Strategies for safe donor expansion: donor management, donations after cardiac death, ex-vivo lung perfusion.

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 cardiac death (DCD) and the use of ex-vivo lung perfusion (EVLP) to assess and improve injured donor lungs. RECENT FINDINGS:DCD lung transplants now account for about 20% of lung transplants in many centres and outcomes after transplantation have been excellent with this source of donation. Clinical experience using EVLP has shown the method to be well tolerated and allow for reassessment and improvement in function from high-risk donor lungs. When these lungs were transplanted, low rates of primary graft dysfunction were achieved and long-term survival was comparable with standard transplantation. Preclinical studies have shown a great potential of EVLP as a platform for the delivery of novel therapies to repair injured donor lungs. SUMMARY:A significant increase on the number of available lungs for transplantation is expected in the coming years with the wider use of DCD lungs and with organ-specific ex-vivo treatment strategies.

authors

Cypel M,Keshavjee S

doi

10.1097/MOT.0b013e328365191b

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

513-7

issue

5

eissn

1087-2418

issn

1531-7013

journal_volume

18

pub_type

杂志文章,评审
  • Prehabilitation in our most frail surgical patients: are wearable fitness devices the next frontier?

    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

    authors: Rumer KK,Saraswathula A,Melcher ML

    更新日期:2016-04-01 00:00:00

  • Lung transplantation for cystic fibrosis.

    abstract:PURPOSE OF REVIEW:There have been several recent articles which have attempted to refine the appropriate timing of listing for lung transplantation and the identification of factors which increase the risk with particular emphasis on pretransplant microbiology in patients with cystic fibrosis. Moreover, there are sever...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e32830fe6b8

    authors: Corris PA

    更新日期:2008-10-01 00:00:00

  • Risk stratification and management of QuantiFERON-positive solid-organ living donors.

    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

    authors: Gibb J,Wong D

    更新日期:2020-08-01 00:00:00

  • Kidney transplantation across HLA and ABO antibody barriers.

    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 a...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e3283636c20

    authors: Becker LE,Süsal C,Morath C

    更新日期:2013-08-01 00:00:00

  • Memory T cells and their exhaustive differentiation in allograft tolerance and rejection.

    abstract:PURPOSE OF REVIEW:Memory T cells have emerged as a major threat to transplant survival; they are well equipped and well positioned to respond to antigens in an accelerated fashion. They participate in transplant rejection and resist interventions that usually contain naïve T cells. Thus, the means to prevent memory T c...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e32834ee443

    authors: Valujskikh A,Li XC

    更新日期:2012-02-01 00:00:00

  • Liver xenotransplantation.

    abstract:PURPOSE OF REVIEW:There continues to be an inadequate organ supply and lack of effective temporary support, for patients with liver failure. The purpose of this review is to discuss recent progress in the field of orthotopic pig-to-nonhuman primate (NHP) liver xenotransplantation (LXT). RECENT FINDINGS:From 1968 to 20...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000459

    authors: Patel MS,Louras N,Vagefi PA

    更新日期:2017-12-01 00:00:00

  • Pathology of C4d-negative antibody-mediated rejection in renal allografts.

    abstract:PURPOSE OF REVIEW:To summarize current evidence supporting the existence of C4d-negative antibody-mediated rejection (AMR) in renal allografts, its potential to cause chronic graft injury, and whether histopathologic features of C4d-negative AMR differ from those of C4d-positive AMR. RECENT FINDINGS:Recently published...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e32835d4daf

    authors: Haas M

    更新日期:2013-06-01 00:00:00

  • Notch and its ligands in alloimmunity and rejection.

    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

    authors: Magee CN,Riella LV

    更新日期:2016-02-01 00:00:00

  • Evaluation and selection of the liver transplant candidate: updates on a dynamic and evolving process.

    abstract:PURPOSE OF REVIEW:Although conceptually unchanged, the evaluation and selection of the liver transplant candidate has seen significant recent advances. Expanding criteria for transplant candidacy, improved diagnostics for risk stratification and advances in prognostic models have paralleled recent changes in allocation...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章

    doi:10.1097/MOT.0000000000000829

    authors: Kriss M,Biggins SW

    更新日期:2021-02-01 00:00:00

  • Generating a self-organizing kidney from pluripotent cells.

