Current opinion in organ transplantation
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Curr Opin Organ Transplant · Feb 2021
ReviewCardiac evaluation of the kidney or liver transplant candidate.
As the field of transplant has advanced, cardiac events have become the leading cause of morbidity and mortality after liver and kidney transplantation ahead of graft failure and infection. This trend has been bolstered by the transplantation of older and sicker patients who have a higher burden of cardiovascular risk factors, accentuating the need to determine which patients should undergo more extensive cardiac evaluation prior to transplantation. ⋯ http://links.lww.com/MOT/A27.
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Curr Opin Organ Transplant · Oct 2020
ReviewAnesthetic considerations for combined heart--liver transplantation in patients with Fontan-associated liver disease.
The success of the Fontan procedure has led to increased survival of patients born with certain congenital heart disease to the point that new sequlae, as a result of Fontan circulation, are being discovered. Included among these is Fontan-associated liver disease (FALD). The purpose of this review is to present available literature on the perioperative management of the combined heart--liver transplantation (CHLT) in patients with FALD. ⋯ The perioperative management of CHLT in patients with FALD is complex and available literature is limited. Future studies are needed to further assess proper perioperative management of patients with FALD who undergo CHLT.
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Curr Opin Organ Transplant · Apr 2020
ReviewKidney transplantation following uncontrolled donation after circulatory death.
The identification and utilization of kidneys from uncontrolled donation after circulatory death (uDCD) donors for transplantation may increase transplantation rates markedly. This article summarizes the latest international results from successful uDCD kidney transplant programmes and considers how such programmes may impact on the transplant waiting list. ⋯ Uncontrolled DCD kidney transplantation has been successfully implemented in several regions in France and Spain. Wider implementation of uDCD programmes would increase substantially the number of kidneys for transplantation, while maintaining acceptable transplant outcomes.
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Incidence of community-acquired respiratory viruses (CARVs) after lung transplantation (LTx) is 10-68 cases per 100 patient-years. Infected patients may develop graft failure and there seems to be an association between CARV infection and development of chronic lung allograft dysfunction (CLAD). This review summarizes the impact of CARV infection after LTx and potential treatment strategies. ⋯ Antivirals against CARV in LTx recipients have not yet demonstrated reduced morbidity in randomized clinical trials. Agents against CARV under development are inhibiting viral attachment and use silencing mechanisms of viral replication. The cohort of lung transplant recipients is a focus of intense research because of the high morbidity of CARV infection and intense surveillance of LTx recipeints.
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Curr Opin Organ Transplant · Apr 2019
ReviewReassessing the role of liver transplantation for patients with metastatic colorectal cancer to the liver.
Early studies reported poor survival rates following liver transplantation for metastatic colorectal cancer to the liver and liver transplantation has thus traditionally been contraindicated for these patients. However, improvements in liver transplantation outcomes, immunosuppression and the treatment of colorectal cancer warrant a reassessment of the role of liver transplantation for metastatic colorectal cancer. ⋯ The role of liver transplantation for patients with metastatic colorectal cancer to the liver needs to be further elucidated and defined by ongoing clinical trials and experience with living donor liver transplantation.