Journal of Transplantation最新文献_第7页

Liver Transplantation for Hepatocellular Carcinoma: A Single Center Resume Overlooking Four Decades of Experience 肝细胞癌的肝移植:单中心简历忽视四十年的经验

IF 2.5

Journal of Transplantation Pub Date : 2016-01-10 DOI: 10.1155/2016/7895956

N. Emmanouilidis, Rickmer Peters, B. Ringe, Z. Güner, W. Ramackers, H. Bektas, F. Lehner, M. Manns, J. Klempnauer, H. Schrem

{"title":"Liver Transplantation for Hepatocellular Carcinoma: A Single Center Resume Overlooking Four Decades of Experience","authors":"N. Emmanouilidis, Rickmer Peters, B. Ringe, Z. Güner, W. Ramackers, H. Bektas, F. Lehner, M. Manns, J. Klempnauer, H. Schrem","doi":"10.1155/2016/7895956","DOIUrl":"https://doi.org/10.1155/2016/7895956","url":null,"abstract":"Background. This is a single center oncological resume overlooking four decades of experience with liver transplantation (LT) for hepatocellular carcinoma (HCC). Methods. All 319 LT for HCC that were performed between 1975 and 2011 were included. Predictors for HCC recurrence (HCCR) and survival were identified by Cox regression, Kaplan-Meier analysis, Log Rank, and χ 2-tests where appropriate. Results. HCCR was the single strongest hazard for survival (exp⁡(B) = 10.156). Hazards for HCCR were tumor staging beyond the histologic MILAN (exp⁡(B) = 3.645), bilateral tumor spreading (exp⁡(B) = 14.505), tumor grading beyond G2 (exp⁡(B) = 8.668), and vascular infiltration of small or large vessels (exp⁡(B) = 11.612, exp⁡(B) = 18.324, resp.). Grading beyond G2 (exp⁡(B) = 10.498) as well as small and large vascular infiltrations (exp⁡(B) = 13.337, exp⁡(B) = 16.737, resp.) was associated with higher hazard ratios for long-term survival as compared to liver transplantation beyond histological MILAN (exp⁡(B) = 4.533). Tumor dedifferentiation significantly correlated with vascular infiltration (χ 2 p = 0.006) and intrahepatic tumor spreading (χ 2 p = 0.016). Conclusion. LT enables survival from HCC. HCC dedifferentiation is associated with vascular infiltration and intrahepatic tumor spreading and is a strong hazard for HCCR and survival. Pretransplant tumor staging should include grading by biopsy, because grading is a reliable and easily accessible predictor of HCCR and survival. Detection of dedifferentiation should speed up the allocation process.","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2016-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7895956","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64538407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

The Kidney Transplant Evaluation Process in the Elderly: Reasons for Being Turned down and Opportunities to Improve Cost-Effectiveness in a Single Center. 老年人肾移植评估过程:在单一中心被拒绝的原因和提高成本效益的机会。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-08-04 DOI: 10.1155/2016/7405930

Beatrice P Concepcion, Rachel C Forbes, Aihua Bian, Heidi M Schaefer

{"title":"The Kidney Transplant Evaluation Process in the Elderly: Reasons for Being Turned down and Opportunities to Improve Cost-Effectiveness in a Single Center.","authors":"Beatrice P Concepcion, Rachel C Forbes, Aihua Bian, Heidi M Schaefer","doi":"10.1155/2016/7405930","DOIUrl":"https://doi.org/10.1155/2016/7405930","url":null,"abstract":"Background. The kidney transplant evaluation process for older candidates is complex due to the presence of multiple comorbid conditions. Methods. We retrospectively reviewed patients ≥60 years referred to our center for kidney transplantation over a 3-year period. Variables were collected to identify reasons for patients being turned down and to determine the number of unnecessary tests performed. Statistical analysis was performed to estimate the association between clinical predictors and listing status. Results. 345 patients were included in the statistical analysis. 31.6% of patients were turned down: 44% due to coronary artery disease (CAD), peripheral vascular disease (PVD), or both. After adjustment for patient demographics and comorbid conditions, history of CAD, PVD, or both (OR = 1.75, 95% CI (1.20, 2.56), p = 0.004), chronic obstructive pulmonary disease (OR = 8.75, 95% CI (2.81, 27.20), p = 0.0002), and cancer (OR 2.59, 95% CI (1.18, 5.67), p = 0.02) were associated with a higher risk of being turned down. 14.8% of patients underwent unnecessary basic testing and 9.6% underwent unnecessary supplementary testing with the charges over a 3-year period estimated at $304,337. Conclusion. A significant number of older candidates are deemed unacceptable for kidney transplantation with primary reasons cited as CAD and PVD. The overall burden of unnecessary testing is substantial and potentially avoidable. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"7405930"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7405930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34350884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Clinical Course and Outcomes of Late Kidney Allograft Dysfunction. 晚期同种异体肾移植功能障碍的临床过程和结果。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-07-10 DOI: 10.1155/2016/7401808

