by Ajay Kumar  and Juveriya Israr

Received: 03 August 2024;  Published: 12 March 2025;  doi: 10.21926/obm.transplant.2501241

Allogeneic stem cell transplantation (allo-SCT) improves the treatment of hematopoietic cancer and non-malignant disease. In this case, stem cells from a genetically similar but not identical donor may stimulate immune-mediated tumor cell destruction. Allogeneic stem cell transplantation, or allo-SCT, has significantly extended the life expectancy of numerous people. Nevertheless, complications such as infections, graft-versus-host disease (GVHD), and recurrence continue. This paper provides a thorough analysis of [...]

by Alberto Ferrarese  , Marco Senzolo  and Patrizia Burra

Received: 29 March 2020;  Published: 18 May 2020;  doi: 10.21926/obm.transplant.2002110

Bacterial infection represents a common event in the natural history of cirrhosis, especially in patients with end-stage liver disease. An episode of bacterial infection may significantly modify a patient’s outcome in the setting of liver transplantation (LT) by impairing hepatic and extrahepatic organ functions, both in pre-operative and post-operative phases. Infections caused by multidrug-resistant organisms (MDRO) are increasing in cirrhosis due to high antibiotic exposure and hospitalizations. This issue is pa [...]

by Hamid Ullah  , Sara Iqbal  , Blanca Lizaola Mayo  and Elizabeth Carey

Received: 31 March 2021;  Published: 20 July 2021;  doi: 10.21926/obm.transplant.2103149

Liver transplantation (LT) has grown monumentally in the last 40 years. Sarcopenia has emerged as an independent factor associated with increased mortality in patients with end stage liver disease. In this review we aim to shed light upon recent developments in assessment, clinical implications, management of sarcopenia in patients requiring a liver transplant. We also bring attention to the impact of COVID-19 pandemic on sarcopenia which ranges from the disease pathology to the unprecedented preventive measures ta [...]

by Shoichiro Sumi  , Sin-Yu Yang  , Priyadarshini Canning  and Kai-Chiang Yang

Received: 29 May 2019;  Published: 24 July 2019;  doi: 10.21926/obm.transplant.1903074

Background: Diabetes mellitus (DM) can be cured or greatly ameliorated by adequate insulin secretion from a relatively small volume of insulin-producing cells. Cell encapsulation enables allo- and even xeno-geneic cell therapy without immunosuppression. However, recent clinical trials show that micro-encapsulated islets are not fully retrievable after transplantation. By contrast, macro-encapsulated islets can be retrieved when necessary. As to the transplantation site, subcutaneous tissue can be promising, if new [...]

by Carly M. Darden  , Srividya Vasu  , Kenjiro Kumano  , Bashoo Naziruddin  and Michael C. Lawrence

Received: 21 November 2018;  Published: 29 January 2019;  doi: 10.21926/obm.transplant.1901043

Islet transplantation is a minimally invasive cell based replacement therapy to prevent or reverse diabetes or hypoglycemia through natural hormonal responses to regulate blood glucose. However, extending the islet graft functional lifespan remains a challenge that prevents long-term success and widespread use of the procedure. Islets are subject to stress and damage and undergo immunological assault during transplantation procedures. Current treatments to prevent immune reactivity toward the graft come with toxic [...]

by Nicholas Lim  , Gregory Beilman  and Timothy Pruett

Received: 21 March 2018;  Published: 12 June 2018;  doi: 10.21926/obm.transplant.1802011

Portal hypertension often occurs transiently with injection of islet cells into the portal system during total pancreatectomy-islet autotransplantation (TPIAT). We describe a TPIAT patient with non-cirrhotic portal hypertension (NCPH) two years after surgery initially identified with esophageal varices on upper endoscopy. The underlying mechanism for the development of NCPH after TPIAT is unclear but infectious and immune-related pathways have been proposed. Management of NCPH is primarily treatment of complication [...]

by David C. Gaston  and Marwan M. Azar

Received: 14 November 2018;  Published: 29 December 2018;  doi: 10.21926/obm.transplant.1804037

The approach to diagnosing fungal infections following solid organ transplantation (SOT) is patient-specific. An assessment of an individual’s risk for particular infections, also understood as the pre-test probability, should guide appropriate diagnostic testing whereas diagnostic stewardship is needed to produce interpretable, actionable and cost-sensitive results. This review provides a cognitive framework for practitioners aiming to diagnose fungal infections in recipients of SOT, taking into consideration the [...]

