Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation (EXP CLIN TRANSPLANT )

Publisher: Middle East Society for Organ Transplantation

Description

Impact factor 0.80

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    Impact factor
  • 5-year impact
    0.73
  • Cited half-life
    3.90
  • Immediacy index
    0.11
  • Eigenfactor
    0.00
  • Article influence
    0.19
  • Other titles
    Journal of experimental and clinical transplantation, JECT
  • ISSN
    1304-0855
  • OCLC
    54768546
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: This study sought to investigate immuno-suppressive medication adherence, therapeutic adherence, school performance, symptom experiences, and depression levels of patients having undergone liver transplant during childhood. We performed a retro-spective, cross-sectional, case-controlled study to compare the depression levels of subjects with those of their healthy peers. Data were collected between June 23, 2014, and July 10, 2014 from 0- to 18-year-old patients having undergone a liver transplant between 1996 and 2014 (n = 27; the participant's mean age, 17.59 y [SD = 4.29, min-max = 8-28 y]). The mean score for the immunosuppressant therapy adherence was 11.18. To collect the data, the Demographic and Clinical Characteristics Form, Immunosuppressant Therapy Adherence Scale, Therapeutic Regimen Adherence Assessment Questionnaire, School Performance Assessment Questionnaire, Modified Transplant Symptom Occurrence and Symptom Distress Scale-58, and Beck Depression Inventory were used. To analyze the data, descriptive statistics (frequencies, mean, and standard deviation), Mann-Whitney U test, and ridit scoring were used. While the rate of adherence with clinical appointments was 55.5%, it was 33.3% with the diet (prescribed regime) and 44.4% with exercise. While 33.3% of the participants repeated a grade or were held back, 44.4% of them missed more than 20 school days. Of the symptoms, the recipients mostly experienced anxiety, restlessness, nervousness, fatigue, and difficulty in concentrating. The patients> mean depression score was 7.77 when they were compared to their healthy peers, the difference was not statistically significant (P > .05). In our study, the recipients> adherence with immunosuppressive therapy and clinical appointment was high. This study will provide data for the literature about pediatric liver transplant recipients> adherence with diet and exercise, and physiological and psychological symptoms such as fatigue and anxiety.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 01/2015;
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    ABSTRACT: Developments in transplantation have progressed dramatically over the past century. Current research is underway to optimize immune modulation, genetically engineering animals for xenografting, and breakthroughs are occurring in regenerative medicine. However, pioneering live-donor transplantation has transformed transplantation in the organ shortage, and these contribute an increased proportion of transplanted organs. Live-donor transplantation is associated with better long-term outcomes, and techniques to recover organs have become less invasive. We set out to examine the evolution of transplantation from its historical beginnings to the developments that make it successful today.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014;
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    ABSTRACT: Mesenchymal stem cells hold promise for renal disease treatment. Vascular endothelial growth factor may heal tubule-interstitial fibrosis in unilateral ureteral obstruction by inhibiting epithelial-mesenchymal transition. We investigated the protective effect of vascular endothelial growth factor in transfected mesenchymal stem cells in unilateral ureteral obstruction-induced renal injury in rats. Male Wistar Albino rats (32 rats; weight, 250-300 g) were divided into 4 equal groups: group 1, control; group 2, unilateral ureteral obstruction; group 3, unilateral ureteral obstruction and mesenchymal stem cells; and group 4, unilateral ureteral obstruction and vascular endothelial growth factor-transfected mesenchymal stem cells. Vascular endothelial growth factor-transfected mesenchymal stem cells were administered intravenously before onset of unilateral ureteral obstruction. On day 14, the rats were killed and kidneys were retrieved. Tubular necrosis, mono-nuclear cell infiltration, and interstitial fibrosis were evaluated in paraffin blocks. We evaluated green fluorescent protein-positive and vascular endothelial growth factor-positive cells; anti-inflammatory (Prostaglandin E2 Receptor) and interleukin 1 receptor antagonist), proinflammatory/anti-inflammatory (interleukin 6), and proinflammatory (MPO) cytokine expression levels; and levels of nitric oxide; transforming growth factor β1, E-cadherin, and hydroxyproline. Green fluorescent protein-positive cells were negative in the renal parenchyma in groups 1 and 2 and positive in groups 3 and 4. Vascular endothelial growth factor levels were significantly higher in group 4. Transforming growth factor β1, nitric oxide, and E-cadherin levels were significantly higher in the unilateral ureteral obstruction than control group; however, in the study groups, these values were not significantly different from the unilateral ureteral obstruction group. In stem cell-transplanted tissue samples, EP3, interleukin 1 receptor antagonist, and interleukin 6 levels were elevated, but MPO expression levels were low. Although there were significant differences for tubular necrosis and fibrosis in group 2, there were significant reductions in tubular injury and fibrosis in groups 3 and 4. Systemic stem cells transplanted into the kidney protected against unilateral ureteral obstruction-induced renal epithelial-mesenchymal transition and renal fibrosis.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014;
