Immunoprotective Encapsulation of Micro-Organs
Abstract
1427 8799
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 [...] 1427 8799 |
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 [...] 1416 9076 |
The Conundrum of High Body Mass Index in Kidney Transplant PatientsAbstract
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 [...] 1413 9310 |
Pediatric Thoracoscopic Repair of Diaphragmatic Herniation Following Liver TransplantationAbstract
Diaphragmatic Hernia (DH) after Liver Transplantation (LT) is a rare complication with unclear pathophysiology. Among 261 LT, we recognized six DH during the post transplant period (2.30%). All patients with DH had received a left lateral segment (LLS) reduced graft. The mean graft weight was 340g with a mean graft-to-recipient body weight ratio (GBWR) of 4.20%. LLS grafts, a GBWR > 4%, previous abdominal surgery and direct trauma during surgery can be enumerated as potential risk factors for DH post-LT. These chil [...] 1408 8314 |
Antibody-Mediated Rejection in Kidney Transplantation: Immunopathogenesis, Innate–Adaptive Crosstalk, and Therapeutic AdvancesAbstract
Antibody-mediated rejection (ABMR) remains a major barrier to long-term graft survival in kidney transplantation. Defined by the presence of donor-specific antibodies (DSAs) and characteristic histological changes, such as C4d deposition in peritubular capillaries, ABMR can present acutely, chronically, or subclinically, often manifesting as graft dysfunction. Recent advances in genomic profiling and diagnostic assays have improved our understanding of its pathophysiology, yet therapeutic strategies remain limited. [...] 1389 15113 |
Appropriate Vancomycin Use and Incidence of Vancomycin-Resistant Enterococci in Liver Transplant RecipientsAbstract
Liver transplant recipients (LTRs) are at risk for vancomycin-resistant Enterococcus (VRE) infections which can lead to significant morbidity or mortality. Antibiotic exposure, including vancomycin, is associated with greater risk of VRE infection. This study aimed to assess the appropriateness of vancomycin use and rates of VRE infection in this population. We performed a retrospective cohort study of 327 patients who underwent liver transplantation at our center from January 1, 2012 to June 30, 2017. Sixty (18.3% [...] 1373 8425 |
Intrapancreatic Parenchymal Cell Transplantation as a Possible Model for the Development of a Cell-based Therapy for Type I Diabetes MellitusAbstract
Background: Transplantation of isolated islets is one of the most powerful approaches to cure insulin-dependent (type I) diabetes mellitus (IDDM). Currently, the most widely used transplantation strategy is percutaneous perfusion into the liver via the portal vein. However, this approach has several drawbacks and is often limited by the large number of islets required and hypoxic damage to the grafts. Methods: In this article, we posit intrapancreatic parenchymal cell transplantation (IPPCT) as a promisin [...] 1367 9722 |
Cytomegalovirus Management in Solid Organ Transplant RecipientsAbstract
Cytomegalovirus (CMV) remains a significant cause of morbidity and mortality in solid organ transplant (SOT) recipients. Despite advancements in prophylaxis and antiviral therapy, CMV continues to pose clinical challenges in transplant medicine. This review provides a comprehensive overview of CMV, exploring its pathophysiology, epidemiology, and clinical presentation in SOT patients, in whom CMV infection can lead to direct organ involvement and systemic symptoms. Additionally, CMV has indirect effects, including [...] 1361 15000 |
Pharmacological Strategies to Enhance Bone Graft Integration: Emerging Agents and Molecular PathwaysAbstract
Bone grafting remains a cornerstone technique in orthopedic and reconstructive surgery, yet achieving successful graft integration continues to pose significant challenges, particularly in conditions such as osteoporosis, diabetes mellitus, and large bone defects. Traditional graft materials such as autografts, allografts, xenografts, and synthetics, often encounter limitations including immune rejection, poor vascularization, and insufficient osteogenic support. Emerging pharmacological strategies have shown promi [...] 1351 3031 |
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 [...] 1350 8956 |
