by Qiqi Yu  , Kran Suknuntha  , Weixiong Zhong  , Daniel R. Matson  , Aaron S. Hess  and William N. Rose

Received: 13 February 2022;  Published: 02 June 2022;  doi: 10.21926/obm.transplant.2202160

We report a case of thrombotic microangiopathy (TMA) diagnosed in the kidney allograft of a 59-year-old woman who had developed plasmacytoma type monomorphic posttransplant lymphoproliferative disorder (PTLD) 30 years after a simultaneous pancreas and kidney transplant. This report demonstrates a rare etiology of TMA in a kidney allograft occurring in association with PTLD-associated monoclonal gammopathy. The main teaching points are: 1) PTLD may be considered in the work-up of a new TMA in the immunosuppressed po [...]

by OBM Transplantation Editorial Office

Received: 16 May 2022;  Published: 18 May 2022;  doi: 10.21926/obm.transplant.2202159

InterviewAn Interview with Prof. Peter SchemmerOBM Transplantation Editorial OfficeLIDSEN Publishing Inc., 2000 Auburn Drive, One Chagrin Highlands, Suite 200, Beachwood, OH, USA; E-Mail: transplantation@lidsen.com OBM Transplantation2022, volume 6, issue 2doi:10.21926/obm.transplant.2202159Received: May 16, 2022Accepted: May 17, 2022Published: May 18, 2022

by Lynne Uhl  , Taye H. Hamza  , Terry Gernsheimer  and Sherrill J. Slichter

Received: 30 December 2021;  Published: 26 April 2022;  doi: 10.21926/obm.transplant.2202158

In the multi-institutional platelet dose trial (PLADO Trial), there were 1,077 hematology/oncology patients ≥18 years of age who received at least one platelet transfusion. These patients were analyzed for types and severity of organ system bleeding based on baseline patient characteristics, laboratory assays, primary diagnosis, and type of treatment. Patients were randomly assigned to receive one of three different prophylactic platelet doses for morning platelet counts of ≤10 × 109 /L. Daily assessmen [...]

by OBM Transplantation Editorial Office

Received: 06 January 2022;  Published: 07 January 2022;  doi: 10.21926/obm.transplant.2201157

The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2021. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recogni [...]

by Wolfgang Rennert  , Katie Cormier  and Samantha Sprott

Received: 22 November 2021;  Published: 24 December 2021;  doi: 10.21926/obm.transplant.2104156

Bone marrow transplants remain an import source of hematopoietic stem cells for patients suffering from specific diseases like aplastic anemia, for pediatric patients with malignant and non-malignant blood cell disorders, and for situations in which graft-versus-host disease (GvHD) is a concern. Identifying the optimal donor to achieve a 3-5 x 108/kg of recipient weight TNC yield may be challenging. In an analysis of 687 consecutive donors, donor and procedure characteristics were related to TNC/kg of recipient wei [...]

by Masahiro Sato  , Yuki Kiyokawa  , Emi Inada  , Eri Akasaka  , Satoshi Watanabe  and Issei Saitoh

Received: 15 March 2021;  Published: 04 November 2021;  doi: 10.21926/obm.transplant.2104155

Although the aging process expands the adipose tissue habitation in mice and due to its close association with the female reproductive system, it can be easily exposed surgically under anesthesia when reproductive organs (including ovary, oviduct, and part of the uterus) are pulled and exposed onto the dorsal skin. This study aimed to consider the suitability of adipose tissue as a target for manipulation, particularly for the grafting of cells or small-sized tissue sections due to its ease of handling. Subsequentl [...]

by Aniruddha Bhattacharyya  , Lee R. Friedman  , Beje S. Thomas  and Coleman I. Smith

Received: 29 August 2021;  Published: 18 October 2021;  doi: 10.21926/obm.transplant.2104154

