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Text Version  RSS  Subscribe  Unsubscribe  Archive  Media Kit December 26, 2014
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As 2014 comes to a close, AST would like to wish its members, partners and other transplant professionals a safe and happy holiday season. As we reflect on the past year for the field, we would like to provide the readers of the AST eNews a look at the most accessed articles from the year. Our regular publication will resume Jan. 9.




Early corticosteroid avoidance in kidney transplant recipients receiving ATG-F induction: 5-year actual results of a prospective and randomized study
American Journal of Transplantation
From Nov. 7, 2014: One hundred ninety-seven patients received anti-T-lymphocyte globulins Fresenius, mycophenolate mofetil and delayed cyclosporine, and were randomized to ≥6-month corticosteroids (+CS; n = 99) or no CS (−CS; n = 98). One- and five-year actual graft survival (censored for death) was 93.2 percent and 86.4 percent in the +CS group versus 94.9 percent and 89.8 percent in the −CS group (5-year follow-up, p = 0.487). Freedom from clinical rejection was 86.9 percent and 81.8 percent versus 74.5 percent and 74.5 percent (p = 0.144), respectively, at 1 and 5 years; 5-year freedom from biopsy-proven rejection was 88.9 percent versus 83.7 percent (p = 0.227).
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Effect of dialysis initiation for preemptively listed candidates in the revised kidney allocation policy
American Journal of Transplantation
From Oct. 24, 2014: The new allocation policy for deceased donor kidneys in the United States is expected to begin in late 2014. As part of this policy, prioritization to the highest quality deceased donor kidneys is dependent on candidate's estimated posttransplant survival (EPTS) score. In particular, candidates with low (≤ 20 percent) EPTS (indicating better estimated survival) will have greater access to donor offers. This study evaluated the effect of dialysis initiation on preemptively listed candidates' EPTS score.
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PRODUCT SHOWCASE
 
You care about your transplant patients. And so do we. That’s why we’re introducing Astellas Cares—a new program that offers you customized tools, educational resources, and comprehensive support to help your patients care for their health. To register, visit AstellasCares.com/Transplant today.
 


A complete treatment of adult living donor liver transplantation: A review of surgical technique and current challenges to expand indication of patients
American Journal of Transplantation
From Nov. 14, 2014: The growing disparity between the number of liver transplant candidates and the supply of deceased donor organs has motivated the development of living donor liver transplantation (LDLT). Over the last two decades, the operation has been markedly improved by innovations rendering modern results comparable with those of deceased donor liver transplantation (DDLT). However, there remains room for further innovation, particularly in adult living donor liver transplantation (ALDLT).
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Frailty predicts waitlist mortality in liver transplant candidates
American Journal of Transplantation
From June 20, 2014: Researchers aimed to determine whether frailty, a validated geriatric construct of increased vulnerability to physiologic stressors, predicts mortality in liver transplant candidates. Consecutive adult outpatients listed for liver transplant with laboratory Model for End-Stage Liver Disease (MELD) at a single center (97 percent recruitment rate) underwent four frailty assessments: Fried Frailty, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL) and Instrumental ADL (IADL) scales.
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OPTN/UNOS guidance regarding Ebola
AST
From Oct. 17, 2014: The OPTN/UNOS Ad Hoc Disease Transmission Advisory Committee (DTAC), after careful review of information available from the Centers for Disease Control (CDC), is offering information to transplant centers and OPOs in light of the first case of Ebola virus disease (EVD) identified in the United States. While the risk of a person with previously undiagnosed EVD becoming an organ donor is thought to be extraordinarily low, the risk of transmitting the disease through transplantation is unstudied. Therefore, it is important for the transplant community to be aware of risk factors for this disease.
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PRODUCT SHOWCASE
  UCLA Immunogenetics Center

The UCLA Immunogenetics Center (UIC) provides comprehensive testing for organ and tissue transplantation. Transplant testing has a long history at UCLA. HLA typing was pioneered here in the 1960's. The development of the microcytoxicity test in 1964 marked the beginning of international testing and standardization of HLA typing. The UCLA Immunogenetics Center has retained its leadership position in HLA research, and in the development of accompanying diagnostic testing. MORE
 


Quantifying the risk of incompatible kidney transplantation: A multicenter study
American Journal of Transplantation
From June 13, 2014: Incompatible live donor kidney transplantation (ILDKT) offers a survival advantage over dialysis to patients with anti-HLA donor-specific antibody (DSA). Program-specific reports (PSRs) fail to account for ILDKT, placing this practice at regulatory risk. Researchers collected DSA data, categorized as positive Luminex, negative flow crossmatch (PLNF), positive flow, negative cytotoxic crossmatch (PFNC) or positive cytotoxic crossmatch (PCC), from 22 centers.
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Pancreas transplantation with enteroanastomosis to native duodenum poses technical challenges—but offers improved endoscopic access for scheduled biopsies and therapeutic interventions
American Journal of Transplantation
From Nov. 28, 2014: To facilitate endoscopic access for rejection surveillance and stenting of the pancreas, this study abandoned the duodenojejunostomy (DJ) in favor of duodenoduodenostomy (DD) in pancreas transplantation (PTx). From September 2012 to September 2013 we performed 40 PTx with DD; 20 solitary-PTx (S-PTx) and 20 simultaneous pancreas and kidney transplantation (SPK). The study compared the outcomes with results from 40 PTx-DJ (10 S-PTx and 30 SPK) from the preceding era. The DD-enteroanastomoses were performed successfully.
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Renal transplantation using belatacept without maintenance steroids or calcineurin inhibitors
American Journal of Transplantation
From April 4, 2014: Kidney transplantation remains limited by toxicities of calcineurin inhibitors (CNIs) and steroids. Belatacept is a less toxic CNI alternative, but existing regimens rely on steroids and have higher rejection rates. Experimentally, donor bone marrow and sirolimus promote belatacept's efficacy. To investigate a belatacept-based regimen without CNIs or steroids, authors transplanted recipients of live donor kidneys using alemtuzumab induction, monthly belatacept and daily sirolimus.
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Risk of antibody-mediated rejection in kidney transplant recipients with anti-HLA-C donor-specific antibodies
American Journal of Transplantation
From May 16, 2014: Anti-HLA donor-specific antibodies cause acute and chronic antibody-mediated rejection. However, the clinical relevance of anti-HLA-C antibodies remains unclear. We evaluated the clinical relevance of the presence of anti-HLA-C DSA at day 0 in renal transplant recipients. In this retrospective, case-controlled study, 608 patients who underwent kidney transplantation between August 2008 and March 2012 were screened for the presence of isolated anti-HLA-C DSA at day 0. A total of 22 renal transplant recipients were selected and followed for a period of 1 year.
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The microbiota, the immune system and the allograft
American Journal of Transplantation
From May 23, 2014: The microbiota represents the complex collections of microbial communities that colonize a host. In health, the microbiota is essential for metabolism, protection against pathogens and maturation of the immune system. In return, the immune system determines the composition of the microbiota. Altered microbial composition (dysbiosis) has been correlated with a number of diseases in humans. The tight reciprocal immune/microbial interactions complicate determining whether dysbiosis is a cause and/or a consequence of immune dysregulation and disease initiation or progression. However, a number of studies in germ-free and antibiotic-treated animal models support causal roles for intestinal bacteria in disease susceptibility.
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Colby Horton, Vice President of Publishing, 469.420.2601
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