Transplantation proceedings最新文献

{"title":"Enterococcus avium Infection After Liver Transplantation in Vietnam: A Case Report.","authors":"Ngo Dinh Trung, Nguyen Chi Tam, Dao Trong Chinh, Ho Nam, Nguyen Duc Trung, Le Thi Phuong Thao, Patrice N Marche, Hoang Xuan Su","doi":"10.1016/j.transproceed.2024.11.020","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.11.020","url":null,"abstract":"<p><strong>Background: </strong>The infectious complications are the most common and can be life-threatening to liver transplant recipients, in particular, within the first month after transplantation. Early diagnosis of these severe complications and accurate detection of causative etiologies are crucial for the choice of therapeutic strategies and management of liver transplants.</p><p><strong>Case report: </strong>We present a case report of a patient with a history of primary sclerosing cholangitis who underwent a liver transplantation (LT) from a living donor. The postoperative care was complicated with the hepatic artery thrombosis on day 16 and then the presence of sepsis on day 22 and intra-abdominal abscess on day 30, caused by Enterococcus avium (E. avium). The patient was treated with stent placement for hepatic artery thrombosis, percutaneous drainage of the abscess, and used an intensive intravenous antibiotic regimen with a combination of fosfomycin and vancomycin for a duration of 14 days. After the interventional procedure, the clinical examination and laboratory findings became normal and the patient left the hospital on day 46 in good general condition.</p><p><strong>Conclusion: </strong>We diagnosed early and well-recognized complications during the perioperative care to make a prompt therapeutic approach with conservative treatment to rescue the patient without requiring urgent surgery and retransplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857405","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}

{"title":"Detection of Gram-Ghost Bacilli and Additional Ziehl-Neelsen Stain for the Early Diagnosis of Driveline Infection: A Case Report.","authors":"Megumi Kawano, Shotaro Komeyama, Tasuku Hada, Hiroki Mochizuki, Naoki Tadokoro, Satoshi Kainuma, Takuya Watanabe, Satsuki Fukushima, Yasumasa Tsukamoto","doi":"10.1016/j.transproceed.2024.10.035","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.10.035","url":null,"abstract":"<p><strong>Background: </strong>Driveline infections (DLI) caused by nontuberculous mycobacteria (NTM) in patients with implantable left ventricular assist devices (iLVAD) are rare but fatal, requiring early diagnosis and appropriate treatment. Herein, we present a rare case of DLI caused by Mycobacterium chelonae, which was promptly diagnosed using Gram stain and Ziehl-Neelsen stain and followed a favorable clinical course.</p><p><strong>Case presentation: </strong>A 51-year-old man with an iLVAD complicated by DLI was admitted to our center. He had no fever but had a slight ache and rash around the driveline exit site on admission. The wound condition gradually deteriorated with increasing purulent discharge from the driveline exit site and an elevated inflammatory response, despite daily irrigation. Gallium scintigraphy led to the diagnosis of deep DLI, followed by surgical debridement and omental flap transposition with driveline translocation. The Gram stain of the purulent discharge from the surgical site showed unstained bacilli (Gram-neutral, neither positive nor negative) along with leukocyte phagocytosis. Additionally, the Ziehl-Neelsen stain was positive. NTM was suspected after confirming the negative polymerase chain reaction for M. tuberculosis. Antibiotic therapy was switched to a specific regimen for skin and soft tissue infections caused by NTM. After identifying M. chelonae, antibiotic therapy was switched to a more specific regimen (clarithromycin and doxycycline) for M. chelonae according to the susceptibility test results. The patient was discharged after 3 months without infection recurrence.</p><p><strong>Conclusions: </strong>Detecting Gram-ghost bacilli and using an additional Ziehl-Neelsen stain can be beneficial for the early diagnosis of repeated DLI with unknown etiology.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796744","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}

