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Tumin, Makmor, Khaled Tafran, Wan Ahmad Hafiz Wan Md Adnan e Ahmad Farid Osman. "Assessing Countries’ Deceased Organ Donation and Transplantation Performance". MARCH 2023 19, n. 2 (13 marzo 2023): 170–74. http://dx.doi.org/10.47836/mjmhs.19.2.25.
Testo completoAbstract (sommario):
Introduction: Donors per million population and transplantations per million population are standardized, widely used indicators to assess and compare countries’ performance in organ donation and transplantation. This study aims to investigate these two particular metrics of organ donation and transplantation performance, and to introduce a new index, namely, ‘transplantations per patients on the waiting list’. Methods: Secondary analyses of data on 23 countries in 2016 were used to construct the transplantations per patients on the waiting list indicator for kidney, liver, pancreas, heart, and lung transplantation, as well as for the transplantation of any of the five aforementioned organs. Results: According to the transplantations per patients on the waiting list, the best-performing countries in terms of organ donation and transplantation are Belarus for kidney transplantation, Finland for liver and pancreas transplantation, Australia for heart transplantation, and France for lung transplantation. Considering all five organs together, Sweden, Australia, Finland, Austria, and Poland were the top five best-performing countries, followed by Spain in the sixth position. Conclusion: The deceased transplantations per patients on the waiting list can be an alternative indicator to assess performance, along with the widely-used donors and transplantations per million population, but still has its limitations in certain scenarios.
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Ratkovic, Marina, Nikolina Basic Jukic, Danilo Radunovic, Vladimir Prelevic e Branka Gledovic. "Kidney Transplantation Program in Montenegro". BANTAO Journal 13, n. 2 (1 dicembre 2015): 68–72. http://dx.doi.org/10.1515/bj-2015-0015.
Testo completoAbstract (sommario):
AbstractIntroduction.There was no transplantation program in Montenegro until 2012. On the other hand, there were 93 patients with transplanted kidney. These transplantations were performed abroad; 15% in areas of black organ markets (India, Pakistan, Russian Federation). Beside the ethical problems, these transplantations carried a high risk of complications.Methods.Our health system had to ensure solution for patients with terminal organ failure. Preparation of all neccessary conditions for the beginning of transplantation program in Montenegro started in 2006 with different activities including public, legal, medical, educational and international cooperation aspects.Results.The first kidney transplantation from living donor in Montenegro was preformed on September 25th, 2012. In the period from 2012 until now 23 kidney transplantations from living related donor were performed and one kidney transplantation from deceased donor in the Clinical Center of Montenegro. In the a two year-follow-up period, all patients to whom kidney transplantation was performed are in a good condition and without serious complications in posttransplant period.Conclusion.Development of the transplantation program allowed controlled transplantation and safety of patients. Our next steps are development of deceased organ donor transplantation and achievement of higher rate of deceased donor organ transplantation and individualization of immunosuppressive therapy.
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Fatobene, Giancarlo, Vanderson Rocha, Andrew St. Martin, Mehdi Hamadani, Stephen Robinson, Asad Bashey, Ariane Boumendil et al. "Nonmyeloablative Alternative Donor Transplantation for Hodgkin and Non-Hodgkin Lymphoma: From the LWP-EBMT, Eurocord, and CIBMTR". Journal of Clinical Oncology 38, n. 14 (10 maggio 2020): 1518–26. http://dx.doi.org/10.1200/jco.19.02408.
Testo completoAbstract (sommario):
PURPOSE To compare the outcomes of patients with Hodgkin or non-Hodgkin lymphoma undergoing nonmyeloablative haploidentical or unrelated cord blood (UCB) hematopoietic cell transplantation. PATIENTS AND METHODS We retrospectively studied 740 patients with Hodgkin lymphoma (n = 283, 38%) and non-Hodgkin lymphoma (n = 457, 62%) age 18-75 years who received transplantations from 2009 to 2016. Data were reported to the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation, Eurocord, or Center for International Blood and Marrow Transplant Research. Of the 526 patients who received haploidentical transplantation, 68% received bone marrow and 32% received peripheral blood. All patients received a uniform transplantation conditioning regimen (2 Gy of total-body irradiation, cyclophosphamide, and fludarabine) and graft-versus-host disease prophylaxis (calcineurin inhibitor and mycophenolate). In addition, patients who received a haploidentical transplantation received posttransplantation cyclophosphamide. RESULTS Compared with haploidentical bone marrow and peripheral-blood transplantations and adjusted for age, lymphoma subtype, and disease status, survival was lower after UCB transplantation (hazard ratio [HR], 1.55; P = .001; and HR, 1.59; P = .005, respectively). Similarly, progression-free survival was lower after UCB transplantations compared with haploidentical bone marrow and peripheral-blood transplantations (HR, 1.44; P = .002; and HR, 1.86; P < .0001), respectively. The 4-year overall and progression-free survival rates after UCB transplantation were 49% and 36%, respectively, compared with 58% and 46% after haploidentical bone marrow transplantation and 59% and 52% after peripheral-blood transplantation, respectively. Lower survival was attributed to higher transplantation-related mortality after UCB transplantation compared with haploidentical bone marrow and peripheral-blood transplantation (HR, 1.91; P = .0001; and HR, 2.27; P = .0002, respectively). CONCLUSION When considering HLA-mismatched transplantation for Hodgkin or non-Hodgkin lymphoma, the data support haploidentical related donor transplantation over UCB transplantation.
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Gluckman, Eliane. "Allogeneic transplantation strategies including haploidentical transplantation in sickle cell disease". Hematology 2013, n. 1 (6 dicembre 2013): 370–76. http://dx.doi.org/10.1182/asheducation-2013.1.370.
Testo completoAbstract (sommario):
Abstract Sickle cell disease (SCD) is the most common inherited hemoglobinopathy. Despite antenatal counseling and neonatal screening programs implemented in higher income countries, SCD is still associated with multiple morbidities and early mortality. To date, the only curative approach to SCD is hematopoietic stem cell transplantation, but this therapy is not yet established worldwide. The registries of the European Blood and Marrow Transplant (EBMT) and the Centre for International Blood and Marrow Transplant Research (CIBMTR) account, respectively, for 611 and 627 patients receiving transplantations for SCD. Most of these patients were transplanted with grafts from an HLA-identical sibling donor. The main obstacles to increasing the number of transplantations are a lack of awareness on the part of physicians and families, the absence of reliable prognostic factors for severity, and the perceived risk that transplantation complications may outweigh the benefits of early transplantation. Results show that more than 90% of patients having undergone an HLA-identical sibling transplantation after myeloablative conditioning are cured, with very limited complications. Major improvement is expected from the use of new reduced-toxicity conditioning regimens and the use of alternative donors, including unrelated cord blood transplantations and related haploidentical bone marrow or peripheral blood stem cell transplantations.
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Gautier, S. V., e S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN RUSSIAN FEDERATION IN 2015. 8th report of National Register". Russian Journal of Transplantology and Artificial Organs 18, n. 2 (25 giugno 2016): 6–26. http://dx.doi.org/10.15825/1995-1191-2016-2-6-26.
Testo completoAbstract (sommario):
Aim. To carry out monitoring of the organization and development of the organ donation and transplantation in theRussian Federationaccording to 2015.Materials and methods. Questioning of heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics by years, between certain regions of theRussian Federation, the transplantation centers is done.Results. According to the register in2015 inthe Russian Federation 36 centers of renal transplantation, 17 centers of liver transplantation and 10 centers of heart transplantation were functioning. The waiting list of kidney transplantation in 2015 included 4167 potential recipients that make 13% of the total number of the patients (31 500) receiving a dialysis. The rate of donor activity in 2015 made 3.0 pmp. Efficiency of donor programs in 2015 continues to increase: the share of multiorgan retrievals made 57.8%, average number of organs, received from one effective donor, made 2.7. In 2015 the rate of kidney transplantation made 6.5 pmp; the rate of liver transplantation made 2.2 pmp; the rate of heart transplantation made 1.2 pmp. The number of transplantations of liver and heart in theRussian Federationcontinues to increase. The number of transplantations of kidney remains approximately at one level in the range of 950–1050.Moscowcapital region continues to be the center of stability and development of the organ donation and transplantation in the country, in which 10 centers of transplantation are functioning and nearly a half from all kidney transplantations and more than 65% of all liver and heart transplantations are carried out.Conclusion. The potential for further development of the transplantation care in theRussian Federationcontinues to persist. In particular, at the expense of increasing efficiency of regional donation programs, expanding practices of multiorgan recuperation and transplantations of extrarenal organs, through interregional transplant coordination. It is critical to keep the volumes of the state order to deliver transplantological medical care to the population and to implement federal funding to conduct donation programs.
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Gajewski, James L., Viviana V. Johnson, S. Gerald Sandler, Antoine Sayegh e Thomas R. Klumpp. "A review of transfusion practice before, during, and after hematopoietic progenitor cell transplantation". Blood 112, n. 8 (15 ottobre 2008): 3036–47. http://dx.doi.org/10.1182/blood-2007-10-118372.
