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  1. New-onset diabetes after renal transplantation: A case series as ...

    African Journals Online (AJOL)

    2012-04-20

    Apr 20, 2012 ... New-onset diabetes after transplantation (NODAT) is an important metabolic complication of transplantation because ... This study was aimed at illustrating the presentation .... Badmus TA, Arogundade FA, Sanusi AA, Akinsola WA, Adesunkanmi AR, ... renal transplantation: Meta-analysis of clinical studies.

  2. Inhibition of Pseudomonas aeruginosa virulence: characterization of the AprA-AprI interface and species selectivity.

    Science.gov (United States)

    Bardoel, Bart W; van Kessel, Kok P M; van Strijp, Jos A G; Milder, Fin J

    2012-01-20

    Pseudomonas aeruginosa secretes the virulence factor alkaline protease (AprA) to enhance its survival. AprA cleaves one of the key microbial recognition molecules, monomeric flagellin, and thereby diminishes Toll-like receptor 5 activation. In addition, AprA degrades host proteins such as complement proteins and cytokines. P. aeruginosa encodes a highly potent inhibitor of alkaline protease (AprI) that is solely located in the periplasm where it is presumed to protect periplasmic proteins against secreted AprA. We set out to study the enzyme-inhibitor interactions in more detail in order to provide a basis for future drug development. Structural and mutational studies reveal that the conserved N-terminal residues of AprI occupy the protease active site and are essential for inhibitory activity. We constructed peptides mimicking the N-terminus of AprI; however, these were incapable of inhibiting AprA-mediated flagellin cleavage. Furthermore, we expressed and purified AprI of P. aeruginosa and the homologous (37% sequence identity) AprI of Pseudomonas syringae, which remarkably show species specificity for their cognate protease. Exchange of the first five N-terminal residues between AprI of P. syringae and P. aeruginosa did not affect the observed specificity, whereas exchange of only six residues located at the AprI surface that contacts the protease did abolish specificity. These findings are elementary steps toward the design of molecules derived from the natural inhibitor of the virulence factor AprA and their use in therapeutic applications in Pseudomonas and other Gram-negative infections. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Respirators: APR Issuer Self Study 33461

    Energy Technology Data Exchange (ETDEWEB)

    Chochoms, Michael [Los Alamos National Laboratory

    2016-07-13

    Respirators: APR Issuer Self-Study (course 33461) is designed to introduce and familiarize employees selected as air-purifying respirator (APR) issuers at Los Alamos National Laboratory (LANL) with the responsibilities, limitations, procedures, and resources for issuing APRs at LANL. The goal is to enable these issuers to consistently provide proper, functioning APRs to authorized users

  4. Design Characteristics of Soft Control for APR+

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yongsoo; Sung, Chanho; Jung, Yeonsub [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    In the global nuclear industry, the design requirements have been largely divided into the US and the European ones. The APR+ design, based on the proven APR1400 design, was developed to fully comply with the US regulatory and utility requirements. It was also developed to improve the technical competitiveness and enlarge the export market share through design uniqueness and the improvement of safety. The robust design of safety and its validation were requested Post-Fukushima accident. So MMIS design and validation for reinforcing safety were accomplished in APR+ development project. In this paper, the design characteristics of soft control for APR+ are presented to enhance the safety of MMIS design. In this paper, the major design characteristics of soft control for APR+ were introduced to increase the safety of MMIS design. In addition to the design characteristics of soft control described above, the following should be investigated closely for APR+ to get into the global nuclear industry.

  5. Design Characteristics of Soft Control for APR+

    International Nuclear Information System (INIS)

    Kim, Yongsoo; Sung, Chanho; Jung, Yeonsub

    2016-01-01

    In the global nuclear industry, the design requirements have been largely divided into the US and the European ones. The APR+ design, based on the proven APR1400 design, was developed to fully comply with the US regulatory and utility requirements. It was also developed to improve the technical competitiveness and enlarge the export market share through design uniqueness and the improvement of safety. The robust design of safety and its validation were requested Post-Fukushima accident. So MMIS design and validation for reinforcing safety were accomplished in APR+ development project. In this paper, the design characteristics of soft control for APR+ are presented to enhance the safety of MMIS design. In this paper, the major design characteristics of soft control for APR+ were introduced to increase the safety of MMIS design. In addition to the design characteristics of soft control described above, the following should be investigated closely for APR+ to get into the global nuclear industry

  6. Development of Core Simulator (CoSi) for APR1400 And Analysis of LPPT Result using APR1400-CoSi

    International Nuclear Information System (INIS)

    Moon, Sang-Rae; Kim, Yong-Bae; Lee, Eun-Ki

    2014-01-01

    According to NRC guidelines, Low Power Physics Test (LPPT) is required to be performed in low temperature/low pressure (160 .deg. C/42.2 kg/cm 2 ) as well as NOT/NOP (291.3 .deg. C/158.2 kg/cm 2 ) because Shin-Kori Unit 3 is FOAK nuclear power plant. Low Power Physics Test (LPPT) is essential to verify the nuclear design and robustness of reactor safety. LPPT consists of initial criticality, Point of Adding Heat (POAH), All Rod Out (ARO) Boron Concentration, Isothermal Temperature Coefficient (ITC), Control Rod Worth measurements and so on. KHNP-CRI has developed the Core Simulator for APR1400 (APR1400-CoSi) in order to improve the ability performing the LPPT. Especially, APR1400-CoSi has enhanced capability to calculate the full Core neutronic parameters by revising RAST-K that is three dimensional real time core kinetic program. APR1400-CoSi has been developed for education-training of Low Power Physics Test(LPPT). Particularly, APR1400-CoSi has an enhanced capability to calculate the full core neutronic parameters by revising RAST-K which is a three dimensional real time core kinetics program. Low Power Physics Test (LPPT) was performed using APR1400-CoSi and the results showed very similar values with the predicted ones. In other words, the initial core model of Shin-Kori Unit 3 in APR1400-CoSi system has been verified to be appropriate enough. Also, it was confirmed that the test range of Low Power Physics Test (LPPT) reamains effective even though the largest incremental bank reactivity is inserted in core by analyzing the power change during the rod SWAP test

  7. Development of Reactor Coolant Pump for APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Sang-Youn; Chu, Sung-Min; Chang, Jin-Young [Doosan Heavy Industries and Construction, Changwon (Korea, Republic of)

    2015-10-15

    The development was focused on the performance requirements for APR1400 and to achieve the goals of the safety, reliability and adaptability for APR1400 system design. In addition, APR1400 RCP design was customized considering convenience of installation, operation and maintainability. This paper describes the details of the development process, improved design feature and type test results. Based on development of core technology of RCP, DOOSAN supplies the localized and improved APR1400 RCP to Shin-Hanul 1 and 2 Project. This would be good experience that the RCP core technology can break foreign monopoly in supplying the domestic nuclear industry. Also, there expect APR1400 RCP can be sustainable revenue models in nuclear industry. Moreover, development of RCP will be a catalyst to enhance design capacity for equipment and system of nuclear power plant as well as evaluation and verification skills of Korean nuclear industry.

  8. ITAAC Development for APR1400 NRC Design Certification

    International Nuclear Information System (INIS)

    Kim, Jin Kwon; Kim, Myoung Ki

    2013-01-01

    ITAAC (Inspections, Tests, Analyses and Acceptance Criteria) is essential document for Design Certification, which is certified by NRC and ruled as the Appendix of the 10 CFR Part 52. Approximately 870 ITAAC items were selected for APR1400 Design Certification to be submitted to NRC. In this paper, the code and standard related to ITAAC and process of ITACC development are discussed to seek the way to complete the best ITAAC to get the Design Certification of APR1400 from NRC through the lessons learned from other competitive applicants. For saving the time and manpower to complete ITAAC of APR1400 NRC DC and reduction of the RAIs (Request Additional Information) from NRC, we took advantage of the lessons learned from the competitive designs like US-APWR and AP1000 based on KNGR ITAAC. Finally new and different ITAAC from ITAAC of KNGR was developed for APR1400 DC from NRC. RG 1.206 and SRPs were applied first in Korea to the APR1400 DCD preparation. For testability and acceptability check, ITAAC V and V table was completed by the system designers. APR1400 DCD will be submitted by the end of September this year and we hope that NRC issues lees RAIs on ITAAC document

  9. Optimization Strategy of the APR+ BOP Technical Specifications

    International Nuclear Information System (INIS)

    Cho, Yoon Sang; Lee, Jae Gon; Han, Sung Heum

    2016-01-01

    The BOP is one of the key factors for successful project implementation of NPP. In constructing the APR1400 NPP, the BOP procurement has been one of the biggest concerns. Due to the design changes and increased capacity of equipment in NPP, lots of BOPs should be ‘first supplied equipment’ [hereinafter, ‘FSE’]. The manufacture-ability, and the performances of FSEs have not been fully proved and tested, manufacturers and suppliers are requested to submit Reports for Equipment Qualification Evaluation in accordance with 10 CFR 50.49, IEEE 323. They need at least 1-2 years’ tests for Environment Qualification (EQ) and Seismic Qualification (SQ). This study is focused how to prepare the BOP purchase specifications in order to control the FSEs, especially in safety class equipment. With the optimization plan for BOP packages of this study, the FSEs’ occurrence can be reasonably controlled as low as possible. For successful NPP project, the concerns in procuring BOPs shall be fully analyzed beforehand. Now Korea is preparing new era of APR+, with closing the time of APR1400. The technical specification of APR+ BOPs can be developed and prepared successfully and very effectively according to this optimization plan. This will be a great contribution not only in constructing APR+ in time, but also in exporting APR+ overseas, all over the world in the future

  10. Optimization Strategy of the APR+ BOP Technical Specifications

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Yoon Sang; Lee, Jae Gon; Han, Sung Heum [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    The BOP is one of the key factors for successful project implementation of NPP. In constructing the APR1400 NPP, the BOP procurement has been one of the biggest concerns. Due to the design changes and increased capacity of equipment in NPP, lots of BOPs should be ‘first supplied equipment’ [hereinafter, ‘FSE’]. The manufacture-ability, and the performances of FSEs have not been fully proved and tested, manufacturers and suppliers are requested to submit Reports for Equipment Qualification Evaluation in accordance with 10 CFR 50.49, IEEE 323. They need at least 1-2 years’ tests for Environment Qualification (EQ) and Seismic Qualification (SQ). This study is focused how to prepare the BOP purchase specifications in order to control the FSEs, especially in safety class equipment. With the optimization plan for BOP packages of this study, the FSEs’ occurrence can be reasonably controlled as low as possible. For successful NPP project, the concerns in procuring BOPs shall be fully analyzed beforehand. Now Korea is preparing new era of APR+, with closing the time of APR1400. The technical specification of APR+ BOPs can be developed and prepared successfully and very effectively according to this optimization plan. This will be a great contribution not only in constructing APR+ in time, but also in exporting APR+ overseas, all over the world in the future.

  11. The APR1400 Core Design by Using APA Code System

    International Nuclear Information System (INIS)

    Choi, Yu Sun; Koh, Byung Marn

    2008-01-01

    The nuclear design for APR1400 has been performed to prepare the core model for Automatic Load Follow Operation Simulation. APA (ALPHA/ PHOENIXP/ ANC) code system is a tool for the multi-cycle depletion calculations for APR1400. Its detail versions for ALPHA, PHOENIX-P and ANC are 8.9.3, 8.6.1 and 8.10.5, respectively. The first and equilibrium core depletion calculations for APR1400 have been performed to assure the target cycle length and confirm the safety parameters. The parameters are satisfied within limitation about nuclear design criteria. This APR1400 core models will be based on the design parameters for APR1400 Simulator

  12. Antenna Pattern Range (APR)

    Data.gov (United States)

    Federal Laboratory Consortium — TheAntenna Pattern Range (APR)features a non-metallic arch with a trolley to move the transmit antenna from the horizon to zenith. At the center of the ground plane,...

  13. Diagnostic Strategy in APR1400

    International Nuclear Information System (INIS)

    Kim, Dongyoung; Kim, Jonghyun

    2013-01-01

    These features may bring out changes in operator tasks, changing the characteristics of tasks, or creating new tasks. Diagnostic strategy for identifying anomaly may be different especially in APR1400 from that in the analog control room due to the change of human-system interface, i.e. alarm system and display system. Since the first plant of APR1400 is being built at this moment, it is not known what strategies the operators will adopt in diagnosis tasks in the new operating environment. In this light, this paper aims at investigating operator's diagnostic strategies which are appropriate for APR1400. In order to collect data, several different approaches which are complementary are used to identify diagnostic strategies in the digital control room: analysis on audio/video recording of operation, observation in the simulator, and interview with the operators. The result shows that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of strategies, mostly, by getting more support from the computerized system. This paper investigated how the digitalized control room may influence operator's diagnostic strategies. Several different approaches, i. e., audio/video record, observation of training, and the interview with operators, were used to gather information about the operator's behaviors. As a conclusion, this paper figured out that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of the strategies, mostly, by getting more support from the computerized system. The operators interviewed also commented that the diagnosis in the APR1400 is quicker, more correct, and easier, compared with the analog control room

  14. Diagnostic Strategy in APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dongyoung; Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-05-15

    These features may bring out changes in operator tasks, changing the characteristics of tasks, or creating new tasks. Diagnostic strategy for identifying anomaly may be different especially in APR1400 from that in the analog control room due to the change of human-system interface, i.e. alarm system and display system. Since the first plant of APR1400 is being built at this moment, it is not known what strategies the operators will adopt in diagnosis tasks in the new operating environment. In this light, this paper aims at investigating operator's diagnostic strategies which are appropriate for APR1400. In order to collect data, several different approaches which are complementary are used to identify diagnostic strategies in the digital control room: analysis on audio/video recording of operation, observation in the simulator, and interview with the operators. The result shows that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of strategies, mostly, by getting more support from the computerized system. This paper investigated how the digitalized control room may influence operator's diagnostic strategies. Several different approaches, i. e., audio/video record, observation of training, and the interview with operators, were used to gather information about the operator's behaviors. As a conclusion, this paper figured out that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of the strategies, mostly, by getting more support from the computerized system. The operators interviewed also commented that the diagnosis in the APR1400 is quicker, more correct, and easier, compared with the analog control room.

  15. Pseudomonas syringae evades host immunity by degrading flagellin monomers with alkaline protease AprA.

    Science.gov (United States)

    Pel, Michiel J C; van Dijken, Anja J H; Bardoel, Bart W; Seidl, Michael F; van der Ent, Sjoerd; van Strijp, Jos A G; Pieterse, Corné M J

    2014-07-01

    Bacterial flagellin molecules are strong inducers of innate immune responses in both mammals and plants. The opportunistic pathogen Pseudomonas aeruginosa secretes an alkaline protease called AprA that degrades flagellin monomers. Here, we show that AprA is widespread among a wide variety of bacterial species. In addition, we investigated the role of AprA in virulence of the bacterial plant pathogen P. syringae pv. tomato DC3000. The AprA-deficient DC3000 ΔaprA knockout mutant was significantly less virulent on both tomato and Arabidopsis thaliana. Moreover, infiltration of A. thaliana Col-0 leaves with DC3000 ΔaprA evoked a significantly higher level of expression of the defense-related genes FRK1 and PR-1 than did wild-type DC3000. In the flagellin receptor mutant fls2, pathogen virulence and defense-related gene activation did not differ between DC3000 and DC3000 ΔaprA. Together, these results suggest that AprA of DC3000 is important for evasion of recognition by the FLS2 receptor, allowing wild-type DC3000 to be more virulent on its host plant than AprA-deficient DC3000 ΔaprA. To provide further evidence for the role of DC3000 AprA in host immune evasion, we overexpressed the AprA inhibitory peptide AprI of DC3000 in A. thaliana to counteract the immune evasive capacity of DC3000 AprA. Ectopic expression of aprI in A. thaliana resulted in an enhanced level of resistance against wild-type DC3000, while the already elevated level of resistance against DC3000 ΔaprA remained unchanged. Together, these results indicate that evasion of host immunity by the alkaline protease AprA is important for full virulence of strain DC3000 and likely acts by preventing flagellin monomers from being recognized by its cognate immune receptor.

  16. Development of Reference Source Terms for EU-APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Kim, ByungIl; Lee, Chonghui; Lee, Dongsu; Ko, Heejin; Kang, Sangho [KEPCO Engineering and Construction Co. Inc., Yongin (Korea, Republic of)

    2014-05-15

    These source terms are developed for the typical U. S. NPP and do not reflect the design characteristics of EU-APR1400 (1,400 MWe PWR) which will be applied for the EUR certification in European countries. The process of developing the RST for EU-APR1400 is to undergo a similar process that NUREG-1465 had gone through when it came out with its proposed source terms. The purpose of this study is to develop the EU-APR1400 design-specific RST complied with the EUR. The Large LOCA is the reference equence used in the NUREG-1465 evaluation, whereas the EUAPR1400 risk-significant sequences are dominated by small LOCA and non-LOCA sequences. Moreover, when considering the EU-APR1400 has many design features to mitigate the consequences of severe accident phenomena, it is not surprising that the aspects of both release fractions and durations are distinctly different from NUREG-1465. This RST will be continuously updated to reflect to the design features of EU-APR1400, and then, be used as the reference for design purposes such as criteria satisfaction of radioactivity releases, equipment survivability, control room habitability for severe accident, and so on.

  17. EU-APR Design in compliance with EUR Grid Requirement

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong-Hwan; Lee, Keun-Sung [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    European Utility Requirements (EUR) provides technical requirements for the generation III nuclear power plant in the European countries. EUR grid requirements present the plant requirements to satisfy the needs of the grid network. The grid requirements are the precondition for the operation of a generating plant on the network. This paper describes EU-APR design which has taken account of EUR grid requirements. In this paper, EU-APR designs according to the EUR grid requirements were described. EU-APR was designed in compliance with the voltage and frequency operation field and also designed to have the capability of load following such as primary control, secondary control, and daily load following. Consequently, the EU-APR design according to the EUR grid requirements is expected to get competitiveness and enhance the license feasibility in the European nuclear market.

  18. A Probability Analysis of the Generating Cost for APR1000+

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Gag-Hyeon; Kim, Dae-Hun [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    The nuclear power plant market is expected to grow rapidly in order to address issues of global warming, cutting CO{sub 2} emissions and securing stable electricity supplies. Under these circumstances, the main primary goal of the APR1000+ development is to ensure export competitiveness in the developing countries in the Middle East and Southeast Asia. To that end, APR1000+(1,000MWe, 3.5 generation) will be developed based on APR+ (1,500MWe, 3.5 generation). And comparing to OPR1000(Korean Standard Nuclear power Plant, 2.5 generation), APR1000+ have many design features such as the 60 year design life time, comprehensive site requirement of 0.3g seismic design, stability improvement, operability improvement and provisions for severe accidents. In this simulation, the results of generating cost for APR1000+ preliminary conceptual design using a probability method was shown to be 48.37 ~ 74.22 won/kWh(median value 56.51 won/kWh). Those of OPR1000 was 42.08 ~ 61.77 won/kWh(median value 48.63 won/kWh). APR1000+ has -16.2% cost advantage over OPR1000 nuclear power plant. The main reason of this results is due to adding several safety designs.

  19. The trauma registry compared to All Patient Refined Diagnosis Groups (APR-DRG).

    Science.gov (United States)

    Hackworth, Jodi; Askegard-Giesmann, Johanna; Rouse, Thomas; Benneyworth, Brian

    2017-05-01

    Literature has shown there are significant differences between administrative databases and clinical registry data. Our objective was to compare the identification of trauma patients using All Patient Refined Diagnosis Related Groups (APR-DRG) as compared to the Trauma Registry and estimate the effects of those discrepancies on utilization. Admitted pediatric patients from 1/2012-12/2013 were abstracted from the trauma registry. The patients were linked to corresponding administrative data using the Pediatric Health Information System database at a single children's hospital. APR-DRGs referencing trauma were used to identify trauma patients. We compared variables related to utilization and diagnosis to determine the level of agreement between the two datasets. There were 1942 trauma registry patients and 980 administrative records identified with trauma-specific APR-DRG during the study period. Forty-two percent (816/1942) of registry records had an associated trauma-specific APR-DRG; 69% of registry patients requiring ICU care had trauma APR-DRGs; 73% of registry patients with head injuries had trauma APR-DRGs. Only 21% of registry patients requiring surgical management had associated trauma APR-DRGs, and 12.5% of simple fractures had associated trauma APR-DRGs. APR-DRGs appeared to only capture a fraction of the entire trauma population and it tends to be the more severely ill patients. As a result, the administrative data was not able to accurately answer hospital or operating room utilization as well as specific information on diagnosis categories regarding trauma patients. APR-DRG administrative data should not be used as the only data source for evaluating the needs of a trauma program. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Radiation exposure reduction in APR1400

    International Nuclear Information System (INIS)

    Bae, C. J.; Hwang, H. R.; Matteson, D. M.

    2002-01-01

    The primary contributors to the total occupational radiation exposure in operating nuclear power plants are operation and maintenance activities during refueling outages. The Advanced Power Reactor 1400 (APR1400) includes a number of design improvements and plans to utilize advanced maintenance methods and robotics to minimize the annual collective dose. The major radiation exposure reduction features implemented in APR1400 are a permanent refueling pool seal, quick opening transfer tube blind flange, improved hydrogen peroxide injection at shutdown, improved permanent steam generator work platforms, and more effective temporary shielding. The estimated average annual occupational radiation exposure for APR1400 based on the reference plant experience and an engineering judgment is determined to be in the order of 0.4 man-Sv, which is well within the design goal of 1 man-Sv. The basis of this average annual occupational radiation exposure estimation is an eighteen (18) month fuel cycle with maintenance performed to steam generators and reactor coolant pumps during refueling outage. The outage duration is assumed to be 28 days. The outage work is to be performed on a 24 hour per day basis, seven (7) days a week with overlapping twelve (12) hour work shifts. The occupational radiation exposure for APR1400 is also determined by an alternate method which consists of estimating radiation exposures expected for the major activities during the refueling outage. The major outage activities that cause the majority of the total radiation exposure during refueling outage such as fuel handling, reactor coolant pump maintenance, steam generator inspection and maintenance, reactor vessel head area maintenance, decontamination, and ICI and instrumentation maintenance activities are evaluated at a task level. The calculated value using this method is in close agreement with the value of 0.4 man-Sv, that has been determined based on the experience and engineering judgement

  1. APR1400 Locked Rotor Transient Analysis using KNAP

    International Nuclear Information System (INIS)

    Lee, Dong-Hyuk; Kim, Yo-Han; Ha, Sang Jun

    2007-01-01

    KEPRI (Korea Electric Power Research Institute) has developed safety analysis methodology for non-LOCA (Loss Of Coolant Accident) analysis of OPR1000 (Optimized Power Reactor 1000, formerly KSNP). The new methodology, named KNAP (Korea Non-LOCA Analysis Package), uses RETRAN as the main system analysis code for most transients. For locked rotor transient DNBR analysis, UNICORN-TM code is used. UNICORN-TM is the unified code of RETRAN, MASTER and TORC. The UNICORN-TM has 1-D and 3-D neutron kinetics calculation capability. For locked rotor DNBR analysis, 1-D neutron kinetics is used. In this paper, we apply KNAP methodology to APR1400 (Advanced Power Reactor 1400) locked rotor analysis and compare the results with those in the APR1400 SSAR(Standard Safety Analysis Report). The locked rotor transient is one of the 'decrease in reactor coolant system flow rate' events and the results are typically described in the chapter 15.3.3 of SAR (Safety Analysis Report). In this study, to confirm the applicability of the KNAP methodology and code system to APR1400, locked rotor transient is analyzed using UNICORN-TM code and the results are compared with those from APR1400 SSAR

  2. APR1400 Locked Rotor Transient Analysis using KNAP

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong-Hyuk; Kim, Yo-Han; Ha, Sang Jun [Korea Electric Power Research Institute, Daejeon (Korea, Republic of)

    2007-07-01

    KEPRI (Korea Electric Power Research Institute) has developed safety analysis methodology for non-LOCA (Loss Of Coolant Accident) analysis of OPR1000 (Optimized Power Reactor 1000, formerly KSNP). The new methodology, named KNAP (Korea Non-LOCA Analysis Package), uses RETRAN as the main system analysis code for most transients. For locked rotor transient DNBR analysis, UNICORN-TM code is used. UNICORN-TM is the unified code of RETRAN, MASTER and TORC. The UNICORN-TM has 1-D and 3-D neutron kinetics calculation capability. For locked rotor DNBR analysis, 1-D neutron kinetics is used. In this paper, we apply KNAP methodology to APR1400 (Advanced Power Reactor 1400) locked rotor analysis and compare the results with those in the APR1400 SSAR(Standard Safety Analysis Report). The locked rotor transient is one of the 'decrease in reactor coolant system flow rate' events and the results are typically described in the chapter 15.3.3 of SAR (Safety Analysis Report). In this study, to confirm the applicability of the KNAP methodology and code system to APR1400, locked rotor transient is analyzed using UNICORN-TM code and the results are compared with those from APR1400 SSAR.

  3. Design characteristics of EU-APR1400 on-site power system

    International Nuclear Information System (INIS)

    Kim, D.H.; Kim, Y.S.; Kim, Y.S.

    2014-01-01

    In the global nuclear market, US and European design requirements have been largely used to develop the design of nuclear power plants(NPPs). The APR1400 design was developed on the basis of US regulatory guide and EPRI utility requirements document(URD). In order to enlarge the export market of APR1400, KHNP (Korea Hydro & Nuclear Power Co., Ltd) has developed the EU-APR1400 design which complies with the European nuclear design requirements. In this paper, the design characteristics of EU-APR1400 on-site power system developed according to the European design requirements of electrical power system are described. The European main design requirements of electrical power system involve 50 Hz rated frequency, 400/110 kV grid voltage, the application of the diversity and the redundancy, and so on. The EU-APR1400 on-site power system has been developed on the basis of these requirements. The representative designs include the redundancy, diversity, independence design, the emergency power supply design, the design for providing electrical power to the dedicated severe accident systems, and the design for European grid requirements. (author)

  4. Pseudomonas syringae evades host Immunity by degrading flagellin monomers with alkaline protease AprA

    OpenAIRE

    Pel, M.J.C.; Van Dijken, A.J.H.; Bardoel, B.W.; Seidl, M.F; Van der Ent, S.; Van Strijp, J.A.G.

    2014-01-01

    Bacterial flagellin molecules are strong inducers of innate immune responses in both mammals and plants. The opportunistic pathogen Pseudomonas aeruginosa secretes an alkaline protease called AprA that degrades flagellin monomers. Here, we show that AprA is widespread among a wide variety of bacterial species. In addition, we investigated the role of AprA in virulence of the bacterial plant athogen P. syringae pv. tomato DC3000. The AprA-deficient DC3000 ΔaprA knockout mutant was significantl...

  5. APR1400 CEA Withdrawal at Power Accident Analysis using KNAP

    International Nuclear Information System (INIS)

    Lee, Dong-Hyuk; Yang, Chang-Keun; Kim, Yo-Han; Sung, Chang-Kyung

    2006-01-01

    KEPRI (Korea Electric Power Research Institute) has been developing safety analysis methodology for non- LOCA (Loss Of Coolant Accident) analysis of OPR1000 (Optimized Power Reactor 1000, formerly KSNP). The new methodology, named KNAP (Korea Non-LOCA Analysis Package), uses RETRAN as the main system analysis code. RETRAN code is a non- LOCA safety analysis code developed by EPRI. The new methodology will replace existing CE (Combustion Engineering) supplied codes and methodologies currently used in non-LOCA analysis of OPR1000. In this paper, we apply KNAP methodology to APR1400 (Advanced Power Reactor 1400). The CEA (Control Element Assembly) withdrawal at power accident is one of the 'reactivity and power distribution anomalies' events and the results are typically described in the chapter 15.4.2 of SAR (Safety Analysis Report). The APR1400 has been designed to generate 1,400MWe of electricity with advanced features for greatly enhanced safety and economic goals. The CEA withdrawal at power analysis in APR1400 SSAR (Standard Safety Analysis Report) is analyzed with CESEC-III computer code. In this study, to confirm the applicability of the KNAP methodology and code system to APR1400, CEA withdrawal at power accident is analyzed using RETRAN code and it is compared with results from APR1400 SSAR

  6. System Response Analysis of LOCV for APR1400 Using KNAP

    International Nuclear Information System (INIS)

    Kim, Yo-Han; Sung, Chang-Kyung; Jun, Hwang-Yong

    2006-01-01

    Korea Electric Power Research Institute (KEPRI) of Korea Electric Power Corporation (KEPCO) has been developed the non-loss-of-coolant accident (non-LOCA) analysis methodology, called as the Korea Non-LOCA Analysis Package (KNAP), for the typical Optimized Power Reactor 1000 (OPR1000) plants. Considering current licensing methodology conducted by ABB-CE, however, the KNAP could be applied to Advanced Power Reactor 1400 (APR1400). In spite of some difference in components of two plant types, there is a close resemblance between their nuclear steam supply systems (NSSS). So, in this study, the loss of condenser vacuum (LOCV) event were analyzed using KNAP for APR1400 to estimate the feasibility of the application and the results were compared with those given in APR1400 Standard Safety Analysis Report (SSAR), which were calculated using the CESEC-III code of ABB-CE. Through the study, it was concluded that the KNAP could be applicable to APR1400 on the view point of LOCV event

  7. Functional Requirement Analysis and Function Allocation for APR 1400

    International Nuclear Information System (INIS)

    Nuraslinda, Anuar; Florah, Kamanja; Noloyiso, Mtoko and others

    2013-01-01

    This paper intends to fulfill the FRA and FA of the HFE as required in Chapter 4 of NUREG-0711 rev. 3 for APR1400 to satisfy both plant safety and power generation objectives. This paper aims to evaluate the FRA and FA for APR1400. The allocation of function is done at the system level for all processes for both the power generation and safety goals, following the NUREG/CR-3331 guideline. As a conclusion, this paper has successfully implemented the requirements and methodology specified in NUREG-0711 for APR 1400. The Functional Requirement Analysis (FRA) and Function Allocation (FA) are required by the regulation in the Human Factors Engineering (HFE) program. The FRA defines the functions, processes, and system for plant safety and power generation. The FA allocates the functions to human operator, automation, or a combination of two. The FRA and FA for APR1400 have been performed in the very early stage of development but only for the plant safety. However, the analysis did not include the goal of power generation and also did not fully satisfy the latest revision of NUREG-0711

  8. Functional similarities between the dictyostelium protein AprA and the human protein dipeptidyl-peptidase IV.

    Science.gov (United States)

    Herlihy, Sarah E; Tang, Yu; Phillips, Jonathan E; Gomer, Richard H

    2017-03-01

    Autocrine proliferation repressor protein A (AprA) is a protein secreted by Dictyostelium discoideum cells. Although there is very little sequence similarity between AprA and any human protein, AprA has a predicted structural similarity to the human protein dipeptidyl peptidase IV (DPPIV). AprA is a chemorepellent for Dictyostelium cells, and DPPIV is a chemorepellent for neutrophils. This led us to investigate if AprA and DPPIV have additional functional similarities. We find that like AprA, DPPIV is a chemorepellent for, and inhibits the proliferation of, D. discoideum cells, and that AprA binds some DPPIV binding partners such as fibronectin. Conversely, rAprA has DPPIV-like protease activity. These results indicate a functional similarity between two eukaryotic chemorepellent proteins with very little sequence similarity, and emphasize the usefulness of using a predicted protein structure to search a protein structure database, in addition to searching for proteins with similar sequences. © 2016 The Protein Society.

  9. Functional similarities between the dictyostelium protein AprA and the human protein dipeptidyl‐peptidase IV

    Science.gov (United States)

    Herlihy, Sarah E.; Tang, Yu; Phillips, Jonathan E.

    2017-01-01

    Abstract Autocrine proliferation repressor protein A (AprA) is a protein secreted by Dictyostelium discoideum cells. Although there is very little sequence similarity between AprA and any human protein, AprA has a predicted structural similarity to the human protein dipeptidyl peptidase IV (DPPIV). AprA is a chemorepellent for Dictyostelium cells, and DPPIV is a chemorepellent for neutrophils. This led us to investigate if AprA and DPPIV have additional functional similarities. We find that like AprA, DPPIV is a chemorepellent for, and inhibits the proliferation of, D. discoideum cells, and that AprA binds some DPPIV binding partners such as fibronectin. Conversely, rAprA has DPPIV‐like protease activity. These results indicate a functional similarity between two eukaryotic chemorepellent proteins with very little sequence similarity, and emphasize the usefulness of using a predicted protein structure to search a protein structure database, in addition to searching for proteins with similar sequences. PMID:28028841

  10. A Probability Analysis of the Generating Cost for EU-APR1400 Single Unit

    International Nuclear Information System (INIS)

    Ha, Gak Hyeon; Kim, Sung Hwan

    2014-01-01

    The nuclear power plant market is expected to grow rapidly in order to address issues of global warming, reducing CO 2 emissions and securing stable electricity supplies. Under these circumstances, the main primary goal of the EU-APR100 development is to ensure export competitiveness in the European countries. To this end, EU-APR1400 have been developed based one te APR1400 (Advanced Power Reactor, GEN Type) The EU-APR1400 adds many advanced design features to its predecessor, as outlined below in Table 1. In this simulation, the results of the generating cost of the EU-APR1400 single unit were determined using the probability cost analysis technique, the generating cost range was shown to be 56.16 ∼ 70.92 won/kWh.

  11. A Probability Analysis of the Generating Cost for EU-APR1400 Single Unit

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Gak Hyeon; Kim, Sung Hwan [KHNP CRI, Seoul (Korea, Republic of)

    2014-10-15

    The nuclear power plant market is expected to grow rapidly in order to address issues of global warming, reducing CO{sub 2} emissions and securing stable electricity supplies. Under these circumstances, the main primary goal of the EU-APR100 development is to ensure export competitiveness in the European countries. To this end, EU-APR1400 have been developed based one te APR1400 (Advanced Power Reactor, GEN Type) The EU-APR1400 adds many advanced design features to its predecessor, as outlined below in Table 1. In this simulation, the results of the generating cost of the EU-APR1400 single unit were determined using the probability cost analysis technique, the generating cost range was shown to be 56.16 ∼ 70.92 won/kWh.

  12. APR1400 Fluidic Device Sensitivity Test

    International Nuclear Information System (INIS)

    Choi, Nam Hyun; Chu, In Cheol; Min, Kyong Ho; Song, Chul Hwa

    2005-12-01

    In the safety injection tank at the emergency core cooling system of APR1400, a new safety design feature, passive fluidic device is equipped which includes no active driving system. It is essential to evaluate the new design feature with various experiments. For this reason, three categories of sensitivity tests have been performed in the present study. As the first sensitivity experiment, the effect of the height of the stand pipe was investigated. The second sensitivity test was conducted with removing the insert plate gasket to examine its effect. The effect of the expansion of the control nozzle width was ascertained from the third sensitivity test. The results of each test showed that the passive fluidic device which will be equipped in the SIT tank of APR1400 has great integrity and repeatability

  13. Le don après un décès d'origine cardiocirculatoire au Canada

    Science.gov (United States)

    Shemie, Sam D.; Baker, Andrew J.; Knoll, Greg; Wall, William; Rocker, Graeme; Howes, Daniel; Davidson, Janet; Pagliarello, Joe; Chambers-Evans, Jane; Cockfield, Sandra; Farrell, Catherine; Glannon, Walter; Gourlay, William; Grant, David; Langevin, Stéphan; Wheelock, Brian; Young, Kimberly; Dossetor, John

    2006-01-01

    Résumé Ces recommandations sont le fruit d'un processus multidisciplinaire national ayant duré un an et visant à déterminer si et comment l'on pourrait procéder au don d'organes après un décès d'origine cardiocirculatoire («don après le décès cardiocirculatoire», ou DDC) au Canada. Le forum national organisé en février 2005 a permis aux participants de discuter et d'élaborer des recommandations sur les principes, interventions et pratiques se rapportant au DDC. Les aspects éthiques et juridiques ont été abordés dans les discussions. À la fin du Forum, la majorité des participants ont été favorables à l'implantation de programmes de DDC au Canada. Les participants du Forum ont également convenu qu'il fallait formuler et prôner des valeurs fondamentales pour orienter l'élaboration de programmes et de protocoles basés sur le cadre médical, éthique et juridique établi lors de cette réunion. Même si la possibilité d'un don d'organes et de tissus doit faire partie intégrante des soins de fin de vie, il faut insister sur le fait que le devoir de diligence envers les patients mourants et leurs familles doit demeurer la priorité des équipes soignantes. La complexité et les répercussions profondes du décès sont reconnues et doivent être respectées, de même que les différences personnelles, ethnoculturelles et religieuses face à la mort et au don d'organes. Les décisions d'arrêter le traitement de maintien des fonctions vitales, la prise en charge des derniers moments de la vie et le diagnostic de décès selon des critères cardiocirculatoires doivent être distincts et indépendants des processus de don et transplantation. Ce rapport contient des recommandations destinées aux gestionnaires de program, aux autorités sanitaires régionales et aux instances appelés à élaborer les protocoles de DDC. Les programmes doivent être conçus en fonction des éléments suivants : direction et planification locales, éducation et

  14. Evaluation of the Planned Outage Durations in EU-APR

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Byung Joon; Lee, Keun Sung [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    EU-APR has been designed to comply with European Utility Requirements (EUR) and nuclear design requirements of the European countries. And it is modified and improved from its original design of APR1400. The whole duration varies depending on items for additional process. Refueling and regular maintenance outage is comprised of basic processes and Main turbine-generator outage includes dismantling inspection of main generator and high pressure turbine as a critical path in addition to basic processes. In-Service Inspection Outage includes Automatic ultrasonic inspection on the upper side/lower side of a nuclear reactor as a critical path in addition to basic processes. The planned outage durations of EU-APR are optimized according to the above results. And they are complied with EUR Requirement (EUR 2.2.7.2.2 B), respectively. In addition, outage duration can be reduced with improved operating technology and more maintenance friendly environment including betterment of filling, drain and ventilation.

  15. Evaluation of the Planned Outage Durations in EU-APR

    International Nuclear Information System (INIS)

    Jung, Byung Joon; Lee, Keun Sung

    2016-01-01

    EU-APR has been designed to comply with European Utility Requirements (EUR) and nuclear design requirements of the European countries. And it is modified and improved from its original design of APR1400. The whole duration varies depending on items for additional process. Refueling and regular maintenance outage is comprised of basic processes and Main turbine-generator outage includes dismantling inspection of main generator and high pressure turbine as a critical path in addition to basic processes. In-Service Inspection Outage includes Automatic ultrasonic inspection on the upper side/lower side of a nuclear reactor as a critical path in addition to basic processes. The planned outage durations of EU-APR are optimized according to the above results. And they are complied with EUR Requirement (EUR 2.2.7.2.2 B), respectively. In addition, outage duration can be reduced with improved operating technology and more maintenance friendly environment including betterment of filling, drain and ventilation

  16. Current status of integrated HFE V and V system of APR1400

    International Nuclear Information System (INIS)

    Lee, M. S.; Hong, J. H.; Lee, S. H.; Lee, Y. K.

    2006-01-01

    The first Advanced Light Water Reactor called Advanced Power Reactor (APR1400) has many specific features such as passive safety features, digital I and C, and digitalized main control room design. This digital-based neo-concept main control room design needs comprehensive verification and validation process to get the license for construction. An integrated system for APR1400 MMIS design validation is under development by KEPRI with the participating of KHNP. The facility which is based on the NUREG/CR-6393 and ANS3.5 can simulate all of the dynamic functions and responses of APR1400, and measure the human factors by using conventional subject methods and measuring the operator's biological signals. This system will be used in human factors V and V process of the PRM (NUREG0711) of APR1400 MMIS design. (authors)

  17. Study on Maintenance Personnel Development Plan For The Exported APR1400 Commissioning

    International Nuclear Information System (INIS)

    Cho, Sungbae; Kim, Jongdae; Jun, Hokwang; Hwang, Inok; Kang, Jaeyuel

    2012-01-01

    This paper indicates ways to develop maintenance personnel for the exported APR1400 commissioning. The exported APR1400 has not been experienced ay maintenance yet, and requirements for maintenance personnel have not been clarified yet. Based on sound maintenance experience, KEPCO Plant Service and Engineering Company (KEPCO KPS) has studied on maintenance training and career requirement to establish a development plan of the maintenance personnel for the exported nuclear power plant. By defining manpower and training requirement, and mobilization plan, we expect to secure reliability of the exported APR1400

  18. 48 CFR 1552.235-76 - Treatment of Confidential Business Information (APR 1996).

    Science.gov (United States)

    2010-10-01

    ... Business Information (APR 1996). 1552.235-76 Section 1552.235-76 Federal Acquisition Regulations System... Provisions and Clauses 1552.235-76 Treatment of Confidential Business Information (APR 1996). As prescribed in 1535.007-70(c), insert the following clause: Treatment of Confidential Business Information (TSCA...

  19. Implementasi Automatic Packet Reporting System (APRS) Untuk Paket Data Pemantauan dan PengukuranUntuk Paket Data Pemantauan dan Pengukuran

    OpenAIRE

    Arief Goeritno

    2016-01-01

    Telah dilakukan implementasi Automatic Packet Reporting System (APRS) untuk paket data pemantauan dan pengukuran melalui tujuan penelitian, berupa: a) penyetelan program aplikasi pada jaringan APRS dan b) pengukuran terhadap penerimaan data berdasarkan kinerja sensor-sensor. Penyetelan program aplikasi APRS merupakan konfigurasi perangkat lunak untuk APRS yang akan digunakan pada stasiun penerimaan data APRS dengan program aplikasi yang biasa digunakan, yaitu hyperterminal dan UI-View 32. Pen...

  20. 48 CFR 1552.235-75 - Access to Toxic Substances Control Act Confidential Business Information (APR 1996).

    Science.gov (United States)

    2010-10-01

    ... Control Act Confidential Business Information (APR 1996). 1552.235-75 Section 1552.235-75 Federal... Confidential Business Information (APR 1996). As prescribed in 1535.007(b), insert the following provision: Access to Toxic Substances Control Act Confidential Business Information (APR 1996) In order to perform...