Liver Transplantation or Resection for Treatment of Hepatocellular Carcinoma in Patients with Well-Compensated Cirrhosis: A Decision Analysis Modelby
Abstract
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 [...] 1315 9893 |
Alpha-1 Antitrypsin Deficiency and Lung Transplantation: A Clinical Caseby
Abstract
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 [...] 1309 9806 |
Economic Considerations in Using HCV and HIV Positive Donors for Kidney TransplantAbstract
End Stage Renal Disease is becoming more prevalent in the United States of America, with demand for kidney transplant exceeding the available organ supply. A novel method to increase the donor pool has been to consider transplanting organs from deceased patients who have had Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV) infections. Transplants with HCV infected kidneys are becoming more prevalent, due to increased organ supply due to increased mortality from injection opioid use. Similarly, deceased [...] 1298 9506 |
Malignancy in the Lung Transplant Populationby
Abstract
The risk for developing a variety of malignancies is significantly elevated in the setting of lung transplantation. Malignancy remains among the three major causes of death in post-transplant recipients, and the relatively high risk of cancer development as well as metastatic aggression pose special threats to this population due to the need for continued immunosuppression. A variety of risks such as tobacco use and inflammatory lung diseases that led to the lung pathology prompting lung transplantation, in additio [...] 1290 9572 |
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 [...] 1290 8746 |
Brief Review: Pancreatic Islet Transplantation for Type 1 Diabetes in HumansAbstract
Pancreatic islet transplantation (ITx) has moved from the experimental phase of development to a position of an accepted and appropriate procedure to apply in clinical medicine. The primary indication for use of ITx is for management of dangerous and recurrent hypoglycemia secondary to use of exogenous insulin for management of hyperglycemia in people with type 1 diabetes. ITx involves procurement of a pancreas donated by a person who has died. The organ is taken to a specialized laboratory for isolation of islets [...] 1286 13062 |
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 [...] 1285 8813 |
Integrating RNA-Seq Biomarkers and Diagnostic Algorithms to Improve Liver Transplant Outcomes: A Comprehensive Reviewby
Abstract
Graft rejection, early allograft dysfunction (EAD), and poor diagnostic accuracy are some of the challenges that still need to be addressed, even though liver transplantation (LT) has the potential to help patients with end-stage liver disease (ESLD) significantly. Traditional procedures, such as liver biopsies and liver function tests (LFTs), often fail to identify abnormalities early and with accuracy. Genomic RNA sequencing (RNA-Seq) has recently emerged as a powerful approach for identifying molecular markers o [...] 1282 8083 |
Prospects of Platelet-Rich Plasma in Regenerative Medicineby
Abstract
Platelet-rich plasma (PRP) is a promising tool in regenerative medicine because it stimulates tissue repair and regeneration. PRP contains a high concentration of platelets, growth factors, and cytokines involved in the healing process. This editorial paper aims to give an overview of PRP in regenerative medicine and its potential applications in various medical fields such as orthopedics, dentistry, dermatology, and wound healing. PRP can be integrated with other regenerative therapies, such as stem cell and gene [...] 1266 7825 |
Prolonged and Resistant Cutaneous Infection in Newly Transplanted Renal Patientby
Abstract
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 [...] 1258 7818 |
Acute Rejection of the Lung Allograft: Phenotypes and ManagementAbstract
Treatment options for end stage lung diseases are limited to stabilizing lung failure, decreasing disease progression, and symptom management, but significant reversal of lost lung function is often not possible. For well selected patients, lung transplantation may be a viable option to improve both longevity and quality of life. Though outcomes for lung transplant recipients have improved over several decades, long term survival still lags behind that of other solid organ transplant recipients. Longevity after lun [...] 1254 12619 |
