Donor-Recipient Matching Is Important but Age Matching Alone Is Insufficient
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Letter Source Type: research

Islet Allotransplantation in the Bone Marrow of Patients With Type 1 Diabetes: A Pilot Randomized Trial
Conclusions. Bone marrow is not a suitable alternative site for pancreatic islet allotransplantation in patients with type 1 diabetes. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Clinical Correlation of Cytomegalovirus Infection With CMV-specific CD8+ T-cell Immune Competence Score and Lymphocyte Subsets in Solid Organ Transplant Recipients
Background. Control of cytomegalovirus (CMV) infection after solid organ transplantation (SOT) requires a functional immune system. We assessed the association between quantitation and function of CMV-specific CD8+ T cells and CMV infection in SOT recipients. Methods. During a 10-year period, selected kidney, heart, lung, pancreas, liver, and composite tissue recipients were tested for CMV-specific CD8+ T cells immune competence (CMV-CD8+), as measured by enumeration, interferon-gamma production, and CD107a/b degranulation. Quantitative and functional data were used to assemble T-cell immune competence (TIC) score. CM...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Role of 18F-FDG PET/CT in Restrictive Allograft Syndrome After Lung Transplantation
Background. Differential diagnosis of phenotypes of chronic lung allograft dysfunction (CLAD) remains troublesome. We hypothesized that 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) may help in differential diagnosis of CLAD phenotypes, as it showed promising results regarding diagnosis and prognosis in interstitial lung diseases. Methods. A monocentric, retrospective study was performed including all lung transplant recipients suffering from bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS) who underwent 18F-FDG PET/CT scan, in comparison w...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Kinetics of Torque Teno Virus-DNA Plasma Load Predict Rejection in Lung Transplant Recipients
Conclusions. In summary, TTV-DNA might be used as an additional tool to monitor immunosuppression in lung transplant recipients. Higher TTV-DNA levels reflect more intense immunosuppression, whereas the TTV-DNA kinetic (ie, decrease of TTV-DNA levels) indicate rejection. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Effect of Donor Age on Outcome of Lung Transplantation Stratified by Recipient Diagnosis: A Nordic Multicenter Study
Conclusions. The BLTx recipients with CF had inferior survival and longer ICU LOS when receiving organs from donors 55 years or older. Recipients with COPD, ILD, or in the “other” group did not have inferior survival in multivariate models. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Gender Differences in Medication Adherence Among Adolescent and Young Adult Kidney Transplant Recipients
Conclusions. Gender differences in adherence vary by age. Whereas younger adolescents show no adherence differences by gender, young women show much better adherence than young men. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Toward a Sensible Single-antigen Bead Cutoff Based on Kidney Graft Survival
Conclusions. With respect to pretransplant risk stratification, we propose a signal-to-background ratio-6 (using the bead of the same HLA-locus with lowest MFI as background) cutoff of 15 combined with an MFI cutoff of 500, resulting in 8% and 21% lower 1- and 10-year graft survivals, respectively, for 8% DSA-positive transplants. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Blood Pressure in De Novo Heart Transplant Recipients Treated With Everolimus Compared With a Cyclosporine-based Regimen: Results From the Randomized SCHEDULE Trial
Conclusions. In this first, randomized trial with early CNI avoidance in de novo HTx recipients, we observed a modest fall in systolic blood pressure over the first 1 to 3 years after transplantation. The fall in systolic blood pressure was more pronounced in patients allocated to everolimus. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Pulse Pressure and Outcome in Kidney Transplantation: Results From the Collaborative Transplant Study
Background. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) are important predictors of graft and patient survival in renal transplantation. Pulse pressure (PP), the difference between systolic and diastolic pressure, has been associated with cardiovascular and renal morbidity in nontransplant epidemiological studies and clinical trials. Methods. In this large retrospective analysis of prospectively collected data, transplant recipients from 1995 to 2015 were examined for patient and death-censored graft survival. Results. In 43 006 recipients, a higher 1-year PP was significantly associated...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Prospective Validation of Prediction Model for Kidney Discard
Conclusions. Prioritizing allocation of high-PODD kidneys to centers that are more likely to transplant them might help reduce kidney discard. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Brain Death in Asia: Do Public Views Still Influence Organ Donation in the 21st Century?
Conclusions. Taken together, our results suggest that views of brain death continue to hamper organ donation, and are seemingly resistant to both time and legislation. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Young People With Biliary Atresia Requiring Liver Transplantation: A Distinct Population Requiring Specialist Care
In this study, we review our experience of YP with BA requiring LT during adolescence and young adulthood. Methods. Retrospective, single-center review of patients with BA requiring LT> 11 years. Results. Thirty-six YP (16 male) underwent LT between 1991 and 2014 at a median age of 16.6 (interquartile range [IQR], 14.2 to 19.5) years. The commonest indications for listing were refractory cholangitis (31%), synthetic failure (25%), and variceal bleeding (14%). Patients listed by the adult team (n = 14) waited longer than those listed by the pediatric team (10 [IQR, 7.7 to 24.6] vs 5.8 [IQR, 4.0 to 15.1] months; P (...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

