1,213 results match your criteria Current Opinion in Organ Transplantation[Journal]


Current status of graft-versus-host disease after intestinal transplantation.

Curr Opin Organ Transplant 2019 Feb 11. Epub 2019 Feb 11.

Division of Pediatric Transplantation, Department of Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Thomas E. Starzl Transplant Institute, University of Pittsburgh School of Medicine, Pittsburgh, USA.

Purpose Of Review: Over the past decades, visceral transplantation has become the standard of care for patients with irreversible intestinal failure who suffer complications of total parenteral nutrition (TPN). Graft-versus-host disease (GVHD) after solid organ transplantation is a rare but often fatal complication with high mortality. GVHD after intestinal transplantation, given the large lymphoid content of the graft, is more frequent compared with other solid organs. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000624DOI Listing
February 2019
6 Reads

Current status of lipid emulsions in the prevention of intestinal failure-associated liver disease.

Curr Opin Organ Transplant 2019 Feb 11. Epub 2019 Feb 11.

Department of Gastroenterology, Hepatology, and Nutrition, Children's Mercy.

Purpose Of Review: The current review provides a summary of available lipid products and discusses current literature and the limitations to the use of various lipid products for treatment and prevention of intestinal failure-associated liver disease (IFALD) in pediatric patients dependent on parenteral nutrition.

Recent Findings: Improvements in markers of cholestasis and liver function have been seen with minimizing soybean lipid, fish oil lipid, and mixed fish oil-containing lipid emulsions. Soybean-based lipid products are thought to be the biggest contributor to development of IFALD. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000620DOI Listing
February 2019

Contemporary management of hepatoblastoma.

Curr Opin Organ Transplant 2019 Feb 11. Epub 2019 Feb 11.

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Purpose Of Review: Hepatoblastoma is the most common primary pediatric liver malignancy. The goal of treatment in hepatoblastoma is complete surgical resection. Recently published multinational collaborative studies are better defining risk factors for disease recurrence and guide optimal treatment strategy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000618DOI Listing
February 2019
1 Read

Financial compensation for organ donors.

Curr Opin Organ Transplant 2019 Feb 11. Epub 2019 Feb 11.

Division of Transplant Surgery, Department of Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.

Purpose Of Review: With an increasing demand for donor organs, strategies to increase the number of available donor organs have become more focused. Compensating donors for donation is one strategy proposed to increase the availability of organs for transplant. This has been implemented in several systems internationally, but debate continues in the United States with respect to appropriate strategies. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000617DOI Listing
February 2019

Intraoperative anesthetic management of the liver transplant recipient with portopulmonary hypertension.

Authors:
Sherif Kandil

Curr Opin Organ Transplant 2019 Feb 11. Epub 2019 Feb 11.

Department of Anesthesiology, Keck Medical School of USC, Los Angeles, California, USA.

Purpose Of Review: Liver transplantation in patients with portopulmonary hypertension (POPH) is associated with increased perioperative risk. Important recent advances in the management of liver transplantation recipients with POPH are discussed.

Recent Findings: The presence of POPH at the time of liver transplantation should not be a contraindication for liver transplantation, as POPH is common and may be related to volume overload and/or high cardiac output (CO). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000613DOI Listing
February 2019

Advances in clinical liver transplantation: expanding indications and improving peri- and post-transplant care.

Curr Opin Organ Transplant 2019 Feb 5. Epub 2019 Feb 5.

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000626DOI Listing
February 2019

Evolving swaps in transplantation: global exchange, vouchers, liver, and trans-organ paired exchange.

Curr Opin Organ Transplant 2019 Feb 5. Epub 2019 Feb 5.

Department of Surgery, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Purpose Of Review: With the ongoing organ shortage, several mechanisms to facilitate organ exchanges and expand the scope of living kidney or liver donation have been proposed. Although each addresses at least one barrier to transplantation, these innovative programs raise important ethical, logistical, and regulatory considerations.

Recent Findings: This review addresses four recent proposals to expand living donor transplantation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000621DOI Listing
February 2019

Donor-specific antibody management in intestine transplantation: hope for improving the long-term durability of the intestine allograft?

Curr Opin Organ Transplant 2019 Jan 28. Epub 2019 Jan 28.

MedStar Georgetown University Hospital, MedStar Georgetown Transplant Institute, Washington, DC.

