Immunosuppressant drugs and quality-of-life outcomes in kidney transplant recipients: An international cohort study (EU-TRAIN).

Patient-Reported Outcomes (PRO) integrate a wide range of holistic dimensions that arenot captured within clinical outcomes. Particularly, from induction treatment to maintenance therapy, patient quality-of-life (QoL) of kidney transplant recipients have been sparsely investigated in international settings. In a prospective, multi-centric cohort study, including nine transplant centers in four countries, we explored the QoL during the year following transplantation using validated elicitation instruments (EQ-5D-3L index with VAS) in a population of kidney transplant patients receiving immunosuppressive therapies.

Reduction of Cold Ischemia Time and Anastomosis Time Correlates with Lower Delayed Graft Function Rates Following Transplantation of Marginal Kidneys.

BACKGROUND In kidney transplantation, the association of cold ischemia time (CIT), anastomosis time (AT), and delayed graft function (DGF) is particularly detrimental in grafts from marginal donors; however, actual cut-off criteria are still debated. MATERIAL AND METHODS Data from patients >65 years (n=193) and patients <65 years (n=1054) transplanted between 2000 and 2010 were retrospectively analyzed regarding the age-dependent impact of ischemia times and DGF. RESULTS Overall death censored graft survival was inferior for ECD/DCD organs.

Optimizing clinical utilization and allocation of older kidneys.

Purpose Of Review: With a persisting organ shortage and constant high discard rates, there is an urgent need to optimize the outcome and allocation of marginal grafts.

Recent Findings: The Eurotransplant Senior Program was established as an 'old-for-old' allocation system emphasizing on the importance of keeping ischemic times short when utilizing marginal grafts. In addition to refined allocation systems, brief cold ischemic times, novel preservation techniques, a careful assessment of organ quality the utilization of dual kidney transplantation and donation after cardiac death kidneys from elderly donors may all help to increase the supply for renal transplantation.

Treatment of recurrent hepatocellular carcinoma confined to the liver with repeated resection and radiofrequency ablation: a single center experience.

Background: Recurrence of hepatocellular carcinoma (HCC) after surgical treatment is a common problem. It can be treated by radiofrequency ablation (RFA) or repeated hepatic resection (HR). This report compares both in a retrospective, single-institution database.

Feasibility of hepatic radiofrequency ablation in patients with bilioenteric anastomoses.

Background/aims: Radiofrequency ablation (RFA) in the liver is contraindicated in the presence of bilioenteric anastomoses, because it predisposes to occasionally devastating infectious complications. The purpose of this single-center experience is to demonstrate the technical feasibility of such procedures.

Methodology: Patients with bilioenteric anastomoses were offered ultrasound-guided RFA, if an interdisciplinary tumor board endorsed this decision, or an intraoperative opportunity to achieve a tumor-free situation emerged.

Results of liver resection in combination with radiofrequency ablation for hepatic malignancies.

Introduction: Liver tumors should be surgically treated whenever possible. In the case of bilobar disease or coexisting liver cirrhosis, surgical options are limited. Radiofrequency ablation (RFA) has been successfully used for irresectable liver tumors.

Potent early immune response after kidney transplantation in patients of the European senior transplant program.

Background: The increasing age of organ donors and the transplantation of older recipients have become clinical practice. Age-adapted immunosuppressive protocols considering these changes are currently not established. This study analyzed the age-dependent immune response after human kidney transplantation.

Open surgical is superior to percutaneous access for radiofrequency ablation of hepatic metastases.

Purpose: This study was designed to determine the best approach to radiofrequency ablation (RFA) in the liver.

Methods: From a total of 41 procedures, 37 patients with 47 tumors were treated with RFA for metastatic disease. Indications included colorectal cancer (n=28, 68%), neuroendocrine tumors (n=2, 5%), gynecological primaries (n=4, 10%), pancreatic/duodenal cancer (n=2, 5%), and miscellaneous entities (n=5, 12%).

Radiofrequency ablation of liver tumors using a novel bipolar device.

Purpose: Radiofrequency ablation (RFA) is now an established tool for treating unresectable liver tumors. Monopolar RFA is currently the accepted standard. However, the variability of the ablation shape and size impedes their further advancement.

Mayo risk score for primary biliary cirrhosis: a useful tool for the prediction of course after liver transplantation?

Background: Survival after orthotopic liver transplantation (OLT) for primary biliary cirrhosis (PBC) is excellent. In order to define the optimal time point for OLT, the Mayo risk score (MRS) was developed and a score of 7.8 was identified for transplantation.

Heterotopic ileal pancreas with lipoma and coexisting fibromatosis associated with a rare case of gastrointestinal bleeding. A case report and review of the literature.

Context: The development of pancreatic tissue outside the confines of the main gland represents a congenital abnormality referred to as heterotopic pancreas. This is a rare pathological and surgical entity which remains mostly asymptomatic.