More Than Just Wait Time? Regional Differences in Liver Transplant Outcomes for Hepatocellular Carcinoma
Background. Regional allocation of deceased donor livers has led to variable wait times for hepatocellular carcinoma (HCC) patients on the liver transplant list. The purpose of our study was to evaluate how regional differences in wait time affect outcomes for HCC patients. Methods. A retrospective, observational study was performed using the Organ Procurement and Transplantation Network database from February 27, 2002, to September 25, 2015. The cumulative incidences of transplant and waitlist death as well as intention-to-treat and posttransplant survival were evaluated for patients 18 years or older listed for dece...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Assessing the Impact of Suboptimal Donor Characteristics on Mortality After Liver Transplantation: A Time-dependent Analysis Comparing HCC With Non-HCC Patients
Background. Patients who receive a liver transplant for hepatocellular carcinoma (HCC) often receive poorer-quality livers. Tumor recurrence also has a negative effect on posttransplant outcomes. We compared mortality of HCC and non-HCC recipients in different posttransplant time periods (epochs) to separate the impact of these different risk factors on short-term and longer-term posttransplant survival. Methods. We identified a population-based cohort of first-time liver transplant recipients (aged ≥16 years) between 2008 and 2016 in the United Kingdom. We used Cox regression to estimate hazard ratios (HRs) compar...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Impact of Donor Hepatectomy Time During Organ Procurement in Donation After Circulatory Death Liver Transplantation: The United Kingdom Experience
In this study, we analyze the impact of the time from aortic perfusion to end of hepatectomy on outcomes after DCD LT in the United Kingdom. Methods. An analysis of 1112 DCD donor LT across all UK transplant centers between 2001 and 2015 was performed, using data from the UK Transplant Registry. Donors were all Maastricht Category III. Graft survival after transplantation was estimated using Kaplan-Meier method and logistic regression to identify risk factors for primary nonfunction (PNF) and short- and long-term graft survivals after LT. Results. Incidence of PNF was 4% (40) and in multivariate analysis only cold is...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

International Liver Transplantation Society Asian Consensus on the Management of Hepatitis C Virus Infection in Resource Limited Setting—From Noncirrhotic to Decompensated Disease and After Liver Transplantation
Conclusions. With the evolving treatment landscape and addition of several new direct-acting antiviral agents and combination regimens into the therapeutic armamentarium, the current article may serve as a guide to the clinicians in optimizing the diagnosis and treatment selection for the management of chronic HCV infection in resource-limited settings. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Inhibition of Cyclin-dependent Kinase 2 Signaling Prevents Liver Ischemia and Reperfusion Injury
Conclusions. Our novel findings revealed the critical role of CDK2 in hepatic cytoprotection and homeostasis against liver IRI. As CDK2 inhibition regulated local immune response and prevented hepatocyte death, this study provided the evidence for new treatment approaches to combat IRI in liver transplant. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Basic Science—Liver Source Type: research

An Easy and Sensitive Method to Profile the Antibody Specificities of HLA–specific Memory B Cells
Conclusions. We developed a novel, highly sensitive method to assess the HLA–specific memory B–cell compartment using luminex SAB technology. This assay allows direct comparison to the serum compartment and may therefore provide a more complete picture of the humoral alloimmune response in patients with a history of alloantigen exposure. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research

mTOR Inhibitor Everolimus in Regulatory T Cell Expansion for Clinical Application in Transplantation
Conclusions. Our results support the feasibility of EVR to expand functionally competent Treg cells for their clinical use. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research

Label-free Identification of Antibody-mediated Rejection in Cardiac Allograft Biopsies Using Infrared Spectroscopic Imaging
Conclusions. In cardiac allograft biopsies with immunopathologic AMR, IR spectroscopy reveals a biochemical signature unique to AMR compared with that of nonrejecting cardiac allografts and native hearts. Future study will focus on the predictive capabilities of this IR signature. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research