Purpose Of Review: In this review, we appraise the current status of donor-specific antibody (DSA) monitoring and treatment in the literature and highlight the current challenges in DSA management for the intestine transplant community.

Recent Findings: Sensitizing events are common in patients referred for intestinal transplant, as these patients universally are repeatedly exposed to immune activation and inflammatory events. Both preformed and de novo DSA have been shown to increase rejection and graft loss in intestine recipients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000619DOI Listing
January 2019
1 Read

The devil is in the detail: current management of perioperative surgical complications after liver transplantation.

Curr Opin Organ Transplant 2019 Jan 28. Epub 2019 Jan 28.

Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.

Purpose Of Review: Despite advances in the field, perioperative morbidity is common after liver transplantation. This review examines the current literature to provide up-to-date management of common surgical complications associated with liver transplantation.

Recent Findings: Research focuses on problems with anastomoses of the vena cava, portal vein, hepatic artery, and bile ducts. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000616DOI Listing
January 2019
1 Read

Living donor liver transplantation.

Curr Opin Organ Transplant 2019 Jan 28. Epub 2019 Jan 28.

Division of Abdominal Transplant Surgery, Department of Surgery, Duke University, Durham, North Carolina, USA.

Purpose Of Review: As experience grows, living donor liver transplantation (LDLT) has become an effective treatment option to overcome the deceased donor organ shortage.

Recent Findings: Donor safety is the highest priority in LDLT. Strict donor selection according to structured protocols and center experience are the main factors that determine donor safety. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000610DOI Listing
January 2019
1 Read

Reassessing the role of liver transplantation for patients with metastatic colorectal cancer to the liver.

Curr Opin Organ Transplant 2019 Jan 28. Epub 2019 Jan 28.

Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Purpose Of Review: Early studies reported poor survival rates following liver transplantation for metastatic colorectal cancer to the liver and liver transplantation has thus traditionally been contraindicated for these patients. However, improvements in liver transplantation outcomes, immunosuppression and the treatment of colorectal cancer warrant a reassessment of the role of liver transplantation for metastatic colorectal cancer.

Recent Findings: The literature on this topic is sparse, the majority of publications being isolated cases of liver transplantation for patients with metastatic colorectal cancer to the liver. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000611DOI Listing
January 2019
1 Read

The finances of a liver transplant program.

Curr Opin Organ Transplant 2019 Jan 28. Epub 2019 Jan 28.

Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Purpose Of Review: The current review provides an overarching examination of liver transplant finances and factors contributing to cost of care.

Recent Findings: Transplant hospitals must seek to optimize areas of revenue and cut costs as the cost of transplantation continues to rise and public policies strain reimbursement.

Summary: Transplantation remains a complicated multipayor system that requires focused attention and care. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000612DOI Listing
January 2019

The parallel paradigm between intestinal transplant inflammation and inflammatory bowel disease.

Curr Opin Organ Transplant 2019 Jan 28. Epub 2019 Jan 28.

MedStar Georgetown Transplant Institute, Georgetown University Hospital, Northwest, Washington, DC.

Purpose Of Review: A significant shift in our understanding of the molecular and cellular basis for inflammatory bowel disease (IBD) mirrors research that has been ongoing in intestinal transplantation. The blurring of lines between these two disease states creates an avenue into potential therapeutic interventions which take advantage of these molecular similarities.

Recent Findings: Traditional knowledge of T-cell involvement in IBD has expanded to highlight the role of T helper 17 (Th17) cells as key effector cells. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000615DOI Listing
January 2019
1 Read

Understanding and managing cardiovascular outcomes in liver transplant recipients.

Curr Opin Organ Transplant 2019 Jan 22. Epub 2019 Jan 22.

Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota, USA.

Purpose Of Review: Cardiovascular disease (CVD) is a common cause of mortality after liver transplantation. The transplant community is focused on improving long-term survival. Understanding the prevalence of CVD in liver transplant recipients, precipitating factors as well as prevention and management strategies is essential to achieving this goal. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000614DOI Listing
January 2019
1 Read

Laparoscopic right hepatectomy for living donor.

Curr Opin Organ Transplant 2019 Jan 22. Epub 2019 Jan 22.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Purpose Of Review: Many institutions have started or are planning to start a purely laparoscopic right hepatectomy (PLRH) for adult living donor recipients but the experience is relatively very limited. The present review will look at the current status of PLRH and go over some of the technical details important for a safe operation. Necessary elements and different strategies to start a safe and reproducible PLRH program will be discussed. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000609DOI Listing
January 2019

Current outcomes after pediatric and adult intestinal transplantation.