The P2X7 Receptor Antagonist AZ10606120 Does Not Alter Graft-Versus-Host Disease Development and Increases Serum Human Interferon-γ in a Humanized Mouse ModelAbstract
Allogeneic hematopoietic stem cell transplantation is a curative therapy for hematological malignancies, but its efficacy is limited by graft-versus-host disease (GVHD). This life-threatening disorder develops when donor (graft) immune cells cause inflammatory damage to recipient (host) tissues. The immune cell receptor channel P2X7 and its ligand adenosine 5’-triphosphate (ATP) have been implicated in GVHD pathogenesis. Therefore, this signaling axis represents a potential therapeutic target. This study aime [...] 1244 9124 |
Maribavir for Management of Cytomegalovirus in Lung Transplant Recipients: A Case Series and Literature ReviewAbstract
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 [...] 1241 10213 |
Identification of Potential Predictive and Diagnostic Urinary Biomarkers for Acute Rejection in Renal Transplant Recipients: A Proteomics Studyby
Abstract
Acute rejection (AR) is one of the main predictors of long-term survival of allograft. The development of noninvasive diagnostic biomarkers of AR is an unmet need for the timely detection. This study aimed to identify novel detective biomarkers of AR by analyzing the urine proteome profile of transplant patients. Forty-two transplant patients including 30 biopsy-proven AR patients (including antibody and T-cell mediated rejection) and 12 transplant patients with stable renal function (control group) were enrolled. [...] 1236 7310 |
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 [...] 1235 9085 |
Plasmapheresis for Thrombotic Microangiopathy Due to a Post-transplant Lymphoproliferative DisorderAbstract
We report a case of thrombotic microangiopathy (TMA) diagnosed in the kidney allograft of a 59-year-old woman who had developed plasmacytoma type monomorphic posttransplant lymphoproliferative disorder (PTLD) 30 years after a simultaneous pancreas and kidney transplant. This report demonstrates a rare etiology of TMA in a kidney allograft occurring in association with PTLD-associated monoclonal gammopathy. The main teaching points are: 1) PTLD may be considered in the work-up of a new TMA in the immunosuppressed po [...] 1234 9550 |
Hepatitis B Reactivation in HBsAg Negative Renal Transplant Patients with Evidence of Previous HBV Infection: A Not Neglectable Occurrenceby
Abstract
Hepatitis B virus (HBV) infection is frequent among patients with chronic kidney disease (CKD). HBV reactivation after kidney transplant (KT) is more common in patients with HBsAg+; however, it can also occur in previously infected individuals, particularly those with HBsAg negative and total antiHBc positive (HBsAg-/antiHBcT+). However, reactivation in this population has scarce and conflicting data. This study aimed to assess the reactivation risk in KT recipients with previous HBV infection (antiHBcT+). A retros [...] 1225 7233 |
Islet Autotransplantations for Total PancreatectomyAbstract
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 [...] 1218 9151 |
Allogeneic Stem Cell Transplantation: Current Status and Future Directionsby
Abstract
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 [...] 1218 10389 |
Never Say Never: Unexpected Pulmonary Pathogens Found on Autopsy in Hematopoietic Cell Transplantation RecipientsAbstract
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 [...] 1216 10751 |
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 [...] 1205 8197 |
Acknowlegement to Reviewers of OBM Transplantation in 2020Abstract
The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2020. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recogni [...] 1200 6087 |
Effect of Foot Reflexology on Laboratory Tests after Kidney Transplantation Surgery: A Secondary Analysis of a Parallel Randomized Controlled Trial Studyby
Abstract
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 [...] 1197 10517 |
The Holy Grail to Clinical Transplant Tolerance Is Paved with HLA EpitopesAbstract
The Holy Grail to Clinical Transplant Tolerance is Paved with HLA Epitopes 1188 7743 |
Utility of MEST and MEST-C Scoring in IgA Nephropathy in Kidney Transplantation: A Mini ReviewAbstract