Importance of Hematopoietic Mixed Chimerism for Induction of Renal Allograft Tolerance in Nonhuman Primates
Background. Although induction of durable mixed chimerism is required for murine skin allograft tolerance (TOL), renal allograft TOL has been achieved after induction of only transient mixed chimerism in nonhuman primates (NHPs) and humans. To better define the level/duration of chimerism required for stable renal allograft TOL, we retrospectively analyzed these parameters and compared them with transplant outcomes in NHP combined kidney and bone marrow transplant recipients. Methods. Peripheral blood levels and duration of myeloid or lymphoid chimerism were retrospectively analyzed in 34 NHP combined kidney and bone ...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research

Correlates and Outcomes of Low Physical Activity Posttransplant: A Systematic Review and Meta-Analysis
Conclusions. We found few studies examining most correlates and outcomes related to low PA despite growing evidence that improving PA might be an effective intervention in improving posttransplant outcomes. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Reviews Source Type: research

Chylous Ascites: Complication of Laparoscopic Donor Nephrectomy. Case Report and Review of Literature
Conclusions. Chylous ascites is a rare complication after donor nephrectomy in experienced centers. Although conservative management remains the first line of treatment, early surgical treatment shall be undertaken in cases of massive ascites. (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Reviews Source Type: research

Regulation of Endothelial-to-Mesenchymal Transition by MicroRNAs in Chronic Allograft Dysfunction
Fibrosis is a universal finding in chronic allograft dysfunction, and it is characterized by an accumulation of extracellular matrix. The precise source of the myofibroblasts responsible for matrix deposition is not understood, and pharmacological strategies for prevention or treatment of fibrosis remain limited. One source of myofibroblasts in fibrosis is an endothelial-to-mesenchymal transition (EndMT), a process first described in heart development and involving endothelial cells undergoing a phenotypic change to become more like mesenchymal cells. Recently, lineage tracing of endothelial cells in mouse models allowed s...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Reviews Source Type: research

Functional Microbiomics in Liver Transplantation: Identifying Novel Targets for Improving Allograft Outcomes
Gut dysbiosis, defined as a maladaptive gut microbial imbalance, has been demonstrated in patients with end-stage liver disease, defined as a contributor to disease progression, and associated clinically with severity of disease and liver-related morbidity and mortality. Despite this well-recognized phenomena in patients with end-stage liver disease, the impact of gut dysbiosis and its rate of recovery following liver transplantation (LT) remains incompletely understood. The mechanisms by which alterations in the gut microbiota impact allograft metabolism and immunity, both directly and indirectly, are multifactorial and r...
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Reviews Source Type: research

Custom-made Clamp Facilitating Stabilization of Cuffs in Murine Heterotopic Cervical Heart Transplantation
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: In Brief Source Type: research

Donor-derived Cell–free DNA May Confirm Real-time Response to Treatment of Acute Rejection in Renal Transplant Recipients
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: In Brief Source Type: research

Physical Activity After Solid Organ Transplantation: Comprehensive Guidance Is Needed to Advance Future Research Efforts
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Commentaries Source Type: research

The Challenges Associated With a Calcineurin Inhibitor-free Regimen After Heart Transplantation
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Commentaries Source Type: research

Pulse Pressure: A Risk Factor for Renal Transplant Failure or a Useful Therapeutic Target?
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Commentaries Source Type: research

Kinetics of TTV-DNA Plasma Load: A Global Measure of Immune Suppression?
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: Commentaries Source Type: research

What Is Hot and New in Basic Science in Liver Transplantation in 2018? Report of the Basic Science Committee of the International Liver Transplantation Society
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: In View: Meeting Report Source Type: research

First Healthy Baby After Deceased Donor Uterus Transplantation: Birth to a New Era?
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: In View: Game Changer Source Type: research

Research Highlights
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: In View: Research Highlights Source Type: research

Current State and Challenges for Organ Donation and Transplantation in Mexico
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: In View: Around the World Source Type: research

Call for an End to Unethical Transplant Practices: A Concerted Effort by the Transplant Community
No abstract available (Source: Transplantation)
Source: Transplantation - March 26, 2019 Category: Transplant Surgery Tags: In View: Special Article Source Type: research

Rapidly Growing Conjunctival Squamous Cell Carcinoma After Corneal Transplantation in a Patient With Xeroderma Pigmentosum
No abstract available (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Letter Source Type: research

