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Organ Procurement From Poisoned Patients: A 14-Year Survey in 2 Academic Centers.

Exp Clin Transplant 2021 Sep 20. Epub 2021 Sep 20.

From the School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objectives: Organ transplant from poisoned donors is an issue that has received much attention, especially over the past decade. Unfortunately, there are still opponents to this issue who emphasize that toxins and drugs affect the body's organs and do not consider organs from poisoned donors appropriate for transplantation.

Materials And Methods: Cases of brain death due to poisoning were collected from 2 academic centers in Tehran, Iran during a period from 2006 to 2020. Read More

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September 2021

Infectious events in kidney transplant recipients from deceased expanded criteria donors: a prospective cohort.

Rev Esc Enferm USP 2021 17;55:e20210255. Epub 2021 Sep 17.

Universidade Federal de São Paulo, Departamento de Saúde Coletiva, Escola Paulista de Enfermagem, São Paulo, SP, Brazil.

Objective: Analyze risk factors for infection in kidney transplant recipients from deceased expanded criteria donors (DECD) in the first two years of follow-up.

Method: This is a prospective cohort study with 466 patients from DECD who underwent kidney transplantation in 2015 and 2016 in Brazil. A total of 551 events were recorded. Read More

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September 2021

Comparison of Scores for Child-Pugh Criteria and Standard and Modified Models for End-Stage Liver Disease to Assess Cardiac Hepatopathy in Heart Transplant Recipients.

Exp Clin Transplant 2021 Sep;19(9):963-969

From the Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objectives: Congestive hepatopathy as a result of advanced heart failure correlates with poor outcomes. Thus, risk-scoring systems have been established to assess the risks for cardiac surgery and hearttransplant, although these systems were originally designed to measure mortality risk in patients with end-stage liver disease. We compared the scores for the Child-Pugh criteria andstandardandmodifiedModels for End-Stage LiverDisease to evaluate the effect of preoperative liver dysfunction on postoperative outcomes inpatients with heart failure who underwent heart transplant. Read More

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September 2021

Revisiting Prognosis After Liver Transplant in Patients Positive for Hepatitis C Virus: Focus on Hepatitis C Recurrence-Unrelated Complications.

Exp Clin Transplant 2021 Sep;19(9):935-942

From the Department of Gastroenterology and Hepatology, Nagoya University School of Medicine, Nagoya, Japan.

Objectives: In this study, we revisited the reasons for poorer prognosis afterlivertransplantin patients with hepatitis C virus, whose main causes of death were generally known to be recurrent disease.

Materials And Methods: Between April 2003 and March 2017, among 132 patients who underwent liver transplantbecause ofliver cirrhosis at ourinstitution, 40 patients (30.3%) were positive for hepatis C virus. Read More

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September 2021

Kidney Transplantation in Low- to Middle-Income Countries: Outcomes and Lessons Learned from Armenia.

Ann Transplant 2021 Sep 21;26:e930943. Epub 2021 Sep 21.

Department of Nephrology, Arabkir Medical Centre - Institute of Child and Adolescent Health, Yerevan, Armenia.

BACKGROUND Treatment of end-stage renal disease constitutes a heavy financial burden, especially in developing countries. Maintaining a kidney transplantation program is an extremely complex task in countries with limited resources. It often requires expertise and support from developed countries. Read More

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September 2021

Association between cardiac autonomic function and physical activity in patients at high risk of sudden cardiac death: a cohort study.

Int J Behav Nutr Phys Act 2021 Sep 20;18(1):128. Epub 2021 Sep 20.

Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China.

Background: High levels of physical activity (PA) and heart rate variability (HRV) are associated with cardiovascular benefits in patients with cardiovascular diseases. HRV, representing cardiac autonomic function, is positively associated with PA. However, the impacts of PA and cardiac autonomic function on cardiovascular outcomes were not analysed in the same study population. Read More

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September 2021

Clinical characteristics and incidence of toxoplasmosis after autologous hematopoietic stem cell transplantation: A retrospective study and literature review.

Transpl Infect Dis 2021 Sep 20. Epub 2021 Sep 20.

Department of Hematology, Nagano Red Cross Hospital, Nagano City, Nagano, Japan.