IgAN is a major cause of end-stage kidney disease (ESKD) leading to kidney transplantation in a significant proportion of patients. However, its recurrence in transplanted kidneys can lead to graft loss. The rate of graft loss attributable to IgAN after transplantation is variably reported in different retrospective cohorts. Previous reports describe recurrence rates of 22-58% with a 1.3% to 16% rate of graft loss. Accurate diagnosis and prediction of graft loss are important for planning effective therapies to imp [...] 1188 7455 |
Peri-transplant Treatment with Ceftaroline in Kidney Transplant Recipients at Risk of Donor-derived MRSA Infections: A Case Seriesby
Abstract
The rising prevalence of MDR pathogens has a significant impact on the recipients' outcome, as this increases the risk of graft complications and makes the management of the peri-transplant phase more difficult. Among the different MDR germs, Methicillin-resistant Staphylococcus aureus (MRSA) represents one of the most frequently isolated pathogens. We report for the first time the off-label use of Ceftaroline in six kidney transplant recipients with donor peritransplantation MRSA bacteremia at the Division of Kidn [...] 1178 6398 |
Evaluation of Total Parenteral Nutrition in the Autologous Transplantation Setting in Patients with AML: A Retrospective Exploratory Analysisby
Abstract
Malnutrition remains a clinical challenge in AML patients undergoing autologous hematopoietic stem cell transplantation (ASCT), leading to physical deconditioning and prolonged hospitalization. Prospective data are mainly lacking to identify those patients who may particularly benefit from parenteral nutrition in this setting. This observational, non-randomized, retrospective, exploratory cohort study assessed the nutritional development in patients following high-dose chemotherapy (HDCT) with ASCT and explored the [...] 1166 6237 |
The Role of Pulmonary Rehabilitation in Lung Transplantation for Cystic FibrosisAbstract
Cystic fibrosis (CF) is a genetic disorder that significantly impacts respiratory function, leading to progressive lung damage and ultimately respiratory failure. Lung transplantation (LTx) is a critical intervention for CF patients with end-stage lung disease, offering improved survival and quality of life. Pulmonary rehabilitation (PR) plays a pivotal role both preoperatively and postoperatively in optimizing outcomes for LTx candidates and recipients. Pre-transplant PR interventions, including exercise programs, [...] 1160 7267 |
Infectious Complications in Liver Transplantation1155 6947 |
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 [...] 1154 8781 |
Normal Saline vs Plasma-Lyte A Use Intra- and Post-Operatively in Adult Kidney Transplant Recipientsby
Abstract
Fluid management intra- and post-operatively for kidney transplant recipients (KTR) is essential to maintain adequate perfusion to the kidney. 0.9% normal saline (NS) is commonly used, but it can cause hyperchloremic metabolic acidosis, which may result in hyperkalemia and lead to delayed graft function (DGF). Plasma-Lyte A (PA) is an alternative option that has a lower amount of chloride and a neutral pH, which may offset the risk of hyperkalemia. The aim of this study is to determine the incidence of DGF in KTRs [...] 1151 7960 |
Biomarkers in the Management of the Lung Transplant Allograft: A Focus on Donor-derived Cell-free DNAAbstract
Advances in the use of molecular biomarkers to guide management of lung transplant recipients are emerging. One such biomarker, donor-derived cell-free DNA (dd-cfDNA), has the potential to alter traditional approaches of lung transplant management, including the detection of acute rejection or infection, surveillance monitoring strategies, risk stratification of vulnerable patient populations and molecular phenotyping of various forms of allograft injury. The emergence of novel genetic and epigenetic approaches uti [...] 1144 7781 |
Machine Perfusion of Donor Hearts – The Recovery and Transplantation of Previously Unrecoverable Heartsby
Abstract
Heart transplantation remains the gold standard treatment for end-stage heart failure. With an increasing population and improving medical therapy there is an increasing number of patients who would benefit from heart transplantation but are unable to receive one due to a shortage of suitable donor organs. This ongoing need, and significant limitations with traditional cold static storage (CSS), have driven the development of machine perfusion technology that have expanded the donor pool. Machine perfusion is divid [...] 1129 6316 |