Utilization and Cost Analysis of Lung Transplantation and Survival After 10 Years of Adapting the Lung Allocation Score
Background. Lungs are allocated in the United States using the lung allocation score (LAS). We investigated the effect of LAS trends on lung transplant-related costs, healthcare utilization, and mortality. Methods. Utilization data from Mayo Clinic (Florida and Minnesota) from 2005 to 2015 were obtained from the electronic health records (N = 465). Costs were categorized as 1-year posttransplant or transplant episode and standardized using 2015 Medicare reimbursement and cost-to-charge ratios. Regression analysis was used to assess the relationship of LAS to length of stay (LOS), mortality, and cost of transplant. Re...
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Open Randomized Multicenter Study to Evaluate Safety and Efficacy of Low Molecular Weight Sulfated Dextran in Islet Transplantation
Conclusions. Even with low dosing, LMW-DS showed similar efficacy in preventing IBMIR to promote islet engraftment when compared to “state-of-the art” treatment with heparin. Furthermore, no substantial differences in the efficacy and safety endpoints were detected, providing important information for future studies with more optimal dosing of LMW-DS for the prevention of IBMIR in islet transplantation. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Protocol Duodenal Graft Biopsies Aid Pancreas Graft Surveillance
Conclusions. Protocol graft duodenal biopsies detect complications after whole-organ pancreas transplantation, are useful in guiding therapy, and carry potential for improving outcome. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Deep Profiling of the CD8+ T-cell Compartment Identifies Activated Cell Subsets and Multifunctional Responses Associated With Control of Cytomegalovirus Viremia
Conclusions. Uncontrolled CMV viremia is associated with specific clusters of memory T-cell subsets and lower frequencies of HCMV-specific multifunctional CD8+ T cells. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Reduced Risk of BK Polyomavirus Infection in HLA-B51–positive Kidney Transplant Recipients
Conclusions. In conclusion, HLA-B51-positive kidney transplant recipients were less susceptible to BKPyV infection, which might be explained by efficient presentation of a particular BKPyV-derived immunogenic peptide. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Comparison of Two Luminex Single-antigen Bead Flow Cytometry Assays for Detection of Donor-specific Antibodies After Renal Transplantation
Conclusions. We report the first comparative study of the 2 Luminex assays available for detecting DSA in the postkidney transplant setting. Although there is a good correlation and reliability between the 2 assays, significant differences exist. Positivity criteria for DSA determination differ and interpretation should take these specificities into account. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Elevated Risk of Cancer After Solid Organ Transplant in Childhood: A Population-based Cohort Study
Conclusions. Childhood transplant recipients have a 30 times greater cancer incidence versus the general population. Further investigation is needed to guide screening strategies in this at-risk population. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Pretransplant Cancer in Kidney Recipients in Relation to Recurrent and De Novo Cancer Incidence Posttransplantation and Implications for Graft and Patient Survival
Background. Whether kidney transplant recipients who were treated for a malignant tumor before transplantation are at an increased risk of developing a tumor posttransplantation has not been adequately quantified and characterized. Methods. We studied more than 270 000 patients on whom pretransplant and posttransplant malignancy data were reported to the Collaborative Transplant Study. More than 4000 of these patients were treated for pretransplant malignancy. The posttransplant tumor incidence in these patients was compared to that in recipients without a pretransplant tumor. Cox regression, considering multip...
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

How Should Social Media Be Used in Transplantation? A Survey of the American Society of Transplant Surgeons
Background. Social media platforms are increasingly used in surgery and have shown promise as effective tools to promote deceased donation and expand living donor transplantation. There is a growing need to understand how social media-driven communication is perceived by providers in the field of transplantation. Methods. We surveyed 299 members of the American Society of Transplant Surgeons about their use of, attitudes toward, and perceptions of social media and analyzed relationships between responses and participant characteristics. Results. Respondents used social media to communicate with: family and friends ...
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Measurement Characteristics of the Knowledge Assessment of Renal Transplantation
This article describes the development and psychometric testing of the Knowledge Assessment of Renal Transplantation (KART). Methods. We administered 17 transplant knowledge items to a sample of 1294 ESRD patients. Item characteristics and scale scores were estimated using an Item Response Theory graded response model. Construct validity was tested by examining differences in scale scores between patients who had spent less than 1 and 1 hour or longer receiving various types of transplant education. Results. Item Response Theory modeling suggested that 15 items should be retained for the KART. This scale had a margin...
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Intensive Care to Facilitate Organ Donation: A Report on the Experience of 2 Spanish Centers With a Common Protocol
Conclusions. ICOD is well accepted by families. Most patients evolve to BD within a short period of time. The practice substantially contributes to increasing organ donation and offers more patients the chance of donating their organs after death. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Split Liver Transplantation and Pediatric Waitlist Mortality in the United States: Potential for Improvement
Conclusions. This comparison, although not conclusive, suggests that we might be missing opportunities to reduce pediatric waitlist mortality without decreasing access for adults—using split liver transplant. Barriers are significant, but further work on strategies to increase split liver transplant is warranted. (Source: Transplantation)
Source: Transplantation - February 27, 2019 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research