{"title":"Tolerability and Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists in Lung Transplant Recipients: A Single Center Report.","authors":"Claire E Fishman, Ciara Walshe, Tamara Claridge, Stephanie Witek, Krishna Pandya, Jason D Christie, Joshua M Diamond, Michaela R Anderson","doi":"10.1016/j.transproceed.2024.11.016","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.11.016","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes and obesity increase risk of death after lung transplantation. Optimal treatment of diabetes and obesity may improve post-transplant outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are FDA-approved to treat diabetes and obesity and demonstrate improvement in renal and cardiovascular outcomes in the general population. However, side effects may limit tolerability in lung transplant recipients. We hypothesized that GLP-1RA would be stopped due to side effects in a higher proportion of lung transplant recipients compared to the general population but result in weight loss for those who were able to tolerate them.</p><p><strong>Methods: </strong>We performed a single-center case series of lung transplant recipients initiated on a GLP-1RA post-transplant between April 1, 2005 and December 31, 2023. We assessed side effects and complications during GLP-1RA use. Weight was assessed at time of GLP-1RA initiation and 3-, 6-, and 12-months postinitiation.</p><p><strong>Results: </strong>Fifty-nine lung transplant recipients initiated a GLP-1RA during the study period with a median (IQR) total time of use of 590 (280-891) days. Thirty-seven percent (22/59) stopped the medication due to side effects, with nausea and vomiting being most common. The median (IQR) percent change in weight at 12-months post-GLP-1RA initiation was -2.5% (-8.7% to 1.5%).</p><p><strong>Discussion: </strong>We report the largest study evaluating GLP-1RA use in lung transplant recipients. Discontinuation rates are higher and weight loss is lower than in the general population. However, most lung transplant recipients tolerated long-term use of GLP-1RA. Further work is required to identify which recipients are most likely to benefit and how to optimize tolerability.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796747","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}

{"title":"Paired Exchange Living Donor Liver Transplantation: A Single Center Experience From Turkiye.","authors":"Ayhan Dinckan, Eryigit Eren, Fatih Ensaroglu, Taylan Sahin, Hakan Parlak, Ali Kocyigit, Utku Alkara, Murat Akyildiz, Mehmet Tokac","doi":"10.1016/j.transproceed.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>In countries with low rates of deceased donor solid organ transplantations, live-donor liver transplantation is the preferred definitive treatment for children and adults with end-stage liver disease. However, it is known that a remarkable number of potential living liver donors are rejected due to ABO incompatibility, suboptimal liver mass, or anatomical features. Paired exchange liver transplantation (PELT) practice emerged to overcome these obstacles. Herein, we present the results of our single-center experience with PELT and compare them with previously reported data.</p><p><strong>Methods: </strong>Patients who underwent PELT between January 2015 and December 2022 constituted the target population. The collected recipient data included demographic parameters, the model for end-stage liver disease score, graft-recipient weight ratio, indication for LT and paired exchange, body-mass index, duration of hospital stay, duration of intensive care unit stay, postoperative complications and inpatient mortality. Donor data, including demographic characteristics, body mass index, type of liver graft (right lobe or left lateral segment), graft weight (g), type of portal vein anatomy (Type 1, 2, or 3), type of biliary anatomy (Type 1, 2, 3a, 3b), duration of hospital stay, complications and mortality were retrieved.</p><p><strong>Results: </strong>Among 18 recipients, 14 (78%) were male, and 4 (22%) were female. The mean recipient age was 50.7 [2-66], while the mean donor age was 29.3 [18-40]. The mean follow-up period was 31.9 [12-71] months. The 1-year patient and graft survivals were calculated as 83.3% and 88.9%.</p><p><strong>Conclusion: </strong>The PELT can be utterly feasible at transplant centers with remarkable LDLT experience.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796746","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}

{"title":"Successful Kidney Transplant From a Donor With Marfan Syndrome: A Case Report.","authors":"Omar Sallout, Francisco Rodriguez Silva, Puneet Sindhwani, Michael Rees, John Rabets, Obi Ekwenna, Deepak Malhotra, Dinkar Kaw, Shobha Ratnam, Kunal Yadav","doi":"10.1016/j.transproceed.2024.11.017","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.11.017","url":null,"abstract":"<p><p>Marfan syndrome, a rare autosomal dominant connective tissue disorder caused by mutations in fibrillin-1, is primarily associated with cardiovascular complications such as aortic aneurysms and dissection. Despite the organ shortage crisis, kidneys from donors with Marfan syndrome are often rejected due to concerns about potential vascular complications. This case report presents the successful transplantation of a kidney from a 47-year-old male donor with Marfan syndrome into a 66-year-old female recipient with end-stage renal disease secondary to diabetic nephropathy. The donor had no prior history of aortic aneurysms, and peri-mortem imaging confirmed the absence of vascular complications. The transplantation was performed without complications. The recipient demonstrated excellent graft function postoperatively and at 17 months posttransplant with no evidence of vascular abnormalities. This case supports the consideration of kidneys from donors with Marfan syndrome to help reduce the organ shortage.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793092","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}