Background: Toxoplasmosis is a rare but life-threatening infection occurring in immunocompromised hosts, including allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. However, thus far, the clinical features and incidence of toxoplasmosis in autologous HSCT (auto-HSCT) recipients remain unknown. This retrospective survey aimed to analyze 152 patients who received auto-HSCT between 1998 and 2017. Read More

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September 2021

Lung transplantation in South Africa: Indications, outcomes and disease-specific referral guidelines.

Afr J Thorac Crit Care Med 2018 7;24(3). Epub 2018 Sep 7.

Chris Barnard Division of Cardiothoracic Surgery, Department of Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.

Lung transplantation (LT) is a robust therapy for advanced lung disease, which offers recipients extended and good-quality survival. In South Africa (SA), patients have historically had limited access to this therapy, particularly if unfunded. LT has been used as a successful therapeutic intervention for a wide variety of end-stage pulmonary parenchymal and vascular diseases, but the most common diseases that lead to LT are chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, alpha-1-antitrypsin deficiency and pulmonary arterial hypertension. Read More

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September 2018

Conversion From Calcineurin Inhibitors to Mammalian Target of Rapamycin Inhibitors in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Front Immunol 2021 3;12:663602. Epub 2021 Sep 3.

Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.

Background: A systematic review and meta-analysis were performed to investigate the efficacy and safety of conversion from calcineurin inhibitors (CNIs) to mammalian target of rapamycin inhibitors (mTORi) in kidney transplant recipients (KTRs).

Methods: MEDLINE, EMBASE, PubMed, and Cochrane Library were searched to identify randomized controlled trials (RCTs) that compared the continuation of CNI with conversion to mTORi therapy.

Results: Twenty-nine RCTs (5,747 KTRs) were included in our analysis. Read More

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September 2021

Macroscopic characteristics of the native liver in children with MPV17-related mitochondrial DNA depletion syndrome: an indication for performing liver transplantation?

Liver Transpl 2021 Sep 18. Epub 2021 Sep 18.

Center for Medical Genetics, Department of Metabolism, Chiba Children's Hospital, Chiba, Japan.

Mitochondrial respiratory chain disorders (MRCDs) are rare conditions with various clinical manifestations that depend on the genetic type, with subsequent severity of the liver disease. Clinical presentations include acute liver failure or chronic liver failure with liver cirrhosis, which are cruelly progressive and fatal. We report six cases of LT for acute liver failure diagnosed pathogenic MPV17 variants. Read More

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September 2021

Delayed headache after COVID-19 vaccination: a red flag for vaccine induced cerebral venous thrombosis.

J Headache Pain 2021 Sep 17;22(1):108. Epub 2021 Sep 17.

Department of Neurology, Akershus University Hospital, Lørenskog, Norway.

Background: Headache is a frequent symptom following COVID-19 immunization with a typical onset within days post-vaccination. Cases of cerebral venous thrombosis (CVT) have been reported in adenovirus vector-based COVID-19 vaccine recipients.

Findings: We reviewed all vaccine related CVT published cases by April 30, 2021. Read More

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September 2021

Community-facility linkage models and maternal and infant health outcomes in Malawi's PMTCT/ART program: A cohort study.

PLoS Med 2021 Sep 17;18(9):e1003780. Epub 2021 Sep 17.

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.

Background: In sub-Saharan Africa, 3 community-facility linkage (CFL) models-Expert Clients, Community Health Workers (CHWs), and Mentor Mothers-have been widely implemented to support pregnant and breastfeeding women (PBFW) living with HIV and their infants to access and sustain care for prevention of mother-to-child transmission of HIV (PMTCT), yet their comparative impact under real-world conditions is poorly understood.

Methods And Findings: We sought to estimate the effects of CFL models on a primary outcome of maternal loss to follow-up (LTFU), and secondary outcomes of maternal longitudinal viral suppression and infant "poor outcome" (encompassing documented HIV-positive test result, LTFU, or death), in Malawi's PMTCT/ART program. We sampled 30 of 42 high-volume health facilities ("sites") in 5 Malawi districts for study inclusion. Read More

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September 2021

Quantitative Image Analysis at Chronic Lung Allograft Dysfunction Onset Predicts Mortality.

Transplantation 2021 Sep 16. Epub 2021 Sep 16.

University of California Los Angeles, Los Angeles, CA, United States Cedars Sinai Medical Center, Los Angeles, CA, United States.

