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Brazilian Journal of Cardiovascular... May 2022Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and...
INTRODUCTION
Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and kidney transplantation.
METHODS
From January 2007 to December 2019, four patients were submitted to combined heart and kidney transplantation. Their mean age was 55.7±4.4 years, and three (75%) patients were males. All patients had Chagas cardiomyopathy, two were hospitalized and inotrope dependent, and all patients were on preoperative dialysis (median of 12 months prior to transplant).
RESULTS
All patients survived and were in New York Heart Association functional class I at the latest follow-up (mean 34.7±17.5 months). Mean retarded kidney graft function was 22.9±9.7 days. One patient lost the kidney graft two years after the transplant due to Polyomavirus infection.
CONCLUSION
Our initial experience of combined heart and kidney transplantation was favorable in selected patients with advanced heart failure and end-stage kidney disease. It requires involvement of a dedicated multispecialty team throughout all the diagnostics and treatment steps.
Topics: Female; Heart Failure; Heart Transplantation; Humans; Kidney Transplantation; Male; Middle Aged; Renal Dialysis; Transplants
PubMed: 35503699
DOI: 10.21470/1678-9741-2020-0720 -
Hematology/oncology and Stem Cell... Dec 2017Algeria is a country of 40.4 million inhabitants and half of which is under 30years. In Algeria, Health-care insurance covered, 90% of the population. Health care is... (Review)
Review
INTRODUCTION
Algeria is a country of 40.4 million inhabitants and half of which is under 30years. In Algeria, Health-care insurance covered, 90% of the population. Health care is free and it is supported by the Ministry of Health. 16 university hospitals exist in Algeria and only two (Algiers and Oran) practicing bone marrow transplant. Adult hematologic malignancies account for 10% (about 4000 new cases/year) of the malignancy affecting in most cases young patients under 65years of age. In 2016, 270 transplants were performed in total (Algiers+Oran), including 149 allografts (related donor transplants: 99%) and 121 autografts. 98% of transplants are done in adults and only 2% in children with cord blood transplants. In summary for the two transplant centers, the predominant types of transplantation performed are allogeneic transplant in 55% and autologous transplant in 45%. The particularity of EHU1st November in Oran, is the use of non-cryopreserved stem cells. Stem cell was mobilized using G-CSF alone and the grafts were kept in a conventional blood bank refrigerator at +4°C until reinfusion on day 0. The outcome with non-cryopreserved stem cells are the same as those with cryopreserved stem cells and we conclude that autologous transplant with non cryopreserved hematopoietic stem cells (HSC) is a simple, effective and safe method and the cryopreservation is not necessary in our work conditions in developing countries. The projects are achieving the autograft in all University Hospitals with non cryopreserved HSC, achieving a center allograft in the east of the country and the development of bone marrow transplantation in children.
CONCLUSION
Currently in Algeria, the number of transplantation is insufficient and the development of new transplant centers is essential. In the future, we hope to implement the National Society of Bone Marrow transplant and also the National recipient registry and Donor registry in Algeria.
Topics: Adult; Aged; Algeria; Allografts; Autografts; Cord Blood Stem Cell Transplantation; Disease-Free Survival; Female; Hematologic Neoplasms; Hematopoietic Stem Cell Transplantation; Hospitals, Teaching; Humans; Male; Middle Aged; Survival Rate
PubMed: 28711452
DOI: 10.1016/j.hemonc.2017.05.019 -
International Journal of Surgery... Oct 2020Orthotopic liver transplantation is an established treatment for end stage liver diseases as well as for some severe metabolic disorders. With increasing number of... (Review)
Review
Orthotopic liver transplantation is an established treatment for end stage liver diseases as well as for some severe metabolic disorders. With increasing number of patients on the waiting list and the ongoing shortage of livers available, domino liver transplantation (DLT) became an option to further expand the organ donor pool. DLT utilizes the explanted liver of one liver transplant recipient as a donor graft in another patient. Despite being a surgically, and logistically demanding procedure, excellent results could be achieved in experienced high-volume transplant centers. In this review we present the current world status of DLT.
Topics: Amyloid Neuropathies, Familial; End Stage Liver Disease; Humans; Liver; Liver Transplantation; Living Donors; Patient Selection; Registries; Transplant Recipients; Transplants; Waiting Lists
PubMed: 32244002
DOI: 10.1016/j.ijsu.2020.03.017 -
American Journal of Transplantation :... Oct 2022
Topics: Cell Engineering; Kidney Transplantation; Transplants; United States
PubMed: 36196493
DOI: 10.1111/ajt.16675 -
International Journal of Surgery... Oct 2020Dynamic preservation strategies are a promising option to improve graft quality before transplantation, and to extend preservation time for either logistic or treatment... (Review)
Review
Dynamic preservation strategies are a promising option to improve graft quality before transplantation, and to extend preservation time for either logistic or treatment reasons. In contrast to normothermic oxygenated perfusion, which intends to mimic physiological conditions in the human body, with subsequent clinical application for up to 24 hrs, hypothermic perfusion is mainly used for a relatively short period with protection of mitochondria and subsequent reduction of oxidative injury upon implantation. The results from two randomized controlled trials, where recruitment has finished are expected this year. Both ex situ perfusion techniques are increasingly applied in clinical transplantation including recent reports on viability assessment, which could open the door for an increased liver utilization in the future.
