4,108 results match your criteria Clinical Transplantation[Journal]


Arenaviruses and West Nile Virus in Solid Organ Transplant Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Apr 25:e13576. Epub 2019 Apr 25.

Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the epidemiology, diagnosis, prevention, and management of infection due to Arenaviruses and West Nile Virus (WNV) in the pre- and post-transplant period. Arenaviruses and WNV have been identified as causes of both donor-derived and post-transplant infection. Most data related to these infections have been published in case reports and case series. Read More

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April 2019
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Human T-Cell Lymphotrophic Virus in Solid Organ Transplant Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Apr 25:e13575. Epub 2019 Apr 25.

Department of Pediatrics, Division of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, Boston, MA.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention and management of Human T-cell lymphotrophic virus 1 (HTLV)-1 in the pre- and post-transplant period. HTLV-1 is an oncogenic human retrovirus rare in North America but endemic in the Caribbean and parts of Africa, South America, Asia, and Oceania. While most infected persons do not develop disease, <5% will develop adult T cell leukemia/lymphoma or neurological disease. Read More

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April 2019
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From embryonic stem cells to induced pluripotent stem cells - ready for clinical therapy?

Authors:
Jing Hu Jimei Wang

Clin Transplant 2019 Apr 23:e13573. Epub 2019 Apr 23.

Neonatal department, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China.

Embryonic stem cells and induced pluripotent stem cells have increasingly important roles in many different fields of research and medicine. Major areas of impact include improved in vitro disease models, drug screening, and the development of cell-based clinical therapies. Here we review the generation and uses of embryonic stem cells compared to induced pluripotent stem cells, and discuss their advantages and limitations. Read More

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HBcrAg to detect HBV reactivation in heart transplant recipients with past HBV infection: a pilot study.

Clin Transplant 2019 Apr 23:e13574. Epub 2019 Apr 23.

Internal Medicine, University of Campania "L. Vanvitelli", Naples, Italy.

Hepatitis B core-related antigen (HBcrAg) has been proposed as a new marker of HBV replication. We analyzed HBcrAg dynamics in 15 heart transplant recipients with active or prior HBV infection and correlated it with quantitative (QT)-HBsAg and HBV-DNA pre- and post-transplant. Serum HBcrAg was detected in HBsAg/HBV-DNA-positive subjects but not in recipients with past HBV infection. Read More

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Sex differences in preformed panel reactive antibody levels and outcomes in patients undergoing heart transplantation.

Clin Transplant 2019 Apr 22:e13572. Epub 2019 Apr 22.

Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.

Background: Sex differences in panel reactive antibody (PRA) levels in heart transplant recipients and their association with transplant-related outcomes are mostly unknown.

Methods: In 20,181 (24.7% women) first time heart transplant recipients included from July 2004 to March 2015 in the prospective Organ Procurement and Transplantation Network (OPTN), we studied sex differences in most recent (mr) and peak (p) PRA and outcomes (graft failure, rejection, cardiac allograft vasculopathy [CAV], retransplantation, mortality). Read More

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Will robots take over?

Authors:
Baris D Yildiz

Clin Transplant 2019 Apr 23:e13558. Epub 2019 Apr 23.

Ankara Numune Teaching Hospital General Surgery, Sihhiye, Ankara, Turkey.

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Long-term Outcome of Percutaneous Transhepatic Biliary Drainage for Biliary Strictures Following Pediatric Liver Transplantation.

Clin Transplant 2019 Apr 21:e13570. Epub 2019 Apr 21.

Department of Transplant Surgery, Jichi Medical University.

Background: We present a retrospective analysis of our experience with pediatric liver transplantation (LT), focusing on the long-term outcome of percutaneous transhepatic biliary drainage (PTBD) for post-transplant biliary strictures.

Methods: Fifty-three PTBDs were performed for 41 pediatric recipients with biliary strictures. The median ages at LT and PTBD were 1. Read More

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April 2019
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Corticosteroids and Methotrexate as Adjuvants to Costimulation Blockade in Nonhuman Primate Renal Transplantation.

Clin Transplant 2019 Apr 21:e13568. Epub 2019 Apr 21.

Emory Transplant Center, Emory University, Atlanta, GA.

