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Transplantation Proceedings Aug 1998
Review
Topics: Adult; Child; Graft Rejection; Graft Survival; Humans; Organ Transplantation; Postoperative Complications; Survival Rate
PubMed: 9723349
DOI: 10.1016/s0041-1345(98)00492-8 -
Transplant International : Official... Apr 2017Barriers to access and long-term complications remain a challenge in transplantation. Further advancements may be achieved through research priority setting with patient... (Review)
Review
Barriers to access and long-term complications remain a challenge in transplantation. Further advancements may be achieved through research priority setting with patient engagement to strengthen its relevance. We evaluated research priority setting in solid organ transplantation and described stakeholder priorities. Databases were searched to October 2016. We synthesized the findings descriptively. The 28 studies (n = 2071 participants) addressed kidney [9 (32%)], heart [7 (25%)], liver [3 (11%)], lung [1 (4%)], pancreas [1 (4%)], and nonspecified organ transplantation [7 (25%)] using consensus conferences, expert panel meetings, workshops, surveys, focus groups, interviews, and the Delphi technique. Nine (32%) reported patient involvement. The 336 research priorities addressed the following: organ donation [43 priorities (14 studies)]; waitlisting and allocation [43 (10 studies)]; histocompatibility and immunology [31 (8 studies)]; immunosuppression [21 (10 studies)]; graft-related complications [38 (13 studies)]; recipient (non-graft-related) complications [86 (14 studies)]; reproduction [14 (1 study)], psychosocial and lifestyle [49 (7 studies)]; and disparities in access and outcomes [10 (4 studies)]. The priorities identified were broad but only one-third of initiatives engaged patients/caregivers, and details of the process were lacking. Setting research priorities in an explicit manner with patient involvement can guide investment toward the shared priorities of patients and health professionals.
Topics: Biomedical Research; Caregivers; Delphi Technique; Focus Groups; Graft Rejection; Graft Survival; Health Services Accessibility; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Living Donors; Organ Transplantation
PubMed: 28120462
DOI: 10.1111/tri.12924 -
Intensive Care Medicine Mar 2019
Topics: Humans; Organ Transplantation; Prognosis; Treatment Outcome
PubMed: 30483836
DOI: 10.1007/s00134-018-5472-6 -
Experimental and Clinical... Apr 2015The risk for respiratory complications after solid-organ transplantation continues to be high, even though progress has been achieved with surgical techniques,... (Review)
Review
The risk for respiratory complications after solid-organ transplantation continues to be high, even though progress has been achieved with surgical techniques, immunosuppressive agents, and perioperative treatment of transplant recipients. This review is an overview of infectious and noninfectious respiratory complications in liver, kidney, heart, and lung transplant patients. Postoperative respiratory complications are more frequent after liver, heart, and lung transplant recipients, but the incidence is lower in kidney transplant recipients. Lung infiltrates due to multidrug-resistant bacterial infections are increasing and may cause respiratory failure associated with high morbidity and mortality. Treatment strategies including early, broad-spectrum empiric antibiotic therapy, lung protective mechanical ventilation, and appropriate timing of tracheotomy for patients who need prolonged mechanical ventilation. Early recognition and aggressive treatment of these respiratory complications may improve outcomes.
Topics: Heart Transplantation; Humans; Kidney Transplantation; Liver Transplantation; Lung Transplantation; Organ Transplantation; Postoperative Complications; Respiratory Insufficiency; Respiratory Tract Infections
PubMed: 25871362
DOI: No ID Found -
Current Opinion in Organ Transplantation Dec 2019The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to... (Review)
Review
PURPOSE OF REVIEW
The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in particular. The Chauvet Workgroup report and International Society of Heart and Lung Transplantation consensus guidelines are used to delineate areas of commonality between SOT and VCA, as well as unique features contributing to post-VCA psychosocial risk.
RECENT FINDINGS
Increasing evidence suggests that depression, cognitive function, and other posttransplant psychosocial factors consistently associate with clinical risk in SOT. However, the mechanisms precipitating these psychosocial risk factors are likely diverse in their cause, with large individual differences across SOT and VCA. Transdiagnostic dimensions may serve as mechanistic factors, increasing the risk of adverse clinical outcomes and suggesting potential treatment strategies for risk mitigation. Psychosocial dimensions including psychological flexibility, self-efficacy, and posttraumatic growth are discussed as potential contributory factors.
SUMMARY
Psychosocial factors hold importance in predicting posttransplant clinical outcomes. Emerging transdiagnostic factors may provide insight into mechanisms and potential treatments.
Topics: Hand Transplantation; Humans; Organ Transplantation; Prognosis; Psychology; Risk Factors
PubMed: 31689261
DOI: 10.1097/MOT.0000000000000712 -
Medicinski Pregled 2007Liver transplantation is the most demanding of all solid organ tranplantations. It requires perfect organization and motivation of health care professionals, patients... (Review)
Review
INTRODUCTION
Liver transplantation is the most demanding of all solid organ tranplantations. It requires perfect organization and motivation of health care professionals, patients and their families. This article deals with the procedure for multiple organ procurement, reviews criteria for organ donation and describes the surgical tehnique for multiple organ procurement.
