Single-Center Outcomes of Heart Transplantation in Patients with Pulmonary Hypertension Bridged with Mechanical Circulatory Support
Abstract
1830 9472
Single-Center Outcomes of Heart Transplantation in Patients with Pulmonary Hypertension Bridged with Mechanical Circulatory Supportby
Abstract
In advanced heart failure, orthotopic heart transplantation (OHT) remains the standard for definitive treatment. Patients with heart failure and concomitant pulmonary hypertension (PH) represent a challenging subgroup, with poor outcomes following OHT. Recently, Mechanical Circulatory Support (MCS) devices have been utilized as a bridge to OHT for these patients. Patients with MCS devices who underwent OHT were evaluated at a single center. Patients were stratified into three groups, depending on baseline pulmonary [...] 1830 9472 |
The Role of Cytochrome P450 2J2 in Cancer: Cell Protector, Therapeutic Target, or Prognostic Marker?Abstract
Cytochrome P450 2J2 (CYP2J2) is one of the recently discovered enzymes that is involved in the metabolism of several drugs. It is mainly an extrahepatic enzyme which can, to some extent, explain some the drugs’ side effects such as cyclophosphamide (Cy). Cyclophosphamide is an alkylating agent that is commonly used in conditioning prior to stem cell transplantation. It is a prodrug that is bio-activated by several CYPs including CYP2J2. Cy is known to have several side effects and its extrahepatic activation by CYP [...] 1530 9461 |
Combination, Sequential Therapies Incorporating Tocilizumab Decrease the Progression of Chronic Lung Allograft Dysfunction (CLAD) after Lung Transplantation: Initial Clinical ExperienceAbstract
Introduction: TH-17 and IL-6 interactions and detrimental biologic effects have been shown in rodent models of Chronic Lung Allograft Dysfunction (CLAD). Similarly, these pathways have been found to be upregulated in human CLAD. Tocilizumab (TCZ), a humanized monoclonal antibody targets the IL-6 receptor subunit alpha and prevents binding of IL-6. We herein report our preliminary experience with adjunctive TCZ therapy for human CLAD.
Methods: We retrospectively reviewed our initial experience with TCZ given after o [...] 1495 9439 |
Estradiol 17-β Induces Pancreatic Beta-Cell Proliferation through Distinct Estrogen Receptors in a Glucose Dependent MannerAbstract
Background: Estradiol 17-beta (E2) enhances the function and survival of pancreatic beta-cells, but its clinical use has been questioned due to concerns regarding oncogenic potential and feminizing effects in males. The G-protein coupled estrogen receptor (GPER), expressed in pancreatic islets, exhibits estrogenic beta-cell protective effects without the feminizing effects of the nuclear ERs. Here, we examine the outcome of selective activation of the three estrogen receptors ERα, ERβ, and GPER on rep [...] 1307 9420 |
An Unusual Case of Recurrent Capillary Leak Syndrome Following Lung TransplantationAbstract
Systemic capillary leak syndrome is a disorder characterized by recurrent, life-threatening episodes of acute capillary hyperpermeability resulting in edema and hypovolemic shock. We report a case of systemic capillary leak syndrome in a lung transplant recipient who developed recurrent episodes of volume overload, respiratory failure, and acute kidney injury in association with hypotension and hypoalbuminemia. Initiation of monthly high dose intravenous immunoglobulin prophylaxis effectively abrogated the syndrome [...] 1679 9375 |
A Breath of Fresh Air - Lung Transplantation Has Come of Ageby
Abstract
A boundless spectrum of chronic lung diseases is said to effect over 500 million persons globally. Lung transplantation is a well-established therapeutic option for patients suffering from end-stage lung diseases, however waitlist mortality and primary graft failure remain major determinants as post-transplantation 5-year survival is just above 50 percent. Recent innovations in lung transplantation have been aimed at increasing organ availability, improving allograft quality, function, and longevity. Ex-vivo Lung P [...] 1475 9353 |
Immunoprotective Encapsulation of Micro-OrgansAbstract
Background: Cell encapsulation technology is most likely the ultimate solution for cell therapy based clinical approaches. A key issue when developing a functional encapsulated construct is to consider not only the nature of the capsule but also how the cells should be incorporated into the capsule in order to minimally compromise their function.