Belatacept, the CD28-B7 costimulation pathway inhibitor, has been approved as a calcineurin inhibitor (CNI) alternative in kidney transplantation. Although costimulation blockade (CoB) allows for CNI avoidance, it is associated with increased rates of early rejection, prompting a search for agents to pair with belatacept. Methotrexate (MTX) is an antimetabolite that has been found to be complimentary with abatacept, a lower affinity CD28-B7-specific analogue of belatacept, in the treatment of rheumatoid arthritis (RA). Read More

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Factors Predicting Kidney Delayed Graft Function Among Recipients of Simultaneous Liver-Kidney Transplantation: Single Center Experience.

Clin Transplant 2019 Apr 21:e13569. Epub 2019 Apr 21.

Division of Transplantation and Hepatobiliary Surgery, University of Florida, FL, USA.

Background: Kidney delayed graft function (kDGF) remains a challenging problem following simultaneous liver and kidney transplantation (SLKT) with a reported incidence up to 40%. Given the scarcity of renal allografts, it is crucial to minimize the development of kDGF among SLKT recipients to improve patient and graft outcomes. We sought to assess the role of preoperative recipient and donor/graft factors on developing kDGF among recipients of SLKT. Read More

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April 2019
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Determine safety of outpatient chemotherapy and autotransplants using refrigerated, non-frozen grafts in persons with multiple sclerosis.

Clin Transplant 2019 Apr 20:e13567. Epub 2019 Apr 20.

Centro de Hematología y Medicina Interna de Puebla, Puebla, México.

Persons with multiple sclerosis (MS) are sometimes treated with intermediate- or high-dose chemotherapy and an autotransplant (1, 2). More than 1000 autotransplants are reported with MS (2-6) but use of autotransplants may be substantially more common as many cases are not reported. Recent data from a small randomized trial of less-intensive chemotherapy reported better outcomes with this approach compared with disease-modifying therapy in persons with advanced relapsing-remitting MS (7). Read More

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Management of Clostridioides (formerly Clostridium) difficile infection (CDI) in Solid Organ Transplant Recipients: Guidelines from the American Society of Transplantation Community of Practice.

Clin Transplant 2019 Apr 19:e13564. Epub 2019 Apr 19.

Department of Medicine, Washington University School of Medicine, St. Louis, MO.

These updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice address the prevention and management of Clostridium difficile infection in solid organ transplant (SOT) recipients. Clostridioides (formerly Clostridium) difficile infection (CDI) is among the most common hospital acquired infections. In SOT recipients the incidence of CDI varies by type and number or organs transplanted. Read More

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Vaccination of Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Apr 19:e13563. Epub 2019 Apr 19.

Transplant Infectious Diseases, University Health Network, Toronto, ON.

These updated guidelines of the AST IDCOP review vaccination of solid organ transplant candidates and recipients. General principles of vaccination as well as the use of specific vaccines in this population are discussed. Vaccination should be reviewed in the pre-transplant setting and appropriate vaccines updated. Read More

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Substance use in kidney transplant candidates and its impact on access to kidney transplantation.

Clin Transplant 2019 Apr 19:e13565. Epub 2019 Apr 19.

Division of Nephrology, Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada.

Background: Due to the increasing public acceptance of substance use, it is important to understand the association between substance use and access to kidney transplant and its outcomes. Here we assess the sociodemographic predictors of substance use and the association between substance use and KT access.

Methods: Predictors of substance use were examined using a multivariable-adjusted multinomial logistic regression. Read More

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April 2019
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Nutrition-related factors associated with waiting list mortality in patients with interstitial lung disease: a retrospective cohort study.

Clin Transplant 2019 Apr 19:e13566. Epub 2019 Apr 19.

Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto, Japan.

Japanese patients with interstitial lung disease (ILD) sometimes die waiting for lung transplantation (LTx) because it takes about 2 years to receive it in Japan. We evaluated nutrition-related factors associated with waiting list mortality. Seventy-six ILD patients were hospitalized in Kyoto University Hospital at registration for LTx from 2013 to 2015. Read More

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April 2019
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Deceased Organ Donor Factors Influencing Pancreatic Graft Transplantation and Survival.

Clin Transplant 2019 Apr 18:e13571. Epub 2019 Apr 18.

VA Portland Health Care System, Operative Care Division, Section of Surgical Critical Care, Portland, OR.