End Stage Renal Disease is becoming more prevalent in the United States of America, with demand for kidney transplant exceeding the available organ supply. A novel method to increase the donor pool has been to consider transplanting organs from deceased patients who have had Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV) infections. Transplants with HCV infected kidneys are becoming more prevalent, due to increased organ supply due to increased mortality from injection opioid use. Similarly, deceased [...]

by Kamyar Afshar  , Michelle Bremer  , Bharath Ravichandran  , Ashley A. Feist  , Eugene Golts  , Elizabeth H. Schonhoft  and Gordon Yung

Received: 14 July 2021;  Published: 15 October 2021;  doi: 10.21926/obm.transplant.2104153

Alpha-1 antitrypsin deficiency (AATD) accounts for approximately 5% of lung transplants (LTx) performed annually. No studies have addressed the potential benefit of ongoing alpha-1 proteinase inhibitor (A1-PI) replacement to AATD patients post-LTx. Our primary objective was to assess potential benefits of continually administering A1-PI from pre- to post-transplantation for AATD LTx recipients. A retrospective case series was performed on AATD LTx recipients between 2002 and 2018. Data reviewed included date of A1- [...]

by Christine Pham  , Brett J Pierce  , Simon W Yau  , Jihad Georges Youssef  , Ahmad Goodarzi  and Howard J Huang

Received: 09 July 2021;  Published: 30 August 2021;  doi: 10.21926/obm.transplant.2103152

Data supporting the use of belatacept in non-abdominal organs are limited to case series and small cohorts involving patients requiring conversion due to CNI intolerance or contraindication. Review articles summarizing the efficacy of belatacept salvage therapy in lung transplantation have previously been published, however, dosing regimens are highly variable and uniform guidance is lacking. In this article, indications and considerations for belatacept use in lung transplant recipients are reviewed with a specifi [...]

by Sunil Daga  , Adarsh Babu  , Natasha Khovanova  and Robert Higgins

Received: 11 May 2021;  Published: 17 August 2021;  doi: 10.21926/obm.transplant.2103151

Antibodies against donor HLA determine access to solid organ transplantation and in many cases the outcome of transplantation, but graft failure is not an inevitable consequence of their presence. Much research has been performed with two main aims – which antibodies represent the highest risk factor prior to transplantation, and second to understand how donor specific HLA antibodies behave after transplantation, with a long-term aim of being able to manipulate their production. HLA antibody incompatible kidney tra [...]

by Oya M. Andacoglu  , Jack Liu  , Abigail L. Brooks  , Amit Blumfield  , Mehul Trivedi  , Shoshana Lehman  , Michael K. Parides  , Enver Akalin  , Jay A. Graham  , Juan P. Rocca  and Stuart M. Greenstein

Received: 17 March 2021;  Published: 20 July 2021;  doi: 10.21926/obm.transplant.2103150

Glomerular filtration rate (GFR) is an excellent indicator of renal function; however, it is rarely evaluated as an endpoint. We investigated donor and recipient factors for associations that might be predictive of mid-term GFR after renal transplantation. We performed a retrospective review of 828 deceased donor renal transplantations performed at Montefiore Medical Center between the years 2009-2015. Donor characteristics included KDPI, [low (<20%), medium (20-80%), high (>80%)], age, graft types [extended [...]

by Hamid Ullah  , Sara Iqbal  , Blanca Lizaola Mayo  and Elizabeth Carey

Received: 31 March 2021;  Published: 20 July 2021;  doi: 10.21926/obm.transplant.2103149

Liver transplantation (LT) has grown monumentally in the last 40 years. Sarcopenia has emerged as an independent factor associated with increased mortality in patients with end stage liver disease. In this review we aim to shed light upon recent developments in assessment, clinical implications, management of sarcopenia in patients requiring a liver transplant. We also bring attention to the impact of COVID-19 pandemic on sarcopenia which ranges from the disease pathology to the unprecedented preventive measures ta [...]

