Abstract:
PURPOSE OF REVIEW:A significant number of kidney transplantations in industrialized countries is currently performed over human leukocyte antigen (HLA) or ABO antibody barriers after living donation to encounter the increasing shortage of organs from deceased donors. Although patients with moderate titers of anti-A/B antibodies may easily be desensitized with no negative impact on allograft survival, recipients with high titers and HLA sensitized patients demonstrate a substantial risk for antibody-mediated rejection, limiting long-term outcomes. RECENT FINDINGS:The use of powerful desensitization strategies including plasmapheresis and immunoadsorption, extended therapeutic options such as the application of the recently introduced complement inhibitors, and refined antibody detection techniques may further facilitate transplantations, especially in the HLA-sensitized kidney transplant recipient. On the contrary, special strategies such as the Eurotransplant Acceptable Mismatch Program or kidney paired exchange help improving long-term outcomes in these difficult to transplant patients by circumventing the HLA (or ABO) antibody barrier. SUMMARY:As compared with waiting for a compatible deceased donor organ, HLA and ABO incompatible transplantations performed in experienced centers have become a reasonable alternative for end-stage kidney disease patients with an incompatible live donor. Whenever possible, however, the transplantation should be performed between ABO compatible donor-recipient pairs in the absence of positive crossmatch results.
journal_name
Curr Opin Organ Transplantjournal_title
Current opinion in organ transplantationauthors
Becker LE,Süsal C,Morath Cdoi
10.1097/MOT.0b013e3283636c20subject
Has Abstractpub_date
2013-08-01 00:00:00pages
445-54issue
4eissn
1087-2418issn
1531-7013pii
00075200-201308000-00011journal_volume
18pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:The trend to extubate patients as soon as possible following large and complex surgery is supported by a large body of evidence showing early extubation is safe and saves money. However, the use of early extubation in liver transplant recipients is still debated. This review will explore the reasons w...
journal_title:Current opinion in organ transplantation
pub_type: 历史文章,杂志文章,评审
doi:10.1097/MOT.0b013e32832b2f6c
更新日期:2009-06-01 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:In the current graft shortage, it is paramount to improve the quality of transplanted organs. Organ preservation represents an underused therapeutic window with great potential to reduce ischaemia-reperfusion injury (IRI) and improve graft quality. Herein, we review strategies using this window as wel...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283446b1d
更新日期:2011-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This review emphasizes new information concerning the role of anaphylatoxins in the regulation of the immune response to allografts. Its timeliness relates the growing concept of the innate immune response as a regulator of the adaptive immune system and to how this concept lends itself to therapeutic...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32831ec551
更新日期:2009-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Fulminant hepatic failure (FHF) is one of the more dramatic and challenging syndromes in clinical medicine. Time constraints and the scarcity of organs complicate the evaluation process in the case of patients presenting with FHF, raising ethical questions related to fairness and justice. The challeng...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000060
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we discuss the current state of donation after circulatory death (DCD). We define the DCD donor and describe the current protocols in management of the DCD patient. We then discuss current techniques in organ procurement of the lung and abdominal organs. RECENT FINDINGS:Although donat...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000179
更新日期:2015-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Donor-derived disease with Mycobacterium tuberculosis (MTB) is likely to become more common as donor pools expand due to increasing transplant volume coupled with patterns of migration and global mobility. Our article reviews the current literature and provides a rational approach for clinicians manag...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000787
更新日期:2020-08-01 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:Over the past decade intestine transplantation has been accepted as standard therapy for patients with life-threatening complications of parenteral nutrition. For patients without life-threatening complications, continued therapy with parenteral nutrition has been standard despite seemingly similar pa...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283398565
更新日期:2010-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This article summarizes the complex interplay between the microbiota and host immune responses, and its impact on intestinal transplantation and allograft rejection. RECENT FINDINGS:Recent findings highlight the importance of Paneth cells as crucial producers of antimicrobial peptides that control th...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000278
更新日期:2016-04-01 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:Xenotransplantation of tissues from swine into humans poses the threat of bidirectional transfer of porcine or human microorganisms to the recipient or to the xenograft, respectively. This review focuses on recipient-derived infection. Recent data are reviewed that assess the susceptibility of porcine...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328336b8f9
