January 25 - Recent Transplant News
Monday, January 28, 2013
Treatment of steroid-resistant acute renal allograft rejection with alemtuzumab
Source: American Journal of Transplantation (subscription required)
Steroid-resistant renal allograft rejections are commonly treated with rabbit antithymocyte globulin (RATG), but alemtuzumab could be an effective, safe and more convenient alternative. Adult patients with steroid-resistant renal allograft rejection treated with alemtuzumab (15–30 mg s.c. on two subsequent days) from 2008 to 2012 were compared to patients treated with RATG. Read more.
Declining liver utilization for transplantation in the United States and the impact of donation after cardiac death
Source: Liver Transplantation (subscription required)
Worsening donor liver quality resulting in decreased organ utilization may be contributing to the recent decline in liver transplants nationally. In recent study, researchers sought to examine trends in donor liver utilization and the relationship between donor characteristics and nonuse. The United Network for Organ Sharing database was used to review all deceased adult organ donors in the United States from whom at least one solid organ was transplanted into a recipient. Read more.
Serious acute kidney injury is on the rise
Source: Renal & Urology News
The incidence of acute kidney injury requiring dialysis is now higher than the incidence of end-stage renal disease requiring dialysis or transplant, discovered a team led by Dr. Chi-yuan Hsu, Nephrology Division Chief at the University of California-San Francisco (UCSF), and UCSF nephrology fellow Dr. Raymond Hsu. Read more.
Use of immune function test in monitoring immunosuppression in liver transplant recipients
Source: Clinical Transplantation (subscription required)
Immune function test (Immuknow) is a measure of cell-mediated immunity based on peripheral CD4 T cell adenosine triphosphate activity (desired range, 225–525 ng/mL). A recent study evaluated the role of immune function test in monitoring and adjustment of immunosuppression in orthotopic liver transplant recipients. Read more.
Intense diuresis plan promising in heart failure
Source: MedPage Today
A diuretic protocol designed to allow rapid real time assessment and adjustment of treatment for acute heart failure patients showed gains, but also potential losses, according to an observational study. Patients with acute decompensated heart failure on the diuretic protocol were 54 percent less likely to be readmitted to the hospital compared with the usual care group, according to Dr. Jeffrey H. Barsuk, MS, and colleagues from Northwestern University Feinberg School of Medicine in Chicago. Read more.
Immunological monitoring after pancreas transplantation
Source: Current Opinion in Organ Transplantation (subscription required)
After switching from bladder to enteric drainage, pancreas graft monitoring, particularly after solitary transplantation, has become an important issue. The aim of a recent study was to systematically review the relevant literature with regard to various biomarkers, imaging techniques and pathologic evaluation of allograft tissue. Read more.
Study: Polyomavirus BK replication in de novo kidney transplant patients receiving tacrolimus or cyclosporine
Source: American Journal of Transplantation
Polyomavirus BK (BKV)-associated nephropathy causes premature kidney transplant (KT) failure. BKV viruria and viremia are biomarkers of disease progression, but associated risk factors are controversial. In a recent study, 682 KT patients receiving basiliximab, mycophenolic acid (MPA), corticosteroids were randomized 1:1 to cyclosporine (CsA) or tacrolimus (Tac). The data suggest a dynamic risk factor evolution of BKV viremia consisting of higher corticosteroids until month 3, Tac-MPA compared to CsA-MPA at month 6 and Tac-MPA, older age, male gender at month 12 posttransplant. Read more.
Solid phase detection of C4d-fixing HLA antibodies to predict rejection in high immunological risk kidney transplant recipients
Source: Transplant International (subscription required)
Protocols for recipient desensitization may allow for successful kidney transplantation across major immunological barriers. Desensitized recipients, however, still face a considerable risk of antibody-mediated rejection (AMR), which underscores the need for risk stratification tools to individually tailor treatment. Here, researchers investigated whether solid phase detection of complement-fixing donor-specific antibodies has the potential to improve AMR prediction in high-risk transplants. Read more.
Transumbilical portal venous catheterization: A useful adjunct in left lobe living donor liver transplantation
Source: Clinical Transplantation (subscription required)
To improve the processes used for perfusion of the explanted graft and measuring the portal venous pressure in adult living donor transplantation, researchers performed transumbilical portal venous catheterization to reopen the umbilical vein and insert the catheter for seven adult patients undergoing left lobe LDLT. Read more.