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Sparing native upper lobes in living-donor lobar lung transplantation: 5 cases from a single center
American Journal of Transplantation (login required)
Living-donor lobar lung transplantation is indicated for rapidly deteriorating patients, and the total volume of two lower lobe grafts must be sufficient for the recipient. To rescue patients with small lobar grafts, we performed five LDLLTs sparing native upper lobes. This strategy was used when upper lobes or segments were preoperatively less impaired. There were no hospital deaths. Extracorporeal circulation time and operative time were similar to those of conventional LDLLTs. The length of intensive care unit stay was also similar. Late complications attributed to the spared lungs were airway infection in one recipient and pneumothorax in two but they were successfully managed.
Registration open for ASTS Leadership Development Program
Join us Sept. 27-30 at Northwestern University's Kellogg School of Management for this interactive, one-of-a-kind course and gain the essential skills to successfully lead transplant centers within a complex financial and regulatory environment.
QAPI adverse events webinar July 8
ASTS, AST, and representatives from the CMS Survey and Certification Group are pleased to announce the latest webinar in a series on various Quality Assessment and Performance Improvement (QAPI) topics throughout 2015.
Smile to support transplantation research
The Foundation of the American Society of Transplant Surgeons has partnered with Amazon Smile. Just start your shopping here and the ASTS Foundation will automatically receive 0.5 percent of the price of your eligible Amazon Smile purchases.
Recipient factors associated with having a potential living donor for liver transplantation
Liver Transplantation (login required)
Because of a persistent discrepancy between the demand for liver transplantation (LT) and the supply of deceased donor organs, there is an interest in increasing living donation rates at centers trained in this method of transplantation. We examined a large socioeconomically heterogeneous cohort of patients listed for LT to identify recipient factors associated with living donation. We retrospectively reviewed 491 consecutive patients who were listed for LT at our center over a 24-month period. Demographic, medical, and socioeconomic data were extracted from electronic records and compared between those who had a potential living donor volunteer for assessment and those who did not; 245 patients (50 percent) had at least 1 potential LD volunteer for assessment.
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Successful transplantation of kidneys from elderly circulatory death donors by using microscopic and macroscopic characteristics to guide single or dual implantation
American Journal of Transplantation (login required)
Most kidneys from potential elderly circulatory death donors are declined. We report single center outcomes for kidneys transplanted from DCD donors over 70 years old, using preimplantation biopsy Remuzzi grading to inform implantation as single or dual transplants. Between 2009 and 2012, 43 single transplants and 12 dual transplants were performed from elderly DCD donors. Remuzzi scores were higher for dual than single implants, indicating more severe baseline injury. Donor and recipient characteristics for both groups were otherwise similar. Early graft loss from renal vein thrombosis occurred in two singly implanted kidneys, and in one dual-implanted kidney; its pair continued to function satisfactorily.
Mayo Clinic and United Therapeutics to build lung restoration center
Lung Disease News
The Mayo Clinic and United Therapeutics Corporation recently announced the establishment of a partnership focused on creating a new lung restoration center. The facility will be built on Mayo's campus in Jacksonville, Florida, and is expected to help improve the number of lungs available for transplant through preservation and restoration of selected marginal donor lungs. The center is scheduled to be completed by the end of 2017.
Contribution of donor factors to post-reperfusion severe hyperglycemia in patients undergoing living donor liver transplantation
Annals of Transplantation
Blood glucose levels increase abruptly after graft reperfusion during living donor liver transplantation, but studies on perioperative factors contributing to this phenomenon are rare. Researchers developed a predictive model for post-reperfusion severe hyperglycemia based on donor-related factors.
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Vitamin D3 does not improve outcomes after kidney transplant
During the first year after kidney transplantation, vitamin D supplementation does not reduce the risk for acute rejection episodes or infection, and might promote the development of hypercalcemia, results from a randomized controlled trial suggest. "VITA-D was a hypothesis-driven study based on recent evidence showing that effects mediated by the vitamin D system go far beyond mineral and bone metabolism, and include immunomodulatory activities, and that these effects could be achieved by administering the active form of vitamin D," said Ursula Thiem, M.D., from the Medical University of Vienna.
Nephrologists can take active role in meds management after kidney transplant
HealthDay via Monthly Prescribing Reference
For adult kidney transplant recipients, nephrologists take an active approach to medication management, according to a study published online June 17 in the Journal of Evaluation in Clinical Practice. Kimberley Crawford, Ph.D., from Monash University in Clayton, Australia, and colleagues developed an online survey to explore how nephrologists promote and assess medication adherence, prescription management, and the frequency of clinic appointments and clinical screening tests for adult kidney transplant recipients.
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