    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

    authors: Little MH,Takasato M

    更新日期:2015-04-01 00:00:00

  • Mechanisms of lung ischemia-reperfusion injury.

    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

    authors: Laubach VE,Sharma AK

    更新日期:2016-06-01 00:00:00

  • Mesenchymal stromal (stem) cells to improve solid organ transplant outcome: lessons from the initial clinical trials.

    abstract:PURPOSE OF REVIEW:Discuss the recent progress on the clinical use of mesenchymal stromal (stem) cells (MSC) in solid organ transplantation (SOT). RECENT FINDINGS:Tissue repair and immunomodulatory properties have been recognized for MSC obtained from different human tissues. MSC-based therapy has been proposed to redu...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000029

    authors: Pileggi A,Xu X,Tan J,Ricordi C

    更新日期:2013-12-01 00:00:00

  • Does the Canadian allocation system for highly sensitized patients work?

    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

    authors: Aleksova N,Ross HJ

    更新日期:2019-06-01 00:00:00

  • Recent trials in immunosuppression and their consequences for current therapy.

    abstract:PURPOSE OF REVIEW:Although the scarcity of clinical trials with de-novo immunosuppression has been typical over the last 2 years, several attempts have been made in drug conversion, dosing optimization, and bioequivalence. On the basis of recent clinical and animal studies, future directions of management and treatment...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000093

    authors: Wohlfahrtova M,Viklicky O

    更新日期:2014-08-01 00:00:00

  • Antibody-mediated rejection after intestinal transplantation.

    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

    authors: Dick AA,Horslen S

    更新日期:2012-06-01 00:00:00

  • Prevention and treatment of coronary artery vasculopathy.

    abstract:PURPOSE OF REVIEW:Cardiac allograft vasculopathy (CAV) is still one of the major causes of death following heart transplantation. Here, we review the recent advances in its prevention and treatment. RECENT FINDINGS:Preventive measures comprise control of classical risk factors, prophylaxis against cytomegalovirus, avo...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e3283577fd9

    authors: Crespo-Leiro MG,Marzoa-Rivas R,Barge-Caballero E,Paniagua-Martín MJ

    更新日期:2012-10-01 00:00:00

  • Pulmonary hypertension in liver transplant.

    abstract:PURPOSE OF REVIEW:Pulmonary hypertension patients provide challenging issues to anesthesiology. The condition is more so when it is associated with liver transplant surgery. This situation is especially true when associated with portopulmonary hypertension (POPH), a subdivision of pulmonary hypertension. Understanding ...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e328346e138

    authors: Ayoub T

    更新日期:2011-06-01 00:00:00

  • Renal dysfunction in the perioperative liver transplant period.

    abstract:PURPOSE OF REVIEW:Acute kidney failure in the perioperative liver transplant recipients results in an increased hospital length of stay, acute rejection, infection rate and overall mortality. Thus, it is of great importance to be able to recognize, prevent and treat kidney injury. RECENT FINDINGS:Immediate post liver ...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e328300a058

    authors: Biancofiore G,Davis CL

    更新日期:2008-06-01 00:00:00

  • Heart transplantation in cardiac storage diseases: data on Fabry disease and cardiac amyloidosis.

