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 [...]

by Sofia Oliveira Correia  , Catarina Eusébio  , Ana Sofia Cipriano  , Virginia Lopes  , José Ramón Vizcaíno  , António Cabrita  , Manuela Almeida  , Sofia Pedroso  , Leonidio Dias  , La Salete Martins  and António Castro Henriques

Received: 18 October 2018;  Published: 07 March 2019;  doi: 10.21926/obm.transplant.1901057

Mucormycosis is an angioinvasive and potentially fatal fungal infection caused by ubiquitous filamentous fungi. Cutaneous mucormycosis is an emerging infection and potentially lethal. Our aim was to review the literature on cutaneous mucormycosis. We present a case of a renal transplant patient with a surgical wound infection 20 days after kidney transplant. This case is an example on how early diagnosis is crucial and, since culture is less sensitive, microscopic evaluation of the characteristic broad hyphae is th [...]

by Katharina Tigges-Limmer  , Stephan Ensminger  , Yvonne Brocks  , Scott Stock Gissendanner  and Jan Gummert

Received: 28 October 2018;  Published: 05 March 2019;  doi: 10.21926/obm.transplant.1901056

Background: The participation of mental health professionals in multidisciplinary care teams for heart transplantation has become an international standard practice. The contribution of these professionals in this setting, which involves assessment and interventions, has not been the subject of systematic study. Methods: This paper explores how psychotherapists contribute to multidisciplinary decision making and care in transplant teams before, during, and after transplantation. To illustrate, it uses the case of a [...]

by Christine A. Beamish  and Omaima M. sabek

Received: 08 November 2018;  Published: 05 March 2019;  doi: 10.21926/obm.transplant.1901055

Pancreatic islet transplantation holds promise for patients with insulin-dependent diabetes, but is severely limited by a shortage of cadaveric donor islets, and more so because of stringent inclusion criteria for organ donation including donor metabolic function, age, and comorbidities. The impact of these diverse factors on islet health has led to a broad investigation of global influences on islet biology, not least of all, characterization of mature, functional cellular identity and maintenance of appropriate e [...]

by Dagan Coppock  , Caytlin Deering  , Shara Epstein  and Dong Heun Lee

Received: 23 December 2018;  Published: 01 March 2019;  doi: 10.21926/obm.transplant.1901054

Infections are a common cause of morbidity and mortality in solid organ transplantation (SOT) recipients. Procalcitonin (PCT) has garnered attention as an inflammatory marker that has been shown to be a valuable marker for early identification of systemic bacterial infection. However, interpretation of PCTs value in the different types of infections, transplanted organs, and post-operative courses can be challenging. We review the role of PCT in the management of infections in SOT recipients. First, the PCT level c [...]