Curr Opin Organ Transplant 2019 Jan 22. Epub 2019 Jan 22.

Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

Purpose Of Review: In this article, we will review the outcomes of patients with intestinal transplant (ITx) with a focus on factors affecting long-term graft and patient survival.

Recent Findings: The most recent International Intestinal Transplant Registry reports a 1-, 5-, and 10-year graft survival of 71%, 50%, and 41% respectively, for ITx grafts transplanted since 2000. Over the past decades, significant improvements have been achieved in short-term graft and patient outcomes for ITx recipients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000608DOI Listing
January 2019
1 Read

Scientific Registry of Transplant Recipients program-specific reports: where we have been and where we are going.

Curr Opin Organ Transplant 2019 Feb;24(1):58-63

Hennepin Healthcare Research Institute, Scientific Registry of Transplant Recipients.

Purpose Of Review: Reporting provider data on quality to patients and the general public is increasingly common in healthcare. Reporting outcomes in solid organ transplantation has always been controversial and deserves careful consideration to ensure optimal results.

Recent Findings: As mandated by Federal law, the Scientific Registry of Transplant Recipients publishes program-specific reports on transplant candidates, recipients, donors, and transplant outcomes every 6 months. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000597DOI Listing
February 2019
1 Read

Biomarkers of rejection in kidney transplantation.

Curr Opin Organ Transplant 2019 Feb;24(1):103-110

Division of Nephrology, Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA.

Purpose Of Review: To provide an update of the literature on the use of new biomarkers of rejection in kidney transplant recipients.

Recent Findings: The kidney allograft biopsy is currently considered the gold standard for the diagnosis of rejection. However, the kidney biopsy is invasive and could be indeterminate. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000606DOI Listing
February 2019
2 Reads

Complementary and integrative medicine in kidney transplantation.

Curr Opin Organ Transplant 2019 Feb;24(1):87-91

Division of Nephrology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.

Purpose Of Review: Complementary and integrative medicine (CIM) use is widely prevalent in kidney transplant recipients but studies of efficacy or potential harm are sparse. This review examines prevalence of use of CIM and discusses potential beneficial and harmful aspects of CIM in renal transplant recipients.

Recent Findings: The prevalence of CIM use in kidney transplant patients varies from 12 to 45%. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000601DOI Listing
February 2019
3 Reads

Delayed graft function in kidney transplantation.

Curr Opin Organ Transplant 2019 Feb;24(1):82-86

Transplant Nephrology, Keck Hospital of USC, California, USA.

Purpose Of Review: Delayed graft function (DGF) has several long-term graft implications in the field of kidney transplantation and remains a challenge. The incidence of DGF is on the rise because of an increasing use of marginal kidneys in an era of organ shortage. Risk factors for DGF are numerous and stem from multiple sources in the transplant chain starting from the donor to its final allocation in the recipient. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000604DOI Listing
February 2019
3 Reads

Novel immunological and clinical insights in vascularized composite allotransplantation.

Curr Opin Organ Transplant 2019 Feb;24(1):42-48

Schuster Transplantation Research Center, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Purpose Of Review: Vascularized composite allotransplantation (VCA) is a promising approach to restore the quality of life of carefully selected patients that suffered extensive injury. Although acute rejection occurs very frequently, still little is known about the specific characteristics of the VCA immune response. This review aims to highlight the current development in the field of VCA concerning the immunobiology and management of upper extremity and face transplant recipients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000592DOI Listing
February 2019
1 Read

Marginal kidney transplantation: the road less traveled.

Curr Opin Organ Transplant 2019 Feb;24(1):92-96

University of Southern California - Keck School of Medicine, Los Angeles, California, USA.

Purpose Of Review: Kidney transplantation indisputably confers a significant survival advantage and a better quality of life compared with dialysis, however, because of the increasing demand for kidney transplantation many patients continue to wait prolonged periods for kidney transplantation. The first step to alleviate the shortage is to reduce the discard rate by utilizing more marginal kidneys. This review studied the recent literature on marginal kidney transplantation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000603DOI Listing
February 2019
1 Read

Tumor necrosis factor-driven cell death in donor organ as a barrier to immunological tolerance.