A Urinary Proteomics Approach to Predict Treatment Response in Acute Antibody-Mediated Rejectionby
Abstract
Acute antibody-mediated rejection (AMR) is a severe complication affecting kidney allografts' long-term survival. Timely detection and appropriate treatment of AMR are crucial for improving graft outcomes. This study aimed to discover non-invasive urinary biomarkers that can predict the response to therapy in patients with AMR. Materials and Methods: In this case-control study, urine samples from 21 biopsy-proven AMR patients underwent proteomics using label-free quantification. The patients were divided into two g [...] 1114 6407 |
Updates in Liver Transplantation for Alcohol-Related Liver Diseaseby
Abstract
The prevalence of alcohol use disorder (AUD) and alcohol-related liver disease (ALD) has increased in the last two decades. ALD is currently the most common indication for both waitlist additions and liver transplant (LT) in the United States, including alcohol-associated cirrhosis, alcohol-associated hepatitis (AH), and acute-on-chronic liver failure (ACLF). ALD also has a significant global disease burden. LT in ALD is a complex paradigm that poses both medical and ethical challenges, requiring a multidisciplinar [...] 1114 8881 |
Lung Transplantation for COVID-19 Related Lung Disease: A Follow-Up Study of Outcomes from a Medium-Size Lung Transplant Programdby
Abstract
In the United States of America, COVID-19 acute respiratory distress syndrome (ARDS) and post-COVID pulmonary fibrosis (PCPF) are raising indications for lung transplant (LT). Another indication for LT is underlying fibrosis with SARS-CoV-2 induced interstitial lung disease exacerbation or rapid progressing fibrosis. Only a few centers have reported on their long-term outcomes after LT for COVID-19. Single center retrospective chart review of patients transplanted for COVID-19 related lung disease. The Henry Ford H [...] 1112 6758 |
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Open Access Short Communication Promising Tactics with Certain Probiotics for the Treatment of Nephropathy in Hematopoietic Stem Cell TransplantationAbstract
Hematopoietic stem cell transplantation (HSCT) is a standard form of cellular therapy for patients suffering from malignant hematological diseases. However, graft-versus-host disease (GVHD) is a very serious complication and a major cause of morbidity and mortality after allogeneic HSCT. Calcineurin inhibitors, such as cyclosporine, are widely used to enhance the survival of patients who have undergone HSCT. Unfortunately, both GVHD and cyclosporine occasionally cause nephropathy. Several studies have shown that th [...] 1106 6845 |
Review of Heterotopic Heart Transplantation Models in Ratsby
Abstract
Heterotopic heart transplantation (HHT) in rats is a valuable tool for cardiac transplantation research. While abdominal HHT has been established in rats for nearly 90 years, novel approaches involving cervical and femoral techniques have also been explored. The abdominal HHT model, despite its long history, is technically demanding and has a steep learning curve. In contrast, the cervical HHT model enables surgeons with more basic microsurgical skills to achieve competency more quickly while producing comparable o [...] 1104 5204 |
A Rare and Complex Case of Multifactorial Thrombotic Microangiopathy in A Kidney Transplant Recipient: Interplay Between Antibody Mediated Rejection, Tacrolimus Toxicity, Cytomegalovirus Disease and BNT162b2mRNA VaccineAbstract
Thrombotic microangiopathy (TMA) in kidney transplant recipients is uncommon and difficult to manage, often with poor graft outcomes [1]. This is a complex and interesting case of an older, highly sensitised kidney transplant recipient who presented with de novo post-transplant TMA in the setting of antibody mediated rejection (ABMR), with other drivers being tacrolimus toxicity, cytomegalovirus (CMV) infection and anti-SARS-CoV-2 BNT162b2 mRNA vaccination. This led to rapid, irrecoverable graft loss. 76-year-old f [...] 1097 6615 |
Shifting Pancreas Transplantation Rates and Demographics are the Culmination of Many Strategic Policy Changesby
Abstract
