Transplant
Chapters
« previous | page 2 of 3 pages | next »Liver Transplantation—An Overview
Tiffany E. Kaiser, E. Steve Woodle and Guy W. Neff
Liver transplantation has offered thousands of patients a new lease on life. The improvements in survivals are attributed to the various treatment modalities before and after liver transplantation. Certain diseases such as chronic Hepatitis C virus (HCV) infection is an epidemic that is currently th...
Metabolic Indicators of Islet Graft Dysfunction
Raquel N. Faradji, Kathy Monroy, Misha Denham, Camillo Ricordi and Rodolfo Alejandro
Assessing b‑cell mass and function is of great importance in the islet transplant setting but it has been challenging. Although achieving insulin independence has been one of the most important end points of islet transplantation (IT), it is critical that it is associated with good glycemic co...
Metabolic Management
Sufan Chien
The removal of an organ, which is subjected to an unnatural environment necessitates special management strategies that differ from in vivo management. The normal human body and the bodies of other mammalian animals involve complex neurologic and hormonal regulatory systems. Adequate substrates and ...
Pancreas and Islet Allograft Failure
Patrick G. Dean, Yogish Kudva and Mark D. Stegall
The treatment of diabetes mellitus is aimed at improving glycemic control. Establishing relatively tight control using exogenous insulin has been shown to reduce the ophthal‑mologic, neurologic and renal complications of diabetes mellitus. However, achieving a glycosylated hemoglobin (Hgb A1C)...
Pathological Aspects of Pancreas Allograft Failure
Cinthia B. Drachenberg and John C. Papadimitriou
Pancreas allograft failure results from a variety of causes, highly dependent on the time posttransplantation. In the early posttransplantation period pancreas allograft failure is usually related to “technical failures”, including thrombosis, infection, pancreatitis, anastomotic leak and bleeding. ...
Pathology of Kidney Allograft Dysfunction
Bela Ivanyi
The pathologic features, clinical correlations and differential diagnoses of the major causes of kidney allograft dysfunction are reviewed. Rejection is an inflammatory process of the recipient during which donor cells bearing alloantigens are destroyed; the rejection process is classified tradition...
Perfusion and Storage Techniques
Amer Rajab, Ronald P Pelletier and Mitchell L Henry
The clinical practice of living‑related renal transplantation became firmly established by the late 1960s to early 1970s. However, it quickly became apparent that the need for transplantable kidneys far exceeded the availability. Subsequent legislation made it possible for people meeting the c...
Perspectives on Chronic Rejection after Hand Transplantation
Vijay S. Gorantla, Carolyn D. Burns and Warren C. Breidenbach
World experience has shown us that acute rejection after hand transplantation is immunologically similar to that in solid organ transplants. The risks of chronic rejection are real after hand transplantation; yet this condition continues to be a poorly defined entity. As in solid organs, there...
Pharmacotherapeutic Options in Solid Organ Transplantation
Jennifer Trofe, Anikphe Imoagene-Oyedeji and Roy D. Bloom
Over the past decade, advances in immunosuppressive therapies have resulted in lower rates of acute rejection and consequently, significant improvements in patient and graft survival after solid organ transplantation. Increasingly successful outcomes have focused attention on the complications of lo...
Polyomavirus Allograft Nephropathy: Clinico‑Pathological Correlations
Volker Nickeleit and Harsharan K. Singh
Polyomavirus nephropathy (PVN) is primarily caused by a productive intra‑renal BK virus infection. It is often an iatrogenic complication due to long term over immunosuppression and frequently leads to chronic kidney dysfunction and failure. Post renal transplantation, PVN has emerged as a maj...
Polyomavirus Type BK‑Associated Nephropathy and Renal Allograft Graft Loss: Natural History, Patho‑Physiology, Diagnosis and Management
Nasimul Ahsan
In recent years, polyomavirus type BK‑associated nephropathy (PVAN) has emerged as an important cause of renal allograft dysfunction and graft loss. It is estimated to affect up to 10% of renal transplant recipients, with allograft failure rate as high as 80%. After primary infection in immuno...
Predictive Parameters of Graft Failure
Paola Romagnani
The incidence of end stage renal disease (ESRD) is increasing at a faster rate than the availability of kidney donors, but unfortunately the improvement in short‑term graft survival rates has not been followed by substantial amelioration in long‑term outcome. Almost half of cadaveric all...
Psychological Considerations in Hand Transplantation
Martin M. Klapheke
Psychiatric consultation can play an important role in the assessment of candidates for solid organ transplantation.1 It can be even more critical in the assessment and manage- ment of patients who are candidates for composite tissue allotransplantation (CTA) in general, and specifically hand t...
