Current Opinion in Organ Transplantation最新文献_第7页

Liver transplantation for intrahepatic cholangiocarcinoma: who, when and how. 肝内胆管癌肝移植：何人、何时、如何进行。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2024-01-23 DOI: 10.1097/MOT.0000000000001136

Pablo Achurra, Eduardo Fernandes, Grainne O'Kane, Robert Grant, Mark Cattral, Gonzalo Sapisochin

{"title":"Liver transplantation for intrahepatic cholangiocarcinoma: who, when and how.","authors":"Pablo Achurra, Eduardo Fernandes, Grainne O'Kane, Robert Grant, Mark Cattral, Gonzalo Sapisochin","doi":"10.1097/MOT.0000000000001136","DOIUrl":"10.1097/MOT.0000000000001136","url":null,"abstract":"Purpose of review: Using transplant oncology principles, selected patients with intrahepatic cholangiocarcinoma (iCCA) may achieve long-term survival after liver transplantation. Strategies for identifying and managing these patients are discussed in this review.Recent findings: Unlike initial reports, several modern series have reported positive outcomes after liver transplantation for iCCA. The main challenges are in identifying the appropriate candidates and graft scarcity. Tumor burden and response to neoadjuvant therapies have been successfully used to identify favorable biology in unresectable cases. New molecular biomarkers will probably predict this response in the future. Also, new technologies and better strategies have been used to increase graft availability for these patients without affecting the liver waitlist.Summary: Liver transplantation for the management of patients with unresectable iCCA is currently a reality under strict research protocols. Who is a candidate for transplantation, when to use neoadjuvant and locoregional therapies, and how to increase graft availability are the main topics of this review.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"161-171"},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520354","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

Regulatory dendritic cell therapy in organ transplantation. 器官移植中的树突状细胞调节性治疗。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2023-11-22 DOI: 10.1097/MOT.0000000000001127

Yannis Hadjiyannis, Angus W Thomson

{"title":"Regulatory dendritic cell therapy in organ transplantation.","authors":"Yannis Hadjiyannis, Angus W Thomson","doi":"10.1097/MOT.0000000000001127","DOIUrl":"10.1097/MOT.0000000000001127","url":null,"abstract":"Purpose of review: Regulatory dendritic cells (DCregs; also 'tolerogenic DCs'), innate immune cells that regulate the alloimmune response, are a novel cellular therapy for organ transplantation. Preliminary results from early-phase clinical trials in live donor kidney and liver transplantation are promising. This follows many years of research elucidating mechanisms of action and utility of DCregs. Herein, we review early-phase clinical trial observations and recent advances in the production, modification, and future-trajectory of DCreg in organ transplantation.Recent findings: Preclinical work has demonstrated the ability of adoptively transferred DCreg to abrogate ischemia-reperfusion injury and promote long-term allograft survival. Good Manufacturing Practice-grade DCregs have been generated in adequate numbers for early-phase trials of autologous DCregs in kidney transplantation and donor-derived DCreg in liver transplantation. These trials have demonstrated feasibility and safety, with preliminary evidence of an influence on host immune reactivity. In both kidney and liver transplantation, reduced effector CD8 + T-cells have been noted, together with other changes that may be conducive to reduced dependence on immunosuppressive therapy.Summary: Substantial progress has been made in bringing DCreg to clinical testing in organ transplantation. Additional clinical and mechanistic studies are now needed to further explore and garner the full potential of DCreg in organ transplantation.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"121-130"},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138290601","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

Emerging phenotypes in kidney transplant rejection. 肾移植排斥反应的新表型。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2023-11-30 DOI: 10.1097/MOT.0000000000001130

