by Hong Chee Chew  , Ling Gao  , Jeanette E. Villaneuva  , Aoife Doyle  , Mark Hicks  , Andrew Jabbour  , Kumud K. Dhital  and Peter S. Macdonald

Received: 09 March 2019;  Published: 18 June 2019;  doi: 10.21926/obm.transplant.1902067

Background: Normothermic machine perfusion (NMP) utilises 1.2-1.5L of donor blood (DB) with a target perfusate haematocrit of 25% to reanimate the donor heart. Limitations to current practise include small donor size and donor anaemia which can impact on the recovery of these hearts. Furthermore, in donation after circulatory death (DCD), blood collection may delay delivery of preservation solutions resulting in longer warm ischaemic times for the heart and other organs. Banked blood (BB) is a potential alternative [...]

by Katerina G. Oikonomou  and Sarah Taimur

Received: 14 February 2019;  Published: 17 June 2019;  doi: 10.21926/obm.transplant.1902066

In non-endemic regions of the world, human T-cell lymphotropic virus type-1 (HTLV-1) is an uncommon pathogen in the transplant host, but can be associated with significant morbidity and mortality. Careful assessment for risk factors, targeted screening and heightened awareness of the clinical presentation of HTLV-1 associated disease is necessary for timely recognition and management in the transplant host. The use of antiretroviral agents in the management of symptomatic disease due to HTLV-1 remains controversial [...]

by Sheila Krishnan  , Chadi Hage  , Raymond Coakley  , David van Duin  and Leonard Jason Lobo

Received: 18 February 2019;  Published: 10 June 2019;  doi: 10.21926/obm.transplant.1902065

Lung transplant recipients are at greater risk of respiratory viral infections as compared to other solid organ transplant recipients due to constant exposure of the allograft to the external environment. There are no standardized methods for surveillance, prevention, or treatment of these infections despite their association with increased morbidity and mortality. Various studies have linked respiratory viral infections with acute cellular rejection and chronic allograft dysfunction, and emerging data indicates a [...]

by Gopalakrishnan Loganathan  , Michael G. Hughes  , Gregory L. Szot  , Kate E. Smith  , Abid Hussain  , Daniel R. Collins  , Michael L. Green  , Francis E. Dwulet  , Stuart K. Williams  , Klearchos K. Papas  , Robert C. McCarthy  and Appakalai N. Balamurugan

Received: 29 March 2019;  Published: 24 May 2019;  doi: 10.21926/obm.transplant.1902064

Background: Purified bacterial collagenase and protease enzymes are commonly used to recover human islets from clinical grade pancreata for subsequent clinical islet transplantation. The high cost of purified enzymes can be prohibitive for recovering human islets from research pancreata used for translational research or pre-clinical studies. In this study, we successfully isolated islets from human research pancreata using enriched collagenase products supplemented with BP Protease (DE Collagenase 800 or Collagena [...]

by Amanda B. Cooper  , Stephen M. Downs  , Nicholas J Skill  , Richard S. Mangus  , Chandrashekhar A. Kubal  and Mary A. Maluccio

Received: 18 March 2019;  Published: 13 May 2019;  doi: 10.21926/obm.transplant.1902063

Background: Hepatocellular carcinoma (HCC) is a lethal tumor, for which liver resection and transplantation are the only potentially curative treatments. No prospective, randomized study has compared survival in patients with compensated cirrhosis after the two operations Methods: Decision analysis modeling is an objective method to quantify risks and benefits. This study aimed to use decision analysis with a Markov model to estimate the impact of liver transplant and surgical resection on survival for patients wit [...]

by Gianluca Donatini  , Sébastien Giraud  , Jean-Louis Kraimps  , Jérôme Danion  and Thierry Hauet

Received: 08 April 2019;  Published: 15 April 2019;  doi: 10.21926/obm.transplant.1902062

Pancreatic islet transplantation represents an effective therapy with lower morbidity for patients carriers of type 1 diabetes compared to whole pancreas transplantation. Although complete insulin independence is usually not achieved it allows control of glycemia balance reducing the risk of severe hypoglycaemia events and impaired awareness of hypoglycaemia. Recent trials had demonstrated islet transplantation to be more effective than current medical treatment and improvements in outcomes also have been reported [...]

by Richard Cheng  and Jon Kobashigawa

Received: 23 January 2019;  Published: 09 April 2019;  doi: 10.21926/obm.transplant.1902061

Cardiac allograft vasculopathy (CAV) limits long-term survival after heart transplantation. CAV with discrete or tubular lesions can be treated with percutaneous coronary intervention (PCI) with high procedural success. Revascularization with balloon angioplasty, bare-metal stents, and first-generation drug-eluting stents has been associated with high and unacceptable restenosis rates. However, second-generation drug-eluting stents are associated with favorable stent and lesion patency. Stent and lesion patency now [...]

by James Farag  and Silvana Marasco

Received: 13 February 2019;  Published: 08 April 2019;  doi: 10.21926/obm.transplant.1902060

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.

by Naoaki Sakata  , Gumpei Yoshimatsu  and Shohta Kodama

Received: 15 January 2019;  Published: 03 April 2019;  doi: 10.21926/obm.transplant.1902059

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 [...]

by Javier Carbone  , Juan Fernandez-Yañez  , Iago Sousa  , Patricia Muñoz  and Elizabeth Sarmiento

Received: 23 November 2018;  Published: 22 March 2019;  doi: 10.21926/obm.transplant.1901058

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 [...]