  1. Insecticidal activity of the metalloprotease AprA occurs through suppression of host cellular and humoral immunity.

    Science.gov (United States)

    Lee, Seung Ah; Jang, Seong Han; Kim, Byung Hyun; Shibata, Toshio; Yoo, Jinwook; Jung, Yunjin; Kawabata, Shun-Ichiro; Lee, Bok Luel

    2018-04-01

    The biochemical characterization of virulence factors from entomopathogenic bacteria is important to understand entomopathogen-insect molecular interactions. Pseudomonas entomophila is a typical entomopathogenic bacterium that harbors virulence factors against several insects. However, the molecular actions of these factors against host innate immune responses are not clearly elucidated. In this study, we observed that bean bugs (Riptortus pedestris) that were injected with P. entomophila were highly susceptible to this bacterium. To determine how P. entomophila counteracts the host innate immunity to survive within the insect, we purified a highly enriched protein with potential host insect-killing activity from the culture supernatant of P. entomophila. Then, a 45-kDa protein was purified to homogeneity and identified as AprA which is an alkaline zinc metalloprotease of the genus Pseudomonas by liquid chromatography mass spectrometry (LC-MS). Purified AprA showed a pronounced killing effect against host insects and suppressed both host cellular and humoral innate immunity. Furthermore, to show that AprA is an important insecticidal protein of P. entomophila, we used an aprA-deficient P. entomophila mutant strain (ΔaprA). When ΔaprA mutant cells were injected to host insects, this mutant exhibited extremely attenuated virulence. In addition, the cytotoxicity against host hemocytes and the antimicrobial peptide-degrading ability of the ΔaprA mutant were greatly decreased. These findings suggest that AprA functions as an important insecticidal protein of P. entomophila via suppression of host cellular and humoral innate immune responses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Radiological Impacts Assessment during Normal Decommissioning Operation for EU-APR

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Do Hyun; Lee, Keun Sung [KHNP CRI, Daejeon (Korea, Republic of); Lee, ChongHui [KEPCO Engineering and Construction, Gimcheon (Korea, Republic of)

    2016-10-15

    In this paper, radiological impacts on human beings during normal execution of the decommissioning operations from the current standard design of EU-APR which has been modified and improved from its original design of APR1400 to comply with EUR, are evaluated. Decommissioning is the final phase in the life cycle of a nuclear installation, covering all activities from shutdown and removal of fissile material to environmental restoration of the site. According to article 5.4 specified in chapter 2.20 of European Utility Requirements (EUR), all relevant radiological impacts on human being should be considered during the environmental assessment of decommissioning, including external exposure from direct radiation of plant and other radiation sources, and internal exposure due to inhalation and ingestion. In this paper, radiological impacts on human beings during normal circumstances of the decommissioning operation were evaluated from the current standard design of EU-APR based on the simple transport model and practical generic methodology for assessing the radiological impact provided by IAEA. The results of dose assessment fulfilled the dose limit for all scenarios.

  3. GOTHIC Simulation of APR1400 Auxiliary Charging Pump room heat up

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Hui-Un; Heo, Sun [KHNP, Daejeon (Korea, Republic of)

    2014-10-15

    As a part of the Advanced Power Reactor 1400 (APR1400) U. S. Nuclear Regulatory Commission Design Certification (NRC DC) project, we have been investigating Auxiliary Charging Pump (ACP) room heat up. With reference to the design specification of the ACP room, we determined input information and developed a GOTHIC model of the APR1400 ACP room. This calculation model is described herein, and representative results from the calculation are presented as well. The results of the present paper are used to determine the integrity of ACP operating in the accident. APR 1400 GOTHIC model was developed for ACP room heat up calculation. Calculation results confirm that door opening is cooling the room properly. It is found that the difference due to the surface option of heat conductors is insignificant. Based on this result, further studies should be performed to confirm integrity of ACP.

  4. Conceptual Designs for the Performance Improvement of APR1400 SIT and Preliminary Performance Evaluation

    International Nuclear Information System (INIS)

    Chu, In-Cheol; Kwon, Tae-Soon; Song, Chul-Hwa

    2008-01-01

    Some evolutionary type PWRs such as APR1400 and APWR adopt advanced safety injection tank (SIT). The SIT of APR1400 has a fluidic device (FD) which passively controls ECC water injection flow rate into reactor coolant system during refill and reflood phases of LB-LOCA (i.e., a high injection flow rate during the refill phase and a low injection flow rate during the reflood phase). The benefit of the FD is the elimination of the function of low pressure safety injection pump from the safety injection system. The flow controlling performance of the APR1400 FD was evaluated using a prototypical full-scale test facility, called VAPER (Valve Performance Evaluation Rig). Even though the performance of the APR1400 FD satisfied major design and licensing requirements, further improvement of the performance is expected such as the extension of total injection period, the delay of nitrogen gas discharge. Several conceptual designs have been being drawn out in order to improve the performance of the APR1400 SIT. The performance of some designs was evaluated using a small scale SIT test rig. The present paper introduces some of the conceptual designs and shows the performance evaluation experimental results

  5. Development of LBB Piping Evaluation Diagram for APR 1000 Main Steam Line Piping

    International Nuclear Information System (INIS)

    Yang, J. S.; Jeong, I. L.; Park, C. Y.; Bai, S. Y.

    2010-01-01

    This paper presents the piping evaluation diagram (PED) to assess the applicability of Leak-Before- Break(LBB) for APR 1000 main steam line piping. LBB-PED of APR 1000 main steam line piping is independent of its piping geometry and has a function of the loads applied in piping system. Also, in order to evaluate LBB applicability during construction process with only the comparative evaluation of material properties between actually used and expected, the expected changes of material properties are considered in the LBB-PED. The LBB-PED, therefore, can be used for quick LBB evaluation of APR 1000 main steam line piping of both design and construction

  6. Review of APR+ Level 2 PSA

    International Nuclear Information System (INIS)

    Lehner, J.R.; Mubayi, V.; Pratt, W.T.

    2012-01-01

    Brookhaven National Laboratory (BNL) assisted the Korea Institute of Nuclear Safety (KINS) in reviewing the Level 2 Probabilistic Safety Assessment (PSA) of the APR+ Advanced Pressurized Water Reactor (PWR) prepared by the Korea Hydro and Nuclear Power Co., Ltd (KHNP) and KEPCO Engineering and Construction Co., Inc. (KEPCO-E and C). The work described in this report involves a review of the APR+ Level 2 PSA submittal (Ref. 1). The PSA and, therefore, the review is limited to consideration of accidents initiated by internal events. As part of the review process, the review team also developed three sets of Requests for Additional Information (RAIs). These RAIs were provided to KHNP and KEPCO-E and C for their evaluation and response. This final detailed report documents the review findings for each technical element of the PSA and includes consideration of all of the RAIs made by the reviewers as well as the associated responses. This final report was preceded by an interim report (Ref. 2) that focused on identifying important issues regarding the PSA. In addition, a final meeting on the project was held at BNL on November 21-22, 2011, where BNL and KINS reviewers discussed their preliminary review findings with KHNP and KEPCO-E and C staffs. Additional information obtained during this final meeting was also used to inform the review findings of this final report. The review focused not only on the robustness of the APR+ design to withstand severe accidents, but also on the capability and acceptability of the Level 2 PSA in terms of level of detail and completeness. The Korean nuclear regulatory authorities will decide whether the PSA is acceptable and the BNL review team is providing its comments for KINS consideration. Section 2.0 provides the basis for the BNL review. Section 3.0 presents the review of each technical element of the PSA. Conclusions and a summary are presented in Section 4.0. Section 5.0 contains the references.

  7. Development of Nanosatellite Technology with APRS Module for Disaster Mitigation

    Science.gov (United States)

    Prahyang, S. Y.; Dhiya’Ulhaq, M. Z.; Golim, O. P.; Gunawan, R.; Suhandinata; Jahja, E.; Nelwan, E. R. G.; Ananta, C.; Chow, I. M.; Mali, N. D. F.

    2018-05-01

    Development of nanosatellite technology has enabled satellites to be developed with multiple capabilities for a specific mission in a short time with a low cost. Satellite communications are proved to be more effective in delivering information due to its large coverage area. Surya Satellite-1 will become the first Indonesian nanosatellite developed by undergraduate students. It is designed with low-cost commercial payloads, including an APRS module for communication and operated on VHF and UHF amateur radio frequencies. The mission of the satellites focused on disaster mitigation through APRS communication network with remote stations located on disaster-prone areas.

  8. Probability Analysis of the Construction Cost of an APR1000 Single Unit

    International Nuclear Information System (INIS)

    Ha, Gak Hyeon; Suh, Yong Pyo; Kang, Yong Chul

    2011-01-01

    The nuclear power plant market is expected to grow rapidly in order to address issues of global warming, cutting CO 2 emissions and securing stable electricity supplies. Under these circumstances, the main primary goal of the APR1000 development is to ensure export competitiveness in the developing countries in the Middle East and Southeast Asia. To that end, APR1000 (1,000MWe, 3 rd generation) will be developed based on the OPR1000 (Korean standard nuclear power plant, 2.5 generation) by incorporating and improving the general requirements such as the 60 year design life time, comprehensive site requirement of 0.3g seismic design, stability improvement, operability improvement and provisions for severe accidents. The APR1000 adds 16 advanced design features to its predecessor, as outlined below in Table 1

  9. Evaluation of the Main Steam Line Break Accident for the APR+ Standard Design using MARS-KS

    Energy Technology Data Exchange (ETDEWEB)

    Park, M. H.; Kim, Y. S.; Hwang, Min Jeong; Sim, S. K. [Environment Energy Technology, Daejeon (Korea, Republic of); Bang, Young Seok [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-05-15

    As a part of licensing evaluation of the APR+ (Advanced Power Reactor +) standard design, Korea Institute of Nuclear Safety(KINS) performed safety evaluation of the APR+ Standard Safety Analysis Report(SSAR). The results of the safety evaluation of the APR+ Main Steam Line Break(MSLB) accident is presented for the most limiting post-trip return-to-power case with the single failure assumption of the Loss Of Offsite Power(LOOP). MARS-KS regulatory safety analysis code has been used to evaluate safety as well as the system behavior during MSLB accident. The MARS-KS analysis results are compared with the results of the MSLB safety analysis presented in the SSAR of the APR+. Independent safety evaluation has been performed using MARS-KS regulatory safety analysis code for the APR+ MSLB accident inside containment for the limiting case of the full power post-trip return-to-power. The results of MARS-KS analysis were compared with the results of the MSLB safety analysis presented in the APR+ SSAR. Due to higher cooldown of the MARS-KS analysis, the MARS-KS analysis results in a higher positive reactivity insertion into the core by the negative moderator and fuel temperature reactivity coefficients than the APR+ SSAR analysis. Both results show no return-to-power during the limiting case of the MSLB inside containment. However, APR+ SSAR moderator temperature reactivity insertion should be evaluated against the MARS-KS moderator density reactivity insertion for is conservatism. This study also clearly shows asymmetric thermal hydraulic behavior during the MSLB accident at intact and affected sides of the downcomer and the core. These asymmetric phenomena should be further investigated for the effects on the system design.

  10. Pseudomonas syringae evades host immunity by degrading flagellin monomers with alkaline protease AprA

    NARCIS (Netherlands)

    Pel, Michiel J C; van Dijken, Anja J H; Bardoel, Bart W; Seidl, Michael F; van der Ent, Sjoerd; van Strijp, Jos A G; Pieterse, Corné M J

    Bacterial flagellin molecules are strong inducers of innate immune responses in both mammals and plants. The opportunistic pathogen Pseudomonas aeruginosa secretes an alkaline protease called AprA that degrades flagellin monomers. Here, we show that AprA is widespread among a wide variety of

  11. Pseudomonas syringae evades host Immunity by degrading flagellin monomers with alkaline protease AprA

    NARCIS (Netherlands)

    Pel, M.J.C.; Van Dijken, A.J.H.; Bardoel, B.W.; Seidl, M.F; Van der Ent, S.; Van Strijp, J.A.G.

    2014-01-01

    Bacterial flagellin molecules are strong inducers of innate immune responses in both mammals and plants. The opportunistic pathogen Pseudomonas aeruginosa secretes an alkaline protease called AprA that degrades flagellin monomers. Here, we show that AprA is widespread among a wide variety of

  12. Quantitative Safety Impact of Severe Accident Management Systems for EU-APR during Low Power Shutdown Operation

    International Nuclear Information System (INIS)

    Lee, Keunsung; Hwang, Do Hun; Chang, Hyun-bin

    2016-01-01

    In order to enlarge and to diversify the export market of APR1400, the EU-APR design was developed based on the APR1400 design to comply with the latest version of the European Utility Requirements (EUR) revision D. The EU-APR design has the distinguished and advanced severe accident management systems taken from the APR1400 to obtain a containment integrity for the beyond design basis accident, such as the Passive Ex-vessel retaining and Cooling System (PECS), the Severe Accident Containment Spray System (SACSS) and the Containment Filtered Vent System (CFVS). The risk associated with the nuclear power plant can be identified through the Probabilistic Safety Assessment (PSA). In the EUR chapter 1 and 17 of volume 2, the Criteria for Limited Impact (CLI) should be applied to the Level 2 PSA as a risk metrics. The fraction of exceeding CLI for the EU-APR during LPSD operation was calculated as 4.52% of the CDF under the condition that all severe accident management systems are credited. The PECS, SACSS and CFVS are considered as the severe accident management system which is EU-APR dedicated system. The exemption of each system leads to increase the fraction of exceeding CLI to 54.18%, 89.74% and 21.32% respectively. In case if all these systems are unavailable, the fraction of exceeding CLI is increased to 100%. The most effective system is the SACSS that the system reduces containment pressure and temperature

  13. Quantitative Safety Impact of Severe Accident Management Systems for EU-APR during Low Power Shutdown Operation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Keunsung; Hwang, Do Hun [KHNP CRI, Daejeon (Korea, Republic of); Chang, Hyun-bin [Future and Challenge Technology Co., Yongin (Korea, Republic of)

    2016-10-15

    In order to enlarge and to diversify the export market of APR1400, the EU-APR design was developed based on the APR1400 design to comply with the latest version of the European Utility Requirements (EUR) revision D. The EU-APR design has the distinguished and advanced severe accident management systems taken from the APR1400 to obtain a containment integrity for the beyond design basis accident, such as the Passive Ex-vessel retaining and Cooling System (PECS), the Severe Accident Containment Spray System (SACSS) and the Containment Filtered Vent System (CFVS). The risk associated with the nuclear power plant can be identified through the Probabilistic Safety Assessment (PSA). In the EUR chapter 1 and 17 of volume 2, the Criteria for Limited Impact (CLI) should be applied to the Level 2 PSA as a risk metrics. The fraction of exceeding CLI for the EU-APR during LPSD operation was calculated as 4.52% of the CDF under the condition that all severe accident management systems are credited. The PECS, SACSS and CFVS are considered as the severe accident management system which is EU-APR dedicated system. The exemption of each system leads to increase the fraction of exceeding CLI to 54.18%, 89.74% and 21.32% respectively. In case if all these systems are unavailable, the fraction of exceeding CLI is increased to 100%. The most effective system is the SACSS that the system reduces containment pressure and temperature.

  14. Design features of Advanced Power Reactor (APR) 1400 steam generator

    International Nuclear Information System (INIS)

    Park, Tae-Jung; Park, Jun-Soo; Kim, Moo-Yong

    2004-01-01

    Advanced Power Reactor 1400 (APR 1400) which is to achieve the improvement of the safety and economical efficiency has been developed by Korea Hydro and Nuclear Power Co., Ltd. (KHNP) with the support from industries and research institutes. The steam generator for APR 1400 is an evolutionary type from System 80 + , which is the recirculating U-tube heat exchanger with integral economizer. Compared to the System 80 + steam generator, it is focused on the improved design features, operating and design conditions of APR 1400 steam generator. Especially, from the operation experience of Korean Standard Nuclear Power Plant (KSNP) steam generator, the lessons-learned measures are incorporated to prevent the tube wear caused by flow-induced vibration (FIV). The concepts for the preventive design features against FIV are categorized to two fields; flow distribution and dynamic response characteristics. From the standpoint of flow distribution characteristics, the egg-crate flow distribution plate (EFDP) is installed to prevent the local excessive flow loaded on the most susceptible tube to wear. The parametric study is performed to select the optimum design with the efficient mitigation of local excessive flow. ATHOS3 Mod-01 is used and partly modified to analyze the flow field of the APR 1400 steam generator. In addition, the upper tube bundle support is designed to eliminate the presence of tube with a low natural frequency. Based on the improved upper tube bundle support, the modal analysis is performed and compared with that of System 80 + . Using the results of flow distribution and modal analysis, the two mechanisms of flow-induced vibration are investigated; fluid-elastic instability (FEI) and random turbulence excitation (RTE). (authors)

  15. Non-Integrated Standalone Tests of APR1400 Simulator

    International Nuclear Information System (INIS)

    Hwang, Su Hyun; Lee, Jeong Ik; Hong, Soon Joon; Lee, Byung Chul; Seo, Jeong Gwan; Lee, Myung Soo

    2007-01-01

    APR1400 being developed for the construction of New Kori 3 and 4 Units has improved safety and more economical efficiency compared with previous PWR. The ESF(Engineered Safety Features) newly introduced to enhance safety are as follows: DVI (Direct Vessel Injection), Fluidic Device, IRWST (In-containment Refueling Water Storage Tank). So the transient pattern of anticipated accidents will show different characteristics from previous PWR. There are multidimensional flow phenomena like as emergency core cooling coolant bypass discharge in the downcomer, downcomer boiling, and different safety injection characteristics due to fluidic device during LBLOCA. Also there is the phenomenon of critical flow due to the open of pressurizer POSRV (Pilot Operated Safety Relief valve) connected to IRWST and safety depressurization system and the prediction of discharge flow is very important. KEPRI is developing APR1400 simulator using RELAP-RT . RELAP-RT was developed by DS and S (Data systems and Solutions) based on RELAP5/MOD3.2. The improved features of RELAP-RT to function as a simulator are as follows: Add simulator functionality - Control by simulator executive - IC snap and reset capability - Back-track snap and reset capability - Fast time capability. Fast time capability(examples) - The rate of condensation has been limited. - Fictional choking model has been developed for internal junctions. - Wall heat transfer coefficients and heat fluxes has been limited. In this study, various NISTs (Non-Integrated Standalone Tests) were performed to verify the capability of RELAP-RT as APR1400 simulator by the comparison with RELAP5/MOD3.3

  16. APR-246/PRIMA-1Met Inhibits and Reverses Squamous Metaplasia in Human Conjunctival Epithelium.

    Science.gov (United States)

    Li, Jing; Li, Cheng; Wang, Guoliang; Liu, Zhen; Chen, Pei; Yang, Qichen; Dong, Nuo; Wu, Huping; Liu, Zuguo; Li, Wei

    2016-02-01

    Squamous metaplasia is a common pathologic condition in ocular surface diseases for which there is no therapeutic medication in clinic. In this study, we investigated the effect of a small molecule, APR-246/PRIMA-1(Met), on squamous metaplasia in human conjunctival epithelium. Human conjunctival explants were cultured for up to 12 days under airlifting conditions. Epithelial cell differentiation and proliferation were assessed by Cytokeratin 10 (K10), K14, K19, Pax6, MUC5AC, and p63 immunostaining patterns. β-catenin and TCF-4 immunofluorescent staining and real-time PCR characterized Wnt signaling pathway involvement. Pterygium clinical samples were cultured under airlifting conditions with or without APR-246 for 4 days. p63, K10, β-catenin, and TCF-4 expression in pterygial epithelium was determined by immunofluorescent staining and real-time PCR. Airlift conjunctival explants resulted in increased stratification and intrastromal epithelial invagination. Such pathology was accompanied by increases in K10, K14, and p63 expression, whereas K19 and Pax6 levels declined when compared to those in freshly isolated tissue. On the other hand, APR-246 reversed all of these declines in K10, K14, and p63 expression. Furthermore, K19 and Pax6 increased along with rises in goblet cell density. These effects of APR-246 were accompanied by near restoration of normal conjunctival epithelial histology. APR-246 also reversed squamous metaplasia in pterygial epithelium that had developed after 4 days in ex vivo culture. Reductions in squamous metaplasia induced by APR-246 suggest it may provide a novel therapeutic approach in different squamous metaplasia-associated ocular surface diseases.

  17. Preliminary Results Of LOCA Problem For APR1400 Reactor

    International Nuclear Information System (INIS)

    Le Dai Dien; Hoang Minh Giang; Le Thi Thu; Vo Thi Huong; Le Van Hong

    2011-01-01

    Several features of NPP with APR1400 nuclear reactor during a loss of coolant accident (LOCA) are investigated in this study. The report describes some main design characteristics of an engineering safety systems of APR1400 and the thermal hydraulic calculation results for steady-state using MARS and RELAP/SCDAPSIM codes. Large Break LOCA accident has been analyzed and evaluated based on acceptable criteria for ECCS given by US NRC. The results from cold leg break LOCA with broken area of 0.0465 m 2 in case of high pressure safety injection system (HPSI) failed to operate or 2 and 4 HPSI pumps are activated. The preliminary results of this work is a part of collaboration between INST researchers and KAERI experts in using RELAP tool for safety analysis of NPPs. (author)

  18. The Ongoing Rediscovery of Après-Coup as a Central Freudian Concept.

    Science.gov (United States)

    House, Jonathan

    2017-10-01

    Après-coup, Freud's Nachträglichkeit, is an essential psychoanalytic concept structuring each of four concepts, four mental processes that lie at the foundation of Freud's thinking: psychic trauma, repression, the creation of the unconscious, and the creation of infantile sexuality. It is argued here that infantile sexual drives, in contrast to the self-preservative instincts, arise from a two-step process of translation and repression in which the residues of failed translation become source-objects of the drives. These residues of failed translation have an associative resonance with adult sexuality, and the child is driven to ongoing attempts to translate them, to make them meaningful après coup. Thus, après-coup is at the heart of the human subject as a sexual creature who requires, desires, and creates meaning.

  19. Deletion of aprA and nprA genes for alkaline protease A and neutral protease A from bacillus thuringiensis: effect on insecticidal crystal proteins.

    Science.gov (United States)

    Tan, Y; Donovan, W P

    2001-11-17

    The aprA gene encoding alkaline protease A (AprA) was cloned from Bacillus thuringiensis subsp. kurstaki, and the cloned gene was used to construct aprA-deleted (aprA1) strains of B. thuringiensis. An aprA1 strain of B. thuringiensis that contained the wild-type gene for neutral protease A (nprA(+)) displayed levels of extracellular proteolytic activity that were similar to those of an aprA(+)nprA(+) strain. However, when EDTA was included in the protease assay to inhibit NprA activity the aprA1nprA(+) strain displayed only 2% of the extracellular proteolytic activity of the aprA(+)nprA(+) strain. A strain that was deleted for both aprA and nprA (aprA1nprA3 strain) failed to produce detectable levels of proteolytic activity either in the presence or absence of EDTA in the assay. Compared with the aprA(+)nprA(+) strain the aprA1nprA(+) strain yielded 10% more full-length Cry1Bb crystal protein and the aprA1nprA3 strain yielded 25% more full-length Cry1Bb protein. No significant differences were seen in the 50% lethal dose of Cry1Bb protein from aprA(+)nprA(+) and aprA1nprA3 strains against three species of lepidopteran insects. These results suggest that enhanced yield of certain crystal proteins can be obtained by deletion of the genes aprA and nprA which are the major extracellular proteases of B. thuringiensis.

  20. Development of the APR+ Auxiliary Building General Arrangement (GA)

    International Nuclear Information System (INIS)

    Moon, Hyung Keun; Park, Young Sheop; Kang, Yong Chul

    2011-01-01

    The general arrangement (GA) drawing of a nuclear power plant is the most basic drawing which contains all of the plant equipment, systems, and rooms. Therefore, it should be issued at an early design stage to provide the contours of the overall plant structure. This type of drawing is typically used widely throughout the design stages. The development project of APR+ (Advanced Power Reactor+), as a succeeding model of the APR1400 (Advanced Power Reactor 1400) design, has its own GA that encompasses all of its power buildings. This was developed starting in October of 2009. Among several of the buildings in this design, the Auxiliary Building (AB) is one of the most important buildings to produce electricity, and to protect against undesirable radiation emissions. This paper focuses on the design characteristics of the general arrangement of the AB

  1. A Source Term Calculation for the APR1400 NSSS Auxiliary System Components Using the Modified SHIELD Code

    International Nuclear Information System (INIS)

    Park, Hong Sik; Kim, Min; Park, Seong Chan; Seo, Jong Tae; Kim, Eun Kee

    2005-01-01

    The SHIELD code has been used to calculate the source terms of NSSS Auxiliary System (comprising CVCS, SIS, and SCS) components of the OPR1000. Because the code had been developed based upon the SYSTEM80 design and the APR1400 NSSS Auxiliary System design is considerably changed from that of SYSTEM80 or OPR1000, the SHIELD code cannot be used directly for APR1400 radiation design. Thus the hand-calculation is needed for the portion of design changes using the results of the SHIELD code calculation. In this study, the SHIELD code is modified to incorporate the APR1400 design changes and the source term calculation is performed for the APR1400 NSSS Auxiliary System components

  2. System Response Analysis of Rod Ejection Accident for APR1400 Using KNAP Hot Spot Model

    International Nuclear Information System (INIS)

    Kim, Yo-Han; Ha, Sang-Jun; Jun, Hwang-Yong

    2006-01-01

    Korea Electric Power Research Institute (KEPRI) has been developed the non-loss-of-coolant accident (non- LOCA) analysis methodology, called as the Korea Non- LOCA Analysis Package (KNAP), for the typical Optimized Power Reactor 1000 (OPR1000) plants. Considering current licensing methodology conducted by ABB-CE, however, the KNAP could be applied to Advanced Power Reactor 1400 (APR1400) also. In spite of some difference in design concepts of two plant types, there is a close resemblance between their nuclear steam supply systems (NSSS). So, in this study, the rod ejection accident (REA) event was analyzed using KNAP hot spot model (HSM) for APR1400 to estimate the feasibility of the application and the results were compared with those given in APR1400 Standard Safety Analysis Report (SSAR), which were calculated using the CESEC-III and STRIKIN-II code of ABB-CE. Through the study, it was concluded that the KNAP could be applicable to APR1400 on the view point of REA

  3. Homology modeling of dissimilatory APS reductases (AprBA of sulfur-oxidizing and sulfate-reducing prokaryotes.

    Directory of Open Access Journals (Sweden)

    Birte Meyer

    Full Text Available BACKGROUND: The dissimilatory adenosine-5'-phosphosulfate (APS reductase (cofactors flavin adenine dinucleotide, FAD, and two [4Fe-4S] centers catalyzes the transformation of APS to sulfite and AMP in sulfate-reducing prokaryotes (SRP; in sulfur-oxidizing bacteria (SOB it has been suggested to operate in the reverse direction. Recently, the three-dimensional structure of the Archaeoglobus fulgidus enzyme has been determined in different catalytically relevant states providing insights into its reaction cycle. METHODOLOGY/PRINCIPAL FINDINGS: Full-length AprBA sequences from 20 phylogenetically distinct SRP and SOB species were used for homology modeling. In general, the average accuracy of the calculated models was sufficiently good to allow a structural and functional comparison between the beta- and alpha-subunit structures (78.8-99.3% and 89.5-96.8% of the AprB and AprA main chain atoms, respectively, had root mean square deviations below 1 A with respect to the template structures. Besides their overall conformity, the SRP- and SOB-derived models revealed the existence of individual adaptations at the electron-transferring AprB protein surface presumably resulting from docking to different electron donor/acceptor proteins. These structural alterations correlated with the protein phylogeny (three major phylogenetic lineages: (1 SRP including LGT-affected Archaeoglobi and SOB of Apr lineage II, (2 crenarchaeal SRP Caldivirga and Pyrobaculum, and (3 SOB of the distinct Apr lineage I and the presence of potential APS reductase-interacting redox complexes. The almost identical protein matrices surrounding both [4Fe-4S] clusters, the FAD cofactor, the active site channel and center within the AprB/A models of SRP and SOB point to a highly similar catalytic process of APS reduction/sulfite oxidation independent of the metabolism type the APS reductase is involved in and the species it has been originated from. CONCLUSIONS: Based on the comparative

  4. Hepatiques du Surinam

    NARCIS (Netherlands)

    Jovet-Ast, S.

    1957-01-01

    Il n’existe pas, actuellement, de catalogue des Hépatiques du Surinam. Les Hépatiques de ce pays restent très peu connues. Cependant, certaines ont attiré l’attention des Bryologues et ont été citées dans quelques ouvrages anciens ou récents. Je ne ferai pas ici une révision complète de ces

  5. Constrained model predictive control for load-following operation of APR reactors

    International Nuclear Information System (INIS)

    Kim, Jae Hwan; Lee, Sim Won; Kim, Ju Hyun; Na, Man Gyun; Yu, Keuk Jong; Kim, Han Gon

    2012-01-01

    The load-following operation of APR+ reactor is needed to control the power effectively using the control rods and to restrain the reactivity control from using the boric acid for flexibility of plant operation. Usually, the reason why the disproportion of axial flux distribution occurs during load-following operation is xenon-induced oscillation. The xenon has a very high absorption cross-section and makes the impact on the reactor delayed by the iodine precursor. The power maneuvering using automatically load-following operation has advantage in terms of safety and economic operation of the reactor, so the controller has to be designed efficiently. Therefore, an advanced control method that meets the conditions such as automatic control, flexibility, safety, and convenience is necessary to load-following operation of APR+ reactor. In this paper, the constrained model predictive control (MPC) method is applied to design APR reactor's automatic load-following controller for the integrated thermal power level and axial shape index (ASI) control. Some controllers use only the current tracking command, but MPC considers future commands in addition to the current tracking command. So, MPC can achieve better tracking performance than others. Furthermore, an MPC is to used in many industrial process control systems. The basic concept of the MPC is to solve an optimization problem for a finite future time interval at present time and to implement the first optimal control input as the current control input. The KISPAC-1D code, which models the APR+ nuclear power plants, is interfaced to the proposed controller to verify the tracking performance of the reactor power level and ASI. It is known that the proposed controller exhibits very fast tracking responses

  6. Implementation and Analysis for APR1400 Soft Control System

    International Nuclear Information System (INIS)

    2015-01-01

    Due to the rapid advancement of digital technology, the definite technical advantages of digital control system compared to analog control system are accelerating the implementation of advanced distributed digital control system in the nuclear power plant. One of the major advantages of digital control system is the capability of Soft Control System. The design of Soft Control System for Advanced Power Reactor 1400 (APR1400) plant of Man-Machine Interface System (MMIS) is based on full digital technologies to enhance reliability, operability and maintainability. Computer-based compact workstation has been adopted in the APR1400 Main Control Room (MCR) to provide convenient working environment. This paper introduces the approaches and methodologies of Soft Control System for the Advanced Control Room (ACR). This paper also explains major design features for operation and display of the Soft Control System and its implementation to cope with regulatory requirements. (authors)

  7. Verbal Communication in the APR1400 Advanced Control Room

    International Nuclear Information System (INIS)

    Kim, Jong Hyun; Shin, Young Cheol

    2007-01-01

    This paper introduces the characteristics of communication in advanced main controlghd rooms (MCRs) and some observations from a case study performed for APR1400 MCR. In advanced MCRs, operators need not maintain the same communication patterns as they do in conventional ones. For example, a senior reactor operator (SRO) does not have to rely on board operators for information acquisition and can get any information from his/her own workstation. This situation may also bring about new problems in MCRs such as lack of shared situation awareness and collaboration between MCR operators. To cope with these problems, the APR1400 MCR adapts several approaches in design and training for encouraging operators to communicate with each other. This paper introduces the possible changes of communication patterns and the countermeasures in design and training. Some findings from an integrated system validation for Shin Kori Units 3 and 4 are also presented

  8. Vingt ans après…

    Directory of Open Access Journals (Sweden)

    François Burgat

    2002-05-01

    Full Text Available Le dixième numéro des Chroniques Yéménites, publié vingt ans après la création du Centre Français d'Archéologie et de Sciences Sociales de Sanaa reflète des ambitions souvent exprimées: donner une chance aux jeunes chercheurs et couvrir un large éventail disciplinaire au service de l'affirmation de la vocation régionale du Centre. Depuis Sanaa ou Paris, chercheurs, doctorants ou stagiaires, de l'Ecole normale supérieure, de l'INALCO, de l'Université de Sanaa et de bon nombre d'institu...

  9. Seismic analysis of APR1400 RCS for site envelope using big mass method

    International Nuclear Information System (INIS)

    Kim, J. Y.; Jeon, J. H.; Lee, D. H.; Park, S. H.

    2002-01-01

    One of design concepts of APR1400 is the site envelope considering various soil sites as well as rock site. The KSNP's are constructed on the rock site where only the translational excitations are directly transferred to the plant. On the other hand, the rotational motions affect the responses of the structures in the soil cases. In this study, a Big Mass Method is used to consider rotational motions as excitations at the foundation in addition to translational ones to obtain seismic responses of the APR1400 RCS main components. The seismic analyses for the APR1400 excited simultaneously by translation and rotational motions were performed. The results show that the effect of soil sites is not significant for the design of main components and supports of the RCS, but it may be considerable for the design of reactor vessel internals, piping, and nozzles which have lower natural frequencies

  10. Preliminary Design of Optimized Reactor Insulator for Severe Accident Mitigation of APR1400

    International Nuclear Information System (INIS)

    Heo, Sun; Lee, Jae-Gon; Kang, Yong-Chul

    2007-01-01

    APR1400, a Korean evolutionary advance light water reactor, has many advanced safety feature to prevent and mitigate of design basis accident (DBA) and severe accident. When reactor cooling system (RCS) fails to cooling its core, the core melted down and the molten core gathers together on bottom of reactor vessel. The molten core hurts reactor vessel and is released to containment, which raises the release of radioactive isotopes and the heating of the containment atmosphere. Finally, the corium is accumulated in the bottom of reactor cavity and it also raises the Molten Core and Concrete Interaction (MCCI) and the heating of containment atmosphere. There are two strategies to cooling molten core. Those are in-vessel retention and ex-vessel cooling. At the early stage of APR1400 design, only ex-vessel cooling which is cooling of the molten core outside the vessel after vessel failure is considered based on EPRI Utility Requirement Document (URD) for Evolutionary LWR. However, a need has been arisen to reflect current research findings on severe accident phenomena and mitigation technologies to Korean URD and IVRERVC (In-Vessel corium Retention using Ex-Reactor Vessel Cooling) was adopted APR1400. The ERVC is not considered as a licensing design basis but based on the defense-in-depth principle and safety margin basis, which is the top-tier requirement of the severe accident mitigation design as stated in the KURD. The Severe Accident Management strategy for APR1400 is intended to aid the plant operating staff to secure reactor vessel integrity in the early stage of the severe accident. As a part of a design implementation of IVR-ERVC for APR1400, we developed the preliminary design requirement, design specification and conceptual design

  11. Single-tube condensation experiment in Passive Auxiliary Feedwater System of APR1400+

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Chang Wook; No, Hee Cheon; Yun, Bong Yo; Jeon, Byong Guk [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2012-05-15

    Conventional Korean nuclear power plants, Advanced Power Reactors (APR), are characterized by an active cooling system. However, Active cooling system may not prevent significant damage without any AC power source available for its operation as vividly illustrated through the recent Fukushima incident. In the APR1400+ to be designed, an independent passive cooling system was added in order to overcome the aforementioned shortcomings. In the Passive Auxiliary Feedwater System (PAFS), gravity force and density difference between steam and water are used. The system comprises of 240 condensation tubes to efficiently remove decay heat. Before applying the PAFS to APR1400+, the system's safety and heat removal performance must be verified. The present study experimentally evaluates the heat removal performance of a single tube in the PAFS. The objectives of SCOP (Single-tube Condensation experiment facility of PAFS) are the evaluation of the heat removal performance in the tube of the PAFS and database construction under various tube designs and test conditions. Reaching these objectives, we developed advanced measurement techniques for the amount of moisture, heat flux, and water film thickness.

  12. aprABC: A Mycobacterium tuberculosis complex-specific locus that modulates pH-driven adaptation to the macrophage phagosome

    Science.gov (United States)

    Abramovitch, Robert B.; Rohde, Kyle H.; Hsu, Fong-Fu; Russell, David G.

    2011-01-01

    Summary Following phagocytosis by macrophages, Mycobacterium tuberculosis (Mtb) senses the intracellular environment and remodels its gene expression for growth in the phagosome. We have identified an Acid and Phagosome Regulated (aprABC) locus that is unique to the Mtb complex and whose gene expression is induced during growth in acidic environments in vitro and in macrophages. Using the aprA promoter, we generated a strain that exhibits high levels of inducible fluorescence in response to growth in acidic medium in vitro and in macrophages. aprABC expression is dependent on the two-component regulator phoPR, linking phoPR signaling to pH sensing. Deletion of the aprABC locus causes defects in gene expression that impact aggregation, intracellular growth, and the relative levels of storage and cell wall lipids. We propose a model where phoPR senses the acidic pH of the phagosome and induces aprABC expression to fine-tune processes unique for intracellular adaptation of Mtb complex bacteria. PMID:21401735

  13. Structural assessments of plate type support system for APR1400 reactor

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Anh Tung; Namgung, Ihn, E-mail: inamgung@kings.ac.kr

    2017-04-01

    Highlights: • This paper investigates plate-type support structure for the reactor vessel of the APR 1400. • The tall column supports of APR1400 reactor challenges in seismic and severe accident events. • A plate-type support of reactor vessel was proposed and evaluated based on ASME code. • The plate-type support was assessed to show its higher rigidity than column-type. - Abstract: This paper investigates an alternative form of support structure for the reactor vessel of the APR 1400. The current reactor vessel adopts a four-column support arrangement locating on the cold legs of the vessel. Although having been successfully designed, the tall column structure challenges in seismic events. In addition, for the mitigation of severe accident consequences, the columns inhibit ex-vessel coolant flow, hence the elimination of the support columns proposes extra safety advantages. A plate-type support was proposed and evaluated for the adequacy of meeting the structural stiffness by Finite Element Analysis (FEA) approach. ASME Boiler and Pressure Vessel Code was used to verify the design. The results, which cover thermal and static structural analysis, show stresses are within allowable limits in accordance with the design code. Even the heat conduction area is increased for the plate-type of support system, the results showed that the thermal stresses are within allowable limits. A comparison of natural frequencies and mode shapes for column support and plate-type support were presented as well which showed higher fundamental frequencies for the plate-type support system resulting in greater rigidity of the support system. From the outcome of this research, the plate-type support is proven to be an alternative to current APR column type support design.

  14. Resultats visuels et complications apres chirurgie de la cataracte ...

    African Journals Online (AJOL)

    Resultats visuels et complications apres chirurgie de la cataracte: cas de l' Hopital Ophtalmologique Saint Andre de Tinre au nord-Benin. K.M. Amedome, C.R.A. Assavedo, M Aboudou, K Vonor, N Maneh, K Nonon Saa, K Dzidzinyo, K.D. Ayena, M Banla, K Balo ...

  15. Containment Performance Analysis with Large Break LOCA for EU-APR1400

    International Nuclear Information System (INIS)

    Hwang, Do Hyun; Lee, Keun Sung; Kim, Yong Soo

    2013-01-01

    In this paper for containment performance analysis, the containment pressurization analysis is performed and thermo-hydraulic response analysis of containment structure is carried out to provide basic understanding of containment transient states under a severe accident sequence. Especially, in EU-APR1400 design, to reduce containment pressure and temperature, Severe Accident Containment Spray System (SACSS) is designed to be actuated automatically when Core Exit Temperature (CET) reaches 922 K (649 .deg. C). The containment performance analysis was carried on LBLOCA sequence for EU-APR1400 with SACSS through MAAP code. If SACSS is actuated when CET reaches 922 K (649 .deg. C) , the containment pressure and temperature decrease to a sufficient low level. The predicted atmospheric pressure of containment will not exceed the ultimate pressure capacity (UPC) and have a sufficient margin to it even though the UPC of the reference plant (Shin-Kori Units 3 and 4) is used instead because the UPC calculation for EU-APR1400 has not been completed. The largest load on the containment by LBLOCA is estimated at 306.1 kPa. Thus the margin to UPC is estimated to be 330 % in comparison with 1.329 MPa as UPC for the reference plant.