    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

    authors: Di Nora C,Livi U

    更新日期:2020-06-01 00:00:00

  • Considerations and experience driving expansion of combined heart-liver transplantation.

    abstract:PURPOSE OF REVIEW:Heart transplantation concomitant with a liver transplant may be warranted when end-stage heart failure results in irreversible liver failure. Previously reported outcomes have been excellent yet the specific immunoprotective role of the liver allograft is not known. We review the current literature a...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章

    doi:10.1097/MOT.0000000000000804

    authors: Gong T,Hall S

    更新日期:2020-10-01 00:00:00

  • Are geographic differences in transplantation inherently wrong?

    abstract:PURPOSE OF REVIEW:Geographic variation in liver transplantation has been the subject of extensive scrutiny, reflecting concerns that location is unfairly determinative for people needing organ transplantation. Drawing upon a number of established ethical approaches, we examine whether geographic differences in access t...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000400

    authors: Ladin K,Hanto DW

    更新日期:2017-04-01 00:00:00

  • An updated Banff schema for diagnosis of antibody-mediated rejection in renal allografts.

    abstract:PURPOSE OF REVIEW:To introduce the updated Banff schema for antibody-mediated renal allograft rejection and related revisions to definitions within this schema agreed upon during and immediately subsequent to the 2013 Banff Conference on Allograft Pathology. RECENT FINDINGS:The original Banff schema for diagnosis of a...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000072

    authors: Haas M

    更新日期:2014-06-01 00:00:00

  • Children as living organ donors: current views and practice in the United States.

    abstract:PURPOSE OF REVIEW:To summarize recent practices and views regarding children as living organ donors in the USA. RECENT FINDINGS:Living donors have become an increasingly important source of organs for transplantation. Concern for the rights of donors has resulted in reconsideration of the use of minors as living organ...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0b013e328337352a

    authors: Olbrisch ME,Levenson JL,Newman JD

    更新日期:2010-04-01 00:00:00

  • Current outcomes after pediatric and adult intestinal transplantation.

    abstract:PURPOSE OF REVIEW:In this article, we will review the outcomes of patients with intestinal transplant (ITx) with a focus on factors affecting long-term graft and patient survival. RECENT FINDINGS:The most recent International Intestinal Transplant Registry reports a 1-, 5-, and 10-year graft survival of 71%, 50%, and ...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000608

    authors: Amin A,Farmer DG

    更新日期:2019-04-01 00:00:00

  • The lectin pathway and its implications in coagulation, infections and auto-immunity.

    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

    authors: Degn SE,Jensenius JC,Bjerre M

    更新日期:2011-02-01 00:00:00

  • Lung re-transplantation: review.

    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

    authors: Warnecke G,Haverich A

    更新日期:2012-10-01 00:00:00

  • The vascular and coagulation issues in xenotransplantation.

    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

    authors: Cowan PJ,Roussel JC,d'Apice AJ

    更新日期:2009-04-01 00:00:00

  • Pluripotent stem cell applications for regenerative medicine.

    abstract:PURPOSE OF REVIEW:In this review, we summarize the current status of clinical trials using therapeutic cells produced from human embryonic stem cells (hESCs) and human induced pluripotent stem cells (hiPSCs). We also discuss combined cell and gene therapy via correction of defined mutations in human pluripotent stem ce...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000244

    authors: Angelos MG,Kaufman DS

    更新日期:2015-12-01 00:00:00

  • Mechanical circulatory support challenges in pediatric and (adult) congenital heart disease.

    abstract:PURPOSE OF REVIEW:Increased miniaturization of ventricular assist devices (VADs) and new mechanical support strategies (MCS) has increased the use of MCS in the pediatric and congenital heart disease (CHD) population. This comes with the need for care providers specialized in this field to determine optimal patient and...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000522

    authors: Schweiger M,Lorts A,Conway J

    更新日期:2018-06-01 00:00:00

  • What will it take before a bioengineered heart will be implanted in patients?

    abstract:PURPOSE OF REVIEW:Heart transplantation is the only curative treatment option for end-stage heart failure. However, a shortage of donor organs is a major limitation of this approach. Regenerative medicine targets the goal of increasing the number of available hearts for transplantation. In this review, we highlight the...

    journal_title:Current opinion in organ transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/MOT.0000000000000583

    authors: Taylor DA,Elgalad A,Sampaio LC

    更新日期:2018-12-01 00:00:00