New Targets for the Prevention of Chronic Rejection after Thoracic Organ Transplantation

2017 ◽  
Vol 66 (01) ◽  
pp. 020-030 ◽  
Author(s):  
Annika Gocht ◽  
Michael Weyand ◽  
Stephan Ensminger ◽  
Christian Heim
Keyword(s):  
Lung Transplantation ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Experimental Models ◽  
Term Survival ◽  
Successful Transplantation ◽  
Terminal Heart Failure ◽  
Life Threatening ◽  
Transplant Immunology ◽  
Thoracic Organ

The gold standard for the treatment of terminal heart failure and irreversible lung diseases includes thoracic organ transplantation. The major obstacle for long-term survival after successful transplantation is chronic rejection, an ongoing immunomodulatory disease so far without effective therapy. Therefore, the aim of this review is to elucidate scientific efforts targeting different new mechanisms of cardiac allograft vasculopathy (CAV) and chronic lung allograft dysfunction (CLAD). For this purpose, we performed a systematic review of the literature to assess recent strategies in transplant immunology research. We searched MEDLINE from 2015 up to date for articles addressing the following keywords: CAV, transplant vasculopathy, transplant arteriosclerosis, CLAD, bronchiolitis obliterans transplant, and obliterative bronchiolitis transplant. All articles including experimental models in the field of transplant immunology addressing new aspects for the prevention of chronic rejection after heart and lung transplantation were included in this review. The prevention of chronic rejection would clearly improve the survival of patients after heart and lung transplantation. Interesting targets were addressed in recent research, but further research is necessary to effectively treat this life-threatening disease in transplant recipients.

scholarly journals A májátültetés aneszteziológiai-intenzív terápiás vonatkozásai

2018 ◽  
Vol 159 (46) ◽  
pp. 1891-1897
Author(s):  
János Fazakas ◽  
Anikó Smudla
Keyword(s):  
Organ Transplantation ◽  
Intensive Therapy ◽  
Surgical Techniques ◽  
Interdisciplinary Approach ◽  
Liver Transplants ◽  
Term Survival ◽  
Successful Transplantation ◽  
Almost All ◽  
End Stage

Abstract: One of the most prominent results of our age is organ transplantation, the single treatment option for patients with end-stage organ failure. The success of transplants depends on the donor care, the patient preoperative preassessment, the perioperative care of organ transplantation and aftercare. Successful transplantation therefore requires a prominent level of continuous collaboration between the surgeon, anaesthesiologist, radiologist, internal medicine and hepatologist, laboratory physician and almost all their associates. The complex interdisciplinary approach based on the research results can be used to improve the patient’s condition through pharmacotherapy, physiotherapy and psychotherapy during the time spent on waiting lists. The emergence of more active, targeted therapeutic options in perioperative graft resuscitation may help the currently inferior quality transplantable grafts or resuscitation out (machine perfusion) or in the recipient, thereby increasing the number of liver transplants. Deeper knowledge of hemostatic processes, along with the development of surgical techniques, would increase the number of blood transplant free transplants, thus improving the long-term survival of grafts. The present study aims at presenting the anaesthesia and early intensive therapy aspects of liver transplantation from aptitude assessment, through anaesthesia to early intensive therapeutic treatment. Orv Hetil. 2018; 159(46): 1891–1897.

scholarly journals Impact of Pediatric Chronic Dialysis on Long-Term Patient Outcome: Single Center Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Daniella Levy Erez ◽  
Irit Krause ◽  
Amit Dagan ◽  
Roxana Cleper ◽  
Yafa Falush ◽  
...  
Keyword(s):  
Survival Rate ◽  
Medical Center ◽  
Significant Risk ◽  
Chronic Dialysis ◽  
Term Survival ◽  
Successful Transplantation ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage

Objective.Owing to a shortage of kidney donors in Israel, children with end-stage renal disease (ESRD) may stay on maintenance dialysis for a considerable time, placing them at a significant risk. The aim of this study was to understand the causes of mortality.Study Design. Clinical data were collected retrospectively from the files of children on chronic dialysis (>3 months) during the years 1995–2013 at a single pediatric medical center.Results.110 patients were enrolled in the study. Mean age was10.7±5.27 yrs. (range: 1 month–24 yrs). Forty-five children (42%) had dysplastic kidneys and 19 (17.5%) had focal segmental glomerulosclerosis. Twenty-five (22.7%) received peritoneal dialysis, 59 (53.6%) hemodialysis, and 6 (23.6%) both modalities sequentially. Median dialysis duration was 1.46 years (range: 0.25–17.54 years). Mean follow-up was13.5±5.84 yrs. Seventy-nine patients (71.8%) underwent successful transplantation, 10 (11.2%) had graft failure, and 8 (7.3%) continued dialysis without transplantation. Twelve patients (10.9%) died: 8 of dialysis-associated complications and 4 of their primary illness. The 5-year survival rate was 84%: 90%for patients older than 5 years and 61%for younger patients.Conclusions.Chronic dialysis is a suitable temporary option for children awaiting renal transplantation. Although overall long-term survival rate is high, very young children are at high risk for life-threatening dialysis-associated complications.

scholarly journals Is alternative cardiac surgery an option in adults with congenital heart disease referred for thoracic organ transplantation?†

2012 ◽  
Vol 43 (2) ◽  
pp. 344-351 ◽  
Author(s):  
Andrew Robert Harper ◽  
David Steven Crossland ◽  
Gianluigi Perri ◽  
John Jude O'Sullivan ◽  
Milind Pralhad Chaudhari ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Organ Transplantation ◽  
Congenital Heart ◽  
Thoracic Organ

scholarly journals Dissecting Serial Immune Response Stages of Chronic Rejection after Murine Orthotopic Lung Transplantation

2021 ◽  
Vol 40 (4) ◽  
pp. S305-S306
Author(s):  
T. Heigl ◽  
J. Kaes ◽  
C. Aelbrecht ◽  
G. Vande Velde ◽  
A. Vanstapel ◽  
...  
Keyword(s):  
Immune Response ◽  
Lung Transplantation ◽  
Chronic Rejection

Clinical epigenetics and acute/chronic rejection in solid organ transplantation: An update

2021 ◽  
pp. 100609
Author(s):  
Maria Vasco ◽  
Giuditta Benincasa ◽  
Carmela Fiorito ◽  
Mario Faenza ◽  
Paride De Rosa ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Chronic Rejection ◽  
Solid Organ Transplantation ◽  
Solid Organ

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

Donor Brain Death Aggravates Chronic Rejection after Lung Transplantation in Rats

2004 ◽  
Vol 78 (9) ◽  
pp. 1251-1258 ◽  
Author(s):  
No??lle Zweers ◽  
Arjen H. Petersen ◽  
Joost A.B. van der Hoeven ◽  
Aalzen de Haan ◽  
Rutger J. Ploeg ◽  
...  
Keyword(s):  
Brain Death ◽  
Lung Transplantation ◽  
Chronic Rejection

Coadministration of itraconazole and tacrolimus after thoracic organ transplantation

2001 ◽  
Vol 33 (1-2) ◽  
pp. 1600-1602 ◽  
Author(s):  
R Banerjee ◽  
N Leaver ◽  
H Lyster ◽  
N.R Banner
Keyword(s):  
Organ Transplantation ◽  
Thoracic Organ
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