by Yoshitaro Shindo  and Mazhar A. Kanak

Received: 29 March 2018;  Published: 22 June 2018;  doi: 10.21926/obm.transplant.1802013

Islet cell transplantation is a developing treatment for patients suffering from severe Type-1 diabetes. The long-term insulin independence after islet cell transplantation has been difficult to achieve, and this has been linked to several factors. One of the major cause of poor long-term outcome is inflammation surrounding the islets. Inflammation in islets is caused at several stages, donor induced, during organ preservation, islet isolation stress, peri-transplant inflammation or instant blood mediated inflammat [...]

by David J. Epstein  and Aruna K. Subramanian

Received: 18 November 2018;  Published: 12 February 2019;  doi: 10.21926/obm.transplant.1901048

Background: Tuberculosis (TB) is a common infection with challenges in diagnosis and treatment. Management of TB in solid organ transplant (SOT) candidates and recipients poses unique challenges not seen in other populations. Questions and Recommendations: Latent TB infection (LTBI) is important to diagnose pre-transplant through history, physical examination, imaging, and laboratory tests. Tuberculin skin tests and interferon-gamma release assays are important tools but not sufficiently sensitive nor specific to d [...]

by Mostafa T. Mohammed  , Esmat Al Sharkawy  , Amel M. Kamal Eldin  , Emad Allam  , Manal M. Saber  , Anthony Nassar  , Nour Younis  , Christa Deban  , Ahmad Jaser  , Indira Guleria  , Basset El Essawy  , Anil Chandraker  , Mahmoud Nasr  and Jamil R. Azzi

Received: 15 March 2023;  Published: 06 November 2023;  doi: 10.21926/obm.transplant.2304201

Human leukocyte antigens (HLA) are unique proteins expressed on the surface of human cells, playing a pivotal role in the immune system, particularly in the contexts of infection, cancer, and transplantation. The widespread adoption of HLA typing methods has become an essential component in assessing donor-recipient compatibility, a crucial limiting factor in solid organ transplantation. In general, the greater the disparity between a donor's and recipient's HLA types, the higher the likelihood of provoking an allo [...]

by Angela Q Maldonado  , Kristoffer Sjöholm,  , Joshua Lee  , Håkan Olsson  , Christian Kjellman  and Darren E Stewart

Received: 01 April 2021;  Published: 03 June 2021;  doi: 10.21926/obm.transplant.2102143

Prioritization in the US Kidney Allocation System (KAS) has led to an improvement in the rates of transplantation in highly sensitized (HS) patients. However, there is a subset of HS patients who are at a disadvantage, despite prioritization under KAS. The purpose of this study was to describe the transplant rate (TR) by calculated panel reactive antibody (CPRA) of HS candidates before and five years post-KAS to characterize their access to deceased donor transplants and quantify the number of HS candidates who are [...]

by Yue Qiu  , Yinqian Kang  , Hao Liu  and Ibtesam Hilmi

Received: 12 May 2024;  Published: 30 August 2024;  doi: 10.21926/obm.transplant.2403224

Machine perfusion (MP) techniques, which simulate physiological conditions to allow for the assessment and preservation of organ viability, are currently applied in various solid organ transplantation fields. Owing to the growing demand for liver transplants and the scarcity of available donor livers, MP offers a practical solution for recovering high-risk grafts and increasing the number of potentially usable donor organs. Furthermore, testing and administering novel therapies to allografts may also become advanta [...]

