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(Source: Transplantation Reviews)
Source: Transplantation Reviews - October 1, 2015 Category: Transplant Surgery Source Type: research
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(Source: Transplantation Reviews)
Source: Transplantation Reviews - October 1, 2015 Category: Transplant Surgery Source Type: research
Renal transplantation in the elderly
As a reflection of increased life expectancy, population is aging in many industrialized countries, particularly in Europe, US, and in Northeast Asia [1]. Accordingly, the number of elderly patients who start dialysis and who are evaluated for kidney transplantation is growing. Based on the findings from earlier US studies [2,3], most professional guidelines recommend that advanced age should not be considered per se a contraindication to kidney transplantation [4–6]. Indeed, elderly subjects currently represent a substantial proportion of the patients undergoing kidney transplantation. (Source: Transplantation Reviews)
Source: Transplantation Reviews - October 1, 2015 Category: Transplant Surgery Authors: Umberto Maggiore, Daniel Abramowicz, Klemens Budde Source Type: research
Allocation strategies for elderly kidney transplant recipients
In all modern societies, the percentage of elderly people is increasing. However, this does not necessary reflect the percentage of patients waiting for a new kidney and the availability of organs for this entity differs markedly between countries. Thus, allocation strategies for elderly kidney recipients should be based on the characteristics of the specific countries and take into account: access to the waiting list and availability of living as well as marginal and conventional post-mortem donors. (Source: Transplantation Reviews)
Source: Transplantation Reviews - October 1, 2015 Category: Transplant Surgery Authors: Uwe Heemann, Lutz Renders Source Type: research
Everolimus immunosuppression in kidney transplantation: What is the optimal strategy?
Two main everolimus-based strategies have been pursued to facilitate calcineurin inhibitor (CNI) reduction after kidney transplantation: (i) everolimus with reduced CNI exposure from time of transplant (ii) pre-emptive introduction of everolimus with CNI reduction or withdrawal at some point post-transplant. Randomized trials have shown no loss of immunosuppressive efficacy for everolimus (targeting 3–8ng/mL) with reduced-exposure CNI versus standard-exposure CNI and mycophenolic acid (MPA) in low-to-moderate risk patients. (Source: Transplantation Reviews)
Source: Transplantation Reviews - September 17, 2015 Category: Transplant Surgery Authors: Oliver Witzke, Claudia Sommerer, Wolfgang Arns Source Type: research
Do elderly recipients really benefit from kidney transplantation?
Data from the nineties showed that even older individuals had a survival advantage with kidney transplantation compared to dialysis. Consequently, we are increasingly wait-listing high-risk patients in terms of age and co-morbidities. However, times are changing. Due to severe organ shortage we now use more often expanded criteria donor kidneys with less favorable outcomes, while at the same time survival on dialysis is improving. The question therefore rises again if elderly patients really benefit from transplantation nowadays. (Source: Transplantation Reviews)
Source: Transplantation Reviews - September 17, 2015 Category: Transplant Surgery Authors: Rachel Hellemans, Vianda S. Stel, Kitty J. Jager, Jean-Louis Bosmans, Daniel Abramowicz Source Type: research
Exploring principles of hibernation for organ preservation
Interest in mimicking hibernating states has led investigators to explore the biological mechanisms that permit hibernating mammals to survive for months at extremely low ambient temperatures, with no food or water, and awaken from their hibernation without apparent organ injury. Hibernators have evolved mechanisms to adapt to dramatic reductions in core body temperature and metabolic rate, accompanied by prolonged periods without nutritional intake and at the same time tolerate the metabolic demands of arousal. (Source: Transplantation Reviews)
Source: Transplantation Reviews - September 5, 2015 Category: Transplant Surgery Authors: Emmett D. Ratigan, Dianne B. McKay Source Type: research
What immunosuppression should be used for old-to-old recipients?