Criteria for organ acceptance in brain dead organ donors remain inconsistent, especially when concerning pancreatic transplants. We sought to examine donor-specific predictors of pancreatic graft use and survival to better guide the selection and management of potential donors. A prospective observational study of all donors from ten organ procurement organizations was conducted from March 2012 to January 2015. Read More

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April 2019
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In Memoriam-Oscar Salvatierra, Jr., MD.

Clin Transplant 2019 Apr;33(4):e13551

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April 2019
2 Reads

Human parvovirus B19 in solid organ transplantation: Guidelines from the American society of transplantation infectious diseases community of practice.

Clin Transplant 2019 Apr 11:e13535. Epub 2019 Apr 11.

Department of Pediatrics, Infectious Diseases and Host Defense, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.

Clinical manifestations of human parvovirus B19 infection can vary widely and may be atypical in solid organ transplant (SOT) recipients. However, disease is apparent when there is destruction of erythrocyte progenitor cells leading to severe acute or chronic anemia with lack of an appropriate reticulocyte response in the setting of active parvovirus B19 infection. Serology may not reliably establish the diagnosis. Read More

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April 2019
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Urothelial carcinoma arising from the transplanted kidney: A single-center experience and literature review.

Clin Transplant 2019 Apr 3:e13559. Epub 2019 Apr 3.

Department of Urology, Imperial College Healthcare NHS Trust, London, UK.

Urothelial carcinoma (UC) is a malignancy predominantly arising in the bladder. Upper tract UC (UUC) is uncommon, accounting only for 5-10% of the cases. High incidence of neoplasms is associated with immunosuppressive therapy; thus, UCs of the transplanted grafts often lead to a more aggressive treatment, in order to withdraw completely the immunosuppression. Read More

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April 2019
2 Reads

Long-term results of desensitization protocol with and without rituximab in sensitized kidney transplant recipients.

Clin Transplant 2019 Apr 2:e13562. Epub 2019 Apr 2.

Sackler School of Medicine, Tel-Aviv University, Tel-aviv, Israel.

Background: Desensitization protocols have been developed in order to overcome the immunological barrier of donor-specific anti-HLA antibodies (DSA).

Methods: During 2006-2012, we implemented a program for desensitizing sensitized (positive DSA, negative NIH-CDC crossmatch) living-donor recipients. The long-term outcome of 36 sensitized recipients, treated with IVIG and plasmapheresis (PP), with or without rituximab (added when > 7500 MFI), was compared to 252 non-sensitized living-donor recipients. Read More

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April 2019
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Expanding the horizons: uncontrolled donors after circulatory death for lung transplantation. first comparison with brain death donors.

Clin Transplant 2019 Apr 2:e13561. Epub 2019 Apr 2.

Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.

Uncontrolled donation after cardiac death is an appealing source of organs for lung transplantation. We compare early and long-term outcomes of lung transplantation with these donors with a cohort of transplants from brain death donors at our institution. Retrospective analysis of all lung transplantations performed from 2002-2012. Read More

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April 2019
7 Reads
1.486 Impact Factor

Clinical outcomes of polyvalent immunoglobulin use in solid organ transplant recipients: A systematic review and meta-analysis.

Clin Transplant 2019 Apr 2:e13560. Epub 2019 Apr 2.

Division of General Internal Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Polyvalent immunoglobulin is commonly used for desensitization and treatment of antibody-mediated rejection in kidney transplantation but its impact on other outcomes is not known. This systematic review investigated the impact of immunoglobulin prophylaxis on infection, rejection, graft loss, and death following kidney transplantation. A comprehensive literature search located 18 studies (n = 8 randomized controlled trials). Read More

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http://dx.doi.org/10.1111/ctr.13560DOI Listing
April 2019
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Management of primary graft failure after heart transplantation: Preoperative risks, perioperative events, and postoperative decisions.

Clin Transplant 2019 Apr 1:e13557. Epub 2019 Apr 1.

Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York.

Primary graft failure (PGF) after heart transplantation (HT) is a devastating and unexpected event characterized by failure of the graft to adequately support recipient circulation necessitating high doses of vasopressors and inotropes and/or temporary mechanical circulatory support. Although it represents an increasingly common event in the current era, there remains a high degree of variability in prevalence, reported risk factors, and approach to this clinical entity. The purpose of the current review is to highlight preoperative considerations including known incidence and risk factors, perioperative issues involving the identification and management of PGF, and postoperative decisions related to weaning of mechanical circulatory support and titration of immunosuppressive therapy. Read More

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April 2019
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The impact of post-transplant diabetes mellitus on liver transplant outcomes.