Michael Mengel, Benjamin A Adam

{"title":"Emerging phenotypes in kidney transplant rejection.","authors":"Michael Mengel, Benjamin A Adam","doi":"10.1097/MOT.0000000000001130","DOIUrl":"10.1097/MOT.0000000000001130","url":null,"abstract":"Purpose of review: This review focuses on more recently emerging rejection phenotypes in the context of time post transplantation and the resulting differential diagnostic challenges. It also discusses how novel ancillary diagnostic tools can potentially increase the accuracy of biopsy-based rejection diagnosis.Recent findings: With advances in reducing immunological risk at transplantation and improved immunosuppression treatment renal allograft survival improved. However, allograft rejection remains a major challenge and represent a frequent course for allograft failure. With prolonged allograft survival, novel phenotypes of rejection are emerging, which can show complex overlap and transition between cellular and antibody-mediated rejection mechanisms as well as mixtures of acute/active and chronic diseases. With the emerging complexity in rejection phenotypes, it is crucial to achieve diagnostic accuracy in the individual patient.Summary: The prospective validation and adoption of novel molecular and computational diagnostic tools into well defined and appropriate clinical context of uses will improve our ability to accurately diagnose, stage, and grade allograft rejection.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"97-103"},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458474","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

Urine CXCL10 as a biomarker in kidney transplantation. 尿液中的 CXCL10 作为肾移植的生物标记物。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2024-01-19 DOI: 10.1097/MOT.0000000000001135

Patricia Hirt-Minkowski, Stefan Schaub

引用次数: 0

Bacterial infections in solid organ transplant recipients. 实体器官移植受者的细菌感染。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2024-01-11 DOI: 10.1097/MOT.0000000000001134

Johan Courjon, Dionysios Neofytos, Christian van Delden

{"title":"Bacterial infections in solid organ transplant recipients.","authors":"Johan Courjon, Dionysios Neofytos, Christian van Delden","doi":"10.1097/MOT.0000000000001134","DOIUrl":"10.1097/MOT.0000000000001134","url":null,"abstract":"Purpose of review: Bacteria are the leading cause of infections in solid organ transplant (SOT) recipients, significantly impacting patient outcome. Recently detailed and comprehensive epidemiological data have been published.Recent finding: This literature review aims to provide an overview of bacterial infections affecting different types of SOT recipients, emphasizing underlying risk factors and pathophysiological mechanisms.Summary: Lung transplantation connects two microbiotas: one derived from the donor's lower respiratory tract with one from the recipient's upper respiratory tract. Similarly, liver transplantation involves a connection to the digestive tract and its microbiota through the bile ducts. For heart transplant recipients, specific factors are related to the management strategies for end-stage heart failure based with different circulatory support tools. Kidney and kidney-pancreas transplant recipients commonly experience asymptomatic bacteriuria, but recent studies have suggested the absence of benefice of routine treatment. Bloodstream infections (BSI) are frequent and affect all SOT recipients. Nonorgan-related risk factors as age, comorbidity index score, and leukopenia contribute to BSI development. Bacterial opportunistic infections have become rare in the presence of efficient prophylaxis. Understanding the epidemiology, risk factors, and pathophysiology of bacterial infections in SOT recipients is crucial for effective management and improved patient outcomes.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"155-160"},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416610","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

Recent advances in cytomegalovirus infection management in solid organ transplant recipients. 实体器官移植受者巨细胞病毒感染管理的最新进展。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2024-01-30 DOI: 10.1097/MOT.0000000000001139

