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The British Journal of Surgery Jun 2020Organ transplantation is predicted to increase as life expectancy and the incidence of chronic diseases rises. Regenerative medicine-inspired technologies challenge the... (Review)
Review
BACKGROUND
Organ transplantation is predicted to increase as life expectancy and the incidence of chronic diseases rises. Regenerative medicine-inspired technologies challenge the efficacy of the current allograft transplantation model.
METHODS
A literature review was conducted using the PubMed interface of MEDLINE from the National Library of Medicine. Results were examined for relevance to innovations of organ bioengineering to inform analysis of advances in regenerative medicine affecting organ transplantation. Data reports from the Scientific Registry of Transplant Recipient and Organ Procurement Transplantation Network from 2008 to 2019 of kidney, pancreas, liver, heart, lung and intestine transplants performed, and patients currently on waiting lists for respective organs, were reviewed to demonstrate the shortage and need for transplantable organs.
RESULTS
Regenerative medicine technologies aim to repair and regenerate poorly functioning organs. One goal is to achieve an immunosuppression-free state to improve quality of life, reduce complications and toxicities, and eliminate the cost of lifelong antirejection therapy. Innovative strategies include decellularization to fabricate acellular scaffolds that will be used as a template for organ manufacturing, three-dimensional printing and interspecies blastocyst complementation. Induced pluripotent stem cells are an innovation in stem cell technology which mitigate both the ethical concerns associated with embryonic stem cells and the limitation of other progenitor cells, which lack pluripotency. Regenerative medicine technologies hold promise in a wide array of fields and applications, such as promoting regeneration of native cell lines, growth of new tissue or organs, modelling of disease states, and augmenting the viability of existing ex vivo transplanted organs.
CONCLUSION
The future of organ bioengineering relies on furthering understanding of organogenesis, in vivo regeneration, regenerative immunology and long-term monitoring of implanted bioengineered organs.
Topics: Artificial Organs; Biomedical Engineering; Humans; Organ Transplantation; Regenerative Medicine
PubMed: 32463143
DOI: 10.1002/bjs.11686 -
Nature Reviews. Nephrology Aug 2021Although overall donation and transplantation activity is higher in Europe than on other continents, differences between European countries in almost every aspect of... (Review)
Review
Although overall donation and transplantation activity is higher in Europe than on other continents, differences between European countries in almost every aspect of transplantation activity (for example, in the number of transplantations, the number of people with a functioning graft, in rates of living versus deceased donation, and in the use of expanded criteria donors) suggest that there is ample room for improvement. Herein we review the policy and clinical measures that should be considered to increase access to transplantation and improve post-transplantation outcomes. This Roadmap, generated by a group of major European stakeholders collaborating within a Thematic Network, presents an outline of the challenges to increasing transplantation rates and proposes 12 key areas along with specific measures that should be considered to promote transplantation. This framework can be adopted by countries and institutions that are interested in advancing transplantation, both within and outside the European Union. Within this framework, a priority ranking of initiatives is suggested that could serve as the basis for a new European Union Action Plan on Organ Donation and Transplantation.
Topics: Europe; European Union; Humans; Kidney Transplantation; Organ Transplantation; Stakeholder Participation; Tissue and Organ Procurement; Waiting Lists
PubMed: 33953367
DOI: 10.1038/s41581-021-00425-3 -
Infectious Disease Clinics of North... Dec 2019Transplants have become common with excellent patient and graft outcomes owing to advances in surgical technique, immunosuppression, and antimicrobial prophylaxis. In... (Review)
Review
Transplants have become common with excellent patient and graft outcomes owing to advances in surgical technique, immunosuppression, and antimicrobial prophylaxis. In 2017, 34,770 solid organ transplants were performed in the United States. For solid organ transplant recipients, infection remains a common complication owing to the regimens required to prevent rejection. Opportunistic infections, which are infections that are generally of lower virulence within a healthy host but cause more severe and frequent disease in immunosuppressed individuals, typically occur in the period 1 month to 1 year after transplantation. This article focuses on opportunistic infections in the solid organ transplant recipient.
Topics: Anti-Infective Agents; Humans; Immunocompromised Host; Opportunistic Infections; Organ Transplantation; Transplant Recipients
PubMed: 31668195
DOI: 10.1016/j.idc.2019.05.008 -
Viruses Apr 2021As guest editors, we are pleased to present this Special Issue on BK virus (BKV) and transplantation with the intention of exploring some aspects related to...
As guest editors, we are pleased to present this Special Issue on BK virus (BKV) and transplantation with the intention of exploring some aspects related to BKV-associated diseases in transplant recipients, since they are still unclear [...].
Topics: BK Virus; Disease Susceptibility; Humans; Kidney Transplantation; Organ Transplantation; Polyomavirus Infections; Transplant Recipients; Tumor Virus Infections
PubMed: 33922350
DOI: 10.3390/v13050733 -
Transplantation Sep 2022
Topics: Bosnia and Herzegovina; Organ Transplantation
PubMed: 36001486
DOI: 10.1097/TP.0000000000004040 -
Current Opinion in Organ Transplantation Aug 2020This review summarizes the advances that have occurred over the past 2 years in organ transplantation in the setting of HIV. (Review)
Review
PURPOSE OF REVIEW
This review summarizes the advances that have occurred over the past 2 years in organ transplantation in the setting of HIV.
