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
2016 ◽  
Vol 3 (4) ◽  
pp. 4
Author(s):  
Mina Al-Badri ◽  
Kunam Reddy ◽  
Paru David ◽  
Raymond Heilman ◽  
Christine Snozek ◽  
...  

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.


Author(s):  
Ajit P. Limaye ◽  
Lynne Strasfeld

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.


2003 ◽  
Vol 16 (3) ◽  
pp. 357-364 ◽  
Author(s):  
Andrea Duchini ◽  
John A. Goss ◽  
Saul Karpen ◽  
Paul J. Pockros

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.


2020 ◽  
Author(s):  
Mehmet Nur Altinörs

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.


2010 ◽  
Vol 30 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Jeffrey Perl ◽  
Joanne M. Bargman ◽  
Sarbjit V. Jassal

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.


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

2017 ◽  
Vol 38 (04) ◽  
pp. 538-545 ◽  
Author(s):  
J. Yserbyt ◽  
W. Wuyts ◽  
S. Verleden ◽  
G. Verleden ◽  
D. Van Raemdonck ◽  
...  

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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