Early steroid withdrawal in repeat kidney transplantation.

Background And Objectives: Kidney re-transplantation (KRT) candidates are considered at high risk for graft failure. Most of these patients are kept on a chronic steroid maintenance (CSM) regimen. The safety of early steroid withdrawal (ESW) remains unanswered in KRT.

The strength of donor-specific antibody is a more reliable predictor of antibody-mediated rejection than flow cytometry crossmatch analysis in desensitized kidney recipients.

The aim of this study was to evaluate the utility of donor-specific antibodies (DSA) and flow cytometry crossmatch (FCCM) as tools for predicting antibody-mediated rejection (AMR) in desensitized kidney recipients. Sera from 44 patients with DSA at the time of transplant were reviewed. Strength of DSA was determined by single antigen Luminex bead assay and expressed as mean fluorescence intensity (MFI).

The fate of human platelets perfused through the pig liver: implications for xenotransplantation.

Background: Pig liver xenotransplantation could offset the shortage of livers available for orthotopic liver transplantation. Studies in pig and baboon liver xenografts revealed the main obstacle to be a lethal thrombocytopenia that occurred within minutes to hours of transplantation.

Methods:   We have created a model of xenotransplantation-induced thrombocytopenia using ex vivo pig liver perfusion with human platelets.

No difference in clinical transplant outcomes for local and imported liver allografts.

In the United States, liver allograft allocation is strictly regulated. Local centers have the first option to accept a donor liver; this is followed by regional allocation for those donor livers not used locally and then by national allocation for those donor livers not accepted regionally. This study reviews the outcomes of all liver allografts used over 6 years (2001-2007) and evaluates initial and long-term function stratified by the geographic source of the donor liver allograft.

Present prospects and future perspectives of intestinal and multivisceral transplantation.

Purpose Of Review: This article reviews the most current indications, technical aspects and results of intestinal and multivisceral transplantation.

Recent Findings: The introduction of induction therapy in the past 8 years, combined with advancements on surgical technique and clinical management, was vital for the improvement in patient and graft survival.

Summary: Intestinal transplantation is now a viable option for patients with intestinal failure who have failed parenteral nutrition.

Intestinal transplantation: an overview.

Intestinal transplantation is just now beginning to emerge as a viable therapeutic option for the large number of patients worldwide with intestinal failure. Intestinal transplantation has experienced consistent growth over the last decade as clinical outcomes have improved. As more centers gain experience in performing and managing these complex transplant patients, referral patterns are established to facilitate the movement of patients to those centers with expertise in this area.

Intestinal and multivisceral transplantation at Indiana University: 6 years' experience with 100 cases.

Intestinal transplantation has shown exceptional growth over the past 20 years with extraordinary progress. As with other solid organ transplants, intestinal transplantation has now transitioned from being experimental to being the standard of care for patients with intestinal failure. The currently reported 1-year graft and patient survival rate is 80%, which approaches that for other solid abdominal organs.

Indiana University kidney transplant program: overview and summary of the last 1022 kidney alone transplants with at least 1 year follow-up.

Indiana University's kidney transplant program has undergone changes in the program's approach to immunosuppression. This change in philosophy has moved the program away from multiple chronic maintenance immunosuppression strategies with corticosteroids to steroid-free maintenance immunosuppressive strategies for both adults and pediatric recipients. Anti-thymocyte globulin induction (beginning pre-reperfusion) has allowed for the rapid post-transplant withdrawal of corticosteroids.