseaseAbstract
In recent years, there has been an alarming increase in the incidence of inflammatory bowel disease (IBD), which includes both Crohn's disease (CD) and ulcerative colitis (UC), particularly in Western countries. This chronic condition is intricately linked to the composition and health of the gut microbiota (GM) — a complex community of microorganisms residing in the gastrointestinal (GI) tract. Despite extensive research, the underlying pathogenesis of IBD remains poorly understood, making it a wide area of invest [...] 755 5914 |
Household Exposure to Secondhand Cigarette Smoke during Pregnancy and Adverse Offspring Health Outcomes in The Gambia: A Cross-Sectional Studyby
Abstract
The adverse effects of maternal passive smoking during pregnancy on offspring health remain understudied in sub-Saharan Africa, particularly in The Gambia, where smoke-free regulations are limited. To determine the prevalence of maternal passive smoking (MPS) during pregnancy and investigate its associations with adverse pregnancy outcomes and offspring health complications in The Gambia. A cross-sectional study was conducted in February 2023 among 401 mothers with children under 5 years in urban and rural regions [...] 760 6503 |
Identification of Soybean Components that Prevent the Entry of Influenza Virusby
Abstract
We have previously demonstrated the anti-influenza virus activity of a soybean extract, indicating the presence of compounds that prevent viral entry into cells. In this study, we sought to identify the compounds in hydrothermal extracts of soybean that blocked viral entrance and analyzed their mechanisms of action. Hot aqueous extracts of roasted soybeans were separated by reverse-phase chromatography on an octadecylsilyl C18 column, and the antiviral activity of individual fractions was measured during the viral [...] 667 3844 |
Increasing the Omega-3 Index of Endurance Trained Adults: A Pilot Study Comparing Microencapsulated Algae to Fish Powders Provided as Chewable TabletsAbstract
Long-chain omega-3 fatty acids (LCn-3PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), support heart function during exercise and recovery by incorporating into the cardiac cell membranes. Traditionally sourced from fish and fish oil, algae-derived LCn-3PUFA have become alternative in supplemental forms. This study evaluated whether 12 weeks supplementation of a microencapsulated algal oil, delivered as chewable tablets, would perform equivalently to fish-derived LCn-3PUFA in boosting the [...] 1088 19346 |
Role of Nutrition in the Management of Inflammatory Bowel Diseaseby
Abstract
The persistent inflammation of the intestinal mucosa is the main characteristic of inflammatory bowel disease (IBD), a lifelong illness that affects people of both genders. The exact etiology is still undefined while previously it was attributed to genetic components. Later, it was investigated that the environment has an equal effect on the development of IBD encompassing both Crohn’s disease (CD) and Ulcerative colitis (UC). Among environmental risk factors linked to IBD, diet, notably the transition toward the W [...] 1415 13894 |
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