August 26: Recent Transplant News
Monday, August 26, 2013
Repopulation of the immunosuppressed retrorsine-treated infant rat liver with human hepatocytes
Xenotransplantation (login required)
Humanized chimeric mice have been generated by transplanting h-hepatocytes into the livers of the diseased-liver transgenic mouse model with immunodeficient background. These mice with livers mostly replaced by human (h) hepatocytes have been proved to be useful for research on drug metabolism and toxicity and on intrahepatic pathogens such as hepatitis. However, their small body size prohibited collecting sufficient biological samples and made surgical manipulation difficult, which motivated us to produce humanized larger animal(s) bearing h-hepatocytes. Read more.
The safety and efficacy of acute graft-versus-host disease prophylaxis with a higher target blood concentration of cyclosporine around 500 ng/mL
Clinical Transplantation
Cyclosporine (CsA) is the most widely used immunosuppressive agent for the prevention of acute graft-versus-host disease (GVHD). In a previous report, the incidence of acute GVHD was decreased by increasing the target blood concentration of CsA during a continuous infusion from 300 to 500 ng/mL without excessive toxicities. To confirm these results, we retrospectively analyzed 69 patients who received a continuous infusion of CsA at a higher target CsA level between 450 and 550 ng/mL (CsA500 group) and compared the clinical outcome with 29 patients who received CsA with a lower target concentration between 250 and 350 ng/mL (CsA300 group). Read more.
Cytomegalovirus prophylaxis in pediatric kidney transplantation: The Dutch experience
Pediatric Transplantation (login required)
Many children receiving a kidney transplant are seronegative for cytomegalovirus (CMV) and therefore, highly susceptible to a primary CMV infection. This study aims at evaluating incidence, time of occurrence, and severity of CMV infection in the first year post-transplantation in relation to different types of CMV prophylaxis. Transplantations in three centers in the Netherlands between 1999 and 2010 were included. Read more.
The time to address the gorillas in the room is overdue
Liver Transplantation (login required)
The two gorillas in the room are: 1)liver allocation in the United States is not equal by any significant metric (wait-time, model for end-stage liver disease score at transplantation, regional review board behavior), and 2) liver allograft utilization, as referenced by an increasing gap between consented liver deceased-donors and transplanted deceased-donor allografts or a decreasing donor risk index at transplantation, is declining. Read more.
Review: Size matching in lung transplantation
The Journal of Heart and Lung Transplantation (login required)
The evidence base for size matching between donors and recipients in lung transplantation has not recently been reviewed in a comprehensive manner. The aim in this study was to assimilate published studies that have addressed size matching of donors to recipients and to establish a pragmatic understanding of the range of lung sizes that may be used for lung transplantation. A comprehensive literature search was performed using Medline and PubMed up to and including September 2012, to identify scientific articles that relate to size matching between donors and lung transplant recipients. Seventy-two articles were identified, of which 21 had addressed the question of the impact of size mismatching on outcomes in lung transplantation. Read more.
It's up to you: A multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois
Clinical Transplantation (login required)
The present project applied successful strategies employed in previous driver facility campaigns occurring during the inception of a registry to examine whether these approaches are effective in growing a mature registry, a registry where the majority of individuals have had the opportunity to register as an organ donor. Read more.
It is more than just size: Obesity and transplantation
Liver Transplantation (login required)
The obesity pandemic is an inescapable problem in healthcare. A recent survey found nearly 80 million Americans, or 36 percent of the population older than 20 years, to be obese. Those caring for persons with end-stage liver disease have seen a 5.4 percent increase in the number of living transplant candidates with a body mass index greater than 30 kg/m2 in the United States. Read more.
Experience of extracorporeal membrane oxygenation as a bridge to lung transplantation in France
The Journal of Heart and Lung Transplantation (login required)
Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation (LTx). However, data concerning this approach remain limited. The study confirms that the use of ECMO as a bridge to LTx in France could provide a medium-term survival benefit for LTx recipients with critical conditions. Survival differed by underlying respiratory disease. Larger studies are needed to further define the optimal use of ECMO. Read more.
Test performance characteristics of quantitative nucleic acid testing for polyomaviruses in kidney and kidney-pancreas transplant recipients
Clinical Transplantation (login required)
Screening for polyoma BK virus (BK) using nucleic testing (NAT) is recommended for kidney and kidney-pancreas transplant recipients, but the performance characteristics of quantitative BK NAT at different thresholds of plasma BK viral loads are unclear. We aim to evaluate the diagnostic accuracy of quantitative BK NAT as an add-on test to qualitative polyoma NAT for the diagnosis of BK virus-associated nephropathy (BKVAN) in kidney and kidney transplant recipients. Read more.
1-year experience with intravenous treprostinil for pulmonary arterial hypertension
The Journal of Heart and Lung Transplantation (login required)
Intravenous (IV) epoprostenol has been the mainstay of therapy in advanced pulmonary arterial hypertension (PAH). Continuous IV treprostinil has several potential advantages over IV epoprostenol; however, there has been a lack of published long-term efficacy and safety data on IV treprostinil in PAH. Read more.