Testo completoAbstract (sommario):
Abstract The increased use of hematopoietic progenitor cell (HPC) transplantation has implications and consequences for transfusion services: not only in hospitals where HPC transplantations are performed, but also in hospitals that do not perform HPC transplantations but manage patients before or after transplantation. Candidates for HPC transplantation have specific and specialized transfusion requirements before, during, and after transplantation that are necessary to avert the adverse consequences of alloimmunization to human leukocyte antigens, immunohematologic consequences of ABO-mismatched transplantations, or immunosuppression. Decisions concerning blood transfusions during any of these times may compromise the outcome of an otherwise successful transplantation. Years after an HPC transplantation, and even during clinical remission, recipients may continue to be immunosuppressed and may have critically important, special transfusion requirements. Without a thorough understanding of these special requirements, provision of compatible blood components may be delayed and often urgent transfusion needs prohibit appropriate consultation with the patient's transplantation specialist. To optimize the relevance of issues and communication between clinical hematologists, transplantation physicians, and transfusion medicine physicians, the data and opinions presented in this review are organized by sequence of patient presentation, namely, before, during, and after transplantation.
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Meirelles Júnior, Roberto Ferreira, Paolo Salvalaggio, Marcelo Bruno de Rezende, Andréia Silva Evangelista, Bianca Della Guardia, Celso Eduardo Lourenço Matielo, Douglas Bastos Neves et al. "Liver transplantation: history, outcomes and perspectives". Einstein (São Paulo) 13, n. 1 (marzo 2015): 149–52. http://dx.doi.org/10.1590/s1679-45082015rw3164.
Testo completoAbstract (sommario):
In 1958 Francis Moore described the orthotopic liver transplantation technique in dogs. In 1963, Starzl et al. performed the first liver transplantation. In the first five liver transplantations no patient survived more than 23 days. In 1967, stimulated by Calne who used antilymphocytic serum, Starzl began a successful series of liver transplantation. Until 1977, 200 liver transplantations were performed in the world. In that period, technical problems were overcome. Roy Calne, in 1979, used the first time cyclosporine in two patients who had undergone liver transplantation. In 1989, Starzl et al. reported a series of 1,179 consecutives patients who underwent liver transplantation and reported a survival rate between one and five years of 73% and 64%, respectively. Finally, in 1990, Starzl et al. reported successful use of tacrolimus in patents undergoing liver transplantation and who had rejection despite receiving conventional immunosuppressive treatment. Liver Transplantation Program was initiated at Hospital Israelita Albert Einstein in 1990 and so far over 1,400 transplants have been done. In 2013, 102 deceased donors liver transplantations were performed. The main indications for transplantation were hepatocellular carcinoma (38%), hepatitis C virus (33.3%) and alcohol liver cirrhosis (19.6%). Of these, 36% of patients who underwent transplantation showed biological MELD score > 30. Patient and graft survival in the first year was, 82.4% and 74.8%, respectively. A major challenge in liver transplantation field is the insufficient number of donors compared with the growing demand of transplant candidates. Thus, we emphasize that appropriated donor/receptor selection, allocation and organ preservation topics should contribute to improve the number and outcomes in liver transplantation.
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Gautier, S. V., Ya G. Moysyuk e S. M. Khomyakov. "ORGAN DONATION AND TRANSPLANTATION IN THE RUSSIAN FEDERATION IN 2014 7th REPORT OF NATIONAL REGISTER". Russian Journal of Transplantology and Artificial Organs 17, n. 2 (26 maggio 2015): 7–22. http://dx.doi.org/10.15825/1995-1191-2015-2-7-22.
Testo completoAbstract (sommario):
Aim. To carry out monitoring of the organization and development of organ donation and transplantation in the Russian Federation according to 2014. Materials and methods. Questioning of heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics of years, between certain regions of the Russian Federation, the transplantation centers, and also with data of the international registers is made. Results. According to the Register in 2014 in the Russian Federation functioned 36 centers of kidney transplantation, 14 centers of liver transplantation and 9 centers of heart transplantation. The waiting list of kidney transplantation in 2014 included 4636 potential recipients that makes 16% of total number of the patients 29 000 receiving dialysis. The rate of donor activity in 2014 made 3.2 per million population (pmp). Efficiency of donor programs in 2014 continued to increase: the share of effective donors after brain death in 2014 increased to 77.2%, the share of multiorgan explantation made 50.5%, average number of organs received from one effective donor made 2.6. In 2014 the rate of kidney transplantation made 7.0 pmp, the rate of liver transplantation made 2.1 pmp and the rate of heart transplantation made 1.1 pmp. In the Russian Federation the number of transplantations of liver and heart continues to increase. The significant contribution to development of the organ donation and transplantation brings the Moscow region in which 11 centers of transplantation function and nearly a half from all kidney transplantations and more than 65% of all liver and heart transplantations are carried out. Conclusion. In theRussian Federation the potential for further development of the transplantology remains. In particular, at the expense of increase in the efficiency of regional donation programs, introduction of technologies, expansion of the practices of multiorgan donation and transplantations of extrarenal organs, interregional transplant coordination. Preservation of volumes of public funding for transplantological medical care and federal financing of donation programs in regions are of great importance.
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Pinchuk, A. V., N. V. Shmarina, I. V. Dmitriev, V. E. Vinogradov e A. I. Kazantsev. "Analysis of recipient and graft survival after primary and second kidney transplantation". Russian Journal of Transplantology and Artificial Organs 23, n. 2 (12 luglio 2021): 21–29. http://dx.doi.org/10.15825/1995-1191-2021-2-21-29.
Testo completoAbstract (sommario):
Objective: to evaluate the 1- and 5-year graft and recipient survival after primary and second kidney transplantation, to compare the outcomes depending on the age of recipients.Material and methods. The treatment outcomes for 364 patients who underwent kidney transplantation at Sklifosovsky Research Institute of Emergency Care, Moscow over the period from 2007 to 2019. Of these, 213 patients underwent kidney transplantation for the first time, while 151 patients were having a second transplantation. We analyzed the effect of previous transplants, as well as the age of the recipients on long-term survival rates.Results. No significant difference in 1- and 5-year survival of kidney recipients after primary and second transplantations was found. In contrast, the long-term graft survival significantly depended on this criterion and turned out to be significantly higher after primary transplantations. The 1- and 5-year survival of older recipients was lower than the survival of younger recipients after primary and second kidney transplantation. The 1-year graft survival after primary kidney transplantation was higher in young recipients than in older recipients of the same group, however, but there were no significant differences in the 5-year graft survival. After second transplantations, there were no significant differences in the 1- and 5-year graft survival depending on the age of recipients.Conclusion. A history of previous transplantation is an important factor in kidney transplantation outcome, which must be taken into account in clinical practice.
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Gautier, S. V., e S. M. Khomyakov. "Organ donation and transplantation in the Russian Federation in 2016 9th report of the National Registry". Russian Journal of Transplantology and Artificial Organs 19, n. 2 (23 giugno 2017): 6–26. http://dx.doi.org/10.15825/1995-1191-2017-2-6-26.
Testo completoAbstract (sommario):
Aim. To carry out monitoring of the organization and tendencies in the development of organ donation and transplantation in the Russian Federation in 2016. Materials and methods. Questioning of the heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics of the years, between certain regions of the Russian Federation and transplantation centers is done. Results. According to the register 35 centers of kidney transplantation, 22 centers of liver transplantation and 11 centers of heart transplantation were functioning in the Russian Federation in 2016. The waiting list of kidney transplantation in 2016 included 4818 potential recipients that make 14% of total number of the patients (35 000) receiving dialysis. The rate of donor activity in 2016 made 3.3 p. m. p. Efficiency of donor programs in 2016 continued to increase: the share of multiorgan retrieval made 64.1%, average number of organs received from one effective donor made 2.7. In 2016 the rate of kidney transplantation made 7.4 p. m. p., the rate of liver transplantation made 2.6 p. m. p.; the rate of heart transplantation made 1.5 p. m. p. In 2016 the number of transplantations in the Russian Federation increased by 14.8% in comparison with 2015 having overcome the level of 1700 organs transplantation. The Moscow region still remains to be the core of stability and development of the organ donation and transplantation in the country where 10 centers of transplantation function and half of all kidney transplantations and more than 70% of all liver and heart transplantations are carried out. Conclusion. The results of 2016 were positively affected by the introduction of targeted financial support of medical activity, related to organ donation, from federal budget resources. Among unresolved problems which constrain the development there are collision of legal regulation of licensing of medical activities for organ donation and transplantation, lack of the state order for the organization of transplantological medical care in each region, lack of responsibility of the heads of the regions and medical organizations for the organization of organ donation. Positive tendencies of the development of organ donation and transplantation in Russia call for further monitoring, strengthening and building.
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Oh, Seung-Young, Eun Jin Jang, Ga Hee Kim, Hannah Lee, Nam-Joon Yi, Seokha Yoo, Bo Rim Kim e Ho Geol Ryu. "Association between hospital liver transplantation volume and mortality after liver re-transplantation". PLOS ONE 16, n. 8 (5 agosto 2021): e0255655. http://dx.doi.org/10.1371/journal.pone.0255655.