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    ABSTRACT: Invasive fungal infection after solid-organ transplantation is known as a severe complication and carries with it a high risk of infection-related mortality. Among patients after heart transplant Aspergillus species most often cause atypical pneumonia. The incidence of invasive aspergillosis after heart transplant has been reported from 3% to 14%. It is the opportunistic pathogen with the highest mortality, ranging from 50% to 80%. Prompt antifungal therapy is crucial, but rapid diagnostic procedures with sufficient sensitivity and specificity are lacking at the moment. We present a rare case of a patient with massive metastasizing invasive aspergillosis within 1 month after heart transplant, undetected before death.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014;
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    ABSTRACT: To develop a new parathyroid allotransplant method for the treatment of permanent hypoparathyroidism. Parathyroid cells 50 × 106 derived from a parathyroid hyperplasia patient were transferred to a 61-year-old patient who had thyroidectomy 17 years earlier, allowing to papillary thyroid cancer; he was admitted to our outpatient clinic with symptomatic chronic hypocalcemia. Cell isolation, cryopreservation, and culturing were conducted according to a new protocol. During a follow-up of 5 months, the patient had no complications that could indicate rejection, and clinical symptoms completely resolved without requiring any drug supplementation. Here, we report a new method, enabling fast and cost-effective parathyroid allotransplant with maintained tissue viability sufficient to treat persistent hypocalcemia.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014;
  • Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):574.
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    ABSTRACT: Calcineurin inhibitors are effective immunosuppressive agents, but associated adverse effects such as nephrotoxicity may limit efficacy. Dietary fish oil may minimize nephrotoxicity caused by long-term use of calcineurin inhibitors. The purpose of the present study was to evaluate the effects of omega-3 fatty acids on calcineurin inhibitor nephrotoxicity in rats that had normal kidney function or chronic kidney failure. Rats that had normal kidney function or chronic renal failure that was induced by mass reduction surgery were treated with tacrolimus without or with fish oil, fish oil alone, or olive oil. Kidney function and histology were evaluated after 14 days. Mean body weight loss, serum creatinine, change in serum creatinine, and rate of decrease in creatinine clearance were greater in normal rats that received than did not receive tacrolimus. Tacrolimus nephrotoxicity was greater in rats that had chronic renal failure than normal kidney function, but the mean change in serum creatinine was significantly lower in rats with chronic renal failure that were treated with tacrolimus and fish oil than tacrolimus alone. Fish oil supplementation was associated with fewer abnormal histopathologic lesions in the kidneys of tacrolimustreated rats that had normal kidney function or chronic renal failure (not signifant). Fish oil may be protective against the development of kidney dysfunction and histopathologic changes in rats treated with tacrolimus.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):522-7.
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    ABSTRACT: OBJECTIVES: The mammalian target of rapamycin inhibitors sirolimus and everolimus are immunosuppressive drugs for kidney transplant patients, but adverse events may include proteinuria. The purpose of this study was to compare the effects of sirolimus and everolimus on creatinine clearance and proteinuria after kidney transplant. MATERIALS AND METHODS: This study was a prospective evaluation period of 50 patients (age, 16-65 y) who had kidney transplant. There were 25 patients who used sirolimus and 25 patients who used everolimus. Evaluation at the beginning mTOR and end of the evaluation period included complete blood count, blood pressure, serum creatinine level, creatinine clearance, and proteinuria level in a 24-hour urine collection. RESULTS: Mean creatinine clearance at the beginning and end of the evaluation period was significantly less in the everolimus than sirolimus group. There was no significant change in creatinine clearance from the beginning to end of the evaluation period in either the sirolimus or everolimus group. Mean proteinuria at the beginning and end of the evaluation period was similar between the sirolimus and everolimus groups. Both groups had a significant increase in mean proteinuria from beginning to end of the evaluation period, but the increase in proteinuria was similar for the sirolimus and everolimus groups (difference not significant). CONCLUSIONS: In kidney transplant recipients, sirolimus and everolimus are associated with a similar level of increased mean proteinuria.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014;
  • Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):572-3.
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    ABSTRACT: As the gap between supply and demand for donor organs is increasing, we sought to clarify the knowledge and attitudes regarding living-organ donation among Chinese medical students and analyze their incentives and influencing factors. Data were collected from Chinese medical students using a standardized questionnaire. Of 320 surveyed participants, 261 participants (81.6%) said they would consider donating their live kidney organ, and 262 participants (81.9%) were willing to donate posthumously. Although 177 participants (55.7%) confirmed current regulations on posthumous organ donation, only 85 participants (26.7%) could correctly identify the regulations on live organ donation in China. Gender differences were not significantly associated with willingness to donate a kidney, whereas religion and socioeconomic status of the respondents were significantly associated with willingness to donate a live or posthumous kidney. Among well-informed, young, healthy, and economically well-off Chinese male and female medical students, most were willing to be live kidney donors. Religion and socioeconomic status may affect the decision-making process for organ disposition.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):506-9.
