Table of Content

Open Access Research Article

Incidence, Location, and Natural History of Perihepatic Fluid Collections after Orthotopic Liver Transplantation

Received: 18 February 2019;  Published: 18 November 2019;  doi: 10.21926/obm.transplant.1904092

Abstract

Objective: The purpose of this study was to evaluate the common locations of perihepatic fluid collections after liver transplantation, assess their complexity, and understand their natural history and clinical significance. Materials and Methods: A retrospective analysis of 189 postoperative orthotopic liver transplant patients was performed using serial CT or MRI to characterize perihepatic fluid collections. Location, size, complexity of the collections, and clinical course were evaluated. Results: 76 patients [...]

949 8389

Open Access Case Report

Toxoplasmosis: “An Often Forgotten Cause for Fever of Unknown Origin in Liver Transplant Recipients”. Case Report and Review of Literature

Received: 24 October 2019;  Published: 18 November 2019;  doi: 10.21926/obm.transplant.1904091

Abstract

Toxoplasmosis in liver transplantation (LT) is uncommon, especially in the current era of universal prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) for Pneumocystis jirovecii pneumonia (PJP). Here we present a case of a 55-year-old woman LT recipient, on dapsone or PJP prophylaxis due to sulfa allergy, who presented on day 25 after LT with fever, diarrhea and abdominal pain. Initially she was diagnosed with cytomegalovirus-associated colitis and was treated with intravenous ganciclovir, with good clinical [...]

1144 7227

Open Access Original Research

Combination, Sequential Therapies Incorporating Tocilizumab Decrease the Progression of Chronic Lung Allograft Dysfunction (CLAD) after Lung Transplantation: Initial Clinical Experience

Received: 19 September 2019;  Published: 07 November 2019;  doi: 10.21926/obm.transplant.1904090

Abstract

INTRODUCTION: TH-17 and IL-6 interactions and detrimental biologic effects have been shown in rodent models of Chronic Lung Allograft Dysfunction (CLAD). Similarly, these pathways have been found to be upregulated in human CLAD. Tocilizumab (TCZ), a humanized monoclonal antibody targets the IL-6 receptor subunit alpha and prevents binding of IL-6. We herein report our preliminary experience with adjunctive TCZ therapy for human CLAD. METHODS: We retrospectively reviewed our initial experience with TCZ given af [...]

824 6264

Open Access Case Report

A Silent and Very Early Post-Liver Transplant Death by Candida Arteritis

Received: 29 August 2019;  Published: 28 October 2019;  doi: 10.21926/obm.transplant.1904089

Abstract

Background: Graft site candidiasis is a serious complication after solid organ transplantation, often presenting as invasive arteritis leading to graft loss or even death. Case Report: We report a case of anastomotic site candidiasis leading to arterial rupture and death at postoperative day 10 with no clinical warning signs. Preservation fluid cultures were negative and postoperative doppler ultrasonography did not show vascular compromise. Postmortem examination revealed microscopic arterial wall abscesses harbou [...]

987 7070

Open Access Original Research

Oral Management in Pre-HSCT Patients: An Evaluation of Oral and Systemic Complications

Received: 14 June 2019;  Published: 21 October 2019;  doi: 10.21926/obm.transplant.1904088

Abstract

Objective Hematopoietic stem cell transplant has to be preceded by chemotherapy and radiotherapy. The following neutropenia and thrombocytopenia could be the cause of post transplant complications. Patient undergoing transplantation need to be eradicated of any possible infectious focus. Nowadays there is not a uniformed protocol to manage these patients oral cavity. Study Design The dental management was decided for each patient according to a more selective protocol, based on: type and size of lesions, symptoma [...]

1230 5823

Open Access Case Report

The Surgical Approach for Obtaining Abdominal Wall Closure in Renal Transplant Recipients with Temporary or Permanent Loss of Fascial Integrity Following Emergency Reoperative Surgery

Received: 01 July 2019;  Published: 08 October 2019;  doi: 10.21926/obm.transplant.1904087

Abstract

A range of corrective surgical procedures may be required in adult renal transplant recipients who sustain loss of integrity of the abdominal wall in the first month postoperatively. Where this involves the fascia, such as in acute fascial dehiscence or in renal allograft compartment syndrome, more sophisticated reconstructive procedures may also be required, particularly in the setting of surgical site infection. There is limited data on the use of prosthetic or biologic mesh for this type of scenario, where urgen [...]

1169 7329

Open Access Review

Present and Future Strategies with Curative Intent for Hereditary Hemoglobinopathies

Received: 27 February 2019;  Published: 24 September 2019;  doi: 10.21926/obm.transplant.1903086

Abstract

Nowadays, hematopoietic stem cell transplantation (HSCT) is a common procedure in Hematology Units within Reference Centres, mainly for the treatment of hematological malignancies such as multiple myeloma, lymphoma and acute leukemia. Nevertheless, HSCT has much wider applications namely in autoimmune diseases, congenital metabolic defects and hemoglobinopathies. Thalassemia major and sickle cell disease comprise, altogether, the most frequent hereditary hemoglobinopathies worldwide. Despite the advances on the pre [...]

1029 6057

Open Access Review

Infectious Considerations for Patients on Immune Checkpoint Inhibitors

Received: 07 July 2019;  Published: 06 September 2019;  doi: 10.21926/obm.transplant.1903085

Abstract

Chronic inflammatory states lead to T cell exhaustion, characterized by reduced T cell proliferation and activity. Immune checkpoint inhibitors (ICPI) reactivate T cells to restore the immune system’s natural defenses against foreign antigens. The widespread use of these agents in the treatment of malignancy has led to markedly reduced tumor burden and improved patient survival, sparking curiosity about their potential role in chronic inflammatory states, including infectious diseases. While ICPI have been associat [...]

977 6508

Open Access Review

Benefits of Combined Liver Transplant: Protection or Tolerance?

Received: 18 April 2019;  Published: 04 September 2019;  doi: 10.21926/obm.transplant.1903084

Abstract

The privileged liver by its immunological status is described as a tolerogenic organ. However, these alone do not explain the installation of a tolerance after single or combined liver transplantation (kidney, heart, pancreas, intestine). Other factors appear to be involved in the identification of patients likely to be tolerant to their graft, such as recipient age, donor hepatic volume, iron metabolism, biomarkers, or imprint of cytomegalovirus infection. All of these factors seem to favor graft tolerance. The us [...]

1023 6999

Open Access Research Article

Characterization of Early Indicators of Cardiac Allograft Vasculopathy Lesions in a Rat Model Using Non-Invasive Cellular MR

Received: 07 January 2019;  Published: 29 August 2019;  doi: 10.21926/obm.transplant.1903083

Abstract

Background: Cardiac allograft vasculopathy (CAV) remains a major obstacle to long-term heart allograft survival. A number of studies show that immune mechanisms involved in CAV. Using non-invasive cellular MRI (CMRI) to explore indicators of CAV lesions and characterize its development could provide new insights into the target immune cells that are responsible for the progression of CAV and reveal early markers of the disease before irreversible changes occur. Methods and Results: Rat heart transplant allograft [...]

1215 7036

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