{"title":"First Case Report of no Fibrous Capsule Kidney Transplantation.","authors":"Lin Fan, Zhiping Xia, Hui Xie, Weiyu Wang, Zhen Fu, Guizhu Peng, Qifa Ye","doi":"10.1016/j.transproceed.2024.10.046","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.10.046","url":null,"abstract":"<p><p>Kidney transplantation (KT) is the optimal treatment for end-stage renal disease. This paper discusses a case where a donated kidney lacking a fibrous capsule was carefully utilized for transplantation. The organ underwent rigorous evaluation and received approval from the ethics committee, with full informed consent obtained from the recipient and their family. Although surface bleeding of the kidney occurred during the operation and was challenging to control, the recipient was successfully discharged 22 days post-transplantation. In conclusion, kidneys lacking a fibrous capsule can be safely used for transplantation after careful evaluation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793090","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}

{"title":"Effect of CYP 3A4*1B and CYP3A5*3 Gene Polymorphisms in Antirejection of Tacrolimus in Liver Transplant Patients.","authors":"Xia Zhou, Rujia Tang, Dali Zhang, Xi He, Zhenwen Liu, Yinjie Gao, Hongling Liu","doi":"10.1016/j.transproceed.2024.10.030","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.10.030","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus is a substrate of CYP 3A5; to reduce the rate of liver injury and rejection in liver transplant (LT) recipients, it is feasible to optimize the administration of tacrolimus by adding CYP gene polymorphism.</p><p><strong>Methods: </strong>We divided 151 LT recipients randomly into an optimization group and a control group. All were tested routinely for clinical indicators such as FK506 trough concentration and biochemistry, and their complications and survival were observed. The optimization group additionally detected single nucleotide polymorphisms in the CYP 3A4*1B and CYP 3A5*3 genes.</p><p><strong>Results: </strong>There were no significant differences in tacrolimus dosage, FK506 trough concentrations, and concentration/dose value between the 2 groups. In the optimization group, all patients tested CYP 3A4*1B as wild type. CYP 3A5*3 detection classification included 35 with the G/G mutation (45.5%) and 36 A/G wild-type individuals (46.8%). The concentration/dose values of G/G mutant patients were significantly higher than those of A/G wild-type and A/A mutant patients (G/G vs. A/G; P < .05), and no significant difference in FK506.</p><p><strong>Conclusion: </strong>The CYP 3A4*1B genotype has less influence on tacrolimus metabolism. The genetic polymorphism of CYP 3A5*3 is obvious and largely affects tacrolimus metabolism, and the variant patients need lower doses of tacrolimus to reach the target concentration.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793089","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}