Testo completoAbstract (sommario):
Background The relationship between institutional liver transplantation (LT) case volume and clinical outcomes after liver re-transplantation is yet to be determined. Methods Patients who underwent liver re-transplantation between 2007 and 2016 were selected from the Korean National Healthcare Insurance Service database. Liver transplant centers were categorized to either high-volume centers (≥ 64 LTs/year) or low-volume centers (< 64 LTs/year) according to the annual LT case volume. In-hospital and long-term mortality after liver re-transplantation were compared. Results A total of 258 liver re-transplantations were performed during the study period: 175 liver re-transplantations were performed in 3 high-volume centers and 83 were performed in 21 low-volume centers. In-hospital mortality after liver re-transplantation in high and low-volume centers were 25% and 36% (P = 0.069), respectively. Adjusted in-hospital mortality was not different between low and high-volume centers. Adjusted 1-year mortality was significantly higher in low-volume centers (OR 2.14, 95% CI 1.05–4.37, P = 0.037) compared to high-volume centers. Long-term survival for up to 9 years was also superior in high-volume centers (P = 0.005). Other risk factors of in-hospital mortality and 1-year mortality included female sex and higher Elixhauser comorbidity index. Conclusion Centers with higher case volume (≥ 64 LTs/year) showed lower in-hospital and overall mortality after liver re-transplantation compared to low-volume centers.
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Scherstén, Tore, Hans Brynger, Ingvar Karlberg e Egon Jonsson. "Cost-Effectiveness Analysis of Organ Transplantation". International Journal of Technology Assessment in Health Care 2, n. 3 (luglio 1986): 545–52. http://dx.doi.org/10.1017/s0266462300002622.
Testo completoAbstract (sommario):
In 1958 Joseph Murray and associates reported the first successful kidney transplantation between two identical twins at Peter Bent Brigham Hospital in Boston (14). Since then organ transplantation has advanced rapidly. Renal transplantation is now a standard treatment for irreversible renal failure, and liver transplantation is an accepted method for treating end-stage liver disease. A number of patients have survived more than 20 years after renal transplantation and more than 10 years after liver transplantation (20). Very few liver transplantations have been performed in Sweden but this method is expected to become more common in the near future.
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Wheeler, Kate A., Susan M. Richards, Clifford C. Bailey, Brenda Gibson, Ian M. Hann, Frank G. H. Hill e Judith M. Chessells. "Bone marrow transplantation versus chemotherapy in the treatment of very high–risk childhood acute lymphoblastic leukemia in first remission: results from Medical Research Council UKALL X and XI". Blood 96, n. 7 (1 ottobre 2000): 2412–18. http://dx.doi.org/10.1182/blood.v96.7.2412.
Testo completoAbstract (sommario):
Abstract The role of bone marrow transplantation (BMT) in first remission of children with high-risk acute lymphoblastic leukemia (ALL) remains unclear. There were 3676 patients (aged 1 to 15 years) entered into the United Kingdom (UK) Medical Research Council (MRC) trials UKALL X and XI from 1985 to 1997. Of these patients, 473 patients (13%) were classified as very high (VH) risk and were eligible for a transplantation from a matched histocompatible sibling donor (MSD). We tissue-typed 286 patients; 99 patients had a matched related donor, and 76 patients received transplantations. Additionally, 25 children received transplantations from a matched unrelated donor (MUD) despite trial guidelines for MSD transplantations only. The median time to transplantation was 5 months (range, 2 to 19 months), and the median follow-up was 8 years. The 10-year event-free survival (EFS) adjusted for the time to transplantation, diagnostic white blood cell (WBC) count, Ph chromosome status, and ploidy was 6.0% higher (95% confidence interval (CI), −10.5% to 22.5%) for 101 patients who received a first-remission transplantation (MSD and MUD) than for the 351 patients treated with chemotherapy (transplantation, 45.3%, vs chemotherapy, 39.3%). The transplantation group had fewer relapses (31%) compared to relapses in the chemotherapy group (55%); however, the transplantation group had more remission deaths (18%) compared to remission deaths in the chemotherapy group (3%). In contrast the adjusted 10-year EFS was 10.7% higher (95% CI, −2.6% to 24.0%) for patients without a human leukocyte antigen (HLA)–matched donor than for those patients with a donor (no donor, 50.4%, vs donor, 39.7%). In conclusion, for the majority of children with VH-risk ALL, the first-remission transplantation has not improved EFS.
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Wheeler, Kate A., Susan M. Richards, Clifford C. Bailey, Brenda Gibson, Ian M. Hann, Frank G. H. Hill e Judith M. Chessells. "Bone marrow transplantation versus chemotherapy in the treatment of very high–risk childhood acute lymphoblastic leukemia in first remission: results from Medical Research Council UKALL X and XI". Blood 96, n. 7 (1 ottobre 2000): 2412–18. http://dx.doi.org/10.1182/blood.v96.7.2412.h8002412_2412_2418.
Testo completoAbstract (sommario):
The role of bone marrow transplantation (BMT) in first remission of children with high-risk acute lymphoblastic leukemia (ALL) remains unclear. There were 3676 patients (aged 1 to 15 years) entered into the United Kingdom (UK) Medical Research Council (MRC) trials UKALL X and XI from 1985 to 1997. Of these patients, 473 patients (13%) were classified as very high (VH) risk and were eligible for a transplantation from a matched histocompatible sibling donor (MSD). We tissue-typed 286 patients; 99 patients had a matched related donor, and 76 patients received transplantations. Additionally, 25 children received transplantations from a matched unrelated donor (MUD) despite trial guidelines for MSD transplantations only. The median time to transplantation was 5 months (range, 2 to 19 months), and the median follow-up was 8 years. The 10-year event-free survival (EFS) adjusted for the time to transplantation, diagnostic white blood cell (WBC) count, Ph chromosome status, and ploidy was 6.0% higher (95% confidence interval (CI), −10.5% to 22.5%) for 101 patients who received a first-remission transplantation (MSD and MUD) than for the 351 patients treated with chemotherapy (transplantation, 45.3%, vs chemotherapy, 39.3%). The transplantation group had fewer relapses (31%) compared to relapses in the chemotherapy group (55%); however, the transplantation group had more remission deaths (18%) compared to remission deaths in the chemotherapy group (3%). In contrast the adjusted 10-year EFS was 10.7% higher (95% CI, −2.6% to 24.0%) for patients without a human leukocyte antigen (HLA)–matched donor than for those patients with a donor (no donor, 50.4%, vs donor, 39.7%). In conclusion, for the majority of children with VH-risk ALL, the first-remission transplantation has not improved EFS.
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Korucu, Berfu, Sena Ulu e Ozkan Gungor. "Current Approach to Renal Transplantation Candidates and Potential Donors with Viral Hepatitis". PRILOZI 44, n. 1 (1 marzo 2023): 135–44. http://dx.doi.org/10.2478/prilozi-2023-0015.
Testo completoAbstract (sommario):
Abstract Renal transplantation is the most beneficial treatment in patients with chronic kidney disease (CKD), increasing life expectancy and improving quality of life. A better understanding of organ and tissue functions, the development of surgical techniques, and new and effective immunosuppressive and antimicrobial drugs increase the success of transplantation. However, the number of renal transplantations from living and cadaveric donors is not at the desired frequency. Among the leading causes of the restrictions for transplantation are both the recipients’ and donors’ chronic diseases. While hepatitis B and C infections are a significant problem affecting the number and success of renal transplantations, the innovation of hepatitis C virus treatments has improved outcomes. Thus, the recipient and donor hepatitis B and C virus infections are no longer considered as relative contraindications for renal transplantation. This review discusses the management of patients and donors with hepatitis B and hepatitis C in renal transplantation.
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Park, Beverly Kosmach. "Intestinal Transplantation in Pediatric Patients". Progress in Transplantation 12, n. 2 (giugno 2002): 97–115. http://dx.doi.org/10.1177/152692480201200205.
Testo completoAbstract (sommario):
Intestine transplantation has evolved into a feasible alternative for children with permanent intestinal failure and life-threatening complications related to total parenteral nutrition. Although the first transplantations were done nearly 40 years ago, long-term survival has only been achieved in the last decade. Nearly 700 intestinal transplantations have been performed internationally since 1985, with an overall patient survival of greater than 50%. Improvements in patient selection, medical management, and assessment and treatment for rejection and infection have contributed to the increased survival. This article will discuss current results and medical management strategies for this innovative type of transplantation for children with end-stage short gut syndrome.
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Szomor, Árpád, Renáta Csalódi, Szabolcs Kosztolányi, Ágnes Nagy, Judit Pammer, Orsolya Tóth, Hajna Losonczy et al. "Autológ haemopoeticus őssejt-transzplantáció szerepe T-sejtes lymphomában. Magyar adatok". Orvosi Hetilap 158, n. 41 (ottobre 2017): 1615–19. http://dx.doi.org/10.1556/650.2017.30869.
Testo completoAbstract (sommario):
Abstract: T-cell lymphoma is a poor prognostic hematological malignancy. The generally used – not sufficiently effective – induction chemotherapy should be improved with consolidative autologous hemopoetic stem cell transplantation. The authors describe the role, place and effectiveness of transplantation in this disorder. One hundred thirty three autologous stem cell transplantations were performed in the last 22 years in Hungary. Detailed results are available from the last 6 years. In this period 43 transplantations were carried out in 4 Hungarian centers. Carmustine-etoposide-cytosine arabinoside-melphalan (BEAM) conditioning regimen was used in 95%. The transplantation was done mainly in complete remission (84%), 1 year after transplantation 65% of patients were still in complete remission. Eleven patients died, 82% of them have progressive disease. Brentuximab vedotin has already proved the effectiveness, several other chemoterapeutics, monoclonal antibodies, kinase inhibitors are under investigation. In certain cases allogeneic stem cell transplantation has real indication among therapeutic options. Orv Hetil. 2017; 158(41): 1615–1619.