DISCUSSION
Adequate selection and evaluation of cadaveric donors and of organs for transplantation should include early identification of potential donors, and early diagnosis of brain death. The procurement of the highest number of viable organs jbfor transplantation requires excellence in each of the phases. Early and aggressive physiologic support in the maintenance of fotential donors can reduce organ donor loss due to irreversible asystole or multiorgan jafiure (it is almost always possible to maintain organ perfusion pressure) and increase the number of organs without increasing post-transplant morbidity or mortality. The ideal donor is a young, previously healthy, brain dead, victim of an accident.
CONCLUSION
The surgical procedure for multiple organ procurement from brain death donors must be performed without intraopertive organ damage.
Topics: Heart Transplantation; Humans; Kidney Transplantation; Liver Transplantation; Organ Transplantation; Pancreas Transplantation; Tissue and Organ Harvesting
PubMed: 17990799
DOI: 10.2298/mpns0708339v -
Transplant Infectious Disease : An... Apr 2023Solid organ transplant recipients (SOTRs) remain at high risk for infection throughout their post-transplant course. Dosing of immunosuppressive medications, strategies... (Review)
Review
Solid organ transplant recipients (SOTRs) remain at high risk for infection throughout their post-transplant course. Dosing of immunosuppressive medications, strategies that prevent infection, and choice of empiric antimicrobial treatment could be optimized by a better understanding of an individual patient's risk for infectious complications. Diagnostic tests that qualitatively or quantitatively measure the function of the immune system and/or its response to infection may be useful for individualized management decisions. Numerous studies have identified an association between infectious outcomes after solid organ transplantation (SOT) and the results of a variety of non-pathogen-specific or "pathogen-agnostic" immune monitoring tests. These biomarkers include humoral immune markers, functional or quantitative assessments of cellular immunity, transcriptomic-based diagnostics, and replication of viruses within the human virome, which have been used to predict or diagnose a variety of different infectious diseases complicating SOT. In this narrative review, we discuss several host-derived immune biomarkers that show promise for either predicting or diagnosing infection among SOTRs. However, additional studies are needed to determine the optimal use of immune response testing. Whether immune biomarkers contribute added benefits to current standard clinical care has not yet been determined. Testing must be validated across a range of clinical scenarios, including surveillance to predict infection risk and diagnosis of active infection at various time points post transplant.
Topics: Humans; Organ Transplantation; Infections; Transplant Recipients; Biomarkers
PubMed: 36705292
DOI: 10.1111/tid.14020 -
Pediatric Transplantation Feb 2002One of the ultimate goals of successful transplantation (Tx) in pediatric solid-organ transplant recipients is the attainment of optimal final adult height. Except for... (Review)
Review
One of the ultimate goals of successful transplantation (Tx) in pediatric solid-organ transplant recipients is the attainment of optimal final adult height. Except for kidney Tx there are limited data to address this issue. Remarkably similar factors impact on growth in pediatric kidney, liver, and heart recipients. Age is a primary factor, with younger recipients exhibiting the greatest immediate catch-up growth. Graft function is a significant contributory factor: a reduction in glomerular filtration rate (GFR) correlates with poor growth in kidney recipients, and the need for re-Tx is associated with impaired growth in liver recipients. The known adverse impact of corticosteroids on growth has led transplant physicians/surgeons to either modify the dose or attempt steroid withdrawal. In kidney and liver recipients this is associated with the development of acute rejection episodes. In infant heart transplant recipients the avoidance of maintenance corticosteroid immunosuppression is associated with normal growth velocity in the majority of recipients. With the marked improvement in patient and graft survival rates in pediatric solid-organ graft recipients, it is timely that the quality-of-life issues receive paramount attention. In children, normal growth following solid-organ Tx should be an achievable goal that results in normal final adult height.
Topics: Child; Child Development; Child, Preschool; Female; Follow-Up Studies; Growth; Humans; Infant; Intestine, Small; Kidney Transplantation; Liver Transplantation; Lung Transplantation; Male; Organ Transplantation; Risk Assessment
PubMed: 11906643
DOI: 10.1034/j.1399-3046.2002.1p067.x -
BMJ (Clinical Research Ed.) Nov 2017
Topics: Community Participation; Humans; Organ Transplantation; Quality Improvement; State Medicine; Tissue and Organ Procurement; United Kingdom
PubMed: 29133305
DOI: 10.1136/bmj.j5218 -
Transplantation Feb 2016
Topics: Diffusion of Innovation; History, 20th Century; History, 21st Century; Humans; Organ Transplantation; Process Assessment, Health Care; Sweden; Time Factors; Tissue Donors; Tissue and Organ Procurement; Treatment Outcome
PubMed: 26813406
DOI: 10.1097/TP.0000000000001109