Chronic rejection as a persisting phantom menace in organ transplantation

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Emmanuel F. Mongodin ◽  
Vikas Saxena ◽  
Jegan Iyyathurai ◽  
Ram Lakhan ◽  
Bing Ma ◽  
...  
2021 ◽  
pp. 100609
Author(s):  
Maria Vasco ◽  
Giuditta Benincasa ◽  
Carmela Fiorito ◽  
Mario Faenza ◽  
Paride De Rosa ◽  
...  

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed

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 .


2017 ◽  
Vol 66 (01) ◽  
pp. 020-030 ◽  
Author(s):  
Annika Gocht ◽  
Michael Weyand ◽  
Stephan Ensminger ◽  
Christian Heim

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.


2021 ◽  
Author(s):  
Mohd Riyaz Beg

The safe changes that go with pregnancy are in a fewdifferent ways like those required for strong organtransplantation. Fruitful pregnancy includes controlleddownregulation of the maternal insusceptibleframework with expanded resilience of fetal cellscommunicating fatherly HLA antigens. This has intercededessentially by human chorionic gonadotrophinwhich has an archived capacity to change the activityof T cells, dendritic cells and common executionercells just as expanding vascularisation.Constant unite dismissal is currently the main sourceof join brokenness and disappointment. Long haulhostile to dismissal treatment is joined by safe inadequacyand an unfriendly cardiovascular profile. Interestingly,by and large, insusceptible capacity is savedin pregnancy and pregnant ladies, by and large, feelwell. As such hCG at first added to ordinary treatmentmay lessen or forestall interminable dismissalin transplantation.


2005 ◽  
Vol 24 (11) ◽  
pp. 1828-1833 ◽  
Author(s):  
Laura J. Pinderski ◽  
James K. Kirklin ◽  
David McGiffin ◽  
Robert Brown ◽  
David C. Naftel ◽  
...  

Author(s):  
O. S. Nykonenko

Immunosuppressive therapy is the most important component of drug treatment after organ transplantation. The goal of immunosuppression is to prevent acute and chronic rejection while maximizing patient survival, and long-term graft survival remains a major therapeutic challenge before and after organ transplantation. However, the benefits of immunosuppressive therapy must be balanced against the side effects and underlying toxicity of the drugs used.Immunosuppressants can be classified as induction agents, maintenance therapy, treatment of acute rejection and chronic rejection, and antibody directed therapy. Although induction therapy remains a subject of debate in the field of organ transplantation, it is still used in most transplant centers. Protocols for maintenance immunosuppressive therapy are more or less standardized and include, as a rule, three drugs, a calcineurin inhibitor, an antimetabolite, and a glucocorticoid. The presence of HLA antibodies in transplantation candidates and the development of de novo antibodies after transplantation remain a serious therapeutic problem before and after organ transplantation. In this lecture, we will look at the drugs used to induce and maintain immunosuppression, as well as their effectiveness in preventing side effects.


2003 ◽  
Vol 22 (1) ◽  
pp. S182
Author(s):  
L Pinderski ◽  
J Kirklin ◽  
D McGiffin ◽  
R Brown ◽  
D Naftel ◽  
...  

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