Organ protection in allograft recipients

Hovaguimian, Frédérique; Schläpfer, Martin; Beck‐Schimmer, Beatrice

doi:10.1097/mot.0000000000000062

Cited by 10 publications

(3 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the study, we discovered that the incidence rate of post-OLT AKI was 3.97%, which was less than the 11.1–90% reported in previous studies 1 3 6 35 36 37 , and similar to the finding of Kirnap et al .’s study (5%) 20 . This relatively low occurrence rate benefited from the development of transplantation surgery and application of precautionary measures to prevent complications after OLT 17 18 22 38 . Compared with the occurrence rate approximately 10 years prior 10 34 39 40 , it decreased gradually in recent years 20 35 , and our result is consistent with this tendency.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Yin

Funian

et al. 2017

Sci Rep

View full text Add to dashboard Cite

In this study, we determined the risk factors for acute kidney injury (AKI) following orthotopic liver transplantation (OLT) in China. We collected 5074 donation after cardiac death (DCD) OLT recipients who underwent surgery between January 1, 2010, and December 31, 2015, in 86 academic hospitals or transplant centers in China. Univariate and multivariate analyses were used to investigate the criticality of donor, graft, or recipient variables in the development of post-OLT AKI. In all, 4482 patients were included (median age, 49.31 years). Post-OLT AKI occurred in 3.97% patients, and 73.6% of all OLT patients were male. The 1- and 5-year cumulative survival rates (CSRs) of the AKI group were 33.95% and 25.24%, respectively, compared with 86.34% and 70.05%, respectively, of the non-AKI group (P < 0.001). The independent risk factors for post-OLT AKI were blood loss, cold ischemia time, warm ischemia time, preoperative serum creatinine, the treatment period with dopamine, overexposure to calcineurin inhibitor, and combined mycophenolate mofetil use (P < 0.05). These had a high prediction accuracy for post-OLT AKI (area under the curve [AUC] = 0.740).

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Yin

Funian

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…To date, the most effective therapy for acute liver failure is liver transplantation. However, donor liver shortages and the requirement for lifelong immunosuppression have limited the use of liver transplantation 1 2 3 4 5 . As a result, hepatocyte transplantation and bioartificial liver (BAL) devices containing active hepatocytes that remove toxins and supply key physiological active molecules to sustain hepatic function have been successfully used to bridge patients to native regeneration or organ transplantation 6 .…”

mentioning

confidence: 99%

Scalable Differentiation of Human iPSCs in a Multicellular Spheroid-based 3D Culture into Hepatocyte-like Cells through Direct Wnt/β-catenin Pathway Inhibition

Pettinato

Ramanathan

Fisher

et al. 2016

Sci Rep

View full text Add to dashboard Cite

Treatment of acute liver failure by cell transplantation is hindered by a shortage of human hepatocytes. Current protocols for hepatic differentiation of human induced pluripotent stem cells (hiPSCs) result in low yields, cellular heterogeneity, and limited scalability. In the present study, we have developed a novel multicellular spheroid-based hepatic differentiation protocol starting from embryoid bodies of hiPSCs (hiPSC-EBs) for robust mass production of human hepatocyte-like cells (HLCs) using two novel inhibitors of the Wnt pathway. The resultant hiPSC-EB-HLCs expressed liver-specific genes, secreted hepatic proteins such as Albumin, Alpha Fetoprotein, and Fibrinogen, metabolized ammonia, and displayed cytochrome P450 activities and functional activities typical of mature primary hepatocytes, such as LDL storage and uptake, ICG uptake and release, and glycogen storage. Cell transplantation of hiPSC-EB-HLC in a rat model of acute liver failure significantly prolonged the mean survival time and resolved the liver injury when compared to the no-transplantation control animals. The transplanted hiPSC-EB-HLCs secreted human albumin into the host plasma throughout the examination period (2 weeks). Transplantation successfully bridged the animals through the critical period for survival after acute liver failure, providing promising clues of integration and full in vivo functionality of these cells after treatment with WIF-1 and DKK-1.

show abstract

“…Renal transplantation is currently the best therapeutic option for treating end-stage kidney disease (ESKD) [1, 2]. Current pre-transplant evaluation of the anesthetic, medical, surgical, and immunological risks of the renal recipient makes this a safe procedure, with a low complication rate [3–5]. Propofol is a powerful general anesthetic agent with a short half-life, and characterized by its immediate action and rapidly reversible sedation, which make it popular for sedation during medical or surgical procedures and for maintained sedation in ICUs [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Propofol Infusion Syndrome in the Postoperative Period of a Kidney Transplant

Dehesa-López

Irizar-Santana

Granado³

et al. 2019

Case Reports in Nephrology

View full text Add to dashboard Cite

Sedation during medical procedures poses a risk to any patient, and the use of specific anesthetic agents should be carefully considered to avoid adverse outcomes. We report on a patient with propofol infusion syndrome diagnosed during the post-operative period of a renal transplant. A 58-year-old female on chronic hemodialysis due to end stage kidney disease secondary to microscopic polyangiitis underwent kidney transplant from a deceased donor. Anesthetic induction was performed with fentanyl, propofol, and cisatracurium, and maintained with continuous propofol infusion. In the recovery room, the patient developed somnolence, tachypnea, and thoracoabdominal dissociation secondary to residual neuromuscular block. An arterial-blood gas test indicated acidemia, high pCO2, low HCO3, and mildly increased serum lactate. The patient remained hemodynamically stable, on volume-controlled ventilation, with sedation by continuous propofol infusion. Blood gas tests revealed persistent acidemia without tissue hypoperfusion. Doppler ultrasound of the renal graft reported adequate blood flow and serum triglycerides were elevated. A diagnosis of propofol infusion syndrome was made, and infusion ceased. A decrease in serum lactate levels was observed, with normalization 4 h later. This case highlights the importance of considering adverse effects of anesthetic agents as the cause of post-operative complications when prolonged sedation is required.

show abstract

Organ protection in allograft recipients

Abstract: This review identified several promising strategies ensuring organ protection and improving patient outcome after solid organ transplantation. However, as outcomes were difficult to compare, further evidence will be needed before drawing firm conclusions.

Cited by 10 publications

References 74 publications

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Risk factors of acute kidney injury after orthotopic liver transplantation in China

Scalable Differentiation of Human iPSCs in a Multicellular Spheroid-based 3D Culture into Hepatocyte-like Cells through Direct Wnt/β-catenin Pathway Inhibition

Propofol Infusion Syndrome in the Postoperative Period of a Kidney Transplant

Contact Info

Product

Resources

About