Curr Opin Organ Transplant 2019 Feb;24(1):12-19

Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, USA.

Purpose Of Review: Regulated cell death (RCD) is likely to play a role in organ rejection but it is unclear how it may be invoked. A well-known trigger of regulated cell death is tumor necrosis factor-alpha (TNF), which activates both caspase-dependent apoptosis and caspase-independent necroptosis. TNF is best known as a pro-inflammatory cytokine because it activates NFκB and MAPK signaling to induce expression of pro-inflammatory genes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000599DOI Listing
February 2019
1 Read

Measuring alloantibodies: a matter of quantity and quality.

Curr Opin Organ Transplant 2019 Feb;24(1):20-30

Regional HLA Laboratory, Laboratory Medicine Program, University Health Network.

Purpose Of Review: This review describes the utility and limitations of measure for assessing the presence, relative strength, and clinical impact of human leukocyte antigen (HLA) alloantibodies, as well as the other qualitative features of antibodies that are important considerations in assessing patient risk.

Recent Findings: Using MFI as a measure of antibody amount is limited for a variety of reasons. Standardized serum manipulations such as ethylene-diamine-tetra-acetic acid treatment or serum dilution results in better definition of relationships between MFI and antibody titer or complement activation, toward greater alignment in defining positivity. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000593DOI Listing
February 2019
2 Reads

Quality initiatives in pediatric transplantation.

Curr Opin Organ Transplant 2019 Feb;24(1):64-72

Department of Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Purpose Of Review: Pediatric transplantation faces unique challenges in implementing dynamic quality improvement measures because of proportionally smaller volumes compared to adults, logistics of being integrated successfully within larger or complex hospital systems, lack of adult-affiliated transplant centers, varying focus in prioritization of relevant outcome metrics, and potential lack of sufficient resources.

Recent Findings: To address these challenges, multiinstitutional collaborations have developed which have proven increasingly effective in driving awareness and quality improvement measures to supplement regulatory efforts in the pediatric population. Relevant work from the Pediatric Heart Transplant Society and Studies in Pediatric Liver Transplantation will be highlighted. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000595DOI Listing
February 2019
3 Reads

Why some organ allografts are tolerated better than others: new insights for an old question.

Curr Opin Organ Transplant 2019 Feb;24(1):49-57

Department of Surgery, Massachusetts General Hospital.

Purpose Of Review: There is great variability in how different organ allografts respond to the same tolerance induction protocol. Well known examples of this phenomenon include the protolerogenic nature of kidney and liver allografts as opposed to the tolerance-resistance of heart and lung allografts. This suggests there are organ-specific factors which differentially drive the immune response following transplantation. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00075200-900000000-9907
Publisher Site
http://dx.doi.org/10.1097/MOT.0000000000000594DOI Listing
February 2019
10 Reads

The Collaborative Improvement and Innovation Network project to drive quality improvement.

Curr Opin Organ Transplant 2019 Feb;24(1):73-81

Department of Organizational Excellence and Member Quality, United Network for Organ Sharing, Richmond, Virginia, USA.

Purpose Of Review: The purpose is to describe an approach for improvement using an organized collaborative improvement framework where participants learn, apply, and share improvement ideas supported through a 3-year Organ Procurement Transplant Network (OPTN) project called Collaborative Improvement and Innovation Network (COIIN). The COIIN project, proposed as an alternative approach to monitoring transplant performance, supported collaboration, and improvement in 58 transplant hospitals and partner organ procurement organizations. The aim was to increase transplantation with a focus on increasing the utilization of moderate-to-high (50-100%) Kidney Donor Profile Index (KDPI) kidneys. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000596DOI Listing
February 2019
16 Reads

Apolipoprotein L1 and kidney transplantation.

Curr Opin Organ Transplant 2019 Feb;24(1):97-102

Division of Nephrology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.

Purpose Of Review: Consistent associations between variants of the apolipoprotein L1 (APOL1) gene and nondiabetic nephropathy have been reported in individuals of African descent. Donor APOL1 genotype has also been linked to shorter renal allograft survival. This review summarizes recent advances in understanding the biology of APOL1 and their implications to kidney donors and recipients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000600DOI Listing
February 2019
1 Read

Editorial: New perspectives to increase transplant numbers and survival.

Authors:
Paolo Cravedi

Curr Opin Organ Transplant 2019 Feb;24(1):1-3

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000602DOI Listing
February 2019
1 Read

Letter to the Editor: Current status and future direction of uterus transplantation.

