Current Opinion in Organ Transplantation最新文献_第4页

Fueling the success of transplantation through nutrition: recent insights into nutritional interventions, their interplay with gut microbiota and cellular mechanisms. 通过营养促进移植成功：对营养干预、其与肠道微生物群和细胞机制的相互作用的最新见解。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-08-01 Epub Date: 2024-06-10 DOI: 10.1097/MOT.0000000000001159

Felix C Koehler, Martin R Späth, Anna M Meyer, Roman-Ulrich Müller

{"title":"Fueling the success of transplantation through nutrition: recent insights into nutritional interventions, their interplay with gut microbiota and cellular mechanisms.","authors":"Felix C Koehler, Martin R Späth, Anna M Meyer, Roman-Ulrich Müller","doi":"10.1097/MOT.0000000000001159","DOIUrl":"10.1097/MOT.0000000000001159","url":null,"abstract":"Purpose of review: The role of nutrition in organ health including solid organ transplantation is broadly accepted, but robust data on nutritional regimens remains scarce calling for further investigation of specific dietary approaches at the different stages of organ transplantation. This review gives an update on the latest insights into nutritional interventions highlighting the potential of specific dietary regimens prior to transplantation aiming for organ protection and the interplay between dietary intake and gut microbiota.Recent findings: Nutrition holds the potential to optimize patients' health prior to and after surgery, it may enhance patients' ability to cope with the procedure-associated stress and it may accelerate their recovery from surgery. Nutrition helps to reduce morbidity and mortality in addition to preserve graft function. In the case of living organ donation, dietary preconditioning strategies promise novel approaches to limit ischemic organ damage during transplantation and to identify the underlying molecular mechanisms of diet-induced organ protection. Functioning gut microbiota are required to limit systemic inflammation and to generate protective metabolites such as short-chain fatty acids or hydrogen sulfide.Summary: Nutritional intervention is a promising therapeutic concept including the pre- and rehabilitation stage in order to improve the recipients' outcome after solid organ transplantation.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"284-293"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Liver Frailty Index: a model for establishing organ-specific frailty metrics across all solid organ transplantation. 肝脏虚弱指数：在所有实体器官移植中建立器官特异性虚弱指标的模型。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-08-01 Epub Date: 2024-06-05 DOI: 10.1097/MOT.0000000000001157

Gabrielle Jutras, Jennifer C Lai

{"title":"The Liver Frailty Index: a model for establishing organ-specific frailty metrics across all solid organ transplantation.","authors":"Gabrielle Jutras, Jennifer C Lai","doi":"10.1097/MOT.0000000000001157","DOIUrl":"10.1097/MOT.0000000000001157","url":null,"abstract":"Purpose of review: In this review, we discuss the development of the Liver Frailty Index (LFI) and how it may serve as a model for developing other organ-specific frailty indices.Recent findings: As the demand for solid organ transplants continues to increase, the transplantation community is enhancing its strategies for organ allocation to gain deeper insights into patient risk profiles and anticipated outcomes. Frailty has emerged as a critical concept in transplant care, offering valuable insights into adverse health outcomes. Standardizing frailty assessment across transplant programs could enhance prognostic accuracy and inform pretransplant interventions.The LFI comprises of three performance-based tests that each represents essential components of the multidimensional frailty construct. This composite metric provides insights beyond liver function and considers nonhepatic comorbid factors. Identifying common frailty principles among all transplant candidates and adopting the LFI methodology, which assesses fundamental frailty principles using liver-specific tools, could establish a foundational pool of shared core frailty principles. From this pool, organ-specific frailty indices could be derived, each equipped with the clinically relevant organ-specific tools to evaluate common core principles.Summary: Creating a standardized framework across all solid-organ transplants, with common principles and organ-specific measurements, would facilitate consistent frailty assessment, standardize the integration of the frailty construct into transplant decision-making, and enable center-level interventions to improve outcomes for patients with end-stage organ disease.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"266-270"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141246987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Viability assessment of the liver during ex-situ machine perfusion prior to transplantation. 移植前原位机器灌注期间的肝脏活力评估。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-08-01 Epub Date: 2024-05-17 DOI: 10.1097/MOT.0000000000001152