{"title":"A Case of Autoimmune Hemolytic Anemia Following COVID-19 Infection Accompanied by Acute Tubulointerstitial Nephritis in a Kidney Transplant Recipient.","authors":"Dong Wook Kim, In Hwa Jeong, Young Ki Son, Seo Hee Rha, Young Soo Chung","doi":"10.1016/j.transproceed.2024.10.042","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.10.042","url":null,"abstract":"<p><strong>Background: </strong>Acute tubular injury is one of the main causes of acute tubular injury (acute kidney injury ) in patients with COVID-19 infection. Autoimmune hemolytic anemia (AIHA) is also one of the autoimmune complications of COVID-19. However, AIHA accompanied by acute tubulointerstitial nephritis (ATIN) caused by SARS-CoV-2 is rarely reported. Here, we report a kidney transplant recipient who underwent graftectomy owing to ATIN accompanied by AIHA, possibly exacerbated by COVID-19 infection.</p><p><strong>Case presentation: </strong>A 32-year-old male renal allograft recipient owing to immunoglobulin A nephropathy visited the emergency department owing to dyspnea and general weakness. Three weeks earlier, the patient had been transplanted with deceased-donor kidney with full HLA-A, -B, -DR match, and had been on tacrolimus, prednisolone, and mycophenolate since then. At the time of the visit, laboratory findings revealed hemoglobin of 2.4 g/dL, reticulocyte of 21.7%, total bilirubin of 1.9 mg/dL, direct bilirubin of 0.3 mg/dL, lactate dehydrogenase of 946 U/L, haptoglobin of <10 mg/dL, and severe red cell agglutination on peripheral blood smear, which suggested AIHA. In addition, his SARS-CoV-2 real-time polymerase chain reaction test was positive. During steroid treatment for AIHA, a sudden decrease in urine volume, estimated glomerular filtration rate (from 64.9 to 35.1 mL/min/1.73 m²) and increase of creatinine (from 1.42 to 2.36 mg/dL) indicated renal function deterioration, so steroid was increased to 500 mg. On the third day of renal function deterioration, dialysis was started owing to anuria and fluid retention. On renal biopsy, C4d was absent; however, ATIN with eosinophilic infiltration was observed. On renal ultrasound examination, a severely enlarged kidney with edema was observed. At the same time, the patient had a high fever with increased C-reactive protein and procalcitonin. Graftectomy was performed to prevent secondary infection. The postgraftectomy renal biopsy showed renal parenchymal and hilar inflammatory change, endotheliitis, and lymphocytic infiltration of peripheral nerve fibers. After graftectomy, dialysis was maintained and AIHA had ameliorated.</p><p><strong>Conclusion: </strong>The patient had to have his allografted kidney removed owing to ATIN possibly caused by COVID-19 infection. Acute kidney injury caused by SARS-CoV-2 can be either by direct viral infection or as consequence of immunological response. The exact immunological mechanism of AIHA secondary to COVID-19 infection remains to be elucidated.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788317","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}

{"title":"Chronic Allograft Enteropathy Treated with Vedolizumab: A Case Report.","authors":"Guido Trentadue, Gursah Kats-Ugurlu, Tjasso Blokzijl, Jan Willem Haveman, Klaas Nico Faber, Gerard Dijkstra","doi":"10.1016/j.transproceed.2024.11.021","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.11.021","url":null,"abstract":"<p><strong>Introduction: </strong>The most common cause of late graft loss in intestinal transplantation is chronic allograft enteropathy (CAE). The diagnosis is often delayed because of late symptoms and signs, and the only available treatment is graft enterectomy. We present the first case of CAE successfully treated with a gut-specific integrin blocker.</p><p><strong>Case report: </strong>We present a patient who developed CAE 15 years after transplantation and was treated with vedolizumab, a gut-specific integrin blocker that is used for inflammatory bowel disease, thereby avoiding complete graft resection. We show the clinical, endoscopic, radiological, serological, and histopathological course of CAE beginning with discovery of the first signs of disease until 15 months after the start of vedolizumab treatment.</p><p><strong>Conclusion: </strong>To our knowledge, this case represents the first use of vedolizumab in such a circumstance and provides evidence of its usefulness as a rescue therapy for chronic intestinal rejection to, at least, extend graft survival.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788319","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}

{"title":"Successful Vascular Graft Reconstruction of Short Renal Artery Using Polytetrafluoroethylene (PTFE) in Living Donor Kidney Transplantation-A Case Report and Review of Literature.","authors":"Hany M El Hennawy, Eisa Al Atta, Amal Awadh, Omar Safar, Shaher Al Kawasmeh, Yasser S Mansour, Mohammad F Zaitoun, Abdullah S Al Faifi","doi":"10.1016/j.transproceed.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.transproceed.2024.11.013","url":null,"abstract":"<p><p>Short donor renal artery during nephrectomy poses a technical challenge. We present a main renal artery (RA) reconstruction case in Living-donor kidney transplantation (LDKT) using an extension polytetrafluoroethylene vascular graft(PTFE). A 57-year-old man received LDKT from his son. Postlaparoscopic donor nephrectomy, a PTFE graft was used to reconstruct the short RA. Excellent reperfusion, good renal turgor, and immediate urine production were noted. Serial Doppler assessments on postoperative days 1, 3, and 7 and 180 confirmed good blood flow. The PTFE graft did not cause any additional morbidity or complications related to kidney transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782145","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}