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Transplantation May 2020
Review
Topics: Humans; Organ Transplantation; Syria; Tissue Donors; Tissue and Organ Procurement; Transplant Recipients
PubMed: 32317608
DOI: 10.1097/TP.0000000000003121 -
Seminars in Cardiothoracic and Vascular... Jun 2022This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation.... (Review)
Review
This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. In 2021, we identified noteworthy papers from over 1,200 peer-reviewed publications on pancreatic transplantation, over 1,400 on intestinal transplantation, and over 9,000 on kidney transplantation. The liver transplantation section focuses on clinical trials and systematic reviews and meta-analyses published in 2021 and features 20 selected papers. COVID-19 and abdominal organ transplantation are featured in an independent section.
Topics: Anesthesiologists; COVID-19; Humans; Kidney Transplantation; Organ Transplantation; Pancreas Transplantation
PubMed: 35608409
DOI: 10.1177/10892532221093955 -
Transplantation Reviews (Orlando, Fla.) Dec 2022Cannabinoid use in patients seeking solid organ transplantation (SOT) is an important and unsettled matter which all transplantation clinicians regularly encounter. It... (Review)
Review
Cannabinoid use in patients seeking solid organ transplantation (SOT) is an important and unsettled matter which all transplantation clinicians regularly encounter. It is also a multifaceted, interprofessional issue, difficult for any specialty alone to adequately address in a research article or during clinical care. Such uncertainty lends itself to bias for or against cannabinoid use accompanied by inconsistent policies and procedures. Scientific literature in SOT regarding cannabinoids often narrowly examines the issue and exists mostly in liver and kidney transplantation. Published recommendations from professional societies are mosaics of vagueness and specificity mirroring the ongoing dilemma. The cannabinoid information SOT clinicians need for clinical care may require data and perspectives from diverse medical literature which are rarely synthesized. SOT teams may not be adequately staffed or trained to address various neuropsychiatric cannabinoid effects and risks in patients. In this article, authors from US transplantation centers conduct a systematized review of the few existing studies regarding clinician perceptions, use rates, and clinical impact of cannabinoid use in SOT patients; collate representative professional society guidance on the topic; draw from diverse medical literature bases to detail facets of cannabinoid use in psychiatry and addiction pertinent to all transplantation clinicians; provide basic clinical and policy recommendations; and indicate areas of future study.
Topics: Humans; Cannabinoids; Organ Transplantation; Kidney Transplantation
PubMed: 35853383
DOI: 10.1016/j.trre.2022.100715 -
Current Opinion in Organ Transplantation Aug 2020Machine learning techniques play an important role in organ transplantation. Analysing the main tasks for which they are being applied, together with the advantages and... (Review)
Review
PURPOSE OF REVIEW
Machine learning techniques play an important role in organ transplantation. Analysing the main tasks for which they are being applied, together with the advantages and disadvantages of their use, can be of crucial interest for clinical practitioners.
RECENT FINDINGS
In the last 10 years, there has been an explosion of interest in the application of machine-learning techniques to organ transplantation. Several approaches have been proposed in the literature aiming to find universal models by considering multicenter cohorts or from different countries. Moreover, recently, deep learning has also been applied demonstrating a notable ability when dealing with a vast amount of information.
SUMMARY
Organ transplantation can benefit from machine learning in such a way to improve the current procedures for donor--recipient matching or to improve standard scores. However, a correct preprocessing is needed to provide consistent and high quality databases for machine-learning algorithms, aiming to robust and fair approaches to support expert decision-making systems.
Topics: Donor Selection; Humans; Machine Learning; Organ Transplantation; Tissue Donors; Tissue and Organ Procurement
PubMed: 32618714
DOI: 10.1097/MOT.0000000000000774 -
American Journal of Transplantation :... Oct 2019
Topics: Health Care Rationing; Health Policy; Humans; Organ Transplantation; Resource Allocation; Tissue Donors; Tissue and Organ Procurement
PubMed: 31267655
DOI: 10.1111/ajt.15521 -
Seminars in Cardiothoracic and Vascular... Jun 2023This review highlights noteworthy literature published in 2022 pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ... (Review)
Review
This review highlights noteworthy literature published in 2022 pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We begin by exploring the impacts that the COVID-19 pandemic has had across the field of abdominal organ transplantation, including the successful use of grafts procured from COVID-19-infected donors. In pancreatic transplantation, we highlight several studies on dexmedetomidine and ischemia-reperfusion injury, equity in transplantation, and medical management, as well as studies comparing pancreatic transplantation to islet cell transplantation. In our section on intestinal transplantation, we explore donor selection. Kidney transplantation topics include cardiovascular risk management, obesity, and intraoperative management, including fluid resuscitation, dexmedetomidine, and sugammadex. The liver transplantation section focuses on clinical trials, systematic reviews, and meta-analyses published in 2022 and covers a wide range of topics, including machine perfusion, cardiovascular issues, renal issues, and coagulation/transfusion.