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 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 Dayu Lv  , Jose Garcia-Tirado  and Chiara Fabris

Received: 17 May 2018;  Published: 11 September 2018;  doi: 10.21926/obm.transplant.1803019

Background: Human pancreatic islet transplantation is a minimally-invasive procedure that is gaining recognition for the treatment of type 1 diabetes (T1D). Selected patients with unstable T1D, hypoglycemia unawareness, history of severe hypoglycemia, and glycemic lability, not successfully stabilized with intensive insulin treatment, can be offered this alternative therapy that has been shown to provide long-term glycemic control with near-normalization of hemoglobin A1c in the absence of severe hypoglycemia. Toda [...]

by Naoaki Sakata  , Gumpei Yoshimatsu  and Shohta Kodama

Received: 02 October 2020;  Published: 27 November 2020;  doi: 10.21926/obm.transplant.2004127

Islet transplantation is a cellular replacement therapy for severe diabetes mellitus. Although the clinical outcome of islet transplant has been improving, the transplant efficacy of this treatment is not superior to that of pancreatic organ transplantation, a similar transplant therapy. Various factors have been characterized as ‘islet transplantation specific’, which includes lack of revascularization and ischemia, innate inflammation, or autoimmunity, affect the therapeutic outcome of this treatment. Among them, [...]

by Masayuki Nigo  , Rodrigo Hasbun  and Karen J Vigil

Received: 29 March 2018;  Published: 02 November 2018;  doi: 10.21926/obm.transplant.1804023

Liver transplantation is a life-saving procedure available worldwide. Despite advances in its surgical and immunosuppressive strategies, infectious complications carry significant morbidity and mortality. Bacterial infections are the most common infective etiologies, and the majority are seen during the first four weeks post liver transplantation. Infectious complications are often intra-abdominal in origin, such as biliary complications and abdominal abscesses. Infections due to multi-drug resistant organisms are [...]

by Marina Moguilevitch  , Michael Rufino  , Shalom Frager  and Tracey Straker

Received: 28 May 2020;  Published: 17 August 2020;  doi: 10.21926/obm.transplant.2003116

Liver transplant is a life-saving therapy for patients with end stage liver disease and liver cancer. Liver re-transplantation cases are usually more challenging and riskier than primary surgery, they require careful consideration and larger recourse utilization. Decision making on who receives transplantation surgery includes individual patient risks and benefits, physician judgment, specific transplant center policies, surgical experience, geographic organ availability, and ethical considerations. Several mathema [...]

by Masayuki Shimoda  and Shinichi Matsumoto

Received: 25 February 2018;  Published: 25 April 2018;  doi: 10.21926/obm.transplant.1802008

More than 10 million people worldwide suffer from type 1 diabetes mellitus (T1DM). Allogeneic islet transplantation has been established to prevent severe hypoglycemia in unstable T1DM patients although there is a serious shortage of donors. Islet xenotransplantation using porcine islets is a promising solution to this issue. Porcine islets offer several advantages over human islets, including unlimited and on-demand supplies, a higher quality of islets from healthy donors, greater safety with designated pathogen-f [...]

by Allison Ramsey  , Christine Natori  , Kristen Cisneros  , David J. Ross  and Abbas Ardehali

Received: 27 March 2020;  Published: 06 May 2020;  doi: 10.21926/obm.transplant.2002107

Biomarker surveillance after solid organ transplant is an advancing field with promise for further elucidation through high-throughput analyses and “omics” technologies. To date, Gene Expression Profiling (GEP; AlloMapâ) is the only FDA-cleared genomic assay as surveillance for moderate-severe TCMR versus allograft quiescence after heart transplantation. Clinical validity and utility, however, have been recently established after kidney and heart transplantation, for analysis of donor-derived cell-free DNA in the a [...]

by Ibrahim Fathi  , Takehiro Imura  , Kozue Imura  , Megumi Goto  , Yasuhiro Igarashi  , Akiko Inagaki  , Makiko Kikkawa  , Fumiko Ono  , Hiroo Iwata  , Yohichi Yasunami  and Masafumi Goto

Received: 27 March 2019;  Published: 09 July 2019;  doi: 10.21926/obm.transplant.1903071

Background: The existing non-human primate diabetic models, particularly those induced by total pancreatectomy or streptozotocin (STZ) injection, have several disadvantages, including a lengthy surgical procedure, the need for continual supplementation of digestive enzymes, and delayed oral intake after total pancreatectomy, and severe hypoglycemia and hepatic/renal toxicity following injection of high-dose STZ. This study aimed to develop and optimize a non-human primate diabetic model that would avoid the disadva [...]

