Showing papers in "American Journal of Transplantation in 2019"

TL;DR: The challenge of providing adequate access to kidney transplant persisted nationally, with additional dramatic regional variation, and the proportion ofliving donor kidney transplants in both adults and children continued to fall, and racial disparities in living donor kidney transplant grew in the past decade.

TL;DR: Children underwent transplant at higher acuity than the past, as evidenced by higher MELD/pediatric end‐stage liver disease scores and listings at status 1A and 1B, and the highest rate of pretransplant mortality persisted for children aged younger than 1 year.

TL;DR: In situ normothermic regional perfusion (NRP) as discussed by the authors restores a blood supply to the abdominal organs after death using an extracorporeal circulation for a limited period before organ recovery.

TL;DR: Bacteriophage therapy was well tolerated and associated with clinical improvement in LTRs with MDR bacterial infection not responsive to antibiotics alone, suggesting it may be a viable adjunct to antibiotics for patients with M DR infections.

TL;DR: It was agreed that frailty should not be used as the sole criterion for delisting a patient for liver transplantation, but should be considered one of many criteria when evaluating transplant candidacy and suitability.

TL;DR: A protocol of sequential DHOPE, controlled oxygenated rewarming (COR), and NMP using a new hemoglobin-based oxygen carrier (HBOC)-based perfusion fluid offers a novel method of liver machine perfusion for combined resuscitation and viability testing of suboptimal livers prior to transplantation.

TL;DR: It is found that pretransplant selection of recipients with low titers of anti‐pig antibodies significantly improved survival in a pig‐to‐rhesus macaque kidney transplant model, and in vitro study results suggested that rhesus CD4+ T cells required the presence of SLA class II to mount an effective proliferative response.

TL;DR: The dd‐cfDNA test did not discriminate CMR from no rejection among kidney transplant recipients, although performance characteristics were stronger for the discrimination of ABMR.

TL;DR: This study highlights the need to understand more fully the connection between foodborne illness and infectious disease outbreaks and how food safety and nutrition can be improved.

TL;DR: The number of new pediatric listings increased over the past decade, as did the number of pediatric heart transplants, although some fluctuation has occurred more recently.

TL;DR: HLA‐DR/DQ single molecule eplet mismatch may represent a precise, reproducible, and widely available prognostic biomarker that can be applied to tailor immunosuppression or design clinical trials based on individual patient risk.

TL;DR: David A. Siegel is the co-chair of the Lung Injury Response Clinical Working Group and the lung injury Response Epidemiology/Surveillance Group, which aims to improve the quality of life for patients with lung injury.

TL;DR: The number of lung transplants has increased each year since 2012, reflecting an increase in the number of donors, improved use of recovered organs, and more candidates being listed for transplant, but the need for organs continues to outpace available donors.

TL;DR: In the context of organ shortage, the opioid epidemic, and effective direct‐acting antiviral (DAA) therapy for hepatitis C virus (HCV), more HCV‐infected donor organs may be used for liver transplants to expand the donor pool and increase access to liver transplantation.

TL;DR: Results for acute tubular necrosis (ATN) were not significantly different from those with biopsy‐proven rejection (BPR) and dd‐cfDNA identified unnecessary biopsies triggered by a rise in plasma creatinine, suggesting that dd‐ cfDNA may detect inadequate immunosuppression resulting in subclinical graft damage.

TL;DR: The standardized dd‐cfDNA test identified acute rejection in samples from a broad population of HT recipients and had a 44% sensitivity to detect rejection and a 97% negative predictive value.

TL;DR: Kidney transplantation from HCV‐infected donors toHCV‐negative recipients should be considered in all eligible patients.

TL;DR: It is concluded that biopsies with ABMRh but without detectable HLA‐DSA represent a distinct, often transient phenotype with superior allograft survival and not contribute to the prognosis of graft function and graft failure.

TL;DR: The main characteristics and perioperative and postoperative courses of both recipients and donors following 4 deceased donor and 5 living donor uterus transplantations are reported.

TL;DR: The data suggest that a blood‐based biomarker that reduces the need for the indiscriminate use of invasive surveillance biopsies and that correlates with transplant outcomes could be used to monitor KT recipients with stable renal function, including after treatment for subAR, potentially improving KT outcomes.

TL;DR: Data suggest FMT is safe in SOT patients, however, repeated FMT(s) or additional antibiotics may be needed to optimize rates of cure with FMT.

TL;DR: A potential benefit for eculizumab compared with SOC in preventing acute AMR in recipients sensitized to their living‐donor kidney transplants (EudraCT 2010‐019630‐28) is suggested.

TL;DR: The EVR + rCNI regimen offers comparable efficacy and graft function with low tBPAR and dnDSA rates and significantly lower incidence of viral infections relative to standard‐of‐care up to 24 months.

TL;DR: This single‐arm trial of orthotopic heart transplantation from HCV‐infected donors into uninfected recipients, followed by elbasvir/grazoprevir treatment after recipient HCV was first detected suggests thatHCV‐negative candidates transplanted with HCV-infected hearts have acceptable outcomes.

TL;DR: Early immunosuppression minimization is feasible in selected liver recipients, while complete withdrawal is successful in only a small proportion, and the composite end point comparison was inconclusive for noninferiority of the withdrawal to the maintenance group.

TL;DR: A novel approach to evade the pericapsular fibrotic response to alginate‐microencapsulated SC‐β cells was used, resulting in long‐term functional competence and glycemic correction without systemic immunosuppression in immunocompetent C57BL/6 mice.

TL;DR: Normothermic machine perfusion of human kidneys for 24 hours appears to be feasible, and urine recirculation was found to facilitate the maintenance of perfusate volume and homeostasis.

TL;DR: BL‐R is a heterogeneous diagnostic grouping, ranging from mild inconsequential inflammation to clinically significant TCMR, which is capable of immune‐mediated tubular injury resulting in inferior functional, immunological, and histological consequences.

TL;DR: In a highly adherent population, tacrolimus did not display high intrapatient variability and given the association between IPV and poor allograft outcomes, future studies are needed to quantitate the influence of adherence and establish target IPV goals.