The 2014 Pancreas Allocation System established national qualifying criteria for simultaneous kidney pancreas (SPK) transplantation. The 2019 UNOS Pancreas Transplantation Committee Policy 11.3.B modified these guidelines to expand transplantation. Subsequent effects on recipient demographics have not been studied. We analyzed 81 SPK transplantations performed at our center from June 2014 to December 2020 to compare recipient demographics and outcomes before and after the 11.3.B policy change. National data were al [...] 1086 7016 |
Acute Liver Failure Due to Assumed Drug Induced Liver Injury but Lack of Any Validated Causality Algorithm: Evidence by 36 Cohort Reports with 21,709 Casesby
Abstract
Liver transplantation (LT) can be the only option for patients with acute liver failure (ALF) where medical approaches are ineffective. Causes of ALF are multiple and commonly easily detectable, but uncertainty remained on the role of drug-induced liver injury (DILI) within the published ALF cohorts. Therefore, an analysis was undertaken to clarify which drugs may have caused the DILI and how the diagnosis of the liver injury was established. Using the PubMed database and Google Science, the search term of acute li [...] 1083 5880 |
Successful Kidney Transplantation of Two Patients with Donors Positive for Severe Acute Respiratory Syndrome Coronavirus InfectionAbstract
Despite preventative measures, including vaccination, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection may result in severe illness, particularly in immunosuppressed transplant recipients. This has had a negative impact on organ donation and transplantation rates. However, the risk of transmission from SARS-CoV-2 positive donors to kidney transplant recipients is unknown. We describe 2 cases of successful kidney transplantation from SARS-CoV-2 positive donors. Case 1: 38-year old unvaccinated fe [...] 1078 6209 |
Robust Outcomes for Hispanic Lung Transplant Recipients in the United Statesby
Abstract
Race, while a social construct, has a strong effect on a person’s health. There is limited data on racial disparities within lung transplantation (LTx), especially for Hispanic recipients. Therefore, the aim of this study was to identify inequalities that may involve this population. We analyzed historical data from the Organ Procurement and Transplantation Network (OPTN) and performed a retrospective review of Hispanic and Caucasian patients who underwent lung transplantation in the United States between May [...] 1070 7234 |
Bilateral Corneal Perforation in a Patient with Chronic Ocular Graft-Versus-Host Disease: A Case Report and Literature Reviewby
Abstract
Graft-versus-host disease (GVHD) is a serious complication that may occur in patients receiving allogeneic hematopoietic stem cell transplant (HSCT). GVHD occurs because of the immunological reaction between the donor’s T cells and the recipient’s antigens; GVHD may develop in different tissues, including the eye. Corneal perforation is an uncommon but vision-threatening manifestation of GVHD. We reported the case of a 65-year-old male patient who developed corneal perforation sequentially in both eyes 3 years afte [...] 1070 7704 |
Lung Transplantation from A Donor with Previous SARS-CoV-2 Infection: 1-Year Outcomesby
Abstract
Few reports have described successful lung transplantation from a donor with a history of SARS-CoV-2 infection, and outcomes beyond 3 to 6 months remain unknown. After weighing the urgency and life-saving benefits of lung transplantation against the risk of viral transmission, we successfully performed a bilateral lung transplant from a donor with confirmed SARS-CoV-2 infection with mild symptoms 2 months before donation. At 1 year after transplant, there is no evidence of donor-derived viral transmission, and allo [...] 1055 6171 |
Detection of Activated Pepsin in Bronchoalveolar Lavage and Acute Cellular Rejection in Lung Transplant RecipientsAbstract
Activated pepsin (pepA) in bronchoalveolar lavage (BAL) fluid may be a biomarker of gastric aspiration. We sought to i) evaluate the association of pepA in BAL fluid with acute cellular rejection (ACR) in a cohort of lung transplant recipients (LTRs), ii) assess the association between pepA and isolation of typical gastrointestinal microorganisms from BAL fluid, and iii) explore the accuracy of using pepA concentration as a biomarker of ACR. After IRB approval, we conducted a retrospective observational study analy [...] 1052 5750 |
