Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
-
Liver ischemia and reperfusion--which cause liver damage that is significant in a variety of diseases, injuries, and procedures (including but not limited to trauma and transplant)--have been the focus of many investigations in recent years. Although the mechanisms of ischemia-reperfusion injury are numerous and complex, many advances in treatment have been made. ⋯ To provide a unique analysis and evaluation, we emphasized the most recent pertinent investigations of the last decade. Specific topics addressed include reactive oxygen species, nitric oxide, toll-like receptors, ischemic preconditioning, T cells, heme oxygenase-1, heat shock proteins, erythropoietin, selectins, protein kinases, matrix metalloproteinases, and cytokines.
-
Exp Clin Transplant · Jun 2009
Clinical TrialEffect of active vitamin D on expression of co-stimulatory molecules and HLA-DR in renal transplant recipients.
Full activation of T cells requires 2 distinct but synergistic signals. The first is the T-cell antigen receptor, which is antigen specific, and the second is activation of co-stimulatory signals. Active vitamin D (1, 25-dihydroxyvitamin D3) decreases T-cell activation and proliferation, inhibits differentiation and maturation of dendritic cells, and induces tolerogenic dendritic cells. These immunoregulatory effects may be due, at least in part, to changes in cytokine secretion and expression of co-stimulatory molecules. The use of active vitamin D has been reported to improve allograft survival, decelerate loss of allograft function, and prevent acute rejection. This study was conducted to assess the effect of active vitamin D on the expression of co-stimulatory molecules and HLA-DR in renal transplant recipients. ⋯ In renal transplant recipients, decreased expression of co-stimulatory and HLA-DR molecules occurred after treatment with active vitamin D. Such changes may be involved in increasing allograft survival.
-
Exp Clin Transplant · Jun 2009
Procalcitonin and C-reactive protein serum levels after hematopoietic stem-cell transplant.
Hematopoietic stem-cell transplant is a curative therapy for several malignant and nonmalignant disorders. The purpose of this study was to investigate the association of serum levels of high-sensitivity C-reactive protein and procalcitonin with complications such as acute graft-versus-host disease, veno-occlusive disease, and infection after hematopoietic stem-cell transplant. ⋯ Our results support theories that serum levels of high-sensitivity C-reactive protein and procalcitonin are biomarkers for transplantrelated complications such as graft-versus-host disease or infection and that the procalcitonin level can differentiate patients with infection from those with graft-versus-host disease.
-
Exp Clin Transplant · Jun 2009
Case ReportsTherapeutic failure in a renal transplant patient with Pneumocystis jiroveci pneumonia: a case report.
Pneumocystis jiroveci pneumonia is common in immunocompromised individuals. ⋯ The therapeutic failure of the drug of choice (co-trimoxazole) was evident. This case raises questions about the development of P jiroveci resistance to current therapies.
-
Exp Clin Transplant · Mar 2009
Ethical issues in live donor kidney transplant: views of medical and nursing staff.
The ongoing development of live donor kidney transplant has generated many ethical dilemmas. It is important to be aware of the attitudes of transplant professionals involved in this practice. ⋯ Live related and unrelated kidney donation are considered ethically acceptable procedures, and nondirected donation is gaining support among transplant professionals. A substantial minority favored direct financial rewards for donors, especially in the case of nondirected donation.