Viktor Denisov, Vadym Zakharov, Anna Ksenofontova, Eugene Onishchenko, Tatyana Golubova, Sergey Kichatyi, Olga Zakharova

{"title":"Clinical Course and Outcomes of Late Kidney Allograft Dysfunction.","authors":"Viktor Denisov, Vadym Zakharov, Anna Ksenofontova, Eugene Onishchenko, Tatyana Golubova, Sergey Kichatyi, Olga Zakharova","doi":"10.1155/2016/7401808","DOIUrl":"https://doi.org/10.1155/2016/7401808","url":null,"abstract":"Background. This study is provided to increase the efficiency of the treatment of kidney transplant recipients by predicting the development of the late allotransplant dysfunction. Methods. 330 patients who have lived for more than one year with functioning kidney allograft were evaluated. To predict the subsequent duration of the well-functioning of allotransplant the prognostic significance of 15 baseline clinical and sociodemographic characteristics on the results of the survey one year after transplantation was investigated. The result was considered to be positive in constructing the regression prognostication model if recipient lived more than 3 years from the time of transplantation. Results. It was established that more late start of renal allograft dysfunction after transplantation correlates with the more time it takes till complete loss of allograft function. Creatinine and hemoglobin blood concentration and the level of proteinuria one year after transplantation within created mathematical model allow predicting the loss of kidney transplant function three years after the transplantation. Patients with kidney transplant dysfunction are advised to renew the program hemodialysis upon reaching plasma creatinine concentration 0.5-0.7 mmol/L. Conclusion. Values of creatinine, hemoglobin, and proteinuria one year after transplantation can be used for subsequent prognostication of kidney transplant function. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"7401808"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7401808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34720600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

The Utility of Routine Ultrasound Imaging after Elective Transplant Ureteric Stent Removal. 择期输尿管支架置换术后常规超声成像的应用。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-07-14 DOI: 10.1155/2016/1231567

Bibek Das, Dorian Hobday, Jonathon Olsburgh, Chris Callaghan

{"title":"The Utility of Routine Ultrasound Imaging after Elective Transplant Ureteric Stent Removal.","authors":"Bibek Das, Dorian Hobday, Jonathon Olsburgh, Chris Callaghan","doi":"10.1155/2016/1231567","DOIUrl":"https://doi.org/10.1155/2016/1231567","url":null,"abstract":"Background. Ureteric stent insertion during kidney transplantation reduces the incidence of major urological complications (MUCs). We evaluated whether routine poststent removal graft ultrasonography (PSRGU) was useful in detecting MUCs before they became clinically or biochemically apparent. Methods. A retrospective analysis was undertaken of clinical outcomes following elective stent removals from adult single renal transplant recipients (sRTRs) at our centre between 1 January 2011 and 31 December 2013. Results. Elective stent removal was performed for 338 sRTRs. Of these patients, 222 had routine PSRGU (median (IQR) days after stent removal = 18 (11-31)), 79 had urgent PSRGU due to clinical or biochemical indications, 12 had CT imaging, and 25 had no further renal imaging. Of the 222 sRTRs who underwent routine PSRGU, 210 (94.6%) had no change of management, three (1.4%) required repeat imaging only, and eight patients (3.6%) had incidental (nonureteric) findings. One patient (0.5%) had nephrostomy insertion as a result of routine PSRGU findings, but no ureteric stenosis was identified. Of 79 patients having urgent PSRGU after elective stent removal, three patients required transplant ureteric reimplantation. Conclusions. This analysis found no evidence that routine PSRGU at two to three weeks after elective stent removal provides any added value beyond standard clinical and biochemical monitoring. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"1231567"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/1231567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34733846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