Puck C Groen, Otto B van Leeuwen, Jeroen de Jonge, Robert J Porte

{"title":"Viability assessment of the liver during ex-situ machine perfusion prior to transplantation.","authors":"Puck C Groen, Otto B van Leeuwen, Jeroen de Jonge, Robert J Porte","doi":"10.1097/MOT.0000000000001152","DOIUrl":"10.1097/MOT.0000000000001152","url":null,"abstract":"Purpose of review: In an attempt to reduce waiting list mortality in liver transplantation, less-than-ideal quality donor livers from extended criteria donors are increasingly accepted. Predicting the outcome of these organs remains a challenge. Machine perfusion provides the unique possibility to assess donor liver viability pretransplantation and predict postreperfusion organ function.Recent findings: Assessing liver viability during hypothermic machine perfusion remains challenging, as the liver is not metabolically active. Nevertheless, the levels of flavin mononucleotide, transaminases, lactate dehydrogenase, glucose and pH in the perfusate have proven to be predictors of liver viability. During normothermic machine perfusion, the liver is metabolically active and in addition to the perfusate levels of pH, transaminases, glucose and lactate, the production of bile is a crucial criterion for hepatocyte viability. Cholangiocyte viability can be determined by analyzing bile composition. The differences between perfusate and bile levels of pH, bicarbonate and glucose are good predictors of freedom from ischemic cholangiopathy.Summary: Although consensus is lacking regarding precise cut-off values during machine perfusion, there is general consensus on the importance of evaluating both hepatocyte and cholangiocyte compartments. The challenge is to reach consensus for increased organ utilization, while at the same time pushing the boundaries by expanding the possibilities for viability testing.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"239-247"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to cultivate sustainable physical health and wellness in transplant recipients: the emerging and enduring role of exercise scientists. 如何培养移植受者可持续的身体健康和保健能力：运动科学家的新兴和持久作用。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI: 10.1097/MOT.0000000000001160

Giorgos K Sakkas, Christoforos D Giannaki, Kenneth R Wilund, Christina Karatzaferi

{"title":"How to cultivate sustainable physical health and wellness in transplant recipients: the emerging and enduring role of exercise scientists.","authors":"Giorgos K Sakkas, Christoforos D Giannaki, Kenneth R Wilund, Christina Karatzaferi","doi":"10.1097/MOT.0000000000001160","DOIUrl":"10.1097/MOT.0000000000001160","url":null,"abstract":"Purpose of review: The aim of the current review is to highlight the importance of exercise training as an important section of transplant recipient rehabilitation process and explain the role of the exercise scientist in the development, implementation, and assessment of the exercise regime.Recent findings: Transplant patients face a unique set of challenges in their recovery and rehabilitation process, often requiring a multifaceted approach to address the physical, emotional, and psychological aspects of their condition. Exercise training has emerged as a crucial component in the care of these patients, providing a means to improve functional capacity, enhance quality of life, and mitigate the adverse effects of transplant-related complications. Exercise scientists who are trained to assess patient's physical limitations, develop and deliver personalized exercise programs, and monitor their progress are uniquely positioned to play a crucial role in the treatment of patients with chronic conditions that require exercise training as a mean of improving and maintaining health and quality of life.Summary: Exercise scientists are the appropriate professionals for providing transplant recipients with the recommended exercise training for maintaining and improving their health status as part of the overall plan of long-term care and support.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"294-298"},"PeriodicalIF":1.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Machine wars and policy provisions: how the landscape of organ procurement and allocation is changing in the United States. 机器大战和政策规定：美国器官获取和分配的格局正在发生怎样的变化。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-06-01 Epub Date: 2024-05-01 DOI: 10.1097/MOT.0000000000001145