Methods: We have developed a tissue engineering approach, composed of decellularized micro scaffolds and various types of cells in which fully functional "Engineered Micro [...] 1607 9315 |
New Frontiers in Solid Organ Transplantation from Donors with Human Immunodeficiency Virus, Hepatitis C Virus Infection, and Multidrug Resistant Organismsby
Abstract
Despite the advances that have been made in the field of solid organ transplant (SOT), organ shortage remains a persistent problem. In addition, the donor pool has been changing with the ongoing opioid epidemic and increase in deaths related to drug overdose each year. More donors are meeting the 2013 United States (U.S.) Public Health Service criteria for increased risk donors (IRDs), or donors who are at higher risk for transmission of Human Immunodeficiency Virus (HIV), Hepatitis C virus (HCV), and other multidr [...] 1824 9294 |
Short-Term Impact of Hematopoietic Stem Cell Transplantation in Leukemia Patients on Bone Bio Markers, Electrolytes and Blood Profileby
Abstract
Hematopoietic stem cell transplantation (HSCT) or Bone Marrow Transplantation (BMT) has significantly improved the survival rates of patients suffering from hematological malignancies. However, the cure can only be achieved at the price of morbidity and long-term complications such as bone diseases leading to fractures and osteopenia. Several studies have reported the impact of organ transplants on bone metabolism, electrolytes and blood profile. This prospective observational clinical study aims at elucidating the [...] 1347 9294 |
Infectious Considerations for Patients on Immune Checkpoint InhibitorsAbstract
Chronic inflammatory states lead to T cell exhaustion, characterized by reduced T cell proliferation and activity. Immune checkpoint inhibitors (ICPI) reactivate T cells to restore the immune system’s natural defenses against foreign antigens. The widespread use of these agents in the treatment of malignancy has led to markedly reduced tumor burden and improved patient survival, sparking curiosity about their potential role in the treatment of other chronic inflammatory states, including infectious diseases. While [...] 1520 9251 |
Donor Age and Ischemia Time Are Independent Factors Affecting Graft Survival after En Bloc Kidney Transplantation from Donors Less than Three Years of Ageby
Abstract
This study aimed to investigate the outcomes of transplantation from donors aged less than three years in a single-center consecutive series. A total of 52 en bloc kidney graft transplantations were performed. In 22 cases, organs were procured from donors aged less than one year (group 1). In 30 cases, the age of donors varied from one to three years (group 2). After transplantation, renal function and graft and patient survival were evaluated retrospectively. No significant difference was observed between the grou [...] 1476 9220 |
Update in the Use of Percutaneous Coronary Intervention for Cardiac Allograft Vasculopathy After Heart Transplantationby
Abstract
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 [...] 1527 9182 |
Airway Complications after Lung TransplantationAbstract
Lung transplantation in patients with end stage lung disease can improve survival and quality of life. Airway complication incidence varies between 2-33%, but the true incidence is difficult to determine due to a lack of validated classification systems. There are many risk factors for post lung transplant airway complications, the most common being anastomotic ischemia, pulmonary infections, surgical technique and allograph dysfunction. Common complications include formation of granulation tissue, anastomotic sten [...] 1448 9168 |
|
Open Access Short Communication Lack of Effect of Human Chorionic Gonadotropin in Mixed Lymphocyte Reaction in XenotransplantationAbstract
It has been speculated that the immunomodulation associated with pregnancy, e.g., decreasing pro-inflammatory cytokines, increasing anti-inflammatory cytokines, upregulation of T regulatory cells (Tregs), is in part due to the effect of human chorionic gonadotropin (hCG). In this study, we tested the effect of hCG on proliferation of human peripheral blood mononuclear cells (PBMCs) stimulated by irradiated pig PBMCs. Mixed lymphocyte reaction (MLR) was carried out with human PBMCs as responders and irradiated wild- [...] 1836 9164 |
Dual Kidney Transplantation after Hypothermic Oxygenated Perfusion from Marginal Donor after Circulatory Death with Acute Kidney Injury: A Case Reportby
Abstract
Donation after circulatory death (DCD) is an increasingly used resource to alleviate chronic renal graft shortages. Organs from donors with progressively increased creatinine levels due to acute kidney injury are used, but the effects of this condition on kidney transplantation are still unclear. Ex-situ machine perfusion is emerging as a potential tool to preserve and resuscitate vulnerable grafts. We report a case of DCD kidneys discarded due to severe acute kidney injury with favorable histological Karpinski sco [...] 1608 9155 |
Present and Future Strategies with Curative Intent for Hereditary HemoglobinopathiesAbstract
Nowadays, hematopoietic stem cell transplantation (HSCT) is a common procedure in hematology units within reference centers, mainly for the treatment of hematological malignancies such as multiple myeloma, lymphoma, and acute leukemia. Nevertheless, HSCT has much wider applications, namely in autoimmune diseases, congenital metabolic defects, and hemoglobinopathies. Thalassemia major and sickle cell disease make up the most frequent hereditary hemoglobinopathies worldwide. Despite advances on the prevention and tre [...] 1729 9103 |
Oral Management in Pre-HSCT Patients: An Evaluation of Oral and Systemic Complicationsby
Abstract
Objective: Hematopoietic stem cells transplant (HSCT) requires being preceded by chemotherapy and radiotherapy. The neutropenia and thrombocytopenia which follows may be the possible cause of post-transplant complications. It is required that the patient undergoing transplantation is eradicated of any possible infectious focus. Currently, a uniform protocol for the oral management of these patients is unavailable.
Methods: The approach for the dental management of each patient was designed as a more selective proto [...] 1853 9042 |
Case of Lung Transplantation in a Recipient with Emphysema: Importance of Determining Alpha 1-Antitrypsin Deficiency Status for Lung TransplantationAbstract
Here we present a case of a lung transplant recipient with alpha 1-antitrypsin deficiency as well as conducted a retrospective review of the United Network for Organ Sharing (UNOS) database from 1990 – 2016 specifically grouping patients with alpha-1 antitrypsin deficiency (A1ATD) and chronic obstructive pulmonary disease (COPD). 1644 9033 |
Secondary Antibody Deficiency in a Heart Recipient with Systemic AspergillosisAbstract
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 [...] 1758 8967 |
Pancreatic Islet Transplantation: State of the Art and Future PerspectivesAbstract
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 [...] 1802 8918 |
The Concerted Action of Multiple Mechanisms to Induce and Sustain Transplant Toleranceby
Abstract
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 [...] 1618 8915 |
Aspiration of Gastrointestinal Material and Induction of Fibronectin Expression in Lung Transplant Recipients: Implications for Early Airway Remodelingby
Abstract
Background: Gastroesophageal reflux disease has been associated with the development of chronic lung allograft dysfunction following lung transplantation. While the mechanisms are unclear, it is postulated that microaspiration of gastrointestinal material (GIM) leads to inflammation and airway remodeling that culminates in obliterative bronchiolitis. As the expression of the matrix glycoprotein fibronectin has been shown to be an early marker of this fibroproliferative process, its induction could suggest a causal [...] 1575 8871 |
TOP