by Sunil Daga  , Adarsh Babu  , Natasha Khovanova  and Robert Higgins

Received: 11 May 2021;  Published: 17 August 2021;  doi: 10.21926/obm.transplant.2103151

Antibodies against donor HLA determine access to solid organ transplantation and in many cases the outcome of transplantation, but graft failure is not an inevitable consequence of their presence. Much research has been performed with two main aims – which antibodies represent the highest risk factor prior to transplantation, and second to understand how donor specific HLA antibodies behave after transplantation, with a long-term aim of being able to manipulate their production. HLA antibody incompatible kidney tra [...]

by Muayad Alali  , Michael Z. David  , Sandra A. Ham  , Danziger-Isakov LA  , Allison H. Bartlett  , Lindsay Petty  and Jennifer C. Pisano

Received: 27 November 2019;  Published: 21 February 2020;  doi: 10.21926/obm.transplant.2001102

Most studies of children with prolonged fever and neutropenia (PFN) have focused on invasive fungal disease (IFD) as the etiology of fever and not on other causes. Data are lacking regarding risk factors and adverse outcomes in pediatric cancer patients with PFN compared with those whose fevers resolve more rapidly. Retrospective medical record review was performed for all cancer patients with febrile neutropenia (FN) in the pediatric oncology unit at University of Chicago Medicine Comer Children’s Hospital f [...]

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 Joachim Andrassy  and Antje Habicht

Received: 05 November 2018;  Published: 27 June 2019;  doi: 10.21926/obm.transplant.1902070

In recent years, the potential of hematopoietic stem cells, regulatory T-cells, and mesenchymal stem cells have brought about a variety of clinical tolerance trials. Every approach has yielded promising results; however, the riddle of transplant tolerance has not been solved as of yet. The results of the ongoing trials in this field will provide additional information regarding the risks and benefits of these therapy approaches.

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 [...]

by Malcolm Voyce

Received: 22 July 2020;  Published: 16 November 2020;  doi: 10.21926/obm.transplant.2004124

This article aims to describe the relationship between donors and their recipients in the context of organ transplants. This analysis is made in the light of Marcel Mauss’s work, offering an expansion on an analysis of his discussion on the “spirit of the gift” and his idea that gifts require reciprocation. It is argued that some recipients of donated organs receive a personal element from the donor in that there is a transfer or sharing of the donors’ personality and spiritual qualities. The article examines the n [...]

by Marion Hemmersbach-Miller  , Cameron R. Wolfe  and Kenneth E. Schmader

Received: 30 November 2018;  Published: 01 February 2019;  doi: 10.21926/obm.transplant.1901046

In the U.S., older adults aged 65 or above comprise nearly one quarter of the solid organ transplant (SOT) waitlists, and the number of transplants performed in this age group continues to increase. There are no specific guidelines for the assessment and follow up of the older SOT candidate or recipient. Older adults are at increased risk of infectious complications after SOT. Despite these complications and even with the use of suboptimal donors, overall outcomes are favorable. We provide an overview to specific c [...]

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 Plamen Mihaylov  , Burcin Ekser  , Daiki Soma  , Andrew Lutz  , Jonathan Fridell  and Chandrashekhar A. Kubal

Received: 04 January 2021;  Published: 11 March 2021;  doi: 10.21926/obm.transplant.2101138

One of the most feared complications in liver transplantation is hepatic arterial thrombosis (HAT). The incidence of HAT in liver transplantation varies from 1.2% and 8%. One of the risk factors for this complication is anatomical complexity of hepatic arterial system. The focus of this short communication is to show our approach in dealing with aberrant left hepatic artery in settings of liver transplantation. This is a single center experience. Between January 2016 and June 2019, we procured and transplanted 357 [...]

by Ashrit Multani  , Libby S. Allard  and Joanna K. Nelson

Received: 03 June 2019;  Published: 29 July 2019;  doi: 10.21926/obm.transplant.1903076