by Makeda L. Robinson  , Kyle Enriquez  and Dora Y. Ho

Received: 02 November 2018;  Published: 08 January 2019;  doi: 10.21926/obm.transplant.1901038

Flaviviruses can cause epidemics and endemics with substantial public health threat and economic impacts. In the last few decades, many flaviviruses have re-emerged or expanded their territories to new regions or continents, including West Nile virus (WNV) which has become endemic in the US since its arrival in 1999 and Zika virus (ZIKV) which recently spread across the Americas. These events demonstrate the speed with which a vector-borne pathogen can disseminate when introduced into a susceptible population with [...]

by Jade M Kozuch  , Kamyar Afshar  and Ashley Feist

Received: 15 November 2024;  Published: 20 February 2025;  doi: 10.21926/obm.transplant.2501235

Lung transplant recipients represent a high-risk group for cytomegalovirus (CMV) infection and disease, even among solid organ transplant (SOT) recipients, due to multiple factors. Additionally, CMV has significant consequences in this group including pneumonitis, acute rejection, and chronic lung allograft dysfunction. For the past two plus decades, treatment of CMV in SOT recipients has been limited to off-label use of 4 antiviral medications associated with significant toxicities including myelosuppression and n [...]

by Camilo A. Velasquez  , Simon Yaguare  , Sabrina Gambini  , Elizabeth McElhiney  and Suresh Keshavamurthy

Received: 19 September 2024;  Published: 27 April 2025;  doi: 10.21926/obm.transplant.2502248

Lung transplantation (LTx) is the gold standard for the surgical treatment of end-stage lung disease. Ongoing discussions persist whether single lung transplantation (SLT) or bilateral lung transplantation (BLT) lead to better patient outcomes and quality of life. This study analyzed 58 peer-reviewed articles from 1990 to 2024, comparing SLT and BLT across several parameters, including indications for transplantation, overall survival, pulmonary hypertension, complications, chronic rejection, functional status, and [...]

by Abdul Al-Toma  and Harry R. Koene

Received: 16 December 2019;  Published: 18 February 2020;  doi: 10.21926/obm.transplant.2001101

Refractory celiac disease (RCD) is a rare condition in which a known celiac patient, usually an adult, suffers from persistence or recurrence of gluten-related symptomatology, laboratory abnormalities, and inflammatory enteropathy despite following an optimal dietary therapy with gluten-free diet (GFD). Arbitrarily, a duration of at least 12 months of GFD has been recommended prior to establishing such a diagnosis. Furthermore, exclusion of the other possible causes of non-celiac villous atrophy, particularly enter [...]

by Alexandria J Coughlan  , Kendall R. McEachron  , Mariya E. Skube  , Sydne Muratore  , Melena D. Bellin  and Greg J Beilman

Received: 29 October 2018;  Published: 24 January 2019;  doi: 10.21926/obm.transplant.1901042

The current predominant location for allo- and auto-transplantation of islets is the liver. Despite the historical success of this site, recent studies have revealed multiple disadvantages. Portal hypertension, portal vein thrombosis, bleeding, low oxygen tension, instant blood mediated inflammatory reaction, inadequate alpha cell function, and delays in neovascularization are factors that continue to drive researchers to explore alternative sites for islet transplantation. Factors of an optimal site include: capac [...]

by Khawla F. Ali  and Betul Hatipoglu

Received: 07 June 2020;  Published: 07 July 2020;  doi: 10.21926/obm.transplant.2003115

Pancreatic islet transplantation is a rapidly evolving field. It has been increasingly regarded as a promising approach for the correction of dysglycemia associated with type 1 diabetes mellitus (allogenic islet transplantation), or the prevention of surgical diabetes in chronic pancreatitis subjects undergoing total pancreatectomy (autologous islet transplantation). In this review, we discuss the latest literature pertaining to metabolic outcomes of autologous and allogenic islet transplantation, shedding close li [...]

