by Victoria Lorenzetti  , Elena Bargagli  , Antonella Fossi  , David Bennett  , Paolo Cameli  and Paola Rottoli

Received: 30 August 2018;  Published: 18 December 2018;  doi: 10.21926/obm.transplant.1804033

Background: Alpha-1-antitrypsin (AAT) deficiency is the most common hereditary disorder in adults and is associated with an increased risk of developing lung emphysema. Methods:Here, we report the case of a 54-year-old man, who underwent bilateral lung transplantation due to AAT deficiency emphysema in the general hospital of Siena, Italy. Results:The patient was diagnosed with partial AAT deficiency (189 mg/dL) associated with the PIMZ genotype; although he quit smoking, his lung disease progressed to chronic resp [...]

by Zaid Albayati  , Sally Heyworth  , Jane Moberly  , Derek Middleton  , Brian Flanagan  , Abdul Hammad  and Stephen E Christmas

Received: 10 October 2018;  Published: 14 December 2018;  doi: 10.21926/obm.transplant.1804032

Background:HLA-G is an immunosuppressive molecule with a potential role in allograft acceptance. Methods:Expression of HLA-G on leucocyte subpopulations was studied in a group of 21 renal transplant patients immediately prior to and 2 months post-transplantation. Results:Significant increases in proportions of total HLA-G+CD4+ T cells were seen (0.5+/-0.1% to 7.9+/-3.2%; p<0.01) and also for CD45RA+, CD45RO+ and CD69+ subsets. Increases in proportions of HLA-G+ cells were also seen in CD8+ T cells and their [...]

by Yi-nan Guo  , Michael Grzelak  and Byoung Chol Oh

Received: 10 October 2018;  Published: 13 December 2018;  doi: 10.21926/obm.transplant.1804031

One of the major hurdles still facing the field of transplantation is the management of immunosuppression and the morbidity that results from treatment. Due to toxicity and complications from a maintenance immunosuppression therapies, a necessary improvement in post-transplant immunosuppressive therapies must be the development of a low-side effect therapy. Cell-based therapies as an emerging candidate offer a novel approach to generating graft tolerance, and when utilized within a combination therapeutic strategy, [...]

by Silvia Martini  , Ezio David  , Francesco Tandoi  , Dominic Dell Olio  , Antonio Amoroso  , Mauro Salizzoni  , Giorgio Maria Saracco  and Renato Romagnoli

Received: 27 September 2018;  Published: 04 December 2018;  doi: 10.21926/obm.transplant.1804030

Background: We performed a liver transplant (LT) with a graft from a 52-year-old donor of blood group O who was HCV viremic. The recipient was a 52-year-old male with blood group A, HCV-related cirrhosis and hepatocellular carcinoma. Methods: A liver biopsy performed on post-LT day 9 revealed acute T-cell-mediated rejection and the patient received three 1.0-g boluses of methylprednisolone. On day 9, the hemoglobin level dropped and the direct antiglobulin test became positive. Passenger lymphocyte syndrome (PLS) w [...]

by Michael Y. Shino  , Ariss Derhovanessian  , David M. Sayah  , Rajan Saggar  , Ying Ying Xue  , Abbas Ardehali  , Barry R. Stripp  , David J. Ross  , Joseph P. Lynch  , Robert M. Elashoff  , S. Samuel Weigt  and John A. Belperio

Received: 11 September 2018;  Published: 30 November 2018;  doi: 10.21926/obm.transplant.1804029

Background: The long term clinical significance of respiratory infections after lung transplantation remains uncertain. Methods: In this retrospective single-center cohort study of 441 lung transplant recipients, we formally evaluate the association between respiratory infection and chronic lung allograft dysfunction (CLAD). We furthermore hypothesized that bronchoalveolar lavage fluid (BALF) CXCL9 concentrations are augmented during respiratory infections, and that episodes of infection with elevated BALF CXCL9 ar [...]

by Laura A. Huppert  , Marie Sinclair  and Jennifer C. Lai

Received: 08 November 2018;  Published: 28 November 2018;  doi: 10.21926/obm.transplant.1804028

Background: Patients with cirrhosis suffer not only from commonly-diagnosed portal hypertensive complications such as ascites and hepatic encephalopathy but also from more insidious effects of chronic liver failure including muscle wasting, under-nutrition, and functional decline. These manifestations of physical frailty have been demonstrated to predict mortality in patients with cirrhosis independently of liver disease severity, but objective biomarkers associated with physical frailty in cirrhosis are needed. Th [...]

by Yujie Wen  , Anita Y. Chhabra  , Joseph R. Leventhal  and Suzanne T. Ildstad

Received: 29 October 2018;  Published: 20 November 2018;  doi: 10.21926/obm.transplant.1804027

This review summarizes the latest results from the interventional clinical trials for inducing clinical tolerance in the recipients of human leukocyte antigen (HLA)-matched or mismatched living donor kidney transplants via allogeneic hematopoietic stem cell (HSC)-based therapies. The protocols utilized by the three medical centers in the United States differ in degree of HLA-matching, relatedness or unrelatedness, donor cell composition of the hematopoietic stem cells transplant (HSCT), timing for infusion and cond [...]

by Maria Irene Bellini  , Joseph Ayathamattam  and Paul Elliot Herbert

Received: 19 October 2018;  Published: 19 November 2018;  doi: 10.21926/obm.transplant.1804026

Obesity is on the rise and the number of end stage renal disease patients who are obese parallel this trend. There is no universally accepted guideline for wait-listing end stage renal disease obese patients in order to reduce surgical complications and improve survival of the kidney graft. Criteria for acceptance are variable among transplant centres, as do post-transplant policies. Careful risk assessment to maximise the benefits of the limited organ donor resource must be undertaken prior to waitlist an obese ki [...]

by Sylvaine You  and Lucienne Chatenoud

Received: 25 September 2018;  Published: 09 November 2018;  doi: 10.21926/obm.transplant.1804025

Transplant tolerance has been achieved in experimental models using immune intervention strategies. Yet, their clinical translation remains unsuccessful and requires further optimization of immunotherapeutic regimens based on a deeper understanding of the cellular and molecular mechanisms at play in the induction and maintenance phases of immune tolerance. Intensive investigations have shed light on the tolerogenic networks underlying graft survival and have unraveled their complexity, which may depend on several p [...]

by Robert C. McCarthy  , Michael L. Green  and Francis E. Dwulet

Received: 24 September 2018;  Published: 07 November 2018;  doi: 10.21926/obm.transplant.1804024

Islet transplantation is becoming an established treatment option for managing a subset of adult patients who have type 1 diabetes mellitus. The success of this procedure is dependent upon the recovery of a sufficient number of functional human islets from donor organs for subsequent transplant. Here, the use of optimized bacterial collagenase-neutral protease enzyme mixtures has been shown to affect the yield and quality (defined by viability and glucose-stimulated insulin secretion) of islets recovered from human [...]