  16. MDEP Design-Specific Common Position CP-APR1400WG-01. Common position addressing Fukushima Daiichi nuclear power plant accident

    International Nuclear Information System (INIS)

    2016-05-01

    The MDEP APR1400 Working Group (APR1400WG) members consist of members from Republic of Korea, United Arab Emirates, and the United States. A main objectives of MDEP is to encourage convergence of code, standard and safety goals with exploring the opportunities for harmonization of regulatory practice and cooperation on safety review of APR-1400 specific designs. This common position addressing is aimed at sharing knowledge, information and experience on safety improvement related to lessons learned from the Fukushima Daiichi NPP Accident or Fukushima Daiichi NPP Accident-related issues amongst APR-1400 WG member states to achieve the MEDP goal. Because not all of these Regulators have completed the regulatory review of their APR1400 applications yet, this paper identifies common preliminary approaches to address potential safety improvements for APR1400 plants, as well as common general expectations for new nuclear power plants, as related to lessons learned from the Fukushima Daiichi NPP Accident or Fukushima Daiichi NPP Accident-related issues. While some asymmetry exists among those of three Regulators in terms of design, regulatory practice and licensing milestone sharing information and common understanding on post-Fukushima Daiichi NPP Accident enhancement would be promote resilient design for countering beyond design extreme external event like Fukushima Daiichi NPP nuclear disaster. This common position paper aims at identifying characteristics of post-Fukushima Daiichi NPP Accident enhancements putting in place by each country and setting common position to achieve balanced and harmonized APR-1400 design. After the safety reviews of the APR1400 design applications that are currently in review are completed, the regulators will update this paper to reflect their safety conclusions regarding the APR1400 design and how the design could be enhanced to address Fukushima Daiichi NPP Accident-related issues. The common preliminary approaches are organised into

  17. Uncertainty Evaluation of a Postulated LBLOCA for APR+ using KINS Realistic Evaluation Methodology and MARS-KS

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Min Jeong; Marigomena, Ralph; Yoo, Tae Ho; Kim, Y. S.; Sim, S. K. [Environment and Energy Technology, Inc., Daejeon (Korea, Republic of); Bang, Young Seok [KINS, Daejeon (Korea, Republic of)

    2014-05-15

    As a part of the regulatory safety research, Korea Institute of Nuclear Safety(KINS) also developed a best estimate safety analysis regulatory audit code, MARS-KS, to realistically predict and better understand the physical phenomena of the design basis accidents. KINS improved uncertainty propagation methodology using MARS-KS and applied the improved uncertainty evaluation method for the Shinkori Units 3 and 4 LBLOC. This study is to evaluate the uncertainty propagation of a postulated LBLOCA and quantify the safety margin using KINS-REM and MARS-KS code for the APR+ (Advanced Pressurizer Reactor Plus) Standard Safety Analysis Report(SSAR) which is under regulatory review by the KINS for its design approval. KINS-REM LBLOCA realistic evaluation methodology was used for the regulatory assessment of the APR+ LBLOCA using MARS-KS to evaluate the uncertainty propagation of the uncertainty variables as well as to assess the safety margin during the limiting case of the APR+ double ended guillotine cold leg LBLOCA. Uncertainty evaluation for the APR+ LBLOCA shows that the reflood PCT with upper limit of 95% probability at 95% confidence level is 1363.2 K and is higher than the blowdown PCT95/95 of 1275.3 K. The result shows that the current evaluation of APR+ LBLOCA PCT is within the acceptance criteria of 1477 K ECCS.

  18. Experience with a New Colour-Scintillographic Method for Diagnosing Liver Tumours and Inflammatory Liver Disorders; Experience d'une Nouvelle Methode d'Enregistrement Scintigraphique en Couleurs, pour le Diagnostic des Tumeurs Hepatiques et des Affections Inflammatoires du Foie; Opyt ispol'zovaniya novogo metoda tsvetnoj'' stsintigrafii dlya diagnostiki pechenochnykh opukholej i vospalitel'nykh protsessov pecheni; Ensayo de un Nuevo Metodo de Registro Centelleografico Policromo, para el Diagnostico de Tumores Hepaticos y de Inflamaciones del Higado

    Energy Technology Data Exchange (ETDEWEB)

    Sparchez, T.; Gheorghescu, B.; Steclaci, A.; Merculiev, E.; Popovici, M. [Clinique Medicale, Bucarest (Romania)

    1964-10-15

    In order to obtain a better picture of the structural details of the diseased parenchyma of the liver, we have been using a device which has been adapted for use with the Scanner- Tracerlab and which produces liver scans made up of seven colours. The colours are chosen arbitrarily, each one corresponding to a given number of counts and representing zones of isoradioactivity, i.e. zones of liver tissue of relatively equivalent volume. The white in these colour scintigrams represents the radiation background and the black corresponds to the peak activity in the centre of the liver, where the parenchyma is thickest. The colours in between correspond to the different zones of isoradioactivity. This method has been used to examine 150 patients suffering from malignant (primary and secondary) and benign tumours, 80 patients suffering from chronic hepatitis and cirrhosis and 50 normal subjects. In most of the cases studied, intravenous injections of colloidal gold-198 (Amersham, UK) were used. In numerous cases parallel studies were carried out with mechanical scans, black-and-white photoscintigrams and colour scintigrams. Diagnoses were checked by means of punctures, laparoscopy, laparophotography or cinematography, biopsic punctures, surgery and necropsy. Colour scintillography brings out more clearly the variations in the intensity of the radioactivity, i.e. the disorganization of the parenchyma of the liver or its substitution by tumoral processes. (author) [French] Pour obtenir des images qui refletent mieux les details de structure du parenchyme hepatique modifie par la maladie, les auteurs ont adapte au Scanner-Tracerlab un dispositif a l'aide duquel on obtient des cartes hepatiques en sept couleurs. Chaque couleur, choisie arbitrairement, correspond a un nombre d'impulsions et represente des zones d'isoradioactivite, c'est-a-dire de tissu hepatique de volume relativement egal. Dans le scintigramme en couleurs, le blanc represente la radioactivite de fond, tandis

  19. [Evaluation of the capacity of the APR-DRG classification system to predict hospital mortality].

    Science.gov (United States)

    De Marco, Maria Francesca; Lorenzoni, Luca; Addari, Piero; Nante, Nicola

    2002-01-01

    Inpatient mortality has increasingly been used as an hospital outcome measure. Comparing mortality rates across hospitals requires adjustment for patient risks before making inferences about quality of care based on patient outcomes. Therefore it is essential to dispose of well performing severity measures. The aim of this study is to evaluate the ability of the All Patient Refined DRG system to predict inpatient mortality for congestive heart failure, myocardial infarction, pneumonia and ischemic stroke. Administrative records were used in this analysis. We used two statistics methods to assess the ability of the APR-DRG to predict mortality: the area under the receiver operating characteristics curve (referred to as the c-statistic) and the Hosmer-Lemeshow test. The database for the study included 19,212 discharges for stroke, pneumonia, myocardial infarction and congestive heart failure from fifteen hospital participating in the Italian APR-DRG Project. A multivariate analysis was performed to predict mortality for each condition in study using age, sex and APR-DRG risk mortality subclass as independent variables. Inpatient mortality rate ranges from 9.7% (pneumonia) to 16.7% (stroke). Model discrimination, calculated using the c-statistic, was 0.91 for myocardial infarction, 0.68 for stroke, 0.78 for pneumonia and 0.71 for congestive heart failure. The model calibration assessed using the Hosmer-Leme-show test was quite good. The performance of the APR-DRG scheme when used on Italian hospital activity records is similar to that reported in literature and it seems to improve by adding age and sex to the model. The APR-DRG system does not completely capture the effects of these variables. In some cases, the better performance might be due to the inclusion of specific complications in the risk-of-mortality subclass assignment.

  20. Design of a Load Following Controller for APR+ Nuclear Plants

    International Nuclear Information System (INIS)

    Lee, Sim Won; Kim, Jae Hwan; Kim, Dong Su; Na, Man Gyun; Yu, Keuk Jong

    2011-01-01

    The load-following operation of an APR+ nuclear plants is required to restrain the adjustment of boric acid concentration and to efficiently control the control rods for the flexibility of the operation. Especially, axial flux distribution disproportion that is usually caused by load-following operation in a reactor core induces xenon oscillation because the absorption cross-section of xenon is extremely large and its effects in a reactor are delayed by the iodine precursor. Rapid and smooth power maneuvering has its benefits in view of the economical and safe operation of reactors, so it is required that the controller is efficiently designed. Therefore, the load-following operation of an APR+ nuclear plants needs the ultimate automatic control and the advanced control method that satisfies the conditions such as the flexibility, safety and convenience. A model predictive control (MPC) method is applied to design an automatic load-following controller for the integrated thermal power level and axial shape index (ASI) control for an APR+ nuclear plants. Some tracking controllers use only the current tracking command. On the other hand, since MPC considers future commands in addition to the current tracking command, the MPC can achieve better tracking performance. Therefore, the MPC has been applied very much to the control of industrial process systems. The basic concept of the MPC is to solve an optimization problem for generating finite future control inputs at current time and to implement as the current control input only the first control input among the solutions of the finite time steps. At the next time step, the second control input is not implemented and the procedure to solve the optimization problem is then repeated. The power level and the ASI are controlled by the regulating control banks and part-strength control banks together with the automatic adjustment of boric acid concentration. The 3-dimensional MASTER code, which models the APR+ nuclear

  1. Design of a Load Following Controller for APR+ Nuclear Plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sim Won; Kim, Jae Hwan; Kim, Dong Su; Na, Man Gyun [Chosun University, Gwnagju (Korea, Republic of); Yu, Keuk Jong [Korea Hydro and Nuclear Power Co., Daejeon (Korea, Republic of)

    2011-08-15

    The load-following operation of an APR+ nuclear plants is required to restrain the adjustment of boric acid concentration and to efficiently control the control rods for the flexibility of the operation. Especially, axial flux distribution disproportion that is usually caused by load-following operation in a reactor core induces xenon oscillation because the absorption cross-section of xenon is extremely large and its effects in a reactor are delayed by the iodine precursor. Rapid and smooth power maneuvering has its benefits in view of the economical and safe operation of reactors, so it is required that the controller is efficiently designed. Therefore, the load-following operation of an APR+ nuclear plants needs the ultimate automatic control and the advanced control method that satisfies the conditions such as the flexibility, safety and convenience. A model predictive control (MPC) method is applied to design an automatic load-following controller for the integrated thermal power level and axial shape index (ASI) control for an APR+ nuclear plants. Some tracking controllers use only the current tracking command. On the other hand, since MPC considers future commands in addition to the current tracking command, the MPC can achieve better tracking performance. Therefore, the MPC has been applied very much to the control of industrial process systems. The basic concept of the MPC is to solve an optimization problem for generating finite future control inputs at current time and to implement as the current control input only the first control input among the solutions of the finite time steps. At the next time step, the second control input is not implemented and the procedure to solve the optimization problem is then repeated. The power level and the ASI are controlled by the regulating control banks and part-strength control banks together with the automatic adjustment of boric acid concentration. The 3-dimensional MASTER code, which models the APR+ nuclear

  2. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

    Science.gov (United States)

    Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration. © 2012 John Wiley & Sons Ltd.

  3. Veselības aprūpes iemaņas pusaudžiem bērnu namā

    OpenAIRE

    Zūpe, Daira

    2008-01-01

    Pētniecības darbā „Veselības aprūpes iemaņas pusaudžiem bērnu namā” autore Daira Zūpe izpēta un analizē vienu no bērnu namu aktuālajām problēmām veselības profilakses veicināšanā – veselības aprūpes iemaņu attīstīšanu. Pētījumā uzmanība pievērsta māsas lomai bērnu nama pusaudžu veselības aprūpes procesā, kur akcentēta veselības aprūpes pamatiemaņu nozīme veselības vecināšanā - fiziskās aktivitātes, ēšanas paradumi, kaitīgie ieradumi un higiēnas iemaņas. Pētniecības darba zinātniskā vadītā...

  4. Aprūpes īpatnības bērniem ar Dauna sindromu stacionārā

    OpenAIRE

    Lūse, Ērika

    2015-01-01

    Bakalaura darba tēma – Aprūpes īpatnības bērniem ar Dauna sindromu stacionārā. Tēmas aktualitāte pievērst uzmanību bērna ar Dauna sindroma aprūpei, kā arī mazināt stereotipus par šiem bērniem. Darba mērķis ir izpētīt Dauna sindromu un māsas lomu šo bērnu aprūpē, kā arī aprūpes īpatnības. Pētniecības uzdevumi ir veikt zinātniskās literatūras analīzi, pētījuma atbilstošas māszinību teorijas atlasi, izstrādāt anketu, veikt pilot pētījumu, iegūto datu apkopošanu, analīze un secinājumu veikšana. I...

  5. APR1400 Electrical Power System Conformance to SECY-91-078

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Che-Wung; Kim, Yun-Ho [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    In this paper, the APR1400 electric power system for NRC-DC was described. In addition, the conformance to SECY 91-078 was evaluated. Enclosure 1 of the SECY provides an overview of the issue and states that the staff concludes that feeding the safety buses from the offsite power sources through non-safety buses or from a common transformer winding with non-safety loads is not the most reliable configuration. Such an arrangement increases the difficulty in properly regulating voltage at the safety buses, subjects the safety loads to transients caused by the non-safety loads, and adds additional failure points between the offsite power sources and safety loads. Therefore, it is the staff’s position that at least one offsite circuit to each redundant safety division should be supplied directly from one of the offsite power sources with no intervening non-safety buses, in such a manner that the offsite source can power the safety buses upon a failure of any non-safety bus. The APR1400 does not have an intervening nonsafety bus in the current offsite to onsite electrical configuration; however, the design does include nonsafety and safety buses coming from the same secondary side 4.16 kV transformer winding. Nevertheless, the APR1400 has designed the electrical interface system between offsite and onsite power with enhanced reliability measures to ensure that the nonsafety system will not impact the safety loads. The design complies with GDC 17 and also conforms to SECY-91-078.

  6. Quality Control of Concrete Structure For APR1400 Construction

    International Nuclear Information System (INIS)

    Seo, Inseop; Song, Changhak; Kim, Duill

    2012-01-01

    Nuclear structure shall be constructed to protect internal facilities in the normal operation against external accidents such as the radiation shielding, earthquakes and to be leak-proof of radioactive substances to the external environment in case of loss of coolants. containment and auxiliary building of nuclear power plants are built in reinforced concrete structures to maintain these protection functions. Nuclear structures shall be designed to ensure soundness in operation since they are located on the waterfront where is easy do drain the cooling water and so deterioration and damage of concrete structures caused by seawater can occur. Durability is ensured for concrete structures of APR1400, a Korea standard NPP, in compliance with all safety requirements. In particular, owners perform quality control directly on the production and pouring of cast in place concrete for the concrete structure construction to make sure concrete structures established with quality homogeneity and durability. This report is to look into the quality control standard and management status of cast in place concrete for APR1400 construction

  7. Study on Applicability of 10 CFR Part 21 to APR1400 DC Project

    International Nuclear Information System (INIS)

    Shin, He Young; Lee, Do Hwan; Lim, Jae Yong

    2014-01-01

    The tools such as NCR (non conformance report), CAR (corrective action request) and CAP (corrective action program) are widely used for that purpose based upon the rule of 10 CFR Part 50 Appendix B and the ASME Code NQA-1 requirements. These are the tools for a utility, as a purchaser taking over related basic components and services, to ensure strong quality assurance. During the conduct of the project for the acquisition of the standard design certification for APR1400 nuclear power plants from the U. S. NRC (APR1400 DC Project), a new CAP procedure that is appropriate to conduct this unique project was developed. However, it was also recommended to comply with the requirements under 10 CFR Part 21 which enhances nuclear safety quality assurances. Consequently, a new QA procedure is developed in order to deal with the 10 CFR Part 21 issues and this is integrated to the CAP procedure In this paper, the current corrective action program for the APR1400 DC project is introduced and the result of the study on the applicability of 10 CFR Part 21 to the project is indicated. In addition, further improving aspects to be considered are identified. As a frontier project to obtain the standard design certification for APR 1400 model from the U. S. NRC, a modified CAP procedure is developed and enhanced to deal with safety concerning issues in accordance with 10 CFR Part 21. In addition, the newly established QA procedure to directly control the reportability on 10 CFR Part 21 is interfaced into the existing CAP procedure

  8. Assistant Personal Robot (APR: Conception and Application of a Tele-Operated Assisted Living Robot

    Directory of Open Access Journals (Sweden)

    Eduard Clotet

    2016-04-01

    Full Text Available This paper presents the technical description, mechanical design, electronic components, software implementation and possible applications of a tele-operated mobile robot designed as an assisted living tool. This robotic concept has been named Assistant Personal Robot (or APR for short and has been designed as a remotely telecontrolled robotic platform built to provide social and assistive services to elderly people and those with impaired mobility. The APR features a fast high-mobility motion system adapted for tele-operation in plain indoor areas, which incorporates a high-priority collision avoidance procedure. This paper presents the mechanical architecture, electrical fundaments and software implementation required in order to develop the main functionalities of an assistive robot. The APR uses a tablet in order to implement the basic peer-to-peer videoconference and tele-operation control combined with a tactile graphic user interface. The paper also presents the development of some applications proposed in the framework of an assisted living robot.

  9. Apreçando Derivativos de Crédito no Brasil Credit Derivatives Pricing in Brazil

    Directory of Open Access Journals (Sweden)

    Jorge C. Kapotas

    2004-12-01

    Full Text Available Neste artigo apresentamos os principais modelos de apreçamento de instrumentos de crédito onde desenvolvem-se as equações de apreçamento de debêntures. Para tal, utilizam-se os modelos estruturais, de intensidade e, finalmente, de rating. A seguir, definimos o que são derivativos de crédito (CDS e derivamos fórmulas de apreçamento para estes instrumentos. Concluímos este artigo com uma aplicação ao mercado brasileiro. In this paper we present the main models used for pricing defaultable bonds and credit derivatives. The Merton structural model, the intensity framework and a Ratings based model are considered. We apply these techniques to the pricing of credit derivatives on Brazilian US$-indexed treasury bonds.

  10. Transplante de intestino delgado Small intestine transplantation

    Directory of Open Access Journals (Sweden)

    Flávio Henrique Ferreira Galvão

    2003-06-01

    Full Text Available RACIONAL: Avanços da biotecnologia e o desenvolvimento de novas drogas imunossupressoras melhoraram os resultados do transplante de intestino delgado. Esse transplante é atualmente indicado para casos especiais da falência intestinal. OBJETIVO: A presente revisão realça os recentes desenvolvimentos na área do transplante de intestino delgado. MATERIAL E MÉTODO: Mais de 600 publicações de transplante de intestino delgado foram revisadas. O desenvolvimento da pesquisa, novas estratégias de imunossupressão, monitorização do enxerto e do receptor, e avanços na técnica cirúrgica são discutidos. RESULTADOS: Realizaram-se cerca de 700 transplante de intestino delgado em 55 centros: 44% intestino-fígado, 41% enxerto intestinal isolado e 15% transplante multivisceral. Rejeição e infecção são as principais limitações desse transplante. Sobrevida de 5 anos na experiência internacional é de 46% para o transplante de intestino isolado, 43% para o intestino-fígado e de cerca de 30% para o transplante multivisceral. Sobrevidas prolongadas são mais freqüentes nos centros com maior experiência. Em série de 165 transplantes intestinais na Universidade de Pittsburgh, PA, EUA, foi relatada sobrevida do paciente maior do que 75% no primeiro ano, 54% em 5 anos e 42% em 10 anos. Mais de 90% desses pacientes assumem dieta oral irrestrita. CONCLUSÃO: O transplante de intestino delgado evoluiu de estratégia experimental para uma alternativa viável no tratamento da falência intestinal permanente. Promover o refinamento da terapia imunossupressora, do manejo e prevenção de infecções, da técnica cirúrgica e da indicação e seleção adequada dos pacientes é crucial para melhorar a sobrevida desse transplante.BACKGROUND: Significant progress has been made in clinical small bowel transplantation over the last decade mainly due advances in biotechnology and new immunosuppressive regiments. This transplantation has now been indicated

  11. Écrire (d’après

    Directory of Open Access Journals (Sweden)

    Denis Saint-Amand

    2009-03-01

    Full Text Available De l’allusion à la citation, de l’emprunt criard au plagiat déguisé, les jeux d’influences et d’aller-retour avec tel ou tel modèle, grand ou mineur, ont toujours participé de l’élaboration du texte littéraire. Si l’intertextualité est sans aucun doute née en même temps que l’écriture (ou quelques minutes après et que, comme ont pu le montrer notamment Jacques-Philippe Saint-Gérand et Daniel Sangsue, les facettes multiples qu’elle déploie ont toujours suscité l’attention des hommes de lettre...

  12. New tools for NTD vaccines: A case study of quality control assays for product development of the human hookworm vaccine Na-APR-1M74.

    Science.gov (United States)

    Pearson, Mark S; Jariwala, Amar R; Abbenante, Giovanni; Plieskatt, Jordan; Wilson, David; Bottazzi, Maria Elena; Hotez, Peter J; Keegan, Brian; Bethony, Jeffrey M; Loukas, Alex

    2015-01-01

    Na-APR-1(M74) is an aspartic protease that is rendered enzymatically inactive by site-directed mutagenesis and is a candidate antigen component in the Human Hookworm Vaccine. The mutant protease exerts vaccine efficacy by inducing antibodies that neutralize the enzymatic activity of wild type enzyme (Na-APR-1wt) in the gut of the hookworm, thereby depriving the worm of its ability to digest its blood meal. Previously, canines immunized with Na-APR-1(M74) and challenged with Ancylostoma caninum were partially protected against hookworm challenge infection, especially from the loss in hemoglobin observed in control canines and canine immunoglobulin (Ig) G raised against Na-APR-1 was shown to inhibit the enzymatic activity of Na-APR-1 wt in vitro, thereby providing proof of concept of Na-APR-1(M74) as a vaccine antigen. The mutated version, Na-APR-1(M74), was then expressed at the cGMP level using a Nicotiana benthamiana expression system (Fraunhofer, CMB, Delaware, MD), formulated with Alhydrogel®, and used to immunize mice in a dose-ranging study to explore the enzyme-neutralizing capacity of the resulting anti- Na-APR-1(M74) IgG. As little as 0.99 μg of recombinant Na-APR-1(M74) could induce anti Na-APR-1(M74) IgG in mice that were capable of inhibiting Na-APR-1w t-mediated digestion of a peptide substrate by 89%. In the absence of enzymatic activity of Na-APR-1(M74) as a surrogate marker of protein functionality, we developed an assay based on the binding of a quenched fluorescence-labeled inhibitor of aspartic proteases, BODIPY-FL pepstatin A (BDP). Binding of BDP in the active site of Na-APR-1 wt was demonstrated by inhibition of enzymatic activity, and competitive binding with unlabelled pepstatin A. BDP also bound to Na-APR-1(M74) which was assessed by fluorescence polarization, but with an ∼ 50-fold reduction in the dissociation constant. Taken together, these assays comprise a "toolbox" that could be useful for the analyses of Na-APR-1(M74) as it

  13. Analytical Assessment of Environmental Impact for APR1400DC UHS Cooling Tower

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jaiho [KHNP-Central Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    Hot process water is pumped from the plant process to the cooling towers. Heat is rejected through evaporation of the process water, interacting with ambient air blown upward by fans.. Plumes generated from exit ports of the cooling tower may have adverse effects on the environment, such as deposition of cooling tower drift release, fogging, icing, shadowing, and ground-level temperature and humidity increase. These kinds of environmental impact of the cooling tower are linked closely with the dispersion of the cooling tower plumes. In this respect, predicting the behavior of the plumes has become one of the most important issues in the environmental assessments of the cooling towers. The SACTI (seasonal/annual cooling tower impact) model is an analytical tool to predict the environmental effect of cooling tower, which was developed by Argonne National Laboratory and University of Illinois with support from EPRI (electric power research institute). The initial version of SACTI has been widely used to assess the environmental effect of cooling towers in many industrial fields such as steam power plants and NPPs. Guo et. al. investigated impact of heat rejection and cooling tower height on plume dispersion using the SACTI model, for the purpose of the future construction of inland NPPs. They found that increasing cooling tower height decreases the plume length and height frequencies. Their simulation results showed that the increase in heat rejection increases the plum radius frequency. The APR1400DC is an advanced light water reactor developed for the purpose of NRC-DC (design certification). The cooling towers for APR1400DC UHS consist of two linear mechanical draft cooling towers (LMDCTs). The LMDCT for APR1400DC UHS is conceptually designed because the plant site has not been decided yet. In the present study, the dependency of plume dispersion on the number of cooling towers is investigated using SACTI-2-beta, for predicting annual environmental effect of APR

  14. Liver transplant

    Science.gov (United States)

    Hepatic transplant; Transplant - liver; Orthotopic liver transplant; Liver failure - liver transplant; Cirrhosis - liver transplant ... The donated liver may be from: A donor who has recently died and has not had liver injury. This type of ...

  15. Hair Transplants

    Science.gov (United States)

    ... Search Skin Experts Skin Treatments Hair Transplants Share » HAIR TRANSPLANTS Before (left) and after (right) - front of ... transplant. Photo courtesy of N. Sadick What are hair transplants? In punch transplanting, a plug containing hair ...

  16. Effectiveness of External Reactor Vessel Cooling (ERVC) strategy for APR1400 and issues of phenomenological uncertainties

    International Nuclear Information System (INIS)

    Oh, S.J.; Kim, H.T.

    2007-01-01

    The APR1400(Advanced Power Reactor 1400) is an evolutionary advanced light water reactor with rated thermal power of 4000 MWt. For APR1400, External Reactor Vessel Cooling (ERVC) is adopted as a primary severe accident management strategy for in-vessel retention (IVR) of corium. The ERVC is a method of IVR by submerging the reactor vessel exterior. At the early stage of the APR1400 design, only ex-vessel cooling, cooling of the core melt outside the vessel after vessel is breached, is considered based on the EPRI Utility Requirement Document for Evolutionary LWR. However, based on the progress in implementation of Severe Accident Management Guidance (SAMG) for operating plants, as well as the research findings related to ERVC, ERVC strategy is adopted as a part of key severe accident management strategies. To improve its success, the strategy is reviewed and we implemented necessary design arrangement to increase its usefulness in managing the severe accident. In this paper, we examine the evolution of ERVC concept and its implementation in APR1400. Then, we review possible approach, including Risk-Oriented Accident Analysis Methodology (ROAAM), to evaluate the effectiveness of the strategy. (authors)

  17. 897.pdf | apr102004 | currsci | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; currsci; apr102004; 897.pdf. 404! error. The page your are looking for can not be found! Please check the link or use the navigation bar at the top. YouTube; Twitter; Facebook; Blog. Academy News. IAS Logo. 29th Mid-year meeting. Posted on 19 January 2018. The 29th Mid-year meeting of the Academy will be held ...

  18. Immediate re-transplantation following early kidney transplant thrombosis.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2012-02-01

    Allograft thrombosis is a devastating early complication of renal transplantation that ultimately leads to allograft loss. We report here on our experience of nine cases of immediate re-transplantation following early kidney transplant thrombosis at a single centre between January 1990 and June 2009. The mean age was 42.9 years at time of transplant. For seven patients, the allograft thrombosis was their first kidney transplant and seven of the nine cases had a deceased donor transplant. The initial transplants functioned for a mean of 1.67 days and the patients received a second allograft at a mean of 3.1 days after graft failure. All of the re-transplants worked immediately. Four allografts failed after a mean of 52.5 months (2-155 months). Two of these died with a functioning allograft, one failed owing to chronic allograft nephropathy and one owing to persistent acute cellular rejection. The remaining five patients still have a functioning allograft after a mean of 101.8 months (7-187 months). One year allograft and patient survival after re-transplantation were 87.5% and 100% respectively (after 5 years, both were 57%). Immediate re-transplantation following early kidney transplant thrombosis can be a success. It may be considered in selected cases after allograft thrombosis.

  19. Implementasi Automatic Packet Reporting System (APRS Untuk Paket Data Pemantauan dan PengukuranUntuk Paket Data Pemantauan dan Pengukuran

    Directory of Open Access Journals (Sweden)

    Arief Goeritno

    2016-03-01

    Full Text Available Telah dilakukan implementasi Automatic Packet Reporting System (APRS untuk paket data pemantauan dan pengukuran melalui tujuan penelitian, berupa: a penyetelan program aplikasi pada jaringan APRS dan b pengukuran terhadap penerimaan data berdasarkan kinerja sensor-sensor. Penyetelan program aplikasi APRS merupakan konfigurasi perangkat lunak untuk APRS yang akan digunakan pada stasiun penerimaan data APRS dengan program aplikasi yang biasa digunakan, yaitu hyperterminal dan UI-View 32. Pengukuran penerimaan data berdasarkan kinerja sensor yang dilakukan melalui proses perekaman pada stasiun penerimaan data APRS. Kinerja sensor-sensor akan diamati pada stasiun pengiriman dan data hasil pengamatan akan dapat diterima pada stasiun penerimaan secara real time. Program aplikasi berbasis hyperterminal dan UI View 32 telah berhasil melakukan proses handshaking antara Terminal Node Controller (TNC dan komputer, sehingga data telemetri dari stasiun pengiriman paket data dapat diterima di stasiun penerimaan. Data telemetri dapat diamati pada stasiun penerimaan dan dapat diperoleh secara real time dengan format: YB0LRB-11>BEACON,WIDE2-1 [05/18/2014 04:03:49]: : T#010,008,093,004,122,075. Notifikasi YB0LRB-11 merupakan stasiun pengiriman paket data telemetri, kemudian data tersebut akan diterima pada stasiun penerima YD1PRY dengan format: YD1PRY-2>APLPN,ARISS [05/18/2014 04:03:07]: : !06.30.37S/106.48.26E#. Notifikasi tersebut merupakan pengiriman informasi data posisi oleh stasiun YD1PRY untuk inisialisasi pada jaringan APRS. Stasiun YB0LRB-11 ketika mengirim paket data telemetri dengan format: YB0LRB-11>BEACON,WIDE2-1 [05/18/2014 04:00:49]: : T#001,004,035,005,122,075. Paket data dari stasiun YB0LRB yang dipancar ulang atau digipeater dengan format: YB0LRB-11>BEACON,YD1PRY-2,WIDE2* [05/18/2014 04:00:50]: : T#001,004,035,005,122,075. Sensor pengukuran berkinerja relatif stabil, walaupun terdapat nilai simpangan pengukuran sebesar 1 cm atau

  20. 75 FR 44847 - Proposed Collection; Comment Request for Forms 943, 943-PR, 943-A, and 943A-PR

    Science.gov (United States)

    2010-07-29

    ... 943, 943-PR, 943- A, and 943A-PR AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and... comments concerning Forms 943, Employer's Annual Tax Return for Agricultural Employees, 943-PR, Planilla..., Agricultural Employer's Record of Federal Tax Liability, and 943A-PR, Registro De La Obligacion Contributiva...

  1. Immediate re-transplantation following early kidney transplant thrombosis.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2011-08-01

    Allograft thrombosis is a devastating early complication of renal transplantation that ultimately leads to allograft loss. We report here on our experience of nine cases of immediate re-transplantation following early kidney transplant thrombosis at a single centre between January 1990 and June 2009. The mean age was 42.9 years at time of transplant. For seven patients, the allograft thrombosis was their first kidney transplant and seven of the nine cases had a deceased donor transplant. The initial transplants functioned for a mean of 1.67 days and the patients received a second allograft at a mean of 3.1 days after graft failure. All of the re-transplants worked immediately. Four allografts failed after a mean of 52.5 months (2-155 months). Two of these died with a functioning allograft, one failed owing to chronic allograft nephropathy and one owing to persistent acute cellular rejection. The remaining five patients still have a functioning allograft after a mean of 101.8 months (7-187 months). One year allograft and patient survival after re-transplantation were 87.5% and 100% respectively (after 5 years, both were 57%). Immediate re-transplantation following early kidney transplant thrombosis can be a success. It may be considered in selected cases after allograft thrombosis.

  2. Numerical Analysis of Molten Corium Dispersion during Hypothetical High-Pressure Accidents in APR1400 Nuclear Power Plant

    International Nuclear Information System (INIS)

    Kim, Jong Tae; Ha, Kwang Soon; Kim, Sang Baik; Kim, Hee Dong; Jeong, Jae Sik

    2010-01-01

    During a hypothetical high-pressure accident in a nuclear power plant (NPP), molten corium can be ejected through a breach of a reactor pressure vessel (RPV) and dispersed by the following jet of a high pressure steam in the RPV. The dispersed corium is fragmented into smaller droplets in a reactor cavity of the NPP by the steam jet with very high velocity and is released into the upper compartment of the NPP by an overpressure in the cavity. The heat-carrying fragments of the corium transfer the thermal energy to the ambient air in the containment and react chemically with steam and generate hydrogen which may be burnt in the containment. The thermal loads from the ejected molten corium on the containment which is called direct containment heating (DCH) can threaten the integrity of the containment. New generation NPPs such as APR1400 and EPR have been designed in consideration of reducing the possibility of the containment failure from the DCH. In order for that, APR1400 has a convolute-type corium chamber connected to the reactor cavity. In the case of EPR, severe-accident dedicated depressurization valves are installed to preclude a high pressure melt ejection (HPME). DCH in a NPP containment is related to many physical phenomena such as multi-phase hydrodynamics, thermodynamics and chemical reaction. In the evaluation of the DCH load, the melt dispersion rates depending on the RPV pressure are the most important parameter. Mostly, DCH was evaluated by using lumped-analysis codes with some correlations obtained from experiments for the dispersion rates. The corium dispersion rates for many types of the NPP containments had been obtained by experiments in 90s. And some correlations from the experimental data were developed. As mentioned above, APR1400 has a corium chamber to reduce the corium dispersion rate. But there is no experimental data for the dispersion rate specific to the APR1400 cavity geometry. So its performance for capturing of the dispersed corium

  3. 78 FR 47051 - Proposed Collection; Comment Request for Forms 943, 943-PR, 943-A, and 943A-PR

    Science.gov (United States)

    2013-08-02

    ... 943, 943-PR, 943- A, and 943A-PR AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and..., 943-PR, Planilla Para La Declarcion Anual De La Contribucion Federal Del Patrono De Empleados Agricolas, 943-A, Agricultural Employer's Record of Federal Tax Liability, and 943A-PR, Registro De La...

  4. Pre-liver transplant psychosocial evaluation predicts post-transplantation outcomes.

    Science.gov (United States)

    Benson, Ariel A; Rowe, Mina; Eid, Ahmad; Bluth, Keren; Merhav, Hadar; Khalaileh, Abed; Safadi, Rifaat

    2018-08-01

    Psychosocial factors greatly impact the course of patients throughout the liver transplantation process. A retrospective chart review was performed of patients who underwent liver transplantation at Hadassah-Hebrew University Medical Center between 2002 and 2012. A composite psychosocial score was computed based on the patient's pre-transplant evaluation. Patients were divided into two groups based on compliance, support and insight: Optimal psychosocial score and Non-optimal psychosocial score. Post-liver transplantation survival and complication rates were evaluated. Out of 100 patients who underwent liver transplantation at the Hadassah-Hebrew University Medical Center between 2002 and 2012, 93% had a complete pre-liver transplant psychosocial evaluation in the medical record performed by professional psychologists and social workers. Post-liver transplantation survival was significantly higher in the Optimal group (85%) as compared to the Non-optimal group (56%, p = .002). Post-liver transplantation rate of renal failure was significantly lower in the Optimal group. No significant differences were observed between the groups in other post-transplant complications. A patient's psychosocial status may impact outcomes following transplantation as inferior psychosocial grades were associated with lower overall survival and increased rates of complications. Pre-liver transplant psychosocial evaluations are an important tool to help predict survival following transplantation.

  5. An Experimental Investigation on APR1400 Penetration Weld Failure by Metallic Melt

    International Nuclear Information System (INIS)

    An, Sang Mo; Ha, Kwang Soon; Kim, Hwan Yeol

    2014-01-01

    The penetrations are considered as the most vulnerable parts with respect to the reactor vessel failure when a core melt severe accident occurs and the corium reaches the lower head. Penetration tube failure modes can be divided into two categories; tube ejection out of the vessel lower head and rupture of the penetration tube outside the vessel. Tube ejection begins with degrading the penetration tube weld strength to zero as the weld is exposed to temperatures as high as the weld melting temperature, which is called weld failure, and then overcoming any binding force in the hole in the vessel wall that results from differential thermal expansion of the tube and vessel wall. Tube rupture assumes that the debris bed has melted the instrument tube inside the reactor and melt migrates down into the tube to a location outside the vessel wall where a pressure rupture can occur, thus breaching the pressure boundary. In the present paper, we have a focus on the tube ejection failure mode, specifically on the APR1400 weld failure by direct contact with a metallic melt. The objective is to investigate experimentally the ablation kinetics of an APR1400 penetration weld during the interactions with a metallic melt and to suggest the modification of the existing weld failure model. This paper involves the interaction experiments of two different metallic melts (metallic corium and stainless steel melts) with a weld specimen, and rough estimation of weld failure time. The interaction experiments between the metallic melts and an APR1400 penetration weld were performed to investigate the ablation kinetics of the penetration weld. Metallic corium and stainless steel melts were generated using an induction heating technique and interacted with a penetration weld specimen. The ablation rate of the weld specimen showed a range from 0.109 to 0..244 mm/s and thus the APR1400 penetration weld was estimated to be failed at hundreds of times after the interaction with the melt

  6. Development of a Test Facility to Simulate the Reactor Flow Distribution of APR+

    International Nuclear Information System (INIS)

    Euh, D. J.; Cho, S.; Youn, Y. J.; Kim, J. T.; Kang, H. S.; Kwon, T. S.

    2011-01-01

    Recently a design of new reactor, APR+, is being developed, as an advanced type of APR1400. In order to analyze the thermal margin and hydraulic characteristics of APR+, quantification tests for flow and pressure distribution with a conservation of flow geometry are necessary. Hetsroni (1967) proposed four principal parameters for a hydraulic model representing a nuclear reactor prototype: geometry, relative roughness, Reynolds number, and Euler number. He concluded that the Euler number should be similar in the prototype and model under the preservation of the aspect ratio on the flow path. The effect of the Reynolds number at its higher values on the Euler number is rather small, since the dependency of the form and frictional loss coefficients on the Reynolds number is seen to be small. ABB-CE has carried out several reactor flow model test programs, mostly for its prototype reactors. A series of tests were conducted using a 3/16 scale reactor model. (see Lee et al., 2001). Lee et al (1991) performed experimental studies using a 1/5.03 scale reactor flow model of Yonggwang nuclear units 3 and 4. They showed that the measured data met the acceptance criteria and were suitable for their intended use in terms of performance and safety analyses. The design of current test facility was based on the conservation of Euler number which is a ratio of pressure drop to dynamic pressure with a sufficiently turbulent region having a high Reynolds number. By referring to the previous study, the APR+ design is linearly reduced to 1/5 ratio with a 1/2 of the velocity scale, which yields a 1/39.7 of Reynolds number scaling ratio. In the present study, the design feature of the facilities, named 'ACOP', in order to investigate flow and pressure distribution are described

  7. Critical heat flux for APR1400 lower head vessel during a severe accident

    International Nuclear Information System (INIS)

    Noh, Sang W.; Suh, Kune Y.

    2013-01-01

    Highlights: ► Studied boiling on downward-facing hemispherical vessel with asymmetric thermal insulator. ► Scaled the APR1400 lower head linearly down by 1/10 including ICI tubes and shear keys. ► Performed thermal analysis using ANSYS V11.0 to determine the internal temperature and heat flux. ► Performed tests to obtain the CHF with saturated demineralized water at atmospheric pressure. ► Measured CHF accounting for 3D random flow effect expected in the APR1400 application. -- Abstract: Corium Ablation Stopper Apparatus (CASA) has a downward-facing hemispherical vessel and geometrically asymmetric thermal insulator of the Advanced Power Reactor 1400 MWe (APR1400) scaled linearly down by 1/10, as well as sixty-one in-core instrumentation (ICI) tubes and four shear keys. The heated vessel plays a pivotal role in CASA depending on the configuration of the oxide pool and metal layer to bring about the focusing effect expected of a molten pool in the lower head during a severe accident. The heated vessel was designed through a trial-and-error method and thermal analysis. Thermal analysis was performed using ANSYS V11.0 to investigate the effect of the internal temperature and heat flux on the integral hemispherical copper vessel. The CASA tests were carried out to obtain the critical heat flux (CHF) with saturated and demineralized water at the atmospheric pressure (0.1 MPa). The CHF in the metal layer through the hemispherical channel was found to be lower than that in the ULPU-2400 configuration V data through the streamlined thermal insulator. The experimental CHF was measured and obtained through the CASA hemispherical heated surface accounting for the three-dimensional random flow effect expected in the APR1400 application

  8. Three-year post-transplant medicare payments in kidney transplant recipients: Associations with pre-transplant comorbidities

    Directory of Open Access Journals (Sweden)

    Gerardo Machnicki

    2011-01-01

    Full Text Available Little is known about the influence of pre-transplant comorbidities on post-transplant expenditures. We estimated the associations between pre-transplant comorbidities and post-transplant Medicare costs, using several comorbidity classification systems. We included recipients of first-kidney deceased donor transplants from 1995 through 2002 for whom Medicare was the primary payer for at least one year pre-transplant (N = 25,175. We examined pre-transplant comorbidities as classified by International Classification of Diseases (ICD-9-CM codes from Medicare claims with the Clinical Cla-ssifications Software (CCS and Charlson and Elixhauser algorithms. Post-transplant costs were calcu-lated from payments on Medicare claims. We developed models considering Organ Procurement and Transplantation Network (OPTN variables plus: 1 CCS categories, 2 Charlson, 3 Elixhauser, 4 num-ber of Charlson and 5 number of Elixhauser comorbidities, independently. We applied a novel regression methodology to account for censoring. Costs were estimated at individual and population levels. The comorbidities with the largest impact on mean Medicare payments included cardiovascular disease, ma-lignancies, cerebrovascular disease, mental conditions and functional limitations. Skin ulcers and infec-tions, rheumatic and other connective tissue disease and liver disease also contributed to payments and have not been considered or described previously. A positive graded relationship was found between costs and the number of pre-transplant comorbidities. In conclusion, we showed that expansion beyond the usually considered pre-transplant comorbidities with inclusion of CCS and Charlson or Elixhauser comorbidities increased the knowledge about comorbidities related to augmented Medicare payments. Our expanded methodology can be used by others to assess more accurately the financial implications of renal transplantation to Medicare and individual transplant centers.

  9. Vibration Analysis for Steam Dryer of APR1400 Steam Generator

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sung-heum; Ko, Doyoung [KHNP CRI, Daejeon (Korea, Republic of); Cho, Minki [Doosan Heavy Industry, Changwon (Korea, Republic of)

    2016-10-15

    This paper is related to comprehensive vibration assessment program for APR1400 steam generator internals. According to U.S. Nuclear Regulatory Commission, Regulatory Guide 1.20 (Rev.3, March 2007), we conducted vibration analysis for a steam dryer as the second steam separator of steam generator internals. The vibration analysis was performed at the 100 % power operating condition as the normal operation condition. The random hydraulic loads were calculated by the computational fluid dynamics and the structural responses were predicted by power spectral density analysis for the probabilistic method. In order to meet the recently revised U.S. NRC RG 1.20 Rev.3, the CVAP against the potential adverse flow effects in APR1400 SG internals should be performed. This study conducted the vibration response analysis for the SG steam dryer as the second moisture separator at the 100% power condition, and evaluated the structural integrity. The predicted alternating stress intensities were evaluated to have more than 17.78 times fatigue margin compared to the endurance limit.

