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 [...]

by Renato Pol  , Tiziana Ruggiero  , Luisa Giaccone  , Davide Camisassa  , Andrea Spadafora  , Giulia Rivetti  , Marta Bezzi  and Stefano Carossa

Received: 14 June 2019;  Published: 21 October 2019;  doi: 10.21926/obm.transplant.1904088

Objective: Hematopoietic stem cells transplant (HSCT) requires being preceded by chemotherapy and radiotherapy. The neutropenia and thrombocytopenia which follows may be the possible cause of post-transplant complications. It is required that the patient undergoing transplantation is eradicated of any possible infectious focus. Currently, a uniform protocol for the oral management of these patients is unavailable. Methods: The approach for the dental management of each patient was designed as a more selective proto [...]

by Susanna Lam  , Jerome M Laurence  and Deborah J Verran

Received: 01 July 2019;  Published: 08 October 2019;  doi: 10.21926/obm.transplant.1904087

A range of corrective surgical procedures may be required in adult renal transplant recipients who sustain loss of integrity of the abdominal wall in the first month postoperatively. Where this involves the fascia, such as in acute fascial dehiscence or in renal allograft compartment syndrome, more sophisticated reconstructive procedures may also be required, particularly in the setting of surgical site infection. There is limited data on the use of prosthetic or biologic mesh for this type of scenario, where urgen [...]

by Vanessa G. Oliveira  , Ana Filipa Saraiva  , Fátima Costa  and Aida Botelho de Sousa

Received: 27 February 2019;  Published: 24 September 2019;  doi: 10.21926/obm.transplant.1903086

Nowadays, hematopoietic stem cell transplantation (HSCT) is a common procedure in hematology units within reference centers, mainly for the treatment of hematological malignancies such as multiple myeloma, lymphoma, and acute leukemia. Nevertheless, HSCT has much wider applications, namely in autoimmune diseases, congenital metabolic defects, and hemoglobinopathies. Thalassemia major and sickle cell disease make up the most frequent hereditary hemoglobinopathies worldwide. Despite advances on the prevention and tre [...]

by Anita Modi  and Sherif Beniameen Mossad

Received: 07 July 2019;  Published: 06 September 2019;  doi: 10.21926/obm.transplant.1903085

Chronic inflammatory states lead to T cell exhaustion, characterized by reduced T cell proliferation and activity. Immune checkpoint inhibitors (ICPI) reactivate T cells to restore the immune system’s natural defenses against foreign antigens. The widespread use of these agents in the treatment of malignancy has led to markedly reduced tumor burden and improved patient survival, sparking curiosity about their potential role in the treatment of other chronic inflammatory states, including infectious diseases. While [...]

by Salim Hamdani  and Daniel Azoulay

Received: 18 April 2019;  Published: 04 September 2019;  doi: 10.21926/obm.transplant.1903084

The privileged liver, due to its immunological status, is referred to as a tolerogenic organ. However, this alone does not explain the introduction of tolerance after single or combined liver transplantation (kidney, heart, pancreas, and intestine); other factors, such as recipient’s age, donor’s hepatic volume, iron metabolism, biomarkers, or imprint of cytomegalovirus infection, appear to be involved in the identification of patients who are likely to be tolerant to their graft. All the afore-stated factors appea [...]