Anji Wall

引用次数: 0

Abdominal normothermic regional perfusion in the United States: current state and future directions. 美国的腹部常温区域灌注：现状与未来方向。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-06-01 Epub Date: 2024-03-20 DOI: 10.1097/MOT.0000000000001144

Anji Wall, Amar Gupta, Giuliano Testa

引用次数: 0

Current challenges in xenotransplantation. 异种移植目前面临的挑战。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-06-01 Epub Date: 2024-04-16 DOI: 10.1097/MOT.0000000000001146

Marta Vadori, Emanuele Cozzi

{"title":"Current challenges in xenotransplantation.","authors":"Marta Vadori, Emanuele Cozzi","doi":"10.1097/MOT.0000000000001146","DOIUrl":"10.1097/MOT.0000000000001146","url":null,"abstract":"Purpose of review: In recent years, the xenotransplantation science has advanced tremendously, with significant strides in both preclinical and clinical research. This review intends to describe the latest cutting-edge progress in knowledge and methodologies developed to overcome potential obstacles that may preclude the translation and successful application of clinical xenotransplantation.Recent findings: Preclinical studies have demonstrated that it is now possible to extend beyond two years survival of primate recipients of life saving xenografts. This has been accomplished thanks to the utilization of genetic engineering methodologies that have allowed the generation of specifically designed gene-edited pigs, a careful donor and recipient selection, and appropriate immunosuppressive strategies.In this light, the compassionate use of genetically modified pig hearts has been authorized in two human recipients and xenotransplants have also been achieved in human decedents. Although encouraging the preliminary results suggest that several challenges have yet to be fully addressed for a successful clinical translation of xenotransplantation. These challenges include immunologic, physiologic and biosafety aspects.Summary: Recent progress has paved the way for the initial compassionate use of pig organs in humans and sets the scene for a wider application of clinical xenotransplantation.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"205-211"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140287100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Squaring the Circle. Brain death and organ transplantation. 方圆。脑死亡与器官移植

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.1097/MOT.0000000000001104

Howard R Doyle

引用次数: 0

Normothermic machine perfusion for liver transplantation: current state and future directions. 肝移植的常温机器灌注：现状与未来方向。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.1097/MOT.0000000000001141

Jessica Lindemann, Jennifer Yu, Mb Majella Doyle

{"title":"Normothermic machine perfusion for liver transplantation: current state and future directions.","authors":"Jessica Lindemann, Jennifer Yu, Mb Majella Doyle","doi":"10.1097/MOT.0000000000001141","DOIUrl":"10.1097/MOT.0000000000001141","url":null,"abstract":"Purpose of review: The number of patients on the liver transplant waitlist continues to grow and far exceeds the number of livers available for transplantation. Normothermic machine perfusion (NMP) allows for ex-vivo perfusion under physiologic conditions with the potential to significantly increase organ yield and expand the donor pool.Recent findings: Several studies have found increased utilization of donation after cardiac death and extended criteria brain-dead donor livers with implementation of NMP, largely due to the ability to perform viability testing during machine perfusion. Recently, proposed viability criteria include lactate clearance, maintenance of perfusate pH more than 7.2, ALT less than 6000 u/l, evidence of glucose metabolism and bile production. Optimization of liver grafts during NMP is an active area of research and includes interventions for defatting steatotic livers, preventing ischemic cholangiopathy and rejection, and minimizing ischemia reperfusion injury.Summary: NMP has resulted in increased organ utilization from marginal donors with acceptable outcomes. The added flexibility of prolonged organ storage times has the potential to improve time constraints and transplant logistics. Further research to determine ideal viability criteria and investigate ways to optimize marginal and otherwise nontransplantable liver grafts during NMP is warranted.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"186-194"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140118981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Normothermic regional perfusion procurement for abdominal organ donors: techniques and troubleshooting. 为腹部器官捐献者进行常温区域灌注采购：技术和故障排除。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-06-01 Epub Date: 2024-03-11 DOI: 10.1097/MOT.0000000000001140

Stephanie Silpe, Eric Martinez, Anji Wall

引用次数: 0