  10. GPM GROUND VALIDATION AIRBORNE SECOND GENERATION PRECIPITATION RADAR (APR-2) GCPEX V1

    Data.gov (United States)

    National Aeronautics and Space Administration — The GPM Ground Validation Airborne Second Generation Precipitation Radar (APR-2) GCPEx dataset was collected during the GPM Cold-season Precipitation Experiment...

  11. 1001.pdf | 25apr2010 | currsci | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    2010-04-25

    Apr 25, 2010 ... error. The page your are looking for can not be found! Please check the link or use the navigation bar at the top. YouTube · Twitter · Facebook · Blog. Academy News. IAS Logo. Summer Research Fellowship Programme 2018. Dates Extended To 7 December 2017. Register here · Focus Area Science ...

  12. Post-transplant lymphoproliferative disorder following kidney transplantation

    DEFF Research Database (Denmark)

    Maksten, Eva Futtrup; Vase, Maja Ølholm; Kampmann, Jan

    2016-01-01

    after long-term post-transplantation follow-up. A retrospective population-based cohort study including all kidney transplant recipients at two Danish centres (1990-2011; population covered 3.1 million; 2175 transplantations in 1906 patients). Pathology reports were reviewed for all patient biopsies...

  13. Improved Design of Crew Operation in Computerized Procedure System of APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Seong, No Kyu; Jung, Yeon Sub; Sung, Chan Ho [KHNP, Daejeon (Korea, Republic of)

    2016-05-15

    The operators perform the paper-based procedures in analog-based conventional main control room (MCR) depending on only communications between operators except a procedure controller such as a Shift Supervisor (SS), however in digital-based MCR the operators can confirm the procedures simultaneously in own console when the procedure controller of computerized procedure (CP) opens the CP. The synchronization and a synchronization function between procedure controller and other operators has to be considered to support the function of crew operation. This paper suggests the improved design of crew operation in computerized procedure system of APR1400. This paper suggests the improved design of APR1400 CPS. These improvements can help operators perform the crew procedures more efficiently. And they reduce a burden of communication and misunderstanding of computerized procedures. These improvements can be applied to CPS after human factors engineering verification and validation.

  14. Greta Kaits 9. apr. 1928 - 29. aug. 1946 : [luuletused] / Mats Traat

    Index Scriptorium Estoniae

    Traat, Mats, 1936-

    2008-01-01

    Sisu : Greta Kaits 9. apr. 1928 - 29. aug. 1946 ; Villem Hänilane 1898 - 1952 ; Peeter Pedak 1897 - 1953 ; Max Äidse 1903 - 1959 ; Lavinia Laidam ; Buchard Pruus ; Sergei Krivokopõtov ; Allan Luht 5. VII 1962 - 17. V 2007 ; Karl Saarmets 9. III 1924 - 14. IX 1981 ; Raimo Ritsik

  15. Les pertes après récolte en Afrique : examen analytique et synthèse ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Partout en Afrique, les pertes après récolte le long de la chaîne alimentaire, de la ferme à la table, mettent en péril la sécurité alimentaire des agriculteurs dépourvus de ressources. La réduction des pertes après récolte peut aider à accroître la disponibilité, la qualité nutritionnelle et la salubrité des aliments, et à améliorer ...

  16. Main steam line break accident simulation of APR1400 using the model of ATLAS facility

    Science.gov (United States)

    Ekariansyah, A. S.; Deswandri; Sunaryo, Geni R.

    2018-02-01

    A main steam line break simulation for APR1400 as an advanced design of PWR has been performed using the RELAP5 code. The simulation was conducted in a model of thermal-hydraulic test facility called as ATLAS, which represents a scaled down facility of the APR1400 design. The main steam line break event is described in a open-access safety report document, in which initial conditions and assumptionsfor the analysis were utilized in performing the simulation and analysis of the selected parameter. The objective of this work was to conduct a benchmark activities by comparing the simulation results of the CESEC-III code as a conservative approach code with the results of RELAP5 as a best-estimate code. Based on the simulation results, a general similarity in the behavior of selected parameters was observed between the two codes. However the degree of accuracy still needs further research an analysis by comparing with the other best-estimate code. Uncertainties arising from the ATLAS model should be minimized by taking into account much more specific data in developing the APR1400 model.

  17. GPM GROUND VALIDATION AIRBORNE SECOND GENERATION PRECIPITATION RADAR (APR-2) GCPEX V1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Second Generation Airborne Precipitation Radar (APR-2) is a dual-frequency (13 GHz and 35 GHz), Doppler, dual-polarization radar system. It has a downward...

  18. The Gravity Makeup on the LORHR Event during Mid-loop Operation for APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Cheol Woo; Lee, Yong Hee; Lee, Gyu Cheon; Kim, Shin Whan [KEPCO, Daejeon (Korea, Republic of)

    2015-05-15

    This paper is to investigate means of the available gravity makeup after the event to prevent or sustain the core uncovery and fuel failure for the typical advanced power reactor nuclear power plants (APR1400). Unlike the OPR1000 (optimized power reactor 1000 nuclear power plants), the refueling water storage tank of APR1400 cannot be used for gravity makeup since it is located on the bottom of the containment with a lower elevation than the reactor vessel. So, the other means of gravity makeup and their effect on the core uncovery are accounted. The use of the water used for the cask loading pit (CLP) during refueling or the safety injection line filling tank (SIFT), which are not designed for gravity makeup during the event, and safety injection tanks (SITs) are considered as the alternative source of makeup feed. The results show that gravity makeup of a SIT provides a sufficient operator action time for the LORHR with the station black out (SBO) during the mid-loop operation for the APR1400. From the LORHR event analysis, the effective means of gravity makeup for APR1400 to cope with this event concurrent loss of all AC power is determined as the gravity feed using SITs. Other means for gravity makeup using CLP or SIFT, which are not designed to mitigate the LORHR event, are evaluated as not effective to the event due to the large flow resistances and the low elevation head to overcome the system pressure increase during the LORHR. The use of one SIT and two SITs for the LORHR provides the core uncovery times as 3 hr 8 min and 4 hr 32 min extending 1 hr 15 min and 2 hr 38 min from the base case, respectively.

  19. Kidney transplant

    Science.gov (United States)

    ... always take your medicine as directed. Alternative Names Renal transplant; Transplant - kidney Patient Instructions Kidney removal - discharge Images Kidney anatomy Kidney - blood and urine flow Kidneys Kidney transplant - ...

  20. MELCOR code modeling for APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young; Park, S. Y.; Kim, D. H.; Ahn, K. I.; Song, Y. M.; Kim, S. D.; Park, J. H

    2001-11-01

    The severe accident phenomena of nuclear power plant have large uncertainties. For the retention of the containment integrity and improvement of nuclear reactor safety against severe accident, it is essential to understand severe accident phenomena and be able to access the accident progression accurately using computer code. Furthermore, it is important to attain a capability for developing technique and assessment tools for an advanced nuclear reactor design as well as for the severe accident prevention and mitigation. The objective of this report is to establish technical bases for an application of the MELCOR code to the Korean Next Generation Reactor (APR1400) by modeling the plant and analyzing plant steady state. This report shows the data and the input preparation for MELCOR code as well as state-state assessment results using MELCOR code.

  1. Pancreatic Islet Cell Transplantation: A new era in transplantation

    OpenAIRE

    Warnock, Garth L.; Rajotte, Ray V.

    1992-01-01

    Transplantation of insulin-producing tissue offers a physiologic approach to restoration of glycemic control. Whereas transplantation of vascularized pancreatic grafts has recently achieved encouraging results, pancreatic islet cell transplantation holds the promise of low morbidity and reduced requirements for agressive immunosuppression for recipients. Islet cell transplantation was recently demonstrated to induce euglycemia with insulin independence.

  2. An investigation of major influences on the seismic response of APR1400 reactor vessel internals - 15145

    International Nuclear Information System (INIS)

    Byun, Y.J.; Kim, J.G.; Sung, K.K.; Lee, D.H.

    2015-01-01

    This paper deals with 3 topics concerning the APR1400 reactor vessel internals (RVI) seismic analysis: nonlinear problems, approaches to account for uncertainties of seismic model, and dynamic responses to various seismic excitations. First, the noticeable nonlinear characteristics of the RVI seismic model are discussed, and the modeling methods for properly simulating the nonlinear behaviors of RVI under seismic loads are presented. By applying these methods to the seismic model, the seismic analysis can correctly predict the dynamic response of RVI. Next, two approaches to account for the uncertainties of seismic model are evaluated: the time history broadening method, and the sensitivity analysis based on NUREG-0800, Section 4.2, Appendix A. From the evaluation results, it is confirmed that the time history broadening method employed in the seismic analysis of APR1400 RVI sufficiently accounts for the uncertainty of seismic model. Finally, the response characteristics of APR1400 RVI to various seismic excitations are investigated. The seismic excitations corresponding to various soil profiles, including the effects of cracked and un-cracked concrete stiffness on the reactor containment building structure, are used as forcing functions. From this study, the effects of various site conditions on the dynamic response of APR1400 RVI are identified. As a result, the enveloped seismic responses obtained from this study will contribute to the development of RVI seismic design that covers a wide range of potential site conditions. (authors)

  3. 967.pdf | 10apr2010 | currsci | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    2010-04-10

    Apr 10, 2010 ... error. The page your are looking for can not be found! Please check the link or use the navigation bar at the top. YouTube; Twitter; Facebook; Blog. Academy News. IAS Logo. 29th Mid-year meeting. Posted on 19 January 2018. The 29th Mid-year meeting of the Academy will be held from 29–30 June 2018 ...

  4. Phylogenetic Diversity of aprA Genes in Subseafloor Sediments on the Northwestern Pacific Margin off Japan.

    Science.gov (United States)

    Aoki, Masataka; Kakiuchi, Ryota; Yamaguchi, Takashi; Takai, Ken; Inagaki, Fumio; Imachi, Hiroyuki

    2015-01-01

    Markedly diverse sequences of the adenosine-5'-phosphosulfate reductase alpha subunit gene (aprA), which encodes a key enzyme in microbial sulfate reduction and sulfur oxidation, were detected in subseafloor sediments on the northwestern Pacific off Japan. The aprA gene sequences were grouped into 135 operational taxonomic units (90% sequence identity), including genes related to putative sulfur-oxidizing bacteria predominantly detected in sulfate-depleted deep sediments. Our results suggest that microbial ecosystems in the subseafloor biosphere have phylogenetically diverse genetic potentials to mediate cryptic sulfur cycles in sediments, even where sulfate is rarely present.

  5. Application of Nuclear Application Programs to APR1400 Simulator

    International Nuclear Information System (INIS)

    Hwang, Do Hyun; Lee, Myeong Soo; Hong, Jin Hyuk

    2012-01-01

    Advanced Power Reactor 1400MWe (APR1400) simulator has been developed and installed at Kori Training Center for operators of ShinKori no.3, 4 nuclear power plant by Korea Hydro and Nuclear Power,s Central Research Institute (KHNP CRI). NAPS (Nuclear Application Programs) is a computerbased system which provides operators with past and real-time information for monitoring and controlling NSSS (Nuclear Steam Supply System), BOP (Balance Of Plant) and Electric system. NAPS consists of several programs such as COLSS (Core Operating Limit Supervisory System), SPADES+ (Safety Parameter Display and Evaluation System), CEA (Control Element Assembly) Application Program, and so on. Each program makes calculations based on its own algorithm and provides information available for operation. In order to use NAPS programs with a simulator even though they are being used in a real plant, they should be modified to add several simulation functions such as reset, snap, run/freeze and backtrack required by ANSI/ANS-3.5 to the original NAPS functionality. On top of that, interfacing programs should be developed for the data communication between respective NAPS programs and simulator sever. The purpose of this paper is to provide the overall architecture of the communication system between NAPS and simulator model, and to describe the method to apply NAPS to APR1400 simulator

  6. Cold-Leg Small Break LOCA Analysis of APR1400 Plant Using a SPACE/sEM Code

    International Nuclear Information System (INIS)

    Lim, Sang Gyu; Lee, Suk Ho; Yu, Keuk Jong; Kim, Han Gon; Lee, Jae Yong

    2013-01-01

    The Small Break Loss-of-Coolant Accident (SBLOCA) evaluation methodology (EM) for APR1400, called sEM, is now being developed using SPACE code. SPACE/sEM is to set up a conservative evaluation methodology in accordance with appendix K of 10 CFR 50. Major required and acceptable features of the evaluation models are described as below. - Fission product decay : 1.2 times of ANS97 decay curve - Critical flow model : Henry-Fauske Moody two phase critical flow model - Metal-Water reaction model : Baker-Just equation - Critical Heat Flux (CHF) : B and W, Barnett and Modified Barnett correlation - Post-CHF : Groeneveld 5.7 film boiling correlation A series of test matrix is established to validate SPACE/sEM code in terms of major SBLOCA phenomena, e.g. core level swelling and boiling, core heat transfer, critical flow, loop seal clearance and their integrated effects. The separated effect tests (SETs) and integrated effect tests (IETs) are successfully performed and these results shows that SPACE/sEM code has a conservatism comparing with experimental data. Finally, plant calculations of SBLOCA for APR1400 are conducted as described below. - Break location sensitivity : DVI line, hot-leg, cold-leg, pump suction leg. - Break size spectrum : 0.4ft 2 ∼0.02ft 2 (DVI) 0.5ft 2 ∼0.02ft 2 (hot-leg, cold-leg, pump suction leg) This paper deals with break size spectrum analysis of cold-leg break accidents. Based on the calculation results, emergency core cooling system (ECCS) performances of APR1400 and typical SBLOCA phenomena can be evaluated. Cold-leg SBLOCA analysis for APR1400 is performed using SPACE/sEM code under harsh environment condition. SPACE/sEM code shows the typical SBLOCA behaviors and it is reasonably predicted. Although SPACE/sEM code has conservative models and correlations based on appendix K of 10 CFR 50, PCT does not exceed the requirement (1477 K). It is concluded that ECCS in APR1400 has a sufficient performance in cold-leg SBLOCA

  7. Cold-Leg Small Break LOCA Analysis of APR1400 Plant Using a SPACE/sEM Code

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Gyu; Lee, Suk Ho; Yu, Keuk Jong; Kim, Han Gon; Lee, Jae Yong [Central Research Institute, KHNP, Ltd., Daejeon (Korea, Republic of)

    2013-10-15

    The Small Break Loss-of-Coolant Accident (SBLOCA) evaluation methodology (EM) for APR1400, called sEM, is now being developed using SPACE code. SPACE/sEM is to set up a conservative evaluation methodology in accordance with appendix K of 10 CFR 50. Major required and acceptable features of the evaluation models are described as below. - Fission product decay : 1.2 times of ANS97 decay curve - Critical flow model : Henry-Fauske Moody two phase critical flow model - Metal-Water reaction model : Baker-Just equation - Critical Heat Flux (CHF) : B and W, Barnett and Modified Barnett correlation - Post-CHF : Groeneveld 5.7 film boiling correlation A series of test matrix is established to validate SPACE/sEM code in terms of major SBLOCA phenomena, e.g. core level swelling and boiling, core heat transfer, critical flow, loop seal clearance and their integrated effects. The separated effect tests (SETs) and integrated effect tests (IETs) are successfully performed and these results shows that SPACE/sEM code has a conservatism comparing with experimental data. Finally, plant calculations of SBLOCA for APR1400 are conducted as described below. - Break location sensitivity : DVI line, hot-leg, cold-leg, pump suction leg. - Break size spectrum : 0.4ft{sup 2}∼0.02ft{sup 2}(DVI) 0.5ft{sup 2}∼0.02ft{sup 2}(hot-leg, cold-leg, pump suction leg) This paper deals with break size spectrum analysis of cold-leg break accidents. Based on the calculation results, emergency core cooling system (ECCS) performances of APR1400 and typical SBLOCA phenomena can be evaluated. Cold-leg SBLOCA analysis for APR1400 is performed using SPACE/sEM code under harsh environment condition. SPACE/sEM code shows the typical SBLOCA behaviors and it is reasonably predicted. Although SPACE/sEM code has conservative models and correlations based on appendix K of 10 CFR 50, PCT does not exceed the requirement (1477 K). It is concluded that ECCS in APR1400 has a sufficient performance in cold-leg SBLOCA.

  8. Intestine Transplant

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  9. Neuchatel ne gardera pas le Palais de l'equilibre apres Expo.02

    CERN Multimedia

    2002-01-01

    "La ville de Neuchatel ne souhaite pas conserver le Palais de l'equilibre apres Expo.02. Par 24 voix contre 7, le Conseil general a rejete le plan special du Conseil communal qui proposait de transformer l'edifice en un centre de congres" (1/2 page).

  10. Islet alloautotransplantation: Allogeneic pancreas transplantation followed by transplant pancreatectomy and islet transplantation.

    Science.gov (United States)

    Nijhoff, M F; Dubbeld, J; van Erkel, A R; van der Boog, P J M; Rabelink, T J; Engelse, M A; de Koning, E J P

    2018-04-01

    Simultaneous pancreas-kidney (SPK) transplantation is an important treatment option for patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD). Due to complications, in up to 10% of patients, allograft pancreatectomy is necessary shortly after transplantation. Usually the donor pancreas is discarded. Here, we report on a novel procedure to rescue endocrine tissue after allograft pancreatectomy. A 39-year-old woman with T1D and ESRD who had undergone SPK transplantation required emergency allograft pancreatectomy due to bleeding at the vascular anastomosis. Islets were isolated from the removed pancreas allograft, and almost 480 000 islet equivalents were infused into the portal vein. The patient recovered fully. After 3 months, near-normal mixed meal test (fasting glucose 7.0 mmol/L, 2-hour glucose 7.5 mmol/L, maximal stimulated C-peptide 3.25 nmol/L, without insulin use in the preceding 36 hours) was achieved. Glycated hemoglobin while taking a low dose of long-acting insulin was 32.7 mmol/mol hemoglobin (5.3%). When a donor pancreas is lost after transplantation, rescue β cell therapy by islet alloautotransplantation enables optimal use of scarce donor pancreata to optimize glycemic control without additional HLA alloantigen exposure. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. Transplant tourism among kidney transplant patients in Eastern Nigeria.

    Science.gov (United States)

    Okafor, U H

    2017-07-05

    Transplant tourism entails movement of recipient, donor or both to a transplant centre outside their country of residence. This has been reported in many countries; and has variously been associated with organ trade. The objective of this study is to determine the frequency and pattern of transplant tourism among transplant patients in Eastern Nigeria. This is a non randomized cross sectional study. All kidney transplant patients who presented at Enugu State University Teaching Hospital Parklane Enugu and Hilton Clinics Port Harcourt in Nigeria were recruited. The clinical parameters including the transplant details of all the patients were documented. The data obtained was analysed using SPSS package. A total of one hundred and twenty six patients were studied, 76.2% were males with M:F ratio of 3.2:1 and mean age of 46.9 ± 13.3 years. Fifty four and 58.7% of the patients were managed in a tertiary hospital and by a nephrologist respectively before referral for kidney transplant. Only 15.8% of the patients had their kidney transplant without delay: finance, lack of donor, logistics including delay in obtaining travelling documents were the common causes of the delay. Ninety percent of the patients had their transplant in India with majority of them using commercial donors. India was also the country with cheapest cost ($18,000.00). 69.8% were unrelated donors, 68.2% were commercial donors and 1.6% of the donors were spouse. All the commercial donors received financial incentives and each commercial donor received mean of 7580 ± 1280 dollars. Also 30.2% of the related donors demanded financial incentive. Transplant tourism is prevalent in eastern Nigeria.

  12. Progress of Design Improvements for APR1400 Computerized Procedure System from HFE V and V results and Design Experience

    International Nuclear Information System (INIS)

    Lee, Sungjin; Seong, Nokyu

    2015-01-01

    This study shows major already improved design features from the above three processes and a design proposal for to-be-improving items. APR1400 CPS has been verified and validated by the HFE process, internal design review and site acceptance tests. APR1400 Computerized Procedure System (CPS) has been applied to Shin-Kori Nuclear Power Plant (SKN) 3 and 4 units, Shin-Hanul Nuclear Power Plant (SHN) 1 and 2 units and Baraka Nuclear Power Plant (BNPP) 1, 2, 3 and 4 units. Since APR1400 CPS is a first-of-a-kind (FOAK) human machine interface (HMI) for executing a computerized procedure in the nuclear power plant's main control room in South Korea, it has been continuously improved through a) the human factor engineering (HFE) verification and validation (V and V), b) the internal design review and c) prototype tests. Human engineering discrepancies (HEDs) can be identified by the HFE V and V activity. Some HEDs of APR1400 CPS for SKN 3 and 4 and SHN 1 and 2 have been adopted as a role of design improvement in the CPS system while others were regarded as an operator training requirement or part of task contents. Various requests for improving the CPS have been collected from those results. A HMI system should be improved continuously for removing potential defects. Some of introduced design features in this paper has been adopted for APR1400 nuclear power plants. Some of them are under the review in the CPS design team of KHNP

  13. Application of Standardized ITAAC to the APR1400 Design Certification

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Deogji; Kim, Yunho [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    Design certification applications (DCAs) submitted pursuant to 10 CFR Part 52 contain two tiers of information, Tier 1 and Tier 2. Tier 1 contains information that is to be certified through rulemaking, and includes the inspections, tests, analyses, and acceptance criteria (ITAAC). Tier 2 contains more detailed information and is the source for information included in Tier1. DC applicants have developed the ITAAC with their own format and contents. This has caused the ineffectiveness of the review process by Nuclear Regulatory Commission (NRC) at the design certification stage. Standardizing the format and content of Tier 1 and ITAAC will achieve greater efficiency and effectiveness for Tier 1 and ITAAC development and NRC review, and for ITAAC implementation and verification. NRC provided the proposed standardized ITAAC for APR1400, and KHNP is considering the application of the proposed ITAAC. The strategy for application of the NRC proposed standardized ITAAC to the APR1400 design certification is now under developing, and a meeting with NRC to review the NRC proposed standardized ITAAC is expected to be held in the near future. In this review process, establishment of industry position on the NRC proposed standardized ITAAC is very important. The support from NEI and US industry is expected to be gained.

  14. Application of Standardized ITAAC to the APR1400 Design Certification

    International Nuclear Information System (INIS)

    Kang, Deogji; Kim, Yunho

    2016-01-01

    Design certification applications (DCAs) submitted pursuant to 10 CFR Part 52 contain two tiers of information, Tier 1 and Tier 2. Tier 1 contains information that is to be certified through rulemaking, and includes the inspections, tests, analyses, and acceptance criteria (ITAAC). Tier 2 contains more detailed information and is the source for information included in Tier1. DC applicants have developed the ITAAC with their own format and contents. This has caused the ineffectiveness of the review process by Nuclear Regulatory Commission (NRC) at the design certification stage. Standardizing the format and content of Tier 1 and ITAAC will achieve greater efficiency and effectiveness for Tier 1 and ITAAC development and NRC review, and for ITAAC implementation and verification. NRC provided the proposed standardized ITAAC for APR1400, and KHNP is considering the application of the proposed ITAAC. The strategy for application of the NRC proposed standardized ITAAC to the APR1400 design certification is now under developing, and a meeting with NRC to review the NRC proposed standardized ITAAC is expected to be held in the near future. In this review process, establishment of industry position on the NRC proposed standardized ITAAC is very important. The support from NEI and US industry is expected to be gained

  15. Post-transplant lymphoproliferative disease in liver transplant recipients

    Directory of Open Access Journals (Sweden)

    Mercedes Rubio-Manzanares-Dorado

    Full Text Available Introduction: Post-transplant lymphoproliferative syndrome (PTLD is a rare and potentially life-threatening complication after liver transplantation. The aim of this study was to analyze the clinicopathologic features related to PTLD in a single institution after liver transplantation. Methods: Observational study where we have retrospectively analyzed 851 cases who underwent liver transplantation. Ten cases have developed PTLD. Their clinical-pathological characteristics and the treatment received have been analyzed. Results: PTLD incidence was 1.2% (10/851. The mean time from liver transplantation to PTLD diagnosis was 36 months (range 1.2 to 144 months. PTLD localization was extranodal in all cases, the most frequent location being intestinal. Seven cases showed a monomorphic lymphoma which in all cases was differentiated B cell lymphomas. Fifty per cent of the series were seropositive for Epstein-Barr virus. Five patients were alive at the time of the review. Among these patients, we observed three cases of complete remission and two cases of disease stabilization. The death rate was higher in the first year after diagnosis of PTLD. Conclusion: PTLD is a rare complication after liver transplantation, but it may pose a threat to the life of a liver transplant recipient. It is essential to identify patients at risk, to establish an early diagnosis and treatment that can change the outcome of the disease.

  16. Pre-transplant history of mental health concerns, non-adherence, and post-transplant outcomes in kidney transplant recipients.

    Science.gov (United States)

    Gumabay, Franz Marie; Novak, Marta; Bansal, Aarushi; Mitchell, Margot; Famure, Olusegun; Kim, S Joseph; Mucsi, Istvan

    2018-02-01

    The association between pre-transplant mental health concerns and non-adherence and post-transplant outcomes after kidney transplantation is not fully established. We examined the relationship between a pre-transplant history of mental health concerns and non-adherence and post-transplant outcomes among kidney transplant recipients. In this retrospective single center cohort study of adult kidney transplant recipients (n=955) the associations between the history of mental health concerns or non-adherence and the time from kidney transplant to biopsy proven acute rejection; death-censored graft failure and total graft failure were examined using Cox proportional hazards models. Mean (SD) age was 51 (13) years, 61% were male and 27% had a history of diabetes. Twenty-two and 11% of patients had mental health concerns and non-adherence, respectively. Fifteen percent of the patients had acute rejection, 5.6% had death-censored graft failure and 13.0% had total graft failure. The history of mental health concerns was not associated with acute rejection, death-censored graft failure or total graft failure. Patients with versus without a history of non-adherence tended to have higher cumulative incidence of acute rejection (23.3% [95% CI: 16.1, 33.2] vs. 13.6% [95% CI: 11.4, 16.2]) and death-censored graft failure (15.0% [95% CI: 6.9, 30.8] vs. 6.4% [95% CI: 4.7, 8.7]) (log rank p=0.052 and p=0.086, respectively). These trends were not significant after multivariable adjustment. In summary, a history of pre-transplant mental health concerns or non-adherence is not associated with adverse outcomes in patients who completed transplant workup and received a kidney transplant. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Organ donation and transplantation in Mexico. A transplantation health professionals’ perspective

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Hernández-Ibarra

    2017-01-01

    Full Text Available Objective. We aimed to explore organ donation and transplantation in Mexico from the point of view of transplantation health professionals. Materials and methods. A qualitative study was carried out. Twenty six organ transplantation health professionals from seven states of Mexico participated. Semi-structured face-to-face interviews were conducted mainly in hospital settings. Critical discourse analysis was performed. Results. According to participants, living organ transplantation offers benefits for recipients as well as for donors. Several factors influence the field of transplantation negatively, among them the scarcity of resources that impedes the incorporation of new health personnel, as well as conflicts between transplantation teams with diverse health professionals and authorities. Conclusion. Besides increasing economic resources, transplantation health personnel should be sensitized to find solutions in order to avoid conflicts with different health professionals. Studies on organ donation and transplants also should include other social actors’ viewpoint.

  18. The comparison between layout and design of APR1400 MCR and EPRI requirement

    International Nuclear Information System (INIS)

    Suharyo Widagdo; Darlis; Sigit Santoso; T J Suryono

    2013-01-01

    A good man-machine interface system is needed by a nuclear power reactor because of its complexity and high safety factor. The man-machine interface system is centralized in the main control room (MCR). All of monitoring and controlling activity to keep the installation operation safety can be done from this place. In order to increase its ability in monitoring and controlling a hard effort to raise the interface system to the highest possible level is done not only by using the latest computer technology and instrumentation system but also using Human Engineering, as well. The paper aims to compare the lay out and design the APR1400 MCR and the requirement from EPRI about main control room lay out and design as response of TMI-2 accident. We can see from the discussion that the design of the MCR of APR1400 have been applied the request of EPRI. (author)

  19. Thoracic organ transplantation.

    Science.gov (United States)

    Pierson, Richard N; Barr, Mark L; McCullough, Keith P; Egan, Thomas; Garrity, Edward; Jessup, Mariell; Murray, Susan

    2004-01-01

    This article presents an overview of factors associated with thoracic transplantation outcomes over the past decade and provides valuable information regarding the heart, lung, and heart-lung waiting lists and thoracic organ transplant recipients. Waiting list and post-transplant information is used to assess the importance of patient demographics, risk factors, and primary cardiopulmonary disease on outcomes. The time that the typical listed patient has been waiting for a heart, lung, or heart-lung transplant has markedly increased over the past decade, while the number of transplants performed has declined slightly and survival after transplant has plateaued. Waiting list mortality, however, appears to be declining for each organ and for most diseases and high-severity subgroups, perhaps in response to recent changes in organ allocation algorithms. Based on perceived inequity in organ access and in response to a mandate from Health Resources and Services Administration, the lung transplant community is developing a lung allocation system designed to minimize deaths on the waiting list while maximizing the benefit of transplant by incorporating post-transplant survival and quality of life into the algorithm. Areas where improved data collection could inform evolving organ allocation and candidate selection policies are emphasized.

  20. Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast.

    Science.gov (United States)

    Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

    2015-01-01

    Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.

  1. Effect of the design change of the LSSBP on core flow distribution of APR+ Reactor

    International Nuclear Information System (INIS)

    Kim, Kihwan; Euh, Dong-Jin; Choi, Hae-Seob; Kwon, Tae-Soon

    2014-01-01

    The uniform core inlet flow distribution of an Advanced Power Reactor Plus (APR+) is required to prevent the failure rate of the HIPER fuel assembly and improve the core thermal margin. KEPCO-E and C and KAERI proposed a design change of the Lower Support Structure Bottom Plate (LSSBP), since the core flow rates were intense near the outer region of the intact LSSBP in a previous study. In this study, an experiment was carried out to evaluate the effect of the design change of the LSSBP on the core flow distribution using the APR+ Core Flow and Pressure (ACOP) test facility. The results showed great improvement on the core flow distribution under a 4-pump balanced flow condition. Under the 4-pump balanced flow condition, fifteen tests were repeated using the ACOP test facility to verify the effect of the 50% blocked flow area at the outer region of the LSSBP on the core inlet flow distribution. The profiles of the core inlet mass flow rates were analyzed using ensemble averaged values, and compared with that of the intact LSSBP. The results showed great improvement for the overall core region. The change in design of the LSSBP is expected to improve the hydraulic performance of an APR+ reactor

  2. Extended Station Blackout Analyses of an APR1400 with MARS-KS

    International Nuclear Information System (INIS)

    Kim, WoongBae; Jang, HyungWook; Oh, Seungjong; Lee, Sangyong

    2016-01-01

    The Fukushima Dai-ichi nuclear power plant accident shows that natural disasters such as earthquakes and the subsequent tsunamis can cause station blackout for several days. The electricity required for essential systems during a station blackout is provided from the emergency backup batteries installed at the nuclear power plant. In South Korea, in the event of an extended station blackout, the life of these emergency backup batteries has recently been extended from 8 hours to 24 hours at Shin-Kori 5, 6 and APR1400 for design certification. For a battery life of 24 hours, available safety means system, equipment and procedures are studied and analyzed in their ability to cope with an extended station blackout. A sensitivity study of reactor coolant pump seal leakage is performed to verify how different seal leakages could affect the system. For simulating of extended station blackout scenarios, the best estimate MARS-KS was used. In this paper, an APR1400 RELAP5 input deck was developed for station blackout scenario to analyze operation strategy by manually depressurizing the reactor coolant system through the steam generator's secondary side. Additionally, a sensitivity study was performed on reactor coolant pump seal leakage

  3. Extended Station Blackout Analyses of an APR1400 with MARS-KS

    Energy Technology Data Exchange (ETDEWEB)

    Kim, WoongBae; Jang, HyungWook; Oh, Seungjong; Lee, Sangyong [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2016-10-15

    The Fukushima Dai-ichi nuclear power plant accident shows that natural disasters such as earthquakes and the subsequent tsunamis can cause station blackout for several days. The electricity required for essential systems during a station blackout is provided from the emergency backup batteries installed at the nuclear power plant. In South Korea, in the event of an extended station blackout, the life of these emergency backup batteries has recently been extended from 8 hours to 24 hours at Shin-Kori 5, 6 and APR1400 for design certification. For a battery life of 24 hours, available safety means system, equipment and procedures are studied and analyzed in their ability to cope with an extended station blackout. A sensitivity study of reactor coolant pump seal leakage is performed to verify how different seal leakages could affect the system. For simulating of extended station blackout scenarios, the best estimate MARS-KS was used. In this paper, an APR1400 RELAP5 input deck was developed for station blackout scenario to analyze operation strategy by manually depressurizing the reactor coolant system through the steam generator's secondary side. Additionally, a sensitivity study was performed on reactor coolant pump seal leakage.

  4. Evaluation of Ablation rate by the change of Sacrificial Material for PECS in EU-APR

    International Nuclear Information System (INIS)

    Hwang, Do Hyun; Kim, Yong Soo; Lee, Keun Sung

    2015-01-01

    EU-APR, modified and improved from its original design of APR1400, has been developed to comply with European Utility Requirements (EUR) and nuclear design requirements of the European countries. In EU-APR, Severe Accident Mitigation Systems are dedicated to providing an independent defense line from that of Engineered Safety Feature (ESF) and Diverse Safety Feature (DSF). They consist of Emergency Reactor Depressurization System (ERDS), Passive Ex-vessel corium retaining and Cooling System (PECS), Severe Accident Containment Spray System (SACSS), Hydrogen Mitigation System (HMS) and Containment Filtered Vent System (CFVS). The PECS, so called core catcher, was introduced to prevent the Molten Core Concrete Interaction (MCCI) after Reactor Vessel (RV) failure. The PECS has experienced a lot of changes from its original design. Recently, the most significant change was that as a SM, limestone concrete is installed on PECS's body wall instead of previous sacrificial material rich in Fe 2 O 3 . The main reason of this design change is to overcome the issue that the sacrificial material is ablated rather too fast when reacting with corium that contains a large fraction of Zr metal. Other changes in the geometry of PECS's wall and downcomer design are considered as minor ones. In this paper, the comparison of ablation rates between previous SM and limestone concrete is carried out using MAAP5 code with respective MCCI model according to the material. In this paper, major improvements of MAAP5 model for PECS in EU-APR are presented and the evaluation of ablation rate for the previous SM model and the new LC model is carried out by means of ablation depths with LBLOCA sequence. Two models have respective unique ablation process. The ablation of LC model proceeds at a constant rate regardless of water while the ablation of SM model proceeds at a faster rate before the arrival of cooling water for corium and SM mixture. The change of sacrificial material also

  5. Carinal transplantation.

    Science.gov (United States)

    Ueda, H; Shirakusa, T

    1992-01-01

    BACKGROUND: Current techniques of management of carinal lesions are not always satisfactory. Carinal transplantation, if feasible, would be valuable in certain circumstances. METHODS AND RESULTS: Carinal transplantation experiments were performed in dogs. In early cross transplant experiments there were problems in controlling ventilation and in obtaining satisfactory anastomoses, and the animals failed to live for even a few days. In seven subsequent experiments the carinal graft was removed from one dog and transplanted into a second dog. Two dogs lived for over four months with immunosuppression. CONCLUSION: The results suggest that carinal transplantation can succeed if (1) the calibre of the graft is matched with that of the recipient; (2) there is an abundant blood supply to the graft; (3) appropriate immunosuppression is provided; (4) ventilation is adequate during surgery. Images PMID:1465758

  6. Rosiglitazone attenuates transplant arteriosclerosis after allogeneic aorta transplantation in rats

    NARCIS (Netherlands)

    Onuta, Geanina; Rienstra, Heleen; de Boer, Jan Freark; Boer, Mark Walther; Roks, Anton J. M.; Klatter, Flip A.; Uges, Donald R. A.; Navis, Gerjan; Rozing, Jan; Hillebrands, Jan-Luuk

    2007-01-01

    Background. Transplant arteriosclerosis is a leading cause of chronic transplant dysfunction and is characterized by occlusive neointima formation in intragraft arteries. Development of transplant arteriosclerosis is refractory to conventional immunosuppressive drugs and adequate therapy is not

  7. The subtilisin-like protease AprV2 is required for virulence and uses a novel disulphide-tethered exosite to bind substrates.

    Directory of Open Access Journals (Sweden)

    Ruth M Kennan

    Full Text Available Many bacterial pathogens produce extracellular proteases that degrade the extracellular matrix of the host and therefore are involved in disease pathogenesis. Dichelobacter nodosus is the causative agent of ovine footrot, a highly contagious disease that is characterized by the separation of the hoof from the underlying tissue. D. nodosus secretes three subtilisin-like proteases whose analysis forms the basis of diagnostic tests that differentiate between virulent and benign strains and have been postulated to play a role in virulence. We have constructed protease mutants of D. nodosus; their analysis in a sheep virulence model revealed that one of these enzymes, AprV2, was required for virulence. These studies challenge the previous hypothesis that the elastase activity of AprV2 is important for disease progression, since aprV2 mutants were virulent when complemented with aprB2, which encodes a variant that has impaired elastase activity. We have determined the crystal structures of both AprV2 and AprB2 and characterized the biological activity of these enzymes. These data reveal that an unusual extended disulphide-tethered loop functions as an exosite, mediating effective enzyme-substrate interactions. The disulphide bond and Tyr92, which was located at the exposed end of the loop, were functionally important. Bioinformatic analyses suggested that other pathogenic bacteria may have proteases that utilize a similar mechanism. In conclusion, we have used an integrated multidisciplinary combination of bacterial genetics, whole animal virulence trials in the original host, biochemical studies, and comprehensive analysis of crystal structures to provide the first definitive evidence that the extracellular secreted proteases produced by D. nodosus are required for virulence and to elucidate the molecular mechanism by which these proteases bind to their natural substrates. We postulate that this exosite mechanism may be used by proteases produced by

  8. Investigation of the Condensation Effect at IRWST Pool Surface on Containment Back Pressure in APR1400 Containment

    International Nuclear Information System (INIS)

    Lee, Eui Jong; Lee, Jin Yong; Lee, Byung Chul

    2006-01-01

    The APR1400 has several new design concepts in order to improve the plant safety functions during a postulated accident. The In-Containment Refueling Water Storage Tank (IRWST) is one of the new design concepts of APR1400 and installed at the bottom of containment building to promote the plant safety functions by simplifying emergency core cooling water source and preventing release of the fission product during an accidents. This design feature, however, brings about uncertainty factors which may necessitate conventional prediction of temperature and pressure of containment building improved or revised under accident conditions. The hot steam which is released from RCS break enters into the IRWST through four Pressure Relief Dampers (PRDs). It is expected to be condensed with water stored in IRWST, colder than incoming steam. The purpose of this study is to examine closely the influence of the condensation effect at IRWST on containment back pressure in APR1400 containment building using the GOTHIC code which can predict the steam condensation on IRWST pool surface

  9. Transplante de bexiga: estudo piloto Bladder transplant: pilot study

    Directory of Open Access Journals (Sweden)

    Frederico Teixeira Brandt

    2004-08-01

    Full Text Available OBJETIVO: Desenvolver um modelo biológico que seja viável para o estudo sistemático do transplante de bexiga. MÉTODOS: Cães mestiços vivos são usados como doadores e receptores do segmento supra-trigonal da bexiga. RESULTADOS: Os pacientes tansplantados só fizeram uso de imunossupressão por 15 dias, estão vivos e sadios com 18 meses de transplante. Desde o primeiro mês de transplante os cães apresentam controle funcional da micção, inclusive sem urina residual importante. CONCLUSÃO: Transplante de bexiga em cães é um modelo viável, fisiológico e simples.PURPOSE: Our aim was to study the feasible of bladder transplants. METHODS: Alive mongrel dogs are being used as trigone bladder segment donators and receptors RESULTS: The transplanted patients had 15 days of immunosuppression and so far an 18-months satisfactory post-operative outcome. Since a month after surgery, the dogs have been presenting full functional control of micturition and the evaluations have been showing normal bladder storage and contraction capacities. CONCLUSION: bladder transplants in dogs its a possible, physiological and simple model.

  10. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study : rationale and methods

    NARCIS (Netherlands)

    Kaplan, Bonnie J.; Giesbrecht, Gerald F.; Leung, Brenda M. Y.; Field, Catherine J.; Dewey, Deborah; Bell, Rhonda C.; Manca, Donna P.; O'Beirne, Maeve; Johnston, David W.; Pop, Victor J.; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P.; Eliasziw, Misha; McCargar, Linda J.; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M.; Letourneau, Nicole; Martin, Jonathan W.

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their

  11. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study : Rationale and methods

    NARCIS (Netherlands)

    Kaplan, B.J.; Giesbrecht, G.F.; Leung, B.M.; Field, C.J.; Dewey, D.; Bell, R.C.; Manca, D.P.; O'Beirne, M.; Johnston, D.W.; Pop, V.J.M.; Singhal, N.; Gagnon, L.; Bernier, F.P.; Eliasziw, M.; McCargar, L.J.; Kooistra, L.; Farmer, A.; Cantell, M.; Goonewardene, L.; Casey, L.M.; Letourneau, N.; Martin, J.W.

