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International Journal of Molecular... Dec 2020Tissue-resident macrophages and those conscripted from the blood/bone marrow are professional phagocytes. They play a role in tissue homeostasis, replacement, and... (Review)
Review
Tissue-resident macrophages and those conscripted from the blood/bone marrow are professional phagocytes. They play a role in tissue homeostasis, replacement, and healing, and are the first-line responders to microbial (viral, bacterial, and fungi) infections. Intrinsic ameboid-type motility allows non-resident macrophages to move to the site of inflammation or injury, where, in response to the inflammatory milieu they perform the anti-microbial and/or tissue repair functions. Depending on the need and the signaling from the surrounding tissue and other immune cells, macrophages acquire morphologically and functionally different phenotypes, which allow them to play either pro-inflammatory or anti-inflammatory functions. As such, the macrophages are also the major players in the rejection of the transplanted organs making an excellent target for the novel anti-rejection therapies in clinical transplantation. In this review, we describe some of the less covered aspects of macrophage response to microbial infection and organ transplantation.
Topics: Animals; Biomarkers; Communicable Diseases; Cytokines; Host-Pathogen Interactions; Humans; Inflammation Mediators; Macrophages; Organ Transplantation; Phagocytosis; Transplants
PubMed: 33352942
DOI: 10.3390/ijms21249669 -
American Journal of Transplantation :... Apr 2021
Topics: Biopsy; Graft Survival; Kidney; Kidney Transplantation; Transplants
PubMed: 32713099
DOI: 10.1111/ajt.16220 -
Transplant International : Official... 2023The organ donation and transplantation program in Spain has long been considered the gold standard worldwide. An in-depth understanding of the Spanish program may... (Review)
Review
The organ donation and transplantation program in Spain has long been considered the gold standard worldwide. An in-depth understanding of the Spanish program may promote the development and reform of transplant programs in other countries. Here, we present a narrative literature review of the Spanish organ donation and transplantation program supplemented by expert feedback and presented according to a conceptual framework of best practices in the field. Core features of the Spanish program include its three-tiered governing structure, close and collaborative relationships with the media, dedicated professional roles, a comprehensive reimbursement strategy, and intensive tailored training programs for all personnel. Several more sophisticated measures have also been implemented, including those focused on advanced donation after circulatory death (DCD) and expanded criteria for organ donation. The overall program is driven by a culture of research, innovation, and continuous commitment and complemented by successful strategies in prevention of end-stage liver and renal disease. Countries seeking ways to reform their current transplant systems might adopt core features and may ultimately aspire to include the aforementioned sophisticated measures. Countries intent on reforming their transplant system should also introduce programs that support living donation, an area of the Spanish program with potential for further improvement.
Topics: Humans; Organ Transplantation; Transplants; Liver; Spain; Tissue and Organ Procurement
PubMed: 37305337
DOI: 10.3389/ti.2023.11009 -
Transplant Infectious Disease : An... Oct 2022Solid organ transplant (SOT) recipients can benefit from traditional antimicrobial stewardship (AMS) activities directed to improve judicious perioperative prescribing... (Review)
Review
BACKGROUND
Solid organ transplant (SOT) recipients can benefit from traditional antimicrobial stewardship (AMS) activities directed to improve judicious perioperative prescribing and management, but evidence is lacking. The aim of this expert opinion review is to provide an update on the current landscape of application of AMS practices for optimization of perioperative prophylaxis (PP).
METHODS
We reviewed the available literature on early postoperative infectious complications in SOT and PP management, on modified perioperative approaches in case of infection or colonization in recipients and donors and on AMS in transplantation PP.
RESULTS
SOT recipients are at high risk for early postoperative infectious complications due to the complexity of surgical procedures, severity of end stage organ disease, net state of immunosuppression in the posttransplant period and to the high risk for multidrug resistant organism. Moreover, SOT may be exposed to preservation fluid infections and expected or unexpected donor-derived infections. We summarize main factors to take into account when prescribing transplant PP.
CONCLUSION
Creating personalized PP to avoid unwanted consequences of antimicrobials while improving outcomes is an emerging and critical aspect in SOT setting. Further studies are needed to offer best PP tailored to SOT type and to evaluate interventions efficacy and safety.