Hematopoietic cell transplantation is frequently complicated by infectious disease-related complications, especially pneumonia. Candida and enterococci are often overlooked as pulmonary pathogens with some clinicians firmly believing that these organisms never cause pneumonia. Here, we present a series of five cases of Candida pneumonia and five cases of enterococcal pneumonia found on autopsy in hematopoietic cell transplantation recipients. We will also review the literature regarding the epidemiology, risk facto [...]

by Atena Samarehfekri  , Mohammad Ali Zakeri  , Hemn Kaka Mirza  , Adnan Rashid Aziz  and Mahlagha Dehghan

Received: 21 December 2022;  Published: 02 June 2023;  doi: 10.21926/obm.transplant.2302186

Foot reflexology has improved numerous physical and psychological symptoms in patients. The researchers in this study aimed to investigate the effect of foot reflexology on laboratory parameters, intake/output/weight and medication regimen after kidney transplant surgery. The research was a secondary analysis of a parallel randomized controlled trial. The research included patients who were admitted to the transplantation ward. The stratified randomization approach divided 53 eligible patients into two groups: foot [...]

by Scott S. Graves  , DavidW. Mathes  and Rainer Storb

Received: 23 November 2018;  Published: 23 August 2019;  doi: 10.21926/obm.transplant.1903080

Background: The application of hematopoietic cell transplantation for induction of immune tolerance has been limited by toxicities associated with conditioning regimens and to graft-versus-host disease (GVHD). Decades of animal studies have culminated into sufficient control of these two problems, making immune tolerance a viable alternative to life-long application of immunosuppressive drugs to prevent allograft rejection. Methods: Studies in mice have paved the way for the application of HCT with limited toxicity [...]

by Michael Mazzei  , Suresh Keshavamurthy  , Olga Timofeeva  and Yoshiya Toyoda

Received: 11 September 2020;  Published: 04 January 2021;  doi: 10.21926/obm.transplant.2101130

Preoperative sensitization of the cardiac transplant recipient, defined as the presence of anti-Human Leukocyte Antigen (HLA) antibodies before transplant, represents a significant management challenge for physicians. Sensitization prolongs the pre-transplant wait time and is associated with postoperative transplant complications and death. It is critical that sensitized heart transplant candidates be identified and optimized before surgery. In this review, we describe the risk for sensitization, discuss the means [...]

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 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 Preeti Chhabra  and Kenneth L. Brayman

Received: 02 April 2018;  Published: 05 June 2018;  doi: 10.21926/obm.transplant.1802010

Pancreas or islet transplantation is the only reliable cure for Type 1 Diabetes. However, shortage of donor tissue supply, longitudinal graft attrition due to innate and adaptive immunity and the recurrence of autoimmunity, as well as the harmful side-effects of chronic immunosuppressive therapy limit the wide-spread acceptance of islet transplantation as a mainstream cure for autoimmune diabetes. Herein, preclinical and clinical stem-cells based research approaches aimed at obtaining large quantities of islets for [...]

by Spinello Antinori  and Laura Milazzo

Received: 28 October 2018;  Published: 15 January 2019;  doi: 10.21926/obm.transplant.1901039

Solid organ transplantation (SOT) is increasingly employed worldwide to treat several diseases causing both acute and chronic organ failure. Recipients of SOT are at an increased risk to develop infections as a consequence of immunosuppressive therapy. Sometimes such infections may be acquired by the transplanted organ or by reactivation of a previously acquired latent infection. The globalization and the increase of international travel poses a risk for exposure to infections such as Chagas disease (CD), leishmani [...]

by Oya M. Andacoglu  , Jack Liu  , Abigail L. Brooks  , Amit Blumfield  , Mehul Trivedi  , Shoshana Lehman  , Michael K. Parides  , Enver Akalin  , Jay A. Graham  , Juan P. Rocca  and Stuart M. Greenstein

Received: 17 March 2021;  Published: 20 July 2021;  doi: 10.21926/obm.transplant.2103150

Glomerular filtration rate (GFR) is an excellent indicator of renal function; however, it is rarely evaluated as an endpoint. We investigated donor and recipient factors for associations that might be predictive of mid-term GFR after renal transplantation. We performed a retrospective review of 828 deceased donor renal transplantations performed at Montefiore Medical Center between the years 2009-2015. Donor characteristics included KDPI, [low (<20%), medium (20-80%), high (>80%)], age, graft types [extended [...]