Table of Content

Open Access Case Report

Generation of Unexpected Allele-Specific Anti-HLA Antibodies after the Transplantation of a Fully-Matched Kidney Allograft and the Diagnostic Approaches Required for Excluding Harmful Effects after Subsequent Renal Regrafts

Received: 26 January 2021;  Published: 02 June 2021;  doi: 10.21926/obm.transplant.2102142

Abstract

The specification of anti-human leukocyte antigen (HLA) antibodies is an important task for patients awaiting kidney allografts. Especially the patients immunized in previous transplantations, transfusions, or pregnancies must be carefully observed, since grafting patients with HLA antigens/phenotypes recognized by their pre-formed antibodies are the main cause of harmful hyperacute and acute rejection. The complement-dependent lymphocytotoxicity-based de facto (physical) crossmatching (CDC-CM) has thus been implem [...]

1185 8060

Open Access Review

The Great Masquerade: Donor-derived Infections with Uncommon Central Nervous System Pathogens

Received: 29 January 2021;  Published: 02 May 2021;  doi: 10.21926/obm.transplant.2102141

Abstract

Donor-derived infections (DDI) are an infrequent event in solid organ transplant (SOT) due to advances in screening recommendations, prophylaxis, and surveillance of common infections. However, unexpected pathogen transmission can still occur when a donor is not known to be infected prior to organ procurement, which can lead to significant morbidity and mortality in the organ recipient. Solid organ donors with central nervous system (CNS) pathogens are an uncommon but deadly source of unexpected DDI. Clinically rec [...]

777 90451

Open Access Review

The Future of Clinical Islet Transplantation in the United States

Received: 12 January 2021;  Published: 25 March 2021;  doi: 10.21926/obm.transplant.2101140

Abstract

Clinical islet transplantation was first realized over four decades ago at the University of Minnesota. Autologous islet transplantation is now widely recognized as a treatment to prevent diabetes in patients after pancreas excision and is offered at major transplant centers throughout the United States and the world. Type 1 diabetes represents a much larger demographic in which islet transplantation may benefit patients. Allogeneic islet transplantation can now offer similar outcomes to pancreas transplantation in [...]

1013 10540

Open Access Perspective

Acute Graft-Versus-Host Disease, Prophylaxis and Therapy

Received: 26 October 2020;  Published: 25 March 2021;  doi: 10.21926/obm.transplant.2101139

Abstract

Graft-versus host disease is one of the major causes of death in patients undergoing allogeneic hematopoietic stem cell transplantation. Major contributing factors to severity of graft-versus host disease include HLA mismatch, conditioning regimen intensity, age of donor and recipient, source of stem cell, and donor type. Strategies and clinical trials are ongoing to reduce the incidence of graft-versus host disease, and to improve on the survival outcome of patients with graft-versus host disease, Research efforts [...]

1001 8364

Open Access Short Communication

Reconstruction of Aberrant Left Hepatic Artery in Orthotopic Liver Transplantation – Single Center Experience

Received: 04 January 2021;  Published: 11 March 2021;  doi: 10.21926/obm.transplant.2101138

Abstract

One of the most feared complications in liver transplantation is hepatic arterial thrombosis (HAT). The incidence of HAT in liver transplantation varies from 1.2% and 8%. One of the risk factors for this complication is anatomical complexity of hepatic arterial system. The focus of this short communication is to show our approach in dealing with aberrant left hepatic artery in settings of liver transplantation. This is a single center experience. Between January 2016 and June 2019, we procured and transplanted 357 [...]

1135 8211

Open Access Case Report

Improved Awareness of Tuberculosis Infection in Advanced Stage Chronic Renal Disease Could Reduce Cases of Active TB: Lessons from Four Challenging Cases

Received: 14 August 2020;  Published: 08 March 2021;  doi: 10.21926/obm.transplant.2101137

Abstract

Patients with chronic kidney disease (CKD) have an increased risk of developing tuberculosis (TB) compared to those with normal renal function. The reasons for this are well described, but include impaired cellular immunity, a high incidence of co-morbid conditions as well as the concomitant use of immunosuppressive medications. Ethnicity as well as socio-economic factors also prevail. Expert guidelines recommend TB chemoprophylaxis in renal transplant recipients deemed at high risk – invariably those from ethnic m [...]

1235 7158

Open Access Research Article

Umbilical Cord Blood as an Alternate Donor Sources for High Risk Elderly Patients Undergoing Allogeneic Stem Cell Transplantation for Hematological Malignancies

Received: 04 November 2020;  Published: 07 February 2021;  doi: 10.21926/obm.transplant.2101136

Abstract

Allogeneic stem cell transplantation remains the only curative option for many hematological malignancies. Umbilical cord blood (UCB) is an alternate donor source with potentially increased morbidity in elderly patients. We evaluated outcomes in alternate donor sources, prior to the initiation of haploidentical transplantation at our institution, of matched unrelated donor (MUD) and UCB in elderly patients (mean age 64, range 60-75). One hundred and eighty-four patients were included (MRD: 57; MUD: 69; UCB: 58). Th [...]

961 6880

Open Access Research Article

Malignancies and Pediatric Liver Transplantation: Promising Management with the mTOR-inhibitor Everolimus

Received: 07 June 2020;  Published: 25 January 2021;  doi: 10.21926/obm.transplant.2101135

Abstract

Some malignancies such as hepatoblastoma may be an indication for liver transplantation (LT) or some, for example, post-transplant lymphoproliferative disease (PTLD) may develop after successful LT. An immunosuppressive therapy after LT can promote the recurrence of the primary malignancy. The mammalian target-of-rapamycin inhibitors (mTORi) are immunosuppressive agents with anti-tumor properties. We examined the impact of everolimus (EVL) together with calcineurin inhibitors on allograft outcome and patient surviv [...]

902 6612

Open Access Research Article

Transmitted Donor Immunology Not Infection: Common Persistence of Donor Hepatitis C Antibody Production in Aviremic Lung Transplant Recipients

Received: 16 September 2020;  Published: 13 January 2021;  doi: 10.21926/obm.transplant.2101134

Abstract

Since 2018 The American Society of Transplant has recommended that Hepatitis C Virus seropositive positive, non-viremic donors (HCVAb+/NAT-) be considered non-infectious and safe for transplantation. This report describes clinical outcomes and HCV serological and virological outcomes following lung transplantation (LTx) utilizing such donors. This retrospective cohort study describes seven HCVAb+/NAT- donors used for bilateral LTx. Donor information was sourced from the national organ donation service and recipient [...]

1297 7243

Open Access Review

The Puzzle of Immunosuppressive Drugs

Received: 30 August 2020;  Published: 11 January 2021;  doi: 10.21926/obm.transplant.2101133

Abstract

Kidney transplantation has become the preferred treatment option in end-stage chronic renal failure as it provides significant improvements over dialysis in terms of both quality and duration of life. Even after several randomized studies conducted in the last 20 years, the combination of CNI, MMF, and steroids continues to be considered the gold standard for kidney transplantation. However, novel molecules aimed at minimizing renal and cardiovascular toxicity, particularly with CNI sparing, are being identified. T [...]

1015 6983

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