Topics: Antimicrobial Stewardship; Communicable Diseases; Humans; Organ Transplantation; Tissue Donors; Transplant Recipients; Transplants
PubMed: 35781915
DOI: 10.1111/tid.13895 -
Journal of the American College of... Jul 2019
Topics: Allografts; Heart Transplantation; Rituximab; Transplantation, Homologous
PubMed: 31272551
DOI: 10.1016/j.jacc.2019.05.028 -
World Journal of Gastroenterology Jul 2016Living-donor liver transplantation has provided a solution to the severe lack of cadaver grafts for the replacement of liver afflicted with end-stage cirrhosis,... (Review)
Review
Living-donor liver transplantation has provided a solution to the severe lack of cadaver grafts for the replacement of liver afflicted with end-stage cirrhosis, fulminant disease, or inborn errors of metabolism. Vascular complications remain the most serious complications and a common cause for graft failure after hepatic transplantation. Doppler ultrasound remains the primary radiological imaging modality for the diagnosis of such complications. This article presents a brief review of intra- and post-operative living donor liver transplantation anatomy and a synopsis of the role of ultrasonography and color Doppler in evaluating the graft vascular haemodynamics both during surgery and post-operatively in accurately defining the early vascular complications. Intra-operative ultrasonography of the liver graft provides the surgeon with useful real-time diagnostic and staging information that may result in an alteration in the planned surgical approach and corrections of surgical complications during the procedure of vascular anastomoses. The relevant intra-operative anatomy and the spectrum of normal and abnormal findings are described. Ultrasonography and color Doppler also provides the clinicians and surgeons early post-operative potential developmental complications that may occur during hospital stay. Early detection and thus early problem solving can make the difference between graft survival and failure.
Topics: Hemodynamics; Hepatic Artery; Hepatic Veins; Humans; Intraoperative Complications; Liver Transplantation; Living Donors; Portal Vein; Postoperative Complications; Transplants; Ultrasonography, Doppler; Ultrasonography, Doppler, Color; Vascular Diseases
PubMed: 27468207
DOI: 10.3748/wjg.v22.i27.6145 -
Transplant International : Official... Jun 2016Vascularized composite allograft (VCA) transplantation, or reconstructive transplantation, has revolutionized the treatment of complex tissue and functional defects.... (Review)
Review
Vascularized composite allograft (VCA) transplantation, or reconstructive transplantation, has revolutionized the treatment of complex tissue and functional defects. Despite arriving during an age in which the immunology of solid organ transplant rejection has been investigated in much detail, these transplants have offered new perspectives from which to explore the immunobiology of transplantation. VCAs have a number of unique molecular, cellular, and architectural features which alter the character and intensity of the rejection response. While much is yet to be clarified, an understanding of these distinct mechanisms affords new possibilities for the control of immune responses in an effort to improve outcomes after VCA transplantation.
Topics: Animals; Composite Tissue Allografts; Graft Rejection; Graft Survival; Humans; Immune System; Immune Tolerance; Immunosuppressive Agents; Immunotherapy; Skin; Transplantation, Homologous; Vascularized Composite Allotransplantation
PubMed: 26927941
DOI: 10.1111/tri.12765 -
American Journal of Transplantation :... Jul 2017
Topics: Allografts; Facial Transplantation; Transplantation, Homologous; Vascularized Composite Allotransplantation
PubMed: 28371193
DOI: 10.1111/ajt.14291 -
Transplant International : Official... 2023Over the past two decades, Portugal has become one of the world leaders in organ donation and transplantation despite significant financial constraints. This study... (Review)
Review
Over the past two decades, Portugal has become one of the world leaders in organ donation and transplantation despite significant financial constraints. This study highlights how Portugal achieved success in organ donation and transplantation and discusses how this information might be used by other countries that are seeking to reform their national programs. To accomplish this goal, we performed a narrative review of relevant academic and grey literature and revised our results after consultation with two national experts. Our findings were then synthesized according to a conceptual framework for organ donation and transplantation programs. Our results revealed several key strategies used by the Portuguese organ donation and transplantation program, including collaboration with Spain and other European nations, a focus on tertiary prevention, and sustained financial commitment. This report also explores how cooperative efforts were facilitated by geographical, governmental, and cultural proximity to Spain, a world leader in organ donation and transplantation. In conclusion, our review of the Portuguese experience provides insight into the development of organ donation and transplantation systems. However, other countries seeking to reform their national transplant systems will need to adapt these policies and practices to align with their unique cultures and contexts.
Topics: Humans; Portugal; Organ Transplantation; Transplants; Geography; Tissue and Organ Procurement
PubMed: 37305338
DOI: 10.3389/ti.2023.11008 -
Science (New York, N.Y.) Oct 2022Recent advances raise hope for a promising solution to the transplant organ shortage.
Recent advances raise hope for a promising solution to the transplant organ shortage.
Topics: Animals; Humans; Organ Transplantation; Swine; Tissue and Organ Procurement; Transplants
PubMed: 36227981
DOI: 10.1126/science.abo7935