by Nour Hasan  , Ankita P. Desai  and Jignesh Dalal

Received: 12 November 2019;  Published: 04 February 2020;  doi: 10.21926/obm.transplant.2001098

Invasive fungal disease (IFD) is a significant contributor to morbidity and mortality in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Early detection and timely initiation of antifungal therapy is important for improved outcome, but diagnosis remains difficult, especially when relying on conventional microbiology methods such as culture and microscopy. Data on the use of fungal biomarkers for screening and diagnosis of IFD in HSCT pediatric patients are limited, precluding the devel [...]

by Maurizio Salvadori  and Aris Tsalouchos

Received: 19 January 2020;  Published: 03 February 2020;  doi: 10.21926/obm.transplant.2001097

Immunosuppressive therapy in renal transplantation is divided into two phases as induction and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, induction immunosuppressive strategies utilized by kidney transplant centers fall in one of the two categories. One approach relies upon high doses of conventional immunosuppressive agents, while the other uses antibodies directed aga [...]

by Federica Odaldi  , Vanessa De Pace  , Giacomo Frascaroli  , Giuliana Germinario  , Giorgia Comai  , Francesco Vasuri  , Gaetano La Manna  and Matteo Ravaioli

Received: 22 November 2019;  Published: 03 February 2020;  doi: 10.21926/obm.transplant.2001096

Donation after circulatory death (DCD) is an increasingly used resource to alleviate chronic renal graft shortages. Organs from donors with progressively increased creatinine levels due to acute kidney injury are used, but the effects of this condition on kidney transplantation are still unclear. Ex-situ machine perfusion is emerging as a potential tool to preserve and resuscitate vulnerable grafts. We report a case of DCD kidneys discarded due to severe acute kidney injury with favorable histological Karpinski sco [...]

by Salem Dehom  , Synnove Knutsen  , David Shavlik  , Khaled Bahjri  , Hatem Ali  , Lance Pompe  and Rhonda Spencer-Hwang

Received: 11 August 2019;  Published: 17 December 2019;  doi: 10.21926/obm.transplant.1904095

Background: Substantial evidence has established links between air pollution and increased risks of overall morbidity and mortality, especially for respiratory and cardiovascular diseases. However, little research has explored these relationships among highly sensitive populations, such as renal transplant recipients. Despite the improvement in quality of life after renal transplantation, cardiovascular diseases (CVD) are major causes of graft loss and mortality. The present study was designed to assess the associa [...]

by Victor Dong  , Aldo J. Montano-Loza  and Andrew L. Mason

Received: 19 November 2019;  Published: 13 December 2019;  doi: 10.21926/obm.transplant.1904094

Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are idiopathic and progressive autoimmune hepatobiliary disorders that lead to liver failure and a need for liver transplantation in a proportion of individuals with poorly controlled disease. It is currently thought that an environmental agent triggers disease in a genetically susceptible host and to date, xenobiotics, bacteria and a human betaretrovirus have all been linked with PBC. However, there is no consensus on which agents predomina [...]

by Maurizio Salvadori  and Aris Tsalouchos

Received: 13 October 2019;  Published: 02 December 2019;  doi: 10.21926/obm.transplant.1904093

Antibody-mediated rejection represents a significant barrier to favorable long-term outcomes after kidney transplantation and remains the most common cause of allograft failure. Therapeutic apheresis techniques are commonly used, in combination with other treatments such as immunosuppressive drugs, in the pre-transplant and post-transplant protocols for the prevention and treatment of antibody-mediated injury. The rationale is to remove the donor-specific antibodies and the other inflammatory mediators, which inclu [...]

by Sumail Bhogal  , Matthew Minn  , Pranay Krishnan  and Reena C. Jha

Received: 18 February 2019;  Published: 18 November 2019;  doi: 10.21926/obm.transplant.1904092

Objective: The purpose of this study was to evaluate the common locations of perihepatic fluid collections after liver transplantation, assess their complexity, and understand their natural history and clinical significance. Materials and Methods: A retrospective analysis of 189 postoperative orthotopic liver transplant patients with a mean age 49.6 years was performed using serial CT or MRI to characterize perihepatic fluid collections. Location, size, complexity of the collections, and clinical course were evalua [...]

by Jose A. Morillas  and Sherif Beniameen Mossad

Received: 24 October 2019;  Published: 18 November 2019;  doi: 10.21926/obm.transplant.1904091

Toxoplasmosis in liver transplantation (LT) is uncommon, especially in the current era of universal prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) for Pneumocystis jirovecii pneumonia (PJP). Here we present a case of a 55-year-old woman LT recipient, on dapsone or PJP prophylaxis due to sulfa allergy, who presented on day 25 after LT with fever, diarrhea and abdominal pain. Initially she was diagnosed with cytomegalovirus-associated colitis and was treated with intravenous ganciclovir, with good clinical [...]

by David J. Ross  , Abbas Ardehali  , Christine Natori  and John A. Belperio

Received: 19 September 2019;  Published: 07 November 2019;  doi: 10.21926/obm.transplant.1904090

Introduction: TH-17 and IL-6 interactions and detrimental biologic effects have been shown in rodent models of Chronic Lung Allograft Dysfunction (CLAD). Similarly, these pathways have been found to be upregulated in human CLAD. Tocilizumab (TCZ), a humanized monoclonal antibody targets the IL-6 receptor subunit alpha and prevents binding of IL-6. We herein report our preliminary experience with adjunctive TCZ therapy for human CLAD. Methods: We retrospectively reviewed our initial experience with TCZ given after o [...]

by Kyungmin Ko  , Juan F. Guerra  and David F. Garvin

Received: 29 August 2019;  Published: 28 October 2019;  doi: 10.21926/obm.transplant.1904089

Background: Graft site candidiasis is a serious complication after solid organ transplantation, often presenting as invasive arteritis leading to graft loss or even death. Case Report: We report a case of anastomotic site candidiasis leading to arterial rupture and death at postoperative day 10 with no clinical warning signs. Preservation fluid cultures were negative and postoperative Doppler ultrasonography did not show vascular compromise. Postmortem examination revealed microscopic arterial wall abscesses harbou [...]