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Weisdorf, Daniel J., Claudio Anasetti, Joseph H. Antin, Nancy A. Kernan, Craig Kollman, David Snyder, Effie Petersdorf, Gene Nelson e Philip McGlave. "Allogeneic bone marrow transplantation for chronic myelogenous leukemia: comparative analysis of unrelated versus matched sibling donor transplantation". Blood 99, n. 6 (15 marzo 2002): 1971–77. http://dx.doi.org/10.1182/blood.v99.6.1971.
Testo completoAbstract (sommario):
Abstract Allogeneic bone marrow transplantation (BMT) offers the only curative therapy for chronic myelogenous leukemia. We compared prospectively collected results of 2464 unrelated donor (URD) transplantations with 450 HLA-identical, matched sibling donor (MSD) transplantations performed at collaborating National Marrow Donor Program institutions. A total of 63% of URDs were matched at HLA-A, -B, and at -DRB1 alleles; all MSDs were genotypically identical at major histocompatibility loci. URD recipients were younger (median 36 vs 39, P = .001) than MSDs and underwent BMT later after diagnosis (median 17 [0-325 months] vs 7 [1-118 months],P = .001) and less often in chronic phase (CP) (67% vs 82%, P = .001). Multivariate analysis demonstrated a significantly increased risk of graft failure and acute graft versus host disease after URD BMT. The risk of hematologic relapse was low after either matched URD or MSD transplantations. We observed significantly though modestly poorer survival and disease-free survival (DFS) after URD transplantations. However, for those undergoing transplantation during CP within 1 year from diagnosis, 5-year DFS was similar or only slightly inferior after matched URD versus MSD transplantation (age < 30: URD 61% ± 8% vs MSD 68% ± 15%,P = .18; 30-40: URD 57% ± 9% vs MSD 67% ± 10%,P = .05; > 40: URD 46% ± 9% vs MSD 57% ± 9%,P = .02). Delay from diagnosis to BMT in CP patients led to substantially poorer 5-year DFS after matched URD than MSD BMT (CP 1-2 years: URD 39% ± 6% vs MSD 63% ± 12%; beyond 2 years: URD 33% ± 7% vs MSD 50% ± 20%). Outcome of matched URD BMT for early CP chronic myelogenous leukemia yields survival and DFS approaching that of MSD transplantation. However, delay may compromise URD outcomes to a greater extent. Improvements in URD and MSD transplantation are still needed, and results of newer, nontransplantation therapies should be evaluated against the established curative potential of URD and MSD marrow transplantation.
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Zykute, Dalia, Arūnas Gelmanas, Darius Trepenaitis e Andrius Macas. "Anaesthesia for Liver Transplantation". Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 76, n. 3 (1 giugno 2022): 387–90. http://dx.doi.org/10.2478/prolas-2022-0060.
Testo completoAbstract (sommario):
Abstract Since the first liver transplantation at the Kaunas Clinic of the Hospital of Lithuanian University of Health Sciences (LUHS), in 2000, many changes have been implemented and an increasing number of cases led to the development of expertise. The aim of this article was to summarise 12-years out of liver transplantation experience. Data was obtained retrospectively from inpatient medical records at the Hospital of LUHS, Kaunas Clinic. All cases of liver transplantations from November 2009 to September 2021 were included (n = 96). The median age of transplant recipients was 50 years (IQR 46–56). Two-thirds of recipients were male (n = 66, 69%). The mean Model for End-Stage Liver Disease (MELD) score was 23 (SD 6). The most common indication for liver transplantation was hepatitis C virus-related end-stage liver disease (n = 24, 25%). Immediate extubation was performed with a median of 63% of cases (IQR 14.3–75.7%). We further compared data between the early (November 2009 – December 2015) and late phases (January 2016 – September 2021) of experience: the number of liver transplantation cases increased by 66% from 36 to 60), MELD scores stayed similar (an average of 22 vs 24, p = 0.282), and mean intraoperative time did not change significantly (543 minutes vs 496 minutes, p = 0.078). Liver transplantation has been gaining momentum in Lithuania. Increasing experience enables our centre to meet an increasing demand for liver transplantations.
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Khubutiya, M. Sh, A. V. Pinchuk, N. V. Shmarina, I. V. Dmitriev, V. E. Vinogradov, A. I. Kazantsev e A. G. Balkarov. "Patient and kidney graft survival rates after first and second kidney transplantation". Transplantologiya. The Russian Journal of Transplantation 13, n. 2 (21 giugno 2021): 130–40. http://dx.doi.org/10.23873/2074-0506-2021-13-2-130-140.
Testo completoAbstract (sommario):
Introduction. Expanding donation criteria is one way of solving the problem of the increasing need of transplantation. The article is dedicated to comparison of the outcomes of first and second repeated kidney transplantation using grafts from standard criteria and expanded criteria donors.Aim. To evaluate 1-year and 5-year recipient and kidney graft survival rates after first and second kidney transplantation according to the donor type – standard criteria or expanded criteria donors.Material and methods. From 2007 till 2019 we performed 1459 kidney transplantations. The comparison study of outcomes of first (n=196) and second (n=143) kidney transplantations from standard criteria (n=245) and expanded criteria (n=94) donors was made.Results. There were no significant differences in a 1-year patient survival according to the donor type (98% and 95%, p=0.13). A 5-year recipient survival was significantly poorer after kidney transplantation from expanded criteria donors (97.6% and 88%, p=0.01). There were no significant differences in 1-year and 5-year graft survival rates according to the order of transplantation (p=0.21 and p=0.36). We found no significant difference in 1-year recipient survival after kidney transplantation from expanded criteria donors according to the order of transplantation (p=0.50). A 5-year recipient survival was significantly difference poorer after second kidney transplantation from expanded criteria donors (p=0.04). One-year and 5-year graft survival rates were significantly lower after kidney transplantation from expanded criteria donors (94%, 88% vs 86%, 65%, p=0.0025 and p=0.0011, respectively). One-year and 5-year survival rates were higher after first kidney transplantation from standard criteria donors in comparison with second kidney transplantation (p=0.052 and p=0.02, statistically significant in both cases). Analyzing outcomes of kidney transplantation from expanded criteria donors we found 1-year and 5-year graft survivals to be higher after first kidney transplantation comparing with second kidney transplantation (p=0.030 and p=0.018, statistically significant in both cases).Conclusion. In case of second organ transplantation, it is reasonable to use organs from standard criteria donors.
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Dmitriev, I. V., S. P. Shchelykalina, D. V. Lonshakov, Yu A. Anisimov, A. I. Kazantsev e A. V. Pinchuk. "Analysis of the results of pancreas transplantation in one transplant center in Russia". Transplantologiya. The Russian Journal of Transplantation 13, n. 3 (21 settembre 2021): 220–34. http://dx.doi.org/10.23873/2074-0506-2021-13-3-220-234.
Testo completoAbstract (sommario):
Introduction. The total number of pancreas transplantations performed in Russia by the end of 2019 had been 176. There are no detailed reports on the number and results of pancreas transplantation in Russia with analysis of factors that significantly affect outcomes.Material and methods. This article presents a retrospective analysis of 60 pancreas transplantation results, which had been performed from January 2008 to July 2019 at the N.V. Sklifosovsky Research Institute for Emergency Medicine. In addition, the assessment of factors that significantly affect the outcomes of pancreas transplantations was performed.Results. 17 intra-abdominal pancreas transplantations with duodenoejunoanastomosis and 43 retroperitoneal pancreas transplantations with interduodenal anastomosis were performed. In 52 patients, the pancreas graft after vascular reconstruction with a Y-shaped vascular prosthesis was used; in other 8 patients, the pancreas graft with isolated blood flow through the splenic artery was used. The rates of immunological and surgical complications were 23.3% and 56.7%, respectively. In-hospital and 1-year recipient, kidney and pancreas graft survival rates were 88.3%, 86.4%, 83.3% and 86.6%, 84.8%, and 81.7%, respectively. The factors that significantly affected the outcomes of pancreas transplantation were the conversion of the dialysis therapy modality, the development of parapancreatic infection, repeated open surgical interventions, surgical complications of IIIb-IVa severity grades by Clavien-Dindo Classification, some features of basic and induction immunosuppressive therapy.Conclusion. The results of pancreas transplantation at the N.V. Sklifosovsky Research Institute for Emergency Medicine are comparable to the outcomes of pancreas transplantation in most world transplant centers.
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Poptsov, V. N. "COMBINED HEART-KIDNEY TRANSPLANTATION". Russian Journal of Transplantology and Artificial Organs 18, n. 1 (16 aprile 2016): 78–82. http://dx.doi.org/10.15825/1995-1191-2016-1-78-82.
Testo completoAbstract (sommario):
Combined heart-kidney transplantation may be performed in carefully selected patients with end-stage heart disease and renal failure. There are two types of combined transplantation of heart and kidney: 1) simultaneous heart-kidney transplantation (SHKT) from the same donor; 2) staged transplantation of heart and kidneys from two genetically different donors. The ISHLT registry in 2014 reported an increase in the number of SHKT over the years: from 22 in 1994 to 97 in 2012. World experience demonstrated excellent results of SHKT. Recipients of SHKT had superior survival, lower rates of acute cardiac and renal rejection compared to heart recipients. This article discusses the indications for simultaneous or staged heart-kidney transplantation in patients with dialysis-independent or dialysis-dependent renal failure, results and posttransplant survival of SHKT recipients. The author describes his own experience of 2 staged combined heart-kidney transplantations.