Transplant centers are faced with an increasing number of elderly patients on the waiting list for renal transplantation. For example, in France, the number of patients over the age of 60 years on the waiting list has multiplied 4-fold in the last ten years and, today, represents 38 % of the patients who are listed and a third of the patients who have had transplants [1]. This is a result of the aging of the End Stage Renal Disease (ESRD) population and is also a consequence of the expected benefit for the recipients, explaining why advanced age is no longer considered a contraindication to transplantation. (Source: Transplantation Reviews)
Source: Transplantation Reviews - September 3, 2015 Category: Transplant Surgery Authors: Yannick Le Meur Source Type: research
Transplanting the elderly: Balancing aging with histocompatibility
Across the world, the proportions of senior citizens (i.e. those ≥65years) increase rapidly and are predicted to constitute over 25% of the general population by 2050. In 2012 already 48% of the population with end stage renal disease (ESRD) was aged 65years or older. Transplantation is considered the preferred treatment option for ESRD offering survival advantage over long-term dialysis in the majority of patients. Indeed, acceptable outcomes have been documented for selected patients over the age of 70years or even cases over 80years. (Source: Transplantation Reviews)
Source: Transplantation Reviews - September 2, 2015 Category: Transplant Surgery Authors: G.J. Dreyer, A.C. Hemke, M.E.J. Reinders, J.W. de Fijter Source Type: research
Transplanting the elderly: Balancing Ageing with Histocompatibility
Across the world, the proportions of senior citizens (i.e. those ≥65 years) increase rapidly and are predicted to constitute over 25% of the general population by 2050. In 2012 already 48% of the population with end stage renal disease (ESRD) was aged 65 years or older. Transplantation is considered the preferred treatment option for ESRD offering survival advantage over long-term dialysis in the majority of patients. Indeed, acceptable outcomes have been documented for selected patients over the age of 70 years or even cases over 80 years. (Source: Transplantation Reviews)
Source: Transplantation Reviews - September 2, 2015 Category: Transplant Surgery Authors: G.J. Dreyer, A.C. Hemke, M.E.J. Reinders, J.W. de Fijter Source Type: research
Immunological characteristics of the elderly allograft recipient
The increasing number of elderly people with a demand for organ transplantation poses an important medical challenge. The effect of aging on the immune system concerns wide modifications with a considerable influence on transplant outcomes. Aging causes significant changes in immune cells repertoire. Thymic involution impairs the production of new naïve cells. Immune remodeling induces important alterations in the activity of immunological molecules. Therefore, clinical implications in elderly transplant recipients should consider appropriate organ allocation with adequate individualization of immunosuppression. (Source: ...
Source: Transplantation Reviews - August 15, 2015 Category: Transplant Surgery Authors: Marian Klinger, Miroslaw Banasik Source Type: research
Need for optimized immunosuppression in elderly kidney transplant recipients
The proportion of elderly kidney transplant candidates is increasing worldwide due to higher number of patients with end-stage renal disease in aging societies. (Source: Transplantation Reviews)
Source: Transplantation Reviews - August 15, 2015 Category: Transplant Surgery Authors: L.J. Lehner, Oliver Staeck, Fabian Halleck, Lutz Liefeldt, Jamal Bamoulid, K. Budde Source Type: research
Renal cell carcinoma in functional renal graft: Toward ablative treatments
The occurrence of a kidney transplant tumor is a rare but serious issue with a double risk: the return to dialysis and the development of metastatic cancer. Publications on this topic are mainly case reports. The purpose of this review was to report an exhaustive literature review of functional graft renal cell carcinomas to highlight the impact of tumors on the renal graft outcomes. 201 de novo renal carcinomas in functional renal grafts from 69 publications were included. Incidence was estimated at 0.18%. (Source: Transplantation Reviews)
Source: Transplantation Reviews - July 31, 2015 Category: Transplant Surgery Authors: Xavier Tillou, Kerem Guleryuz, Sylvie Collon, Arnaud Doerfler Source Type: research
Role of IL-21 signaling pathway in transplant-related biology
Since pro-inflammatory cytokine IL-21 and its receptor (IL-21R) are closely involved in regulating both innate and adaptive immune responses, it is conceivable that they may play important roles in the field of organ transplantation. IL-21/IL21-R regulates immune activities of CD8+T cells, Tfh cells, Th17 cells, B cells, NK cells, dendritic cells and stimulates dendritic cells to produce high level of IL-6, TNF-alpha, and CCL2. However, their roles and underlying mechanisms remain obscure. Our present study is the first describing role of IL-21 signaling pathway in transplant biology. (Source: Transplantation Reviews)
Source: Transplantation Reviews - July 3, 2015 Category: Transplant Surgery Authors: Xiaoyu Shi, Risheng Que, Baochun Liu, Mingming Li, Jinzhen Cai, Dawei Shou, Liang Wen, Dahai Liu, Li Chen, Tingbo Liang, Weihua Gong Source Type: research
Extracorporeal Machine Perfusion of the Pancreas: Technical Aspects and its Clinical Implications – A Systematic Review of Experimental Models
Pancreas or pancreatic islet transplantation is an important treatment option for insulin-dependent diabetes and its complications. However, as the pancreas is particularly susceptible to ischaemic-reperfusion injury, the criteria for pancreas and islet donation are especially strict. With a chronic shortage of donors, one critical challenge is to maximise organ availability and expand the donor pool. To achieve that, continuous improvement in organ preservation is required, with the aims of reducing ischaemia-reperfusion injury, prolong preservation time and improve graft function. (Source: Transplantation Reviews)
Source: Transplantation Reviews - June 19, 2015 Category: Transplant Surgery Authors: Kean Guan Kuan, Markus Trochsler, Wen Yuan Chung, Mau Nam Wee, Rohan Kumar, Soeren Torge Mees, Ashley Dennison, Guy Maddern Source Type: research
