March 29 - Recent Transplant News

Multidrug-resistant gram-negative bacteria infections in solid organ transplantation
Source: American Journal of Transplantation (subscription required)
The prevalence of multidrug resistance in gram-negative bacteria isolated form clinical samples continues to increase globally. Several reports indicate a similar continued trend toward increased resistance in gram-negative bacteria isolated from transplant patients. Clinically important MDR bacteria that have been reported in transplant recipients include nonlactose fermenters such as Pseudomanas species, burkholderia species and stenotrophomas species, as well as carbapenem-resistant acinetobacter species and MDR anterobacteriaceae, with CR enterobacteriacaea being of particular concern. The impact of infection with MDR or PR bacteria on transplant recipient survival has become an important concern as several reports indicate significantly decreased survival of patients with such bacteria. Read more.

Hypothermic reconditioning in organ transplantation
Source: Current Opinion in Organ Transplantation (subscription required)
Vascular and parenchymal tissue homeostasis can be restored to a notable extent in cold-preserved organ grafts by hypothermic reconditioning: A short period of preimplantation treatment allows for better graft function after transplantation in livers and kidneys. Hypothermic reconditioning represents a promising and easily applicable tool for post hoc enhancement of organ viability in marginal grafts and should be validated in randomized controlled trials. Read more.

Association between granzyme B and perforin I polymorphisms and allograft outcomes in Hispanic kidney transplant recipients
Source: Clinical Transplantation
Granzyme B (GZMB) and perforin 1 gene (PRF1) are key effector molecules of cytotoxic T lymphocytes, in causing acute and chronic solid organ transplant rejection. In this study, researchers analyzed the impact of GZMB and PRF1 polymorphism on kidney allograft outcomes. The result suggests that PRF1 and GZMB gene polymorphisms may determine the incidence of acute rejection or graft survival among Hispanic allograft recipients. Read more.

Cytokine concentrations and regulatory T cells in living donor and deceased donor liver transplant recipients
Source: Pediatric Transplantation (subscription required)
Outcomes of pediatric liver transplantation have constantly improved in the last decade. Living-related liver transplantation does not seem to improve long-term outcomes following liver transplantation, but few studies have evaluated immunological parameters of the alloimmune response after living vs. deceased donor organ transplantation. Researchers analyzed numbers of regulatory T cells, lymphocyte subsets and serum cytokine concentrations in 12 pediatric recipients of living-related liver transplants and in 28 pediatric recipients of deceased donor organs during their annual follow-ups. Living-related liver transplantation may have potentially beneficial immunological aspects, although long-term outcomes do not seem to be better in recipients of living donor organs than in recipients of deceased donor organs. Read more.

Review: Efficacy of carbon dioxide insufflation for cerebral and cardiac protection during open heart surgery
Source: Artificial Organs (subscription required)
In spite of widespread application around the world, there has been controversy on the cerebral and cardiac protection efficacy of carbon dioxide insufflation (CDI) during open heart surgery. To make a comprehensive evaluation, researchers screened all relevant published randomized controlled trials to perform the first systematic review and meta-analysis for CDI during open heart surgery. Because of the insufficiency of powerful evidences, the cerebral and cardiac protection efficacy of CDI during open heart surgery needs to be further verified by more high-quality trials. Read more.

Vitamins A, D deficiencies common among patients evaluated for liver transplantation
Source: Healio
Most liver transplant candidates are vitamin A- and vitamin D-deficient, with bilirubin levels, BMI and Child-Turcotte-Pugh class predictive of vitamin A deficiency, according to a recent study. Researchers performed a retrospective chart review of 63 patients who underwent liver transplantation at a single medical facility between January 2008 and September 2011. Demographic information was collected and levels of vitamins A, E and 25-OH-D were assessed, along with BMI, MELD score and Child-Turcotte-Pugh (CTP) class. Read more.

Time to death after withdrawal of treatment in donation after circulatory death (DCD) donors
Source: Current Opinion in Organ Transplantation (subscription required)
Controlled donation after circulatory death (DCD) donors make an important contribution to organ transplantation but there is considerable scope for further increasing the conversion of potential to actual DCD organ donors. The period between withdrawal of life-supporting treatment and death (the withdrawal period) is a major determinant of whether organ donation proceeds and it is therefore timely to review recent relevant studies in this area. Read more.

The impact of C4d and microvascular inflammation
Source: Clinical Transplantation (subscription required)
It is important to identify prognostically important morphologic criteria in posttransplant management to tailor therapy and improve outcomes. Therefore, using biopsies carried out for cause less than one year posttransplant, from an era when C4d staining and microvascular inflammation (MVI) were not clinically utilized, researchers studied the importance of C4d and MVI on graft survival. Snap-frozen first renal allograft biopsy specimens (done for cause) in the first post-transplant year from 1996 to 2001 were stained/examined for C4d, and pathology re-examined by a separate blinded pathologist. Graft outcomes in patients with and without MVI and/or C4d were compared. Read more.