Topics: Humans; Dexmedetomidine; Pandemics; COVID-19; Organ Transplantation; Kidney Transplantation
PubMed: 37037789
DOI: 10.1177/10892532231169075 -
Endocrine Reviews Mar 2021Metabolic complications affect over 50% of solid organ transplant recipients. These include posttransplant diabetes, nonalcoholic fatty liver disease, dyslipidemia, and... (Review)
Review
Metabolic complications affect over 50% of solid organ transplant recipients. These include posttransplant diabetes, nonalcoholic fatty liver disease, dyslipidemia, and obesity. Preexisting metabolic disease is further exacerbated with immunosuppression and posttransplant weight gain. Patients transition from a state of cachexia induced by end-organ disease to a pro-anabolic state after transplant due to weight gain, sedentary lifestyle, and suboptimal dietary habits in the setting of immunosuppression. Specific immunosuppressants have different metabolic effects, although all the foundation/maintenance immunosuppressants (calcineurin inhibitors, mTOR inhibitors) increase the risk of metabolic disease. In this comprehensive review, we summarize the emerging knowledge of the molecular pathogenesis of these different metabolic complications, and the potential genetic contribution (recipient +/- donor) to these conditions. These metabolic complications impact both graft and patient survival, particularly increasing the risk of cardiovascular and cancer-associated mortality. The current evidence for prevention and therapeutic management of posttransplant metabolic conditions is provided while highlighting gaps for future avenues in translational research.
Topics: Humans; Immunosuppressive Agents; Liver Transplantation; Obesity; Organ Transplantation; Risk Factors; Weight Gain
PubMed: 33247713
DOI: 10.1210/endrev/bnaa030 -
Current Opinion in Organ Transplantation Aug 2020Classifiers based on artificial intelligence have emerged in all areas of medicine. Although very subtle, many decisions in organ transplantation can now be addressed in... (Review)
Review
PURPOSE OF REVIEW
Classifiers based on artificial intelligence have emerged in all areas of medicine. Although very subtle, many decisions in organ transplantation can now be addressed in a more concisely manner with the support of these classifiers.
RECENT FINDINGS
Any aspect of organ transplantation (image processing, prediction of results, diagnostic proposals, therapeutic algorithms or precision treatments) consists of a set of input variables and a set of output variables. Artificial intelligence classifiers differ in the way they establish relationships between the input variables, how they select the data groups to train patterns and how they are able to predict the possible options of the output variables. There are hundreds of classifiers to achieve this goal. The most appropriate classifiers to address the different aspects of organ transplantation are Artificial Neural Networks, Decision Tree classifiers, Random Forest, and Naïve Bayes classification models. There are hundreds of examples of the usefulness of artificial intelligence in organ transplantation, especially in image processing, organ allocation, D-R matching, precision pathology, real-time immunosuppression, transplant oncology, and predictive analysis.
SUMMARY
In the coming years, clinical transplant experts will increasingly use Deep Learning-based models to support their decisions, specially in those cases where subjectivity is common.
Topics: Artificial Intelligence; Bayes Theorem; Humans; Neural Networks, Computer; Organ Transplantation
PubMed: 32487888
DOI: 10.1097/MOT.0000000000000775 -
Current Opinion in Organ Transplantation Feb 2024Advances in pediatric transplant parallel those in adult populations; however, there remain critical unique considerations and differences that require specialized... (Review)
Review
PURPOSE OF REVIEW
Advances in pediatric transplant parallel those in adult populations; however, there remain critical unique considerations and differences that require specialized knowledge and a specific skill set to optimize care afforded to the pediatric transplant candidate. We introduce general themes regarding optimization of the transplant candidate that are unique to children.
RECENT FINDINGS
The pathologies leading to pediatric organ transplant candidacy differ from adults and a precise understanding of the physiologies and natural histories of such diseases is critical for optimized care. Regardless of etiology, comorbidities including malnutrition, sarcopenia, and developmental delay are seen and often require disease and organ specific approaches to management. Additionally, an understanding of the concepts of developmental immunology and their relevance to transplant is critical.
SUMMARY
When looking to optimize pretransplant care, awareness of the pediatric-specific challenges by the transplant community in addition to organ- and age-specific management strategies enable the best outcomes for children awaiting solid organ transplantation.
Topics: Adult; Child; Humans; Organ Transplantation; Waiting Lists
PubMed: 37823752
DOI: 10.1097/MOT.0000000000001115 -
Transplant International : Official... 2024
Topics: Humans; Tissue and Organ Procurement; Organ Transplantation; Tissue Donors
PubMed: 38655205
DOI: 10.3389/ti.2024.13011