Management of Malignancies After Liver Transplantation
Due to advances in medical and surgical expertise leading to significant improvements in graft and patient survival, there is an increased recognition of long term complications in survivors such as de novo malignancies, cardiovascular events and infections.Data show solid organ transplant recipients have 2-3 times the increased risk of developing a de novo malignancy compared to an age-matched and sex-matched general population and malignancy is expected to be the number one cause of mortality in long term transplant recipients in the next two decades. (Source: Transplantation Reviews)
Source: Transplantation Reviews - November 17, 2014 Category: Transplant Surgery Authors: Anjana A. Pillai Source Type: research
Liver Disease Related to the Heart
In this article, we review both acute and chronic liver diseases that occur as a result of heart or circulatory system failure. Ischemic hepatitis, congestive hepatopathy, cardiac cirrhosis, and Fontan liver disease are reviewed. We review clinical presentation, diagnostic data, prognosis, and available therapeutic strategies for these entities. We aim to increase awareness about cardio-hepatic disease as the prevalence of this disorder in adults is increasing. Due to advances in medical and surgical care, patients with heart disease are living longer and thus exposing long-term effects on the liver that are clinically rel...
Source: Transplantation Reviews - November 17, 2014 Category: Transplant Surgery Authors: Ryan M. Ford, Wendy Book, James R. Spivey Source Type: research
Monitoring T cell alloreactivity
Currently, immunosuppressive therapy in kidney transplant recipients is center-specific, protocol-driven, and adjusted according to functional or histological evaluation of the allograft and/or signs of drug toxicity or infection. As a result, a large fraction of patients are likely to receive too much or too little immunosuppression, exposing them to higher rates of infection, malignancy and drug toxicity, or increased risk of acute and chronic graft injury from rejection, respectively. To help clinicians individualize a immunosuppression regimens requires the development of assays able to reliably quantify and/or predict...
Source: Transplantation Reviews - November 13, 2014 Category: Transplant Surgery Authors: Anita Mehrotra, Jeremy Leventhal, Carolina Purroy, Paolo Cravedi Source Type: research
Monitoring Drug Adherence
Medication nonadherence is prevalent in transplant recipients and is a major reason for graft loss. The present review discusses the measurement of adherence in transplant recipients and strategies to improve adherence. (Source: Transplantation Reviews)
Source: Transplantation Reviews - October 30, 2014 Category: Transplant Surgery Authors: Sarah R. Lieber, Jacqueline Helcer, Eyal Shemesh Source Type: research
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Source: Transplantation Reviews - September 26, 2014 Category: Transplant Surgery Source Type: research
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Source: Transplantation Reviews - September 26, 2014 Category: Transplant Surgery Source Type: research
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Source: Transplantation Reviews - September 26, 2014 Category: Transplant Surgery Source Type: research
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Source: Transplantation Reviews - September 26, 2014 Category: Transplant Surgery Source Type: research
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Source: Transplantation Reviews - September 26, 2014 Category: Transplant Surgery Source Type: research
Liver Disease after Hematopoietic Cell Transplantation in Adults
Liver-related complications constitute a large component of the overall morbidity and mortality associated with hematopoietic cell transplantation. Affecting up to 80% of allogeneic HCT recipients, prompt recognition and treatment is essential. The differential diagnosis is broad and is best categorized by time of onset after transplantation. Early complications include drug-induced liver injury, sinusoidal obstruction syndrome, and graft-versus-host disease. Late complications include infectious sequelae, cirrhosis, and hepatic malignancies. (Source: Transplantation Reviews)
Source: Transplantation Reviews - August 27, 2014 Category: Transplant Surgery Authors: J.P. Norvell Source Type: research
Liver Disease in Kidney Transplant Recipients
Kidney transplant recipients can develop acute and chronic liver disease from a variety of conditions. Chronic viral hepatitis from hepatitis C is seen in increased frequency in hemodialysis patients. Genetic conditions, such as polycystic kidney disease, which lead to the need for kidney transplantation are also associated with liver diseases including congenital hepatic fibrosis and polycystic liver disease.Other conditions that can induce liver disease in this immune-suppressed population include a multitude of viral infections, as well as other systemic infections that can involve the liver. (Source: Transplantation Reviews)
Source: Transplantation Reviews - August 27, 2014 Category: Transplant Surgery Authors: Alan Gunderson, Adnan Said Source Type: research
mTOR inhibitors and dyslipidemia in transplant recipients: A cause for concern?
Post-transplant dyslipidemia is exacerbated by mammalian target of rapamycin (mTOR) inhibitors. Early clinical trials of mTOR inhibitors used fixed dosing with no concomitant reduction in calcineurin inhibitor (CNI) exposure, leading to concerns when consistent and marked dyslipidemia was observed. With use of modern concentration-controlled mTOR inhibitor regimens within CNI-free or reduced-exposure CNI regimens, however, the dyslipidemic effect persists but is less pronounced. Typically, total cholesterol levels are at the upper end of normal, or indicate borderline risk, in kidney and liver transplant recipients, and ar...
Source: Transplantation Reviews - August 27, 2014 Category: Transplant Surgery Authors: Hallvard Holdaas, Luciano Potena, Faouzi Saliba Source Type: research
Renal transplantation in elderly patients. How to select the candidates to the waiting list?
Today, old age does not represent a formal contraindication to kidney transplantation. Rather, there is evidence that in elderly patients renal transplantation offers longer life expectancy and better quality of life in comparison with dialysis. Yet, the results of renal transplantation in recipients older than 65years are inferior to those observed in younger adults, death with functioning graft representing a major cause of failure. Therefore, the selection of aged patients is of paramount importance. (Source: Transplantation Reviews)
Source: Transplantation Reviews - July 30, 2014 Category: Transplant Surgery Authors: Claudio Ponticelli, Manuel Alfredo Podestà , Giorgio Graziani Source Type: research
Renal transplantation in elderly patients. how to select the candidates to the waiting list?
Today, old age does not represent a formal contraindication to kidney transplantation. Rather, there is evidence that in elderly patients renal transplantation offers longer life expectancy and better quality of life in comparison with dialysis. Yet, the results of renal transplantation in recipients older than 65years are inferior to those observed in younger adults, death with functioning graft representing a major cause of failure. Therefore, the selection of aged patients is of paramount importance. (Source: Transplantation Reviews)
Source: Transplantation Reviews - July 30, 2014 Category: Transplant Surgery Authors: Claudio Ponticelli, Manuel Alfredo Podestà , Giorgio Graziani Source Type: research
Organ transplantation from donors (cadaveric or living) with a history of malignancy: Review of the literature
The evolution of organ transplantation has resulted in extended lifespan as well as better life quality of patients with end-stage diseases, which in turn causes an increased demand for organs. The persistent organ shortage requires a careful reconsideration of potential donors (living or cadaveric) that have current or historical malignancies. Donors with low-grade skin tumors, carcinomas in situ of the uterine cervix, and primary central nervous system (CNS) tumors can be considered as potential donors for recipients dying on wait list longing for organ transplantation. (Source: Transplantation Reviews)
Source: Transplantation Reviews - July 23, 2014 Category: Transplant Surgery Authors: Sheng Zhang, Jin Yuan, Wei Li, Qifa Ye Source Type: research
