Clinical Approach to the Management of Infections before and after Liver Transplantation
Abstract
1975 15908
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 [...] 1975 15908 |
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 [...] 2057 12067 |
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 [...] 1663 10383 |
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 [...] 3073 14983 |
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 [...] 1890 13489 |
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 [...] 1702 10886 |
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 [...] 1611 11561 |
Eplet-Based HLA Class II Matching for Transplantation: Design of a Repertoire of Interlocus Eplets Shared between HLA-DR, -DQ and -DP Allelesby
Abstract
Many studies have demonstrated that HLA-DR, HLA-DQ and HLA-DP matching at the eplet level reduces allograft rejection and improves transplant outcome. Such studies have examined the eplet effect for the individual class II loci, but until now little attention has been given to so-called interlocus class II eplets shared between HLA-DR, HLA-DQ and/or HLA-DP alleles. This report summarizes current information about antibody-verified interlocus class II eplets. It describes a structural modeling method to determine po [...] 2024 14102 |
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