Novel Nanoimaging Strategies for Noninvasive Graft Monitoring in Vascularized Composite Allotransplantation
This article focuses on the unmet needs and key challenges in vascularized composite allotransplantation (VCA) and the opportunities for current nanotechnology advances in therapeutics and diagnostics for personalized treatment and optimization of clinical outcomes. The transformative role of nanoimaging as a noninvasive tool in the longitudinal surveillance of acute and chronic rejection after VCA is critically reviewed. Nanoimaging can inform management decisions and guide continuous treatment adjustments over time in patients to improve safety and efficacy in VCA. Nanoimaging signatures can be unbiased and quantitative measures of treatment effectiveness as well as medication adherence, both of which are critical prerequisites for overall graft survival and patient quality of life.
We have read the letter by Lenain et al.,1 which raised concerns about the potential for collinearity given our use of the kidney donor profile index (KDPI) for multivariable adjustment in analyses that showed deceased-donor acute kidney injury (AKI) was not independently associated with allograft failure at a median follow-up of 4 y ears.2 We used KDPI for adjustment because the score is very familiar to the transplant community for describing overall organ quality given that it incorporates 10 donor factors associated with allograft survival.
A 55-year-old man with a history of end-stage renal disease due to autosomal dominant polycystic kidney disease and bilateral nephrectomy without adrenalectomy underwent his first kidney transplantation after 6 years of hemodialysis. The patient had no history of donor-specific antibodies. The donor was described as a 69-year-old man with a history of active smoking and aortic valvulopathy who died of a stroke without cardiac arrest or collapse. Maintenance immunosuppressive therapy consisted of low-dose tacrolimus and everolimus.
A 30-year-old man who underwent renal transplantation 10 years ago presented with multiple painful swellings in his limbs and joints with limitation of movement (Supplementary Figure S1), which had developed over 3 weeks. He was on dual immunosuppression with prednisolone and tacrolimus because of multiple infections in the past. He was normotensive and afebrile. Each swollen area was tender and fluctuant. His hemoglobin level was 7.3 g/dl; the total leukocyte count was 21,800 cells/mm3; and the serum creatinine level was 2.9 mg/dl.
Condition: Infertility of Uterine Origin Intervention: Procedure: Uterine Transplant from Deceased Donor Sponsor: Brigham and Women's Hospital Not yet recruiting
Conditions: Complication, Postoperative; Regeneration Liver Intervention: Drug: Potassium Phosphate Injection Sponsor: Institute of Liver and Biliary Sciences, India Recruiting
Condition: Antibody-mediated Rejection Intervention: Sponsors: University Hospital, Montpellier; Institut National de la Santé Et de la Recherche Médicale, France Not yet recruiting
Authors: de la Fuente S, Citores MJ, Lucena JL, Muñoz P, Cuervas-Mons V Abstract Aim: To determine whether TLR9 polymorphisms are associated with tumor recurrence after liver transplantation for hepatocellular carcinoma (HCC). Patients &methods: All patients who underwent liver transplantation, and had viable HCC in the explanted liver were included. TLR9 -1237C/T and -1486C/T polymorphisms were analyzed by real-time PCR and melting curves analysis. Results: 20 of 159 patients (12.6%) developed post-transplant HCC recurrence. Tumors exceeding Milan criteria, moderately-to-poorly differenti...
Publication date: Available online 18 July 2019Source: The Lancet HaematologyAuthor(s): Saad Zafar Usmani, Fredrik Schjesvold, Albert Oriol, Lionel Karlin, Michele Cavo, Robert M Rifkin, Habte Aragaw Yimer, Richard LeBlanc, Naoki Takezako, Robert Donald McCroskey, Andrew Boon Ming Lim, Kenshi Suzuki, Hiroshi Kosugi, George Grigoriadis, Irit Avivi, Thierry Facon, Sundar Jagannath, Sagar Lonial, Razi Uddin Ghori, Mohammed Z H FarooquiSummaryBackgroundLenalidomide and dexamethasone has been a standard of care in transplant-ineligible patients with newly diagnosed multiple myeloma. The addition of a third drug to the combinati...
Publication date: Available online 19 July 2019Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Shahram Ghanaati, Sarah Al-Maawi, Torsten Conrad, Jonas Lorenz, Ralf Rössler, Robert SaderSummaryThree-dimensional augmentation in severely atrophic bone and after cancer resection is a challenging clinical indication that is mostly solved using autologous bone transplantation. The development of the digital technique along with the additive manufacturing and three-dimensional (3D) printing opened new avenues for reconstructive oral and maxillofacial surgery. Therefore, patient-specific titanium mesh is a novel mea...
CONCLUSION: The PDTX model is highly consistent with the pathology of the patient's tumor, and can be used as a substitute for clinical patients to guide the accurate treatment and scientific research of gynecological tumors. PMID: 31312388 [PubMed]