April 12 - Recent Transplant News
Transcatheter Potts shunt creation in patients with severe pulmonary arterial hypertension: Initial clinical experience
Source: The Journal of Heart and Lung Transplantation
Patients with severe pulmonary arterial hypertension (PAH) face significant morbidity and death as a consequence of progressive right heart failure. Surgical shunt placement between the left PA and descending aorta (Potts shunt) appears promising for PAH palliation in children; however, surgical mortality is likely to be unacceptably high in adults with PAH. In a recent study, researchers describe a technique for transcatheter Potts shunt (TPS) creation by fluoroscopically guided retrograde needle perforation of the descending aorta at the site of apposition to the left PA to create a tract for deployment of a covered stent between these vessels. Read more.
Prostate cancer need not preclude kidney transplants
Source: Renal & Urology News
Early kidney transplantation in patients with prostate cancer (PCa) is associated with improved survival compared with remaining on hemodialysis (HD), researchers reported at the National Kidney Foundation's 2013 Spring Clinical Meetings. Dr. Thet Zaw and colleagues at Newark Beth Israel Medical Center in Newark, N.J., noted that for patients on HD to be eligible for a kidney transplant, they must have a two-year cancer-free period immediately preceding transplantation. The purpose of their study was to determine if some patients with PCa would be better served by undergoing kidney transplantation rather than waiting for two years to be declared cancer-free. Read more.
Knowledge paves the way for transplantation
Source: MedPage Today (subscription required)
Patients in desperate need of a kidney transplant are more likely to get on the organ transplant list if they are better versed in the intricacies of the healthcare system and their disease, researchers suggested at the National Kidney Foundation spring meetings. Read more.
Antiperlecan antibodies are novel accelerators of immune-mediated vascular injury
Source: American Journal of Transplantation (subscription required)
Acute vascular rejection (AVR) is characterized by immune-mediated vascular injury and heightened endothelial cell (EC) apoptosis. It has been reported previously that apoptotic ECs release a bioactive C-terminal fragment of perlecan referred to as LG3. Here, researchers tested the possibility that LG3 behaves as a neoantigen, fuelling the production of anti-LG3 antibodies of potential importance in regulating allograft vascular injury. Read more.
Suppression of NF-kappaB p65 expression attenuates delayed xenograft rejection
Source: Xenotransplantation (subscription required)
Delayed xenograft rejection (DXR) involves type II vascular endothelial cell (VEC) activation including upregulation of pro-inflammatory genes, which contributes to infiltration into the graft and a complex process of cytokine production. Approaches to prevent DXR have shown limited success. In this study, researchers modified heart donors using siRNA in an attempt to attenuate DXR and to improve xenograft survival in the mouse-to-rat heterotopic heart transplant model. Read more.
Abnormal blood pressure raises delayed graft function risk
Source: Renal & Urology News
Low diastolic and high systolic blood pressure (BP) immediately after kidney transplantation are associated with an increased likelihood of delayed graft function (DGF), researchers reported at the National Kidney Foundation's 2013 Spring Clinical Meetings. In a retrospective study of 183 adult kidney transplant recipients, Dr. Dhiren Kumar and colleagues at Virginia Commonwealth University in Richmond found that systolic BP above 160 mm Hg and diastolic BP below 60 mm Hg during postoperative day 0-5 were associated with a 4.3 times and 3.5 times increased likelihood of DGF. Read more.
Duration beyond liver transplant improved patients' tolerance to immunosuppression cessation
Liver transplant recipients are more likely to tolerate withdrawal from immunosuppressant therapy if cessation is initiated well after transplantation, according to recent study results. Researchers gradually discontinued immunosuppressive drug therapy during a six- to nine-month period in 102 stable liver transplant recipients. All participants had undergone transplantation more than 3 years earlier and had no history of autoimmune liver disease. Read more.