Do not forget late aortic pseudoaneurysm after heart transplantation

We read with great interest the case report by Bojko and colleagues1 of a patient with aortic aneurysm very late after heart transplantation (HTx). The patient, who had a history of aortic valve replacement for bicuspid aortic valve (BAV) disease, underwent HTx for developed cardiomyopathy secondary to sarcoidosis. An incidental computed tomographic image of the chest taken to rule out pneumonia revealed a distal ascending aortic aneurysm with maximal diameter of 7.2  cm. The patient had been followed up with transthoracic echocardiography, which had shown no evidence of dilatation of the thoracic aorta.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Letter to the Editor Source Type: research

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Changes in indices of mineral metabolism, bone protein expression, and bone turnover were assessed between pre – and post–renal transplant bone biopsies obtained 12 months apart. Circulating sclerostin and fibroblast growth factor 23 (FGF-23) levels decreased, and a low bone turnover state was highly prevalent on follow-up. In contrast, bone sclerostin expression increased, whereas FGF-23 bone expression was unchanged/decreased. These findings underscore the limitations of circulating biomarkers and the critical role of bone biopsy to understand osteocyte biology in chronic kidney disease–mineral bone disorder.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Commentary Source Type: research
A 63-year-old man was admitted 2 months after a deceased-donor kidney transplantation with an acute rise of his creatinine from a baseline of 1.9 mg/dl to 3.7 mg/dl. The patient had received basiliximab induction, followed by maintenance with belatacept, mycophenolic acid, and steroids. Physical examination and an ultrasound of the kidney transplant were unremarkable. Kidney biopsy revealed Banff acute cellular rejection grade IIB. Belatacept was replaced with tacrolimus, and steroid pulse and rabbit antithymocyte globulin were administered.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research
A 36-year-old female recipient of simultaneous pancreas-kidney transplantation 2 months previously was admitted to the emergency room because of a fever of unknown origin. Physical examination was unremarkable. Klebsiella pneumoniae was isolated in urine culture and treated with ceftriaxone according to antibiogram. High-grade fever persisted despite the increase in antibiotic spectrum with meropenem. Blood cultures were negative (including mycobacteria), as were quantiferon, cytomegalovirus, BK virus, Epstein –Barr virus polymerase chain reaction, and Toxoplasma gondii serologies.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research
AbstractPurpose of ReviewLiver transplantation (LT) has been utilized in the last two decades for the treatment of selected patients with hepatocellular carcinoma (HCC). Currently, in most jurisdictions worldwide, only tumor size and number determine transplant candidacy, which may not sufficiently predict tumor behavior. Both tumor downstaging and expanding transplant criteria play an important role in expanding access to LT for HCC patients.Recent FindingsNew downstaging protocols are emerging that incorporate response to locoregional therapies (LRT) among those that initially present beyond the accepted Milan criteria. ...
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research
AbstractThe use of hypomethylating agents (HMAs) prior to hematopoietic stem cell transplantation (HSCT) in patients with myelodysplastic syndromes (MDS) was still controversial. Therefore, we sought to evaluate the impact of hypomethylation therapy before HSCT, with a special focus on long-term outcome. Databases, including PubMed, Embase Ovid, and the Cochrane Library, were searched for studies published up to 4 November 2018. Overall survival (OS) was selected as the primary endpoint, and relapse-free survival (RFS) was the secondary endpoint. A total of 6 cohort studies were included in the final meta-analysis. Our res...
Source: Annals of Hematology - Category: Hematology Source Type: research
Publication date: Available online 20 October 2019Source: Best Practice &Research Clinical HaematologyAuthor(s): Richard J. JonesAbstractClose HLA matching of donors and recipients has been the dogma for successful allogeneic blood or marrow transplantation (BMT), to limit the complications of graft rejection and graft-versus-host disease (GVHD). However, many patients in need, especially those in certain racial and ethnic groups such as African-Americans and Hispanics, are unable to find matches despite increased availability of unrelated donors. Unfortunately, despite many early attempts to develop safe, related hapl...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
MONDAY, Oct. 21, 2019 -- Many U.S. transplant centers accept less-than-ideal kidneys from deceased donors, but their willingness to use such organs varies widely. That's the conclusion of a study that examined the use of deceased-donor kidneys at...
Source: Drugs.com - Daily MedNews - Category: General Medicine Source Type: news
ConclusionsOur results suggest that sex-specific differences in LV geometry, hyper-contractility and diastolic function, not greater degree of LV myopathy, contribute to a higher, age-independent risk of diastolic HF in women with HCM.Graphical abstract
Source: American Heart Journal - Category: Cardiology Source Type: research
DiscussionGiven the multiorgan system potential adverse side effects of prednisone, proving noninferiority of an alternate regimen would be sufficient to make the alternative compare favorably to standard dose steroids. This is the first ever clinical trial in cardiac sarcoidosis and thus in addition to the listed goals of the trial, we will also establish a multi-center, multinational cardiac sarcoidosis clinical trials network. Such a collaborative infrastructure will enable a new era of high quality data to guide physicians when treating cardiac sarcoidosis patients.
Source: American Heart Journal - Category: Cardiology Source Type: research
Condition:   Transplant; Decision-making Interventions:   Other: Total Survival;   Other: Stratified Transplant Survival Sponsor:   Carnegie Mellon University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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