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Schrezenmeier, Hubert, Jakob R. Passweg, Judith C. W. Marsh, Andrea Bacigalupo, Christopher N. Bredeson, Eduardo Bullorsky, Bruce M. Camitta et al. "Worse outcome and more chronic GVHD with peripheral blood progenitor cells than bone marrow in HLA-matched sibling donor transplants for young patients with severe acquired aplastic anemia". Blood 110, n. 4 (15 agosto 2007): 1397–400. http://dx.doi.org/10.1182/blood-2007-03-081596.
Testo completoAbstract (sommario):
AbstractWe analyzed the outcome of 692 patients with severe aplastic anemia (SAA) receiving transplants from HLA-matched siblings. A total of 134 grafts were peripheral blood progenitor cell (PBPC) grafts, and 558 were bone marrow (BM) grafts. Rates of hematopoietic recovery and grades 2 to 4 chronic graft-versus-host disease (GVHD) were similar after PBPC and BM transplantations regardless of age at transplantation. In patients older than 20 years, chronic GVHD and overall mortality rates were similar after PBPC and BM transplantations. In patients younger than 20 years, rates of chronic GVHD (relative risk [RR] 2.82; P = .002) and overall mortality (RR 2.04; P = .024) were higher after transplantation of PBPCs than after transplantation of BM. In younger patients, the 5-year probabilities of overall survival were 73% and 85% after PBPC and BM transplantations, respectively. Corresponding probabilities for older patients were 52% and 64%. These data indicate that BM grafts are preferred to PBPC grafts in young patients undergoing HLA-matched sibling donor transplantation for SAA.
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Tsakiris, D. A., e G. Stussi. "Late effects on haemostasis after haematopoietic stem cell transplantation". Hämostaseologie 32, n. 01 (2012): 63–66. http://dx.doi.org/10.5482/ha-1184.
Testo completoAbstract (sommario):
SummaryAllogeneic and autologous hematopoietic stem cell transplantations are important therapeutic options for patients with hematologic disorders. Hemostatic complications are frequent after hematopoietic stem cell transplantation with a considerable morbidity and mortality. The incidence of bleedings and thrombosis is highest in the first few weeks after transplantation, but may also occur later. However, beyond the first year of transplantation only limited data are available. In longterm survivors the risk for premature atherosclerosis increases over time after allogeneic hematopoietic stem cell transplantation and it is higher than in the age-adjusted general population and in recipients of autologous transplantation.
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Tsakiris, A., e G. Stussi. "Late effects on haemostasis after haematopoietic stem cell transplantation". Onkologische Welt 03, n. 01 (2012): 12–15. http://dx.doi.org/10.1055/s-0038-1630988.
Testo completoAbstract (sommario):
SummaryAllogeneic and autologous hematopoietic stem cell transplantations are important therapeutic options for patients with hematologic disorders. Hemostatic complications are frequent after hematopoietic stem cell transplantation with a considerable morbidity and mortality. The incidence of bleedings and thrombosis is highest in the first few weeks after transplantation, but may also occur later. However, beyond the first year of transplantation only limited data are available. In longterm survivors the risk for premature atherosclerosis increases over time after allogeneic hematopoietic stem cell transplantation and it is higher than in the age-adjusted general population and in recipients of autologous transplantation.
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Levine, John E., Richard E. Harris, Fausto R. Loberiza, James O. Armitage, Julie M. Vose, Koen Van Besien, Hillard M. Lazarus e Mary M. Horowitz. "A comparison of allogeneic and autologous bone marrow transplantation for lymphoblastic lymphoma". Blood 101, n. 7 (1 aprile 2003): 2476–82. http://dx.doi.org/10.1182/blood-2002-05-1483.
Testo completoAbstract (sommario):
Lymphoblastic lymphoma (LBL) is a rare, clinically aggressive neoplasm of the young that frequently involves the bone marrow (BM) and/or central nervous system. Because LBL is similar to acute lymphoblastic leukemia, some centers prefer allogeneic hematopoietic stem cell (SC) transplantation to autologous SC transplantation. We retrospectively analyzed outcomes for patients who underwent autologous (auto, n = 128) or HLA-identical sibling (allo, n = 76) SC transplantations from 1989 to 1998 and were reported to International Bone Marrow Transplant Registry (IBMTR) or Autologous Blood and Marrow Transplant Registry (ABMTR). Allo stem cell transplant (SCT) recipients had higher treatment-related mortality (TRM) at 6 months (18% versus 3%, P = .002), and this disadvantage persisted at 1 and 5 years. Early relapse rates after alloSC transplantation and autoSC transplantation were similar, but significantly lower relapse rates were observed in alloSCT recipients at 1 and 5 years (32% versus 46%, P = .05; and 34% versus 56%,P = .004, respectively). No differences were noted in lymphoma-free survival rates between alloSC transplantations and autoSC transplantations (5-year rates 36% versus 39%,P = .82). AutoSCT recipients had higher overall survival at 6 months (75% versus 59%, P = .01), but survival did not significantly differ between the 2 groups at 1 and 5 years (60% versus 49%, P = .09; 44% versus 39%,P = .47, respectively). Multivariate analyses to account for confounding factors confirmed these results. Independent of SCT type, BM involvement at the time of transplantation and disease status more advanced than first complete remission were associated with inferior outcomes. In summary, alloSC transplantation for LBL is associated with fewer relapses than with autoSC transplantation, but higher TRM offsets any potential survival benefit.
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Mohebipour, Alireza, Serena Gianfaldoni, Torello Lotti, Marigdalia K. Ramirez-Fort, Christopher S. Lange, Homayoun Sadeghi-Bazargani, Uwe Wollina, Georgi Tchernev e Amir Feily. "Recycling of Previously Transplanted Hair: A Novel Indication for Follicular Unit Extraction". Open Access Macedonian Journal of Medical Sciences 6, n. 6 (17 giugno 2018): 1095–97. http://dx.doi.org/10.3889/oamjms.2018.096.
Testo completoAbstract (sommario):
BACKGROUND: Hair transplantation has enhanced the realm of procedural dermatology. Before the advent of follicular transplantation, androgenetic alopecia was a difficult disease to manage, as there is a limited armamentarium of topical and systemic pharmaceuticals. However, as with other novel surgical procedures, there is a steep learning curve, that may result in poor transplantation or cosmesis.CASE REPORT: We present a case of androgenetic alopecia, where previously, poorly implanted hairs were recycled by follicular unit extraction to increase hair density at the vertex of the scalp, which resulted in improved cosmesis and patient satisfaction.CONCLUSION: We have demonstrated that re-transplantation is not only feasible but is effective; therefore redesigning of previous transplantations should be considered as a possible indication follicle unit extraction, particularly in the setting of scarce follicular reserves. The utility of our recycling method may also inspire hope in patients that have undergone failed or unsatisfactory hair transplantations.
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Arbeiter, Klaus, Andrea Pichler, Gabriele Muerwald, Thomas Mueller, Bettina Bidmon, Egon Balzar, Dagmar Ruffingshofer, Laurence Greenbaum e Christoph Aufricht. "Timing of Peritoneal Dialysis Catheter Removal after Pediatric Renal Transplantation". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 21, n. 5 (settembre 2001): 467–70. http://dx.doi.org/10.1177/089686080102100507.
Testo completoAbstract (sommario):
Background A peritoneal dialysis (PD) catheter is in place at the time of kidney transplantation in children receiving PD. Removal of the catheter eliminates the risk of catheter-related infections. However, the patient benefits from leaving the catheter in place if dialysis is necessary posttransplantation. There is currently no consensus on the proper timing of PD catheter removal after kidney transplantation in children. Objective To identify the risks and benefits of an indwelling PD catheter after renal transplantation in children. Design Retrospective single-center study of infectious complications and posttransplantation PD catheter use in 31 renal transplantations in 26 children. Results Peritoneal dialysis catheters were used postoperatively in 13 of the 31 transplantations. In 12 instances the catheter was needed during the first month after transplantation, and 2 of the patients involved did not have a catheter in place when needed. Six catheter-related infections occurred in 5 patients posttransplantation, with only 1 infection taking place within 1 month after transplantation. Conclusion Our data suggest that the need for catheter use occurs predominantly during the first month, while infectious complications usually happen later. This strongly suggests that PD catheters should not be removed until approximately 1 month after kidney transplantation.
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Schaefers, Hans J. "Lung transplantation-current status". Journal of the Japanese Association for Chest Surgery 19, n. 3 (2005): 285. http://dx.doi.org/10.2995/jacsurg.19.285.
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Dabak, Gül, e Ömer Şenbaklavacı. "History of Lung Transplantation". Turkish Thoracic Journal 17, n. 2 (10 giugno 2016): 71–75. http://dx.doi.org/10.5578/ttj.17.2.014.
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Dewangan, Sangeeta. "Renal Transplantation in Children". International Journal of Trend in Scientific Research and Development Volume-3, Issue-2 (28 febbraio 2019): 644–49. http://dx.doi.org/10.31142/ijtsrd21432.
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El Danaf, Ahmed. "Plastic and Transplantation Surgeries". International Journal of Transplantation & Plastic Surgery 8, n. 1 (2024): 1. http://dx.doi.org/10.23880/ijtps-16000181.
Testo completoAbstract (sommario):
Enthusiasm ensures continuous evolution through trials and errors. Surgical developments rely on a strong foundation in basic medical and surgical sciences, as well as training in procedural technical skills and the accumulation of experience. Tissue transfer serves as the common ground between plastic and transplantation surgery. Both disciplines require precision and often involve micro vascular expertise.
