June 14: Recent transplant news

Friday, June 14, 2013

A case for bariatric surgery among obese renal transplant candidates
By Maria Frisch
Approximately 1 in 3 U.S. adults are obese or have a body mass index of 30 or higher. England and Canada aren't far behind at every 1 in 4. This is unfortunate, given the common association between obesity and excess morbidity and mortality. This association is particularly true in renal transplant surgery. Thus, consideration of presurgical bariatric surgery may be warranted in cases where prescribed dietary therapy and physical activity has failed. Read more.

Results of pretransplant treatment of hepatorenal syndrome with terlipressin
Current Opinion in Organ Transplantation (login required)
Hepatorenal syndrome (HRS) is a dreaded complication of end-stage liver disease. The best treatment option for HRS is liver transplantation (LT) in suitable candidates. Pretransplant care of HRS is of utmost importance in order to secure a good posttransplant outcome. In a recent study, advances during the last year in the diagnosis and management of HRS in candidates who are awaiting liver transplantation are reviewed. Read more.

Production of cloned NIBS and a-1, 3-galactosyltransferase knockout MGH miniature pigs by somatic cell nuclear transfer
Nuclear transfer (NT) technologies offer a means for producing the genetically modified pigs necessary to develop swine models for mechanistic studies of disease processes as well as to serve as organ donors for xenotransplantation. Most previous studies have used commercial pigs as surrogates. In this study, researchers established a cloning technique for miniature pigs by somatic cell nuclear transfer (SCNT) using Nippon Institute for Biological Science (NIBS) miniature pigs as surrogates. Read more.

Screening pigs for xenotransplantation: Prevalence and expression of porcine endogenous retroviruses
Xenotransplantation (login required)
To establish the safety of xenotransplantation when cells, tissues, or organs of pigs are used, an effective screening for potential zoonotic microorganisms has to be performed. In doing so, special attendance has to be paid to porcine endogenous retroviruses (PERVs) that are widely distributed as proviruses in the genome of pigs. PERV-A and PERV-B are present in all pigs, they infect human cells in vitro and therefore represent a direct risk. PERV-C infects only pig cells; however, recombinant PERV-A/C infecting human cells and replicating at a higher rate were found in pigs indicating an indirect risk. Read more.

Echocardiography for the detection of portopulmonary hypertension in liver transplant candidates: An analysis of cutoff values
Liver Transplantation (login required)
Portopulmonary hypertension (POPH), a complication of chronic liver disease, may be a contraindication to liver transplantation (LT) because of the elevated risk of peritransplant and posttransplant morbidity and mortality. Because POPH is frequently asymptomatic, screening with echocardiography is recommended. Read more.

Autologous gastrointestinal reconstructive surgery: Complement or alternative to intestinal transplantation
Current Opinion in Organ Transplantation (login required)
Autologous intestinal reconstructive surgery has evolved over the past 3 decades from rescue to main surgical procedure in the multidisciplinary approach to short bowel syndrome (SBS) patients with intestinal failure. The purpose of this review is to clarify the actual place of intestinal reconstructive surgical techniques in the management of intestinal failure related to SBS and their relationship with intestinal transplantation. Read more.

ECLS for children with late (post-discharge) rejection after heart transplantation
Pediatric Transplantation (login required)
Rejection with acute hemodynamic compromise after OHT is rare in children, and is associated with poor survival. The study retrospectively reviewed the management, course and outcome of recipients with late (following initial hospital discharge) rejection with acute hemodynamic compromise who were supported on ECLS. Read more.