Pediatric solid organ transplantation and end stage disease: A slow journey towards understanding neurocognitive outcomes and their ramifications for clinical care

2015 ◽  
Vol 19 (2) ◽  
pp. 136-138 ◽  
Author(s):  
Lisa G. Sorensen
Keyword(s):  
Organ Transplantation ◽  
Clinical Care ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Stage Disease ◽  
Neurocognitive Outcomes ◽  
End Stage

scholarly journals A case of positive pregnancy test in a sexually inactive solid organ transplant recipient -- can human chorionic gonadotropin be transmitted through solid organ transplantation?

2016 ◽  
Vol 3 (4) ◽  
pp. 4
Author(s):  
Mina Al-Badri ◽  
Kunam Reddy ◽  
Paru David ◽  
Raymond Heilman ◽  
Christine Snozek ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Organ Transplant Recipient ◽  
Solid Organ Transplant Recipient ◽  
Solid Organ ◽  
Post Transplantation ◽  
Pregnancy Test ◽  
Stage Renal Disease ◽  
End Stage

A 21-year-old female with end stage renal disease underwent a non-related renal transplantation from a deceased pregnant donor. The recipient had a negative serum pregnancy test prior to her surgery. However postoperatively, a rise in her serum human chorionic gonadotrophin (hCG) level, which lasted several days, was documented. Solid organ transplantation is known to transmit various infections, malignant cells and antibodies from donor to recipient but no previous reports described transmission of hCG. This case report highlights the importance of considering this possibility when managing post-transplantation hormonal disturbances. Further research is warranted to evaluate the different mechanisms through which transmission occurs between donor and recipient.

scholarly journals Calcidiol Deficiency in End-Stage Organ Failure and after Solid Organ Transplantation: Status quo

Nutrients ◽  
2013 ◽  
Vol 5 (7) ◽  
pp. 2352-2371 ◽  
Author(s):  
Ursula Thiem ◽  
Bartosz Olbramski ◽  
Kyra Borchhardt
Keyword(s):  
Organ Failure ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Status Quo ◽  
Solid Organ ◽  
End Stage

Introduction

2016 ◽  
Author(s):  
Ajit P. Limaye ◽  
Lynne Strasfeld
Keyword(s):  
Organ Transplantation ◽  
De Novo ◽  
Multimodality Imaging ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Immune Competence ◽  
Laboratory Assessment ◽  
Suspected Infection ◽  
Organ Rejection ◽  
End Stage

Chapter 2 focuses on the solid organ transplantation (SOT). The Solid organ transplantation (SOT) is undertaken to restore organ function for patients with failing or end-stage disease of the liver, heart, lung, kidneys, and/or pancreas or to re-establish function in patients with short gut or other disorders of the intestinal tract. Organ transplantation requires lifelong maintenance immune suppression to prevent organ rejection. Infection can be related to donor transmission, reactivation from latency in the recipient, or acquisition de novo post-transplant. The evaluation of suspected infection in SOT recipients is guided by the clinical presentation, with likelihood shaped by prophylaxis strategies, host factors, and exposure history. Prompt evaluation is critical, often requiring multimodality imaging, microbiologic testing with cultures and molecular diagnostics, and invasive diagnostics or biopsy. The chapter concludes that, through use of biomarkers and indicators of pathogen-specific immune competence as well as better laboratory assessment of overall immune competence, a more granular identification of those SOT recipients at highest risk for infection will allow for optimization of prophylaxis and other infection prevention strategies.

scholarly journals Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

2003 ◽  
Vol 16 (3) ◽  
pp. 357-364 ◽  
Author(s):  
Andrea Duchini ◽  
John A. Goss ◽  
Saul Karpen ◽  
Paul J. Pockros
Keyword(s):  
Organ Transplantation ◽  
Patient Population ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Vaccination Strategy ◽  
Oral Polio Vaccine ◽  
Solid Organ ◽  
Immunosuppressed Patients ◽  
Severe Infections ◽  
End Stage

SUMMARY Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population.

scholarly journals Future Prospects of Organ Transplantation

2020 ◽  
Author(s):  
Mehmet Nur Altinörs
Keyword(s):  
Quality Of Life ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Tissue Transplantation ◽  
Solid Organ ◽  
Uterus Transplantation ◽  
Composite Tissue ◽  
End Stage ◽  
Therapeutic Alternatives

The gap between organ demand and supply is an universal problem in organ and tissue transplantation therapy. The gap is growing in spite of efforts spent in medical, educational, social areas and mass media support. This reality has created the need for completely new therapeutic alternatives for the management of end-stage organ disease. The present research should continue in future aiming to discover systems and devices capable of totally replacing the traditional transplantation. On the other hand, a different progress in underway in transplantation. The indication for solid organ transplantation is to save life and promote quality of life. The new developing transplantations of composite tissue, uterus and face are performed with completely different indications. Facial defects caused by various insults cause serious functional and esthetic disorders, psychological and social problems. Facial transplant surgery is accomplished to overcome such problems. Uterus transplantation is emerging as an alternative to female infertility. Transplantation of composite tissue includes different organs. The main purpose of composite tissue transplantation is to restore reduced or completely lost functions and to increase the quality of life. Nerve regeneration must occur as a consequence of transplant to regain sensory and motor functions. It appears that the future of transplantation involves developments in two main streams; invention of completely new tools for solid organ transplantation and advances in the transplantation of different organs including uterus, face and composite tissue.

