Abstract:
PURPOSE OF REVIEW:To outline recent studies describing the mechanisms of antibody-mediated rejection (AMR) and new clinical protocols aimed at prevention and/or treatment of this difficult clinical entity. RECENT FINDINGS:The natural history of acute AMR after positive cross-match kidney transplantation involves an acute rise in donor-specific alloantibody (DSA) in the first few weeks after transplantation. Whereas the exact cellular mechanisms responsible for AMR are not known, it seems likely that both pre-existing plasma cells and the conversion of memory B cells to new plasma cells play a role in the increased DSA production. One recent study suggested that combination therapy with plasmapheresis, high-dose IVIG and rituximab was more effective treatment for AMR than high-dose intravenous immunoglobulin (IVIG) alone, but the role of anti-CD20 antibody is still unclear. Two new promising approaches to AMR focus on depletion of plasma cells with the proteasome inhibitor, bortezomib, and the inhibition of terminal complement activation with a humanized, anti-C5 antibody, eculizumab. SUMMARY:The pathogenesis of AMR in several different clinical settings is becoming clearer and more effective treatments are being developed. Whether the prevention or successful treatment of AMR will decrease the prevalence of chronic injury and improved long-term graft survival will require longer-term studies.
journal_name
Curr Opin Organ Transplantjournal_title
Current opinion in organ transplantationauthors
Stegall MD,Gloor JMdoi
10.1097/MOT.0b013e3283342712subject
Has Abstractpub_date
2010-02-01 00:00:00pages
8-10issue
1eissn
1087-2418issn
1531-7013journal_volume
15pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Transplantation of islets of Langerhans is an emerging treatment procedure for patients with severe type 1 diabetes, but despite recent progress the procedure is associated with massive tissue loss caused by an inflammatory reaction termed instant blood-mediated inflammatory reaction (IBMIR). This rea...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32834c2393
更新日期:2011-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The number of sensitized heart transplant candidates is rising. Highly sensitized patients are disadvantaged because they encounter longer waiting times to heart transplant. Strategies to reduce their waiting times include waitlist prioritization and desensitization therapies. The purpose of this revi...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000635
更新日期:2019-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Extensive research in murine transplant models over the past two decades has convincingly demonstrated the ability of regulatory dendritic cells (DCregs) to promote long-term allograft survival. We review important considerations regarding the source of therapeutic DCregs (donor or recipient) and thei...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000097
更新日期:2014-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Frailty is the concept of accumulating physiologic declines that make people less able to deal with stressors, including surgery. Prehabilitation is intervention to enhance functional capacity before surgery. Frailty and prehabilitation among transplant populations and the role of wearable fitness tra...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000295
更新日期:2016-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Bioengineering the lung based on its natural extracellular matrix (ECM) offers novel opportunities to overcome the shortage of donors, to reduce chronic allograft rejections, and to improve the median survival rate of transplanted patients. During the last decade, lung tissue engineering has advanced ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000584
更新日期:2018-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Lungs are extremely susceptible to injury, and despite advances in surgical management and immunosuppression, outcomes for lung transplantation are the worst of any solid organ transplant. The success of lung transplantation is limited by high rates of primary graft dysfunction because of ischemia-rep...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000304
更新日期:2016-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indic...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000451
更新日期:2017-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Manipulating costimulatory signals has been shown to alter T cell responses and prolong graft survival in solid organ transplantation. Our understanding of and ability to target various costimulation pathways continues to evolve. RECENT FINDINGS:Since the approval of belatacept in kidney transplantat...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000656
更新日期:2019-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The role of T-cell exhaustion in the failure of clearance of viral infections and tumors is well established. There are several ongoing trials to reverse T-cell exhaustion for treatment of chronic viral infections and tumors. The mechanisms leading to T-cell exhaustion and its role in transplantation,...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000153
更新日期:2015-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize recent evidence in literature regarding incidence and risk factors for biliary complications in living donor liver transplantation (LDLT), and current concepts in evaluation of donor biliary anatomy and surgical techniques of biliary reconstruction, to reduce the incidence of biliary comp...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000693
更新日期:2019-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Re-transplantation of the lung has come of age. Here, we wish to review the recent literature on the topic and discuss clinical implications. RECENT FINDINGS:Many large volume transplant centres routinely perform lung re-transplantation with satisfactory outcomes. The main indication is bronchiolitis...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328357d8ba
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To deeply investigate one type of intracellular cardiac storage disease, the Fabry disease and one example of extracellular cardiac storage disease, the cardiac amyloidosis, with the aim to collect data about cardiac treatment at the end-stage level and the feasibility of heart transplantation (HTx) i...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000756
更新日期:2020-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The Notch signaling pathway is known to play a pivotal role in T- and B-cell development and fate, presenting it as an attractive therapeutic target in alloimmunity. This review provides an overview of the mechanisms of Notch signaling, focusing on new insights into its diverse functions in T-cell act...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000266
