Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation 

About: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation is an academic journal. The journal publishes majorly in the area(s): Liver transplantation & Kidney transplantation. It has an ISSN identifier of 2146-8427. Over the lifetime, 1615 publications have been published receiving 10609 citations.

Autologous bone marrow derived mononuclear cell therapy for spinal cord injury: A phase I/II clinical safety and primary efficacy data.

Abstract: Objective: We sought to assess the safety and therapeutic efficacy of autologous human bone marrow derived mononuclear cell transplantation on spinal cord injury in a phase I/II, nonrandomized, open-label study, conducted on 297 patients. Materials and Methods: We transplanted unmanipulated bone marrow mononuclear cells through a lumbar puncture, and assessed the outcome using standard neurologic investigations and American Spinal Injury Association (ASIA) protocol,andwithrespecttosafety,therapeutictime window, CD34+ cell count, and influence on sex and age. Results: No serious complications or adverse events were reported, except for minor reversible complaints. Sensory and motor improvements occurred in 32.6% of patients, and the time elapsed between the injury and the treatment considerably influenced the outcome of the therapy. The CD34+ cell count determined the state of improvement, or no improvement, but not the degree of improvement. No correlation was found between level of injury and improvement, and age and sex had no role in the outcome of the cellular therapy. Conclusion: Transplant of autologous human bone marrow derived mononuclear cells through a lumbar puncture is safe, and one-third of spinal cord injury patients show perceptible improvements in the neurologic status. The time elapsed between injury and therapy and the number of CD34+ cells injected influenced the outcome of the therapy.

Treatment of diabetic impotence with umbilical cord blood stem cell intracavernosal transplant: preliminary report of 7 cases.

Abstract: Objectives Stem cells are characterized by self renewal and multipotent differentiation.We report the effects of intracavernosal transplant of human umbilical cord blood stem cells on diabetic erectile dysfunction. Materials and methods Seven type 2 diabetics who had failed to achieve an erection for at least 6 months despite medications, and who are currently awaiting penile prostheses, participated. All laboratory results were normal, except for impotence and diabetes mellitus. A total of 1.5 x 10(7) human umbilical cord blood stem cells were infused into the corpus cavernosum. No immunosuppressive measures were taken in any of the patients. International index of erectile function-5, SEP, GAQ, erection diary, blood glucose diary, and medication dosage were followed for 9 months. Results The mean age was 69.5 years (range, 57-87 years). Morning erections were regained in 3 participants within 1 month, and for all except 1 by the third month, and maintained for more than 6 months. Rigidity increased as the result of stem cell therapy alone, but was insufficient for penetration. With the addition of PDE5 inhibitor before coitus, 2 achieved penetration and experienced orgasm, and maintained for more than 6 months; however, 1 participant could not achieved penetration at ninth month. All but 1 reported increased desire. During follow-up, 2 returned for prosthesis, 4 returned to a nonerectile condition at 9 months, and 1 maintained erection sufficient for coitus with medication until the 11th month. Blood glucose levels decreased by 2 weeks, and medication dosages were reduced in all but 1 subject for 4 to 7 months. Glycosylated hemoglobin levels improved after treatment for up to 3 to 4 months. Conclusions Human umbilical cord blood stem cell therapy has positive effects on erectile dysfunction and diabetes mellitus. Stem cells and unknown humoral factors of human umbilical cord blood stem cells mediate mechanism may contribute to these positive effects.

Donor-specific HLA alloantibodies: long-term impact on cardiac allograft vasculopathy and mortality after heart transplant.

Abstract: Objectives The clinical significance of anti-HLA-alloantibodies remains controversial. Recent studies have linked development of donor-specific HLA-antibodies to chronic allograft rejection and graft loss after heart, kidney, and lung transplants. We investigated the clinical impact of donor-specific humoral alloreactivity during the follow-up of heart transplant recipients. Patients and methods The sera of 213 heart transplant recipients were screened by enzyme-linked immunosorbent assay for HLA-antibody production. The antigen specificity of the detected HLA class I and class II antibodies was identified using a Luminex assay. Outcome variables were survival, cardiac allograft vasculopathy, and cellular rejection. Results The cumulative incidence of alloantibody formation was 23/213 patients (10.8%). The majority of detected alloantibodies were donor-specific for HLA class II. Mean follow-up at antibody measurements was 7 -/+ 4.9 years. Freedom from vasculopathy at 5 and 10 years was 77.9% and 26% in donor-specific HLA-antibody-positive patients compared with 84.6% and 65.2% in antibody-negative controls (P = .025). Freedom from treated, biopsy-proven rejection was 44.4% for donor-specific HLA-antibody-positive patients compared with 70.2% in the controls (P = .06). Multivariate analyses identified donor-specific HLA antibody positivity as an independent risk factor for vasculopathy. Conclusions Our results demonstrate a strong correlation between the development of donor-specific HLA antibodies and adverse outcomes after heart transplant. Detection of donor-specific HLA antibodies might identify high-risk patients and offer an opportunity for early clinical intervention and modification of immunosuppression.

The global role of kidney transplantation.

Abstract: World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.

Graft and quality of life outcomes in older recipients of a kidney transplant.

Abstract: BACKGROUND It is well recognized that kidney transplants significantly improve quality of life for patients with end-stage renal disease (ESRD). This benefit is not as clearly documented for older recipients as it is for younger recipients. We looked at outcomes, both medical and psychosocial, in a group of older (> or =65 years) kidney transplant recipients and compared the results to a group of younger recipients (18 to 64 years). METHODS From 1990 through 2002, we performed 2,746 kidney transplants at our center: 2,596 (94.5%) in recipients 18 to 64 years old and 150 (5.5%) in recipients 65 years or older. In our retrospective analysis, we determined outcomes such as patient and graft survival rates. To determine whether or not older recipients had an improved health-related quality of life, we used the national SF-36 (short form) questionnaire. We compared those results with a group of younger recipients and with national age-appropriate norms. RESULTS The mean recipient age was 69.1 years in the older group vs. 42.8 years in the younger group (p < 0.001). Living donors were used in 43.3% of the transplants in the older group vs. 47.5% in the younger group (p < 0.01). At 5 years posttransplant, patient and graft survival rates were 73% and 68% in the older group vs. 86% and 79% in the younger group (p < 0.001). We analyzed the SF-36 responses for all recipients with completed forms: 42 completed forms from the older group vs. 149 from the younger group. The overall benefit to quality of life was similar for both groups. General physical health was rated slightly higher than national norms in both groups. Benefits to mental health were more pronounced in the older group. CONCLUSION Kidney transplants can be performed in older recipients with acceptable outcomes. Such recipients enjoy significant benefits to their quality of life after a transplant, similar to benefits seen in younger recipients. Older age, by itself, should not be a contraindication to a transplant.