Tacrolimus Therapeutic Response, Pharmacokinetics and Adherence in Liver Transplant Recipientsby
Abstract
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 [...] 1047 9666 |
Poly ε-Caprolactone Scaffolds: Advancements in Bone Regeneration and GraftingAbstract
In orthopedics and oncology, benign and malignant bone lesions pose significant clinical challenges. Malignant tumors, like osteosarcomas and multiple myeloma, pose substantial health dangers and can spread common and mostly non-life-threatening benign lesions, including non-sizing fibromas and unicameral bone cysts. Treatment plans for bone lesions may involve radiation, chemotherapy, and surgical excision, depending on their type. Combining stem cell research, bioactive materials, and advanced scaffold design, cu [...] 1045 8583 |
Contribution of a Single Islet Transplant Program to Basic Researchers in North America, Europe, and Asia through Distributing Human Isletsby
Abstract
There has been a steady expansion in islet isolation and transplantation activity worldwide. In addition to preparing human islets for transplantation, we have been providing human islets to basic researchers. The aim of this study was to review the activity of distribution of human islets to basic researchers in North America, Europe, and Asia, and to investigate if there are any differences in utilization rate of islets among three continents. We reviewed our islet isolation batch files, donor records, and docume [...] 1044 7291 |
Monitoring Survival Following Lung Transplantation with Inclusion of Unaccounted Risksby
Abstract
Lung transplant (LTx) survival and quality of life have been steadily improving, partially from changes in candidate selection for transplantation. There are well-known high-risk factors that lead to poor LTx outcomes, which may be referred to as ‘accounted’ risks. However, there are also other ‘unaccounted’ risks that are not included in the existing model for expected LTx survival to help programs for resource allocation. We performed a retrospective cohort study of all LTx recipients over the age of 18 at UC San [...] 1029 6829 |
Impact of Sex and Age at Lung Transplantation on Long-Term Survival of Patients with Cystic FibrosisAbstract
Careful selection of lung transplant (LT) recipients with cystic fibrosis (CF) may improve outcomes; therefore, we studied the impact of sex and age at the time of LT on long-term survival of patients with CF. LT recipients with CF who received post-LT care at our center between July 1, 2007 and April 30, 2021 were included. The primary outcome was death or retransplantation. Cox proportional hazard analysis and the Kaplan-Meier method were used. Of 59 included LT recipients, the median age at first LT was 28 (22, [...] 1025 6775 |
Acknowledgement to Reviewers of OBM Transplantation in 2021Abstract
The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2021. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recogni [...] 1015 7529 |
Calculated Human Leucocyte Antigens Evolutionary Divergence (cHED)by
Abstract
Human Leucocyte Antigens (HLA) constitute a highly polymorphic set of genes pivotal to the immune response. The HLA heterozygous advantage hypothesis assumes that heterozygous individuals at the HLA level have a wider range of peptides for T cell recognition than homozygous individuals. Consequently, they possess an enhanced capacity to trigger a targeted immune reaction. The divergent allele advantage hypothesis is an extension of heterozygous advantage, considering the excessive sequence divergence between allele [...] 1010 6728 |
Immune-Suppression Modulation in Solid Organ Transplant Recipients Admitted for COVID-19by
Abstract
SARS-CoV-2 infection has significantly impacted solid organ transplant (SOT) recipients, who are at high risk of disease and worse outcomes. Moreover, therapeutic management in this population is not precise yet. Our study aimed to evaluate the overall survival of SOT recipients and predictive factors for mortality. We also aimed to assess the impact of antiviral treatments and immunosuppressant changes on overall mortality and to evaluate the length of hospital stay of SOT compared to the general population. This [...] 1004 5571 |