by Gerald Schlaf  , Jakob Kehlen  , Anja Wahle  , Diana Mauer  and Wolfgang Altermann

Received: 26 January 2021;  Published: 02 June 2021;  doi: 10.21926/obm.transplant.2102142

The specification of anti-human leukocyte antigen (HLA) antibodies is an important task for patients awaiting kidney allografts. Especially the patients immunized in previous transplantations, transfusions, or pregnancies must be carefully observed, since grafting patients with HLA antigens/phenotypes recognized by their pre-formed antibodies are the main cause of harmful hyperacute and acute rejection. The complement-dependent lymphocytotoxicity-based de facto (physical) crossmatching (CDC-CM) has thus been implem [...]

by Raquel López-Vilella  , Alba Cecilia Ruiz Gaitán  , José Ricardo Gimeno Costa  , Elena Marqués-Sulé  , Rosario Vicente Guillén  , Javier Pemán García  , Ignacio Sánchez-Lázaro  and Luis Almenar Bonet

Received: 15 October 2018;  Published: 27 February 2019;  doi: 10.21926/obm.transplant.1901053

In recent years, several agencies have issued warnings about the spread of Candida auris infections, a multidrug-resistant yeast that is associated with serious infections and with a mortality rate that can reach 70%. This problem is especially serious in transplant recipients receiving intense immunosupressive therapy. There are no established criteria on the relevance of this colonization or on when the transplant should be contraindicated in these cases. Five cases of colonization and two of candidemia have been [...]

by Julianna Holzer  , John Wu  , Yi He  , Mingyang Ma  , Yuan Xing  , Jose Oberholzer  and Yong Wang

Received: 08 November 2018;  Published: 21 December 2018;  doi: 10.21926/obm.transplant.1804034

In this review, we discuss the application of microfluidic devices in studying the physiology and pathophysiology of human islets and beta-cells, especially its application for human islet transplantation. Human islet transplantation is a promising therapy for Type I diabetes; however, the islet transplant outcomes for achieving complete insulin independence are far from perfect and face many challenges. This review focuses on the microfluidic devices developed in our laboratory, which can address these challenges [...]

by Sean A. Hebert  , Aleksandra M. De Golovine  , Rita D. Swinford  , Cynthia S. Bell  , Karen J. Vigil  and Sonal Bhatnagar

Received: 30 June 2018;  Published: 14 August 2018;  doi: 10.21926/obm.transplant.1803017

Background: Human Papilloma virus (HPV) infections are an increasingly concerning etiology for post-transplantation viral-related malignancies. The nonavalent HPV vaccine (Gardasil 9) affords transplant recipients the best opportunity for malignancy prevention, but vaccine uptake remains low. Not previously reported for solid organ transplant recipients, we studied influential factors for HPV vaccine non-initiation. Methods: This survey, conducted from May to December 2017, examined influential factors for HPV vacc [...]

by Mouna Daldoul  , Rim Charfi  , Khouloud Ferchichi  , Mouna Ben Sassi  , Syrine Ben Hammamia  , Fatma Medhioub  , Emna Gaies  , Rym Enneifer  , Hanene Eljebari  , Anis Klouz  , Riadh Daghfous  and Sameh Trabelsi

Received: 20 August 2024;  Published: 13 December 2024;  doi: 10.21926/obm.transplant.2404228

A high intra and interindividual pharmacokinetics variability characterize Tacrolimus. Data regarding factors influencing its pharmacokinetics and pharmacodynamics in liver transplantation are limited. This study aimed to assess tacrolimus therapeutic response, pharmacokinetics and adherence in liver transplant recipients. The study was conducted at the Clinical Pharmacology Department for 12 years, from January 2009 to March 2021. We included liver transplant patients treated with tacrolimus referred to our depart [...]