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their

  12. Calculation of fuel and moderator temperature coefficients in APR1400 nuclear reactor by MVP code

    International Nuclear Information System (INIS)

    Pham Tuan Nam; Le Thi Thu; Nguyen Huu Tiep; Tran Viet Phu

    2014-01-01

    In this project, these fuel and moderator temperature coefficients were calculated in APR1400 nuclear reactor by MVP code. APR1400 is an advanced water pressurized reactor, that was researched and developed by Korea Experts, its electric power is 1400 MW. The neutronics calculations of full core is very important to analysis and assess a reactor. Results of these calculation is input data for thermal-hydraulics calculations, such as fuel and moderator temperature coefficients. These factors describe the self-safety characteristics of nuclear reactor. After obtaining these reactivity parameters, they were used to re-run the thermal hydraulics calculations in LOCA and RIA accidents. These thermal-hydraulics results were used to analysis effects of reactor physics parameters to thermal hydraulics situation in nuclear reactors. (author)

  13. Evolution of the role of the transplant pharmacist on the multidisciplinary transplant team.

    Science.gov (United States)

    Alloway, R R; Dupuis, R; Gabardi, S; Kaiser, T E; Taber, D J; Tichy, E M; Weimert-Pilch, N A

    2011-08-01

    Transplant pharmacists have been recognized as an essential part of the transplant team by their colleagues along with several governing and professional organizations. The specific education, training and responsibilities of the transplant pharmacist have not been clearly delineated in the literature. Various pharmacists across the country have been called upon to serve on the transplant team necessitating standardization of their fundamental and desirable activities. Therefore, the purpose of this manuscript is to describe the training and role of a transplant pharmacist on the patient care team and provide a roadmap to implementation of novel transplant pharmacy services. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

  14. Pancreatic islet transplantation

    Directory of Open Access Journals (Sweden)

    Corrêa-Giannella Maria

    2009-09-01

    Full Text Available Abstract Background No formulation of exogenous insulin available to date has yet been able to mimic the physiological nictemeral rhythms of this hormone, and despite all engineering advancements, the theoretical proposal of developing a mechanical replacement for pancreatic β cell still has not been reached. Thus, the replacement of β cells through pancreas and pancreatic islet transplantation are the only concrete alternatives for re-establishing the endogenous insulin secretion in type 1 diabetic patients. Since only 1 to 1.5% of the pancreatic mass corresponds to endocrine tissue, pancreatic islets transplantation arises as a natural alternative. Data from the International Islet Transplant Registry (ITR from 1983 to December 2000 document a total of 493 transplants performed around the world, with progressively worse rates of post-transplant insulin independence. In 2000, the "Edmonton Protocol" introduced several modifications to the transplantation procedure, such as the use of a steroid-free immunosuppression regimen and transplantation of a mean islet mass of 11,000 islet equivalents per kilogram, which significantly improved 1-year outcomes. Although the results of a 5-year follow-up in 65 patients demonstrated improvement in glycemic instability in a significant portion of them, only 7.5% of the patients have reached insulin independence, indicating the need of further advances in the preservation of the function of transplanted islet. In addition to the scarcity of organs available for transplantation, islets transplantation still faces major challenges, specially those related to cell loss during the process of islet isolation and the losses related to the graft site, apoptosis, allorejection, autoimmunity, and immunosuppression. The main strategies to optimize islet transplantation aim at improving all these aspects. Conclusion Human islet transplantation should be regarded as an intervention that can decrease the frequency of

  15. The effect of nodalization and temperature of reactor upper region: Sensitivity analysis for APR-1400 LBLOCA

    International Nuclear Information System (INIS)

    Kang, Dong Gu

    2017-01-01

    Highlights: • The nodalization of APR-1400 was modified to reflect the characteristic of upper region temperature. • The effect of nodalization and temperature of reactor upper region on LBLOCA consequence was evaluated. • The modification of nodalization is an essential prerequisite in APR-1400 LBLOCA analysis. - Abstract: In best estimate (BE) calculation, the definition of system nodalization is important step influencing the prediction accuracy for specific thermal-hydraulic phenomena. The upper region of reactor is defined as the region of the upper guide structure (UGS) and upper dome. It has been assumed that the temperature of upper region is close to average temperature in most large break loss of coolant accident (LBLOCA) analysis cases. However, it was recently found that the temperature of upper region of APR-1400 reactor might be little lower than or similar to hot leg temperature through the review of detailed design data. In this study, the nodalization of APR-1400 was modified to reflect the characteristic of upper region temperature, and the effect of nodalization and temperature of reactor upper region on LBLOCA consequence was evaluated by sensitivity analysis including best estimate plus uncertainty (BEPU) calculation. In basecase calculation, in case of modified version, the peak cladding temperature (PCT) in blowdown phase became higher and the blowdown quenching (or cooling) was significantly deteriorated as compared to original case, and as a result, the cladding temperature in reflood phase became higher and the final quenching was also delayed. In addition, thermal-hydraulic parameters were compared and analyzed to investigate the effect of change of upper region on cladding temperature. In BEPU analysis, the 95 percentile PCT used in current regulatory practice was increased due to the modification of upper region nodalization, and it occurred in the reflood phase unlike original case.

  16. Seismic analysis of the APR1400 nuclear reactor system using a verified beam element model

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong-beom [Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 (Korea, Republic of); Park, No-Cheol, E-mail: pnch@yonsei.ac.kr [Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 (Korea, Republic of); Lee, Sang-Jeong; Park, Young-Pil [Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 (Korea, Republic of); Choi, Youngin [Korea Institute of Nuclear Safety, 62 Gwahak-ro, Yuseong-gu, Daejeon 34142 (Korea, Republic of)

    2017-03-15

    Highlights: • A simplified beam element model is constructed based on the real dynamic characteristics of the APR1400. • Time history analysis is performed to calculate the seismic responses of the structures. • Large deformations can be observed at the in-phase mode of reactor vessel and core support barrel. - Abstract: Structural integrity is the first priority in the design of nuclear reactor internal structures. In particular, nuclear reactor internals should be designed to endure external forces, such as those due to earthquakes. Many researchers have performed finite element analyses to meet these design requirements. Generally, a seismic analysis model should reflect the dynamic characteristics of the target system. However, seismic analysis based on the finite element method requires long computation times as well as huge storage space. In this research, a beam element model was developed and confirmed based on the real dynamic characteristics of an advanced pressurized water nuclear reactor 1400 (APR1400) system. That verification process enhances the accuracy of the finite element analysis using the beam elements, remarkably. Also, the beam element model reduces seismic analysis costs. Therefore, the beam element model was used to perform the seismic analysis. Then, the safety of the APR1400 was assessed based on a seismic analysis of the time history responses of its structures. Thus, efficient, accurate seismic analysis was demonstrated using the proposed beam element model.

  17. Seismic analysis of the APR1400 nuclear reactor system using a verified beam element model

    International Nuclear Information System (INIS)

    Park, Jong-beom; Park, No-Cheol; Lee, Sang-Jeong; Park, Young-Pil; Choi, Youngin

    2017-01-01

    Highlights: • A simplified beam element model is constructed based on the real dynamic characteristics of the APR1400. • Time history analysis is performed to calculate the seismic responses of the structures. • Large deformations can be observed at the in-phase mode of reactor vessel and core support barrel. - Abstract: Structural integrity is the first priority in the design of nuclear reactor internal structures. In particular, nuclear reactor internals should be designed to endure external forces, such as those due to earthquakes. Many researchers have performed finite element analyses to meet these design requirements. Generally, a seismic analysis model should reflect the dynamic characteristics of the target system. However, seismic analysis based on the finite element method requires long computation times as well as huge storage space. In this research, a beam element model was developed and confirmed based on the real dynamic characteristics of an advanced pressurized water nuclear reactor 1400 (APR1400) system. That verification process enhances the accuracy of the finite element analysis using the beam elements, remarkably. Also, the beam element model reduces seismic analysis costs. Therefore, the beam element model was used to perform the seismic analysis. Then, the safety of the APR1400 was assessed based on a seismic analysis of the time history responses of its structures. Thus, efficient, accurate seismic analysis was demonstrated using the proposed beam element model.

  18. Characterisation of the thermostable protease AprX in strains of Pseudomonas fluorescens and impact on the shelf-life of dairy products: preliminary results

    Directory of Open Access Journals (Sweden)

    Nadia Andrea Andreani

    2016-12-01

    Full Text Available Bacterial proteases are involved in food spoilage and shelf-life reduction. Among the bacterial proteases, a predominant role in spoilage of dairy products seems to be played by the thermostable metallo-protease AprX, which is produced by various strains of Pseudomonas fluorescens. Differences in AprX enzyme activity among different strains were highlighted, but the most proteolytic strains were not identified. In this study, the presence of the aprX gene was evaluated in 69 strains isolated from food matrices and 18 reference strains belonging to the P. fluorescens group, which had been previously typed by the multi locus sequence typing method. Subsequently, a subset of reference strains was inoculated in ultra-high temperature milk, and the expression of the aprX gene was evaluated at 22 and 6°C. On the same milk samples, the proteolytic activity was then evaluated through Azocasein and trinitrobenzenesulfonic acid solution assays. Finally, to assess the applicability of the former assay directly on dairy products the proteolityc activity was tested on industrial ricotta samples using the Azocasein assay. These results demonstrate the spread of aprX gene in most strains tested and the applicability of Azocasein assay to monitor the proteolytic activity in dairy products.

  19. Cerebral Post-Transplant Lymphoproliferative Disorder Occurring after Renal Transplantation: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Jang Ho; Byun, Woo Mok; Kim, Hong Chul; Hwang, Min Su [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2012-04-15

    Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation and immunosuppression. A 36-year-old woman with a history of renal transplantation visited the hospital complaining of headache and on pathology was diagnosed with cerebral PTLD manifesting as multiple rim enhanced masses in both hemispheres. We report here a case of post-transplant lymphoproliferative disorder involving the cerebrum occurring after renal transplantation, and describe the MRI findings for this patient

  20. Cerebral Post-Transplant Lymphoproliferative Disorder Occurring after Renal Transplantation: A Case Report

    International Nuclear Information System (INIS)

    Suh, Jang Ho; Byun, Woo Mok; Kim, Hong Chul; Hwang, Min Su

    2012-01-01

    Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation and immunosuppression. A 36-year-old woman with a history of renal transplantation visited the hospital complaining of headache and on pathology was diagnosed with cerebral PTLD manifesting as multiple rim enhanced masses in both hemispheres. We report here a case of post-transplant lymphoproliferative disorder involving the cerebrum occurring after renal transplantation, and describe the MRI findings for this patient

  1. After the Transplant

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  2. Stem Cell Transplant

    Science.gov (United States)

    ... Graft-versus-host disease: A potential risk when stem cells come from donors If you receive a transplant ... medications and blood products into your body. Collecting stem cells for transplant If a transplant using your own ...

  3. Cardiac transplantation in South Carolina: 300 transplants.

    Science.gov (United States)

    Crumbley, A J; Odom, Sylvia; Van Bakel, Adrian B; Pereira, Naveen; Ikonomidis, John S; Bradley, Scott; Kratz, John M; Sade, Robert M; Uber, Walt; Stroud, Martha R; Crawford, Fred A

    2006-02-01

    For nearly 20 years, the Medical University's Heart Transplant Program has been providing the citizens of South Carolina with excellent results with a minimum of delay. We present here the results of our first 300 heart transplants, spanning the first 18 years of the Cardiac Transplant Program at the Medical University. Overall survival has been very good, with one, five and ten year survival rates in the adults being 92 +/- 2%, 78 +/- 3%, and 58 +/- 4%. The children's group showed survival rates of 94 +/- 5%, 79 +/- 11%, and 79 +/- 11% over the same lengths of time. Most recently, the federally sponsored Scientific Registry of Transplant Recipients (www.ustransplant.org, July 2005) reports for MUSC a one-year survival of 97.67% and three-year survival of 90.74%; both leading the Southeast. We attribute this success to the dedicated work of health care workers at all levels who believe in attention to detail and that the patient always comes first. It is our hope that we will be able to continue to provide expert, state-of-the-art, cardiac transplant services long into the future, while continuing to expand our heart failure management program as dictated by further developments in this rapidly evolving specialty.

  4. Complex regulation of AprA metalloprotease in Pseudomonas fluorescens M114: evidence for the involvement of iron, the ECF sigma factor, PbrA and pseudobactin M114 siderophore.

    Science.gov (United States)

    Maunsell, Bláithín; Adams, Claire; O'Gara, Fergal

    2006-01-01

    In the soil bacterium Pseudomonas fluorescens M114, extracellular proteolytic activity and fluorescent siderophore (pseudobactin M114) production were previously shown to be co-ordinately negatively regulated in response to environmental iron levels. An iron-starvation extracytoplasmic function sigma factor, PbrA, required for the transcription of siderophore biosynthetic genes, was also implicated in M114 protease regulation. The current study centred on the characterization and genetic regulation of the gene(s) responsible for protease production in M114. A serralysin-type metalloprotease gene, aprA, was identified and found to encode the major, if not only, extracellular protease produced by this strain. The expression of aprA and its protein product were found to be subject to complex regulation. Transcription analysis confirmed that PbrA was required for full aprA transcription under low iron conditions, while the ferric uptake regulator, Fur, was implicated in aprA repression under high iron conditions. Interestingly, the iron regulation of AprA was dependent on culture conditions, with PbrA-independent AprA-mediated proteolytic activity observed on skim milk agar supplemented with yeast extract, when supplied with iron or purified pseudobactin M114. These effects were not observed on skim milk agar without yeast extract. PbrA-independent aprA expression was also observed from a truncated transcriptional fusion when grown in sucrose asparagine tryptone broth supplied with iron or purified pseudobactin M114. Thus, experimental evidence suggested that iron mediated its effects via transcriptional activation by PbrA under low iron conditions, while an as-yet-unidentified sigma factor(s) may be required for the PbrA-independent aprA expression and AprA proteolytic activity induced by siderophore and iron.

  5. Expression, purification, and characterization of the Necator americanus aspartic protease-1 (Na-APR-1 (M74)) antigen, a component of the bivalent human hookworm vaccine.

    Science.gov (United States)

    Seid, Christopher A; Curti, Elena; Jones, R Mark; Hudspeth, Elissa; Rezende, Wanderson; Pollet, Jeroen; Center, Lori; Versteeg, Leroy; Pritchard, Sonya; Musiychuk, Konstantin; Yusibov, Vidadi; Hotez, Peter J; Bottazzi, Maria Elena

    2015-01-01

    Over 400 million people living in the world's poorest developing nations are infected with hookworms, mostly of the genus Necator americanus. A bivalent human hookworm vaccine composed of the Necator americanus Glutathione S-Transferase-1 (Na-GST-1) and the Necator americanus Aspartic Protease-1 (Na-APR-1 (M74)) is currently under development by the Sabin Vaccine Institute Product Development Partnership (Sabin PDP). Both monovalent vaccines are currently in Phase 1 trials. Both Na-GST-1 and Na-APR-1 antigens are expressed as recombinant proteins. While Na-GST-1 was found to express with high yields in Pichia pastoris, the level of expression of Na-APR-1 in this host was too low to be suitable for a manufacturing process. When the tobacco plant Nicotiana benthamiana was evaluated as an expression system, acceptable levels of solubility, yield, and stability were attained. Observed expression levels of Na-APR-1 (M74) using this system are ∼300 mg/kg. Here we describe the achievements and obstacles encountered during process development as well as characterization and stability of the purified Na-APR-1 (M74) protein and formulated vaccine. The expression, purification and analysis of purified Na-APR-1 (M74) protein obtained from representative 5 kg reproducibility runs performed to qualify the Na-APR-1 (M74) production process is also presented. This process has been successfully transferred to a pilot plant and a 50 kg scale manufacturing campaign under current Good Manufacturing Practice (cGMP) has been performed. The 50 kg run has provided a sufficient amount of protein to support the ongoing hookworm vaccine development program of the Sabin PDP.

  6. Extended station blackout analyses of an APR1400 with MARS-KS

    Directory of Open Access Journals (Sweden)

    Kim Woongbae

    2016-01-01

    Full Text Available The Fukushima Daiichi nuclear power plant accident shows that natural disasters such as earthquakes and the subsequent tsunamis can cause station blackout for several days. The electric energy required for essential systems during a station blackout is provided from emergency backup batteries installed at the nuclear power plant. In South Korea, in the event of an extended station blackout, the life of these emergency backup batteries has recently been extended from 8 hours to 24 hours at Shin-Kori 5, 6, and APR1400 for design certification. For a battery life of 24 hours, available safety means system, equipment and procedures are studied and analyzed in their ability to cope with an extended station blackout. A sensitivity study of reactor coolant pump seal leakage is performed to verify how different seal leakages could affect the system. For simulating extended station blackout scenarios, the best estimate MARS-KS computer code was used. In this paper, an APR1400 RELAP5 input deck was developed for station blackout scenario to analyze operation strategy by manually depressurizing the reactor coolant system through the steam generator's secondary side. Additionally, a sensitivity study on reactor coolant pump seal leakage was carried out.

  7. Organ Transplants in Kazakhstan.

    Science.gov (United States)

    Baigenzhin, Abay; Doskaliyev, Zhaksylyk; Tuganbekova, Saltanat; Zharikov, Serik; Altynova, Sholpan; Gaipov, Abduzhappar

    2015-11-01

    The Republic of Kazakhstan is one of the fastest developing countries in the world and has a health care system that is unique in Central Asia. Its organ transplant services are also developing rapidly. We aimed to analyze and briefly report on the current status of organ transplant in the Republic of Kazakhstan. We analyzed organ transplant activities in that country for the period 2012 to 2014. All data were collected from the official database of the National Transplant Coordinating Center of the Republic of Kazakhstan. At the end of 2014, the number of transplant centers had increased to 10, three of which could perform multiorgan transplants; during the same period, the number of deceased-donor organ-donating hospitals increased up to 37. By 2013, the transplant activity rate for all centers had reached 9.22 per million population. During the previous 3 years (2012-2014), there was a 3-fold increase in the number of living donors and an 18-fold increase in the number of kidney transplants. Between 2012 and 2014, the number of living-donor liver transplants increased from 17 to 25, and the number of deceased-donor transplants increased from 3 to 7. During the last 3 years (2012-2014), the number of heart transplants increased to 7 cases. During the last 3 years (2012-2014), Kazakhstan achieved a significant improvement in the organization of its transplant services, and a noticeable upward trend in the system continues.

  8. Carinal transplantation.

    OpenAIRE

    Ueda, H; Shirakusa, T

    1992-01-01

    BACKGROUND: Current techniques of management of carinal lesions are not always satisfactory. Carinal transplantation, if feasible, would be valuable in certain circumstances. METHODS AND RESULTS: Carinal transplantation experiments were performed in dogs. In early cross transplant experiments there were problems in controlling ventilation and in obtaining satisfactory anastomoses, and the animals failed to live for even a few days. In seven subsequent experiments the carinal graft was removed...

  9. Evaluation of Ablation rate by the change of Sacrificial Material for PECS in EU-APR

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Do Hyun; Kim, Yong Soo; Lee, Keun Sung [KHNP-CRI, Daejeon (Korea, Republic of)

    2015-05-15

    EU-APR, modified and improved from its original design of APR1400, has been developed to comply with European Utility Requirements (EUR) and nuclear design requirements of the European countries. In EU-APR, Severe Accident Mitigation Systems are dedicated to providing an independent defense line from that of Engineered Safety Feature (ESF) and Diverse Safety Feature (DSF). They consist of Emergency Reactor Depressurization System (ERDS), Passive Ex-vessel corium retaining and Cooling System (PECS), Severe Accident Containment Spray System (SACSS), Hydrogen Mitigation System (HMS) and Containment Filtered Vent System (CFVS). The PECS, so called core catcher, was introduced to prevent the Molten Core Concrete Interaction (MCCI) after Reactor Vessel (RV) failure. The PECS has experienced a lot of changes from its original design. Recently, the most significant change was that as a SM, limestone concrete is installed on PECS's body wall instead of previous sacrificial material rich in Fe{sub 2}O{sub 3}. The main reason of this design change is to overcome the issue that the sacrificial material is ablated rather too fast when reacting with corium that contains a large fraction of Zr metal. Other changes in the geometry of PECS's wall and downcomer design are considered as minor ones. In this paper, the comparison of ablation rates between previous SM and limestone concrete is carried out using MAAP5 code with respective MCCI model according to the material. In this paper, major improvements of MAAP5 model for PECS in EU-APR are presented and the evaluation of ablation rate for the previous SM model and the new LC model is carried out by means of ablation depths with LBLOCA sequence. Two models have respective unique ablation process. The ablation of LC model proceeds at a constant rate regardless of water while the ablation of SM model proceeds at a faster rate before the arrival of cooling water for corium and SM mixture. The change of sacrificial material

  10. [Transplant Surgeon Meets Nephrologist: Important Nephrological Aspects Before and After Kidney or Liver Transplantation].

    Science.gov (United States)

    Vondran, F W R; Wintterle, S; Bräsen, J H; Haller, H; Klempnauer, J; Richter, N; Lehner, F; Schiffer, M

    2017-04-01

    In cases of chronic renal insufficiency, successful kidney transplantation is the method of choice to restore patients' health, well-being and physical fitness. The interdisciplinary collaboration of nephrologists and transplant surgeons has always been a prerequisite for the successful pre-, peri- and post-transplant care of renal transplant patients. The same holds true for liver transplant patients. Here the nephrologist is often involved in cases requiring pre- or post-transplant dialysis as well as in decision making for combined liver-kidney transplantation. This review focuses on nephrological aspects in patient care before and after kidney and liver transplantation. Georg Thieme Verlag KG Stuttgart · New York.

  11. Too poor for transplant: finance and insurance issues in transplant ethics.

    Science.gov (United States)

    Laurentine, Kyle Alexander; Bramstedt, Katrina A

    2010-06-01

    Donor organs are a scarce gift. Additionally, transplantation is very expensive and the United States lacks universal health insurance for all citizens. These facts combine to make personal finance and insurance some of the criteria for wait listing at US transplant centers. Previous research has shown that the poor and the uninsured (as well as women and nonwhites) are less likely to receive a transplant. Living donor candidates are also limited by the US insurance system. To determine the effect of finance and insurance variables on access to transplant and living donation. A qualitative descriptive study of ethics consultation data contained in a research registry approved by the institutional review board at California Pacific Medical Center. This study analyzes research registry data from a large community hospital in Northern California that serves patients from California, Oregon, and Nevada. The registry data are derived from transplant ethics consultations occurring between January 1, 2007, and June 30, 2009. This study explores the restriction of access to transplantation and of participation in living donation. More than a quarter of all transplant ethics consultation reports described the restriction of transplant-related treatment for reasons rooted in finance or insurance. Individuals on the recipient side and on the donor side were hindered with regard to access. Insurance status and personal ability to pay significantly affect access to transplantation in the United States, and this theme is a frequent feature of ethics consultations at California Pacific Medical Center.

  12. History of Lung Transplantation.

    Science.gov (United States)

    Dabak, Gül; Şenbaklavacı, Ömer

    2016-04-01

    History of lung transplantation in the world can be traced back to the early years of the 20 th century when experimental vascular anastomotic techniques were developed by Carrel and Guthrie, followed by transplantation of thoracic organs on animal models by Demikhov and finally it was James Hardy who did the first lung transplantation attempt on human. But it was not until the discovery of cyclosporine and development of better surgical techniques that success could be achieved in that field by the Toronto Lung Transplant Group led by Joel Cooper. Up to the present day, over 51.000 lung transplants were performed in the world at different centers. The start of lung transplantation in Turkey has been delayed for various reasons. From 1998 on, there were several attempts but the first successful lung transplant was performed at Sureyyapasa Hospital in 2009. Today there are four lung transplant centers in Turkey; two in Istanbul, one in Ankara and another one in Izmir. Three lung transplant centers from Istanbul which belong to private sector have newly applied for licence from the Ministry of Health.

  13. Outcomes of patients with abdominoperineal resection (APR) and low anterior resection (LAR) who had very low rectal cancer.

    Science.gov (United States)

    Yeom, Seung-Seop; Park, In Ja; Jung, Sung Woo; Oh, Se Heon; Lee, Jong Lyul; Yoon, Yong Sik; Kim, Chan Wook; Lim, Seok-Byung; Kim, Nayoung; Yu, Chang Sik; Kim, Jin Cheon

    2017-10-01

    We compared the oncological outcomes of sphincter-saving resection (SSR) and abdominoperineal resection (APR) in 409 consecutive patients with very low rectal cancer (i.e., tumors within 3 cm from the anal verge); 335 (81.9%) patients underwent APR and 74 (18.1%) underwent SSR. The APR group comprised higher proportions of men (67.5% vs 55.4%, P = .049) and advanced-stage patients (P cancer stages. RFS was associated with ypT and ypN stages in patients who received PCRT, while pN stage, lymphovascular invasion (LVI), and circumferential resection margin (CRM) involvement were risk factors for RFS in those who did not receive PCRT. Notably, SSR was not found to be a risk factor for RFS in either subgroup. Patients who were stratified according to cancer stage and PCRT also showed no differences in RFS according to the mode of surgery. Our results demonstrate that, regardless of PCRT administration, SSR is an effective treatment for very low rectal cancer, while CRM is an important prognostic factor for patients who did not receive PCRT.

  14. Development of phenomena identification and ranking table for APR1400 main steam line break

    International Nuclear Information System (INIS)

    Song, J. H.; Chung, B. D.; Jeong, J. J.

    2003-01-01

    A Phenomena Identification and Ranking Table (PIRT) was developed for the Main Steam Line Break (MSLB) event of an APR-1400 (Advanced Power Reactor-1400). A team of experts from research institutes, industries, and regulatory bodies participated in the development. The selected event was a double-ended steam line break at full power with the reactor coolant pump running. The panel selected the fuel performance as the primary safety criterion for ranking. The plant design data, the results of APR-1400 safety analysis, and the results of additional best estimate analysis by MARS2.1 were utilized. Three phases of pre-trip, rapid cool-down, and safety injection phase were identified. Then, the ranking of a system, components, phenomenon/process based on the relative importance to the primary evaluation criterion were followed for each time phase. Finally, the knowledge-level for each important process in the component was ranked in terms of the existing knowledge. The highly ranked phenomena identified for APR-1400 MSLB are tube wall heat transfer at the steam generator shell, void distribution at the steam generator shell, liquid entrainment in the separators, mixture level in the separators, boron mixing in the upper down comer, boron transport and thermal mixing in the lower plenum, stored energy release in the upper head, and flow to and/from the upper head. The PIRT will be used as a guide in planning cost effective experimental programs and code development efforts, especially for the quantification of the process and/or phenomena, which have a high importance but low knowledge level

  15. Perspectives of Older Kidney Transplant Recipients on Kidney Transplantation.

    Science.gov (United States)

    Pinter, Jule; Hanson, Camilla S; Chapman, Jeremy R; Wong, Germaine; Craig, Jonathan C; Schell, Jane O; Tong, Allison

    2017-03-07

    Older kidney transplant recipients are susceptible to cognitive impairment, frailty, comorbidities, immunosuppression-related complications, and chronic graft failure, however, there has been limited focus on their concerns and expectations related to transplantation. This study aims to describe the perspectives of older kidney transplant recipients about their experience of kidney transplantation, self-management, and treatment goals to inform strategies and interventions that address their specific needs. Face-to-face semistructured interviews were conducted with 30 kidney transplant recipients aged 65-80 years from five renal units in Australia. Transcripts were analyzed thematically. Six themes were identified: restoring vitality of youth (with subthemes of revived mindset for resilience, embracing enjoyment in life, drive for self-actualization); persisting through prolonged recovery (yielding to aging, accepting functional limitations, pushing the limit, enduring treatment responsibilities); imposing sicknesses (combatting devastating comorbidities, painful restrictions, emerging disillusionment, anxieties about accumulating side effects, consuming treatment burden); prioritizing graft survival (privileged with a miracle, negotiating risks for longevity, enacting a moral duty, preserving the last opportunity); confronting health deterioration (vulnerability and helplessness, narrowing focus to immediate concerns, uncertainty of survival); and value of existence (purpose through autonomy, refusing the burden of futile treatment, staying alive by all means). Older kidney transplant recipients felt able to enjoy life and strived to live at their newly re-established potential and capability, which motivated them to protect their graft. However, some felt constrained by slow recuperation and overwhelmed by unexpected comorbidities, medication-related side effects, and health decline. Our findings suggest the need to prepare and support older recipients for self

  16. Blood and Bone Marrow Transplant?

    Science.gov (United States)

    ... Topics / Blood and Bone Marrow Transplant Blood and Bone Marrow Transplant Also known as Hematopoietic Stem Cell Transplant , Hematopoietic ... person, called a donor, it is an allogeneic transplant. Blood or bone marrow transplants most commonly are used to treat ...

  17. Kaposi's sarcoma in organ transplant recipients. The Collaborative Transplantation Research Group of Ile de France.

    Science.gov (United States)

    Farge, D

    1993-01-01

    Kaposi's Sarcoma (KS) is a tumour of multicentric origin with increased frequency after organ transplantation. To date, only North American data from the Cincinnati Transplant Tumor Registry have given some information about this disease in organ transplant recipients, but its true prevalence still has to be determined. In order to analyze Kaposi's sarcoma after kidney, liver and heart transplantation, we performed a retrospective study using the oldest registry of organ transplant recipients in Europe. Among all 7923 organ transplant recipients recorded in the Groupe Collaboratif de Recherche en Transplantation de l'Ile de France (GCIF) registry from 1968 to 1990, we analyzed the prevalence and the clinical characteristics of Kaposi's sarcoma in 6229 kidney, 727 liver and 967 heart transplant recipients. In the subgroup of kidney transplant recipients, we assessed the role of cyclosporine on disease evolution. Overall prevalence of Kaposi's sarcoma after organ transplantation was 0.52%, but it was significantly higher among liver (1.24%) than among kidney (0.45%) and heart (0.41%) transplant recipients. Chronic hepatitis B surface antigen carriers were more frequent in liver than in kidney transplant recipients who developed Kaposi's sarcoma (66% vs 21%, p < 0.03). Following kidney transplantation, Kaposi's sarcoma was more severe in patients receiving cyclosporine (n = 16) when compared with those under conventional immunosuppression (n = 12). True prevalence of Kaposi's sarcoma among European transplant recipients is high (0.52%) and appeared significantly higher in liver compared with other organ transplant recipients. Cyclosporine seems to increase severity of the disease among kidney transplant recipient.

  18. Opportunities to deter transplant tourism exist before referral for transplantation and during the workup and management of transplant candidates.

    Science.gov (United States)

    Gill, Jagbir; Diec, Olivier; Landsberg, David N; Rose, Caren; Johnston, Olwyn; Keown, Paul A; Gill, John S

    2011-05-01

    Transplant tourism is a global issue, and physicians in the developed world may be in a position to actively deter this practice. To examine such opportunities, we identified 93 residents of British Columbia, Canada who had a kidney graft through tourism and determined their previous interactions with our transplant programs. These patients were mainly ethnic minorities (90%) who traveled to their country of origin for transplantation. Many tourists were transplanted early in their disease course, with 27 having a preemptive transplant. Among the 65 tourists referred for transplant, 33 failed to complete the evaluation. All tourists who completed an evaluation were placed on a waiting list in British Columbia and, after waiting a median of 2 years, pursued tourism. Most of these patients (62%) had a potential living donor, but none had an approved donor, with 13 donors found medically unsuitable, 8 ABO incompatible, and 12 who did not complete their evaluation. Thus, strategies to deter tourism should start before the development of end-stage renal disease and should be part of pretransplant workup and wait-list management, focusing on patients not progressing through their evaluation, those with a declined living donor, and those facing longer wait times, as these groups appear to be at higher risks for transplant tourism. Further studies are needed to identify individuals at risk for transplant tourism and to define effective strategies to deter these individuals.

  19. Evaluation of Coolant Injection Procedure in the Severe Accident Management Strategy of APR1400

    International Nuclear Information System (INIS)

    Cho, Yongjin; Lim, Kukhee; Song, Sungchu; Lee, Sukho; Hwang, Taesuk

    2013-01-01

    A coolant injection strategy in the severe accident management guideline (SAMG) of APR1400 relates to immediate coolant injection into RCS (Reactor Coolant System) or injection following the recovery of secondary coolant inventory. This strategy could play important role in accident mitigation and radiological consequences. In this study, appropriateness of the strategy was evaluated using MELCOR1.8.6 and several sensitivity studies of the key parameters were performed. Analysis for APR1400 using MELCOR 1.8.6 was performed to evaluate the effectiveness of accident management strategies and the following conclusions were identified. Sequential operation of secondary and RCS injection may not be the best strategy and the simultaneous injection of secondary and RCS injection could be more preferable. At least, the RCS injection should start before complete drainage of water in the safety injection tank using mobile pumps. In this study, the effectiveness of timing of operator action has been examined and the amount of injection flowrate needs to be studied in the future

  20. Transplant tourism: Outcomes of United States residents who undergo kidney transplantation overseas.

    Science.gov (United States)

    Canales, Muna T; Kasiske, Bertram L; Rosenberg, Mark E

    2006-12-27

    Although international commerce in kidney transplantation is a reality, little is known about U.S. residents who travel abroad for kidney transplantation. We retrospectively reviewed the clinical outcomes of patients who were evaluated at the University of Minnesota Medical Center or Hennepin County Medical Center, but then surreptitiously underwent kidney transplantation overseas. We identified 10 patients who underwent kidney transplantation outside the United States between September 16, 2002 and June 30, 2006 and then returned for care in our programs. Eight were transplanted in Pakistan (all Somali), one was transplanted in China (Chinese), and one was transplanted in Iran (Iranian). All but one had a living donor. Mean age was 36.8+/-12.5 years with median follow-up of 2.0 years (range 0.4-3.7). Three patients communicated their intent to travel abroad before transplantation. Induction immunosuppressive therapy (if any) was available in 3/10, and initial maintenance immunosuppression was known in 5/10. Complications were primarily infectious, with six potentially life-threatening infections in four patients. At last follow-up, mean serum creatinine was 1.13+/-0.34 mg/dL, acute rejection occurred in 2/10, 1/10 grafts failed due to acute rejection, and 9/10 patients were alive. Kidney function and graft survival were generally good after surreptitious overseas kidney transplantation. Major problems included incomplete perioperative information communicated to the posttransplant care facility and a high incidence of posttransplant infections. Longer follow-up and detailed cost analysis are needed to better understand the implications of the growing phenomenon of transplant tourism.

  1. Evaluation of contributing factors of post transplant erythrocytosis in renal transplant patients

    International Nuclear Information System (INIS)

    Ahmed, S.; Ahmed, E.; Naqvi, R.; Qureshi, S.

    2012-01-01

    Objective: To evaluate the prevalence and contributing factors causing post transplant erythrocytosis in renal transplant patients. Methods: This retrospective study was conducted on live related renal transplant patients at SIUT. The records of all transplant recipients transplanted between April 2008 and December 2008 and who had at least 24 months follow up were studied. Patients in whom haematocrit exceeded 51% and those who received treatment for it were classified into post transplant erythrocytosis group. Results: Out of 200 renal transplant patients who had functioning graft at the time of analysis, 40 (20%) developed post transplant erythrocytosis (HCT >51%) after a mean interval of 9.5+- 2.5 months. Patients with erythrocytosis were mostly males (95% in PTE group vs 73.75% in non PTE group) ,had a shorter period on dialysis before undergoing renal transplantation (9.28 months in PTE group vs 14.56 months in non PTE group) and had relatively better graft function at the onset of erythrocytosis as judged by serum creatinine (S. Creatinine of 1.06+-0.29 mg/dl in PTE group vs 1.37 +- 0.51 mg/dl in non PTE group). No thrombotic complications were observed. All patients with erythrocytosis were treated with enalapril (ACE inhibitors) and 28 out of 40 required phlebotomy in addition to ACE inhibitors. The mean HCT at the time of last follow up in treated patients was 48.61+-1.85%. Conclusion: Post transplant erythrocytosis generally occurs in male patients with good graft function, thrombotic complications are of rare occurrence and response to ACE inhibitors is good. (author)

  2. Syngeneic transplantation in aplastic anemia

    DEFF Research Database (Denmark)

    Gerull, Sabine; Stern, Martin; Apperley, Jane

    2013-01-01

    Aplastic anemia is usually treated with immunosuppression or allogeneic transplant, depending on patient and disease characteristics. Syngeneic transplant offers a rare treatment opportunity with minimal transplant-related mortality, and offers an insight into disease mechanisms. We present here...... a retrospective analysis of all syngeneic transplants for aplastic anemia reported to the European Group for Blood and Marrow Transplantation. Between 1976 and 2009, 88 patients received 113 transplants. Most transplants (n=85) were preceded by a conditioning regimen, 22 of these including anti-thymocyte globulin...

  3. Simplified study for the proposed APR1400 condenser performance based on EL-DABAA SITE, EGYPT, with respect to BNPP and SHIN KORI NPP

    Energy Technology Data Exchange (ETDEWEB)

    Abdoelatef, M. Gomaa; Rezk, Osama; Lee, YonKwan [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2015-10-15

    • Perception of nuclear power as a convenient, economically competitive and viable source of energy which, if introduced in the country, would not only complement the traditional energy sources, but would also promote technological development and serve as an incentive for social and economic progress. In this paper we will introduce APR-1400 as the most likely selected reactor type for 1st Egyptian Nuclear Power Plant. Then we will study the optimized APR-1400 condenser performance based on El-Dabaa site conditions. As the climate conditions, especially the seawater temperatures (intake for the cooling system) having a direct effects on the condenser performance and the overall NPP Efficiency, we studied the seawater temperature change based on EL-Dabaa site conditions and it's feedback on the proposed APR-1400 condenser performance and the NPP efficiency. All of the calculations and analysis had been executed by using KINGS NPA by applying EL-Dabaa seawater temperature variations for the 2 types of APR-1400 Condensers (Shinkori, south Korea and Barakah, UAE), and the main findings were as follow: For the APR-1400 condensers (Shinkori and Barakah) performance • The average difference all over the year for saturation temperature, cooling water outlet temperature, and condenser pressure are 0.135 .deg. C, .05785 .deg. C, and 0.3948 mHgA respectively. This shows that the Barakah condenser performance is not significantly better than the shinkori condenser performance based on EL-Dabaa Conditions, especially if we considered the cost difference between the two condensers designs. For APR-1400 NPPs (Shinkori and Barakah) net efficiency • The average difference all over the year for the power productions and net efficiency are 1.4791 MWe and .00037 %, respectively.

  4. What can happen after lung transplantation and the importance of the time since transplantation: radiological review of post-transplantation complications.

    Science.gov (United States)

    Daimiel Naranjo, I; Alonso Charterina, S

    2016-01-01

    Lung transplantation is the best treatment option in the final stages of diseases such as cystic fibrosis, pulmonary hypertension, chronic obstructive pulmonary disease, or idiopathic pulmonary fibrosis. Better surgical techniques and advances in immunosuppressor treatments have increased survival in lung transplant recipients, making longer follow-up necessary because complications can occur at any time after transplantation. For practical purposes, complications can be classified as early (those that normally occur within two months after transplantation), late (those that normally occur more than two months after transplantation), or time-independent (those that can occur at any time after transplantation). Many complications have nonspecific clinical and radiological manifestations, so the time factor is key to narrow the differential diagnosis. Imaging can guide interventional procedures and can detect complications early. This article aims to describe and illustrate the complications that can occur after lung transplantation from the clinical and radiological viewpoints so that they can be detected as early as possible. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Bioethics of organ transplantation.

    Science.gov (United States)

    Caplan, Arthur

    2014-03-01

    As the ability to transplant organs and tissues has grown, the demand for these procedures has increased as well--to the point at which it far exceeds the available supply creating the core ethical challenge for transplantation--rationing. The gap between supply and demand, although large, is worse than it appears to be. There are two key steps to gaining access to a transplant. First, one must gain access to a transplant center. Then, those waiting need to be selected for a transplant. Many potential recipients do not get admitted to a program. They are deemed too old, not of the right nationality, not appropriate for transplant as a result of severe mental impairment, criminal history, drug abuse, or simply because they do not have access to a competent primary care physician who can refer them to a transplant program. There are also financial obstacles to access to transplant waiting lists in the United States and other nations. In many poor nations, those needing transplants simply die because there is no capacity or a very limited capacity to perform transplants. Although the demand for organs now exceeds the supply, resulting in rationing, the size of waiting lists would quickly expand were there to suddenly be an equally large expansion in the number of organs available for transplantation. Still, even with the reality of unavoidable rationing, saving more lives by increasing organ supply is a moral good. Current public policies for obtaining organs from cadavers are not adequate in that they do not produce the number of organs that public polls of persons in the United States indicate people are willing to donate.

  6. Effectiveness of Multimedia for Transplant Preparation for Kidney Transplant Waiting List Patients.

    Science.gov (United States)

    Charoenthanakit, C; Junchotikul, P; Sittiudomsuk, R; Saiyud, A; Pratumphai, P

    2016-04-01

    A multimedia program could effectively advise patients about preparing for transplantation while on the waiting list for a kidney transplant. This study aimed to compare knowledge about transplant preparation for patients on a kidney transplant waiting list before and after participating in a multimedia program, and to evaluate patient satisfaction with the multimedia program. Research design was quasiexperimental with the use of 1 group. Subjects were 186 patients on the kidney transplant waiting list after HLA matching in Ramathibodi Hospital. The questionnaires were developed by the researchers. The statistical tools used were basic statistics, percentage, average, standard deviation, and the difference of score between before and after participation in the multimedia program (t test). The evaluation knowledge for transplant preparation for kidney transplant waiting list patients after participating in the multimedia program averaged 85.40%, and there was an increased improvement of score by an average 3.27 out of a possible full score of 20 (P multimedia program had good average, 4.58. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Key issues in transplant tourism.

    Science.gov (United States)

    Akoh, Jacob A

    2012-02-24

    Access to organ transplantation depends on national circumstances, and is partly determined by the cost of health care, availability of transplant services, the level of technical capacity and the availability of organs. Commercial transplantation is estimated to account for 5%-10% (3500-7000) of kidney transplants performed annually throughout the world. This review is to determine the state and outcome of renal transplantation associated with transplant tourism (TT) and the key challenges with such transplantation. The stakeholders of commercial transplantation include: patients on the waiting lists in developed countries or not on any list in developing countries; dialysis funding bodies; middlemen, hosting transplant centres; organ-exporting countries; and organ vendors. TT and commercial kidney transplants are associated with a high incidence of surgical complications, acute rejection and invasive infection which cause major morbidity and mortality. There are ethical and medical concerns regarding the management of recipients of organs from vendors. The growing demand for transplantation, the perceived failure of altruistic donation in providing enough organs has led to calls for a legalised market in organ procurement or regulated trial in incentives for donation. Developing transplant services worldwide has many benefits - improving results of transplantation as they would be performed legally, increasing the donor pool and making TT unnecessary. Meanwhile there is a need to re-examine intrinsic attitudes to TT bearing in mind the cultural and economic realities of globalisation. Perhaps the World Health Organization in conjunction with The Transplantation Society would set up a working party of stakeholders to study this matter in greater detail and make recommendations.

