April 19 - Recent Transplant News

Friday, April 19, 2013

Transmission of Strongyloides stercoralis through transplantation of solid organs
Source: Centers for Disease Control and Prevention
Strongyloides stercoralis is an intestinal nematode endemic in the tropics and subtropics. Immunocompetent hosts typically are asymptomatic, despite chronic Strongyloides infection. In contrast, immunocompromised patients are at risk for hyperinfection syndrome and disseminated disease, with a fatality rate more than 50 percent (1–3). The infection source for immunocompromised patients, such as solid organ transplant recipients, is not always apparent and might result from reactivation of chronic infection after initiation of immunosuppressive therapy or transmission from the donor. Read more.

Innate immunity in donor procurement
Source: Current Opinion in Organ Transplantation
Ischemic kidney injury occurs during organ procurement and can lead to delayed graft function or nonviable grafts. The innate immune system is a key trigger of inflammation in renal ischemia. This review discusses the components of innate immunity known to be involved in renal ischemic reperfusion injury (IRI). Understanding how inflammatory damage is initiated in renal IRI is important for the development of targeted therapies aimed at preserving the donor organ. Read more.

Reciprocal interaction between intestinal microbiota and mucosal lymphocyte in cynomolgus monkeys after alemtuzumab treatment
Source: American Journal of Transplantation (login reqiured)
It has been known that the gut microbiota plays a central role in shaping normal mucosal immunity, however, little information is available whether the variability of mucosal lymphocytes impacts the commensal flora. Here, researchers applied a cynomolgus monkey model to characterize the structure and composition of the gut microbiota in response to lymphocyte depletion and to determine their potential association. Read more.

Relationship between occurrence of surgical complications and hospital finances
Source: JAMA
In this hospital system, the occurrence of postsurgical complications was associated with a higher per-encounter hospital contribution margin for patients covered by Medicare and private insurance but a lower one for patients covered by Medicaid and who self-paid. Depending on payer mix, many hospitals have the potential for adverse near-term financial consequences for decreasing postsurgical complications. Read more.

Outcomes and predictive factors of pediatric kidney transplants: An analysis of the Thai Transplant Registry
Source: Pediatric Transplantation (login required)
As universal coverage for pediatric kidney transplantation (KT) was introduced in Thailand in 2008, the number of recipients has been increasing. Researchers evaluated predictive factors for graft failure to understand how to improve clinical outcomes in these children. Using data obtained from the National Transplant registry, they assessed the risk of graft failure using the Kaplan–Meier method and Cox proportional hazards regression. Read more.

Rat kidneys made in lab point to aid for humans
Source: The New York Times
Researchers at Massachusetts General Hospital in Boston have made functioning rat kidneys in the laboratory, a bioengineering achievement that may one day lead to the ability to create replacement organs for people with kidney disease. The scientists said the rat kidneys produced urine in the laboratory as well as when transplanted into rats. The kidneys were made by stripping donor kidneys of their cells and putting new cells that regenerate tissue into them. Read more.

The need to reduce cold ischemia time in kidney transplantation
Source: Current Opinion in Organ Transplantation (subscription required)
Hypothermic preservation is a prerequisite for kidney exchange in transplantation. The severity of tissue damage caused by hypothermic preservation influences the level of ischemia/reperfusion injury and subsequent graft function. With the purpose of reviewing the implications of prolonged cold ischemia time (CIT) in kidney transplantation, its pathophysiology, effects on early and late outcome of transplantation for different types of deceased organ donors, and preservation methods are discussed based on recent literature. Read more.

Vascularized composite tissue allotransplantation — state of the art
Source: Clinical Transplantation (login required)
Vascularized composite tissue allotransplantation is a viable treatment option for injuries and defects that involve multiple layers of functional tissue. In the past 15 years, more than 150 vascularized composite allotransplantation (VCA) surgeries have been reported for various anatomic locations including — but not limited to — trachea, larynx, abdominal wall, face and upper and lower extremities. VCA can achieve a level of esthetic and functional restoration that is currently unattainable using conventional reconstructive techniques. Read more.

Suppression of NF-kappaB p65 expression attenuates delayed xenograft rejection
Source: Xenotransplantation
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.

Duodenal Infusion of donor feces for recurrent Clostridium difficile
Source: The New England Journal of Medicine (login required)
Recurrent Clostridium difficile infection is difficult to treat, and failure rates for antibiotic therapy are high. Researchers studied the effect of duodenal infusion of donor feces in patients with recurrent C. difficile infection. Read more.