by Bin Ni  , Nidhi Sharma  , Ashley Rosko  , Don M. Benson  and Yvonne A. Efebera

Received: 12 April 2021;  Published: 09 July 2021;  doi: 10.21926/obm.transplant.2103148

Prior to the advent of anti-retroviral therapy (ART), autologous stem cell transplant (ASCT) was relatively contraindicated for multiple myeloma (MM) patients with human immunodeficiency virus (HIV) due to issues associated with stem cell harvest and the risk of opportunistic infections. With the widespread use of ART for control of HIV, ASCT is now the preferred treatment for relapsed lymphoma, the leading hematopoietic malignancy associated with HIV/AIDS. Hence, MM patients with HIV controlled by ART may benefit [...]

by Shalika B. Katugaha  , Amit K. Mahajan  , Meg Fregoso  , Haresh Mani  and Oksana A. Shlobin

Received: 25 October 2020;  Published: 03 July 2021;  doi: 10.21926/obm.transplant.2103147

A 65-year-old female with a history of right lung transplantation (LTx) for chronic obstructive pulmonary disease (COPD) 9-years prior complicated by grade 3 bronchiolitis obliterans syndrome (BOS) was admitted to the hospital for chest pain and dyspnea on exertion (DOE). Her bronchoscopy revealed fluffy, endobronchial lesions that were adherent to the right sided anastomosis resulting in mild obstruction of the right mainstem bronchus. Pathology from biopsies of the endobronchial lesions revealed hyphal fungal org [...]

by Abhijit Jagdale  , C. Adam Banks  , Hayato Iwase  , David K.C. Cooper  and Hidetaka Hara

Received: 29 December 2020;  Published: 30 June 2021;  doi: 10.21926/obm.transplant.2102146

It has been speculated that the immunomodulation associated with pregnancy, e.g., decreasing pro-inflammatory cytokines, increasing anti-inflammatory cytokines, upregulation of T regulatory cells (Tregs), is in part due to the effect of human chorionic gonadotropin (hCG). In this study, we tested the effect of hCG on proliferation of human peripheral blood mononuclear cells (PBMCs) stimulated by irradiated pig PBMCs. Mixed lymphocyte reaction (MLR) was carried out with human PBMCs as responders and irradiated wild- [...]

by Justin P. Rosenheck  , Mena M Botros  and David R Nunley

Received: 15 March 2021;  Published: 27 June 2021;  doi: 10.21926/obm.transplant.2102145

Lung transplantation is a therapeutic option for patients with advanced lung diseases. Lung transplant outcomes have improved over time with improvements in the management of these complex patients. Cytomegalovirus is a common opportunistic organism affecting all solid organ transplant recipients. Characteristics unique to lung transplantation can make this virus difficult to manage, with myriad complications including graft failure and death. Ongoing research into and understanding of cytomegalovirus has opened ex [...]

by Victoria Gómez-Dos-Santos  , Vital Hevia-Palacios  , María Laura García-Bermejo  , Alberto Alcázar-González  , Miren Edurne Ramos-Muñoz  , Laura Salinas-Muñoz  , Elisa Conde-Moreno  , Alejandro Escobar-Peso  , Ana Belén Serrano-Romero  , Ana Saiz-González  , Miriam Menacho-Román  and Francisco Javier Burgos-Revilla

Received: 22 December 2020;  Published: 10 June 2021;  doi: 10.21926/obm.transplant.2102144

The efficacy and safety of using high concentrations of oxygen during hypothermic machine perfusion (HMP) have not been fully elucidated to date. This study investigated the impact of administering high concentrations of oxygen on renal function during HMP in a porcine donation after circulatory death (DCD), as well as the metabolic and biochemical effects of this method. A randomized nonblinded cohort study was established in a porcine transplant (KT) model mimicking Maastricht type III DCD under oxygen-supplement [...]