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Several expanded criteria for liver transplantation for hepatocellular carcinoma (HCC) have been suggested out of concern that the Milan criteria may be too strict, and thereby exclude patients who could benefit from this surgical procedure. However, most expanded criteria were designed for deceased d...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000294
更新日期:2016-04-01 00:00:00
abstract:PURPOSE OF REVIEW:To give a comprehensive overview of the recently published studies on the role of the lectin pathway in coagulation, infections and auto-immunity. RECENT FINDINGS:We present the status quo picture of the lectin pathway, including the newly discovered member, MAp44 (a.k.a. MAP-1), which may act as a s...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32834253df
更新日期:2011-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Recipients of pancreas transplantation bear the burden of chronic complications of diabetes, both microvascular and macrovascular. Pancreas transplantation provides the most effective method of glycemic and metabolic control. As transplantation provides immediate relief from acute complications of dia...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000045
更新日期:2014-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Immune monitoring is needed in small bowel transplantation (SBTx) because of a high incidence of rejection and graft loss, and life-threatening complications of high-dose prophylactic immunosuppression. RECENT FINDINGS:Clinical tests relevant to SBTx include methods to detect antidonor human leukocyt...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328339489c
更新日期:2010-06-01 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:The first generation of implantable pulsatile ventricular assist devices (VADs) has proven to be successful as bridge to transplantation. Adverse events such as mechanical failure and infections, however, limit their use for long-term support (>1 year) or as alternative for heart transplantation. Newe...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283303750
更新日期:2009-10-01 00:00:00
abstract:PURPOSE OF REVIEW:High infectious risk donors (HRDs) fall into a behavioral category thought to increase risk of infectious transmission through transplantation; despite controversy surrounding their use, they comprise almost 9% of donors in which at least one organ is recovered. This review seeks to describe national ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283449dd3
更新日期:2011-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this article is to review recent reports on whole pancreas and islet cell transplantation. It focuses on 'what the call to the future looks like' for both therapies as treatment options for those type 1 diabetes patients who do not respond well to conventional therapy. RECENT FINDINGS:The ...
journal_title:Current opinion in organ transplantation
pub_type: 历史文章,杂志文章,评审
doi:10.1097/MOT.0b013e32833553f8
更新日期:2010-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The number of patients listed for lung transplantation largely exceeds the number of available transplantable organs because of both a shortage of organ donors and a low utilization rate of lungs from those donors. Two major innovations in recent years include the use of lungs from donations after car...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328365191b
更新日期:2013-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To define the natural history of kidney allograft loss related to recurrent diabetes following transplant, and to understand the potential benefit of pancreas transplantation upon kidney allograft survival. RECENT FINDINGS:A postulated benefit of simultaneous pancreas kidney transplant is that, unlik...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000547
更新日期:2018-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Because the gap between liver organ supply and demand continues to increase, adult living-donor liver transplantation continues to represent a significant pool of organs. RECENT FINDINGS:With this in mind, we discuss recent issues in adult living-donor liver transplantation, including issues with don...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328300a352
更新日期:2008-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Adoptive cell therapy using CD4FOXP3 regulatory T cells (Treg) has emerged as a promising therapeutic strategy to treat autoimmunity and alloimmunity. Preclinical studies suggest that the efficacy of Treg therapy can be improved by modifying the antigen specificity, stability and function of therapeut...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000566
更新日期:2018-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Recent studies on the directed differentiation of human pluripotent stem cells report tissue self-organization in vitro such that multiple component cell types arise in concert and arrange with respect to each, thereby recapitulating the morphogenetic events typical for that organ. Such self-organizat...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000174
更新日期:2015-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Organ shortage remains a major obstacle for liver transplantation, resulting in an increased mortality on the liver transplant waiting list. The usage of extended criteria donors (ECD) is a strategy to increase the number of available donor organs, however, with the risk of a higher rate of posttransp...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000471
更新日期:2017-12-01 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
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: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: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