Background: Chronic lung allograft dysfunction (CLAD) phenotype determines prognosis and may have therapeutic implications. Despite the clarity achieved by recent consensus statement definitions, their reliance on radiologic interpretation introduces subjectivity. The Center for Computer Vision and Imaging Biomarkers at UCLA has established protocols for chest HRCT based computer-aided quantification of both interstitial disease and air-trapping. Read More

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September 2021

Comparison of Outcomes of Kidney Transplantation From Extremely Low Body Weight ≤5kg Larger Body Weight Pediatric Donors.

Front Immunol 2021 31;12:738749. Epub 2021 Aug 31.

Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China.

Background: Kidney transplantation from donors who weigh ≤5 kg is performed at only a few transplant centers owing to the high complication and low graft survival rates associated with this approach.

Methods: We retrospectively compared the results of kidney transplantation at our center between January 2015 and December 2019 based on the following pediatric donor criteria: donor body weight ≤5 kg (n=32), 5 kg< donor weight ≤20 kg (n=143), and donor weight >20 kg (n=110). We also perform subgroup analysis of kidney transplantation outcomes from ≤5 kg donors, using conventional (dual separate and classic en-bloc KTx)/novel (en-bloc KTx with outflow tract) surgical methods and allocating to adult/pediatric recipients. Read More

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Pregnancy after liver transplant: maternal and perinatal outcomes.

BMC Pregnancy Childbirth 2021 Sep 16;21(1):627. Epub 2021 Sep 16.

Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Nowogrodzka 59, 02-006, Warsaw, Poland.

Background: Liver transplantation is a life-saving and successful therapeutic procedure which is more and more frequent worldwide, also among women of reproductive age. Consequently, there is an increasing number of reports of pregnancy following liver transplantation, but doubts still exist regarding preconception counseling and the optimal method of managing pregnancy. The aim of this study was to report and evaluate pregnancy outcomes in women who had undergone liver transplantation. Read More

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September 2021

De novo Tacrolimus extended-release tablets (LCPT) vs twice-daily tacrolimus in adult heart transplantation: Results of a single-center non-inferiority matched control trial.

Clin Transplant 2021 Sep 16:e14487. Epub 2021 Sep 16.

Baylor Scott & White Research Institute, Baylor Scott & White Health, Dallas, TX, USA.

Extended-release tacrolimus for prophylaxis of allograft rejection in orthotopic heart transplant (OHT) recipients is currently not FDA-approved. One such extended-release formulation of tacrolimus known as LCPT allows once-daily dosing and improves bioavailability compared to immediate-release tacrolimus (IR-tacrolimus). We compared the efficacy and safety of LCPT to IR-tacrolimus applied de novo in adult OHT recipients. Read More

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September 2021

Early everolimus-facilitated reduced tacrolimus in liver transplantation: Results from the randomized HEPHAISTOS trial.

Liver Transpl 2021 Sep 15. Epub 2021 Sep 15.

Novartis Pharma GmbH, Nürnberg, Germany.

Background: Everolimus-facilitated reduced tacrolimus exposure (EVR+rTAC) at 30 days post-liver transplantation (LT) has shown advantages in renal preservation. This study evaluated the effects of early initiation of EVR+rTAC in de novo liver transplant recipients (LTR).

Methods: In HEPHAISTOS (NCT01551212, EudraCT 2011-003118-17), a 12-month (M), multicenter, controlled study, LTR were randomized at 7-21 days post-LT to receive EVR+rTAC or standard tacrolimus (sTAC), with steroids. Read More

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September 2021

Phase 1a/b Study of Monoclonal Antibody CAEL-101 (11-1F4) in Patients with AL Amyloidosis.

Blood 2021 Sep 14. Epub 2021 Sep 14.

New York Presbyterian Hospital - Columbia Campus, New York, New York, United States.

Systemic immunoglobulin light-chain (AL) amyloidosis is characterized by pathologic deposition of immunoglobulin light chains as amyloid fibrils in vital organs, leading to organ impairment and eventual death. That the process is reversible was evidenced in an in vivo experimental model in which fibril-reactive chimeric monoclonal antibody (mAb) 11-1F4 directly targeted human light-chain amyloid deposits and effected their removal via a phagocyte-mediated response. To determine tolerability and potential amyloidolytic effect of this agent (now designated mAb CAEL-101), we conducted a phase 1a/b study involving 27 patients, most of whom had manifestations of organ involvement. Read More

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September 2021

A Programmatic Response, Including Bamlanivimab or Casirivimab-Imdevimab Administration, Reduces Hospitalization and Death in COVID-19 Positive Abdominal Transplant Recipients.

