Current Opinion in Organ Transplantation最新文献_第9页

Pushing the limits of treatment for hepatocellular carcinoma. 推动肝细胞癌治疗的极限。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-30 DOI: 10.1097/MOT.0000000000001123

Michelle Jones-Pauley, David W Victor, Sudha Kodali

引用次数: 0

Molecular profiling in the management of hepatocellular carcinoma. 分子分析在肝细胞癌治疗中的应用。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-12-01 DOI: 10.1097/MOT.0000000000001124

Nadine Soliman, Ashish Saharia, Maen Abdelrahim, Ashton A Connor

引用次数: 0

Optimizing the prelung transplant candidate. 优化肺移植前候选者。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-07 DOI: 10.1097/MOT.0000000000001116

John Pagteilan, Scott Atay

{"title":"Optimizing the prelung transplant candidate.","authors":"John Pagteilan, Scott Atay","doi":"10.1097/MOT.0000000000001116","DOIUrl":"10.1097/MOT.0000000000001116","url":null,"abstract":"Purpose of review: Lung transplant outcomes are impacted by multiple modifiable risk factors. Candidate deterioration on the wait list remains problematic. Innovative technology and strategies to identify and impact pretransplant morbidity have improved short- and long-term outcomes. We focus our review on recent advances in pretransplant recipient assessment and optimization.Recent findings: Advancements in recipient management have focused on risk factor identification for adverse outcomes and the development of a lung transplant specific frailty assessment. Early surgical correction of gastroesophageal reflux disease (GERD), including the use of partial fundoplication in the setting of esophageal dysmotility, leads to improvements in graft function/longevity. New evidence supports expanding criteria for extracorporeal life support as a bridge to transplant.Summary: Candidate optimization requires early intervention to limit functional deterioration potentially contributing to adverse outcomes. Frailty can be identified with a transplant specific frailty assessment, and positively impacted with dedicated rehabilitation. Pretransplant frailty is reversible following transplant and should be considered in the context of overall fitness at the time of candidate selection. Invasive support modes including extracorporeal membrane oxygenation (ECMO) are appropriate to preserve strength and mobility, with awake, ambulatory ECMO preferred. The deleterious effect of GERD on graft function can be managed with early fundoplication over medical management alone.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"37-42"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479206","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

Ethical issues in solid organ transplantation: transfusion-free transplantation in Jehovah's witness patients. 实体器官移植的伦理问题：耶和华见证人患者的无输血移植。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-12-06 DOI: 10.1097/MOT.0000000000001128

Rick Selby, Taylor Selby-Medical, Michael Richman

{"title":"Ethical issues in solid organ transplantation: transfusion-free transplantation in Jehovah's witness patients.","authors":"Rick Selby, Taylor Selby-Medical, Michael Richman","doi":"10.1097/MOT.0000000000001128","DOIUrl":"10.1097/MOT.0000000000001128","url":null,"abstract":"Purpose of review: Jehovah's Witnesses do not accept transfusion of major allogeneic blood fractions. Successful solid organ transplantation is challenging for Jehovah's Witnesses when anemia, coagulation disturbances, and difficult technical aspects co-exist, and key blood bank resources cannot be utilized. Organ availability for transplantation is limited and demand exceeds supply for all organ types. Historically, the likelihood of poor outcomes in Jehovah's Witnesses patients placed ethical limitations on transplant candidacy for this population violating the precept of maximal utilization of a limited resource. The review's purpose is to describe advancements and strategies that make Jehovah's Witnesses transplant outcomes comparable to transfusion-eligible patients and allay the ethical concerns of their candidacy.Recent findings: Immunomodulation from allogeneic transfusion is a cause of significant postop morbidity. Blood conservation strategies have led to improved outcomes across different medical and surgical cohorts and set the stage for expanded utility in Jehovah's Witnesses with organ insufficiency.Published single-center series with descriptions of specific peri-operative strategies describe the path to major blood product avoidance.Summary: Comparable outcomes in solid organ transplantation for Jehovah's Witnesses without allogeneic transfusion are possible when inclusion-exclusion criteria are respected, and blood conservation strategies employed.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"82-87"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138486947","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

Transplantation for colorectal liver metastasis. 大肠癌肝转移的移植治疗。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-23 DOI: 10.1097/MOT.0000000000001126

Pål-Dag Line, Svein Dueland

{"title":"Transplantation for colorectal liver metastasis.","authors":"Pål-Dag Line, Svein Dueland","doi":"10.1097/MOT.0000000000001126","DOIUrl":"10.1097/MOT.0000000000001126","url":null,"abstract":"Purpose of review: Liver transplantation has emerged as a possible treatment for selected patients with nonresectable colorectal liver metastasis, but controversy still exists regarding optimal selection criteria and acceptable outcomes.Recent findings: Univariate analysis in the largest cohorts confirms that metachronous disease, Oslo score = 0-1, metabolic tumor volume (MTV) less than 70 cm 3 , and tumor burden score less than 9 are positive predictive factors for good overall survival outcomes. Some recent trials might suggest that technical resectability is not a valid exclusion criterion for patients with high tumor load and favorable prognostic scores in the transplant evaluation. Recent developments in circulation DNA technology and liquid biopsy may play a future role in the selection and monitoring of patients.Summary: Evaluation for transplant needs multidisciplinary involvement and should not be delayed until the failure of conventional oncological therapy. Larger data sets are needed to refine the selection criteria for liver transplantation in colorectal liver metastasis (CRLM).","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"23-29"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10763714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298616","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