by Angela Q Maldonado  , Kristoffer Sjöholm,  , Joshua Lee  , Håkan Olsson  , Christian Kjellman  and Darren E Stewart

Received: 01 April 2021;  Published: 03 June 2021;  doi: 10.21926/obm.transplant.2102143

Prioritization in the US Kidney Allocation System (KAS) has led to an improvement in the rates of transplantation in highly sensitized (HS) patients. However, there is a subset of HS patients who are at a disadvantage, despite prioritization under KAS. The purpose of this study was to describe the transplant rate (TR) by calculated panel reactive antibody (CPRA) of HS candidates before and five years post-KAS to characterize their access to deceased donor transplants and quantify the number of HS candidates who are [...]

by Gerald Schlaf  , Jakob Kehlen  , Anja Wahle  , Diana Mauer  and Wolfgang Altermann

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

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 [...]

by Amy Spallone  and Marion Hemmersbach-Miller

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

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 [...]

by Michael F Knoll  , Carmela A Knoll  , Rita Bottino  , Suzanne Bertera  and Massimo Trucco

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

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 [...]

by Nidhi Sharma  and Yvonne Efebera

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

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 [...]

by Plamen Mihaylov  , Burcin Ekser  , Daiki Soma  , Andrew Lutz  , Jonathan Fridell  and Chandrashekhar A. Kubal

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

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 [...]

by Siva Mahendran  , Paramit Chowdhury  , Ronan Breen  , Grainne d’Ancona  and Heather J. Milburn

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

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 [...]

by Patrick Hagen  , William Adams  , Shruti Singh  , Shuai Qin  , Loredana Campo  , Stephanie Tsai  , Nasheed Hossain  , Scott E Smith  and Patrick J Stiff

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

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 [...]

by M Wehming  , A Briem-Richter  , R Ganschow  , F Brinkert  , B Winkler  , L Fischer  and Enke Grabhorn

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

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 [...]

by Olivia C Smibert  , Joseph S Doyle  , Adam WJ Jenney  , David Pilcher  , Miranda A Paraskeva  , Glen P Westall  and Greg I Snell

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

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 [...]

by Anis Chaba  , Manon Dekeyser  , Julie Oniszczuk  and Antoine Durrbach

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

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 [...]

by OBM Transplantation Editorial Office

Received: 04 January 2021;  Published: 06 January 2021;  doi: 10.21926/obm.transplant.2101132

The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2020. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recogni [...]

by Inês Pessanha  , Catarina Cunha  , Cláudia Piedade  , Emanuel Furtado  and Maria Francelina Lopes

Received: 09 August 2020;  Published: 05 January 2021;  doi: 10.21926/obm.transplant.2101131

Diaphragmatic Hernia (DH) after Liver Transplantation (LT) is a rare complication with unclear pathophysiology. Among 261 LT, we recognized six DH during the post transplant period (2.30%). All patients with DH had received a left lateral segment (LLS) reduced graft. The mean graft weight was 340g with a mean graft-to-recipient body weight ratio (GBWR) of 4.20%. LLS grafts, a GBWR > 4%, previous abdominal surgery and direct trauma during surgery can be enumerated as potential risk factors for DH post-LT. These chil [...]

by Michael Mazzei  , Suresh Keshavamurthy  , Olga Timofeeva  and Yoshiya Toyoda

Received: 11 September 2020;  Published: 04 January 2021;  doi: 10.21926/obm.transplant.2101130

Preoperative sensitization of the cardiac transplant recipient, defined as the presence of anti-Human Leukocyte Antigen (HLA) antibodies before transplant, represents a significant management challenge for physicians. Sensitization prolongs the pre-transplant wait time and is associated with postoperative transplant complications and death. It is critical that sensitized heart transplant candidates be identified and optimized before surgery. In this review, we describe the risk for sensitization, discuss the means [...]

by Shehab Mohamed  , Davide Tosi  , Sara Pieropan  , Andrea Cara  , Giovanni Caffarena  , Giorgio Alberto Croci  and Lorenzo Rosso