For and against Organ Donation and Transplantation: Intricate Facilitators and Barriers in Organ Donation Perceived by German Nurses and Doctors. 支持和反对器官捐献与移植：德国护士和医生眼中器官捐献中错综复杂的促进因素和障碍。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-08-15 DOI: 10.1155/2016/3454601

Niels Christian Hvidt, Beate Mayr, Piret Paal, Eckhard Frick, Anna Forsberg, Arndt Büssing

{"title":"For and against Organ Donation and Transplantation: Intricate Facilitators and Barriers in Organ Donation Perceived by German Nurses and Doctors.","authors":"Niels Christian Hvidt, Beate Mayr, Piret Paal, Eckhard Frick, Anna Forsberg, Arndt Büssing","doi":"10.1155/2016/3454601","DOIUrl":"10.1155/2016/3454601","url":null,"abstract":"Background. Significant facilitators and barriers to organ donation and transplantation remain in the general public and even in health professionals. Negative attitudes of HPs have been identified as the most significant barrier to actual ODT. The purpose of this paper was hence to investigate to what extent HPs (physicians and nurses) experience such facilitators and barriers in ODT and to what extent they are intercorrelated. We thus combined single causes to circumscribed factors of respective barriers and facilitators and analyzed them for differences regarding profession, gender, spiritual/religious self-categorization, and self-estimated knowledge of ODT and their mutual interaction. Methods. By the use of questionnaires we investigated intricate facilitators and barriers to organ donation experienced by HPs (n = 175; 73% nurses, 27% physicians) in around ten wards at the University Hospital of Munich. Results. Our study confirms a general high agreement with the importance of ODT. Nevertheless, we identified both facilitators and barriers in the following fields: (1) knowledge of ODT and willingness to donate own organs, (2) ethical delicacies in ODT, (3) stressors to handle ODT in the hospital, and (4) individual beliefs and self-estimated religion/spirituality. Conclusion. Attention to the intricacy of stressors and barriers in HPs continues to be a high priority focus for the availability of donor organs. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"3454601"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34710456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 Treatment Approaches to HCC with a Special Consideration to Transplantation. 当前肝细胞癌的治疗方法，特别考虑移植。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-06-20 DOI: 10.1155/2016/7926264

N Bhardwaj, M T P R Perera, M A Silva

{"title":"Current Treatment Approaches to HCC with a Special Consideration to Transplantation.","authors":"N Bhardwaj, M T P R Perera, M A Silva","doi":"10.1155/2016/7926264","DOIUrl":"https://doi.org/10.1155/2016/7926264","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths worldwide. The mainstay of treatment of HCC has been both resectional and transplantation surgery. It is well known that, in selected, optimized patients, hepatectomy for HCC may be an option, even in patients with underlying cirrhosis. Resectable patients with early HCC and underlying liver disease are however increasingly being considered for transplantation because of potential for better disease-free survival and resolution of underlying liver disease, although this approach is limited by the availability of donor livers, especially in resectable patients. Outcomes following liver transplantation improved dramatically for patients with HCC following the implementation of the Milan criteria in the late 1990s. Ever since, the rather restrictive nature of the Milan criteria has been challenged with good outcomes. There has also been an increase in the donor pool with marginal donors including organs retrieved following cardiac death being used. Even so, patients still continue to die while waiting for a liver transplant. In order to reduce this attrition, bridging techniques and methods for downstaging disease have evolved. Additionally new techniques for organ preservation have increased the prospect of this potentially curative procedure being available for a greater number of patients. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"7926264"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7926264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34731314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Incidence, Characteristics, and Prognosis of Incidentally Discovered Hepatocellular Carcinoma after Liver Transplantation. 肝移植术后偶然发现的肝细胞癌的发生率、特点及预后。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-06-15 DOI: 10.1155/2016/1916387