更新日期:2016-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To review the current understanding of the ethical and societal difficulties of penile transplantation. RECENT FINDINGS:Penile transplantation, as with other forms of vascularized composite allotransplantation, has increasing acceptance in society but is still not entirely accepted. Guidelines aiming...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章
doi:10.1097/MOT.0000000000000820
更新日期:2020-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Pancreas transplantation is considered the optimal therapy for patients with insulin-dependent diabetes. Successful pancreas transplantation achieves euglycemia and allows freedom from insulin therapy. Long-term allograft success may be limited by the development of impaired glucose metabolism. The ob...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3282f44a3e
更新日期:2008-02-01 00:00:00
abstract:PURPOSE OF REVIEW:In spite of impressive improvements in short-term outcomes for intestine transplant recipients, late allograft loss continues to plague the field. Attention has mostly been focused on T-cell-mediated cellular mechanisms of allograft rejection to explain these losses; however, as in other forms of soli...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283533847
更新日期:2012-06-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an overview of currently available immunosuppressive strategies and novel therapeutic developments in pancreas transplantation. RECENT FINDINGS:From 1966 through 2012 more than 30 000 pancreas transplantations have been performed around the world with excellent patient and graft survival. ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32835c6eda
更新日期:2013-02-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights current outcomes in intestinal transplantation and summarizes advances that have recently occurred in five interrelated areas: progress in intestinal rehabilitation, immunologic and technical modifications, awareness of opportunities for improved allograft monitoring, and better...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328330680d
更新日期:2009-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review features articles published during 2018 and 2019 regarding pediatric visceral transplantation in Europe. In this biannual review, the authors identify and summarize key articles pertinent to clinical and research areas. RECENT FINDINGS:There is a trend to a lower use of intestinal transpl...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000736
更新日期:2020-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Vascular injury is a complex process that is central to the rejection of solid-organ xenografts in the preclinical pig-to-primate model of xenotransplantation. This review summarizes recent work that provides insights into the mechanisms of vascular injury in GalT KO pig xenografts. RECENT FINDINGS:S...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/mot.0b013e3283279591
更新日期:2009-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review summarizes current data on the induction of immunologic tolerance through mixed hematopoietic chimerism relevant to applying this approach to vascularized composite allotransplantation. RECENT FINDINGS:Clinical allograft tolerance has been achieved recently for kidney transplants, ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000248
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Porcine islet xenotransplantation into humans faces two major hurdles - safety issues related to xenosis and xenorejection of the transplants. The former has been overcome mainly by selection of a suitable disease-free source herd. RECENT FINDINGS:Four strategies have been employed to date to overcom...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283449dec
更新日期:2011-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Macrophages are members of the innate immune response. However, their role in the adaptive immune response is not known. The purpose of this review is to highlight our current understanding of macrophage structure and function and how they may participate in allograft injury. RECENT FINDINGS:Studies ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32834ee5b6
更新日期:2012-02-01 00:00:00
abstract:PURPOSE OF REVIEW:In June 2011 the US Food and Drug Administration approved belatacept (Nulojix; Bristol-Myers Squibb, Princeton, New Jersey, USA) for the prophylaxis of organ rejection in adult kidney transplant recipients. This review will discuss the use of belatacept for the prevention of acute rejection as part of...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32835a4c0d
更新日期:2012-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The immunomodulatory enzyme indoleamine 2,3-dioxygenase (IDO) is activated by interferon-gamma and via tryptophan depletion and the production of proapoptotic downstream metabolites IDO suppresses adaptive T-cell-mediated immunity in inflammation, host immune defence and maternal tolerance. In additio...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3282f3df26
更新日期:2008-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Ischaemic kidney injury occurs during organ procurement and can lead to delayed graft function or nonviable grafts. The innate immune system is a key trigger of inflammation in renal ischaemia. This review discusses the components of innate immunity known to be involved in renal ischaemic reperfusion ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32835e2b0d
更新日期:2013-04-01 00:00:00
abstract:PURPOSE OF REVIEW:With improving survival rates following solid organ transplantation, assessment of its success has broadened with a focus on long-term outcomes, including nongraft-related medical outcomes and family and patient perceptions of quality of life. Posttransplant renal dysfunction contributes to long-term ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32833da439
更新日期:2010-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Organ shortage in transplantation medicine forces surgical research toward the development of more efficient approaches in organ preservation to enable the application of 'less than optimal' grafts. This review summarizes current techniques aiming to recondition cold-stored organ grafts prior to trans...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000402
更新日期:2017-06-01 00:00:00
abstract::World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost-effectiveness. Anything that is both cheaper and better, but ...
journal_title:Current opinion in organ transplantation
pub_type: 社论
doi:10.1097/MOT.0b013e328354c277
更新日期:2012-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Vascularized composite allograft (VCA) transplantation restores function and form following major soft tissue and musculoskeletal injury. Lifelong immunosuppression is necessary for graft function and survival but acute skin-targeted rejection episodes remain common. We review recent advances in skin ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000136
更新日期:2014-12-01 00:00:00