Paolo Antonio Grossi, Maddalena Peghin

{"title":"Recent advances in cytomegalovirus infection management in solid organ transplant recipients.","authors":"Paolo Antonio Grossi, Maddalena Peghin","doi":"10.1097/MOT.0000000000001139","DOIUrl":"10.1097/MOT.0000000000001139","url":null,"abstract":"Purpose of review: Human cytomegalovirus (CMV) continues to be the most important infectious complication following solid organ transplantation (SOT).Recent findings: Universal prophylaxis and preemptive therapy are the most adopted strategies for prevention of CMV disease globally. Prophylaxis with valganciclovir is the most widely used approach to CMV prevention, however leukopenia and late onset CMV disease after discontinuation of prophylaxis requires new strategies to prevent this complication. The use of assays detecting CMV-specific T cell-mediated immunity may individualize the duration of antiviral prophylaxis after transplantation. Letermovir has been recently approved for prophylaxis in kidney transplant recipients. CMV-RNAemia used together with CMV-DNAemia in the viral surveillance of CMV infection provides accurate information on viral load kinetics, mostly in patients receiving letermovir prophylaxis/therapy. The development of refractory and resistant CMV infection remains a major challenge and a new treatment with maribavir is currently available. In the present paper we will review the most recent advances in prevention and treatment of CMV diseases in SOT recipients.Summary: Recent findings, summarized in the present paper, may be useful to optimize prevention and treatment of CMV infection in SOT.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"131-137"},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10919264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139574223","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

Current Opinion in Organ Transplantation welcomes a new Editor-in-Chief. 器官移植最新观点》迎来了新任主编。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2024-01-04 DOI: 10.1097/MOT.0000000000001132

Sarah J Booth

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2024-01-04 DOI: 10.1097/MOT.0000000000001121

引用次数: 0

Optimizing the pediatric transplant candidate. 优化儿科移植候选者。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-10-12 DOI: 10.1097/MOT.0000000000001115

James E Squires, Vikram K Raghu, George V Mazariegos

{"title":"Optimizing the pediatric transplant candidate.","authors":"James E Squires, Vikram K Raghu, George V Mazariegos","doi":"10.1097/MOT.0000000000001115","DOIUrl":"10.1097/MOT.0000000000001115","url":null,"abstract":"Purpose of review: Advances in pediatric transplant parallel those in adult populations; however, there remain critical unique considerations and differences that require specialized knowledge and a specific skill set to optimize care afforded to the pediatric transplant candidate. We introduce general themes regarding optimization of the transplant candidate that are unique to children.Recent findings: The pathologies leading to pediatric organ transplant candidacy differ from adults and a precise understanding of the physiologies and natural histories of such diseases is critical for optimized care. Regardless of etiology, comorbidities including malnutrition, sarcopenia, and developmental delay are seen and often require disease and organ specific approaches to management. Additionally, an understanding of the concepts of developmental immunology and their relevance to transplant is critical.Summary: When looking to optimize pretransplant care, awareness of the pediatric-specific challenges by the transplant community in addition to organ- and age-specific management strategies enable the best outcomes for children awaiting solid organ transplantation.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"43-49"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41194237","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

Controlling infections in hospitalized pretransplant candidates. 控制住院移植前患者的感染。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-14 DOI: 10.1097/MOT.0000000000001120

Marian G Lacy, Evgenii Filippov, Saman Nematollahi

{"title":"Controlling infections in hospitalized pretransplant candidates.","authors":"Marian G Lacy, Evgenii Filippov, Saman Nematollahi","doi":"10.1097/MOT.0000000000001120","DOIUrl":"10.1097/MOT.0000000000001120","url":null,"abstract":"Purpose of review: Infections in hospitalized patients awaiting solid organ transplantation can pose complicated diagnostic and therapeutic challenges. Goals of management include stabilizing the patient, treating or controlling infections, and decreasing the risk of reactivation of infection after transplant.Recent findings: Groups such as The Organ Procurement and Transplantation Network, American Society of Transplantation Infectious Diseases Community of Practice and the European Society of Clinical Microbiology and Infectious Diseases have updated their guidelines on screening and treatment of infection in transplant candidates. There are also recent developments in therapeutic options for tuberculosis, COVID-19, Clostridioides difficile colitis, bloodstream infections, and other common infections.Summary: Ideally, antimicrobial therapy should be complete prior to transplantation. In situations in which completion of therapy prior to transplant is not feasible, therapy may need to be prolonged or modified. In most situations, infections can be managed similarly to the general population, although some infections, particularly fungal and mycobacterial, require a different management approach. We review disease- and organ-specific management.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"56-63"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138290599","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