Walid El Moghazy, Samy Kashkoush, Glenda Meeberg, Norman Kneteman

{"title":"Incidence, Characteristics, and Prognosis of Incidentally Discovered Hepatocellular Carcinoma after Liver Transplantation.","authors":"Walid El Moghazy, Samy Kashkoush, Glenda Meeberg, Norman Kneteman","doi":"10.1155/2016/1916387","DOIUrl":"https://doi.org/10.1155/2016/1916387","url":null,"abstract":"Background. We aimed to assess incidentally discovered hepatocellular carcinoma (iHCC) over time and to compare outcome to preoperatively diagnosed hepatocellular carcinoma (pdHCC) and nontumor liver transplants. Methods. We studied adults transplanted with a follow-up of at least one year. Patients were divided into 3 groups according to diagnosis of hepatocellular carcinoma. Results. Between 1990 and 2010, 887 adults were transplanted. Among them, 121 patients (13.6%) had pdHCC and 32 patients (3.6%) had iHCC; frequency of iHCC decreased markedly over years, in parallel with significant increase in pdHCC. Between 1990 and 1995, 120 patients had liver transplants, 4 (3.3%) of them had iHCC, and only 3 (2.5%) had pdHCC, while in the last 5 years, 263 patients were transplanted, 7 (0.03%) of them had iHCC, and 66 (25.1%) had pdHCC (P < 0.001). There was no significant difference between groups regarding patient survival; 5-year survival was 74%, 75.5%, and 77.3% in iHCC, pdHCC, and non-HCC groups, respectively (P = 0.702). Patients with iHCC had no recurrences after transplant, while pdHCC patients experienced 17 recurrences (15.3%) (P = 0.016). Conclusions. iHCC has significantly decreased despite steady increase in number of transplants for hepatocellular carcinoma. Patients with iHCC had excellent outcomes with no tumor recurrence and survival comparable to pdHCC. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"1916387"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/1916387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34659629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Effectively Screening for Coronary Artery Disease in Patients Undergoing Orthotopic Liver Transplant Evaluation. 原位肝移植患者冠状动脉病变的有效筛查

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-06-22 DOI: 10.1155/2016/7187206

Bryan C Lee, Feng Li, Adam J Hanje, Khalid Mumtaz, Konstantinos D Boudoulas, Scott M Lilly

{"title":"Effectively Screening for Coronary Artery Disease in Patients Undergoing Orthotopic Liver Transplant Evaluation.","authors":"Bryan C Lee, Feng Li, Adam J Hanje, Khalid Mumtaz, Konstantinos D Boudoulas, Scott M Lilly","doi":"10.1155/2016/7187206","DOIUrl":"https://doi.org/10.1155/2016/7187206","url":null,"abstract":"Coronary artery disease (CAD) is prevalent in patients with end-stage liver disease and associated with poor outcomes when undergoing orthotopic liver transplantation (OLT); however, noninvasive screening for CAD in this population is less sensitive. In an attempt to identify redundancy, we reviewed our experience among patients undergoing CAD screening as part of their OLT evaluation between May 2009 and February 2014. Demographic, clinical, and procedural characteristics were analyzed. Of the total number of screened patients (n = 132), initial screening was more common via stress testing (n = 100; 75.8%) than coronary angiography (n = 32; 24.2%). Most with initial stress testing underwent angiography (n = 52; 39.4%). Among those undergoing angiography, CAD was common (n = 31; 23.5%). Across the entire cohort the number of traditional risk factors was linearly associated with CAD, and those with two or more risk factors were found to have CAD by angiography 50% of the time (OR 1.92; CI 1.07-3.44, p = 0.026). Our data supports that CAD is prevalent among pre-OLT patients, especially among those with 2 or more risk factors. Moreover, we identified a lack of uniformity in practice and the need for evidence-based and standardized screening protocols. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"7187206"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7187206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34672714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique. 成人双肾移植与单肾移植的中期结果:一种手术技术的演变。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-07-10 DOI: 10.1155/2016/2586761