Case Report: We present the case of a 28-year-old male, who was admitted to hospital because of a history of blood in bowel movements.

Radiofrequency ablation prior to liver transplantation: focus on complications and on a rare but severe case.

Background: Radiofrequency ablation (RFA) is an established treatment for hepatocellular carcinoma (HCC) in patients awaiting liver transplantation, due to its comparably low rate of complication and high effectiveness. Complications are thought to be rare and mostly self-limiting. By contrast, we report on a life-threatening complication and discuss it in the context of other complications.

Role of B-mode ultrasound screening in detection of local tumor recurrence in the first year after radiofrequency ablation in the liver.

Background: Ultrasound is known to be useful in imaging radiofrequency ablation (RFA) lesions intra- and postoperatively. The presented study intends to prove the value of ultrasound examination as a means of screening RFA-treated patients for local tumor recurrence.

Patients And Methods: During a period of 47 months, 91 RFA treatments were performed in 61 patients in a single institution.

Simultaneous presentation of soft tissue and bone tissue in computed tomography with combined window.

Objectives: To examine whether in computed tomography (CT) soft tissue and bone tissue can be simultaneously presented with a combined window without loss of diagnostic information compared to the separate presentations with soft tissue and bone tissue windows.

Materials And Methods: Forty-seven CT examinations from different patients with pathological changes at the soft tissue or bone tissue after an accident or due to malignant tumour were evaluated. The CT data were transformed into grey level data with three different windows: (1) soft tissue window; (2) bone tissue window to show spongiosa and bone cortex; and (3) special window to show ethmoidal sinus and mastoidal cells.

Intrapartum translabial ultrasound (ITU): sonographic landmarks and correlation with successful vacuum extraction.

Objective: Having studied intrapartum translabial ultrasound (ITU) to define easily obtainable sonographic criteria during maternal pushing, we used it dynamically immediately before vacuum extraction to determine its use in predicting successful operative vaginal delivery.

Methods: In a pilot study, maternal and fetal landmarks were determined sonographically during maternal pushing from a mid-sagittal translabial insonation using a curved array transducer in women delivering singleton fetuses in cephalic presentation spontaneously. With this transducer placed infrapubically ('infrapubic plane'), easily obtainable landmarks and signs were: (i) the 'infrapubic line', perpendicular to the long axis of the pubic joint and extending dorsally from its inferior margin in a mid-sagittal plane, (ii) the widest fetal head diameter and its movement with regard to the infrapubic line during pushing, and (iii) the 'head direction' with respect to the long axis of the symphysis.

Long-term follow-up after recurrence of primary biliary cirrhosis after liver transplantation in 100 patients.

Orthotopic liver transplantation (OLT) is the only effective curative therapy for end-stage primary biliary cirrhosis (PBC). Survival after OLT is excellent, although recent data have shown a recurrence rate of PBC of up to 32% after transplantation. The aim of this study is to investigate the course after disease recurrence, particularly with regard to liver function and survival in a long-term follow-up.

Liver transplantation for primary biliary cirrhosis: influence of primary immunosuppression on survival.

Introduction: Liver transplantation is the only established curative therapy for end-stage primary biliary cirrhosis (PBC). However, the influence of primary immunosuppression on long-term patient and graft survival is still controversial.

Patients And Methods: Among 1372 patients who underwent liver transplantation from April 1989 to January 2001, 95 (6.

Age and immune response in organ transplantation.

The immune system undergoes a complex and continuous remodeling as the result of aging. These changes have a major impact on allorecognition and alloresponse. In addition, immunosuppression in the elderly is challenging as a consequence of an increased incidence of associated comorbidities and altered pharmacokinetics.

Donor hypertension increases graft immunogenicity and intensifies chronic changes in long-surviving renal allografts.

Background: Marginal donor organs are used increasingly for transplantation. To define the influences of donor hypertension, we compared the behavior of kidney allografts from hypertensive and normotensive donors in an established rat model of chronic rejection.

Methods: Donor hypertension was induced by partial occlusion of the right renal artery with a silver clip.

Accumulation of crystal deposits in abdominal organs following perfusion with defrosted University of Wisconsin solutions.

Previous studies reported on both visible and invisible particles in University of Wisconsin (UW) solutions. Those particles originated from components of the bags. In recent clinical observations we noticed macroscopically visible, indissoluble particles in UW bags reaching subzero temperatures during transportation of organs and preservation solutions.

Low malignant epithelioid peritoneal mesothelioma: successful treatment with surgical therapy alone.

A 31-year-old man presented with malignant peritoneal mesothelioma. His past medical history was uneventful, specifically there was no personal or environmental asbestos exposure. The patient was treated by complete tumor resection including peritonectomy.