Topics: Humans; Hypothermia, Induced; Liver; Liver Transplantation; Organ Preservation; Perfusion; Transplants; Treatment Outcome
PubMed: 32353556
DOI: 10.1016/j.ijsu.2020.04.057 -
Xenotransplantation Mar 2023Formal clinical trials of pig-to-human organ transplant-known asxenotransplantation-may begin this decade, with the first trials likely to consist of either adult renal... (Review)
Review
Formal clinical trials of pig-to-human organ transplant-known asxenotransplantation-may begin this decade, with the first trials likely to consist of either adult renal transplants or pediatric cardiac transplant patients. Xenotransplantation as a systematic scientific study only reaches back to the latter half of the 20th century, with episodic xenotransplantation events occurring prior to that. As the science of xenotransplantation has progressed in the 20th and 21st centuries, the public's knowledge of the potential therapy has also increased. With this, there have been shifting ethical stances toward xenotransplantation in key areas, such as religious and public viewpoints towards xenotransplantation, animal rights, and public health concerns. This review provides a historical-ethical account of xenotransplantation and details if or how viewpoints have shifted over time.
Topics: Adult; Humans; Animals; Child; Swine; Transplantation, Heterologous; Organ Transplantation; Heart Transplantation; Kidney Transplantation; Transplants
PubMed: 36943143
DOI: 10.1111/xen.12797 -
Transplant International : Official... Jun 2016Vascularized composite allografts (VCAs) are a growing field within the area of transplantation. In 2014, the birth of a healthy baby after a successful uterus... (Review)
Review
Vascularized composite allografts (VCAs) are a growing field within the area of transplantation. In 2014, the birth of a healthy baby after a successful uterus transplant from a living donor was reported in Sweden. VCAs are not specifically mentioned in any of the transplant acts of the Eurotransplant (ET) member states, which all belong to the European Union (EU). The Competent Authorities (CA) of the EU decided in 2012 that VCAs are to be regarded as organs. At the moment, there are no general guidelines in the ET area concerning wait list registration, allocation, procurement and transplantation, and also no regulations concerning reimbursement. To further develop this aspect, common policies and guidelines within the ET member states have to be developed.
Topics: Composite Tissue Allografts; Europe; Female; Graft Rejection; Graft Survival; Humans; Immune Tolerance; Skin Transplantation; Tissue and Organ Procurement; Transplantation Chimera; Transplantation, Homologous; Uterus; Vascularized Composite Allotransplantation
PubMed: 26824440
DOI: 10.1111/tri.12753 -
The Journal of Clinical Investigation Jan 2019Donor age and recipient age are factors that influence transplantation outcomes. Aside from age-associated differences in intrinsic graft function and alloimmune... (Review)
Review
Donor age and recipient age are factors that influence transplantation outcomes. Aside from age-associated differences in intrinsic graft function and alloimmune responses, the ability of young and old cells to exert either rejuvenating or aging effects extrinsically may also apply to the transplantation of hematopoietic stem cells or solid organ transplants. While the potential for rejuvenation mediated by the transfer of youthful cells is currently being explored for therapeutic applications, aspects that relate to accelerating aging are no less clinically significant. Those effects may be particularly relevant in transplantation with an age discrepancy between donor and recipient. Here, we review recent advances in understanding the mechanisms by which young and old cells modify their environments to promote rejuvenation- or aging-associated phenotypes. We discuss their relevance to clinical transplantation and highlight potential opportunities for therapeutic intervention.
Topics: Aging; Allografts; Animals; Cellular Microenvironment; Cellular Senescence; Hematopoietic Stem Cell Transplantation; Humans; Organ Transplantation; Tissue Donors
PubMed: 30601138
DOI: 10.1172/JCI123946 -
Transplant International : Official... Sep 2021
Topics: Humans; Organ Transplantation; Transplants
PubMed: 34310784
DOI: 10.1111/tri.13994 -
American Journal of Transplantation :... Jul 2021
Topics: Humans; Lung Transplantation; Palliative Care; Transplants
PubMed: 34196485
DOI: 10.1111/ajt.16035