Ana K Islam, Richard J Knight, Wesley A Mayer, Adam B Hollander, Samir Patel, Larry D Teeter, Edward A Graviss, Ashish Saharia, Hemangshu Podder, Emad H Asham, A Osama Gaber

{"title":"Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique.","authors":"Ana K Islam, Richard J Knight, Wesley A Mayer, Adam B Hollander, Samir Patel, Larry D Teeter, Edward A Graviss, Ashish Saharia, Hemangshu Podder, Emad H Asham, A Osama Gaber","doi":"10.1155/2016/2586761","DOIUrl":"https://doi.org/10.1155/2016/2586761","url":null,"abstract":"Background. Acceptance of dual kidney transplantation (DKT) has proven difficult, due to surgical complexity and concerns regarding long-term outcomes. We herein present a standard technique for ipsilateral DKT and compare outcomes to single-kidney transplant (SKT) recipients. Methods. A retrospective single-center comparison of DKT and SKT performed between February 2007 and July 2013. Results. Of 516 deceased donor kidney transplants, 29 were DKT and 487 were SKT. Mean follow-up was 43 ± 67 months. DKT recipients were older and more likely than SKT recipients to receive an extended criteria graft (p < 0.001). For DKT versus SKT, the rates of delayed graft function (10.3 versus 9.2%) and acute rejection (20.7 versus 22.4%) were equivalent (p = ns). A higher than expected urologic complication rate in the DKT cohort (14 versus 2%, p < 0.01) was reduced through modification of the ureteral anastomosis. Graft survival was equivalent between DKT and SKT groups (p = ns) with actuarial 3-year DKT patient and graft survivals of 100% and 93%. At 3 years, the groups had similar renal function (p = ns). Conclusions. By utilizing extended criteria donor organs as DKT, the donor pool was enlarged while providing excellent patient and graft survival. The DKT urologic complication rate was reduced by modification of the ureteral anastomosis. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 ","pages":"2586761"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/2586761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34720599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Everolimus and Malignancy after Solid Organ Transplantation: A Clinical Update. 依维莫司与实体器官移植后的恶性肿瘤:临床进展。

IF 2.5

Journal of Transplantation Pub Date : 2016-01-01 Epub Date: 2016-10-11 DOI: 10.1155/2016/4369574

Hallvard Holdaas, Paolo De Simone, Andreas Zuckermann

{"title":"Everolimus and Malignancy after Solid Organ Transplantation: A Clinical Update.","authors":"Hallvard Holdaas, Paolo De Simone, Andreas Zuckermann","doi":"10.1155/2016/4369574","DOIUrl":"10.1155/2016/4369574","url":null,"abstract":"Malignancy after solid organ transplantation remains a major cause of posttransplant mortality. The mammalian target of rapamycin (mTOR) inhibitor class of immunosuppressants exerts various antioncogenic effects, and the mTOR inhibitor everolimus is licensed for the treatment of several solid cancers. In kidney transplantation, evidence from registry studies indicates a lower rate of de novo malignancy under mTOR inhibition, with some potentially supportive data from randomized trials of everolimus. Case reports and small single-center series have suggested that switch to everolimus may be beneficial following diagnosis of posttransplant malignancy, particularly for Kaposi's sarcoma and nonmelanoma skin cancer, but prospective studies are lacking. A systematic review has shown mTOR inhibition to be associated with a significantly lower rate of hepatocellular carcinoma (HCC) recurrence versus standard calcineurin inhibitor therapy. One meta-analysis has concluded that patients with nontransplant HCC experience a low but significant survival benefit under everolimus monotherapy, so far unconfirmed in a transplant population. Data are limited in heart transplantation, although observational data and case reports have indicated that introduction of everolimus is helpful in reducing the recurrence of skin cancers. Overall, it can be concluded that, in certain settings, everolimus appears a promising option to lessen the toll of posttransplant malignancy.","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2016 1","pages":"4369574"},"PeriodicalIF":2.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/4369574","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64382587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 54