RECENT FINDINGS
Although HIV+ organ transplantation is both safe and effective, recent studies show that HIV+ patients continue to experience barriers to transplantation. In the United States, the HOPE Act is not only expected to increase the donor pool for HIV+ transplant candidates, but to also allow for the use of donors with false-positive HIV+ tests, which had previously been banned under the US National Organ Transplant Act. More effective HCV treatment, increased experience with heart and lung transplantation and the potential for increased organ availability with the inclusion of HIV+ organ donors have provided for significant advances in the care of these patients.
SUMMARY
There continues to be progress in the field of organ transplantation in persons living with HIV. Future efforts should continue aiming to limit barriers to transplantation and improving the understanding of immunologic derangements seen in transplant recipients with HIV infection.
Topics: HIV Infections; Humans; Organ Transplantation; Tissue Donors; Tissue and Organ Procurement; United States
PubMed: 32692041
DOI: 10.1097/MOT.0000000000000792 -
Experimental and Clinical... Dec 2021In India, organ donation and transplant activities are managed under the National Organ and Tissue Transplant Organisation, established per the mandate of the...
OBJECTIVES
In India, organ donation and transplant activities are managed under the National Organ and Tissue Transplant Organisation, established per the mandate of the Transplantation of Human Organs and Tissues Act 1994, as stipulated by World Health Organization guidelines.
MATERIALS AND METHODS
The National Organ and Tissue Transplant Organisation reached out to various hospitals and concerned authorities at national, regional, and local levels through E-mails and telephone calls to gather and to analyze 2019 data regarding the World Health Organization-Global Observatory on Donation and Transplantation questionnaire.
RESULTS
In 2019, India had 550 transplant centers registered with state-appropriate authorities and 140 nontransplant organ retrieval centers. Most living donors were kidney donors (8613) or liver donors (1993). Of all solid-organ transplants, most were kidney transplants, followed by liver, heart, lung, and pancreas. There were few heart and pancreas transplants in 2019, with higher percentage of female donors (65.4% and 54.3%, respectively, n = 5633 and 1084). Of transplant procedures, there were more living donor transplants (84%, n = 10 600) than deceased donor transplants (16%, n = 2023). Among all organs, wait lists for kidney transplants were higher than for other organs.
CONCLUSIONS
Reporting on organ donation and transplant of 2019 from the National Organ and Tissue Transplant Organisation, India's national registry, continued in 2020 despite the challenges of COVID-19. India has been submitting organ donation and transplant data at the national level to the Global Observatory on Donation and Transplantation consistently from 2013 to 2019 and is the only country in the World Health Organization South-East Asia Region to have done so, providing information from all states and union territories in India.
Topics: Female; Humans; Living Donors; Male; Organ Transplantation; Tissue Donors; Tissue and Organ Procurement; Treatment Outcome
PubMed: 34763630
DOI: 10.6002/ect.2021.0105 -
Der Urologe. Ausg. A Jan 2020
Topics: Humans; Kidney Transplantation; Organ Transplantation; Tissue Donors; Tissue and Organ Procurement
PubMed: 31953552
DOI: 10.1007/s00120-019-01095-7 -
Transplantation Nov 2019
Topics: Accreditation; Bone Marrow Transplantation; Delayed Graft Function; Humans; Immunosuppression Therapy; Latvia; Living Donors; Organ Transplantation; Societies, Medical; Surveys and Questionnaires; Tissue Donors; Tissue and Organ Procurement
PubMed: 31651730
DOI: 10.1097/TP.0000000000002764 -
Current Opinion in Organ Transplantation Dec 2022To review and summarize the literature published between 1 January 2020 and 30 June 2022, on the prevalence, risk factors and impact of depression in transplant... (Review)
Review
PURPOSE OF REVIEW
To review and summarize the literature published between 1 January 2020 and 30 June 2022, on the prevalence, risk factors and impact of depression in transplant population.
RECENT FINDINGS
Depression is common in transplantation candidates and recipients, with a prevalence up to 85.8% in kidney recipients. Multiple studies have indicated after transplantation depression correlates with increased mortality and with higher healthcare utilization. Social risk factors for posttransplant depression include financial difficulties and unemployment, while less is understood about the biological substrate of depression in this population. There is evidence that dynamic psychotherapy is effective for depression in organ transplant recipients, while cognitive behavioral therapy or supportive therapy did not lead to improvement of depression in transplant recipients. For living organ donors, the rates of depression are similar to the general population, with financial factors and the clinical status of the recipient playing a significant role.
SUMMARY
Depression is a common finding in transplant population. More research is needed to understand the biological substrate and risk factors and to develop effective treatment interventions.
Topics: Humans; Depression; Transplant Recipients; Organ Transplantation; Kidney Transplantation; Living Donors
PubMed: 36227755
DOI: 10.1097/MOT.0000000000001024