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    ABSTRACT: To study the histopathologic and optical coherence tomography changes after Descemet's Stripping Endothelial Keratoplasty in rabbits. Descemet's Stripping Endothelial Keratoplasty was performed in 14 rabbit eyes and descemetorhexis was performed in 10 rabbits, as control. Histopathologic examination and anterior-segment optical coherence tomography were conducted in the Descemet's Stripping Endothelial Keratoplasty group at 1, 2, 4, and 8 weeks. For the control group, histopathologic examination was performed before surgery and at 1, 2, 4, and 8 weeks after surgery. In the Descemet's Stripping Endothelial Keratoplasty group, corneas cleared completely within 2 weeks of surgery. Moreover, in most cases, the retained Descemet's membrane was present at the peripheral donor-host interface. The retrocorneal fibrocellular membrane also was seen in the peripheral Descemet's membrane stripped area without donor coverage. Anterior-segment optical coherence tomography revealed that the stroma deturgesed most rapidly between weeks 1 and 2. Retained Descemet's membrane was not the cause for graft dislocation and the retrocorneal fibrocellular membrane may be a kind of protective reaction to denuded endothelium.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):548-54.
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    ABSTRACT: Thus far, there is no active treatment for BK virus-associated nephropathy after a kidney transplant that has proven to be effective. We sought to assess the effectiveness of treatment with leflunomide, intravenous immunoglobulin, and ciprofloxacin on graft outcome after 1 year compared with a historical group treated with reduced immunosuppressive medications strategy. Group 1 (n = 19) was composed of kidney transplant recipients with twice positive BK virus-polymerase chain reaction in urine and blood who underwent graft biopsy to confirm BK virus-associated nephropathy. Once BK virus-associated nephropathy was diagnosed, antimetabolite (mycophenolate mofetil or azathioprine) was changed to leflunomide, and intravenous immunoglobulin and oral ciprofloxacin were given. Group 2 (n = 14) was composed of BK virus-associated nephropathy patients treated conventionally with reduced immunosuppressive medications. Thirty-three patients were treated, 23 were males (70%), there were 15 were deceased donors (45.5%), 15 were diabetics (45.5%), mean human leukocyte antigen mismatches were 3.76, seven had a zero DR mismatch (21.2%), and 8 were CW7 negative (24.2%). All patients received induction therapy (thymoglobulin in 22 [66.6%]), 7 had delayed graft function (21.2%) and 18 received antirejection therapy before receiving BK virusassociated nephropathy diagnosis (52.9%). Maintenance immunosuppression was prednisolone and mycophenolate mofetil (2 g/d) in 31 patients (94%), and tacrolimus in 13 (39.4%). Tacrolimus was given to 12 patients in group 1 (63.1%), while sirolimus was given to 7 patients in group 2 (50%). One graft was lost in each group by the end of the study, and 1 patient died with functioning graft in group 2. No significant difference existed in 1-year graft outcomes between treatment of BK virus-associated nephropathy by reduction of immunosuppressive medications or actively by leflunomide, intravenous immunoglobulin, and ciprofloxacin.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):528-33.
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    ABSTRACT: We explored the categorizing of expanded criteria donors based on systemic disease processes linked to symmetric bilateral renal injury. We evaluated expanded criteria donor kidneys where the paired kidney was discarded owing to biopsy results, termed the discard group compared with those expanded criteria donors (where both were transplanted), termed the nondiscard group. Analysis of the Organ Procurement and Transplant Network data was completed focusing on the effect of glomerulosclerosis. Our investigation revealed 754 and 9575 recipients in the discard group and nondiscard groups. Fewer glomerulosclerosis was seen the nondiscard group. An assessment revealed improved 1-, 3-, and 5-year graft (P < .001) and patient (P < .05) survivals in the nondiscard group compared with the discard group. However, multivariate analysis demonstrated glomerulosclerosis had little to no effect on graft and patient survival. Expanded criteria donor kidneys with 0% to 5% glomerulosclerosis had no significant differences in graft function as compared with expanded criteria donor kidneys that had > 10% glomerulosclerosis. In fact, expanded criteria donor kidneys with 0% to 5% glomerulosclerosis showed no statistically significantly protective effect over any biopsy with > 5% glomerulosclerosis in patient survival. Owing to the limited supply of biopsy results in predicting outcomes when controlled for pertinent variables, relying on biopsy findings for kidney allocation may result in many valuable kidneys being discarded.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):499-505.
