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 immunobiology, emphasizing findings in clinical and experimental VCAs. We also highlight advances in immunotherapy and tolerance protocols with implications for the prevention of VCA rejection, and ultimately, induction of clinically applicable strategies for VCA tolerance. RECENT FINDINGS:There is now an increasing appreciation for the role of skin-specific mechanisms, including lymphoid neogenesis, in VCA rejection. In contrast, expression of the regulatory master-switch FOXP3 was demonstrated to be significantly upregulated in the skin of tolerant VCAs in large animal models compared with normal skin and rejecting controls. SUMMARY:Most VCA transplant centers continue to utilize antibody-mediated induction therapy and triple agent maintenance immunosuppression. Skin remains the primary target of rejection in VCAs, and current multicenter studies hope to elucidate the mechanisms involved. Proposed standardized procedures for skin biopsies, and diligent reporting of clinical data to the international registry, will be important to maximize the strength of these studies.
journal_name
Curr Opin Organ Transplantjournal_title
Current opinion in organ transplantationauthors
Chadha R,Leonard DA,Kurtz JM,Cetrulo CL Jrdoi
10.1097/MOT.0000000000000136subject
Has Abstractpub_date
2014-12-01 00:00:00pages
566-72issue
6eissn
1087-2418issn
1531-7013journal_volume
19pub_type
杂志文章,评审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: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: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
更新日期:2013-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Travel-related diseases may be seen in transplant recipients after travel, after transplant tourism, and via transmission from blood and organ donors, augmented by recent increases in travel, migration, and globalization. Such infections include tuberculosis, Plasmodium (malaria), Babesia, Trypanosoma...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328359266b
更新日期:2012-12-01 00:00:00
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
更新日期:2014-08-01 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: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:PURPOSE OF REVIEW:The review will discuss the current pathological criteria for the diagnosis and classification of antibody-mediated rejection (AMR) in the cardiac allograft. RECENT FINDINGS:Until recently, the diagnosis of AMR required clinical dysfunction, presence of donor specific antibodies and pathological alte...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328353660f
更新日期:2012-06-01 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:Inadequate insulin-producing pancreatic β-cell mass is a key feature of both type 1 and type 2 diabetes. Efforts to regenerate β-cell mass from pancreatic precursors may thus ameliorate absolute or relative insulin deficiency, thereby improving glucose homeostasis. A clear understanding of the process...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章
doi:10.1097/MOT.0b013e328012b281
更新日期:2007-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Maintenance of T-cell function and modulation of tolerance are critical issues in organ transplantation. The thymus is the primary organ for T-cell generation, and a preserved thymic function is essential for a self-tolerant diverse T-cell repertoire. Transplant procedures and related immunosuppressiv...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283615df9
更新日期:2013-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Cellular human antipig immune responses are increasingly recognized as an important barrier to successful clinical xenotransplantation. This review addresses the role of monocytes/macrophages, natural killer (NK) cells, and T cells in xenograft rejection. We focus on the receptor-ligand interactions t...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328336b8e5
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The use of everolimus has recently emerged for solid-organ transplantation in children. This review gives an overview of the relevant studies and clinical trials involving the immunosuppressive effects of everolimus in child organ transplant. RECENT FINDINGS:The use of everolimus in pediatric organ t...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328356b080
更新日期:2012-10-01 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: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:Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients. RECENT FINDINGS:Graft survival continues to improve, and recent multicenter studies show that islet t...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000355
更新日期:2016-10-01 00:00:00
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
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To review the experience to date and unique challenges associated with liver transplantation in hepatitis C virus (HCV)/HIV-coinfected patients. RECENT FINDINGS:The prevalence of cirrhosis and hepatocellular carcinoma is rising among HIV-infected individuals. With careful patient selection and in the...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000199
更新日期:2015-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Xenotransplantation may become clinically feasible once the mechanisms of graft loss and rejection are better understood. Inflammatory reactions to vasculature of grafted pig organs and pancreatic islets have been linked to procoagulant activation and consumption with resulting thrombosis that preclud...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283373ccc
更新日期:2010-04-01 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:Pulmonary antibody-mediated rejection (AMR) while contributing to acute and chronic allograft dysfunction remains a diagnostic and therapeutic challenge. The diagnostic tenets upon which AMR is defined will be reviewed in the light of recent studies. RECENT FINDINGS:The introduction of solid phase as...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000235
更新日期:2015-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The bidirectional exchange of cells, both mature and progenitor types, at the maternal-fetal interface is a common feature of mammalian reproduction. The presence of semiallogeneic cells in a host can have significant immunological effects on transplantation tolerance and rejection. Here, we review re...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283484b57
更新日期:2011-08-01 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: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
更新日期:2020-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Orthotopic liver transplant (OLT) is a major surgical procedure that can be both challenging and lengthy. One of the common findings in end-stage liver disease is renal failure, whether acute or chronic, which may complicate the intraoperative course. RECENT FINDINGS:The use of intraoperative hemodia...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328346c8a2
更新日期:2011-06-01 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:Pediatric kidney transplantation has made great strides over the preceding years. It has become an accepted and successful remedy for thousands of patients worldwide. For best outcomes, it must be viewed and treated as a distinct entity from adult transplantation with focus on the unique challenges pa...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000783
更新日期:2020-08-01 00:00:00
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
更新日期:2021-02-01 00:00:00
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
更新日期:2017-04-01 00:00:00