Clin Transplant 2019 Mar 29:e13554. Epub 2019 Mar 29.

Division of Gastroenterology and Hepatology, Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina.

Background: Post-transplant diabetes mellitus (PTDM) is common after liver transplantation (LT). Yet, how PTDM relates to graft outcomes and survival needs elucidation as more individuals are transplanted for nonalcoholic fatty liver disease (NAFLD).

Methods: This single-center, retrospective study of adult LT recipients (2003-2016) identified PTDM incidence and associations with graft steatosis, rejection, and post-LT patient survival. Read More

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March 2019
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Insights into Gene Expression Profile Scores and Rejection in Simultaneous Heart-Kidney Transplant Patients.

Clin Transplant 2019 Mar 29:e13555. Epub 2019 Mar 29.

Department of Cardiology, Mid America Heart Institute, Saint Luke's Hospital, Kansas City, Missouri.

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Endemic fungal infections in solid organ transplant recipients-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 29:e13553. Epub 2019 Mar 29.

Department of Internal Medicine, University of Kansas School of Medicine Wichita, Wichita, Kansas.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention and management of blastomycosis, histoplasmosis, and coccidioidomycosis in the pre- and post-transplant period. Though each of these endemic fungal infections has unique epidemiology and clinical manifestations, they all share a predilection for primary pulmonary infection and may cause disseminated infection, particularly in immunocompromised hosts. Culture remains the gold standard for definitive diagnosis, but more rapid diagnosis may be achieved with direct visualization of organisms from clinical specimens and antigen-based enzyme immunoassay assays. Read More

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March 2019
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Ventricular Assist Device Related Infections and Solid Organ Transplantation - Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 29:e13552. Epub 2019 Mar 29.

Medicine and Surgery, Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 900, Chicago, IL, 60611.

The Infectious Diseases Community of Practice of the American Society of Transplantation has published evidenced based guidelines on the prevention and management of infectious complications in SOT recipients since 2004. This updated guideline reviews the epidemiology of VAD infections and provides recommendations for the management and prevention of these infections. Almost one half of those awaiting heart transplantation are supported with ventricular assist devices (VADs). Read More

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March 2019
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Diagnosis and management of diarrhea in solid-organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 26:e13550. Epub 2019 Mar 26.

Department of Medicine, The Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.

These guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of diarrhea in the pre- and post-transplant period. Diarrhea in an organ transplant recipient may result in significant morbidity including dehydration, increased toxicity of medications, and rejection. Transplant recipients are affected by a wide range of etiologies of diarrhea with the most common causes being Clostridioides (formerly Clostridium) difficile infection, cytomegalovirus, and norovirus. Read More

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March 2019
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Vancomycin-Resistant Enterococcus in Solid Organ Transplant Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 26:e13549. Epub 2019 Mar 26.

Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation address vancomycin-resistant enterococci (VRE) infections in SOT candidates and recipients. VRE are an important cause of infection and have been named by the CDC as a serious public threat. Typically, a commensal of the gastrointestinal tract, VRE may become pathogenic after abdominal organ manipulation like transplantation. Read More

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March 2019
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Donor-derived infections: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 23:e13547. Epub 2019 Mar 23.

Divisions of Infectious Diseases & Organ Transplantation, Northwestern University Feinberg School of Medicine, Northwestern University Comprehensive Transplant Center, Chicago, Illinois.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation will review the current state of the art of donor-derived infections. Specifically, the guideline will summarize standardized definitions and approaches to defining imputability, updated data on the epidemiology of donor-derived infections, and approaches to risk mitigation against transmission of infections. This update will additionally provide guidance on the use of HIV+ donors in HIV+ recipients, the use of HCV-viremic donors in non-viremic recipients, donors with endemic infections, and donors with bacteremia, meningitis, and encephalitis. Read More

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March 2019
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Screening of Donor and Candidate Prior to Solid Organ Transplantation - Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 21:e13548. Epub 2019 Mar 21.

Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, 800 Washington Street, Box 238, 02111.

This updated section of the guideline from the Infectious Diseases Community of Practice of the American Society of Transplantation reviews the screening of donor and candidate prior to solid organ transplantation. Screening of donor and candidate is vital for optimizing post-transplant outcomes. Risk assessment based on detailed history and appropriate diagnostic evaluation is vital. Read More

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March 2019
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Cryptococcosis in solid organ transplantation-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 22:e13543. Epub 2019 Mar 22.