Transplantation 2021 Sep 13. Epub 2021 Sep 13.

Department of Surgery Keck Medical Center of USC. Los Angeles, CA Department of Medicine Keck Medical Center of USC. Los Angeles, CA.

Background: Coronavirus-19 disease (COVID-19) has resulted in significant morbidity and mortality in solid organ transplant recipients. In December 2020, at the peak of the Los Angeles outbreak, our center rapidly implemented a protocol to improve outpatient management and provide Bamlanivimab or Casirivimab-Imdevimab (COVID mAb therapies) to all eligible COVID-19 positive liver and kidney transplant recipients.

Methods: A retrospective review of all abdominal organ transplant recipients who were COVID-19 PCR+ between 2/2020-2/2021 from our center was performed. Read More

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September 2021

Does the Side Matter? A Retrospective Cohort Study Comparing Left and Right Pure Laparoscopic Donor Nephrectomies.

Urol Int 2021 Aug 6:1-9. Epub 2021 Aug 6.

Department of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.

Objectives: Right laparoscopic donor nephrectomy (RLDN) is no longer regarded inferior to left LDN (LLDN). However, this knowledge is based on many studies suffering from inherent learning curves, center-specific imbalances, and different laparoscopic techniques.

Methods: Pure LDNs at a high-volume referral center from 2011 to 2016 were retrospectively analyzed. Read More

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Epidemiology and outcomes of medically attended and microbiologically confirmed bacterial foodborne infections in solid organ transplant recipients.

Am J Transplant 2021 Sep 12. Epub 2021 Sep 12.

Transplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Food-safety measures are recommended to solid organ transplant (SOT) recipients. However, the burden of foodborne infections in SOT recipients has not been established. We describe the epidemiology and outcomes of bacterial foodborne infections in a nationwide cohort including 4405 SOT recipients in Switzerland between 2008 and 2018. Read More

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September 2021

Successful Outcomes with Transplanting Kidneys from Deceased Donors with Acute Kidney Injury on Temporary Renal Replacement Therapy.

Clin Transplant 2021 Sep 12:e14465. Epub 2021 Sep 12.

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

Background And Objectives: We aimed to determine outcomes with transplanting kidneys from deceased donors with severe acute kidney injury requiring acute renal replacement therapy (RRT).

Materials And Methods: 172 recipients received a kidney from donors with acute kidney injury stage 3 (AKIN3) requiring RRT. We compared the study group to 528 recipients who received a kidney from donors with AKIN stage 3 not on RRT and 463 recipients who received <85% Kidney Donor Profile Index (KDPI) AKIN stage 0 kidney. Read More

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September 2021

Kidney Transplantation From Hepatitis C Viremic Deceased Donors to Aviremic Recipients in a Real-world Setting.

Transplant Direct 2021 Oct 7;7(10):e761. Epub 2021 Sep 7.

Division of Kidney and Pancreas Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.

Transplantation of hepatitis C viremic (HCV+) deceased donor kidney transplants (DDKT) into aviremic (HCV-) recipients is a strategy to increase organ utilization. However, there are concerns around inferior recipient outcomes due to delayed initiation of direct-acting antiviral (DAA) therapy and sustained HCV replication when implemented outside of a research setting.

Methods: This was a retrospective single-center matched cohort study of DDKT recipients of HCV+ donors (cases) who were matched 1:1 to recipients of HCV- donors (comparators) by age, gender, race, presence of diabetes, kidney donor profile index, and calculated panel-reactive antibody. Read More

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October 2021

Biliary Complications Following Adult Deceased Donor Liver Transplantation: Risk Factors and Implications at a High-volume US Center.

Transplant Direct 2021 Oct 7;7(10):e754. Epub 2021 Sep 7.

Department of Surgery, Division of Transplantation, Emory University School of Medicine, Atlanta, GA.