Received: 01 July 2020;  Published: 21 December 2020;  doi: 10.21926/obm.transplant.2004129

Pulmonary transplantation (LuTx) is established as a treatment option for patients with end-stage lung diseases, such as chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease, and pulmonary arterial hypertension. Acute rejection and infection are implicated as potential risk factors in developing complications such as bronchiolitis obliterans syndrome (BOS) and chronic rejection, leading to high morbidity and mortality rates after the LuTx. Thus, surveillance procedures after transplanta [...]

by Jun Gu  , Wei Wang  , Guilin Tang  , Gokce A. Toruner  , Ming Zhao  , Steven Sfamenos  , Zhenya Tang  , Joseph D. Khoury  and L. Jeffrey Medeiros

Received: 13 October 2020;  Published: 07 December 2020;  doi: 10.21926/obm.transplant.2004128

Donor cell-derived leukaemia (DCL) is an uncommon complication of allogeneic hematopoietic stem cell transplantation (HSCT). DCL might represent up to 5% of the post-HSCT disease relapses, but case numbers reported in the literature might underestimate the frequency. The leukemogenesis of DCL is not well understood due to the limited numbers of cases reported and lack of detailed molecular genetic information from recipients and donors. Although many theories have been proposed for leukemogenesis of DCL, the underl [...]

by Naoaki Sakata  , Gumpei Yoshimatsu  and Shohta Kodama

Received: 02 October 2020;  Published: 27 November 2020;  doi: 10.21926/obm.transplant.2004127

Islet transplantation is a cellular replacement therapy for severe diabetes mellitus. Although the clinical outcome of islet transplant has been improving, the transplant efficacy of this treatment is not superior to that of pancreatic organ transplantation, a similar transplant therapy. Various factors have been characterized as ‘islet transplantation specific’, which includes lack of revascularization and ischemia, innate inflammation, or autoimmunity, affect the therapeutic outcome of this treatment. Among them, [...]

by Kamal Kant Sahu

Received: 01 November 2020;  Published: 19 November 2020;  doi: 10.21926/obm.transplant.2004126

by Preeti Chhabra  and Kenneth L. Brayman

Received: 20 September 2020;  Published: 16 November 2020;  doi: 10.21926/obm.transplant.2004125

Clinical islet allotransplantation represents a minimally invasive, efficacious alternative to pancreas transplantation for restoring glycemic control and insulin independence in select patients with type 1 diabetes that is complicated by intractable impaired hypoglycemia awareness and/or severe hypoglycemic events refractory to stabilization by other means. Over the last decade, islet transplantation outcomes have steadily improved in part due to refinements in the selection of optimal donors, islet isolation tech [...]

by Malcolm Voyce

Received: 22 July 2020;  Published: 16 November 2020;  doi: 10.21926/obm.transplant.2004124

This article aims to describe the relationship between donors and their recipients in the context of organ transplants. This analysis is made in the light of Marcel Mauss’s work, offering an expansion on an analysis of his discussion on the “spirit of the gift” and his idea that gifts require reciprocation. It is argued that some recipients of donated organs receive a personal element from the donor in that there is a transfer or sharing of the donors’ personality and spiritual qualities. The article examines the n [...]

by Marina Moguilevitch  and Tracey Straker

Received: 05 July 2020;  Published: 12 November 2020;  doi: 10.21926/obm.transplant.2004123

Clinical presentation and progression of Wilson’s disease can be diverse in different groups of patients. While young children most likely to present with acute or chronic liver failure, older children and adults may exhibit extrahepatic manifestation like neuropsychiatric, cardiac, renal, pancreatic and several others. Diagnosis of Wilson’s disease is based on the combination of specific clinical findings, laboratory and genetic testing. There are different modalities of treatment available for this condition. Liv [...]