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Xiao, Yuhua, Chunfu Li, Yuelin He, Xuedong Wu, Zhiyong Peng, Yuqiong Ren, Yongsheng Ruan e Xiaoqin Feng. "A Retrospective Analysis of Transplantation Related Mortality in 515 Cases of Children β-Thalassemia Major". Blood 132, Supplement 1 (29 novembre 2018): 2187. http://dx.doi.org/10.1182/blood-2018-99-118739.
Testo completoAbstract (sommario):
Abstract Objective: At present allo-genetic hematopoietic stem cell transplantation (Allo-HSCT) remains the only consolidated curative approach for β- thalassemia major. How to reduce transplantation related mortality is the key to improve the curative ratio. Hence, the aim of this study was to retrospectively analyze the clinical data of 27 cases of β- thalassemia major in children who were died related allo-HSCT, and sum up the death factors related to transplantation as well as clinical experience. Methods: There were 515 children with β- thalassemia major who underwent transplantation in Nanfang Hospital from December 2008 to December 2017. In this study, we used the life tables and chi-square test in SPSS 20.0 statistical software to analyze the survival rate, causes of death and related factor. Results: In our center, the nine-year disease-free survival was 90%±3%, and the transplantation related mortality was 6%±1%. A total of 27 dead patients including 20 boys and 7 girls underwent 30 transplantations at the age from 7-month-old to 14-year-old, while median age was 5-year-old, with 20 human leukocytes antigen (HLA) matched donors and 10 HLA mismatched donors. As for source of stem cell, 23 transplantations used peripheral blood stem cell (PBSC), 1 transplantation used umbilical cord blood (CB), 2 transplantations used bone marrow (BM), 1 transplantation used PBSC+CB, 2 transplantations used BM+CB and 1 transplantation used PBSC+BM+CB. Before transplantation, the mean values of cardiac ejection fraction, serum ferritin and erythrocyte infusion were 69.3%, 3555.5ng/ml and 94.5 infusions, respectively. During transplantation, the mean mononuclear cells(MNC) and CD34+ cells were 7.7×10^8/kg and 5.1×10^5/kg respectively. Granulocytes were engrafted in +17.2 days and platelets were engrafted in +22.8 days. After HSCT, 25.9% of deaths occurred within 100 days and 81.5% within one year. Thirteen cases( 48.1% ) died of graft versus host disease (GVHD) or GVHD combined with infection. Eight cases( 29.6%) died of severe infection (including 1 case of severe dengue fever). Two cases died of hepatic vein obstruction disease(HVOD). Two cases died of bone marrow failure. One case died of hypoxic ischemic encephalopathy and one case died of hemolytic uremia syndrome. Compared with the incidence of GVHD and infection, GVHD had no significant correlation with infection (χ2= 3.095, P=0.128). At last, pulmonary infection was the most common complication (24/27, 88.9%). Conclusion: The mortality of transplantation in our center was 6%±1%. This study showed that the majority of deaths occurred within 1 year of transplantation. The most common causes of death were acute or chronic GVHD and infection. Pulmonary infection was the most common complication in the cases of death. However, there was no significant correlation between the incidence of GVHD and infection. Therefore, strategies of prophylaxis of GVHD and infection should be strengthened, and the dialectical relationship between the GVHD and infection still need to be further investigated. Disclosures No relevant conflicts of interest to declare.
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Czigány, Zoltán, Junji Iwasaki, Shintaro Yagi, Kazuyuki Nagai, Attila Szijártó, Shinji Uemoto e René H. Tolba. "Improving Research Practice in Rat Orthotopic and Partial Orthotopic Liver Transplantation: A Review, Recommendation, and Publication Guide". European Surgical Research 55, n. 1-2 (2015): 119–38. http://dx.doi.org/10.1159/000437095.
Testo completoAbstract (sommario):
Background: Due to a worldwide shortage of donor organs for liver transplantation, alternative approaches, such as split and living donor liver transplantations, were introduced to increase the donor pool and reduce mortality on liver transplant waiting lists. Numerous details concerning the mechanisms and pathophysiology of liver regeneration, small-for-size syndrome, rejection, and tolerance in partial liver transplantation facilitated the development of various animal models. The high number of preclinical animal studies contributed enormously to our understanding of many clinical aspects of living donor and partial liver transplantations. Summary: Microsurgical rat models of partial orthotopic liver transplantation are well established and widely used. Nevertheless, several issues regarding this procedure are controversial, not clarified, or not yet properly standardized (graft rearterialization, size reduction techniques, etc.). The major aim of this literature review is to give the reader a current overview of rat orthotopic liver transplantation models with a special focus on partial liver transplantation. The aspects of model evolution, microsurgical training, and different technical problems are analyzed and discussed in detail. Our further aim in this paper is to elaborate a detailed publication guide in order to improve the quality of reporting in the field of rat liver transplantation according to the ARRIVE guidelines and the 3R principle. Key Messages: Partial orthotopic liver transplantation in rats is an indispensable, reliable, and cost-efficient model for transplantation research. A certain consensus on different technical issues and a significant improvement in scientific reporting are essential to improve transparency and comparability in this field as well as to foster refinement.
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Hussein, Mohamad A., Vanessa Bolejack, Jeffrey A. Zonder, Brian G. M. Durie, Andrzej J. Jakubowiak, John J. Crowley e Bart Barlogie. "Phase II Study of Thalidomide Plus Dexamethasone Induction Followed by Tandem Melphalan-Based Autotransplantation and Thalidomide-Plus-Prednisone Maintenance for Untreated Multiple Myeloma: A Southwest Oncology Group Trial (S0204)". Journal of Clinical Oncology 27, n. 21 (20 luglio 2009): 3510–17. http://dx.doi.org/10.1200/jco.2008.19.9240.
Testo completoAbstract (sommario):
Purpose Thalidomide-dexamethasone (THAL-DEX) is standard induction therapy for multiple myeloma (MM). Tandem melphalan-based transplantations have yielded superior results to single transplantations. Phase II trial S0204 was designed to improve survival results reported for the predecessor, phase III trial S9321 by 50%. Patients and Methods Newly diagnosed patients with MM were eligible for S0204 with THAL-DEX induction, tandem melphalan-based tandem transplantation, and THAL-prednisone maintenance. Results Of 143 eligible patients, 142 started induction, 73% completed first transplantation, 58% completed second transplantation, and 56% started maintenance. The quantity of stem cells required for two transplantations was reached in 88% of 111 patients undergoing collection, 74% of whom completed both transplantations. Partial response, very good partial remission, and complete response were documented after 12 months of maintenance therapy in 87%, 72%, and 22% of patients, respectively. During a median follow-up time of 37 months, 4-year estimates of event-free and overall survival were 50% and 64%, respectively. Survival outcomes were superior for International Staging System (ISS) stage 1 disease, when lactate dehydrogenase (LDH) levels were normal and a second transplantation was applied in a timely fashion. Conclusion Both overall survival (P = .0002) and event-free survival (P < .0001) were significantly improved with S0204 compared with S9321 when 121 and 363 patients, respectively, were matched on ISS stage and LDH.
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Gok, Emre, Carrie A. Kubiak, Erin Guy, Stephen W. P. Kemp e Kagan Ozer. "Effect of Static Cold Storage on Skeletal Muscle after Vascularized Composite Tissue Allotransplantation". Journal of Reconstructive Microsurgery 36, n. 01 (14 luglio 2019): 009–15. http://dx.doi.org/10.1055/s-0039-1693455.
Testo completoAbstract (sommario):
Background Prolonged cold ischemia associated with static cold storage (SCS) results in higher incidence of acute and chronic allograft rejection in solid organ transplantations. Deleterious effects of SCS on vascularized composite tissue allograft were studied with limited data on muscle structure and function. The aim of this study is to evaluate the long-term impact of SCS on muscle metabolism, structure, and force generation using a syngeneic rat hindlimb transplantation model. Methods Sixty-five male Lewis rats (250 ± 25 g) were distributed into five groups, including naive control, sciatic nerve denervation/repair, immediate transplantation, transplantation following static warm storage for 6 hours at room temperature, and transplantation following SCS for 6 hours at 4°C. Sciatic nerves were repaired in all transplantations. Muscle samples were taken for histology and metabolomics analysis following electromyography and muscle force measurements at 12 weeks after transplantation. Results All cold-preserved limbs remained viable at 12 weeks, whereas animals receiving limbs preserved in room temperature had no survivors. The SCS transplantation group showed a 73% injury score, significantly higher than groups receiving immediate transplants without cold preservation (50%, p < 0.05). A significant decline in muscle contractile force was also demonstrated in comparison to the immediate transplantation group (p < 0.05). In the SCS group, muscle energy reserves remained relatively well preserved in surviving fibers. Conclusion SCS extends allograft survival but fails to preserve muscle structure and force.
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Lang, György, Krisztina Czebe, Balázs Gieszer e Ferenc Rényi-Vámos. "Lung transplantation program for Hungarian patients". Orvosi Hetilap 154, n. 22 (giugno 2013): 868–71. http://dx.doi.org/10.1556/oh.2013.29638.