Curr Opin Organ Transplant 2019 Feb;24(1)

Baylor University Medical Center, Simmons Transplant Institute, Dallas, Texas, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000598DOI Listing
February 2019
1 Read

Xenogeneic transplantation and tolerance in the era of CRISPR-Cas9.

Curr Opin Organ Transplant 2019 Feb;24(1):5-11

Robinson Research Institute & Adelaide School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.

Purpose Of Review: The use of genetically modified donor pigs has been integral to recent major advances in xenograft survival in preclinical nonhuman primate models. CRISPR-Cas9 gene editing technology has dramatically accelerated the development of multimodified pigs. This review examines the current and projected impact of CRISPR-Cas9-mediated donor modification on preventing rejection and potentially promoting tolerance of porcine xenografts. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000589DOI Listing
February 2019
1 Read

Effector B cells in cardiac allograft vasculopathy.

Authors:
Emmanuel Zorn

Curr Opin Organ Transplant 2019 Feb;24(1):31-36

Columbia Center for Translational Immunology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.

Purpose Of Review: B cells have recently emerged as important immune players in solid organ rejection, especially in cardiac allograft vasculopathy (CAV), a chronic form of rejection following heart transplantation. B cells can exert either regulatory or effector functions. This review will provide an update on effector B cells in CAV. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000591DOI Listing
February 2019
9 Reads

Natural killer cells as modulators of alloimmune responses.

Curr Opin Organ Transplant 2019 Feb;24(1):37-41

Division of Abdominal Transplant, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.

Purpose Of Review: Natural killer (NK) cells are effector cells of the innate immune system that can lyse target cells without prior sensitization and are important in host defense to virally infected and transformed cells. Although the concept of 'missing-self' would suggest NK cells could target foreign allografts, the prevailing dogma has been that NK cells are not active participants in the rejection of solid organ allografts. This review summarizes recent studies that challenge this conclusion and instead suggest NK cells are important in outcomes posttransplant. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000590DOI Listing
February 2019
2 Reads

Xenotransplantation tolerance: applications for recent advances in modified swine.

Curr Opin Organ Transplant 2018 Dec;23(6):642-648

Columbia Center for Translational Immunology, Columbia University College of Physicians and Surgeons.

Purpose Of Review: The aim of this study was to review the recent progress in xenotransplantation achieved through genetic engineering and discuss the potential of tolerance induction to overcome remaining barriers to extended xenograft survival.

Recent Findings: The success of life-saving allotransplantation has created a demand for organ transplantation that cannot be met by the supply of human organs. Xenotransplantation is one possible solution that would allow for a nearly unlimited supply of organs. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000585DOI Listing
December 2018
2 Reads

Mesenchymal stromal cell therapy in intestinal diseases.

Curr Opin Organ Transplant 2018 Dec;23(6):679-689

Gastroenterology Unit, Department of Medicine, AOUI Policlinico G.B. Rossi & University of Verona, Verona, Italy.

Purpose Of Review: The advent of cell therapies, mainly based on the use of mesenchymal stromal cells (MSCs), represents a great step forward in the treatment of immune-mediated conditions. Here, we focus on those intestinal disorders wherein MSCs have been applied for immunotherapeutic purposes and whose results are available.

Recent Findings: By virtue of their ability to favour both tissue regeneration and immune tolerance, together with a substantial lack of immunogenicity, MSCs have gained huge attention in the last decade. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000586DOI Listing
December 2018
2 Reads

Lung bioengineering: advances and challenges in lung decellularization and recellularization.

Curr Opin Organ Transplant 2018 Dec;23(6):673-678

Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.

Purpose Of Review: Bioengineering the lung based on its natural extracellular matrix (ECM) offers novel opportunities to overcome the shortage of donors, to reduce chronic allograft rejections, and to improve the median survival rate of transplanted patients. During the last decade, lung tissue engineering has advanced rapidly to combine scaffolds, cells, and biologically active molecules into functional tissues to restore or improve the lung's main function, gas exchange. This review will inspect the current progress in lung bioengineering using decellularized and recellularized lung scaffolds and highlight future challenges in the field. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000584DOI Listing
December 2018
13 Reads

Infections after xenotransplantation.

