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With liver donors in short supply, cell transplants offer new options
Called hepatocyte transplantation, the technique replaces approximately 10 percent of the liver with healthy cells from a deceased donor. The patient's organ is not removed, decreasing recovery time, complications and cost. With fewer than 150 U.S. recipients so far, the approach is in its early days.
Get the member rate for ATC!
Have you paid your ASTS dues? To receive the member rate for ATC, you must be a member in good standing by April 1. Allowing your membership to lapse also impacts your AJT subscription; delivery to those who have not yet paid membership dues will stop as of March.
CMS QAPI webinar series for 2015
ASTS, AST, and representatives from the CMS Survey and Certification Group are pleased to announce a series of webinars on various Quality Assessment and Performance Improvement (QAPI) topics throughout 2015.
New policies added to policy library
New policies have been added to the ASTS Transplant Center Policy Library! The library is available for purchase as an annual subscription service.
Impact of antibiotic resistance on the development of recurrent and relapsing symptomatic urinary tract infection in kidney recipients
American Journal of Transplantation (login required)
We sought to determine the frequency, risk factors and clinical impact of recurrent urinary tract infections (UTI) in kidney transplant recipients. Of 867 patients who received a kidney transplant between 2003 and 2010, 174 (20 percent) presented at least one episode of UTI. Fifty-five patients presented a recurrent UTI (32 percent) and 78 percent of them could be also considered relapsing episodes. Recurrent UTI was caused by extended-spectrum betalactamase (ESBL)–producing Klebsiella pneumoniae (31 percent), followed by non-ESBL producing Escherichia coli (15 percent), multidrug-resistant (MDR) Pseudomonas aeruginosa (14 percent) and ESBL-producing E. coli (13 percent).
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Low sodium levels increase liver transplant survival benefit
Science World Report
Low sodium levels in the blood, otherwise known as hyponatremia, can increase the risk of dying for patients on a liver transplant waiting list. Recent findings published in Liver Transplantation show that survival chances are increased when patients with hyponatremia and a Model for End Stage Liver Disease (MELD) score of 12 or more.
Protein kinase C inhibitor sotrastaurin in de novo liver transplant recipients: A randomized phase II trial
American Journal of Transplantation (login required)
Efficacy and safety of protein kinase C inhibitor sotrastaurin (STN) with tacrolimus (TAC) was assessed in a 24-month, multicenter, phase II study in de novo liver transplant recipients. A total of 204 patients were randomized (1:1:1:1) to STN 200 mg b.i.d. + standard-exposure TAC (n = 50) or reduced-exposure TAC (n = 52), STN 300 mg b.i.d. + reduced-exposure TAC (n = 50), or mycophenolate mofetil (MMF) 1 g b.i.d. + standard-exposure TAC (control, n = 52); all with steroids. Owing to premature study termination, treatment comparisons were only conducted for month 6.
Older donor age, nonlocal distribution potentially increase HCC recurrence after liver transplant
Liver transplant recipients were at increased risk for hepatocellular carcinoma recurrence if they received a liver from a donor aged at least 60 years or from a nonlocal share distribution, according to study data. Overall, 324 transplant recipients experienced recurrence posttransplant. In donors aged at least 60 years, incidence for HCC recurrence within four years posttransplant was greater compared with recipients younger than 60 years.
Is the organ transplant cup half-full or half-empty?
By Alan Kelsky
JAMA Surgery recently released an original investigation called "Survival Benefit of Solid-Organ Transplant in The United States." The results are quite amazing, showing that organ transplants have contributed to more than 2 million years of life saved across 25 years. The evidence is clear that transplanting organs adds years of life, and that recipients can enjoy, for the most part, a good quality of life. But more organs are needed to meet increasing demand for transplants that proved themselves viable and new ones being worked on in laboratories.
Building the case for enhanced recovery protocols in living kidney donors
Transplantation (login required)
Enhanced recovery protocols align with the current advantages of laparoscopic donor nephrectomy and may continue to decrease disincentives to donation. In this single-center retrospective analysis, we compare the outcomes of the first 60 living kidney donors enrolled in our enhanced recovery program (ERP) to those patients treated before implementation of the protocol. In addition to improved coordination of care, highlights of the ERP bundle included the use of transversus abdominus plane block, preoperative carbohydrate loading and narcotic free pain regimens. Chi-square and Student t test were used where appropriate.
ROTEM more sensitive for fragile liver transplant patients
Although thromboelastography (TEG) and rotational thromboelastometry (ROTEM) both are accepted means for measuring coagulation parameters, the two have rarely been compared in liver transplantation surgery. A recent study has concluded that although the two modalities provide comparable results, ROTEM corresponded better with partial thromboplastin time (PTT) and was more sensitive in identifying fibrinolysis.
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