Enhanced recovery after surgery for liver transplantation: a review of recent literature. 肝移植术后恢复增强：近期文献综述。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-08 DOI: 10.1097/MOT.0000000000001117

Cara E Crouch, Erin Stewart, Adrian Hendrickse

{"title":"Enhanced recovery after surgery for liver transplantation: a review of recent literature.","authors":"Cara E Crouch, Erin Stewart, Adrian Hendrickse","doi":"10.1097/MOT.0000000000001117","DOIUrl":"10.1097/MOT.0000000000001117","url":null,"abstract":"Purpose of review: This review was created to highlight important articles from the past year related to the evolving field of enhanced recovery after surgery (ERAS) in liver transplantation that are relevant to the transplant anesthesiologist.Recent findings: The International Liver Transplantation Society (ILTS) recently completed a landmark project, the ERAS4OLT.org project, which culminated in 80 recommendations for ERAS in liver transplantation. These recommendations encompass management for deceased donor recipients, living donor recipients and living donors. This review highlights selected articles relevant to the perioperative management of deceased donor liver transplant recipients.Summary: Though, there are now published internationally agreed upon recommendations for ERAS topics specific to liver transplantation, there is an obvious need for further investigation into this area to provide high quality evidence to support these recommendations. It is reasonable to utilize these recommendations in ERAS protocols for individual institutions; however, more evidence is needed in several areas to confirm the effects of these protocols on short-term outcomes.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"64-71"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479205","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

Advances in desensitization for human leukocyte antigen incompatible kidney transplantation. 人类白细胞抗原不相容肾移植脱敏疗法的进展。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2023-12-14 DOI: 10.1097/mot.0000000000001131

Ashley Vo, Noriko Ammerman, Stanley C Jordan

引用次数: 0

Living liver donor pain management. 活体肝脏捐献者疼痛管理。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2023-12-01 Epub Date: 2023-09-07 DOI: 10.1097/MOT.0000000000001099

Ryung A Kang, Justin Sangwook Ko

{"title":"Living liver donor pain management.","authors":"Ryung A Kang, Justin Sangwook Ko","doi":"10.1097/MOT.0000000000001099","DOIUrl":"10.1097/MOT.0000000000001099","url":null,"abstract":"Purpose of review: Optimal pain control in living liver donors undergoing hepatectomy is strongly recommended considering their unique status as healthy individuals willingly undergoing surgery for the benefit of the recipient. This review aims to examine and evaluate different strategies aimed at ensuring effective postoperative pain management in living liver donors.Recent findings: Enhanced recovery after surgery (ERAS) protocols have proven effective in optimizing patient outcomes, including in living liver donor hepatectomy. By implementing these protocols, healthcare professionals can enhance postoperative pain control and accelerate recovery. Multimodal analgesia, which combines different techniques and agents, is crucial in pain management for living liver donors. Regional analgesia techniques, such as spinal anesthesia and various peripheral nerve blocks, have shown efficacy in reducing pain and facilitating early recovery. Systemic nonopioid analgesics, including acetaminophen, nonsteroidal anti-inflammatory drugs, ketamine, lidocaine, and dexmedetomidine act synergistically to alleviate pain and reduce inflammation. Minimizing the use of opioids is important to avoid adverse effects, and they should be reserved for rescue medication or breakthrough pain.Summary: Applying the principles of ERAS and multimodal analgesia to living liver donors can effectively control pain while promoting early recovery.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"391-396"},"PeriodicalIF":2.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10552782","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

Editorial introductions. 编辑介绍。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1097/MOT.0000000000001112

引用次数: 0

Expanding indications for urogenital transplantation: congenital and oncologic defects, and gender affirmation. 泌尿生殖道移植的扩大适应症：先天性和肿瘤学缺陷，以及性别确认。

IF 2.2 4区医学

Current Opinion in Organ Transplantation Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI: 10.1097/MOT.0000000000001111

Christopher D Lopez, Alisa O Girard, Richard J Redett

{"title":"Expanding indications for urogenital transplantation: congenital and oncologic defects, and gender affirmation.","authors":"Christopher D Lopez, Alisa O Girard, Richard J Redett","doi":"10.1097/MOT.0000000000001111","DOIUrl":"10.1097/MOT.0000000000001111","url":null,"abstract":"Purpose of review: Penile transplantation has become an emerging option for patients with severe genital defects. Only transplantation restores anatomy, sexual, and reproductive function of the penis. However, penile transplantation comes with important technical, psychosocial, ethical, and surgical challenges that must be considered for successful implementation. Indications for penile transplantation have yet to be clearly elucidated.Recent findings: Since 2006, only five penile transplants have been performed globally. Four of the five transplants have been performed following traumatic defects, and one was performed following a total penectomy from squamous cell carcinoma. Only two of the five penile transplants remain intact. However, long-term outcomes are encouraging with optimal surgical planning, patient selection, and immunologic compliance. Clinical implications and ethical considerations are discussed.Summary: Penile transplantation is a novel solution for penile defects not amenable to traditional reconstructive approaches. With an evidence-based surgical technique, potential advantages include improved urinary function, sensation, and cosmesis. While patient selection is challenging, there is an ongoing effort to identify potential candidates. Indications are discussed in this article.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":"28 6","pages":"425-430"},"PeriodicalIF":2.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421483","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