VA Portland Healthcare System, Portland, Oregon.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of cryptococcosis in the pre- and post-transplant period. The current update now includes a discussion of cryptococcosis, which is the third most common invasive fungal infection in SOT recipients. Infection often occurs a year after transplantation; however, early infections occur and donor-derived infections have been described within 3 months after transplant. Read More

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March 2019
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Invasive Aspergillosis in solid-organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 21:e13544. Epub 2019 Mar 21.

Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida.

These updated AST-IDCOP guidelines provide information on epidemiology, diagnosis, and management of Aspergillus after organ transplantation. Aspergillus is the most common invasive mold infection in solid-organ transplant (SOT) recipients, and it is the most common invasive fungal infection among lung transplant recipients. Time from transplant to diagnosis of invasive aspergillosis (IA) is variable, but most cases present within the first year post-transplant, with shortest time to onset among liver and heart transplant recipients. Read More

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March 2019
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Tissue and Blood Protozoa including Toxoplasmosis, Chagas disease, Leishmaniasis, Babesia, Acanthamoeba, Balamuthia, & Naegleria in Solid Organ Transplant Recipients - Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation.

Clin Transplant 2019 Mar 21:e13546. Epub 2019 Mar 21.

Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention and management of tissue and blood protozoal infections in the pre- and post-transplant period. Significant new developments in the field have made it necessary to divide the previous single guideline published in 2013 into two sections, with the intestinal parasites separated from this guideline devoted to tissue and blood protozoa. The current update reflects the increased focus on donor screening and risk-based recipient monitoring for parasitic infections. Read More

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March 2019
8 Reads

Pneumonia in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

Clin Transplant 2019 Mar 21:e13545. Epub 2019 Mar 21.

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zürich, Switzerland.

These guidelines from the AST Infectious Diseases Community of Practice review the diagnosis and management of pneumonia in the post-transplant period. Clinical presentations and differential diagnosis for pneumonia in the solid organ transplant recipient are reviewed. A two-tier approach is proposed based on the net state of immunosuppression and the severity of presentation. Read More

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March 2019
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Short-term outcomes of en bloc combined heart and liver transplantation in the failing Fontan.

Clin Transplant 2019 Mar 20:e13540. Epub 2019 Mar 20.

Department of Pediatrics, Division of Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, California.

Patients with failing Fontan physiology and liver cirrhosis are being considered for combined heart and liver transplantation. We performed a retrospective review of our experience with en bloc combined heart and liver transplantation in Fontan patients > 10 years old from 2006 to 18 per Institutional Review Board approval. Six females and 3 males (median age 20. Read More

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http://dx.doi.org/10.1111/ctr.13540DOI Listing
March 2019
4 Reads

The Impact of Intraoperative Fluid Management During Laparoscopic Donor Nephrectomy on Donor and Recipient Outcomes.

Clin Transplant 2019 Mar 19:e13542. Epub 2019 Mar 19.

Department of Surgery, Division of Transplantation, University of Michigan, Ann Arbor, MI, USA.

Background: Intraoperative fluid management during laparoscopic donor nephrectomy (LDN) may have a significant effect on donor and recipient outcomes. We sought to quantify variability in fluid management and investigate its impact on donor and recipient outcomes.

Methods: A retrospective review of patients who underwent LDN from July 2011 to January 2016 with paired kidney recipients at a single center was performed. Read More

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March 2019
4 Reads
1.486 Impact Factor

Single-center, real-world experience with granulocyte colony-stimulating factor for management of leukopenia following kidney transplantation.

Clin Transplant 2019 Mar 19:e13541. Epub 2019 Mar 19.

Department of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

Background: Leukopenia is a frequent complication following kidney transplantation. Granulocyte colony-stimulating factor (G-CSF) has been used to accelerate white blood cell (WBC) count recovery; however, published experience in kidney transplantation is limited.

Methods: We retrospectively reviewed our kidney transplant recipients from January 2012 to September 2016 with a G-CSF order to evaluate leukopenia management (defined as WBC <3000 cells/μL). Read More

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March 2019
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Delivery of transplant care among Hmong kidney transplant recipients: Outcomes from a single institution.

Clin Transplant 2019 Mar 18:e13539. Epub 2019 Mar 18.

Division of Transplantation, Department of Surgery, Minneapolis, Minnesota.