  8. Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients 2014 Data Report: Intestine.

    Science.gov (United States)

    Cai, Junchao; Wu, Guosheng; Qing, Annie; Everly, Matthew; Cheng, Elaine; Terasaki, Paul

    2014-01-01

    As of September 19, 2014, 2441 cases of intestinal transplantation have been performed in 46 centers (2400 deceased, 41 living). Eight centers did more than 100 transplants. Annual case numbers peaked in 2007 (N = 198) and steadily decreased to 109 cases in 2013. Short gut syndrome (68%) and functional bowel problems (15%) are two major indications for intestinal transplantation. The 3 major types of transplants involving the intestine include: isolated intestine transplant (I); simultaneous intestine, liver, and pancreas transplant (I+L+P); and, combined intestine and liver (I+L) transplant. Graft survival has significantly improved in recent years, mainly due to improved first year graft survival. The 1-, 5-, and 10-year graft survivals were: 74%, 42%,and 26%, respectively (I); 70%, 50%, and 40%, respectively (I+L+P); and 61%, 46%, and 40%, respectively (I+L). The longest graft survivals for I, l+L+P, and l+L were 19 years, 16 years, and 23 years, respectively. Steroids, Thymoglobulin, and rituximab are 3 major induction agents used in recent years. Prograf, steroids, and Cellcept are 3 major maintenance agents. Induction recipients (68% of all patients) had a significantly lower acute rejection rate than nonrecipients before discharge (60% versus 75%, p compatible transplants. ABO identical transplant recipients had a significantly higher 5-year graft survival rate than ABO compatible recipients (39% versus 21%, p compatible (N = 188, 11%) than in the early decade (p compatible transplants were lower than those of ABO identical transplants. However, the difference did not reach statistical significance (46% versus 49%, p = 0.07). The effect of ABO compatibility on graft outcome was further confirmed by Cox Analysis. ABO incompatible transplants are still rarely performed (N = 4) in intestine. In conclusion, annual case numbers of intestinal transplants have been decreasing, regardless of improved graft survival. ABO compatible intestinal transplants previously

  9. [Liver transplantation].

    Science.gov (United States)

    Pompili, Maurizio; Mirante, Vincenzo Giorgio; Rapaccini, Gian Ludovico; Gasbarrini, Giovanni

    2004-01-01

    Liver transplantation represents the first choice treatment for patients with fulminant acute hepatitis and for patients with chronic liver disease and advanced functional failure. Patients in the waiting list for liver transplantation are classified according to the severity of their clinical conditions (evaluated using staging systems mostly based on hematochemical parameters related to liver function). This classification, together with the blood group and the body size compatibility, remains the main criterion for organ allocation. The main indications for liver transplantation are cirrhosis (mainly HCV-, HBV- and alcohol-related) and hepatocellular carcinoma emerging in cirrhosis in adult patients, biliary atresia and some inborn errors of metabolism in pediatric patients. In adults the overall 5-year survival ranges between 60 and 70%, in both American and European series. Even better results have been reported for pediatric patients: in fact, the 5-year survival rate for children ranges between 70 and 80% in the main published series. In this study we evaluated the main medical problems correlated with liver transplantation such as immunosuppressive treatment, acute and chronic rejection, infectious complications, the recurrence of the liver disease leading to transplantation, and cardiovascular and metabolic complications.

  10. Bone metabolism dynamics in the early post-transplant period following kidney and liver transplantation.

    Science.gov (United States)

    Schreiber, Peter W; Bischoff-Ferrari, Heike A; Boggian, Katia; Bonani, Marco; van Delden, Christian; Enriquez, Natalia; Fehr, Thomas; Garzoni, Christian; Hirsch, Hans H; Hirzel, Cédric; Manuel, Oriol; Meylan, Pascal; Saleh, Lanja; Weisser, Maja; Mueller, Nicolas J

    2018-01-01

    Bone disease contributes to relevant morbidity after solid organ transplantation. Vitamin D has a crucial role for bone metabolism. Activation of vitamin D depends on the endocrine function of both, liver and kidney. Our study assessed key markers of bone metabolism at time of transplantation and 6 months after transplantation among 70 kidney and 70 liver recipients. In 70 kidney recipients 25-OH vitamin D levels did not differ significantly between peri-transplant (median 32.5nmol/l) and 6 months post-transplant (median 41.9nmol/l; P = 0.272). Six months post-transplant median 1, 25-(OH)2 vitamin D levels increased by >300% (from 9.1 to 36.5ng/l; Ptransplantation and of intact parathyroid hormone 6 months post-transplant. Among 70 liver recipients, 25-OH vitamin D, 1, 25-(OH)2 vitamin D and intact parathyroid hormone levels were not significantly altered between peri-transplant and 6 months post-transplant. Contrary to kidney recipients, median CTx increased by 60.0% (from 0.45 to 0.72 ng/ml; P = 0.002) and P1NP by 49.3% (from 84.0 to 125.4ng/ml; P = 0.001) in the longitudinal course. Assessed biomarkers didn't differ between liver recipients with and without fractures. To conclude, the assessed panel of biomarkers proved highly dynamic after liver as well as kidney transplantation in the early post-transplant period. After kidney transplantation a significant gain in 1, 25-(OH)2 vitamin D combined with a decline in iPTH, CTx and P1NP, whereas after liver transplantation an increase in CTx and P1NP were characteristic.

  11. Pancreatic Islet Cell Transplantation

    Science.gov (United States)

    Warnock, Garth L.; Rajotte, Ray V.

    1992-01-01

    Transplantation of insulin-producing tissue offers a physiologic approach to restoration of glycemic control. Whereas transplantation of vascularized pancreatic grafts has recently achieved encouraging results, pancreatic islet cell transplantation holds the promise of low morbidity and reduced requirements for agressive immunosuppression for recipients. Islet cell transplantation was recently demonstrated to induce euglycemia with insulin independence. Imagesp1656-a PMID:21221366

  12. Changing Patterns of Foreigner Transplants in Korea and Overseas Organ Transplants Among Koreans.

    Science.gov (United States)

    Ahn, Hyung Joon; Kim, Hwi Won; Han, Miyeun; Jeon, Hee Jung; Kwon, Oh Jung; Ahn, Curie

    2018-02-01

    This study aimed to estimate the numbers of foreign patients seeking organ transplantation (OT) in Korea and to examine the relationship between the trend of deceased donors in Korea and number of Korean patients seeking OT overseas since 2000. Data on foreigners who received a transplant in Korea were obtained from the Korean Network for Organ Sharing. Data on overseas transplants were obtained from 42 transplant centers surveyed through transplant coordinators. A total of 336 foreigners underwent OT (kidney transplantation [KT], 174; liver transplantation [LT], 162) in Korea between 2006 and 2016. The Mongolians were the most common foreigners who undergo KTs (32%), followed by the Chinese (18%), Americans (9%), and Emiratis (7%). Among foreigners undergoing LTs, the most common country of origin was Mongolia (39%), followed by United Arab Emirates (23%), China (13%), and the United States (6%). A total of 2206 Korean patients underwent overseas OT (KT, 977; LT, 1229) between 2000 and 2016. In 97% of overseas KT cases (n = 942) and 98% (n = 1205) of overseas LT cases, the transplantations were performed in China. The relationship between the number of deceased donors in Korea and the number of overseas transplants after 2006 indicates a highly negative correlation. (ρ = -0.988, P tourism.

  13. Heart transplantation from older donors

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2017-01-01

    Full Text Available In the current situation of the shortage of suitable donor organs, heart transplantation from older donors is one of the ways to increase the performance of more heart transplants, particularly, in patients with urgent need of transplantation. While planning a heart transplantation from older donor one should consider increased risk of early cardiac allograft dysfunction, preexisting coronary artery disease, accelerated transplant vasculopathy which may adversely affect early and long-term survival of recipients. Subject to careful selection of donor–recipient pairs, effective prevention and treatment of early cardiac allograft dysfunction, pre-existing atherosclerosis and transplant vasculopathy the early and long-term survival of heart transplant recipients from older donors is comparable to heart transplantation from young donors.

  14. Using a Classroom Response System to Improve Multiple-Choice Performance in AP[R] Physics

    Science.gov (United States)

    Bertrand, Peggy

    2009-01-01

    Participation in rigorous high school courses such as Advanced Placement (AP[R]) Physics increases the likelihood of college success, especially for students who are traditionally underserved. Tackling difficult multiple-choice exams should be part of any AP program because well-constructed multiple-choice questions, such as those on AP exams and…

  15. Analysis of Turbine Load Rejection for APR1400 using SPACE

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Jin; Park, Chan Eok; Choi, Jong Ho; Lee, Gyu Cheon [KEPCO Engineering and Construction Co. Ltd., Deajeon (Korea, Republic of)

    2016-10-15

    Turbine Load Rejection event is one of the Performance Related Design Basis Event (PRDBE) that can be stabilized using plant control systems without any safety system actuation. The initiation of the event is turbine load rejection from 100% to 5% in 0.019 seconds. The NSSS control systems of APR1400 is composed of the Power Control System (PCS) and the Process-Component Control System (P-CCS). The PCS includes Reactor Regulating System (RRS), Reactor Power Cutback System (RPCS) and Digital Rod Control System (DRCS). The P-CCS includes the Pressurizer Pressure Control System (PPCS), the Pressurizer Level Control System (PLCS), the Feedwater Control System (FWCS) and the Steam Bypass Control System (SBCS). Turbine load rejection results in the increase of secondary pressure due to sudden blocking of steam flow to turbine. Then the Reactor Coolant System (RCS) cooling through steam generators is decreased rapidly and the RCS temperature will be increased. Turbine load rejection is a typical event to test NSSS control systems since it requires the automatic response of all major NSSS control systems. It is shown that the NSSS control systems of APR1400 have the capability to stabilize the plant without any safety system actuation for turbine load rejection event. This analysis results show that SPACE code has the capability to analyze the turbine load rejection event. However, further validation is necessary for other PRDBEs such as Two Main Feedwater Pumps Trip, Turbine Load Step Change and Turbine Load Ramp Down (5%/min) to verify the capability of SPACE for the full range of performance analyses.

  16. Analysis of Turbine Load Rejection for APR1400 using SPACE

    International Nuclear Information System (INIS)

    Kim, Sang Jin; Park, Chan Eok; Choi, Jong Ho; Lee, Gyu Cheon

    2016-01-01

    Turbine Load Rejection event is one of the Performance Related Design Basis Event (PRDBE) that can be stabilized using plant control systems without any safety system actuation. The initiation of the event is turbine load rejection from 100% to 5% in 0.019 seconds. The NSSS control systems of APR1400 is composed of the Power Control System (PCS) and the Process-Component Control System (P-CCS). The PCS includes Reactor Regulating System (RRS), Reactor Power Cutback System (RPCS) and Digital Rod Control System (DRCS). The P-CCS includes the Pressurizer Pressure Control System (PPCS), the Pressurizer Level Control System (PLCS), the Feedwater Control System (FWCS) and the Steam Bypass Control System (SBCS). Turbine load rejection results in the increase of secondary pressure due to sudden blocking of steam flow to turbine. Then the Reactor Coolant System (RCS) cooling through steam generators is decreased rapidly and the RCS temperature will be increased. Turbine load rejection is a typical event to test NSSS control systems since it requires the automatic response of all major NSSS control systems. It is shown that the NSSS control systems of APR1400 have the capability to stabilize the plant without any safety system actuation for turbine load rejection event. This analysis results show that SPACE code has the capability to analyze the turbine load rejection event. However, further validation is necessary for other PRDBEs such as Two Main Feedwater Pumps Trip, Turbine Load Step Change and Turbine Load Ramp Down (5%/min) to verify the capability of SPACE for the full range of performance analyses

  17. The impact of repeated mismatches in kidney transplantations performed after nonrenal solid organ transplantation.

    Science.gov (United States)

    Côté, J M; Zhang, X; Dahhou, M; Sapir-Pichhadze, R; Foster, B; Cardinal, H

    2018-01-01

    The aim of this study was to determine whether kidney transplantations performed after previous nonrenal solid organ transplants are associated with worse graft survival when there are repeated HLA mismatches (RMM) with the previous donor(s). We performed a retrospective cohort study using data from the Scientific Registry of Transplant Recipients. Our cohort comprised 6624 kidney transplantations performed between January 1, 1990 and January 1, 2015. All patients had previously received 1 or more nonrenal solid organ transplants. RMM were observed in 35.3% of kidney transplantations and 3012 grafts were lost over a median follow-up of 5.4 years. In multivariate Cox regression analyses, we found no association between overall graft survival and either RMM in class 1 (hazard ratio [HR]: 0.97, 95% confidence interval [CI] 0.89-1.07) or class 2 (HR: 0.95, 95% CI 0.85-1.06). Results were similar for the associations between RMM, death-censored graft survival, and patient survival. Our results suggest that the presence of RMM with previous donor(s) does not have an important impact on allograft survival in kidney transplant recipients who have previously received a nonrenal solid organ transplant. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  18. Imaging in pancreatic transplants

    International Nuclear Information System (INIS)

    Heller, Matthew T; Bhargava, Puneet

    2014-01-01

    Pancreatic transplantation, performed alone or in conjunction with kidney transplantation, is an effective treatment for advanced type I diabetes mellitus and select patients with type II diabetes mellitus. Following advancements in surgical technique, postoperative management, and immunosuppression, pancreatic transplantation has significantly improved the length and quality of life for patients suffering from pancreatic dysfunction. While computed tomography (CT) and magnetic resonance imaging (MRI) have more limited utility, ultrasound is the preferred initial imaging modality to evaluate the transplanted pancreas; gray-scale assesses the parenchyma and fluid collections, while Doppler interrogation assesses vascular flow and viability. Ultrasound is also useful to guide percutaneous interventions for the transplanted pancreas. With knowledge of the surgical anatomy and common complications, the abdominal radiologist plays a central role in the perioperative and postoperative evaluation of the transplanted pancreas

  19. Design of transplanting mechanism for system of rice intensification (SRI) transplanter in Kedah, Malaysia

    Science.gov (United States)

    Imran, M. S.; Manan, M. S. Abdul; Khalil, A. N. M.; MdNaim, M. K.; Ahmad, R. N.

    2017-08-01

    There is a demand to develop transplanter specifically for system of rice intensification (SRI) cultivation in Malaysia. This SRI transplanter is different from conventional transplanter as it is required special requirements for transplanting. The work focused on transplanting mechanism design which can be later attached to SRI transplanter. The mechanical design was established using linkage mechanism, having a wheel that act as timing wheel that will control the distance between transplanted seedlings. The linkage mechanism also control the opening of the flapper that allow the seedling together with its nursery soil to be dropped, and control the stopper to prevent next seedling from sliding down the tray. The use of simple mechanism will have low cost for fabrication. The design was analysed using motion analysis software. Results show the design is perfectly good and can be fabricated without any problem. The animation successfully shows the perfect movement of the mechanism and transplanting process.

  20. Breast Reconstruction After Solid Organ Transplant.

    Science.gov (United States)

    Koonce, Stephanie L; Giles, Brian; McLaughlin, Sarah A; Perdikis, Galen; Waldorf, James; Lemaine, Valerie; TerKonda, Sarvam

    2015-09-01

    Solid organ transplant patients frequently develop posttransplant malignancies including breast cancer. They may desire breast reconstruction after mastectomy, which could potentially be complicated by their transplant status, immunosuppressive regimen, and previous operations. We review our experience with patients who have undergone solid organ transplant and subsequent breast reconstruction after mastectomy After institutional review board approval, we queried our prospective breast reconstruction and solid organ transplant databases for corresponding patients. Inclusion criteria comprised breast reconstruction after solid organ transplant. A chart review was conducted of identified patients. Seventeen patients were identified: 1 pulmonary transplant, 4 cardiac transplants, 2 liver transplants, 1 pancreas transplant, 2 combined kidney/pancreas transplants, and 7 kidney transplants. Indications for mastectomy included posttransplant malignancy and prophylaxis. Median time from transplant to completion of reconstruction was 186 months (range, 11-336 months). Median age at transplant was 34.5 years (range, 21-65 years) with the median age of the patients at reconstructive surgery 51.5 years (range, 34-71 years). Median body mass index was 25.3 (range, 21.3-46.5). No significant complications were noted after reconstructive surgery. All patients were on full immunosuppression at time of reconstruction. Breast reconstruction is a viable option for transplant patients after mastectomy and should not be refused based on their transplant status. Close coordination with the transplant team and careful preoperative planning is essential for optimal outcomes.

  1. Choosing a Transplant Center

    Science.gov (United States)

    ... however you can Daughter's dying wish became mother's motivation Be The Match Blog Stories Anna, transplant recipient ... for transplant costs. Location – You might have to travel to receive a transplant. Consider how far the ...

  2. Appraisal of transplant-related stressors, coping strategies, and psychosocial adjustment following kidney transplantation.

    Science.gov (United States)

    Pisanti, Renato; Lombardo, Caterina; Luszczynska, Aleksandra; Poli, Luca; Bennardi, Linda; Giordanengo, Luca; Berloco, Pasquale Bartolomeo; Violani, Cristiano

    2017-10-01

    This study examined the relations between appraisal of transplant-related stressors, coping, and adjustment dimensions following kidney transplantation (KT). Two models were tested: (1) the main effects model proposing that stress appraisal and coping strategies are directly associated with adjustment dimensions; and (2) the moderating model of stress proposing that each coping strategy interacts with stress appraisal. Importantly, there is a lack of research examining the two models simultaneously among recipients of solid organ transplantation. A total of 174 KT recipients completed the questionnaires. Predictors of post-transplant adjustment included appraisal of transplant-related stressors and coping strategies (task-, emotion-, and avoidance-focused). Adjustment dimensions were psychological distress, worries about the transplant, feelings of guilt, fear of disclosure of transplant, adherence, and responsibility for the functioning of the new organ. The main and moderating effects were tested with regression analyses. Appraisal of transplant-related stressors and emotion-oriented coping were related to all adjustment dimensions, except of adherence and responsibility. Task-oriented coping was positively related to responsibility. Avoidance-oriented coping was negatively correlated with adherence. Only 1 out of 18 hypothesized interactive terms was significant, yielding a synergistic interaction between appraisal of transplant-related stressors and emotion-oriented coping on the sense of guilt. The findings have the potential to inform interventions promoting psychosocial adjustment among KT recipients. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Split-liver transplantation : An underused resource in liver transplantation

    NARCIS (Netherlands)

    Rogiers, Xavier; Sieders, Egbert

    2008-01-01

    Split-liver transplantation is an efficient tool to increase the number of liver grafts available for transplantation. More than 15 years after its introduction only the classical splitting technique has reached broad application. Consequently children are benefiting most from this possibility.

  4. Analysis of hemodialysis patients’ thoughts about kidney transplantation and the national organ transplant system in terms of organ transplantation services management

    Directory of Open Access Journals (Sweden)

    Yasin Uzuntarla

    2017-03-01

    Results: It was determined that the hemodialysis patients responding to the survey were in the 20-95 age group with an average age of 58,64±15,64 years. 87,9% of the patients reported that they had been briefed about kidney transplants, 32,2% of those had been briefed said that the information had been delivered by the dialysis physician, 77,7% stated that they wanted a kidney transplant from a cadaver, 49,5% did not want a kidney transplant from a live donor and 35,5% indicated that the national organ transplant system operated adequately. Furthermore, it was noted that 50,9% of the responders were registered on the waiting lists of kidney transplant centers. Conclusions: It was concluded that it is necessary to provide sufficient information to hemodialysis patients about kidney transplants and the national organ transplant system to steer them to transplant centers. It is anticipated that the results of this study will assist officers of the Ministry of Health, politicians involved in health issues, decision makers and health professionals. [Arch Clin Exp Surg 2017; 6(1.000: 33-37

  5. The lived experience of autologous stem cell-transplanted patients: Post-transplantation and before discharge.

    Science.gov (United States)

    Alnasser, Qasem; Abu Kharmah, Salahel Deen; Attia, Manal; Aljafari, Akram; Agyekum, Felicia; Ahmed, Falak Aftab

    2018-04-01

    To explore the lived experience of the patients post-haematopoietic stem cell transplantation and specifically after engraftment and before discharge. Patients post-stem cell transplantation experience significant changes in all life aspects. Previous studies carried out by other researchers focused mainly on the postdischarge experience, where patients reported their perceptions that have always been affected by the life post-transplantation and influenced by their surroundings. The lived experience of patients, specifically after engraftment and prior to discharge (the "transition" phase), has not been adequately explored in the literature. Doing so might provide greater insight into the cause of change post-haematopoietic stem cell transplantation. This study is a phenomenological description of the participants' perception about their lived experience post-haematopoietic stem cell transplantation. The study used Giorgi's method of analysis. Through purposive sampling, 15 post-haematopoietic stem cell transplantation patients were recruited. Data were collected by individual interviews. Data were then analysed based on Giorgi's method of analysis to reveal the meaning of a phenomenon as experienced through the identification of essential themes. The analysis process revealed 12 core themes covered by four categories that detailed patients lived experience post-haematopoietic stem cell transplantation. The four categories were general transplant experience, effects of transplantation, factors of stress alleviation and finally life post-transplantation. This study showed how the haematopoietic stem cell transplantation affected the patients' physical, psychological and spiritual well-being. Transplantation also impacted on the patients' way of thinking and perception of life. Attending to patients' needs during transplantation might help to alleviate the severity of the effects and therefore improve experience. Comprehensive information about transplantation needs

  6. PLUS 7TM advanced fuel assembly development program for KSNPs and APR1400

    International Nuclear Information System (INIS)

    Kim, Kyutae; Stucker, David L.

    2002-01-01

    KNFC and Westinghouse have recently completed the development of the PLUS 7 TM advanced 16 X 16 fuel assembly for the Korean Standard Nuclear Plants (KSNPs) and the Advanced Power Reactor 1400 (APR 1400). This fuel design utilized the proven advanced design features including mixing vane spacer grids to increase critical heat flux performance, ZIRLO TM advanced materials to enable high-duty, high burnup fuel management and an optimized fuel rod diameter which improves fuel cycle cost while resulting in significant standardization of Korean fuel manufacture. PLUS 7 TM , also includes a patented spacer grid design with conformal fuel rod support designed to provide superior fuel rod wear/fretting resistance while minimizing pressure drop. This paper will present an overview of the PLUS 7 TM fuel assembly development process including a summary of the three-year design and testing program from a mechanical, neutronic, and thermal/hydraulic perspective. The PLUS 7 TM fuel for the KSNPs and the APR1400 reactors results in multi-million dollar per cycle savings in imported enriched uranium product for the Korean nuclear power program with technology specifically developed for Korea by experienced Korean engineers

  7. Donor transplant programme

    International Nuclear Information System (INIS)

    Abu Bakar Sulaiman

    1999-01-01

    The transplantation of organs and tissues from one human to another human has become an essential and well established form of therapy for many types of organ and tissue failure. In Malaysia, kidney, cornea and bone marrow transplantation are well established. Recently, liver, bone and heart transplanation have been performed. Unfortunately, because of the lack of cadaveric organ donation, only a limited number of solid organ transplantation have been performed. The cadaveric organ donor rate in Malaysia is low at less than one per million population. The first tissue transplanted in Malaysia was the cornea which was performed in the early 1970s. At that time and even now the majority of corneas came from Sri Lanka. The first kidney transplant was performed in 1975 from a live related donor. The majority of the 629 kidney transplants done at Hospital Kuala Lumpur to date have been from live related donors. Only 35 were from cadaver donors. Similarly, the liver transplantation programme which started in 1995 are from live related donors. A more concerted effort has been made recently to increase the awareness of the public and the health professionals on organ and tissue donation. This national effort to promote organ and tissue donation seems to have gathered momentum in 1997 with the first heart transplant successfully performed at the National Heart Institute. The rate of cadaveric donors has also increased from a previous average of I to 2 per year to 6 per year in the last one year. These developments are most encouraging and may signal the coming of age of our transplantati on programme. The Ministry of Health in conjunction with various institutions, organizations and professional groups, have taken a number of proactive measures to facilitate the development of the cadaveric organ donation programme. Efforts to increase public awareness and to overcome the negative cultural attitude towards organ donation have been intensified. Equally important are efforts

  8. Pulmonary rehabilitation in lung transplant candidates.

    Science.gov (United States)

    Li, Melinda; Mathur, Sunita; Chowdhury, Noori A; Helm, Denise; Singer, Lianne G

    2013-06-01

    While awaiting lung transplantation, candidates may participate in pulmonary rehabilitation to improve their fitness for surgery. However, pulmonary rehabilitation outcomes have not been systematically evaluated in lung transplant candidates. This investigation was a retrospective cohort study of 345 pre-transplant pulmonary rehabilitation participants who received a lung transplant between January 2004 and June 2009 and had available pre-transplant exercise data. Data extracted included: 6-minute walk tests at standard intervals; exercise training details; health-related quality-of-life (HRQL) measures; and early post-transplant outcomes. Paired t-tests were used to examine changes in the 6MW distance (6MWD), exercise training volume and HRQL during the pre-transplant period. We evaluated the association between pre-transplant 6MWD and transplant hospitalization outcomes. The final 6MWD prior to transplantation was only 15 m less than the listing 6MWD (n = 200; p = 0.002). Exercise training volumes increased slightly from the start of the pulmonary rehabilitation program until transplant: treadmill, increase 0.69 ml/kg/min (n = 238; p volumes are well preserved among lung transplant candidates participating in pulmonary rehabilitation, even in the setting of severe, progressive lung disease. Participants with greater exercise capacity prior to transplantation have more favorable early post-transplant outcomes. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  9. PHENOMENON OF DEMIKHOV. "Transplantation of vital organs In experiment" (1960. Transplantation immunity, artifi cial circulation in organ transplantation

    Directory of Open Access Journals (Sweden)

    S. P. Glyantsev

    2017-01-01

    Full Text Available The article (the fourth of five presents the analysis of the 4th and 5th chapters from V.P.Demikhov's monograph "Transplantation of vital organs in experiment" (MedGIz Publisher, Moscow, 1960, where he described his studies of transplantation immunity in originally created models and his use of artificial blood-circulation systems in experimental organ transplantation. It has been shown that V.P.Demikhov changed his views on the tissue biological incompatibility in homoplastic transplants and turned from the Michurin-Pavlov's concepts (1946–1953 to natural-scientific views (1959. Meanwhile, his multiple attempts to study both the morphological and humoral immunological response to transplanted organs did not give conclusive results because of lacking the experience of such studies even in the country's leading scientists and due the imperfection of their techniques. Realizing that the retrieval of a beating heart from a human would have created further problems for its subsequent transplantation, V.P. Demikhov attempted to reanimate human hearts in corpses by means of extracorporeal devices to provide artificial circulation. Methodologically, those devices were based on S.S.Bryukhonenko's research and his "auto-injector" pump modified by V.P.Demikhov. However, by 1960, those studies had not come beyond the experiments.

  10. A Study on the Embedment Effect in the Soil-Structure Interaction Analysis of the APR1400

    International Nuclear Information System (INIS)

    Young-Sun Jang; Kwang-Ho Joo; Chong-Hak Kim

    2002-01-01

    The SSI (Soil-Structure Interaction) analyses are being performed for the APR1400 (Advanced Power Reactor 1400 MWe, Old name - KNGR; Korean Next Generation Reactor) design, because the APR1400 is developed as a Standard Nuclear Power Plant concept enveloping suitable soil conditions. For the SSI analyses, SASSI program which adopts the Flexible Volume Method is used. In the SSI analyses, there can be uncertainties by Bond and De-bond problem between the structure and lateral soil elements. According to ASCE Standard 4, one method to address this concern is to assume no connectivity between structure and lateral soil over the upper half of the embedment of 20 ft (6 m), whichever is less. This study is performed as a part of the parametric analyses for the APR1400 seismic analyses to address the concern of the potential embedment effect on the in-structure response spectra due to connectivity between structure and lateral soil. In this study, 4 model cases are analyzed to check the potential embedment effect - Full connection, 20 ft no connectivity which is defined as a minimum De-bond depth of the soil in ASCE Standard 4 and 26.5 ft no connectivity between structure and lateral soil over the upper half of the embedment. Last one is full no connection for only reference. The in-structure response spectra are compared with the response spectra without considering the embedment effect. (authors)

  11. Evaluation Methodology for Void Swelling Susceptibility of APR1400 Reactor Vessel Internals for U.S. NRC Design Certification

    Energy Technology Data Exchange (ETDEWEB)

    Kweon, Hyeong Do; Lee, Do Hwan [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    The APR1400 RVI (Reactor Vessel Internals) operates in harsh conditions, such as long term exposure to neutron irradiation, high temperatures, reactor coolant environment, and other operating loads. Therefore, even though the RVI components are mainly made of austenitic stainless steel which is well known to have good mechanical and corrosion-resistive properties, these operating conditions. The aging is characterized by a chromium depletion along grain boundaries of austenitic stainless steel, a decrease in ductility and fracture toughness of the steel, an increase in yield and ultimate strength of the steel, and a potential volume change due to void formation in the steel. For these reasons, under certain conditions of stress, temperature, and level of irradiation, the void swelling which is one of the challenging degradation mechanisms affecting the integrity of the RVI may appear at specific locations of the RVI, especially due to high neutron fluence and high temperature under localized gamma heating and low velocity of coolant flow. To assess the effects of operating neutron fluences, temperatures and stresses on the material properties changes and the susceptibility to the void swelling, the evaluation methodology of the APR1400 RVI components for U.S. NRC Design Certification was suggested in this paper. The approach to the evaluation is summarized as follows: 1. RVI component list of the APR1400 is collected. 2. Initial screening to determine the evaluation scope is completed using the design values of fluences. 3. Functionality assessments (radiation transport analysis, CFD analysis, structural analysis) are sequentially performed. 4. Susceptibility to the void swelling is identified through ANSYS/USERMAT module. KHNP believes that the proposed methodology which is based on the EPRI works for operating reactors is the best way to evaluate the void swelling for new reactors such as the APR1400.

  12. Cloned Bacillus subtilis alkaline protease (aprA) gene showing high level of keratinolytic activity.

    Science.gov (United States)

    Zaghloul, T I

    1998-01-01

    The Bacillus subtilis alkaline protease(aprA) gene was previously cloned on a pUBHO-derivative plasmid. High levels of expression and gene stability were demonstrated when B. subtilis cells were grown on the laboratory medium 2XSG. B. subtilis cells harboring the multicopy aprA gene were grown on basal medium, supplemented with 1 % chicken feather as a source of energy, carbon, and nitrogen. Proteolytic and keratinolytic activities were monitored throughout the cultivation time. A high level of keratinolytic activity was obtained, and this indicates that alkaline protease is acting as a keratinase. Furthermore, considerable amounts of soluble proteins and free amino acids were obtained as a result of the enzymatic hydrolysis of feather. Biodegradation of feather waste using these cells represents an alternative way to improve the nutritional value of feather, since feather waste is currently utilized on a limited basis as a dietary protein supplement for animal feedstuffs. Moreover, the release of free amino acids from feather and the secreted keratinase enzyme would promote industries based on feather waste.

  13. Pre-transplantation glucose testing for predicting new-onset diabetes mellitus after renal transplantation.

    Science.gov (United States)

    Ramesh Prasad, G V; Huang, M; Bandukwala, F; Nash, M M; Rapi, L; Montada-Atin, T; Meliton, G; Zaltzman, J S

    2009-02-01

    New-onset diabetes after renal transplantation (NODAT) adversely affects graft and patient survival. However, NODAT risk based on pre-transplant blood glucose (BG) levels has not been defined. Our goal was to identify the best pre-transplant testing method and cut-off values. We performed a case-control analysis of non-diabetic recipients who received a live donor allograft with at least 6 months post-transplant survival. Pre-transplant glucose abnormalities were excluded through 75 g oral glucose tolerance testing (OGTT) and random BG (RBG) measurement. NODAT was defined based on 2003 Canadian Diabetes Association criteria. Multivariate logistic and Cox regression analysis was performed to determine independent predictor variables for NODAT. Receiver-operating-characteristic (ROC) curves were constructed to determine threshold BG values for diabetes risk. 151 recipients met initial entry criteria. 12 had pre-transplant impaired fasting glucose and/or impaired glucose tolerance, among who 7 (58%) developed NODAT. In the remaining 139, 24 (17%) developed NODAT. NODAT risk exceeded 25% for those with pre-transplant RBG > 6.0 mmol/l and 50% if > 7.2 mmol/l. Pre-transplant RBG provided the highest AUC (0.69, p = 0.002) by ROC analysis. Increasing age (p = 0.025), acute rejection (p = 0.011), and RBG > 6.0 mmol/l (p = 0.001) were independent predictors of NODAT. Pre-transplant glucose testing is a specific marker for NODAT. Patients can be counseled of their incremental risk even within the normal BG range if the OGTT is normal.

  14. Stem-cell-activated organ following ultrasound exposure: better transplant option for organ transplantation.

    Science.gov (United States)

    Wang, Sen; Li, Yu; Ji, Ying-Chang; Lin, Chang-Min; Man, Cheng; Zheng, Xiao-Xuan

    2010-01-01

    Although doctors try their best to protect transplants during surgery, there remain great challenges for the higher survival rate and less rejection of transplants after organ transplantation. Growing evidence indicates that the stem cells could function after injury rather than aging, implying that suitable injury may activate the stem cells of damaged organs. Furthermore, it has been revealed that stem cells can be used to induce tolerance in transplantation and the ultrasound has great biological effects on organs. Basing on these facts, we hypothesize that the stem cells within the transplants can be activated by ultrasound with high-frequency and medium-intensity. Therefore, the stem-cell-activated organs (SCAO) can be derived, and the SCAO will be better transplant option for organ transplantation. We postulate the ultrasound can change the molecular activity and/or quantity of the stem cells, the membrane permeability, the cell-cell junctions, and their surrounding microenvironments. As a result, the stem cells are activated, and the SCAO will acquire more regenerative capacity and less rejection. In the paper, we also discuss the process, methods and models for verifying the theory, and the consequences. We believe the theory may provide a practical method for the clinical application of the ultrasound and stem cells in organ transplantation.

  15. Constructibility assessment of APR1400

    International Nuclear Information System (INIS)

    Cho, Sung Jae; Kang, Yong Chul; Lee, Jae Gon; Lim, Woo Sang

    2003-01-01

    APR1400 (formerly KNGR) development is one of national G-7 projects sponsored by government and KHNP (Korea Hydro and Nuclear Power Co., LTD). It is an evolutionary standard reactor with the thermal output of 4000MWt and has been adopted for Shin-Kori Unit 3 and 4. The government organizations, research institutes, universities and industries have participated in the project since 1992 along with KHNP, and the standard design certification program was issued in May 2002. The project set up the top-tier requirements about the safety, economy, operability and maintainability, and constructibility in the early design stage. The requirements have been evaluated periodically during the design process, and the results were reflected to the design. This paper describes the methods for constructibility enhancement and the results of schedule analysis to assure meeting construction duration target, which is set to 48 months from the first concrete pouring to the commercial operation on the condition that learning effects are maximized at Nth plant. To meet the target schedule, the design characteristics and constructibility studies such as new construction methods and construction schedule analysis were performed. The new construction methods presented here are over the top method for NSSS components, deck plate and steel from for concrete wall and slab, automatic welding for large bore piping, and modularization of components and structure, etc. (author)

  16. Analysis of Total Loss of Feedwater for APR1400 using SPACE

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Seong Min; Park, Seok Jeong; Park, Chan Eok; Choi, Jong Ho; Lee, Gyu Cheon [KEPCO Engineering and Construction, Deajeon (Korea, Republic of)

    2016-10-15

    The Total Loss of FeedWater (TLOFW) event is an accident that main feedwater and auxiliary feedwater of secondary side are not supplied to steam generators. APR1400 uses the Safety Depressurization and Vent System (SDVS) for the F and B operation and SDVS is designed to perform the rapid depressurization function of Reactor Coolant System (RCS) through the remote manual operation when TLOFW is occurred. If RCS pressure falls below a Safety Injection Pump (SIP) working pressure, it can be possible to start the F and B operation which injects SIP flow to RCS and releases the RCS vapor and two-phase flow through Pilot Operated Safety Relief Valves (POSRVs) by opening the POSRVs, and then it can be possible to remove the decay heat. The design requirement of SDVS is that the core water level should be maintained at higher than 2 feet from the top of active core during the F and B operation. The TLOFW analysis was carried out to evaluate the capability of decay heat removal for APR1400 using newly developed SPACE code. The analysis results show that the F and B operation with 2 POSRVs and 2 SIPs and the F and B operation with 4 POSRVs and 4 SIPs meet the SDVS design requirement for the fuel cladding temperature. The comparison with RELAP5 shows good agreement and it validates the applicability of SPACE code for this type of accident analysis.

  17. Single port-assisted fully laparoscopic abdominoperineal resection (APR) with immediate V-RAM flap reconstruction of the perineal defect.

    LENUS (Irish Health Repository)

    Ali, Sayid

    2012-09-01

    Abdominoperineal resection (APR) of anorectal cancers after neoadjuvant chemoradiotherapy may incur significant perineal morbidity. While vertical rectus abdominis muscle (V-RAM) flaps can fill the pelvic resection space with health tissue, their use has previously been described predominantly in association with laparotomy. Here, we describe a means of combination laparoscopic APR with V-RAM flap reconstruction that allows structural preservation of the entire abdominal wall throughout the oncological resection and of the deep parietal layers after V-RAM donation. Furthermore, a single port access device used at the end colostomy site allows a second senior surgeon assist with an additional two working instruments for the purpose of improved pelvic tissue retraction, especially useful in obese patients.

  18. [Serum soluble HLA-G, soluble CD30 is correlated to the time after transplantation in renal transplant recipients].

    Science.gov (United States)

    Jin, Zhankui; Xu, Cuixiang; Duan, Wanli; Yang, Jiangcun; Tian, Puxun

    2017-07-01

    Objective To investigate the expressions of serum soluble human leukocyte antigen G (sHLA-G) and soluble CD30 (sCD30) in renal transplant recipients at different time after transplantation, and explore the relationship between the expressions of serum sHLA-G, sCD30 and the time after renal transplantation. Methods Eleven kidney transplant recipients and 10 healthy donors were selected, in which the dynamic changes of serum sHLA-G and sCD30 were detected by ELISA before transplantation and 1 year after transplantation; 33 kidney transplant recipients with normal renal graft were selected and divided into three groups: 1-5 years, 5-10 years and 10 years post-transplantation. The expressions of serum sHLA-G and sCD30 in the recipients were tested over one year after transplantation. Results The level of serum sHLA-G before transplantation was not significantly different from that of the control group. There was no significant difference between pre-transplantation, 1 week and 1 month after transplantation. Serum sHLA-G level of renal transplant recipients at 3 months after transplantation was higher than that 1 month after transplantation. There was no significant change in serum sHLA-G level among 3, 6 and 12 months after transplantation. The level of serum sHLA-G in the group of transplant time >10 years was significantly higher than that in the group of transplant time ≤5 years. The serum sHLA-G level was significantly associated with the time after renal transplantation. The level of serum sCD30 before transplantation was higher than that in the control group and decreased in 1 week after transplantation. There were no significant differences in sCD30 level between 1, 3, 6, and 12 months after transplantation, and similarly, there were also no significant differences between the groups of transplant time ≤5 years, 5-10 years and 10 years after transplantation. The level of sCD30 was significantly associated with the time within 1 month after renal

  19. Microsurgical techniques for experimental kidney transplantation and general guidelines to establish studies about transplantation immunology Técnicas microcirúrgicas para transplante renal experimental e condutas para estabelecer experimentos sobre imunologia do transplante

    Directory of Open Access Journals (Sweden)

    Paulo Ney Aguiar Martins

    2003-08-01

    Full Text Available Experimental models of organ transplantation played a crucial role to establish the principles of transplantation immunology. The renal transplantation in rodents became the most used model to study the mechanisms of allograft rejection. To perform it, it is necessary to master the microsurgery techniques and the research group should cooperate with other specialists in the field. In this article we review the surgical techniques employed in rats, and we draw guidelines to establish studies about transplantation immunology.Os princípios da imunologia do transplante estabeleceram-se após o surgimento de modelos experimentais. Esses modelos foram fundamentais para descoberta de mecanismos de tolerância imunológica e as bases genéticas da reação de rejeição. Transplante renal em roedores utilizando técnicas de microcirurgia tornou-se o modelo ideal, e abriu um novo horizonte para condução de pesquisas sobre imunologia e fisiologia de transplantes. Neste artigo revisamos as técnicas de transplante renal, e esboçamos diretrizes para elaboração de estudos imunológicos em modelos de rejeição.

  20. Pediatric Liver Transplantation: Our Experiences.

    Science.gov (United States)

    Basturk, Ahmet; Yılmaz, Aygen; Sayar, Ersin; Dinçhan, Ayhan; Aliosmanoğlu, İbrahim; Erbiş, Halil; Aydınlı, Bülent; Artan, Reha

    2016-10-01

    The aim of our study was to evaluate our liver transplant pediatric patients and to report our experience in the complications and the long-term follow-up results. Patients between the ages of 0 and 18 years, who had liver transplantation in the organ transplantation center of our university hospital between 1997 and 2016, were included in the study. The age, sex, indications for the liver transplantation, complications after the transplantation, and long-term follow-up findings were retrospectively evaluated. The obtained results were analyzed with statistical methods. In our organ transplantation center, 62 pediatric liver transplantations were carried out since 1997. The mean age of our patients was 7.3 years (6.5 months-17 years). The 4 most common reasons for liver transplantation were: Wilson's disease (n=10; 16.3%), biliary atresia (n=9; 14.5%), progressive familial intrahepatic cholestasis (n=8; 12.9%), and cryptogenic cirrhosis (n=7; 11.3%). The mortality rate after transplantation was 19.6% (12 of the total 62 patients). The observed acute and chronic rejection rates were 34% and 4.9%, respectively. Thrombosis (9.6%) was observed in the hepatic artery (4.8%) and portal vein (4.8%). Bile leakage and biliary stricture rates were 31% and 11%, respectively. 1-year and 5-year survival rates of our patients were 87% and 84%, respectively. The morbidity and mortality rates in our organ transplantation center, regarding pediatric liver transplantations, are consistent with the literature.

