by Qiqi Yu  , Kran Suknuntha  , Weixiong Zhong  , Daniel R. Matson  , Aaron S. Hess  and William N. Rose

Received: 13 February 2022;  Published: 02 June 2022;  doi: 10.21926/obm.transplant.2202160

We report a case of thrombotic microangiopathy (TMA) diagnosed in the kidney allograft of a 59-year-old woman who had developed plasmacytoma type monomorphic posttransplant lymphoproliferative disorder (PTLD) 30 years after a simultaneous pancreas and kidney transplant. This report demonstrates a rare etiology of TMA in a kidney allograft occurring in association with PTLD-associated monoclonal gammopathy. The main teaching points are: 1) PTLD may be considered in the work-up of a new TMA in the immunosuppressed po [...]

by OBM Transplantation Editorial Office

Received: 16 May 2022;  Published: 18 May 2022;  doi: 10.21926/obm.transplant.2202159

InterviewAn Interview with Prof. Peter SchemmerOBM Transplantation Editorial OfficeLIDSEN Publishing Inc., 2000 Auburn Drive, One Chagrin Highlands, Suite 200, Beachwood, OH, USA; E-Mail: transplantation@lidsen.com OBM Transplantation2022, volume 6, issue 2doi:10.21926/obm.transplant.2202159Received: May 16, 2022Accepted: May 17, 2022Published: May 18, 2022

by Lynne Uhl  , Taye H. Hamza  , Terry Gernsheimer  and Sherrill J. Slichter

Received: 30 December 2021;  Published: 26 April 2022;  doi: 10.21926/obm.transplant.2202158

In the multi-institutional platelet dose trial (PLADO Trial), there were 1,077 hematology/oncology patients ≥18 years of age who received at least one platelet transfusion. These patients were analyzed for types and severity of organ system bleeding based on baseline patient characteristics, laboratory assays, primary diagnosis, and type of treatment. Patients were randomly assigned to receive one of three different prophylactic platelet doses for morning platelet counts of ≤10 × 109 /L. Daily assessmen [...]

by OBM Transplantation Editorial Office

Received: 06 January 2022;  Published: 07 January 2022;  doi: 10.21926/obm.transplant.2201157

The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2021. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recogni [...]

by Wolfgang Rennert  , Katie Cormier  and Samantha Sprott

Received: 22 November 2021;  Published: 24 December 2021;  doi: 10.21926/obm.transplant.2104156

Bone marrow transplants remain an import source of hematopoietic stem cells for patients suffering from specific diseases like aplastic anemia, for pediatric patients with malignant and non-malignant blood cell disorders, and for situations in which graft-versus-host disease (GvHD) is a concern. Identifying the optimal donor to achieve a 3-5 x 108/kg of recipient weight TNC yield may be challenging. In an analysis of 687 consecutive donors, donor and procedure characteristics were related to TNC/kg of recipient wei [...]

by Masahiro Sato  , Yuki Kiyokawa  , Emi Inada  , Eri Akasaka  , Satoshi Watanabe  and Issei Saitoh

Received: 15 March 2021;  Published: 04 November 2021;  doi: 10.21926/obm.transplant.2104155

Although the aging process expands the adipose tissue habitation in mice and due to its close association with the female reproductive system, it can be easily exposed surgically under anesthesia when reproductive organs (including ovary, oviduct, and part of the uterus) are pulled and exposed onto the dorsal skin. This study aimed to consider the suitability of adipose tissue as a target for manipulation, particularly for the grafting of cells or small-sized tissue sections due to its ease of handling. Subsequentl [...]

by Aniruddha Bhattacharyya  , Lee R. Friedman  , Beje S. Thomas  and Coleman I. Smith

Received: 29 August 2021;  Published: 18 October 2021;  doi: 10.21926/obm.transplant.2104154

End Stage Renal Disease is becoming more prevalent in the United States of America, with demand for kidney transplant exceeding the available organ supply. A novel method to increase the donor pool has been to consider transplanting organs from deceased patients who have had Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV) infections. Transplants with HCV infected kidneys are becoming more prevalent, due to increased organ supply due to increased mortality from injection opioid use. Similarly, deceased [...]

