March 8 - Recent Transplant News
Cardiac troponin T before and after kidney transplantation: Determinants and implications for posttransplant survival
Source: American Journal of Transplantation (subscription required)
Pretransplant cardiac troponin T (cTnTpre) is a significant predictor of survival postkidney transplantation. Researchers assessed correlates of cTnT levels pre- and posttransplantation and their relationship with recipient survival. A total of 1206 adult recipients of kidney grafts between 2000 and 2010 were included. Read more.
Older circulatory-death donor kidneys acceptable for transplant
Source: Renal & Urology News
Kidneys from non-heart-beating donors (NHBD) older than 60 years are associated with a similar risk of graft loss as kidneys from brain-death donors (BDD) in the same age group, according to a new study by British investigators. In addition, a cold ischemia time of more than 24 hours predicts worse graft survival of BDD kidneys compared with NHBD kidneys. The government-funded study of 6,490 kidney transplants also confirmed that donor age over 60 years compared to age under 40 years is associated with a significantly increased risk of graft loss for both BDD and NHBD kidneys, a research team led by Dr. Dominic Summers of Addenbrooke's Hospital in Cambridge, U.K., reported in The Lancet. Read more.
Standardizing skin biopsy sampling to assess rejection in vascularized composite allotransplantation
Source: Clinical Transplantation (subscription required)
More than 70 hands and 20 faces have been transplanted during the past 13 years, which have shown good to excellent functional and aesthetic outcomes. However, (skin) rejection episodes complicate the post-operative courses of hand and face transplant recipients and are still a major obstacle to overcome after reconstructive allotransplantation. As more and more centers plan to implement a vascularized composite allotransplantation (VCA) program, they further develop guidelines and recommendations on collection and processing of skin biopsies from hand and face allograft recipients. Read more.
Anatomic fitting of total artificial hearts for in vivo evaluation
Source: Artificial Organs
Successful anatomic fitting of a total artificial heart (TAH) is vital to achieve optimal pump hemodynamics after device implantation. Although many anatomic fitting studies have been completed in humans prior to clinical trials, few reports exist that detail the experience in animals for in vivo device evaluation. Optimal hemodynamics are crucial throughout the in vivo phase to direct design iterations and ultimately validate device performance prior to pivotal human trials. Read more.
Importance of the temporary portocaval shunt during adult living donor liver transplantation
Source: Liver Transplantation (subscription required)
Adult living donor liver transplantation (aLDLT) is associated with surgical risks for the donor and with the possibility of small-for-size syndrome (SFSS) for the recipient, with both events being of great importance. An excessively small liver graft entails a relative increase in the portal blood flow during reperfusion, and this factor predisposes the recipient to an increased risk of SFSS in the postoperative period, although other causes related to recipient, graft and technical factors have also been reported. Read more.
Missed viral surveillance testing visits associate with full blown viral diseases in children receiving kidney transplants
Source: Pediatric Transplantation (subscription required)
Surveillance testing for major viral infections such as CMV, EBV and BKV early in their natural history course may allow for early intervention and prevention of FBVD, but the testing is expensive and optimal interval/frequency are uncertain. Researchers initiated routine monthly viral surveillance for CMV, EBV and BKV in July 2008 for the first 12 months posttransplant. In a small group of contemporaneous patients on identical immunosuppression, those patients who missed regular viral surveillance were more likely to develop FBVD. Read more.
Preoperative acute renal failure, renal replacement therapy increased liver transplant mortality risk
Liver transplant recipients with preoperative acute renal failure who received renal replacement therapy were at greater risk for death than patients with preoperative acute-on-chronic renal failure in a recent study. In a post-hoc analysis, researchers evaluated mortality rates in a cohort of 135 patients aged older than 16 years who underwent liver transplantation at a medical facility between January 2003 and December 2008. Read more.
Clinical significance of quantitative cytomegalovirus detection in bronchoalveolar lavage fluid in lung transplant recipients
Source: Transplant Infectious Disease
Cytomegalovirus (CMV) is an important pathogen after lung transplant (LTx) and may be associated with bronchiolitis obliterans syndrome (BOS). In a retrospective survey, researchers assessed the outcome of LTx patients with CMV DNA-positive bronchoalveolar lavage (BAL) during surveillance. Detection of CMV-positive BAL after the sixth month appears common, but did not correlate with BOS-free survival after LTx in this study. An increased risk of developing blood antigenemia was observed in patients with positive CMV PCR in BAL, warranting close follow-up. Read more.