May 24: Recent transplant news

Friday, May 24, 2013

4 key issues in facial allotransplantation
By Maria Frisch
Facial allotransplantation has transformed the future of patients with severe facial disfigurement by allowing for nearly normal facial restoration. Since 2005, at least 21 facial allotransplantations have been performed worldwide, with an estimated 90 percent overall success rate — two of the 21 patients died. This article summarizes four key issues regarding this procedure. Read more. 

Liver transplantation for children with biliary atresia in the pediatric end-stage liver disease era: The role of insurance status
Liver Transplantation (login required)
Socioeconomic status influences health outcomes, although its impact on liver transplantation (LT) in children with biliary atresia (BA) is unknown. It has been hypothesized that governmental insurance [public insurance (PU)], rather than private insurance (PR), would be associated with poorer outcomes for children with BA. Read more. 

Living donor size affects kidney transplant outcomes
Renal & Urology News
Small donor size has an adverse impact on allograft function following living kidney donor transplantation, researchers reported at the 2013 American Transplant Congress. Dr. Hasan Khamash and colleagues at Mayo Clinic Arizona in Phoenix retrospectively studied 579 pairs of living kidney donors and recipients who had their estimated glomerular filtration rate ascertained at one year posttransplant. Read more. 

Treatment of children suffering from chronic myelogenous leukemia: Imatinib mesylate and allogeneic hematopoietic stem cell transplantation
Pediatric Transplantation (login required)
HSCT is the only proven treatment option for CML, a rare disease in children. Recently, there are promising reports on the advantageous effect of imatinib mesylate for pediatric patients with CML. Researchers recently conducted a retrospective study on 33 pediatric patients suffering from CML. Fourteen underwent HSCT and the rest were treated with imatinib. With a median follow-up of 24 months, the two-year OS in the HSCT group and the imatinib group was 84 percent and 87 percent, respectively (p = 0.714). Read more. 

Fewer kids die while waiting for new organs
MedPage Today
Fewer children died waiting for organ transplants in the past decade after policy changes to the national organ allocation system, researchers stated. The number of children dying before they could receive a transplant dramatically decreased from 262 to 110 as pediatric transplants increased from 2001 to 2010, stated Dr. Jennifer Workman, of the University of Utah School of Medicine in Salt Lake City and colleagues, in Pediatrics. Read more.

Immunosuppression after liver transplantation for primary sclerosing cholangitis influences activity of inflammatory bowel disease
Clinical Gastroenterology and Hepatology (login required)
Previous studies have shown conflicting results regarding the course of inflammatory bowel disease (IBD) after liver transplantation in patients with primary sclerosing cholangitis (PSC). Researchers studied the progression of IBD in patients with PSC who have undergone liver transplantation. They also studied risk factors, including medical therapy, that could influence on IBD disease activity. Read more.

Robotic kidney transplants may be best option for obese patients
Medical News Today
Obese patients who received robotic kidney transplants had fewer wound complications than patients who received traditional "open" transplant surgery, according to surgeons at the University of Illinois Hospital & Health Sciences System. The findings should allow more obese patients to receive kidney transplants. Read more. 

Epstein-Barr virus-associated smooth muscle tumors after kidney transplantation: Treatment and outcomes in a single center
Pediatric Transplantation (login required)
Epstein–Barr virus-associated smooth muscle tumors (EBV SMT) in adult kidney transplant recipients (KTR) are rare. The aims of this study are to document the clinical features, types of treatment given and outcomes of KTR with EBV SMT. Sixteen patients were identified from our institution's databases. Patients' survival, tumor outcome and graft survival were compared between patients who remained on cyclosporine-based immunosuppressant and those who converted to sirolimus-based therapy. Read more. 

Tripped T-cells reject transplant organs
Certain cells "stick their feet" in the bloodstream to trip up and collect immune system T-cells, which can lead to transplant organ rejection. This recent discovery challenges a long-held assumption about how biologic pathways trigger immune system rejection of donor organs — and suggests a different paradigm is needed to develop better anti-rejection therapies. Read more.

 Immune function assay (ImmuKnow) as a predictor of allograft rejection and infection in kidney transplantation
Clinical Transplantation (login required)
The Cylex ImmuKnow (IK) assay provides a rapid and quantitative assessment of T-cell-mediated immune function. Studies have shown correlations between ImmuKnow assay and adverse events, such as immunosuppression and low or high calcineurin inhibitor trough levels. Researchers investigated the correlation between IK changes and rejection or infection in kidney transplant patients and studied the potential application of the IK assays in optimizing individual immunosuppressive therapy. Read more.