Kidney transplantation entails well-coordinated complex care delivery. Patient-provider cultural and linguistic discordance can lead to healthcare disparities. We analyzed kidney transplantation outcomes among our institution's Hmong recipients using a retrospective cohort study. Read More

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The importance of graft cell composition in outcome after allogeneic stem cell transplantation in patients with malignant disease.

Clin Transplant 2019 Mar 15:e13537. Epub 2019 Mar 15.

Department of Clinical Research Center, Karolinska Institute, Stockholm, Sweden.

Background: Graft-versus-host disease (GVHD) and relapse remain major obstacles for treatment success in allogeneic hematopoietic stem cell transplantation (HSCT). In the present study, we evaluated the immune cell profile of the graft to outcome after HSCT.

Study Design And Method: Flow cytometry data of graft cell subsets [CD34+, CD3+, CD19+, CD4+, CD8+, CD3-CD56+CD16+, CD4+CD127 CD25 ] from G-CSF primed peripheral blood stem cell (PBSC) donors was collected retrospectively from 299 patients with hematological malignancies undergoing HSCT between 2006 and 2013. Read More

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Extracorporeal membrane oxygenation as a salvage therapy for patients with severe primary graft dysfunction after heart transplant.

Clin Transplant 2019 Mar 14:e13538. Epub 2019 Mar 14.

Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.

Background: Severe primary graft dysfunction (PGD) is the leading cause of early death after heart transplant.

Aim: To examine the outcomes of heart transplant recipients who received venoarterial extracorporeal membrane oxygenation (VA-ECMO) for severe PGD.

Methods: We reviewed electronic health records of adult patients who underwent heart transplant from November 2005 through June 2015. Read More

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http://dx.doi.org/10.1111/ctr.13538DOI Listing
March 2019
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Evaluation of outcomes in renal transplantation with hypothermic machine perfusion for the preservation of kidneys from expanded criteria donors.

Clin Transplant 2019 Mar 14:e13536. Epub 2019 Mar 14.

Agence de la Biomédecine, Direction Prélèvement Greffe Organes-Tissus, Saint-Denis La Plaine, France.

In 2012, an expert working group from the French Transplant Health Authority recommended the use of hypothermic machine perfusion (HMP) to improve kidney preservation and transplant outcomes from expanded criteria donors, deceased after brain death. This study compares HMP and cold storage (CS) effects on delayed graft function (DGF) and transplant outcomes. We identified 4,316 kidney transplants from expanded criteria donors (2011-2014) in France through the French Transplant Registry. Read More

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http://dx.doi.org/10.1111/ctr.13536DOI Listing

Alemtuzumab induction and belatacept maintenance in marginal pathology renal allografts.

Clin Transplant 2019 Mar 13:e13531. Epub 2019 Mar 13.

Department of Transplant, University of Maryland School of Medicine, Baltimore, Maryland.

We performed a prospective, 12-month, single-center, nonrandomized, open-label pilot study to investigate the use of belatacept therapy combined with alemtuzumab induction in renal allografts with preexisting pathology, as these kidneys may be more susceptible to additional toxicity when exposed to calcineurin inhibitors posttransplant. Nineteen belatacept recipients were matched retrospectively to a cohort of tacrolimus recipients on the basis of preimplantation pathology. The estimated glomerular filtration rate was not significantly different between belatacept and tacrolimus recipients at either 3 or 12 months posttransplant (59 vs 45, P = 0. Read More

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http://dx.doi.org/10.1111/ctr.13531DOI Listing

Clinical outcomes in HIV+/HCV+ coinfected kidney transplant recipients in the pre- and post-direct-acting antiviral therapy eras: 10-Year single center experience.

Clin Transplant 2019 Mar 13:e13532. Epub 2019 Mar 13.

Division of Nephrology, Department of Medicine, University of Miami Miller School of Medicine Miami, Florida.

Background: Previous studies have demonstrated inferior patient and graft survival following kidney transplant (KT) in HIV+/HCV+ coinfected patients compared to HIV+/HCV- recipients. However, these studies were conducted prior to the availability of direct-acting antiviral (DAA) agents and data in the modern era are lacking.

Methods: Single center retrospective study of HIV+/HCV+ coinfected KT recipients (2007-2017). Read More

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http://doi.wiley.com/10.1111/ctr.13532
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http://dx.doi.org/10.1111/ctr.13532DOI Listing
March 2019
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Decision support needs of kidney transplant candidates regarding the deceased donor waiting list: A qualitative study and conceptual framework.

