Table of Contents
Open Access
ISSN 2577-5820
© 2020 by the authors; CC BY 4.0 licence
OBM Transplantation , Volume 4 , Issue 1 (2020)
Pages: 138
Published: April 2020
(This book is a printed edition that was published in OBM Transplantation)
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Cover story: HLA antibodies react specifically with epitopes defined by so-called eplets. HLA-DR, HLA-DQ and HLA-DP matching at the eplet level has been widely reported to reduce allograft rejection and improves transplant outcome. The eplet effect has been studied for the individual class II loci, but a report in this issue gives attention to interlocus eplets shared between class II loci. View this paper.
Volume 4,Issue 1
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Pediatric Mixed Left Ventricular Non-Compaction and Restrictive Cardiomyopathy Bridged to Heart Transplant with Ventricular Assistby
Adam K. Morrison
,
Robert J. Gajarski
,
Ashley Hodge
,
Sara Fitzgerald-Butt
,
Peter Baker
,
Patrick M. McConnell
and
Deipanjan Nandi
Abstract Left ventricular noncompaction cardiomyopathy (LVNC) is a rare form of heritable cardiomyopathy with wide genotypic variability, numerous phenotypic variations, and a wide spectrum of clinical disease from asymptomatic to end stage heart failure. Here, we present a case of a 2-year-old boy who presented to their pediatrician with a cough as a first clinical sign of heart failure, rapidly progressing to severe heart failure. He was found to have mixed LVNC with a restrictive phenotype [...] |
Medawar's Paradox and Immune Mechanisms of Fetomaternal ToleranceAbstract Brazilian-born British biologist Dr. Peter Medawar played an integral role in developing the concepts of immunologic rejection and tolerance, which led to him receiving the Nobel Prize “for the discovery of acquired immunologic tolerance” and eventually made organ transplantation a reality. However, at the time of his early work in tolerance, a paradox to his theories was brought to his attention; how was pregnancy possible? Pregnancy resembles organ transplantation in that the fetus, possessing [...] |
Histoplasmosis in Liver Transplant Recipients: Case Reports and a Review of the LiteratureAbstract We report two cases of histoplasmosis in orthotopic liver transplant (OLT) recipients to illustrate the variable presentations, complications encountered during treatment, the spectrum of diagnostic modalities, and case outcomes. Case 1 describes the insidious presentation of presumed gastrointestinal histoplasmosis 12 years after OLT, which was defined by months of intermittent diarrhea and focal colonic disease on colonoscopy. A diagnosis of Histoplasma capsulatum was ultimately made by broad [...] |
Febrile Neutropenia in Children: Etiologies, Outcomes, and Risk Factors with Prolonged Feverby
Muayad Alali
,
Michael Z. David
,
Sandra A. Ham
,
Danziger-Isakov LA
,
Allison H. Bartlett
,
Lindsay Petty
and
Jennifer C. Pisano
Abstract Most studies of children with prolonged fever and neutropenia (PFN) have focused on invasive fungal disease (IFD) as the etiology of fever and not on other causes. Data are lacking regarding risk factors and adverse outcomes in pediatric cancer patients with PFN compared with those whose fevers resolve more rapidly. Retrospective medical record review was performed for all cancer patients with febrile neutropenia (FN) in the pediatric oncology unit at University of Chicago Medicine Comer Childre [...] |
Hematopoietic Stem Cell Transplantation in Refractory Celiac Disease: An Overview with Focus on Infectious Complicationsby
Abdul Al-Toma
and
Harry R. Koene
Abstract Refractory celiac disease (RCD) is a rare condition in which a known celiac patient, usually an adult, suffers from persistence or recurrence of gluten-related symptomatology, laboratory abnormalities, and inflammatory enteropathy despite following an optimal dietary therapy with gluten-free diet (GFD). Arbitrarily, a duration of at least 12 months of GFD has been recommended prior to establishing such a diagnosis. Furthermore, exclusion of the other possible causes of non-celiac villous atrophy [...] |
Eplet-Based HLA Class II Matching for Transplantation: Design of a Repertoire of Interlocus Eplets Shared between HLA-DR, -DQ and -DP Allelesby
Rene J. Duquesnoy
and
Marilyn Marrari
Abstract Many studies have demonstrated that HLA-DR, HLA-DQ and HLA-DP matching at the eplet level reduces allograft rejection and improves transplant outcome. Such studies have examined the eplet effect for the individual class II loci, but until now little attention has been given to so-called interlocus class II eplets shared between HLA-DR, HLA-DQ and/or HLA-DP alleles. This report summarizes current information about antibody-verified interlocus class II eplets. It describes a structural modeling me [...] |
Utility of Fungal Cell Markers in Pediatric Bone Marrow Transplant Recipients for Screening and Diagnosis of Invasive Fungal InfectionsAbstract Invasive fungal disease (IFD) is a significant contributor to morbidity and mortality in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Early detection and timely initiation of antifungal therapy is important for improved outcome, but diagnosis remains difficult, especially when relying on conventional microbiology methods such as culture and microscopy. Data on the use of fungal biomarkers for screening and diagnosis of IFD in HSCT pediatric patients are limited, [...] |
Immunosuppression in Kidney TransplantationAbstract Immunosuppressive therapy in renal transplantation is divided into two phases as induction and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, induction immunosuppressive strategies utilized by kidney transplant centers fall in one of the two categories. One approach relies upon high doses of conventional immunosuppressive agents, while the other uses ant [...] |
Dual Kidney Transplantation after Hypothermic Oxygenated Perfusion from Marginal Donor after Circulatory Death with Acute Kidney Injury: A Case Reportby
Federica Odaldi
,
Vanessa De Pace
,
Giacomo Frascaroli
,
Giuliana Germinario
,
Giorgia Comai
,
Francesco Vasuri
,
Gaetano La Manna
and
Matteo Ravaioli
Abstract Donation after circulatory death (DCD) is an increasingly used resource to alleviate chronic renal graft shortages. Organs from donors with progressively increased creatinine levels due to acute kidney injury are used, but the effects of this condition on kidney transplantation are still unclear. Ex-situ machine perfusion is emerging as a potential tool to preserve and resuscitate vulnerable grafts. We report a case of DCD kidneys discarded due to severe acute kidney injury with favorable histol [...] |