by Kamyar Afshar  , Michelle Bremer  , Bharath Ravichandran  , Ashley A. Feist  , Eugene Golts  , Elizabeth H. Schonhoft  and Gordon Yung

Received: 14 July 2021;  Published: 15 October 2021;  doi: 10.21926/obm.transplant.2104153

Alpha-1 antitrypsin deficiency (AATD) accounts for approximately 5% of lung transplants (LTx) performed annually. No studies have addressed the potential benefit of ongoing alpha-1 proteinase inhibitor (A1-PI) replacement to AATD patients post-LTx. Our primary objective was to assess potential benefits of continually administering A1-PI from pre- to post-transplantation for AATD LTx recipients. A retrospective case series was performed on AATD LTx recipients between 2002 and 2018. Data reviewed included date of A1- [...]

by Christine Pham  , Brett J Pierce  , Simon W Yau  , Jihad Georges Youssef  , Ahmad Goodarzi  and Howard J Huang

Received: 09 July 2021;  Published: 30 August 2021;  doi: 10.21926/obm.transplant.2103152

Data supporting the use of belatacept in non-abdominal organs are limited to case series and small cohorts involving patients requiring conversion due to CNI intolerance or contraindication. Review articles summarizing the efficacy of belatacept salvage therapy in lung transplantation have previously been published, however, dosing regimens are highly variable and uniform guidance is lacking. In this article, indications and considerations for belatacept use in lung transplant recipients are reviewed with a specifi [...]

by Sunil Daga  , Adarsh Babu  , Natasha Khovanova  and Robert Higgins

Received: 11 May 2021;  Published: 17 August 2021;  doi: 10.21926/obm.transplant.2103151

Antibodies against donor HLA determine access to solid organ transplantation and in many cases the outcome of transplantation, but graft failure is not an inevitable consequence of their presence. Much research has been performed with two main aims – which antibodies represent the highest risk factor prior to transplantation, and second to understand how donor specific HLA antibodies behave after transplantation, with a long-term aim of being able to manipulate their production. HLA antibody incompatible kidney tra [...]

by Oya M. Andacoglu  , Jack Liu  , Abigail L. Brooks  , Amit Blumfield  , Mehul Trivedi  , Shoshana Lehman  , Michael K. Parides  , Enver Akalin  , Jay A. Graham  , Juan P. Rocca  and Stuart M. Greenstein

Received: 17 March 2021;  Published: 20 July 2021;  doi: 10.21926/obm.transplant.2103150

Glomerular filtration rate (GFR) is an excellent indicator of renal function; however, it is rarely evaluated as an endpoint. We investigated donor and recipient factors for associations that might be predictive of mid-term GFR after renal transplantation. We performed a retrospective review of 828 deceased donor renal transplantations performed at Montefiore Medical Center between the years 2009-2015. Donor characteristics included KDPI, [low (<20%), medium (20-80%), high (>80%)], age, graft types [extended [...]

by Hamid Ullah  , Sara Iqbal  , Blanca Lizaola Mayo  and Elizabeth Carey

Received: 31 March 2021;  Published: 20 July 2021;  doi: 10.21926/obm.transplant.2103149

Liver transplantation (LT) has grown monumentally in the last 40 years. Sarcopenia has emerged as an independent factor associated with increased mortality in patients with end stage liver disease. In this review we aim to shed light upon recent developments in assessment, clinical implications, management of sarcopenia in patients requiring a liver transplant. We also bring attention to the impact of COVID-19 pandemic on sarcopenia which ranges from the disease pathology to the unprecedented preventive measures ta [...]

by Bin Ni  , Nidhi Sharma  , Ashley Rosko  , Don M. Benson  and Yvonne A. Efebera

Received: 12 April 2021;  Published: 09 July 2021;  doi: 10.21926/obm.transplant.2103148

Prior to the advent of anti-retroviral therapy (ART), autologous stem cell transplant (ASCT) was relatively contraindicated for multiple myeloma (MM) patients with human immunodeficiency virus (HIV) due to issues associated with stem cell harvest and the risk of opportunistic infections. With the widespread use of ART for control of HIV, ASCT is now the preferred treatment for relapsed lymphoma, the leading hematopoietic malignancy associated with HIV/AIDS. Hence, MM patients with HIV controlled by ART may benefit [...]