Authors:
Anoma Nellore

Curr Opin Organ Transplant 2018 Dec;23(6):628-632

University of Alabama at Birmingham, Birmingham, Alabama, USA.

Purpose Of Review: Xenotransplantation offers a solution for the global shortage of available organs. However, cross-species transplantation and immunosuppression raises concerns about transmission of zoonotic infections to the recipient as well as to the public.

Recent Findings: Here, we review the major infections of concern after xenotransplantation, risks of their transmission, diagnostic, therapeutic as well as prevention modalities for these infections after xenotransplantation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000580DOI Listing
December 2018
1 Read

Advances in liver xenotransplantation.

Curr Opin Organ Transplant 2018 Dec;23(6):615-620

Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Purpose Of Review: This review highlights advances in liver xenotransplantation, focusing on immunologic barriers and mechanisms underlying graft failure and recipient demise, and discussion of recent in-vivo results.

Recent Findings: Pig to primate models of liver xenotransplantation have been plagued by thrombocytopenia, anemia, and coagulopathy. It is now known that platelet sequestration is mediated by liver sinusoidal endothelial cells and Kupffer cells in part by asialoglycoprotein receptor 1-driven mechanisms. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00075200-900000000-9908
Publisher Site
http://dx.doi.org/10.1097/MOT.0000000000000578DOI Listing
December 2018
19 Reads

What will it take before a bioengineered heart will be implanted in patients?

Curr Opin Organ Transplant 2018 Dec;23(6):664-672

Department of Regenerative Medicine Research.

Purpose Of Review: Heart transplantation is the only curative treatment option for end-stage heart failure. However, a shortage of donor organs is a major limitation of this approach. Regenerative medicine targets the goal of increasing the number of available hearts for transplantation. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00075200-900000000-9909
Publisher Site
http://dx.doi.org/10.1097/MOT.0000000000000583DOI Listing
December 2018
31 Reads

Recent progress in porcine islet isolation, culture and engraftment strategies for xenotransplantation.

Curr Opin Organ Transplant 2018 Dec;23(6):633-641

Chair for Molecular Animal Breeding and Biotechnology, Gene Center.

Purpose Of Review: Xenotransplantation of porcine islets is a realistic option to restore β-cell function in type 1 diabetic patients. Among other factors, such as islet donor age (fetal, neonatal and adult) and genotype (wild type and genetically modified), choice of the transplantation site, and immune protection of the islets, efficient strategies for islet isolation, culture and engraftment are critical for the success of islet xenotransplantation.

Recent Findings: Neonatal porcine islets (NPIs) are immature at isolation and need to be matured in vitro or in vivo before they become fully functional. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000579DOI Listing
December 2018
2 Reads

Progress and challenges in lung xenotransplantation: an update.

Curr Opin Organ Transplant 2018 Dec;23(6):621-627

Center for Transplantation Sciences and Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

Purpose Of Review: Recent progress in genetic engineering has facilitated development of transgenic donor animals designed to overcome the known barriers to discordant xenotransplantation, and greatly accelerated progress in the field of xenotransplantation. Here we review and summarize recent progress in lung xenotransplantation, and discuss possible additional genetic modifications and other interventions that may further advance the use of pulmonary xenografts towards clinical applications based on known mechanisms of xeno lung injury.

Recent Findings: Ex-vivo lung perfusion experiments have shown that the addition of human complement (hCD46, hCD55), coagulation (hEPCR, hVWF, hTBM, hTFPI, hCD39), or anti-inflammatory pathway regulatory genes (HO-1, HLA-E), and the knockout (KO) of major porcine carbohydrates (GalT, Neu5Gc, B4Gal) have each protective effects on lung survival and function. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000582DOI Listing
December 2018
20 Reads

Three-dimensional bioprinting for organ bioengineering: promise and pitfalls.

Curr Opin Organ Transplant 2018 Dec;23(6):649-656

Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston Salem, North Carolina, USA.

Purpose Of Review: Loss of organ function is a critical issue that threatens a patient's life. Currently, the only available treatment is organ transplantation; however, shortage of donor organs, histocompatibility, and life-long immunosuppression present major challenges. Three-dimensional bioprinting technology holds a promising solution for treating organ failure by fabricating autologous tissues and organs for transplantation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000581DOI Listing
December 2018
4 Reads

Bioengineering the innate vasculature of complex organs: what have we learned so far.

Curr Opin Organ Transplant 2018 Dec;23(6):657-663

Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.

