July 19: Recent Transplant News

Friday, July 19, 2013

Focal nodular hyperplasia of the liver in children after hematopoietic stem cell transplantation
Pediatric Transplantation (login required)
FNH is a non-malignant neoplasia of the liver rarely described in children. A significant percentage of the pediatric cases have been reported in patients with a history of malignant disease treated with chemo-radiation therapy and in children who were given HSCT. Little is known about the pathogenesis of FNH in transplanted children, but many risk factors linked to the HSCT procedure have been hypothesized. The detection of hepatic nodules, particularly in children who underwent HSCT for a previous malignancy, always raises a diagnostic dilemma. To help the physicians in the diagnostic management of this rare entity, researchers have retrospectively evaluated a series of transplanted children diagnosed with FNH. Read more.

Mesenchymal stem cells in organ transplantation
By Maria Frisch
In October of 2012, the Mesenchymal Stem Cells Solid Organ Transplantation (MiSOT) Consortium met to review the current state of clinical data. In June, they released a position paper that reviewed the safety and efficacy of mesenchymal stem cells (MCS) as a therapeutic agent in solid organ transplantation. This article has been adapted from that position paper to present the clinically applicable highlights and to summarize what you need to know for your practice. Read more.

Trial: Conversion from twice-Daily tacrolimus capsules to once-daily extended-release tacrolimus
Transplantation
LCP-Tacro is an extended-release formulation of tacrolimus designed for once-daily dosing. Phase 1 studies demonstrated greater bioavailability to twice-daily tacrolimus capsules and no new safety concerns. Read more.

The use of lung donors older than 55 years: A review of the United Network of Organ Sharing database
The Journal of Heart and Lung Transplantation (login required)
Current lung transplantation guidelines stipulate that the ideal donor is aged younger than 55 years, but several institutions have reported that outcomes using donors aged 55 years and older are comparable with those of younger donors. Read more.

Underreporting of liver transplant waitlist removals due to death or clinical deterioration
Transplantation (login required)
Few studies have evaluated the accuracy of United Network for Organ Sharing or Scientific Registry of Transplant Recipients data among patients listed for liver transplantation. Of particular importance for transplant policy and practice is whether patients’ outcomes are coded properly. Read more.

Consequences of needle tract seeding of hepatocellular cancer after liver transplant
Clinical Transplantation (login required)
Although liver biopsy is a relatively safe procedure, needle tract seeding (NTS) of hepatocellular carcinoma (HCC) is described in up to 5 percent of patients after liver biopsy. The rate of NTS in patients with HCC who had liver transplantation is unknown. We performed a retrospective analysis of 759 HCC cases from August 1992 to August 2011. Read more.

Heart rate variability arterial hypertension in young heart-transplanted recipients: Association progression of cardiac allograft vasculopathy?
Pediatric Transplantation (login required)
Hypertension and reduced HRV are frequent in heart transplant recipients. Recently, 26 young recipients were studied to investigate the relationship between BP and HRV during simultaneous 24-hour monitoring. Presence of CAV was considered. All HRV measures were significantly lower than normal values. Read more. 

Excellent liver retransplantation outcomes in hepatitis C-infected recipients
Clinical Transplantation (login required)
Survival outcomes for liver retransplantation (LRTx) after graft loss in HCV patients (HCV-LRTx) are generally considered inferior to those after non-HCV-LRTx. Between January 1, 2005 and June 30, 2011, 663 LTx were performed, including 116 (17.5 percent) LRTx, 41 (35.3 percent) of which were more than 90 d after the LTx. Twenty-nine (70.7 percent) LRTx were performed in HCV antibody–positive individuals. Read more.

Organ allocation: What is just and fair?
By Dorothy L. Tengler
The Cleveland Clinic will be holding a conference on Emerging Issues in Organ Transplantation on Sept. 23-24 at Kiawah Island, S.C., focusing on current issues that are in various states of transition. One such issue is organ allocation, a topic that raises some serious questions about ethics and best practices in a field that is already fraught with tension over life-and-death decisions. Read more.

Revised cardiac risk index is a useful tool for evaluation of perioperative cardiac morbidity in kidney transplant recipients
Transplantation (login required)
Researchers recently evaluated a published Revised Cardiac Risk Index to determine if this preoperative cardiovascular risk stratification tool would be useful in the kidney transplant recipient population. Read more.

The prognostic value of kidney transplant center report cards
American Journal of Transplantation (login required)
SRTR report cards provide the basis for quality measurement of U.S. transplant centers. There is limited data evaluating the prognostic value of report cards, informing whether they are predictive of prospective patient outcomes. Using national SRTR data, researchers have simulated report cards and calculated standardized mortality ratios (SMR) for kidney transplant centers over five distinct eras. Read more.