by Jessica Ferguson  , Marisa Holubar  , Waldo Concepcion  and Dora Y. Ho

Received: 24 July 2020;  Published: 09 November 2020;  doi: 10.21926/obm.transplant.2004122

Liver transplant recipients (LTRs) are at risk for vancomycin-resistant Enterococcus (VRE) infections which can lead to significant morbidity or mortality. Antibiotic exposure, including vancomycin, is associated with greater risk of VRE infection. This study aimed to assess the appropriateness of vancomycin use and rates of VRE infection in this population. We performed a retrospective cohort study of 327 patients who underwent liver transplantation at our center from January 1, 2012 to June 30, 2017. Sixty (18.3% [...]

by Courtney Tate  , Jason P Butler  , Cameron Curley  , Siok-Keen Tey  , Glen A Kennedy  and Ashleigh P Scott

Received: 23 June 2020;  Published: 23 October 2020;  doi: 10.21926/obm.transplant.2004121

Acquired Severe Aplastic Anaemia (SAA) is a rare bone marrow failure syndrome, for which allogeneic haematopoietic stem cell transplant (HSCT) is a proven curative therapy. Despite excellent outcomes for matched sibling SAA recipients in terms of engraftment and survival, HSCT remains highly challenging in older matched-unrelated-donor (MUD) recipients, due to increased non-relapse mortality (NRM) from causes such as graft versus host disease (GVHD), organ failure and infection. We sought to evaluate our local HSCT [...]

by Shalika B. Katugaha  , Oksana Shlobin  , Chris King  , Steve Nathan  , Shambu Aryal  , Kareem Ahmad  and Whitney Brown

Received: 04 September 2020;  Published: 13 October 2020;  doi: 10.21926/obm.transplant.2004120

Strongyloides stercoralis infection derived from the donor in solid organ transplant (SOT) places recipients at risk for hyperinfection syndrome and death. We describe the case of a lung transplant recipient who developed strongyloidiasis presenting with GI symptoms and progressing to diffuse alveolar hemorrhage, bacteremia and multi-organ failure. The patient's clinical course illustrates the life cycle of Strongyloides. For treatment, the patient received ivermectin and albendazole. We advocate that early diagnos [...]

by Pierpaolo Di Cocco  , Alberto Fratti  , Kerim B. Kaylan  , Ivo G. Tzvetanov  and Enrico Benedetti

Received: 22 August 2020;  Published: 28 September 2020;  doi: 10.21926/obm.transplant.2003119

This article reviews the current treatment strategies of antibody-mediated rejection in kidney transplantation, which is increasingly recognized as the leading immunological cause of graft failure. The pathophysiologic complexity of this condition poses significant challenges for its treatment; however, progress toward advancing our understanding of its pathogenesis and diagnosis will allow for identification of new therapeutic targets. Emphasis is also given to prevention, which is mainly based on careful assessme [...]

by Bhagyashree Deshmankar  , Craig E. Eckfeldt  , Graf Oliver  , Aleksandr Lazaryan  and Nelli Bejanyan

Received: 19 July 2020;  Published: 18 September 2020;  doi: 10.21926/obm.transplant.2003118

Severe hypercholesterolemia is an uncommon complication of allogenic hematopoietic cell transplantation (HCT). Treatment options for hypercholesterolemia due to liver graft-versus-host disease (GVHD) are limited because many antilipidemic medications are known to worsen hepatic functions. We report our experience on a case of a 38-year-old male with Philadelphia chromosome positive acute lymphoblastic leukemia presenting with steroid-refractory hepatic and lower gastrointestinal acute GVHD after matched sibling don [...]

by Renly Dutton  , Frank Abdi  , Levon Minnetyan  and James L. Sherley

Received: 22 April 2020;  Published: 28 August 2020;  doi: 10.21926/obm.transplant.2003117