Purpose Of Review: Engineering vasculature that meets an organ's specific physiology and function is a fundamental step in organ bioengineering. In this article, we review approaches for engineering functional vasculature for organ bioengineering, with an emphasis on the engineering of organ-specific endothelium and vasculature.

Recent Findings: Recent advances in hydrogel-based engineering of vascularized organ bud enable vascular regeneration in self-assembled cellular niche containing parenchymal and stromal cells. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000577DOI Listing
December 2018
7 Reads

Vascularized composite allotransplantation in children: what we can learn from solid organ transplantation.

Authors:
Sue V McDiarmid

Curr Opin Organ Transplant 2018 Oct;23(5):605-614

David Geffen School of Medicine, University of California, Los Angeles, USA.

Purpose Of Review: This review will focus on the lessons learned over several decades of solid organ transplantation in children, and their relevance to the emerging field of pediatric VCA. Particular attention will be focused on the risk-benefit ratio of immunosuppression as it applies to children receiving a life-enhancing transplant as compared with a life-saving transplant. Potential indications for pediatric VCA will be considered. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000576DOI Listing
October 2018
1 Read

Current status and future direction of uterus transplantation.

Curr Opin Organ Transplant 2018 Oct;23(5):592-597

Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg and Stockholm IVF-Eugin, Stockholm, Sweden.

Purpose Of Review: The current review gives an updated synopsis of all cases of uterus transplantation (UTx) that has been published and technical details about surgery. The live births that so far have been reported are described regarding pregnancy and outcome. In addition, the review highlights some specific areas of live donor UTx, deceased donor UTx and UTx in general that need further research for clarification/optimization. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00075200-900000000-9909
Publisher Site
http://dx.doi.org/10.1097/MOT.0000000000000568DOI Listing
October 2018
26 Reads

Stem cell-based approaches to enhance nerve regeneration and improve functional outcomes in vascularized composite allotransplantation.

Curr Opin Organ Transplant 2018 Oct;23(5):577-581

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

Purpose Of Review: The current review will discuss the current understanding of nerve regeneration in vascularized composite allotransplantation (VCA). The success of proximal arm and leg transplants has been hampered by the limitations of nerve regrowth across long distances resulting in poor regeneration and functional recovery. Relevant research in stem-cell therapies to overcome these issues will be reviewed. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000569DOI Listing
October 2018
5 Reads

Chronic rejection in vascularized composite allotransplantation.

Curr Opin Organ Transplant 2018 Oct;23(5):582-591

Department of Dermatology, Edouard Herriot Hospital, Lyon, France.

Purpose Of Review: Vascularized composite allografts (VCA), which restore severely damaged body parts that cannot be repaired with conventional surgical techniques, often undergo acute skin rejection episodes in the early postgraft period. Although the risk of human VCA to be affected by chronic rejection was initially unknown, such cases were recently observed.

Recent Findings: Chronic rejection targets preferentially the skin (dermal sclerosis, adnexal atrophy, necrosis) and vessels (graft vasculopathy) and may cause graft dysfunction, often resulting in ischemic graft loss. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000571DOI Listing
October 2018
2 Reads

Vascularized composite allotransplantation: a field is maturing.

Curr Opin Organ Transplant 2018 Oct;23(5):559-560

Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000574DOI Listing
October 2018
1 Read

A view of the future of regulatory immune cell therapy in organ transplantation.

Authors:
Angus W Thomson

Curr Opin Organ Transplant 2018 Oct;23(5):507-508

Starzl Transplantation Institute, Department of Surgery, and Department of Immunology and Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000570DOI Listing
October 2018
13 Reads

Advances in machine perfusion, organ preservation, and cryobiology: potential impact on vascularized composite allotransplantation.

Curr Opin Organ Transplant 2018 Oct;23(5):561-567

Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Purpose Of Review: In this review, we discuss novel strategies that allow for extended preservation of vascularized composite allografts and their potential future clinical implications for the field of vascularized composite allotransplantation (VCA).

Recent Findings: The current gold standard in tissue preservation - static cold preservation on ice - is insufficient to preserve VCA grafts for more than a few hours. Advancements in the field of VCA regarding matching and allocation, desensitization, and potential tolerance induction are all within reasonable reach to achieve; these are, however, constrained by limited preservation time of VCA grafts. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000567DOI Listing
October 2018
1 Read