Rationale for Hand Transplantation
Justin M. Sacks and W.P. Andrew Lee
Hand transplantation is a clinical reality that offers immense reconstructive potential. Benefits of human hand allografts based on reviews of replantation literature are fa- vorable for significant functional return. The role of immunosuppression in allograft survival is revealed in its relation...
Recurrent Glomerular Disease in the Allograft: Risk Factors and Management
Hani M. Wadei, Xochiquetzal J. Geiger and Martin L. Mai
In contrast to the major improvement in immunologically mediated allograft loss, little advances have been made in the area of recurrent glomerular disease which currently stands as the third leading cause of renal allograft loss. This chapter will focus on the current status of recurrent glomerular...
Renal Allograft Survival: Epidemiologic Considerations
Titte R. Srinivas and Herwig-Ulf Meier-Kriesche
Kidney transplantation is the treatment of choice for patients with end‑stage renal disease. From initial pioneering experiences 50 years ago, kidney transplantation has become a clinical reality with over a 100,000 patients living with a functioning kidney transplant at the end of 2004 in the...
Science of Organ Preservation
Roberto Anaya-Prado, Luis H. Toledo-Pereyra and Juan M. Palma-Vargas
The goal of organ preservation is to obtain perfect preservation for as long as needed. Unfortunately, this has not been accomplished for the majority of organs; although the use of different techniques and solutions for preservation has modified and improved the results observed both clinically and...
Solid Organ Transplantation—An Overview
Roy D. Bloom, Lee R. Goldberg, Andrew Y. Wang, Thomas W. Faust and Robert M. Kotloff
Human solid organ transplantation became a reality in 1954 with the performance of the first successful kidney transplant by Dr. Joseph Murray and colleagues. The ensuing 15‑20 years witnessed an expansion of the clinical science to encompass transplantation of heart, liver, pancreas and lung ...
T-Cell Depletion Strategies for Tolerance Induction: Potential Application in Composite Tissue Transplantation
Erik Schadde and Stuart J. Knechtle
The clinical experience with immunosuppression in composite tissue allografts (CTA) is still small compared with the experience in solid organ transplantation. By 1998 and 2005, 24 hands have been transplanted into 18 recipients.1 The documented experience with immunosuppression in CTA other t...
The Basic Science of Lung Allograft Failure
Trudie Goers, Ryan Fields and Thalachallour Mohanakumar
Although great strides have been made in the field of lung transplantation with respect to surgical technique, treatment of acute rejection and post‑operative management, the long term success of lung transplantation is limited by the development of chronic rejection as manifest by the bronchi...
The Evolution and History of Hand Transplantation and Current Status of Composite Tissue Allotransplantation
Chad R. Gordon and Charles W. Hewitt
Composite tissue allotransplantation (CTA) involves “transplanting a graft, composed of a variety of heterogeneous antigenic tissues, across a genetic mismatch,” as in the case of a hand (i.e., skin, muscle, bone, tendon, nerve, vessels). This challenge presents multiple barriers and complexit...
The Graft: Emerging Viruses in Transplantation
Deepali Kumar and Atul Humar
Emerging infections have become increasingly recognized as causes of morbidity, mortality, graft dysfunction, graft failure and donor‑transmitted infections. Specifically, a number of emerging viral pathogens have had significant adverse effects in transplant patients. These viruses may occur ...
The Immunology of Chronic Allograft Injury
Raphael Thuillier and Roslyn B. Mannon
The causes of chronic graft injury are diverse and are dependant on the recipient, donor organ and immunosuppressive strategy. In this chapter, we explore the contribution of the immune system to this problem, recognizing that nonimmune factors have been shown to contribute to chronic injury as well...
The Pathology of Heart Allograft Rejection
Jon Carthy, Heather Heine, Alice Mui and Bruce McManus
In 1905, the innovative French surgeon Alexis Carrel performed the first heterotopic canine heart transplant with Charles Guthrie. Twenty years later, the concept of cardiac allograft rejection was proposed by Frank Mann at the Mayo Clinic to explain the eventual failure of heterotopic canine allogr...
The Role for Cytokine Responses in the Pathogenesis of Lung Allograft Dysfunction
John A. Belperio, Brigette Gomperts, Samuel Weigt and Michael P. Keane
Lung transplantation is now considered to be a therapeutic option for patients with end‑stage pulmonary disorders. However, due to problems of allograft dysfunction, 5 year survival rates are only 42%, as compared to greater than 70% for other solid organ transplantations. There are three dist...
« previous | page 2 of 3 pages | next »