Clin Transplant 2019 Mar 13:e13530. Epub 2019 Mar 13.

Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, Minnesota.

Background: Kidney transplant candidates face complex decisions about transplant options such as living donation or acceptance of lower quality kidneys. We sought to characterize knowledge and decision support needs regarding kidney transplant outcomes and options.

Methods: We conducted 10 interviews and four focus groups of 28 adult kidney transplant candidates from two centers in Minnesota. Read More

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http://dx.doi.org/10.1111/ctr.13530DOI Listing

The results of HLA-incompatible kidney transplantation according to pre-transplant crossmatch tests: Donor-specific antibody as a prominent predictor of acute rejection.

Clin Transplant 2019 Mar 12:e13533. Epub 2019 Mar 12.

Division of Kidney & Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: Crossmatching (XM) between organ donors and recipients is correlated with clinical outcomes. This study evaluates the results of HLA-incompatible kidney transplant (HLA-i KT) according to pre-transplant XM modalities.

Methods: This study included 731 consecutive patients. Read More

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http://dx.doi.org/10.1111/ctr.13533DOI Listing
March 2019
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Higher rates of rejection in HIV-infected kidney transplant recipients on ritonavir-boosted protease inhibitors: 3-year follow-up study.

Clin Transplant 2019 Mar 12:e13534. Epub 2019 Mar 12.

The Mount Sinai Hospital, New York, New York.

Rejection rates in HIV-infected kidney transplant (KTx) recipients are higher than HIV-negative recipients. Immunosuppression and highly active antiretroviral therapy (HAART) protocols vary with potentially significant drug-drug interactions, likely influencing outcomes. This is an IRB-approved, single-center, retrospective study of adult HIV-infected KTx patients between 5/2009 and 12/2014 with 3-year follow-up, excluding antibody-depleting induction. Read More

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http://dx.doi.org/10.1111/ctr.13534DOI Listing
March 2019
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A single-center analysis of early readmission after renal transplantation.

Clin Transplant 2019 Mar 12:e13520. Epub 2019 Mar 12.

Division of Organ Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Background: Thirty-day readmission rates (early hospital readmission, EHR) are an important benchmark for quality improvement. Nationally, patients undergoing renal transplantation incur a 31% EHR rate. While national databases provide useful data, the impact of EHR on individual centers has received little attention. Read More

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http://doi.wiley.com/10.1111/ctr.13520
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http://dx.doi.org/10.1111/ctr.13520DOI Listing
March 2019
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Characteristics, risks, and outcomes of post-transplant lymphoproliferative disease >3 years after pediatric heart transplant: A multicenter analysis.

Clin Transplant 2019 Mar 12:e13521. Epub 2019 Mar 12.

Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.

Post-transplant lymphoproliferative disorder (PTLD) is a significant complication after pediatric heart transplantation (HT), occurring in 5%-15% of patients within 3 years. Data >3 years from HT are limited. We sought to describe the prevalence, risk factors, and outcomes of PTLD occurring late (>3 years) after pediatric HT in the Pediatric Heart Transplant Study from 1993 to 2010. Read More

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http://dx.doi.org/10.1111/ctr.13521DOI Listing
March 2019
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How patients choose kidney transplant centers: A qualitative study of patient experiences.

Clin Transplant 2019 Mar 12:e13523. Epub 2019 Mar 12.

Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.

Little is known about how patients make the critical decision of choosing a transplant center. In the United States, acceptance criteria, waiting times, and mortality vary significantly by geography and center. We sought to understand patients' experiences and perspectives when selecting transplant centers. Read More

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http://dx.doi.org/10.1111/ctr.13523DOI Listing
March 2019
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Hospital admissions and emergency department visits among kidney transplant recipients.

Clin Transplant 2019 Mar 12:e13522. Epub 2019 Mar 12.

Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.

Reducing acute care utilization is a means of improving long-term patient outcomes. We sought to assess high inpatient (IP) admission and standalone emergency department (ED) utilization within a 9-month period post-kidney transplantation and to identify mutable factors to reduce utilization. In this ten-year retrospective study, 1599 adult kidney transplant recipients were identified. Read More

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http://dx.doi.org/10.1111/ctr.13522DOI Listing
March 2019
2 Reads