Biliary leaks and anastomotic strictures comprise the majority of biliary complications (BCs) following liver transplantation (LT). Currently, there are few large contemporary case series of BCs in adult deceased donor liver transplant (DDLT) recipients in the literature. The purpose of this study was to examine the pretransplant and intraoperative risk factors associated with BCs at a high-volume tertiary care center and determine the impact of these BCs on their posttransplant course and long-term transplant outcomes. Read More

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October 2021

Dissecting Tumor Antigens and Immune Subtypes of Glioma to Develop mRNA Vaccine.

Front Immunol 2021 27;12:709986. Epub 2021 Aug 27.

Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, China.

Background: Nowadays, researchers are leveraging the mRNA-based vaccine technology used to develop personalized immunotherapy for cancer. However, its application against glioma is still in its infancy. In this study, the applicable candidates were excavated for mRNA vaccine treatment in the perspective of immune regulation, and suitable glioma recipients with corresponding immune subtypes were further investigated. Read More

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A Long-Term Prospective Study of Quality of Life, Abdominal Symptoms, and Cosmesis of Donors After Hepatectomy for Live-Donor Liver Transplantation.

J Clin Exp Hepatol 2021 Sep-Oct;11(5):579-585. Epub 2020 Dec 7.

Department of Hepato Pancreato Biliary and Liver Transplant Surgery, Institute of Liver & Biliary Sciences, D1 Vasant Kunj, New Delhi, 110070, India.

Background: Comprehensive assessment of quality of life of live liver donors is required for adequate donor outcome reporting, but there is a lack of prospective data. Assessment of all aspects of liver donation over a long period is a necessity to have complete understanding of the donation process.

Methods: Prospectively collected data of liver donors operated between March 2012 to August 2013, examined donors (n = 52) from predonation to five years after the donation. Read More

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December 2020

An Essential Guide for Managing Post-Liver Transplant Patients: What Primary Care Physicians Should Know.

Am J Med 2021 Sep 8. Epub 2021 Sep 8.

Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy.

With long-term survival after liver transplantation becoming the rule, care for medical problems arising over time in liver transplanted patients gained increasing importance. The most common causes of death occurring more than one year after liver transplantation are unrelated to liver diseases and facilitated by immunosuppressive treatments, such as malignancies, renal failure, cardiovascular, metabolic and infectious diseases. Recipients receive life-long follow-up care at transplant centers; however, the increasing number of liver transplanted patients is saturating the health care supply that transplant centers have to offer. Read More

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September 2021

Adherence to community versus facility-based delivery of monthly malaria chemoprevention with dihydroartemisinin-piperaquine for the post-discharge management of severe anemia in Malawian children: A cluster randomized trial.

PLoS One 2021 10;16(9):e0255769. Epub 2021 Sep 10.

School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.

Background: The provision of post-discharge malaria chemoprevention (PMC) in children recently admitted with severe anemia reduces the risk of death and re-admissions in malaria endemic countries. The main objective of this trial was to identify the most effective method of delivering dihydroartemesinin-piperaquine to children recovering from severe anemia.

Methods: This was a 5-arm, cluster-randomized trial among under-5 children hospitalized with severe anemia at Zomba Central Hospital in Southern Malawi. Read More

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September 2021

normothermic perfusion in heart transplantation: a review of the TransMedics Organ Care System.

Future Cardiol 2021 Sep 10. Epub 2021 Sep 10.

Cedars- Sinai Smidt Heart Institute, Los Angeles, CA 90048, USA.

Cardiac transplantation is the gold standard for treatment for select patients with end-stage heart failure, yet donor supply is limited. machine perfusion is an emerging technology capable of safely preserving organs and expanding the viable donor pool. The TransMedics Organ Care System™ is an investigational device which mimics physiologic conditions while maintaining the heart in a warm, beating state rather than cold storage. Read More

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September 2021

Post-Irradiation Hyperamylasemia Is a Prognostic Marker for Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Pediatric Population: A Retrospective Single-Centre Cohort Analysis.

J Clin Med 2021 Aug 26;10(17). Epub 2021 Aug 26.

Institute for Maternal and Child Health-IRCCS Burlo Garofolo, via dell'Istria 65/1, 34137 Trieste, Italy.

Background: Total body irradiation (TBI) is a mandatory step for patients with acute lymphoblastic leukemia (ALL), undergoing allogeneic hematopoietic stem cell transplantation (HSCT). In the past, amylases have been reported to be a possible sign of TBI toxicity. We investigated the relationship between total amylases (TA) and transplant-related outcomes in pediatric recipients. Read More

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