  1. Diversity of sulfur-cycle prokaryotes in freshwater lake sediments investigated using aprA as the functional marker gene.

    Science.gov (United States)

    Watanabe, Tomohiro; Kojima, Hisaya; Takano, Yoshinori; Fukui, Manabu

    2013-09-01

    The diversity of sulfate-reducing prokaryotes (SRPs) and sulfur-oxidizing prokaryotes (SOPs) in freshwater lake ecosystems was investigated by cloning and sequencing of the aprA gene, which encodes for a key enzyme in dissimilatory sulfate reduction and sulfur oxidation. To understand their diversity better, the spatial distribution of aprA genes was investigated in sediments collected from six geographically distant lakes in Antarctica and Japan, including a hypersaline lake for comparison. The microbial community compositions of freshwater sediments and a hypersaline sediment showed notable differences. The clones affiliated with Desulfobacteraceae and Desulfobulbaceae were frequently detected in all freshwater lake sediments. The SOP community was mainly composed of four major phylogenetic groups. One of them formed a monophyletic cluster with a sulfur-oxidizing betaproteobacterium, Sulfuricella denitrificans, but the others were not assigned to specific genera. In addition, the AprA sequences, which were not clearly affiliated to either SRP or SOP lineages, dominated the libraries from four freshwater lake sediments. The results showed the wide distribution of some sulfur-cycle prokaryotes across geographical distances and supported the idea that metabolic flexibility is an important feature for SRP survival in low-sulfate environments. Copyright © 2013 Elsevier GmbH. All rights reserved.

  2. Precificação de consultoria empresarial com a contribuição das estratégias de apreçamento = Entrepreneurial Counseling Pricing with Pricing Strategy Contribution

    Directory of Open Access Journals (Sweden)

    Nivaldo João dos Santos

    2008-11-01

    Full Text Available A precificação de serviços de consultoria também pode se beneficiar dos conceitos e idéias das estratégias de apreçamento de bens de consumo de massa, especificamente na área de consultoria de gestão empresarial. Apesar deste campo ser dominado por grandes corporações multinacionais, ainda existe espaço para empresas e profissionais nacionais. Por se tratar de mercado que envolve valores de grande magnitude, imaginasse que as instituições de sucesso adotem estratégia de apreçamento. Neste trabalho, estratégias de apreçamento foram selecionadas para exame e verificação de aplicabilidade quando do estabelecimento valor pelos serviços da consultoria de gestão empresarial. O apreçamento de desnatação, apreçamento de penetração, apreçamento neutro e apreçamento baseado em valor tiveram seus conceitos sintetizados para fins de verificação. O apreçamento baseado em valor se revelou o mais propício para este tipo de produto (consultoria e o processo de comunicação é o elemento crítico para evidenciar valor, benefícios e, finalmente, justificar o preço do serviço. A sugestão de roteiro para apreçamento de serviço de consultoria empresarial é apresentada ao final, como resultado da análise das diversas estratégias de apreçamento.The pricing of counseling services may also benefit from strategy concepts and ideas ofmass consumption goods pricing, specifically within the entrepreneurial managementcounseling area. Even though this field has been taken over by big multinationalcorporations, there is still some space for national enterprisings and professionals. As itis a market that involves values of great magnitude, it is thought that successfulinstitutions adopt this pricing strategy. In this study, pricing strategies were selectedfor analysis and applicability checking by the time the price for entrepreneurialmanagement counseling service was established. The skimming pricing, penetratingpricing, neutral

  3. Concurrent validity of kidney transplant questionnaire in US renal transplant recipients

    Directory of Open Access Journals (Sweden)

    Chisholm-Burns MA

    2011-10-01

    Full Text Available Marie A Chisholm-Burns1,2, Steven R Erickson3, Christina A Spivey1, Rainer WG Gruessner2, Bruce Kaplan4 1Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, AZ; 2Department of Surgery, University of Arizona College of Medicine, Tucson, AZ; 3Department of Clinical Sciences, University of Michigan College of Pharmacy, Ann Arbor, MI; 4Department of Medicine, The University of Arizona College of Medicine Tucson, AZ, USA Background: Valid instrumentation in the assessment of health-related quality of life (HQoL in renal transplant recipients is critical to identifying particular nuances and determinants of HQoL in this population. Therefore, the validity of disease-specific instruments to measure HQoL in renal transplant recipients, such as the Kidney Transplant Questionnaire (KTQ, needs further investigation. The objective of this study was to assess the concurrent validity of the KTQ in adult US renal transplant recipients using the well established SF-12 Health Survey version 2 (SF-12v2 as the comparison instrument. Methods: One hundred and fourteen renal transplant recipients met the following inclusion criteria for this study, ie, were at least 21 years of age, more than two years post-transplant, and receiving immunosuppressant therapy. Subjects were asked to complete a series of HQoL instruments, ie, the KTQ and the SF-12v2 (physical component summary [PCS-12] and mental component summary [MCS-12]. Descriptive statistics were calculated, and correlational analyses were conducted to examine the concurrent validity of the HQoL instruments. Results: Among 100 participants (87.7% response rate, the majority of participants were male (52%, had deceased donor transplants (63%, and received Medicare benefits (84%. PCS-12 was positively correlated with three of five KTQ subscales (P < 0.05, ie, KTQ-physical (r = 0.43, KTQ-fatigue (r = 0.42, and KTQ-uncertainty/fear (r = 0.2. MCS-12 was positively correlated

  4. Immune System and Kidney Transplantation.

    Science.gov (United States)

    Shrestha, Badri Man

    2017-01-01

    The immune system recognises a transplanted kidney as foreign body and mounts immune response through cellular and humoral mechanisms leading to acute or chronic rejection, which ultimately results in graft loss. Over the last five decades, there have been significant advances in the understanding of the immune responses to transplanted organs in both experimental and clinical transplant settings. Modulation of the immune response by using immunosuppressive agents has led to successful outcomes after kidney transplantation. The paper provides an overview of the general organisation and function of human immune system, immune response to kidney transplantation, and the current practice of immunosuppressive therapy in kidney transplantation in the United Kingdom.

  5. Clinical pancreatic islet transplantation.

    Science.gov (United States)

    Shapiro, A M James; Pokrywczynska, Marta; Ricordi, Camillo

    2017-05-01

    Clinical pancreatic islet transplantation can be considered one of the safest and least invasive transplant procedures. Remarkable progress has occurred in both the technical aspects of islet cell processing and the outcomes of clinical islet transplantation. With >1,500 patients treated since 2000, this therapeutic strategy has moved from a curiosity to a realistic treatment option for selected patients with type 1 diabetes mellitus (that is, those with hypoglycaemia unawareness, severe hypoglycaemic episodes and glycaemic lability). This Review outlines the techniques required for human islet isolation, in vitro culture before the transplant and clinical islet transplantation, and discusses indications, optimization of recipient immunosuppression and management of adjunctive immunomodulatory and anti-inflammatory strategies. The potential risks, long-term outcomes and advances in treatment after the transplant are also discussed to further move this treatment towards becoming a more widely available option for patients with type 1 diabetes mellitus and eventually a potential cure.

  6. ABO-incompatible kidney transplantation

    DEFF Research Database (Denmark)

    Schousboe, Karoline; Titlestad, Kjell; Baudier, Francois

    2010-01-01

    INTRODUCTION: Kidney transplantation is the optimal treatment for many patients with end-stage renal disease (ESRD). Due to shortage of donor kidneys in Denmark, there is a need to expand the possibilities for donation. At the Odense University Hospital (OUH), we have introduced ABO......-incompatible kidney transplantation. We used antigenspecific immunoadsorptions to remove blood group antibodies and anti-CD20 antibody (rituximab) to inhibit the antibody production. The aim of introducing the ABO-incompatible kidney transplantation at the OUH was to increase the rate of living donor kidney...... transplantation without increasing rejection or mortality rates. MATERIAL AND METHODS: Retrospective evaluation. Eleven patients received ABO-incompatible kidney transplantation. The patients were followed for 3-26 months. RESULTS: One patient had an antibody-mediated rejection, one patient suffered T...

  7. A Quantitative Feasibility Study on Potential Safety Improvement Effects of Advanced Safety Features in APR-1400 when Applied to OPR-1000

    Energy Technology Data Exchange (ETDEWEB)

    Ualikhan Zhiyenbayev [KAIST, Daejeon (Korea, Republic of); Chung, Dae Wook [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-10-15

    This study aims to test the feasibility of the applications using Probabilistic Safety Assessment (PSA). Particularly, three of those advanced safety features are selected as follows: 1. Providing an additional Emergency Diesel Generator (EDG); 2. Increasing the capacity of Class 1E batteries; 3. Placing a Refueling Water Storage Tank (RWST) inside containment, i.e., change from RWST to IRWST. The Advanced Power Reactor 1400 (APR-1400) adopts several advanced safety features compared to its predecessor, the Optimized Power Reactor 1000 (OPR-1000), which includes an additional Emergency Diesel Generator, increase in battery capacity, in-containment refueling water storage tank (IRWST), and so on. Considering the remarkable advantages of these safety features in safety improvement and the design similarities between APR-1400 and OPR-1000, it is feasible to apply key advanced safety features of APR-1400 to OPR-1000 to enhance the safety. The selected safety features are incorporated into OPR-1000 PSA model using the Advanced Information Management System (AIMS) for PSA and CDFs are re-evaluated for each application and combination of three applications. Based on current results, it is concluded that three of key advanced safety features of APR-1400 can be effectively applied to OPR-1000, resulting in considerable safety improvement. In aggregate, three advanced safety features, which are an additional EDG, increased battery capacity and IRWST, can reduce the CDF of OPR-1000 by more than 15% when applied altogether.

  8. A Quantitative Feasibility Study on Potential Safety Improvement Effects of Advanced Safety Features in APR-1400 when Applied to OPR-1000

    International Nuclear Information System (INIS)

    Ualikhan Zhiyenbayev; Chung, Dae Wook

    2015-01-01

    This study aims to test the feasibility of the applications using Probabilistic Safety Assessment (PSA). Particularly, three of those advanced safety features are selected as follows: 1. Providing an additional Emergency Diesel Generator (EDG); 2. Increasing the capacity of Class 1E batteries; 3. Placing a Refueling Water Storage Tank (RWST) inside containment, i.e., change from RWST to IRWST. The Advanced Power Reactor 1400 (APR-1400) adopts several advanced safety features compared to its predecessor, the Optimized Power Reactor 1000 (OPR-1000), which includes an additional Emergency Diesel Generator, increase in battery capacity, in-containment refueling water storage tank (IRWST), and so on. Considering the remarkable advantages of these safety features in safety improvement and the design similarities between APR-1400 and OPR-1000, it is feasible to apply key advanced safety features of APR-1400 to OPR-1000 to enhance the safety. The selected safety features are incorporated into OPR-1000 PSA model using the Advanced Information Management System (AIMS) for PSA and CDFs are re-evaluated for each application and combination of three applications. Based on current results, it is concluded that three of key advanced safety features of APR-1400 can be effectively applied to OPR-1000, resulting in considerable safety improvement. In aggregate, three advanced safety features, which are an additional EDG, increased battery capacity and IRWST, can reduce the CDF of OPR-1000 by more than 15% when applied altogether

  9. Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation.

    Science.gov (United States)

    Butler, Javed; Stankewicz, Mark A; Wu, Jack; Chomsky, Don B; Howser, Renee L; Khadim, Ghazanfar; Davis, Stacy F; Pierson, Richard N; Wilson, John R

    2005-02-01

    Pre-transplant fixed pulmonary hypertension is associated with higher post-transplant mortality. In this study, we assessed the significance of pre-transplant reversible pulmonary hypertension in patients undergoing cardiac transplantation. Overall, we studied 182 patients with baseline normal pulmonary pressures or reversible pulmonary hypertension, defined as a decrease in pulmonary vascular resistance (PVR) to 50 mm Hg had a higher risk of death (odds ratio [OR] 5.96, 95% confidence interval [CI] 1.46 to 19.84 as compared with PAS 4.0 WU, but patients with TPG > or =16 had a higher risk of mortality (OR 4.93, 95% CI 1.84 to 13.17). PAS pressure was an independent predictor of mortality (OR 1.04, 95% CI 1.02 to 1.06). Recipient body mass index, history of sternotomy; and donor ischemic time were the other independent predictors of mortality. Pre-transplant pulmonary hypertension, even when reversible to a PVR of < or =2.5 WU, is associated with a higher mortality post-transplant.

  10. Fecal microbiota transplant

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007703.htm Fecal microbiota transplant To use the sharing features on this page, please enable JavaScript. Fecal microbiota transplantation (FMT) helps to replace some of the " ...

  11. Renal transplantation at the Johns Hopkins Comprehensive Transplant Center.

    Science.gov (United States)

    Montgomery, Robert A; Cooper, Matthew; Kraus, Edward; Rabb, Hamid; Samaniego, Milagros; Simpkins, Christopher E; Sonnenday, Christopher J; Ugarte, Richard M; Warren, Daniel S; Zachary, Andrea A

    2003-01-01

    A stagnant supply of transplantable organs in the face of a relentless burgeoning of transplant waiting lists has created a crisis. Necessity continues to be the mother of invention and as the crisis has deepened it has served as a crucible for the development of new ways to think about perennial problems. Our program has taken a 2-pronged approach to increasing the organ supply for our patients. First, through innovations like the laparoscopic donor nephrectomy, ABO-incompatible and positive-crossmatch transplantation protocols, unconventional paired kidney exchanges, and the use of altruistic donors we have more than doubled our utilization of live donor organs. At the same time, we have developed algorithms and interrogative techniques to enhance the intelligent use of kidneys from expanded criteria donors for patients who do not have an available live donor. The laparoscopic nephrectomy has proven to be a safe and effective way of removing a significant barrier to live donation. Our results from 100 ABOi, (+)XM, and PKE transplants are similar to national statistics for compatible live donor transplants, suggesting that existing paradigms of compatibility can be safely expanded. These encouraging early outcomes and the savings they transmit to the health care system have allowed us to obtain insurance coverage for the InKTP programs, setting the stage for further expansion of these opportunities to broaden the options for patients with end-stage renal disease.

  12. [Kidney transplantation epidemiology in France].

    Science.gov (United States)

    Hiesse, Christian

    2013-11-01

    Kidney transplantation activity in France is among the most important worldwide: in 2011, 2976 transplants have been performed (47.5 per million population), and the number of patients living with a functional graft is estimated around 30,000, representing 44.7% of all patients (n = 67,270) treated for end-stage renal failure. However, the rate of preemptive kidney transplants remains very low, only 3.3% of incident patients starting renal replacement therapy. The analysis of demand showed a progressive increase in recent years, as demonstrated by the registration rate on the kidney transplantation waiting list, increasing by 5% yearly between 2006 and 2010, but with huge differences according to age categories and regional registration areas, reflecting discrepant appreciations in indications for kidney transplantation. The median waiting time between registration and transplantation increased progressively in recent years, reaching 22.3 months with considerable variations according to regional areas and transplantation teams. Kidney transplantation activity, while increasing continuously, is far to cover the rising demand, and inexorably patients accumulate on the waiting list (around 9000 patients were registered by January 2012). This situation is the consequence of insufficient organ procurement activity. The deceased organ procurement rate remained high: 1572 harvested donors in 2011 (24.1 per million population), but the proportion of older donors rose in recent years, to reach the rate of 26% of donors older than 65 years in 2011. The procurement activity of donors after cardiac arrest was reintroduced in 2006, but increased slowly: 65 transplants were performed in 2011 using kidney procured in non heart-beating donors. The living donor kidney transplantation activity has markedly increased recently: 302 living donor transplantations were performed in 2011, representing 10.1% of the kidney transplantations. Facing the predictable increase in the number of

  13. Liver transplantation in the Nordic countries - An intention to treat and post-transplant analysis from The Nordic Liver Transplant Registry 1982-2013

    DEFF Research Database (Denmark)

    Fosby, Bjarte; Melum, Espen; Bjøro, Kristian

    2015-01-01

    AIM AND BACKGROUND: The Nordic Liver Transplant Registry (NLTR) accounts for all liver transplants performed in the Nordic countries since the start of the transplant program in 1982. Due to short waiting times, donor liver allocation has been made without considerations of the model of end-stage...

  14. Transplant tourism: a growing phenomenon.

    Science.gov (United States)

    Cohen, David J

    2009-03-01

    Medical tourism is increasing owing to high costs of care, lack of availability or long waits for procedures, and improvements in technology and standards of care in many countries. Transplant tourism is one example of medical tourism that has been attracting increasing attention because of concerns over poor treatment and outcomes of both donors and recipients. Most such cases involve vended kidneys obtained from vulnerable populations, and both donors and recipients receive inferior care by US standards. This commentary discusses a paper by Gill et al. that compared outcomes of 33 transplant tourists with those of patients transplanted at a US center. Fewer complications and better outcomes were seen in patients transplanted in the US center than among transplant tourists. Large transplant centers with long waiting times are increasingly likely to see patients return newly transplanted from overseas; such patients require urgent attention, with particular consideration to infectious complications.

  15. Risk factors for Epstein-Barr virus-related post-transplant lymphoproliferative disease after allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Uhlin, Michael; Wikell, Helena; Sundin, Mikael; Blennow, Ola; Maeurer, Markus; Ringden, Olle; Winiarski, Jacek; Ljungman, Per; Remberger, Mats; Mattsson, Jonas

    2014-02-01

    Allogeneic hematopoietic stem cell transplantation is a successful treatment for hematologic malignancies and a variety of genetic and metabolic disorders. In the period following stem cell transplantation, the immune-compromised milieu allows opportunistic pathogens to thrive. Epstein-Barr virus-associated post-transplant lymphoproliferative disease can be a life-threatening complication for transplanted patients because of suppressed T-cell-mediated immunity. We analyzed possible risk factors associated with post-transplant lymphoproliferative disease in a cohort of over 1,000 patients. The incidence of post-transplant lymphoproliferative disease was 4%. Significant risk factors identified by multivariate analysis were: human leukocyte antigen-mismatch (PEpstein-Barr virus mismatch recipient-/donor+ (Pdisease grade II to IV (P=0.006), pre-transplant splenectomy (P=0.008) and infusion of mesenchymal stromal cells (P=0.015). The risk of post-transplant lymphoproliferative disease has increased in more recent years, from less than 2% before 1998 to more than 6% after 2011. Additionally, we show that long-term survival of patients with post-transplant lymphoproliferative disease is poor despite initial successful treatment. The 3-year survival rate among the 40 patients with post-transplant lymphoproliferative disease was 20% as opposed to 62% among patients without post-transplant lymphoproliferative disease (Pdisease after transplantation in need of pre-emptive measures.

  16. The incidence of post-transplant cancer among kidney transplant recipients is associated with the level of tacrolimus exposure during the first year after transplantation.

    Science.gov (United States)

    Lichtenberg, Shelly; Rahamimov, Ruth; Green, Hefziba; Fox, Benjamin D; Mor, Eytan; Gafter, Uzi; Chagnac, Avry; Rozen-Zvi, Benaya

    2017-07-01

    Immunosuppressive therapy plays a major role in the development of post-transplant cancer. In this nested case-control study of kidney transplant recipients (KTRs), we investigated whether the incidence of post-transplant cancer is associated with the level of tacrolimus exposure over time. We screened the Rabin Medical Center database for adults who received kidney transplants between 2001 and 2014 and developed post-transplant cancer (excluding basal and squamous cell skin cancers). They were matched against KTRs without cancer. All patients received a maintenance immunosuppressive treatment with tacrolimus, mycophenolate mofetil and corticosteroids. The degree of exposure to tacrolimus was estimated as the time-weighted average (tTWA) value of tacrolimus blood levels. The tTWA was calculated as the area under the curve divided by time at 1, 6, and 12 months after transplantation and at time of cancer diagnosis. Thirty-two cases were matched against 64 controls. tTWA values above 11 ng/mL at 6 and 12 months after transplantation were associated with odds ratio (OR) of 3.1 (95% CI 1.1-9) and 11.7 (95% CI = 1.3-106), respectively, for post-transplant cancer; and with OR of 5.2 (95% CI 1.3-20.5) and 14.1 (95% CI = 1.5-134.3), respectively, for cancer diagnosed more than 3 years after transplantation. Exposure to a tacrolimus time-weighted average level above 11 ng/mL at 6 or 12 months after kidney transplantation is associated with an increased risk of developing cancer.

  17. What's hot, what's new in clinical organ transplantation: report from the American Transplant Congress 2015.

    Science.gov (United States)

    Sung, R S

    2015-11-01

    Innovative and exciting advances in the clinical sciences in organ transplantation were presented at the American Transplant Congress 2015. The full spectrum of transplantation was covered, with important developments in many topics. Key areas covered by presentations included living donor outcomes, optimal utilization and allocation of deceased donors, new immunosuppression regimens, antibody-mediated rejection and tolerance induction. This review highlights some of the most interesting and noteworthy clinical presentations from the meeting. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  18. Exchange donor transplantation: ethical option for living renal transplantation.

    Science.gov (United States)

    Gürkan, A; Kaçar, S; Varılsuha, C; Tilif, S; Turunç, V; Doǧan, M; Dheir, H; Sahin, S

    2011-04-01

    Taking in consideration the opinion of our team, which necessitates obligation of a relative relation between donors and recipients (genetic or matrimonial), we performed donor exchanges as an ethical alternative in living donor transplantations. We reviewed the outcomes of our exchange series. Between July 2003 and August 2010 we performed 110 exchange donor transplantations in four hospitals: one four-way, two three-way, and 100 two-way cases. Donors were mostly spouses (n = 71) or mothers (n = 15). The mean age of the donors was 48.8 (range = 23-69) and the recipients 41.4 years (range = 5-66). Two were transplanted preemptively and the others had a mean dialysis duration of 43 months (range = 1-120). Among 110 patients, three compatible pairs joined the group voluntarily; 71, due to ABO incompatibility and 36, due to crossmatch positivity. Induction therapy was used in 92 patients. HLA mismatches (MM) were: one MM in three; two MM in three; three MM in 18, four MM in 36; five MM in 34; and six MM in 18. Among 90 patients tested for panel-reactive antibodies PRA, five showed class I and 10, class II positivity. In 11 patients, B-cell positivity was detected by flow cytometry. Delayed graft function (n = 2), acute rejection (n = 11), BK virus infection (n = 1), and cytomegalovirus infection (n = 3) were seen postoperatively. Three (2.7%) patients died due to sepsis. Five patients returned to dialysis program due to interstitial fibrosis tubular atrophy (IFTA) (n = 2), renal vein thrombosis (n = 1), de novo glomerulopathy (n = 1), or primary nonfunction (n = 1). The 1- and 5-year patient and graft survival rates were 96% and 96%, 95% and 89%, respectively. We believe that exchange donor transplantation is as successful as direct transplants; it is a good, ethical alternative to unrelated living transplantations. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Identifying Barriers to Preemptive Kidney Transplantation in a Living Donor Transplant Cohort

    Directory of Open Access Journals (Sweden)

    Ryan A. Helmick, MD

    2018-04-01

    Conclusions. Even among a patient population that is primarily white, educated, and has a spouse or first-degree relative donor, PreKTx rates remain concerningly low. Increased time between diagnosis or education and transplant are predictors of PreKTx. Greater emphasis on transplant education earlier in the stages of chronic kidney disease and community outreach from transplant centers may help to increase the rate of PreKTx.

  20. Carcinoma of the tongue in a renal transplant recipient: A rare post-transplant malignancy

    Directory of Open Access Journals (Sweden)

    Jai Prakash

    2015-01-01

    Full Text Available Current immunosuppression improved long-term outcome of transplant patients, but it also increased the incidence of de novo malignancy. Organ transplant recipients have a threeto four-fold increased risk of developing carcinoma in comparison with the general population. Common malignancies encountered after transplantation include cancer of the skin, lips, post-transplant lymphoproliferative disease, ano-genital carcinoma and Kaposi sarcoma. Squamous cell carcinoma of the tongue is very rare. We report here a case of squamous cell carcinoma of the tongue in an adult male patient who developed it 11 years post-transplant. He underwent right hemiglossectomy and his graft function remained stable.

  1. Probability of Neutralization Estimation for APR1400 Physical Protection System Design Effectiveness Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myungsu; Lim, Heoksoon; Na, Janghwan; Chi, Moongoo [Korea Hydro and Nuclear Power Co. Ltd. Central Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    It is focusing on development of a new designing process which can be compatible to international standards such as IAEA1 and NRC2 suggest. Evaluation for the design effectiveness was found as one of the areas to improve. If a design doesn't meet a certain level of effectiveness, it should be re-designed accordingly. The effectiveness can be calculated with combination of probability of Interruption and probability of neutralization. System Analysis of Vulnerability to Intrusion (SAVI) has been developed by Sandia National Laboratories for that purpose. With SNL's timely detection methodology, SAVI has been used by U.S. nuclear utilities to meet the NRC requirements for PPS design effectiveness evaluation. For the SAVI calculation, probability of neutralization is a vital input element that must be supplied. This paper describes the elements to consider for neutralization, probability estimation methodology, and the estimation for APR1400 PPS design effectiveness evaluation process. Markov chain and Monte Carlo simulation are often used for simple numerical calculation to estimate P{sub N}. The results from both methods are not always identical even for the same situation. P{sub N} values for APR1400 evaluation were calculated based on Markov chain method and modified to be applicable for guards/adversaries ratio based analysis.

  2. Review of EU-APR Design for Selected Safety Issues of WERNA RHWG 2013

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Soo; Kim, Ji Hwan [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    Western European Nuclear Regulators' Association (WENRA) was established in 1999 to develop a harmonized approach to nuclear safety and radiation protection and their regulation. In 2013, the Reactor Harmonization Working Group (RHWG) of WENRA sets out the common positions on the seven selected key safety issues. This paper is to introduce the regulatory positions of WENRA RHWG 2013 and to review the compliance of the EU-APR with them. In this paper, we reviewed the compliance of the EUAPR regarding seven safety issues for new NPPs presented by WERNA RHWG in 2013. The EU-APR design fully complies with all WERNA RHWG safety issues since the following measures have been incorporated in it: - Successive five levels of DiD maintaining independence between different levels of DiD - Diverse design against multiple failure events such as ATWS, SBO, Loss of Ultimate Heat Sink, and Loss of Spent Fuel Pool Cooling - SAs dedicated mitigation systems to ensure the containment integrity during the SAs. - Practically eliminates accident sequences with a large or early release of radiological materials by diverse designs for multiple failure events, SAs dedicated mitigation system, and double containment design - Standard site parameters not lead to core melt accidents due to natural or man-made external hazards.

  3. Association between pre-transplant dialysis modality and patient and graft survival after kidney transplantation

    DEFF Research Database (Denmark)

    Kramer, Anneke; Jager, Kitty J; Fogarty, Damian G

    2012-01-01

    Previous studies have found inconsistent associations between pre-transplant dialysis modality and subsequent post-transplant survival. We aimed to examine this relationship using the instrumental variable method and to compare the results with standard Cox regression.......Previous studies have found inconsistent associations between pre-transplant dialysis modality and subsequent post-transplant survival. We aimed to examine this relationship using the instrumental variable method and to compare the results with standard Cox regression....

  4. Employment 12 months after kidney transplantation: An in-depth bio-psycho-social analysis of the Swiss Transplant Cohort.

    Directory of Open Access Journals (Sweden)

    Brigitta Danuser

    Full Text Available Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model.All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation.Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation, pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6 and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1% was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery.Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified.

  5. Development of the National Transplant Program Has Significantly Decreased but Not Ended Transplant Tourism in Montenegro.

    Science.gov (United States)

    Ratkovic, M; Basic Jukic, N; Kastelan, Z; Radunovic, D; Kavaric, P; Brezak, J; Topalovic Grkovic, M; Hudolin, T; Prelevic, V

    2018-06-01

    Organ transplantation has prolonged and improved the lives of many patients around the world. However, a widespread shortage of donors remains the main factor that has led to organ trafficking and transplant tourism. To stop transplant tourism and to provide optimal treatment for its citizens with end-stage renal disease, Montenegro started performing renal transplantations in September 2012. Thirty-five transplantations have been performed since that time, 34 from living donors and only 1 from a deceased donor. This practice has significantly decreased but not ended transplant tourism in Montenegro. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Thoracic organ transplantation: laboratory methods.

    Science.gov (United States)

    Patel, Jignesh K; Kobashigawa, Jon A

    2013-01-01

    Although great progress has been achieved in thoracic organ transplantation through the development of effective immunosuppression, there is still significant risk of rejection during the early post-transplant period, creating a need for routine monitoring for both acute antibody and cellular mediated rejection. The currently available multiplexed, microbead assays utilizing solubilized HLA antigens afford the capability of sensitive detection and identification of HLA and non-HLA specific antibodies. These assays are being used to assess the relative strength of donor specific antibodies; to permit performance of virtual crossmatches which can reduce the waiting time to transplantation; to monitor antibody levels during desensitization; and for heart transplants to monitor antibodies post-transplant. For cell mediated immune responses, the recent development of gene expression profiling has allowed noninvasive monitoring of heart transplant recipients yielding predictive values for acute cellular rejection. T cell immune monitoring in heart and lung transplant recipients has allowed individual tailoring of immunosuppression, particularly to minimize risk of infection. While the current antibody and cellular laboratory techniques have enhanced the ability to manage thoracic organ transplant recipients, future developments from improved understanding of microchimerism and graft tolerance may allow more refined allograft monitoring techniques.

  7. Lung transplantation in children. Specific aspects.

    Science.gov (United States)

    Moreno Galdó, Antonio; Solé Montserrat, Juan; Roman Broto, Antonio

    2013-12-01

    Lung transplantation has become in recent years a therapeutic option for infantswith terminal lung disease with similar results to transplantation in adults.In Spain, since 1996 114 children lung transplants have been performed; this corresponds to3.9% of the total transplant number.The most common indication in children is cystic fibrosis, which represents between 70-80% of the transplants performed in adolescents. In infants common indications areinterstitial lung disease and pulmonary hypertension.In most children a sequential double lung transplant is performed, generally with the help ofextracorporeal circulation. Lung transplantation in children presents special challenges in monitoring and follow-up, especially in infants, given the difficulty in assessing lung function and performing transbronchial biopsies.There are some more specific complications in children like postransplant lymphoproliferative syndrome or a greater severity of respiratory virus infections .After lung transplantation children usually experiment a very important improvement in their quality of life. Eighty eight per cent of children have no limitations in their activity after 3 years of transplantation.According to the registry of the International Society for Heart & Lung Transplantation (ISHLT) survival at 5 years of transplantation is 54% and at 10 years is around 35%. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  8. Real-time PCR quantification and diversity analysis of the functional genes aprA and dsrA of sulfate-reducing bacteria in marine sediments of the Peru continental margin and the Black Sea

    Directory of Open Access Journals (Sweden)

    Axel eSchippers

    2011-12-01

    Full Text Available A quantitative, real-time PCR (Q-PCR assay for the functional gene adenosine 5´-phosphosulfate reductase (aprA of sulfate-reducing bacteria (SRB was designed. This assay was applied together with described Q-PCR assays for dissimilatory sulfite reductase (dsrA and the 16S rRNA gene of total Bacteria to marine sediments from the Peru margin (0 – 121 meters below seafloor (mbsf and the Black Sea (0 – 6 mbsf. Clone libraries of aprA show that all isolated sequences originate from SRB showing a close relationship to aprA of characterised species or form a new cluster with only distant relation to aprA of isolated SRB. Below 40 mbsf no aprA genes could be amplified. This finding corresponds with results of the applied new Q-PCR assay for aprA. In contrast to the aprA the dsrA gene could be amplified up to sediment depths of 121 mbsf. Even in such an extreme environment a high diversity of this gene was detected. The 16S rRNA gene copy numbers of total Bacteria were much higher than those of the functional genes at all sediment depths and used to calculate the proportion of SRB to the total Bacteria. The aprA and dsrA copy numbers comprised in average 0.5 - 1 % of the 16S rRNA gene copy numbers of total Bacteria in the sediments up to a depth of ca. 40 mbsf. Depth profiles of the aprA and dsrA copy numbers were almost equal for all sites. Gene copy numbers decreased concomitantly with depth from around 108 / g sediment close to the sediment surface to less than 105 / g sediment at 5 mbsf. In the zone without detectable sulfate in the pore water from ca. 40 – 121 mbsf (Peru margin ODP site 1227, only dsrA (but not aprA was detected with copy numbers of less than 104 / g sediment, comprising ca. 14 % of the 16S rRNA gene copy numbers of total Bacteria. In this zone sulfate might be provided for SRB by anaerobic sulfide oxidation.

  9. Cell transplantation for Parkinson's disease

    Institute of Scientific and Technical Information of China (English)

    Jia Liu; Hongyun Huang

    2006-01-01

    OBJECTIVE: The motor symptoms of Parkinson's disease (PD) can be improved by cell transplantation,which has caught general attention from the field of the therapy for PD recently. In this paper, we summarize the cell-based therapy for PD.DATA SOURCES: A search for English literature related to the cellular transplantation of PD from January 1979to July 2006 was conducted in Medline with the key words of "Parkinson's disease, cell transplantation,embryonic stem cells, neural stem cells".STUDY SELECTTON: Data were checked in the first trial, and literatures about PD and cell transplantation were selected. Inclusive criteria: ① PD; ② Cell transplantation. Exclusive criteria: repetitive researches.DATA EXTRACTTON: A total of 100 papers related to cellular transplant and PD were collected and 41literatures were in accordance with the inclusive criteria.DATA SYNTHESIS: PD is a neural degeneration disease that threatens the health of the aged people, and most traditional therapeusis cannot delay its pathological proceeding. Cell transplantation is becoming popular as a new therapeutic tool, and the cells used to transplant mainly included dopamine-secreting cells, fetal ventral mesencephalic cells, embryonic stem cells and neural stem cells up to now. Animal experiment and clinical test demonstrate that cell transplantation can relieve the motor symptoms of Parkinson's disease obviously, but there are some problems need to be solved.CONCLUSTON: Cell transplantation has visible therapeutic efficacy on PD. Following the improvement of technique, and we have enough cause to credit that cell therapy may cure PD in the future.

  10. Intellectual and Academic Outcomes After Pediatric Liver Transplantation: Relationship with Transplant-Related Factors.

    Science.gov (United States)

    Afshar, Soheil; Porter, Melanie; Barton, Belinda; Stormon, Michael

    2018-05-09

    As survival rates for pediatric liver transplantation continue to increase, research attention is turning towards long-term functional consequences, with particular interest in whether medical and transplant-related factors are implicated in neurocognitive outcomes. The relative importance of different factors is unclear, due to a lack of methodological uniformity, inclusion of differing primary diagnoses, variable transplant policies, and organ availability in different jurisdictions. This cross-sectional, single-site study sought to address various methodological limitations in the literature and the paucity of studies conducted outside of North America and Western Europe by examining the intellectual and academic outcomes of Australian pediatric liver transplant recipients (N = 40). Participants displayed significantly poorer intellectual and mathematical abilities compared to the normative population. Greater time on the transplant waitlist was a significant predictor of poorer verbal intelligence, working memory, mathematical abilities and reading, but only when considering the subgroup of children with biliary atresia. These findings support reducing the time children wait for a transplant as a priority. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Developing Optimal Procedure of Emergency Outside Cooling Water Injection for APR1400 Extended SBO Scenario Using MARS Code

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jong Rok; Oh, Seung Jong [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-10-15

    In this study, we examined optimum operator actions to mitigate extended SBO using MARS code. Particularly, this paper focuses on analyzing outside core cooling water injection scenario, and aimed to develop optimal extended SBO procedure. Supplying outside emergency cooling water is the key feature of flexible strategy in extended SBO situation. An optimum strategy to maintain core cooling is developed for typical extended SBO. MARS APR1400 best estimate model was used to find optimal procedure. Also RCP seal leakage effect was considered importantly. Recent Fukushima accident shows the importance of mitigation capability against extended SBO scenarios. In Korea, all nuclear power plants incorporated various measures against Fukushima-like events. For APR1400 NPP, outside connectors are installed to inject cooling water using fire trucks or portable pumps. Using these connectors, outside cooling water can be provided to reactor, steam generators (SG), containment spray system, and spent fuel pool. In U. S., similar approach is chosen to provide a diverse and flexible means to prevent fuel damage (core and SFP) in external event conditions resulting in extended loss of AC power and loss of ultimate heat sink. Hence, hardware necessary to cope with extended SBO is already available for APR1400. However, considering the complex and stressful condition encountered by operators during extended SBO, it is important to develop guidelines/procedures to best cope with the event.

  12. Customizing Fair Use Transplants

    Directory of Open Access Journals (Sweden)

    Peter K. Yu

    2018-02-01

    Full Text Available In the past decade, policymakers and commentators across the world have called for the introduction of copyright reform based on the fair use model in the United States. Thus far, Israel, Liberia, Malaysia, the Philippines, Singapore, South Korea, Sri Lanka and Taiwan have adopted the fair use regime or its close variants. Other jurisdictions such as Australia, Hong Kong and Ireland have also advanced proposals to facilitate such adoption. This article examines the increasing efforts to transplant fair use into the copyright system based on the U.S. model. It begins by briefly recapturing the strengths and weaknesses of legal transplants. The article then scrutinizes the ongoing effort to transplant fair use from the United States. Specifically, it identifies eight modalities of transplantation. This article concludes with five lessons that can be drawn from studying the ongoing transplant efforts.

  13. Domestic activity for technical development of the APR1400's RCP performance test

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Seok; Kim, Seok; Bae, Byung-Uhn; Cho, Yun-Jae; Kim, Yeon-Sik; Jeon, Woo-Jin; Yun, Young-Jung [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    The thermal hydraulic and electric capability of the RCP test facility (RCPTF) covers up to 18.5 MPa, 343 .deg. C, 11.7 m{sup 3}/s, and 14.0 MW in the design pressure, temperature, flow rate, and the maximum electric power, respectively. In 2013, commissioning test had been performed to verify its designed capability, followed by several modifications in the RCPTF including signal processing and control logic to enhance verification and evaluation capability of the RCP performance. After finishing the commissioning and modification of the RCPTF, type test for the new-type RCP had been performed successfully. In this paper, several technical issues developed in the 2013 and the type test's method and results will be described. In the present paper, the technical activities for the development of the verification test of APR1400's RCP are described. KAERI has completed the full set of technology development, prerequisite for the RCP verification test, and now on the way to perform a test for the sealing capacity of the seal assembly during the Station Block Out (SBO) condition of APR1400.

  14. Islet transplantation using donors after cardiac death: report of the Japan Islet Transplantation Registry.

    Science.gov (United States)

    Saito, Takuro; Gotoh, Mitsukazu; Satomi, Susumu; Uemoto, Shinji; Kenmochi, Takashi; Itoh, Toshinori; Kuroda, Yoshikazu; Yasunami, Youichi; Matsumoto, Shnichi; Teraoka, Satoshi

    2010-10-15

    This report summarizes outcomes of islet transplantation employing donors after cardiac death (DCD) between 2004 and 2007 as reported to the Japan Islet Transplantation Registry. Sixty-five islet isolations were performed for 34 transplantations in 18 patients with insulin-dependent diabetes mellitus, including two patients who had prior kidney transplantation. All but one donor (64/65) was DCD at the time of harvesting. Factors influencing criteria for islet release included duration of low blood pressure of the donor, cold ischemic time, and usage of Kyoto solution for preservation. Multivariate analysis selected usage of Kyoto solution as most important. Of the 18 recipients, 8, 4, and 6 recipients received 1, 2, and 3 islet infusions, respectively. Overall graft survival defined as C-peptide level more than or equal to 0.3 ng/mL was 76.5%, 47.1%, and 33.6% at 1, 2, and 3 years, respectively, whereas corresponding graft survival after multiple transplantations was 100%, 80.0%, and 57.1%, respectively. All recipients remained free of severe hypoglycemia while three achieved insulin independence for 14, 79, and 215 days. HbA1c levels and requirement of exogenous insulin were significantly improved in all patients. Islet transplantation employing DCD can ameliorate severe hypoglycemic episodes, significantly improve HbA1c levels, sustain significant levels of C-peptide, and achieve insulin independence after multiple transplantations. Thus, DCD can be an important resource for islet transplantation if used under strict releasing criteria and in multiple transplantations, particularly in countries where heart-beating donors are not readily available.

  15. Monitoring the impact of an aspartic protease (MpAPr1) on grape proteins and wine properties.

    Science.gov (United States)

    Theron, Louwrens Wiid; Bely, Marina; Divol, Benoit

    2018-04-23

    The perception of haze in wine is brought about when pathogenesis-related proteins become unstable and aggregate, subsequently resulting in crosslinking until it develops into light-dispersing particles. Elimination of these proteins is usually achieved via bentonite fining, which, although effective, suffers from several drawbacks. The utilization of proteases has been proposed as an ideal alternative. In a previous study, an aspartic protease (MpAPr1) from the yeast Metschnikowia pulcherrima was purified and shown to be partially active against grape proteins in synthetic medium. In this study, the effects of pure MpAPr1 supplemented to Sauvignon Blanc juice on subsequent fermentation were investigated. The juice was incubated for 48 h and thereafter inoculated with Saccharomyces cerevisiae. Results revealed that the enzyme had no observable effects on fermentation performance and retained activity throughout. Protein degradation could be detected and resulted in a significant modification of the wine composition and an increase in the presence of certain volatile compounds, especially those linked to amino acid metabolism.

  16. Validation of the Dutch version of the transplant effects questionnaire in liver transplant recipients

    NARCIS (Netherlands)

    Annema, Coby; Roodbol, Petrie F.; Stewart, Roy E.; Ranchor, Adelita V.