Testo completoAbstract (sommario):
When conservative treatment fails, lung transplantation often remains the only therapeutic option for patients with end stage parenchymal or vascular lung diseases. According to the statistics of the International Society for Heart and Lung Transplantation, in 2010 more than 3500 lung transplantations have been performed worldwide. The Department of Thoracic Surgery at the University of Vienna is considered to be one of the world’s leading lung transplantation centres; in the last year 115, since 1989 more than 1500 lung transplantation procedures under the supervision of Prof. Dr. Walter Klepetko. Similar to other Central-European countries, lung transplantation procedures of Hungarian patients have also been performed in Vienna whithin the framework of a twinning aggreement. However, many crucial tasks in the process, such indication and patient selection preoperative rehabilitation organ procurement and long term follow-up care have been stepwise taken over by the Hungarian team. Although the surgery itself is still preformed in Vienna, professional experience is already available in Hungary, since the majority of Hungarian recipients have been transplanted by hungarian surgeons who are authors of this article the professional and personal requirements of performing lung transplantations are already available in Hungary. The demand of performing lung transplantation in Hungary has been raising since 1999 and it soon reaches the extent which justifies launching of an individual national program. Providing the technical requirements is a financial an organisational issue. In order to proceed, a health policy decision has to be made. Orv. Hetil., 2013, 154, 868–871.
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Edelman, Jeffrey D. "Outcomes, Management, and Complications of Lung Transplantation for Pulmonary Hypertension". Advances in Pulmonary Hypertension 9, n. 1 (1 gennaio 2010): 40–46. http://dx.doi.org/10.21693/1933-088x-9.1.40.
Testo completoAbstract (sommario):
Successful lung and heart-lung transplantations were achieved nearly 3 decades ago at a time when medical therapeutic options for patients with pulmonary arterial hypertension were extremely limited. While the medical arsenal for treatment of pulmonary arterial hypertension has expanded considerably since this time, lung and heart-lung transplantations continue to offer potential for improved survival and quality of life for patients who experience disease progression despite medical therapy. The majority of patients with pulmonary hypertension requiring transplantation can be successfully treated with lung transplantation and do not require combined heart-lung transplantation. Advances in surgical techniques, medical management, donor and recipient selection, pharmacologic therapies, and clinical outcomes assessment have led to ongoing improvements in short- and long-term outcomes. Long-term success requires appropriate candidate and donor selection, experienced surgical and medical teams, diligent medical follow-up by the transplant team in collaboration with community medical providers, and excellent patient adherence with post-transplant care and therapy. This article addresses short- and long-term management and complications associated with lung transplantation. Outcomes after transplantation, immunosuppressive management, acute and chronic rejection, medical morbidities, and underlying diagnosis-specific concerns are discussed.
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Morrell, Matthew R., Sarah C. Kiel e Joseph M. Pilewski. "Organ Transplantation for Cystic Fibrosis". Seminars in Respiratory and Critical Care Medicine 40, n. 06 (dicembre 2019): 842–56. http://dx.doi.org/10.1055/s-0039-3399554.
Testo completoAbstract (sommario):
AbstractCystic fibrosis (CF) remains the most common indication for lung transplantation in children and the third most common in adults and has the highest median survival posttransplant for all pretransplant diagnoses. Criteria for transplant in patients with CF vary widely among transplant centers and early referral to multiple centers may be needed to maximize opportunities for lung transplantation. Comorbidities unique to CF such as resistant and atypical pathogens like Burkholderia and Mycobacterium abscessus, and cirrhosis require special consideration for lung transplantation but should not be considered as absolute contraindications. For those patients who are listed for lung transplantation, mechanical support with extracorporeal membrane oxygenation and mechanical ventilation can be efficacious as bridges to lung transplantation in experienced centers with adequate resources. Liver and pancreas transplantations are also acceptable options for end-organ disease related to CF and can provide improvements in both quantity and quality of life.
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Ruutu, Tapani, Christian Koenecke e Grzegorz W. Basak. "Allogeneic hematopoietic stem cell transplantation and solid organ transplantation in the same patient". Cellular Therapy and Transplantation 4, n. 1-2 (2015): 14–18. http://dx.doi.org/10.18620/1866-8836-2015-4-1-2-14-18.
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Tokalak, Ibrahim, Hamdi Karakayali, Gökhan Moray, Nevzat Bilgin e Mehmet Haberal. "Coordinating Organ Transplantation in Turkey: Effects of the National Coordination Center". Progress in Transplantation 15, n. 3 (settembre 2005): 283–85. http://dx.doi.org/10.1177/152692480501500313.
Testo completoAbstract (sommario):
In January 2001, the National Coordination Center, which brought tissue and organ procurement and transplantation under the Turkish Health Ministry, was established in Turkey. The main aims of this organization are to expand cadaveric donation and increase the number of transplantable organs supplied by cadaveric donors. We compared the proportions of cadaveric organ transplantations that were performed in Turkey before and after the national coordination system was established. Of all the cadaveric transplantations completed to date, 91.6% of kidney and 71.5% of liver procedures were done before implementation of the new system, and 8.4% and 28.5%, respectively, were performed after the system was established. The data show that the frequency of cadaveric donation has increased, as well as the number of cadaveric organ transplantations performed annually. The new national transplantation coordination system is making a good start at increasing cadaveric transplantation in Turkey. This system will hopefully lead to a larger organ pool and shorter waiting lists in future.
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Bátai, Árpád, Péter Reményi, Marienn Réti, Anikó Barta, László Gopcsa, Lilla Lengyel, Éva Torbágyi et al. "Allogén vérképzőőssejt-átültetés Magyarországon". Orvosi Hetilap 158, n. 8 (febbraio 2017): 291–97. http://dx.doi.org/10.1556/650.2017.30648.
Testo completoAbstract (sommario):
Abstract: Introduction and aim: The publication summarizes the 2548 stem cell transplantations performed in the period of 1993-2015 in Szent Laszló Hospital, Budapest and provides a detailed discussion of the 425 allogeneic transplantations during 2007–2013. Method: The analysis explains the major steps of the evolution of allogeneic stem cell transplantation and compares the results of the unique Hungarian allogeneic center. Results: The significant shift in the transplantation indications from chronic myeloid leukemia to myelodysplastic syndromes and the rising age of the recipients are in line with world wide tendencies. The latter one is the consequence of the introduction and improvement of the concept of reduced intensity conditioning regimens, originally arising from the idea of Endre Kelemen. The most limiting factor, the donor availability seems to be resolved with the use of a new immunomodulating regimen, the application of posttransplantation cyclophosphamide, which allows the transplantation through HLA barriers with haploidentical family donors with comparable results to the HLA matched volunteer unrelated donors. The above mentioned tendencies result the wider use of allogeneic stem cell transplantation less dependent from recipient age, comorbidities and even donor availability. Conclusions: The publication highlights the need of expanding the stem cell transplantation budget and the involvement of new centers in Hungary in allogeneic of stem cell transplantation. Orv. Hetil., 2017, 158(8), 291–297.
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Zitelli, Basil J., J. Jeffrey Malatack, J. Carlton Gartner, Andrew H. Urbach, Laurel Williams, Joanne W. Miller e Beverly Kirkpatrick. "Evaluation of the Pediatric Patient for Liver Transplantation". Pediatrics 78, n. 4 (1 ottobre 1986): 559–65. http://dx.doi.org/10.1542/peds.78.4.559.
Testo completoAbstract (sommario):
In a 36-month period from 1981 to 1984, 209 pediatric patients were evaluated for liver transplantation. The purpose of the evaluation was to assess the severity and progression of the disease, anatomical suitability for transplantation, and psychosocial stability and to initiate family education. Of the 209 patients evaluated, 85 (41%) underwent transplantations and 64 (75%) survived at least 12 months. Thirty-four (16%) patients were not considered candidates for transplantation. The mean waiting period increased from 80.3 days to 232 days. Of 174 patients considered for transplantation, 41 (24%) died prior to surgery. A formal evaluation for liver transplantation permitted appropriate selection of candidates and provided education for informed consent. We also stress the need for greater participation in pediatric organ donation.
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Brunstein, Claudio G., Daniel J. Weisdorf, Todd DeFor, Juliet N. Barker, Jakub Tolar, Jo-Anne H. van Burik e John E. Wagner. "Marked increased risk of Epstein-Barr virus-related complications with the addition of antithymocyte globulin to a nonmyeloablative conditioning prior to unrelated umbilical cord blood transplantation". Blood 108, n. 8 (15 ottobre 2006): 2874–80. http://dx.doi.org/10.1182/blood-2006-03-011791.
Testo completoAbstract (sommario):
AbstractUmbilical cord blood (UCB) is increasingly used as an alternative source of hematopoietic stem cells for transplantation for patients who lack a suitable sibling donor. Despite concerns about a possible increased risk of Epstein-Barr virus (EBV) posttransplantation lymphoproliferative disorder (PTLD) after UCB transplantation, early reports documented rates of PTLD comparable to those reported after HLA-matched unrelated marrow myeloablative (MA) transplantations. To further investigate the incidence of EBV PTLD after UCB transplantation and potential risk factors, we evaluated the incidence of EBV-related complications in 335 patients undergoing UCB transplantation with an MA or nonmyeloablative (NMA) preparative regimen. The incidence of EBV-related complications was a 4.5% overall, 3.3% for MA transplantations, and 7% for NMA transplantations. However, the incidence of EBV-related complications was significantly higher in a subset of patients treated with an NMA preparative regimen that included antithymocyte globulin (ATG) versus those that did not (21% vs 2%; P < .01). Nine of 11 patients who developed EBV PTLD were treated with rituximab (anti-CD20 antibody), with the 5 responders being alive and disease free at a median of 26 months. Use of ATG in recipients of an NMA preparative regimen warrants close monitoring for evidence of EBV reactivation and potentially preemptive therapy with rituximab.