Although tissue stem cells are essential for the maintenance, renewal, and repair of vertebrate organs and tissues, previously, the simple act of counting them has not been possible. For more than a half-century, progress in tissue stem cell research and medicine has been undermined by the lack of a means to determine tissue stem cell number. In particular, a major unmet need for stem cell transplantation medicine has been a way to quantify the specific dosage of tissue stem cell treatments. The counting problem pe [...]

by Marina Moguilevitch  , Michael Rufino  , Shalom Frager  and Tracey Straker

Received: 28 May 2020;  Published: 17 August 2020;  doi: 10.21926/obm.transplant.2003116

Liver transplant is a life-saving therapy for patients with end stage liver disease and liver cancer. Liver re-transplantation cases are usually more challenging and riskier than primary surgery, they require careful consideration and larger recourse utilization. Decision making on who receives transplantation surgery includes individual patient risks and benefits, physician judgment, specific transplant center policies, surgical experience, geographic organ availability, and ethical considerations. Several mathema [...]

by Khawla F. Ali  and Betul Hatipoglu

Received: 07 June 2020;  Published: 07 July 2020;  doi: 10.21926/obm.transplant.2003115

Pancreatic islet transplantation is a rapidly evolving field. It has been increasingly regarded as a promising approach for the correction of dysglycemia associated with type 1 diabetes mellitus (allogenic islet transplantation), or the prevention of surgical diabetes in chronic pancreatitis subjects undergoing total pancreatectomy (autologous islet transplantation). In this review, we discuss the latest literature pertaining to metabolic outcomes of autologous and allogenic islet transplantation, shedding close li [...]

by Dominic Emerson  , Jon Kobashigawa  , Ryan Levine  , Jamie Moriguchi  , Dominick Megna  , Joshua Chung  , Dany Ramzy  , Alfredo Trento  and Fardad Esmailian

Received: 14 April 2020;  Published: 06 July 2020;  doi: 10.21926/obm.transplant.2003114

In advanced heart failure, orthotopic heart transplantation (OHT) remains the standard for definitive treatment. Patients with heart failure and concomitant pulmonary hypertension (PH) represent a challenging subgroup, with poor outcomes following OHT. Recently, Mechanical Circulatory Support (MCS) devices have been utilized as a bridge to OHT for these patients. Patients with MCS devices who underwent OHT were evaluated at a single center. Patients were stratified into three groups, depending on baseline pulmonary [...]

by Brian C. Keller  , Sadia Z. Shah  and Amy Pope-Harman

Received: 24 April 2020;  Published: 15 June 2020;  doi: 10.21926/obm.transplant.2002113

Systemic capillary leak syndrome is a disorder characterized by recurrent, life-threatening episodes of acute capillary hyperpermeability resulting in edema and hypovolemic shock. We report a case of systemic capillary leak syndrome in a lung transplant recipient who developed recurrent episodes of volume overload, respiratory failure, and acute kidney injury in association with hypotension and hypoalbuminemia. Initiation of monthly high dose intravenous immunoglobulin prophylaxis effectively abrogated the syndrome [...]

by Robert B. Diller  , Robert G. Audet  , Mediha Gurel  , Eric E. Lee  , Aaron J. Tabor  , Peter McFetridge  and Robert S. Kellar

Received: 25 September 2019;  Published: 09 June 2020;  doi: 10.21926/obm.transplant.2002112

Mesenchymal Stromal/Stem Cells (MSCs) were originally discovered in the 1970s. MSCs are considered a multipotent population that retain tri-lineage differentiation. These cells can be sourced from a variety of tissues, including bone marrow, adipose, molar pulp, and birth tissues. Historically varying definitions of MSCs have existed, but in 2006, the International Society for Cellular Therapy (ISCT) set forth a standardized, minimal criteria for MSCs, including plastic adherence, differentiation into osteoblasts, [...]

by Yasuhiko Sugawara

Received: 15 May 2020;  Published: 18 May 2020;  doi: 10.21926/obm.transplant.2002111