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    ABSTRACT: Severe cholestasis after liver transplant is common. In this study, our aim was to develop an algorithm to guide biliary intervention in these patients. A retrospective review was performed on patients who had undergone a hepatobiliary scan, with or without subsequent endoscopic retrograde cholangiogram, during the immediate postoperative period. These findings were evaluated along with laboratory values to determine the benefit for this evaluative process. Biliary duct obstruction was defined as > than a 50% reduction in serum bilirubin within 48 hours of endoscopic retrograde cholangiogram intervention. Twelve patients had endoscopic retrograde cholangiogram with 6 stents in 25 patients with normal a hepatobiliary scan, and 2 patients met criteria for biliary duct obstruction. Twenty-two patients had endoscopic retrograde cholangiogram with 14 stents in 32 patients with delayed uptake, suggesting hepatocellular dysfunction on a hepatobiliary scan, and 4 patients met criteria for biliary duct obstruction. In the 57 patients with severe hyperbilirubinemia, 6 patients (11%) had biliary duct obstruction as a cause. Among the 34 endoscopic retrograde cholangiograms performed, 17% had biliary obstruction. On multivariate analysis, patients having both serum aspartate transaminase concentrations < 1500 IU/L and serum total bilirubin levels > 257 μmol/L had an odds ratio of 25.1 for predicting biliary obstruction (95% CI: 6-37; P = .002). A hepatobiliary scan with a combination peak serum aspartate transaminase and peak serum total bilirubin levels offer a valuable tool to identify patients with hepatocellular dysfunction and can avoid endoscopic retrograde cholangiogram in the immediate posttransplant period.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2014; 12(6):543-7.
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    ABSTRACT: The mechanism responsible for the development of posttransplant diabetes mellitus associated with tacrolimus treatment remains unclear. To investigate the possible effect of tacrolimus on the development of impaired glucose tolerance in transplant recipients, this study focused on early and second phase insulin secretion, which may be affected by reactive oxygen species under tacrolimus therapy. We measured the anti-oxidant status and reactive oxygen species levels before and after tacrolimus treatment. The production of reactive oxygen species was determined by flow cytometry. Total antioxidant status was measured using total antioxidant status kits. The antioxidant status decreased while reactive oxygen species level increased significantly (P = .032) CONCLUSIONS: Tacrolimus treatment resulted in dose- and time-dependent increases in the production of reactive oxygen species by beta cells. The antioxidant status decreased in beta cells after tacrolimus treatment. Increased production of reactive oxygen species and decreased antioxidant status by tacrolimus in beta cells may lead to some adverse events.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 11/2014;
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    ABSTRACT: Focal segmental glomerulosclerosis is a common cause of end-stage renal disease in children. Focal segmental glomerulosclerosis recurrence in renal transplants is a challenging disease, and can cause graft dysfunction and loss. Different therapies exist with varying responses, from complete remission to resistance to all modes of treatment. Abatacept was recently introduced as a treatment for primary focal segmental glomerulosclerosis in native kidneys and in recurrent disease after transplant. We present a pediatric case with immunosuppression-resistant primary NPHS2-negative focal segmental glomerulosclerosis recurrence after renal transplant. The standard therapy for recurrent focal segmental glomerulosclerosis (rituximab, plasmapheresis, high-dose cyclosporine, and corticosteroids) was tried but failed to induce remission. Abatacept (10 mg/kg) was given at 0, 2, and 4 weeks (total, 3 doses) with no good response. We conclude that abatacept may work in patients with B7-1-positive focal segmental glomerulosclerosis recurrence and its efficacy is uncertain in disease with B7-1-negative or unknown staining status.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 11/2014;
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    ABSTRACT: Introduction: HCV recurrence after transplant is universal. Histological recurrence is seen in more than 50% of HCV-infected grafts within the first year. Primary aim of our study was to evaluate factors responsible for HCC recurrence and mortality including histological markers. Material and Methods: All the patients who have undergone transplant for HCC associated with HCV from 2002 to 2012 were evaluated retrospectively. Statistical analysis was done using SPSS version 21. (IBM). Results: One hundred and nine patients with HCC associated with HCV underwent living donor liver transplant from July 2002 to June 2012. On Univariate analysis, pre-operative MELD Score (p=0.026), AFP levels (0.020) and Rapid fibrosis (0.008), HAI greater than 6 (p=0.008) were associated with recurrence. On multivariate cox regression analysis MELD (p<0.0001) score and Rapid fibrosis (p=0.015) independently predicted HCC recurrence. Conclusions: Significant HCV recurrence on biopsy is poor prognostic indicator and is associated with higher chance of HCC recurrence post liver transplant. Rapid fibrosis post liver transplant independently predicts HCC recurrence.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 11/2014;