scholarly journals Machine Learning Applications in Solid Organ Transplantation and Related Complications

2021 ◽  
Vol 12 ◽  
Author(s):  
Jeremy A. Balch ◽  
Daniel Delitto ◽  
Patrick J. Tighe ◽  
Ali Zarrinpar ◽  
Philip A. Efron ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Organ Transplantation ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Care ◽  
Solid Organ Transplantation ◽  
Machine Learning Algorithms ◽  
Machine Learning Techniques ◽  
Solid Organ

The complexity of transplant medicine pushes the boundaries of innate, human reasoning. From networks of immune modulators to dynamic pharmacokinetics to variable postoperative graft survival to equitable allocation of scarce organs, machine learning promises to inform clinical decision making by deciphering prodigious amounts of available data. This paper reviews current research describing how algorithms have the potential to augment clinical practice in solid organ transplantation. We provide a general introduction to different machine learning techniques, describing their strengths, limitations, and barriers to clinical implementation. We summarize emerging evidence that recent advances that allow machine learning algorithms to predict acute post-surgical and long-term outcomes, classify biopsy and radiographic data, augment pharmacologic decision making, and accurately represent the complexity of host immune response. Yet, many of these applications exist in pre-clinical form only, supported primarily by evidence of single-center, retrospective studies. Prospective investigation of these technologies has the potential to unlock the potential of machine learning to augment solid organ transplantation clinical care and health care delivery systems.

Peritoneal Dialysis after Nonrenal Solid Organ Transplantation: Clinical Outcomes and Practical Considerations

2010 ◽  
Vol 30 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Jeffrey Perl ◽  
Joanne M. Bargman ◽  
Sarbjit V. Jassal
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Organ Transplantation ◽  
End Stage Renal Disease ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Membrane Structure And Function ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

The incidence of end-stage renal disease following nonrenal solid organ transplantation (NRSOT) is increasing and is associated with a poor prognosis. The etiology of end-stage renal disease is multifactorial, with calcineurin inhibitor (CNI) nephrotoxicity being primarily responsible. The impact of dialysis modality on the survival of these patients remains unclear. Peritoneal dialysis appears to be a feasible and safe option for renal replacement therapy in NRSOT patients. Concerns that NRSOT patients are at a higher risk of infectious and noninfectious complications necessitate practical considerations when prescribing and planning for peritoneal dialysis in these patients. While nephrotoxicity is a well-recognized complication of long-term CNI use, “peritoneotoxic” effects with significant alterations in peritoneal membrane structure and function have recently been described. Further study including the role of CNI-free immunotherapy protocols to optimize the outcomes of NRSOT recipients is needed.

scholarly journals End-Stage Kidney Disease After Pediatric Nonrenal Solid Organ Transplantation

PEDIATRICS ◽  
2013 ◽  
Vol 132 (5) ◽  
pp. e1319-e1326 ◽  
Author(s):  
Rebecca L. Ruebner ◽  
Peter P. Reese ◽  
Michelle R. Denburg ◽  
Peter L. Abt ◽  
Susan L. Furth
Keyword(s):  
Kidney Disease ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Solid Organ Transplantation in Sarcoidosis

2017 ◽  
Vol 38 (04) ◽  
pp. 538-545 ◽  
Author(s):  
J. Yserbyt ◽  
W. Wuyts ◽  
S. Verleden ◽  
G. Verleden ◽  
D. Van Raemdonck ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Clinical Observation ◽  
Solid Organ Transplantation ◽  
Specific Treatment ◽  
Solid Organ ◽  
Immunomodulatory Treatment ◽  
Systemic Inflammatory Disease ◽  
Organ Specific ◽  
End Stage ◽  
Noncaseating Granulomas

AbstractSarcoidosis is a chronic systemic inflammatory disease which is histopathologically characterized by the presence of noncaseating granulomas. When the extent of the disease is limited, without endangering the function of affected organs, clinical observation can be sufficient given that in a majority of cases, inflammation will subside with time. In more advanced sarcoidosis, especially when one or more specific organs are threatened, immunomodulatory treatment, of which steroids are the key element, over a prolonged period of time, in general, may attenuate disease activity. Treatment-refractory sarcoidosis (due to the lack of efficacy, drug toxicity or intolerability) may be progressive and, although infrequent, can result in end-stage organ failure. In these selected cases, solid organ transplantation (SOT) should be considered. In this article, SOT is positioned within the organ-specific treatment of systemic sarcoidosis and data on outcome after transplantation are discussed.

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