"Let's Live Life - Let's Give Life": Donor Program Improvement as the Key to Transplantation Success in 21st Century - A Croatian ExperienceAbstract
Transplantation is a widely accepted and successful life-saving treatment for hundreds of thousands of patients. However, transplant medicine still faces a number of obstacles. One of the most significant is the large disparity between the number of donors and recipients and the growing need for re-transplantation. In the last two decades, the improvement and organization of the national transplantation program in Croatia have resulted in a steadily increasing donor rate and therefore the transplantation numbers. A [...] 1001 8068 |
Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Fanconi Anemia: Results of a Single Center with a Fludarabine-Based Conditioning Regimenby
Abstract
Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) remains the only curative treatment for bone marrow failure (BMF) and hematologic complications of Fanconi anemia (FA). The evolution remains affected by the toxicity, the risk of graft failure, and clonal evolution. This study aimed to identify factors affecting outcomes in FA patients after allo-HSCT. We included FA patients who underwent allo-HSCT between January 2006 and December 2021. The conditioning regimen was cyclophosphamide/fludarabine (Cy/Fl [...] 999 5759 |
Oral Versus Intravenous Anti-CMV Preemptive Strategies in Allogeneic Stem Cell Transplant Patients with CMV Reactivation: Experience from the National Center of Bone Marrow Transplantation, Tunis, Tunisiaby
Abstract
Cytomegalovirus (CMV) infection is a common and severe complication following allogeneic stem cell transplantation (ASCT) and requires effective preemptive antiviral therapy. Both oral and intravenous (IV) antiviral agents effectively reduce CMV viral load and achieve viral clearance. Studies comparing oral and IV anti-CMV preemptive treatment in ASCT patients with CMV reactivation showed a potential difference in treatment response and safety profiles between the two administration routes. We retrospectively compa [...] 997 6842 |
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Open Access Short Communication Surgical Tips for Improving Success Rate of Deep Anterior Lamellar Keratoplasty in Keratoconusby
Abstract
This article aims to provide some personal surgical tips to increase the success rate of deep anterior lamellar keratoplasty (DALK), a very advantageous yet complex procedure for treating keratoconus. The most troublesome surgical step is obtaining a successful pneumatic dissection of the deep stromal tissue, allowing the exposure of a deep cleavage plane. The following tips may aid the trainee surgeon in mastering this step, among others: performing a deep trephination, using intraoperative anterior segment optica [...] 997 7183 |
What Is the Current Status of Single Lung Transplantation? A Literature Reviewby
Abstract
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 [...] 988 10736 |
Management of Steatosis in Living Donors: Where Do We Stand?Abstract
With the progressive rise in rates of liver transplantation, stagnant donor pool, and social factors, living donor liver transplantation (LDLT) forms the majority of liver transplantations performed in Asian countries. As the global prevalence of metabolic-associated fatty liver disease (MAFLD) is increasing, around 17-25% of all the prospective donors turn out to be steatotic at the time of evaluation and, as such, rejected for donor hepatectomy, thereby considerably reducing the living donor pool. Steatotic graft [...] 964 6533 |
Mobilization of Autologous Peripheral Blood Stem Cells (PBSC) in CD20+ Lymphoma Patients Using RICE, Granulocyte-Colony Stimulating Factor (G-CSF) and PlerixaforAbstract
RICE is salvage therapy for treating CD20+non-Hodgkin lymphoma (NHL). It is combined with G-CSF to collect autologous peripheral blood stem cells (aPBSC). Little data exists, though, on the combination of G-CSF and Plerixafor after RICE in mobilizing adequate number of CD34 cells and the product’s immune content. We report on the results of twenty CD20+ NHL patients after RICE, G-CSF and Plerixafor were given to collect aPBSC. The median number of cells collected was 12.92 × 106 CD34 cells/kg (range 5.4 [...] 959 6766 |
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