Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients 2014 Data Report: Intestine.
In conclusion, annual case numbers of intestinal transplants have been decreasing, regardless of improved graft survival. ABO compatible intestinal transplants previously had a significantly lower graft survival rate than ABO identical transplants. However, the graft survival difference became less significant in recent years, possibly due to, or at least partly due to the use of new immunosuppressive agents.
PMID: 26281125 [PubMed - indexed for MEDLINE] (Source: Clinical Transplants)
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Intestinal Transplantation: International Outcomes.
Authors: Ganoza AJ, Farmer DG, Marquez MA, Mazariegos GV
Abstract
Intestinal transplantation has continued to evolve over the past decade. Fewer patients have received intestine transplants in the past 5 years, perhaps due to efforts in intestine rehabilitation. Despite improvement in earlier outcomes, long-term survival has remained steady over the past decade. This is potentially due to the complications of immunosuppression, as well as inherent poor graft half-life due to chronic rejection. Improvements in outcome will require multidisciplinary efforts to understand the long-term mechanisms of intestine...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Deceased Donor Kidney Transplantation in Taiwan in 2015.
Authors: Lee PC, Chiang YJ, Chen ST
Abstract
There were 1997 deceased donor renal transplants reported to the Taiwan Organ Registry and Sharing Center between April 1, 2005, and December 31, 2014. The median age of transplant recipients was 45 years, with most patients between 35 and 64 years old. The number of male patients was comparable to that of female patients. There were more blood type O patients than any other blood type. The 1-, 3-, and 5-year patient survival rates were 96%, 93%, and 89%, respectively. Graft survival rates at 1, 3, and 5 years were 94%, 88%, and 82%, respectively. Overall patien...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Kidney Transplant Program at the Mayo Clinic in Arizona.
Authors: Heilman RL, Khamash HA, Huskey JL, Chakkera HA, Batra RK, Katariya NN, Singer AL, Mathur AK, Moss AA, Reddy KS
Abstract
Since 1999, we have performed 2,302 kidney transplants at the Mayo Clinic in Arizona. Transplant volume has increased by 45% since 2010. Our center performed 269 kidney transplants in 2013. Our growth is related to multiple factors, including an experienced, committed team and strong support from our institution and referring nephrologists. Areas of program innovation at our center include: transplanting deceased donors with acute kidney injury, outcomes in older kidney transplan...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
25 Years of Kidney Transplantation--A Period of Change.
Authors: Stippel DL, Cingöz T, Wahbal R, Müller RU, Bauerfeind U, Dieplinger G
Abstract
At the University of Cologne Hospital, 1062 kidney transplants in adults and 136 pediatric transplants were performed between 1990 and 2014. Immunosuppressive therapy was changed during this time period from a therapy with anti-lymphocyte globulin induction followed by a triple therapy to a period using induction (IL2 receptor antagonists) followed by low dose tacrolimus, mycophenolate mofetil and steroids. Antiviral therapy has been constant during the 25 years, consisting of ganciclovir or valganciclovir. Major chan...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
The Thirty-Six Year Experience in Kidney Transplantation at Changzheng Hospital.
Authors: Zhu Y, Zhang L, Min Z, He C
Abstract
Between June 1978 and June 2014, 4,199 kidney transplants were performed at the Transplantation Center of PLA, Changzheng Hospital, Second Military Medical University. In our initial practice period (1978-1985), graft and patient survivals were 48.2% and 56.5%, 27.3% and 31.7%, 22.5% and 24.4%, 20.1% and 23.2%, and 16.5% and 20.8%, at 1, 5, 10, 15, and 20 years, respectively. These results improved tremendously after cyclosporine A (1986-1998) was used at our center. The rates of 1-, 5-, 10-, 15-, and 20-year graft and patient survival were 84.3% and 88.5%, 72....
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Liver Transplantation at Mayo Clinic Florida.
Authors: Lee DD, Croome KP, Perry DK, Burns JM, Nguyen JH, Keaveny AP, Taner CB
Abstract
Over the sixteen year history of liver transplantation (LT) at Mayo Clinic in Jacksonville, Florida (MCF), we have maintained a practice devoted to excellence in pre- and post-LT management for patients suffering from end stage liver disease. With an emphasis on quality, MCF has made several adjustments with the goal of better utilizing marginal grafts for both successful post-transplant outcomes and minimizing waitlist mortality. This systematic approach is most exemplified in our experience with donation after cardia...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
The New Zealand Liver Transplant Unit: Auckland District Health Board.