by Shalika B. Katugaha  , Amit K. Mahajan  , Meg Fregoso  , Haresh Mani  and Oksana A. Shlobin

Received: 25 October 2020;  Published: 03 July 2021;  doi: 10.21926/obm.transplant.2103147

A 65-year-old female with a history of right lung transplantation (LTx) for chronic obstructive pulmonary disease (COPD) 9-years prior complicated by grade 3 bronchiolitis obliterans syndrome (BOS) was admitted to the hospital for chest pain and dyspnea on exertion (DOE). Her bronchoscopy revealed fluffy, endobronchial lesions that were adherent to the right sided anastomosis resulting in mild obstruction of the right mainstem bronchus. Pathology from biopsies of the endobronchial lesions revealed hyphal fungal org [...]

by Abhijit Jagdale  , C. Adam Banks  , Hayato Iwase  , David K.C. Cooper  and Hidetaka Hara

Received: 29 December 2020;  Published: 30 June 2021;  doi: 10.21926/obm.transplant.2102146

It has been speculated that the immunomodulation associated with pregnancy, e.g., decreasing pro-inflammatory cytokines, increasing anti-inflammatory cytokines, upregulation of T regulatory cells (Tregs), is in part due to the effect of human chorionic gonadotropin (hCG). In this study, we tested the effect of hCG on proliferation of human peripheral blood mononuclear cells (PBMCs) stimulated by irradiated pig PBMCs. Mixed lymphocyte reaction (MLR) was carried out with human PBMCs as responders and irradiated wild- [...]

by Justin P. Rosenheck  , Mena M Botros  and David R Nunley

Received: 15 March 2021;  Published: 27 June 2021;  doi: 10.21926/obm.transplant.2102145

Lung transplantation is a therapeutic option for patients with advanced lung diseases. Lung transplant outcomes have improved over time with improvements in the management of these complex patients. Cytomegalovirus is a common opportunistic organism affecting all solid organ transplant recipients. Characteristics unique to lung transplantation can make this virus difficult to manage, with myriad complications including graft failure and death. Ongoing research into and understanding of cytomegalovirus has opened ex [...]

by Victoria Gómez-Dos-Santos  , Vital Hevia-Palacios  , María Laura García-Bermejo  , Alberto Alcázar-González  , Miren Edurne Ramos-Muñoz  , Laura Salinas-Muñoz  , Elisa Conde-Moreno  , Alejandro Escobar-Peso  , Ana Belén Serrano-Romero  , Ana Saiz-González  , Miriam Menacho-Román  and Francisco Javier Burgos-Revilla

Received: 22 December 2020;  Published: 10 June 2021;  doi: 10.21926/obm.transplant.2102144

The efficacy and safety of using high concentrations of oxygen during hypothermic machine perfusion (HMP) have not been fully elucidated to date. This study investigated the impact of administering high concentrations of oxygen on renal function during HMP in a porcine donation after circulatory death (DCD), as well as the metabolic and biochemical effects of this method. A randomized nonblinded cohort study was established in a porcine transplant (KT) model mimicking Maastricht type III DCD under oxygen-supplement [...]

by Angela Q Maldonado  , Kristoffer Sjöholm,  , Joshua Lee  , Håkan Olsson  , Christian Kjellman  and Darren E Stewart

Received: 01 April 2021;  Published: 03 June 2021;  doi: 10.21926/obm.transplant.2102143

Prioritization in the US Kidney Allocation System (KAS) has led to an improvement in the rates of transplantation in highly sensitized (HS) patients. However, there is a subset of HS patients who are at a disadvantage, despite prioritization under KAS. The purpose of this study was to describe the transplant rate (TR) by calculated panel reactive antibody (CPRA) of HS candidates before and five years post-KAS to characterize their access to deceased donor transplants and quantify the number of HS candidates who are [...]

by Gerald Schlaf  , Jakob Kehlen  , Anja Wahle  , Diana Mauer  and Wolfgang Altermann

Received: 26 January 2021;  Published: 02 June 2021;  doi: 10.21926/obm.transplant.2102142

The specification of anti-human leukocyte antigen (HLA) antibodies is an important task for patients awaiting kidney allografts. Especially the patients immunized in previous transplantations, transfusions, or pregnancies must be carefully observed, since grafting patients with HLA antigens/phenotypes recognized by their pre-formed antibodies are the main cause of harmful hyperacute and acute rejection. The complement-dependent lymphocytotoxicity-based de facto (physical) crossmatching (CDC-CM) has thus been implem [...]