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Kvaratskheliya, Malkhaz Viktorovich. "Combined or isolated transplantation of pancreas and kidney at the terminal stage of diabetic nephropathy". Diabetes mellitus 13, n. 4 (15 dicembre 2010): 76–82. http://dx.doi.org/10.14341/2072-0351-6062.
Testo completoAbstract (sommario):
This review of current foreign literature is focused on the analysis of different variants of pancreas and kidney transplantation in patients with terminalrenal insufficiency resulting from diabetic nephropathy. Most authors consider combined pancreas and kidney transplantation to be the method ofchoice for patients with this pathology. Given the adequately functioning pancreas implant, this operation ensures excellent engaftment of the kidneyimplant and survival of the recipient. An alternative method is isolated transplantation of a kidney from a live donor with subsequent transplantationof the pancreas. Isolated transplantation of a cadaveric kidney results in transplant and recipient.
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Nguyen, Dung, Shira Gurvitz-Gambrel, Paul A. Sloan, Jeremy S. Dority, Amy DiLorenzo, Zaki-Udin Hassan e Annette Rebel. "The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience". International Surgery 100, n. 4 (1 aprile 2015): 672–77. http://dx.doi.org/10.9738/intsurg-d-14-00279.1.
Testo completoAbstract (sommario):
The objective of this study was to assess whether resident exposure to liver transplantation anesthesia results in improved patient care during a simulated critical care scenario. Our hypothesis was that anesthesia residents exposed to liver transplantation anesthesia care would be able to identify and treat a simulated hyperkalemic crisis after reperfusion more appropriately than residents who have not been involved in liver transplantation anesthesia care. Participation in liver transplantation anesthesia is not a mandatory component of the curriculum of anesthesiology training programs in the United States. It is unclear whether exposure to liver transplantation anesthesia is beneficial for skill set development. A high-fidelity human patient simulation scenario was developed. Times for administration of epinephrine, calcium chloride, and secondary hyperkalemia treatment were recorded. A total of 25 residents with similar training levels participated: 13 residents had previous liver transplantation experience (OLT), whereas 12 residents had not been previously exposed to liver transplantations (non-OLT). The OLT group performed better in recognizing and treating the hyperkalemic crisis than the non-OLT group. Pharmacologic therapy for hyperkalemia was given earlier (OLT 53.3 ± 27.0 seconds versus non-OLT 148 ± 104.1 seconds; P < 0.01) and hemodynamics restored quicker (OLT 87.9 ± 24.9 seconds versus non-OLT 219.9 ± 87.1 seconds; P < 0.01). Simulation-based assessment of clinical skills is a useful tool for evaluating anesthesia resident performance during an intraoperative crisis situation related to liver transplantations. Previous liver transplantation experience improves the anesthesia resident's ability to recognize and treat hyperkalemic cardiac arrest.
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Altaş, Özge. "Are we going to survive transplant during the coronavirus disease 2019 outbreak: A case report". Cardiovascular Surgery and Interventions 10, n. 1 (28 marzo 2023): 68–71. http://dx.doi.org/10.5606/e-cvsi.2023.1492.
Testo completoAbstract (sommario):
Coronavirus disease 2019 (COVID-19) creates a challenge on donor selection, posttransplant management, and immunosuppressive therapy. A question arises about continuing heart transplantation due to risk of immunosuppressive therapy, as well as exposure during hospitalization. After the identification of the first COVID-19 patient, our center conducted the management of selection and treatment of candidates and continued to perform cardiac transplantations. Herein, we present two cases who underwent successful heart transplantation after the determination of patient zero in Türkiye to highlight clinical implications by describing our clinical principle in the ethical knowledge of the International Society for Heart and Lung Transplantation COVID-19 task force statement regarding heart transplantation.
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Moysyuk, Ya G., Yu O. Malinovskaya, L. V. Bel'skikh, P. O. Bogomolov, A. I. Lobakov, А. A. Ammosov, A. B. Sidorenko, N. S. Grigor'ev e A. A. Kosov. "Liver transplantation in the Moscow Region: the regional project and its implementation". Almanac of Clinical Medicine 46, n. 6 (29 novembre 2018): 572–83. http://dx.doi.org/10.18786/2072-0505-2018-46-6-572-583.
Testo completoAbstract (sommario):
Rationale: Liver transplantation is the only curative treatment for diffuse end-stage liver disease and some liver neoplasms. The amount of these interventions in the Moscow Region is very low.Aim: To analyze the results of the first series of liver transplantations done in the Moscow Regional Research and Clinical Institute (MONIKI), to compare it with those done currently in Russia and worldwide, and to establish the optimal volume and trend of development for this new regional center.Materials and methods: More than 200 patients with liver cirrhosis, polycystosis and alveococcus invasion have been examined from May 2016 to August 2018; 70 of them were eligible for liver transplantation and were put on the waiting list. From October 2016 to July 2018, 29 liver transplantations from deceased donors (including 2 retransplantations) and one living related transplantation of the right lobe have been performed. Among the indications to the transplantation, the leading one was viral (HCV or HBV-related) cirrhosis. Four patients were diagnosed with hepatocellular carcinoma.Results: The waitlist mortality was 19%. Median waiting time was 5.5 [3; 9] (0 to 27) months. Until now, the results were followed till 22 months, with median follow-up of 7 [2; 13] months. The survival rate of the recipients was 96.4%, of the grafts 93.3%. In-patient mortality was 3.6%. Early allograft dysfunction was seen in 33% of cases. Median length of the in-hospital stay was 22 [19; 25] days.Conclusion: The successful implementation of the liver transplant program at its initial stage demonstrates the results that meet current efficacy criteria. Achieved level of organ procurement from deceased donors in the Moscow Region could ensure at least 30 liver transplantations annually, with current facilities and a potential for further growth. An increase in the transplantation number would depend on the improvement of transplantation service facilities in MONIKI and on the stable financial support of the program. Finally, it would promote increased availability of this transplantation technology in the region, lower waitlist mortality and shorter waiting times.
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Shang, Wenjun, Yonghua Feng, Jinfeng Li, Xinzhou Wang, Hongchang Xie e Guiwen Feng. "Effect of Bicyclol tablets on drug induced liver injuries after kidney transplantation". Open Medicine 12, n. 1 (4 maggio 2017): 62–69. http://dx.doi.org/10.1515/med-2017-0012.
Testo completoAbstract (sommario):
AbstractLiver injury is one of the most common complications in patients after kidney transplantation. Bicyclol tablets possess obvious anti-inflammatory and liver-protective functions. This study aimed to explore the clinical effect of preventive application of Bicyclol on drug induced liver injuries at an early stage after kidney transplantation.A total of 1600 patients who accepted kidney transplantations at our hospital from January 2009 to May 2015 were enrolled in this study, and divided into the prevention group (Bicyclol) and the control group (no hepatic protectors) based on whether or not hepatic protectors were regularly administered after the operation. The occurrence of liver injuries at an early stage after the operation and their influencing factors were analyzed.Total of 745 cases were included in the final analysis of which 82 developed liver injuries post-operation, with 22 in the prevention group (4.82%) as compared to 60 in the control group (20.76%) (P= 0.001). As compared to the control group, OR (95% CI) of the prevention group was 0.197 (0.116, 0.334) after revising HBsAg status, age and maintenance immunosuppression.Prophylactic application of Bicyclol as liver-protective treatment was a protective factor against drug induced liver injuries at an early stage after kidney transplantation.
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Rummo, O. "Treatment of the early postoperative complications following liver transplantation". Cell and Organ Transplantology 2, n. 2 (30 novembre 2014): 122–26. http://dx.doi.org/10.22494/cot.v2i2.33.
Testo completoAbstract (sommario):
Despite considerable reduction of the lethality rate after ortotopic liver transplantation and owing to the achievements in modern surgery, immunology and anesthesiology, the early postoperative complications still occur in nearly 70 % and can significantly compromise patient survival.The aim of this study was to assess the frequency and causes of early post-transplantation complications and to develop effective means for their prophylaxis and treatment.Materials and methods. Within the period from 03.04.2008 to 01.07.2014, altogether 260 liver transplantations were performed in 252 recipients in the Republican Center for organ and tissue transplantation (Minsk, Belarus: of them 209 (81.2 %) according to the classic technique, 46 (17.7 %) cavaplasty and 5 portal transposition (2.4 %).Thirty-six liver transplantations (13.9 %) were performed in children before 18 years of age. The strategy of peri-operative techniques and immune-suppressive therapy were the same for all patients.Results. Vascular complications occurred in 44 cases (16.9 %), biliary complications in 46 (17.7 %), acute kidney injury in 47 (18.1 %), primary non-functioning after 3 liver transplantations (1.2 %), early allograft dysfunction in 71 (27.3 %) cases, and bacterial complications after 66 (25.4 %) liver transplantations. Predictors of early allograft dysfunction were thermal ischemia and graft steatosis. Three-year patients’ survival was 85 %.Conclusion. The main cause of death was multiple organ failure developed in a sign of bacterial complications and early allograft dysfunction. Significant role in early postoperative complications prophylaxis acts interdisciplinary prevention of nosocomial infection.