Authors: Munn SR, Evans HM, Gane EJ
Abstract
New Zealand is a geographically isolated country with 4.55 million inhabitants. It has endemic hepatitis B (HBV) infection that is especially evident in Maori and Pacific Island communities and impacts indications for liver transplantation. The country has a socialised medical system that allows for full coverage of the assessment for, and completion of liver transplants in suitable recipients. Between February 1998 and December 2014, the New Zealand Liver Transplant Unit (NZLTU) had performed 595 liver transplants in 568 patients, indicating a crude re-transpla...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
The Alfred Hospital Lung Transplant Experience.
Authors: Paraskeva MA, Westall GP, Pilcher D, McGiffin D, Levvey BJ, Williams TJ, Snell GI
Abstract
The management of patients undergoing lung transplantation has continued to evolve, leading to improvements in 90-day and 1-year survival. The significant advancements in donor management and utilization at our center have led to significant increases in lung transplant activity without any compromise in recipient outcomes. Through the use of a patient-centered multidisciplinary model of care involved in all aspects of recipient management, from assessment and waitlisting to pre-, peri- and post-operative ca...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Efficacy of Intravenous Immunoglobulin in the Treatment of Persistent BK Viremia and BK Virus Nephropathy in Renal Transplant Recipients.
Authors: Shah T, Vu D, Naraghi R, Campbell A, Min D
Abstract
BK virus associated nephropathy (BKVN) can cause clinically significant viral infections in renal transplant recipients, leading to allograft dysfunction and loss. The usual management of BKVN involves reduction of immunosuppression and the addition of leflunomide, quinolones, and cidofovir, but the rate of graft loss remains high. The aim of this study was to assess the impact of treatment with intravenous immunoglobulin (IVIG) on the outcome of BKVN in renal transplant recipients. Upon diagnosis of BKVN, patients remained on anti-polyomavirus t...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Renal Transplant Outcomes in Waitlist Candidates with a Previous Inactive Status Due to Being Temporarily Too Sick.
CONCLUSION: Recipients with a history of reason 7 have lower patient and graft survival when compared to the active group. Nonetheless, the margins of difference are minimal. Candidates with a history of reason 7 should not be discouraged from transplantation once they return to active status. Standardized criteria for placing candidates on inactive status should be developed to reduce disparities among transplant centers.
PMID: 26281135 [PubMed - indexed for MEDLINE] (Source: Clinical Transplants)
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Update on Alloantibodies in Solid Organ Transplantation.
Authors: Everly MJ
Abstract
In the last few years, there have been studies published on serial testing and longitudinal analysis of anti-human leukocyte antigen (anti-HLA) antibodies. The focus of these studies was to determine specific characteristics of the impact of donor specific anti-HLA antibodies (DSA) in organ transplant dysfunction. These publications have led to an increasing concern about DSA and a growing effort to better understand DSA and to develop treatment for patients with DSA. In 2014, several reports were published that either confirm or expand upon both the understanding of the humoral...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
The Virtual Crossmatch: An Essential Tool for Transplanting Sensitized Patients.
Authors: Jackson AM
Abstract
Improved virtual crossmatch assessments following the implementation of solid phase HLA antibody immunoassays has significantly impacted transplantation of sensitized candidates, using either deceased or living donor organs. In deceased donor transplants, the virtual crossmatch has reduced the number of unexpected positive crossmatch tests resulting in improved organ allocation and reduced ischemia and wait times. The virtual crossmatch has also improved access to living donor transplantation by expediting donor evaluation by impacting clinical decisions regarding desensitizati...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Improved Long-Term Survival in Kidney Transplant Recipients with Donor-Specific HLA Antibodies After Mycophenolic Acid Escalation.
Authors: Rebellato LM, Parker K, Everly MJ, Briley KP, Kendrick W, Kendrick S, Haisch CE, Terasaki PI, Bolin P
Abstract
The development of donor specific antibodies (DSA) post transplant has been associated with chronic rejection and graft failure. In a longitudinal study, we have shown that increases in DSA precede rejection by months, thus allowing time for intervention. We hypothesized that mycophenolic acid (MPA) dose increases may reduce and/or stabilize DSA strength and also preserve renal function. Thirty stable DSA positive kidney transplant recipients participated in this Institutional Review Boar...
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
Impact of Donor Specific HLA Antibody Monitoring After Kidney Transplantation.
In conclusion, the detrimental effects of DSA on allograft function could be mitigated by serial DSA surveillance, protocol biopsies, and alterations in immunosuppression. With these measures, the improvement in graft survival in DSA positive KT recipients, at least at short-term, is encouraging.
PMID: 26281139 [PubMed - indexed for MEDLINE] (Source: Clinical Transplants)
Source: Clinical Transplants - November 20, 2015 Category: Transplant Surgery Tags: Clin Transpl Source Type: research