by Amy Spallone  and Marion Hemmersbach-Miller

Received: 29 January 2021;  Published: 02 May 2021;  doi: 10.21926/obm.transplant.2102141

Donor-derived infections (DDI) are an infrequent event in solid organ transplant (SOT) due to advances in screening recommendations, prophylaxis, and surveillance of common infections. However, unexpected pathogen transmission can still occur when a donor is not known to be infected prior to organ procurement, which can lead to significant morbidity and mortality in the organ recipient. Solid organ donors with central nervous system (CNS) pathogens are an uncommon but deadly source of unexpected DDI. Clinically rec [...]

by Michael F Knoll  , Carmela A Knoll  , Rita Bottino  , Suzanne Bertera  and Massimo Trucco

Received: 12 January 2021;  Published: 25 March 2021;  doi: 10.21926/obm.transplant.2101140

Clinical islet transplantation was first realized over four decades ago at the University of Minnesota. Autologous islet transplantation is now widely recognized as a treatment to prevent diabetes in patients after pancreas excision and is offered at major transplant centers throughout the United States and the world. Type 1 diabetes represents a much larger demographic in which islet transplantation may benefit patients. Allogeneic islet transplantation can now offer similar outcomes to pancreas transplantation in [...]

by Nidhi Sharma  and Yvonne Efebera

Received: 26 October 2020;  Published: 25 March 2021;  doi: 10.21926/obm.transplant.2101139

Graft-versus host disease is one of the major causes of death in patients undergoing allogeneic hematopoietic stem cell transplantation. Major contributing factors to severity of graft-versus host disease include HLA mismatch, conditioning regimen intensity, age of donor and recipient, source of stem cell, and donor type. Strategies and clinical trials are ongoing to reduce the incidence of graft-versus host disease, and to improve on the survival outcome of patients with graft-versus host disease, Research efforts [...]

by Plamen Mihaylov  , Burcin Ekser  , Daiki Soma  , Andrew Lutz  , Jonathan Fridell  and Chandrashekhar A. Kubal

Received: 04 January 2021;  Published: 11 March 2021;  doi: 10.21926/obm.transplant.2101138

One of the most feared complications in liver transplantation is hepatic arterial thrombosis (HAT). The incidence of HAT in liver transplantation varies from 1.2% and 8%. One of the risk factors for this complication is anatomical complexity of hepatic arterial system. The focus of this short communication is to show our approach in dealing with aberrant left hepatic artery in settings of liver transplantation. This is a single center experience. Between January 2016 and June 2019, we procured and transplanted 357 [...]

by Siva Mahendran  , Paramit Chowdhury  , Ronan Breen  , Grainne d’Ancona  and Heather J. Milburn

Received: 14 August 2020;  Published: 08 March 2021;  doi: 10.21926/obm.transplant.2101137

Patients with chronic kidney disease (CKD) have an increased risk of developing tuberculosis (TB) compared to those with normal renal function. The reasons for this are well described, but include impaired cellular immunity, a high incidence of co-morbid conditions as well as the concomitant use of immunosuppressive medications. Ethnicity as well as socio-economic factors also prevail. Expert guidelines recommend TB chemoprophylaxis in renal transplant recipients deemed at high risk – invariably those from ethnic m [...]

by Patrick Hagen  , William Adams  , Shruti Singh  , Shuai Qin  , Loredana Campo  , Stephanie Tsai  , Nasheed Hossain  , Scott E Smith  and Patrick J Stiff

Received: 04 November 2020;  Published: 07 February 2021;  doi: 10.21926/obm.transplant.2101136

Allogeneic stem cell transplantation remains the only curative option for many hematological malignancies. Umbilical cord blood (UCB) is an alternate donor source with potentially increased morbidity in elderly patients. We evaluated outcomes in alternate donor sources, prior to the initiation of haploidentical transplantation at our institution, of matched unrelated donor (MUD) and UCB in elderly patients (mean age 64, range 60-75). One hundred and eighty-four patients were included (MRD: 57; MUD: 69; UCB: 58). Th [...]