    Little is known about the extent to which transplant recipients face emotional problems with the receipt of a transplanted organ. The Transplant Effects Questionnaire (TxEQ) enables the quantification of these problems. This study evaluates the psychometric properties of the Dutch translation of the

  17. About the Operation: Heart Transplant

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  18. Organ Transplantation: Frequently Asked Questions

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  19. Numerical Investigation of APR1400 Loop Seal Reformation and Clearing Phenomena during Post-LOCA Long-term Cooling Period using RELAP5

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S. I.; Jeon, J. H.; Park, J. H.; Sung, H. J.; Lee, J. I.; Choi, T. S. [KEPCO NF, Daejeon (Korea, Republic of)

    2016-10-15

    Hand calculations had been tried to show that the loop seal reformation does not degrade the LTC performance of the APR1400, but the result was unclear. Therefore, the code assessments of the phenomena for APR1400 are required to guarantee the performance of LTC. In the present study, RELAP5/MOD3.3 patch04 (3.3iy) is used for the assessments. The safety degradation, e.g., possible cladding temperature rise due to LSRC during LTC period would be stronger when the safety injection (SI) is larger, while the core uncovery is more probable when the SI is smaller. In other words, it is not easy to determine the limiting condition of safety injection as two or four safety injection pumps (SIPs) in APR1400. In the present study, both the minimum SI condition with two SIPs and the maximum SI condition with four SIPs are considered. The study focuses only on the top slot break condition due to its highest possibility of LSRC phenomena. The LSRC issues for APR1400 are discussed and investigated through numerical investigation using RELAP5MOD3.3 patch04 for top-slot cold leg (pump discharge line) breaks. The major items investigated are whether the simultaneous four loop seal reformation is possible and whether there is any possible violation of the long term coolability criteria in 10 CFR 50.46. Safety injection with two SIPs and four SIPs are investigated to find that the four loop seal reformation condition before the simultaneous injection may occur only with four SIPs.

  20. Radionuclide evaluation of renal transplants

    International Nuclear Information System (INIS)

    Yang Hong; Zhao Deshan

    2000-01-01

    Radionuclide renal imaging and plasma clearance methods can quickly quantitate renal blood flow and function in renal transplants. They can diagnose acute tubular necrosis and rejection, renal scar, surgical complications such as urine leaks, obstruction and renal artery stenosis after renal transplants. At the same time they can assess the therapy effect of renal transplant complications and can also predict renal transplant survival from early post-operative function studies

  1. Allogeneic and Autologous Bone-Marrow Transplantation

    OpenAIRE

    Deeg, H. Joachim

    1988-01-01

    The author of this paper presents an overview of the current status of bone marrow transplantation, including indications, pre-transplant considerations, the transplant procedure, acute and delayed transplant-related problems, results currently attainable, and a short discussion of possible future developments.

  2. Socioeconomic aspects of heart transplantation.

    Science.gov (United States)

    Evans, R W

    1995-03-01

    Heart transplantation is an established treatment modality for end-stage cardiac disease. Unfortunately, relative to other health care priorities, heart transplantation has fallen into disrepute. Efforts to reform the health care system have focused on three fundamental issues--cost, quality, and access. On each count, heart transplantation is vulnerable to criticism. Managed care is an incremental approach to health care reform that imposes fiscal constraint on providers. This constraint is expressed in the form of capitation which, in turn, requires providers to assume risk and accept economic responsibility for clinical decisions. While the need for transplantation is considerable, there are both clinical and economic factors limiting the overall level of activity. In 1993, over 2200 heart transplants were performed in the United States on people who were dying of end-stage cardiac disease. The total demand for heart transplantation was estimated to be about 5900 persons, which was not met due to an insufficient supply of donor hearts. Absent donors, the fiscal consequences of heart transplantation are minimized. In 1993, actuaries estimated that the total charge per heart transplant was $209,100. By designating centers based on price and quality considerations, managed care plans have reduced this per procedure expense to less than $100,000. While the benefits of transplantation are noteworthy, there are still concerns. Sixty percent of patients report that they are able to work, but only 30% do so. Employers hope to improve upon this record by expanding the designated center approach. In conclusion, the future of heart transplantation is unclear. Opportunities for innovation are limited, although the management of heart failure is an area of increased interest.

  3. Bone-marrow transplant - series (image)

    Science.gov (United States)

    Bone-marrow transplants are performed for: deficiencies in red blood cells (aplastic anemia) and white blood cells (leukemia or ... Bone-marrow transplants prolong the life of patients who might otherwise die. As with all major organ transplants, however, ...

  4. Sporotrichosis in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Paulo Gewehr

    2013-01-01

    Full Text Available The current report describes two renal transplant recipients who presented with sporotrichosis. In addition, the authors review the general aspects of sporotrichosis in renal transplant recipients reported in the literature. Sporotrichosis is a rare fungal infection in transplant patients and has been reported primarily in renal transplant recipients not treated with antifungal prophylaxis. Extracutaneous forms of sporotrichosis without skin manifestations and no previous history of traumatic injuries have been described in such patients and are difficult to diagnose. Renal transplant recipients with sporotrichosis described in the present report were successfully treated with antifungal therapy including amphotericin B deoxycholate, lipid amphotericin B formulations, fluconazole and itraconazole.

  5. Imaging in transplantation

    International Nuclear Information System (INIS)

    Bankier, A.A.

    2008-01-01

    This book covers all topics related to the imaging of organ transplantation. An introductory section addresses such issues as organ procurement, patient selection, immune responses, and ethical and economic considerations. The main part of the book then offers in-depth coverage of heart, renal, liver, lung, bone marrow and pancreatic and intestinal transplantation. Each of these topics is discussed firstly in a clinical chapter and then in a radiological chapter. The clinical chapters detail the epidemiology, clinical background, and surgical procedures, as well as any clinically relevant issues of which the radiologist should be aware. The radiological chapters describe and depict the imaging manifestations of specific organ transplantations, document the normal radiological appearance of transplanted organs and consider both early and late complications. This is a unique, superbly illustrated volume that will be of great assistance to all who work in this field. (orig.)

  6. Multimodality postoperative imaging of liver transplantation

    International Nuclear Information System (INIS)

    Zamboni, Giulia A.; Pedrosa, Ivan; Kruskal, Jonathan B.; Raptopoulos, Vassilios

    2008-01-01

    Liver transplantation is the only effective and definitive treatment for patients with end-stage liver disease. The shortage of cadaveric livers has lead to the increasing use of split-liver transplantation and living-donor liver transplantation, but the expansion of the donor pool has increased the risk for postoperative vascular and biliary complications. Early recognition of the imaging appearances of the various postoperative complications of liver transplantation is crucial for both graft and patient survival. This review describes the imaging findings of normal and abnormal transplanted liver parenchyma and of vascular and biliary post-transplantation complications. (orig.)

  7. How Should Social Media Be Used in Transplantation? A Survey of The American Society of Transplant Surgeons.

    Science.gov (United States)

    Henderson, Macey L; Adler, Joel T; Van Pilsum Rasmussen, Sarah E; Thomas, Alvin G; Herron, Patrick D; Waldram, Madeleine M; Ruck, Jessica M; Purnell, Tanjala S; DiBrito, Sandra R; Holscher, Courtenay M; Haugen, Christine E; Alimi, Yewande; Konel, Jonathan M; Eno, Ann K; Garonzik Wang, Jacqueline M; Gordon, Elisa J; Lentine, Krista L; Schaffer, Randolph L; Cameron, Andrew M; Segev, Dorry L

    2018-04-21

    Social media platforms are increasingly used in surgery and have shown promise as effective tools to promote deceased donation and expand living donor transplantation. There is growing need to understand how social media-driven communication is perceived by providers in the field of transplantation. We surveyed 299 members of the American Society of Transplant Surgeons (ASTS) about their use of, attitudes toward, and perceptions of social media and analyzed relationships between responses and participant characteristics. Respondents used social media to communicate with: family and friends (76%), surgeons (59%), transplant professionals (57%), transplant recipients (21%), living donors (16%), and waitlisted candidates (15%). Most respondents (83%) reported using social media for at least one purpose. While most (61%) supported sharing information with transplant recipients via social media, 42% believed it should not be used to facilitate living donor-recipient matching. Younger age (p=0.02) and fewer years of experience in the field of transplantation (p=0.03) were associated with stronger belief that social media can be influential in living organ donation. Respondents at transplant centers with higher reported use of social media had more favorable views about sharing information with transplant recipients (psocial media. Transplant center involvement and support for social media may influence clinician perceptions and practices. Increasing use of social media among transplant professionals may provide an opportunity to deliver high quality information to patients.

  8. In Utero Hepatocellular Transplantation in Rats

    Directory of Open Access Journals (Sweden)

    Emma Muñoz-Sáez

    2013-01-01

    Full Text Available This work represents a step forward in the experimental design of an in utero hepatocellular transplantation model in rats. We focused on the enrichment optimization of isolated fetal hepatocytes suspension, arranging the surgery methodology of in utero transplantation, monitoring the biodistribution of the transplanted hepatocytes, and assessing the success of the transplants. Rat fetuses have been transplanted at the 17th embryonic day (ED17 with fetal hepatocytes isolated from rats at the end of pregnancy (ED21. We assessed possible differences between lymphocyte population, CD4 positive, CD8 positive, double-positive T-cells, and anti-inflammatory cytokines interleukins 4 and 10 (IL4 and IL10 as well. Cellular viability reached the rates of 90–95%. Transplanted groups had a limited success. Transplanted hepatocytes were not able to pass through the hematoplacental barrier. The hepatocytes injected were primarily located in the liver. There was an upward trend in the whole amount of T CD4 and T CD8 cells. There was an increased IL4 in the transplanted groups observed in the pregnant rats. The possibility to induce tolerance in fetuses with a hepatocyte transplant in utero could be a key point to avoid the immunosuppression treatments which must be undergone by transplanted patients.

  9. Motion Transplantation Techniques: A Survey

    NARCIS (Netherlands)

    van Basten, Ben; Egges, Arjan

    2012-01-01

    During the past decade, researchers have developed several techniques for transplanting motions. These techniques transplant a partial auxiliary motion, possibly defined for a small set of degrees of freedom, on a base motion. Motion transplantation improves motion databases' expressiveness and

  10. Psychological rejection of the transplanted organ and graft dysfunction in kidney transplant patients

    Directory of Open Access Journals (Sweden)

    Látos M

    2016-06-01

    Full Text Available Melinda Látos,1 György Lázár,1 Zoltán Horváth,1 Victoria Wittmann,1 Edit Szederkényi,1 Zoltán Hódi,1 Pál Szenohradszky,1 Márta Csabai2 1Department of Surgery, Faculty of Medicine, 2Psychology Institute, University of Szeged, Szeged, Hungary Abstract: Interdisciplinary studies suggest that the mental representations of the transplanted organ may have a significant effect on the healing process. The objective of this study was to examine the representations of the transplanted organ and their relationship with emotional and mood factors, illness perceptions, and the functioning of the transplanted organ. One hundred and sixty-four kidney transplant patients were assessed using the Spielberger Anxiety Inventory, the Beck’s Depression Scale, the Posttraumatic Growth Inventory, the Brief Illness Perception Questionnaire, and the Transplanted Organ Questionnaire. Medical parameters were collected from the routine clinical blood tests (serum creatinine and estimated glomerular filtration rate levels and biopsy results. Our most outstanding results suggest that kidney-transplanted patients’ illness representations are associated with health outcomes. The Transplanted Organ Questionnaire “psychological rejection” subscale was connected with higher serum creatinine and estimated glomerular filtration rate levels. Logistic regression analysis showed that psychological rejection subscale, Brief Illness Perception Questionnaire, and Posttraumatic Growth Questionnaire total scores were associated with graft rejection. These results may serve as a basis for the development of complex treatment interventions, which could help patients to cope with the bio-psycho-social challenges of integrating the new organ as part of their body and self. Keywords: anxiety, depression, illness representations, posttraumatic growth, psychological rejection, renal transplantation

  11. Soluble CD30 levels in recipients undergoing heart transplantation do not predict post-transplant outcome.

    Science.gov (United States)

    Ypsilantis, Efthymios; Key, Timothy; Bradley, J Andrew; Morgan, C Helen; Tsui, Stephen; Parameshwar, Jayan; Taylor, Craig J

    2009-11-01

    The pre-transplant serum level of soluble CD30 (sCD30), a proteolytic derivative of the lymphocyte surface receptor CD30, has been suggested as a biomarker for immunologic risk after organ transplantation. Pre-transplant serum sCD30 levels were determined in 200 consecutive adult heart transplant recipients undertaken at a single center. Transplant outcome (acute rejection in the first 12 months and patient survival up to 5 years post-transplant) was determined. Patients treated with a left ventricular assist device (LVAD) prior to transplantation (n = 28) had higher levels of sCD30 (median 64 U/ml, range 12 to 112 U/ml) than those (n = 172) with no LVAD (median 36 U/ml, range 1 to 158 U/ml, p sCD30 levels were "low" (lower quartile, 58 U/ml, n = 50). Neither acute rejection nor recipient survival differed according to sCD30 level, with values (mean +/- SEM) of 0.30 +/- 0.04, 0.23 +/- 0.03 and 0.30 +/- 0.05 acute rejection episodes per 100 days in the low, intermediate and high groups, respectively, with recipient survival rates at 1 year of 77.7%, 84.9% and 86% and at 5 years of 73.6%, 67.9% and 75.8%, respectively. Pre-transplant serum sCD30 level does not predict acute allograft rejection or recipient survival after heart transplantation, although sCD30 levels are increased by LVAD, possibly as a result of biomaterial-host immune interaction.

  12. Risk factors of post renal transplant hyperparathyroidism

    International Nuclear Information System (INIS)

    Jahromi, Alireza Hamidian; Roozbeh, Jamshid; Raiss-Jalali, Ghanbar Ali; Dabaghmanesh, Alireza; Jalaeian, Hamed; Bahador, Ali; Nikeghbalian, Saman; Salehipour, Mehdi; Salahi, Heshmat; Malek-Hosseini, Ali

    2009-01-01

    It is well recognized that patients with end stage renal diseases (ESRD) have hyper-plastic parathyroid glands. In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation. However, some renal transplant recipients continue to have elevated level of PTH. We prospectively evaluated 121 patients undergoing renal transplantation between August 2000 and 2002. The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation. These 121 patients were on dialysis for an average period of 17.4 months prior to transplantation. An increase in the serum Ca and a decrease in serum P and iPTH level was seen in the patients after transplantation (P< 0.001). Hyperparathyroidism was in 12 (9.9%) and 7 (5.7%) patients three months and one year after transplantation respectively. Elderly patients and patients with longer duration on dialysis had an increased risk of developing post transplant hyperparathyroidism and hypercalcemia in the first year post transplant (P< 0.05). In conclusion age and duration on dialysis before transplantation seems to be important risk factors for post transplant hyperparathyroidism. (author)

  13. Gaming the Liver Transplant Market

    OpenAIRE

    Jason Snyder

    2010-01-01

    The liver transplant waiting list is designed to allocate livers to the sickest patients first. Before March 1, 2002, livers were allocated to patients based on objective clinical indicators and subjective factors. In particular, a center placing a prospective transplant recipient in the intensive care unit (ICU) leads to a higher position on the liver transplant waiting list. After March 1, 2002, a policy reform mandated that priority on the liver transplant waiting list no longer be influen...

  14. [Laparoscopic cholecystectomy in transplant patients].

    Science.gov (United States)

    Coelho, Júlio Cezar Uili; Contieri, Fabiana L C; de Freitas, Alexandre Coutinho Teixeira; da Silva, Fernanda Cristina; Kozak, Vanessa Nascimento; da Silva Junior, Alzemir Santos

    2010-02-01

    This study reviews our experience with laparoscopic cholecystectomy in the treatment of cholelithiasis in transplant patients. Demographic data, medications used, and operative and postoperative data of all transplant recipients who were subjected to laparoscopic cholecystectomy for cholelithiasis at our hospital were obtained. A total of 15 transplant patients (13 renal transplantation and 2 bone marrow transplantation) underwent laparoscopic cholecystectomy. All patients were admitted to the hospital on the day of the operation. The immunosuppressive regimen was not modified during hospitalization. Clinical presentation of cholelithiasis was biliary colicky (n=12), acute cholecystitis (n=2), and jaundice (n=1). The operation was uneventful in all patients. Postoperative complications were nausea and vomiting in 2 patients, prolonged tracheal intubation in 1, wound infection in 1 and large superficial hematoma in 1 patient. Laparoscopic cholecystectomy is associated to a low morbidity and mortality and good postoperative outcome in transplant patients with uncomplicated cholecystitis.

  15. Predicting Alloreactivity in Transplantation

    Directory of Open Access Journals (Sweden)

    Kirsten Geneugelijk

    2014-01-01

    Full Text Available Human leukocyte Antigen (HLA mismatching leads to severe complications after solid-organ transplantation and hematopoietic stem-cell transplantation. The alloreactive responses underlying the posttransplantation complications include both direct recognition of allogeneic HLA by HLA-specific alloantibodies and T cells and indirect T-cell recognition. However, the immunogenicity of HLA mismatches is highly variable; some HLA mismatches lead to severe clinical B-cell- and T-cell-mediated alloreactivity, whereas others are well tolerated. Definition of the permissibility of HLA mismatches prior to transplantation allows selection of donor-recipient combinations that will have a reduced chance to develop deleterious host-versus-graft responses after solid-organ transplantation and graft-versus-host responses after hematopoietic stem-cell transplantation. Therefore, several methods have been developed to predict permissible HLA-mismatch combinations. In this review we aim to give a comprehensive overview about the current knowledge regarding HLA-directed alloreactivity and several developed in vitro and in silico tools that aim to predict direct and indirect alloreactivity.

  16. Does hypertension remain after kidney transplantation?

    Directory of Open Access Journals (Sweden)

    Gholamreza Pourmand

    2015-05-01

    Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

  17. Influenza in solid organ transplant recipients.

    Science.gov (United States)

    Martin, Spencer T; Torabi, Mina J; Gabardi, Steven

    2012-02-01

    To review available data describing the epidemiology, outcomes, prevention, and treatment of influenza virus in the solid organ transplant population and to evaluate the strengths and limitations of the current literature, with a focus on literature reviewing annual influenza strains and the recent pandemic novel influenza A/H1N1 strain. A systematic literature search (July 1980-June 2011) was performed via PubMed using the following key words: influenza, human; influenza; novel influenza A H1/N1; transplantation; solid organ transplantation; kidney transplant; renal transplant; lung transplant; heart transplant; and liver transplant. Papers were excluded if they were not written in English or were animal studies or in vitro studies. Data from fully published studies and recent reports from international conferences were included. The influenza virus presents a constant challenge to immunocompromised patients and their health care providers. The annual influenza strain introduces a highly infectious and pathogenic risk to solid organ transplant recipients. In 2009, the World Health Organization declared a pandemic as a result of a novel influenza A/H1N1 strain. The pandemic introduced an additional viral threat to solid organ transplant patients at increased risk for infectious complications. The mainstay for prevention of influenza infection in all at-risk populations is appropriate vaccination. Antiviral therapies against influenza for chemoprophylaxis and treatment of infection are available; however, dosing strategies in the solid organ transplant population are not well defined. The solid organ transplant population is at an increased risk of severe complications from influenza infection. Identifying risks, preventing illness, and appropriately treating active infection is essential in this patient population.

  18. Attitude and Impact Factors Toward Organ Transplantation and Donation Among Transplantation Nurses in China.

    Science.gov (United States)

    Xie, J-F; Wang, C-Y; He, G-P; Ming, Y-Z; Wan, Q-Q; Liu, J; Gong, L-N; Liu, L-F

    Health workers' awareness and knowledge of transplantation medicine can improve people's sensitivity and reduce their degree of opposition to donations. The medical literature contains numerous examples of attitudes toward organ transplantation and donation aimed at university students or medical staff members, but rarely for transplantation nurses. The purposes of the study were to investigate the attitudes toward organ transplantation and donation among transplantation nurses and to explore the impact factors. The study was conducted in 37 transplantation surgery wards in 22 hospitals using cross-sectional approach. SPSS (International Business Machines Corporation, Armonk, New York, USA) 7.0 software was used to analysis descriptive and inferential statistics for data. Five hundred thirty-six effective questionnaires were received and the effective rate was 89.33%. Nurses' mean age was 28.40 years with a mean service length of 6.54 years. Among these nurses, 66.6% and 78.0% were willing to accept organ transplantation surgery for themselves and their relatives, respectively. Of these nurses, 33.4% would donate their organs after death; whereas 39.9% were uncertain. Only 38.2% were willing to register in the national organ donation system. Of these nurses, 28.2% were willing to sign the organ donation consent forms when their relatives became potential organ donors, and 45.7% were uncertain. Eight independent variables that affected nurses' attitudes toward donating their organs from most to least significant were: ratio of nurse to bed, title, employment form, age, length of service, position, monthly income, and the highest educational degree earned. Pearson correlation analysis showed a significant correlation among nurses' attitudes toward organ transplantation, organ donation, and online registration. The attitude toward donation and transplantation in the hospitals was not too optimistic, and an improvement in the training regarding transplantation and

  19. Liver transplantation for nontransplant physicians

    Directory of Open Access Journals (Sweden)

    Amany AbdelMaqsod Sholkamy

    2014-01-01

    Full Text Available Many of the nontransplant physicians who manage hepatic patients (internists and hepatologists keep asking about liver transplantation. The purpose of this article is to highlight important topics a nontransplant colleague may require in his practice. There are many topics in this respect; however, three most important topics need to be highlighted; those are; the time of referral to transplantation, the indications and contraindications and the metabolic issues regarding a transplanted patient. Still, there are no clear guidelines for the management of many of the metabolic issues regarding liver transplanted patients. And this why, collaborative efforts of transplant and nontransplant physicians are needed to conduct multicenter, long term randomized controlled trials and proper follow up programs.

  20. Nanoparticle delivery of donor antigens for transplant tolerance in allogeneic islet transplantation.

    Science.gov (United States)

    Bryant, Jane; Hlavaty, Kelan A; Zhang, Xiaomin; Yap, Woon-Teck; Zhang, Lei; Shea, Lonnie D; Luo, Xunrong

    2014-10-01

    Human islet cell transplantation is a promising treatment for type 1 diabetes; however, long-term donor-specific tolerance to islet allografts remains a clinically unmet goal. We have previously shown that recipient infusions of apoptotic donor splenocytes chemically treated with 1-ethyl-3-(3'-dimethylaminopropyl)-carbodiimide (donor ECDI-SP) can mediate long-term acceptance of full major histocompatibility complex (MHC)-mismatched murine islet allografts without the use of immunosuppression. In this report, we investigated the use of poly(lactide-co-glycolide) (PLG) particles in lieu of donor ECDI-SP as a synthetic, cell-free carrier for delivery of donor antigens for the induction of transplant tolerance in full MHC-mismatched murine allogeneic islet transplantation. Infusions of donor antigen-coupled PLG particles (PLG-dAg) mediated tolerance in ∼20% of recipient mice, and the distribution of cellular uptake of PLG-dAg within the spleen was similar to that of donor ECDI-SP. PLG-dAg mediated the contraction of indirectly activated T cells but did not modulate the direct pathway of allorecognition. Combination of PLG-dAg with a short course of low dose immunosuppressant rapamycin at the time of transplant significantly improved the tolerance efficacy to ∼60%. Furthermore, altering the timing of PLG-dAg administration to a schedule that is more feasible for clinical transplantation resulted in equal tolerance efficacy. Thus, the combination therapy of PLG-dAg infusions with peritransplant rapamycin represents a clinically attractive, biomaterials-based and cell-free method for inducing long-term donor-specific tolerance for allogeneic cell transplantation, such as for allogeneic islet transplantation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Terapia nutricional no transplante hepático Nutritional therapy in liver transplantation

    Directory of Open Access Journals (Sweden)

    Mônica Beatriz PAROLIN

    2002-04-01

    Full Text Available Racional - Deficiências nutricionais, por vezes graves, são comuns em pacientes com insuficiência hepática, candidatos a transplante de fígado. A terapia nutricional pode corrigir total ou parcialmente tais deficiências, melhorando as condições clínicas e o prognóstico desses indivíduos, frente ao grande desafio do transplante hepático. Objetivos - Breve revisão do papel do fígado no metabolismo dos diversos nutrientes. Descrição dos métodos de avaliação do estado nutricional, traçando-se as bases da terapia nutricional segundo condições hepáticas diversas, no pré e pós-transplante, em relação às necessidades calóricas e dos diversos nutrientes. Apresentação de intervenções nutricionais, no controle das complicações metabólicas resultantes do uso de drogas imunossupressoras. Conclusão - A terapia nutricional é valiosa aliada no tratamento clínico de pacientes candidatos ou já submetidos ao transplante hepático, contribuindo para um prognóstico favorável e para a melhora da qualidade de vida desses indivíduos.Background - Malnutrition, sometimes severe is common in patients with chronic hepatic diseases who are candidates for liver transplantation. Nutritional therapy can induce partial or total correction of such deficiencies, improving clinical conditions and prognosis of patients who face the great defiance of liver transplantation. Aims - Brief revision of hepatic role in the metabolism of several nutrients. Description of available methods of dietary therapy and its application both under different abnormal hepatic conditions and pre and post-transplant periods. The role of nutritional intervention in metabolic side effects due to immunosuppressive drugs. Conclusion - Nutritional therapy is a valuable adjuvant resource to the clinical treatment of candidates and submitted patients to hepatic transplantation providing better prognosis and improved life quality.

  2. MR Imaging of renal transplants

    International Nuclear Information System (INIS)

    Gremo, L.; Avataneo, T.; Potenzoni, F.; Colla, L.; Segoloni, G.

    1988-01-01

    The authors report their experience in the study of renal transplant recipients by MR, in order to determine its clinical potentials. The main purpose of this work is to focus on MR patterns in relation to clinical findings of rejector or normally fuctioning kidney. Twenty-four patients were examined with a 0.5 T superconductive magnete, body coil, spin-echo pulse sequence (SE) and inversion-recovery (IR). MRI patterns could be seen in normally functioning kidneys and transplant rejections, while variable MRI findings were observed in transplants with acute tubular necrosis (ATN). In the normally functioning transplanted kidney there is a clear corticomedullary differentiation (CMD), and the extent of vascular penetration into the renal parenchyma is clearly seen. In transplant rejection, CMD is either diminished or absent, and there is no vascular penetration into the parenchyma; to differentiate acute from chronic rejections, the increase/decrease in renal size and the change in renal shape (spherical shape in acute transplant rejection) respectively must be observed. MRI proves thus to be useful in the study of renal transplants, even in case of questionable clinical findings, and in patients in whom renal biopsy is contraindicated

  3. Spironolactone ameliorates transplant vasculopathy in renal chronic transplant dysfunction in rats

    NARCIS (Netherlands)

    Waanders, Femke; Rienstra, Heleen; Boer, Mark Walther; Zandvoort, Andre; Rozing, Jan; Navis, Gerjan; van Goor, Harry; Hillebrands, Jan-Luuk

    Waanders F, Rienstra H, Walther Boer M, Zandvoort A, Rozing J, Navis G, van Goor H, Hillebrands JL. Spironolactone ameliorates transplant vasculopathy in renal chronic transplant dysfunction in rats. Am J Physiol Renal Physiol 296: F1072-F1079, 2009. First published February 25, 2009;

  4. Outcomes of Technical Variant Liver Transplantation versus Whole Liver Transplantation for Pediatric Patients: A Meta-Analysis.

    Science.gov (United States)

    Ye, Hui; Zhao, Qiang; Wang, Yufang; Wang, Dongping; Zheng, Zhouying; Schroder, Paul Michael; Lu, Yao; Kong, Yuan; Liang, Wenhua; Shang, Yushu; Guo, Zhiyong; He, Xiaoshun

    2015-01-01

    To overcome the shortage of appropriate-sized whole liver grafts for children, technical variant liver transplantation has been practiced for decades. We perform a meta-analysis to compare the survival rates and incidence of surgical complications between pediatric whole liver transplantation and technical variant liver transplantation. To identify relevant studies up to January 2014, we searched PubMed/Medline, Embase, and Cochrane library databases. The primary outcomes measured were patient and graft survival rates, and the secondary outcomes were the incidence of surgical complications. The outcomes were pooled using a fixed-effects model or random-effects model. The one-year, three-year, five-year patient survival rates and one-year, three-year graft survival rates were significantly higher in whole liver transplantation than technical variant liver transplantation (OR = 1.62, 1.90, 1.65, 1.78, and 1.62, respectively, ptechnical variant liver transplantation. Continuing efforts should be made to minimize surgical complications to improve the outcomes of technical variant liver transplantation.

  5. Post-test analysis for the APR1400 LBLOCA DVI performance test using MARS

    International Nuclear Information System (INIS)

    Bae, Kyoo Hwan; Lee, Y. J.; Kim, H. C.; Bae, Y. Y.; Park, J. K.; Lee, W.

    2002-03-01

    Post-test analyses using a multi-dimensional best-estimate analysis code, MARS, are performed for the APR1400 LBLOCA DVI (Direct Vessel Injection) performance tests. This report describes the code evaluation results for the test data of various void height tests and direct bypass tests that have been performed at MIDAS test facility. MIDAS is a scaled test facility of APR1400 with the objective of identifying multi-dimensional thermal-hydraulic phenomena in the downcomer during the reflood conditions of a large break LOCA. A modified linear scale ratio was applied in its construction and test conditions. The major thermal-hydraulic parameters such as ECC bypass fraction, steam condensation fraction, and temperature distributions in downcomer are compared and evaluated. The evaluation results of MARS code for the various test cases show that: (a) MARS code has an advanced modeling capability of well predicting major multi-dimensional thermal-hydraulic phenomena occurring in the downcomer, (b) MARS code under-predicts the steam condensation rates, which in turn causes to over-predict the ECC bypass rates. However, the trend of decrease in steam condensation rate and increase in ECC bypass rate in accordance with the increase in steam flow rate, and the calculation results of the ECC bypass rates under the EM analysis conditions generally agree with the test data

  6. The Swiss Transplant Cohort Study's framework for assessing lifelong psychosocial factors in solid-organ transplants.

    Science.gov (United States)

    De Geest, Sabina; Burkhalter, Hanna; Berben, Lut; Bogert, Laura Jane; Denhaerynck, Kris; Glass, Tracy R; Goetzmann, Lutz; Kirsch, Monika; Kiss, Alexander; Koller, Michael T; Piot-Ziegler, Chantal; Schmidt-Trucksäss, Arno

    2013-09-01

    Understanding outcomes after transplant requires a biopsychosocial model that includes biomedical and psychosocial factors. The latter, to date, are assessed only in a limited way as part of transplant registries or cohort studies. The Swiss Transplant Cohort Study (STCS) is a nationwide open cohort study (starting May 2008) to systematically and prospectively assess psychosocial factors. This article describes the framework underpinning STCS's psychosocial assessment. The STCS framework was adapted from the multidimensional conceptual perspective of Dew et al to describe transplant psychosocial domains and specific outcomes by adding a time perspective, a system perspective, and interaction among domains. We propose a multidimensional, multilevel biopsychosocial framework representing mutually influencing domains from before to after transplant, and exemplify each domain by factors included in STCS and their measurement. The transplant patient, centrally positioned, is described by clinical and sociodemographic characteristics (eg, socioeconomic status, educational, professional, and relationship status). The following psychosocial domains further describe the patient: (1) physical/functional (eg, perceived health status, sleep quality, daytime sleepiness), (2) psychological (eg, depression, stress), (3) behavioral (eg, medication adherence, smoking, drug use, physical activity, sun protection), (4) social (eg, work capacity/return to work), and (5) global quality of life. Factors associated with health care system level (eg, trust in transplant team) are also included in the model. The STCS's psychosocial framework provides a basis for studying the interplay of biomedical, sociodemographic, psychosocial, behavioral, and health care system factors in view of transplant outcomes and therefore has the potential to guide biopsychosocial transplant research.

  7. [History of kidney transplantation surgery].

    Science.gov (United States)

    Timsit, M O; Kleinclauss, F; Thuret, R

    2016-11-01

    To perform a state of the art about the history of kidney transplantation. An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH): kidney transplantation, history, vascular anastomosis. From the first vascular ligations to the discovery of ciclosporin, the history of organ transplantation was made of surgical bets and medical discoveries, such as blood group, HLA-system, immunity, etc. The audacity of some surgeons led to the onset of renal transplantation as the treatment of choice for end stage renal disease. This article aims to describe the first surgical methods for vascular anastomosis and renal transplantation. Through a comprehensive search within the archives of the French National Library, the authors provide a precise description of the first renal transplantations performed, the technique that have been used and their authors. Copyright © 2016. Published by Elsevier Masson SAS.

  8. Benjamin Crémieux, Inquiétude et reconstruction. Essai sur la littérature d’après-guerre

    OpenAIRE

    Brangé, Mireille

    2016-01-01

    Après xxe siècle (1924) en 2010 reparaît ce recueil de 1931 où l’A. étudie ensemble «les faits littéraires, les concordances et les divergences qui caractérisent une époque, les formes spécifiques qu’y prennent les œuvres, […] leurs rapports avec le milieu historique et social, la vision de la vie qui s’y exprime» (p. 8). La même année que les Essais critiques d’Arland et que les articles de Drieu La Rochelle sur «la fin de l’après-guerre», il interroge l’inquiétude des années 1920 et envisag...

  9. Migration d'une broche dans le canal médullaire cervical après une ...

    African Journals Online (AJOL)

    Migration d'une broche dans le canal médullaire cervical après une ostéosynthèse de l'articulation acromio-claviculaire. Bah Aliou, El Alaoui Adil. Abstract. We report the case of a 49 year-old right-handed chef with left shoulder trauma occurred during a football game. The diagnosis was fracture of the distal quarter of ...

  10. Association Between GLCCI1 Promoter Polymorphism (Rs37972 and Post-Transplant Hypertension in Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Aki Mafune Hamada

    2017-12-01

    Full Text Available Background/Aims: Post-transplant hypertension is highly prevalent in renal transplant recipients and is a risk factor for graft loss, cardiovascular disease and death. Glucocorticoid is used to prevent rejection, but simultaneously increases the risk of post-transplant hypertension. The glucocorticoid-induced transcript 1 (GLCCI1 promoter polymorphism (rs37972 has been reported to be associated with response to glucocorticoid therapy in asthma. We therefore examined the association between GLCCI1 promoter polymorphism and post-transplant hypertension in renal transplant recipients. Methods: We conducted a retrospective cohort study of renal transplantation at a single university hospital from October 2003 to January 2014. Fifty consecutive adult recipients were analyzed, with clinical data retrieved from a prospectively collected database. Genotyping was carried out using genomic DNA derived from recipient’s blood. GLCCI1 immunoreactivity in vascular endothelial cells was quantitatively analyzed by immunohistochemical staining of recipients’ native kidney biopsy-specimens. The primary outcome measure was post-transplant hypertension. Results: Post-transplant hypertension was observed in 14/17 (82% of recipients with CC, 18/20 (90% with CT, and 2/13 (15% with TT genotype. CC/CT genotype was significantly associated with post-transplant hypertension, even after adjustment for covariates (odds ratio, 10.6; 95% confidence intervals, 1.32 to 85.8; P = 0.026. In addition, we observed that GLCCI1 immunoreactivity in arteriolar endothelial cells was higher in kidney specimens obtained from recipients with a CC/CT genotype than a TT genotype (P = 0.021. Conclusion: GLCCI1 promoter polymorphism rs37972 may be associated with post-transplant hypertension.

  11. Post-transplant outcomes in pediatric ventricular assist device patients: A PediMACS-Pediatric Heart Transplant Study linkage analysis.

    Science.gov (United States)

    Sutcliffe, David L; Pruitt, Elizabeth; Cantor, Ryan S; Godown, Justin; Lane, John; Turrentine, Mark W; Law, Sabrina P; Lantz, Jodie L; Kirklin, James K; Bernstein, Daniel; Blume, Elizabeth D

    2017-12-13

    Pediatric ventricular assist device (VAD) support as bridge to transplant has improved waitlist survival, but the effects of pre-implant status and VAD-related events on post-transplant outcomes have not been assessed. This study is a linkage analysis between the PediMACS and Pediatric Heart Transplant Study databases to determine the effects of VAD course on post-transplant outcomes. Database linkage between October 1, 2012 and December 31, 2015 identified 147 transplanted VAD patients, the primary study group. The comparison cohort was composed of 630 PHTS patients without pre-transplant VAD support. The primary outcome was post-transplant survival, with secondary outcomes of post-transplant length of stay, freedom from infection and freedom from rejection. At implant, the VAD cohort was INTERMACS Profile 1 in 33 (23%), Profile 2 in 89 (63%) and Profile 3 in 14 (10%) patients. The VAD cohort was older, larger, and less likely to have congenital heart disease (p < 0.0001). However, they had greater requirements for inotrope and ventilator support and increased liver and renal dysfunction (p < 0.0001), both of which normalized at transplant after device support. Importantly, there were no differences in 1-year post-transplant survival (96% vs 93%, p = 0.3), freedom from infection (81% vs 79%, p = 0.9) or freedom from rejection (71% vs 74%, p = 0.87) between cohorts. Pediatric VAD patients have post-transplant outcomes equal to that of medically supported patients, despite greater pre-implant illness severity. Post-transplant survival, hospital length of stay, infection and rejection were not affected by patient acuity at VAD implantation or VAD-related complications. Therefore, VAD as bridge to transplant mitigates severity of illness in children. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  12. Long-term effects of islet transplantation.

    Science.gov (United States)

    Holmes-Walker, D Jane; Kay, Thomas W H

    2016-10-01

    Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients. Graft survival continues to improve, and recent multicenter studies show that islet transplantation is particularly effective to prevent hypoglycemic events even in those who do not become insulin-independent and to achieve excellent glycemic control. Concerns include histocompatability leucocyte antigen (HLA) sensitization and other risks including from immunosuppression that islet transplantation shares with other forms of allotransplantation. Reversal of hypoglycemia unawareness and protection from severe hypoglycemia events are two of the main benefits of islet transplantation and they persist for the duration of graft function. Islet transplantation compares favorably with other therapies for those with hypoglycemia unawareness, although new technologies have not been tested head-to-head with transplantation. HLA sensitization increases with time after transplantation especially if immunosuppression is ceased and is a risk for those who may require future transplantation as well as being associated with loss of graft function.

  13. The Economics of Organ Transplantation.

    Science.gov (United States)

    Altınörs, Nur; Haberal, Mehmet

    2018-03-01

    To determine the cost effectiveness of transplantation, we analyzed the financial economics of the organ and tissue transplant process. We compared the cost of this process with traditional modalities for treating endstage liver and kidney disease. Medical, surgical, legal, social, ethical, and religious issues are important in organ transplant procedures. Government, health insurance companies, and uninsured individuals are affected by the financial economics of organ transplantation. The distribution of financial burden differs among countries and is dependent on the unique circumstances of each country.

  14. Infrastructure, logistics and regulation of transplantation: UNOS.

    Science.gov (United States)

    Heimbach, Julie K

    2013-12-01

    Organ transplantation has evolved into the standard of care for patients with end-stage organ failure. Despite considering increasingly complex transplant recipients for organs recovered from donors with increasing comorbid conditions, 1-year patient survival following kidney transplantation is 97% in the United States, whereas liver transplant recipient 1-year survival is 90%. There were 16,485 kidney recipients in the United States in 2012, and 6256 patients who underwent liver transplantation. The intent of this review is to highlight the logistics required for transplantation as well as reviewing the current oversight of transplantation. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Screening retinal transplants with Fourier-domain OCT

    Science.gov (United States)

    Rao, Bin

    2009-02-01

    Transplant technologies have been studied for the recovery of vision loss from retinitis pigmentosa (RP) and age-related macular degeneration (AMD). In several rodent retinal degeneration models and in patients, retinal progenitor cells transplanted as layers to the subretinal space have been shown to restore or preserve vision. The methods for evaluation of transplants are expensive considering the large amount of animals. Alternatively, time-domain Stratus OCT was previously shown to be able to image the morphological structure of transplants to some extent, but could not clearly identify laminated transplants. The efficacy of screening retinal transplants with Fourier-domain OCT was studied on 37 S334ter line 3 rats with retinal degeneration 6-67 days after transplant surgery. The transplants were morphologically categorized as no transplant, detachment, rosettes, small laminated area and larger laminated area with both Fourier-domain OCT and histology. The efficacy of Fourier-domain OCT in screening retinal transplants was evaluated by comparing the categorization results with OCT and histology. Additionally, 4 rats were randomly selected for multiple OCT examinations (1, 5, 9, 14 and 21days post surgery) in order to determine the earliest image time of OCT examination since the transplanted tissue may need some time to show its tendency of growing. Finally, we demonstrated the efficacy of Fourier-domain OCT in screening retinal transplants in early stages and determined the earliest imaging time for OCT. Fourier-domain OCT makes itself valuable in saving resource spent on animals with unsuccessful transplants.

  16. Lung Transplantation for Lymphangioleiomyomatosis in Japan

    Science.gov (United States)

    Ando, Katsutoshi; Okada, Yoshinori; Akiba, Miki; Kondo, Takashi; Kawamura, Tomohiro; Okumura, Meinoshin; Chen, Fengshi; Date, Hiroshi; Shiraishi, Takeshi; Iwasaki, Akinori; Yamasaki, Naoya; Nagayasu, Takeshi; Chida, Masayuki; Inoue, Yoshikazu; Hirai, Toyohiro; Seyama, Kuniaki; Mishima, Michiaki

    2016-01-01

    Background Lung transplantation has been established as the definitive treatment option for patients with advanced lymphangioleiomyomatosis (LAM). However, the prognosis after registration and the circumstances of lung transplantation with sirolimus therapy have never been reported. Methods In this national survey, we analyzed data from 98 LAM patients registered for lung transplantation in the Japan Organ Transplantation Network. Results Transplantation was performed in 57 patients as of March 2014. Survival rate was 86.7% at 1 year, 82.5% at 3 years, 73.7% at 5 years, and 73.7% at 10 years. Of the 98 patients, 21 had an inactive status and received sirolimus more frequently than those with an active history (67% vs. 5%, p<0.001). Nine of twelve patients who remained inactive as of March 2014 initiated sirolimus before or while on a waiting list, and remained on sirolimus thereafter. Although the statistical analysis showed no statistically significant difference, the survival rate after registration tended to be better for lung transplant recipients than for those who awaited transplantation (p = 0.053). Conclusions Lung transplantation is a satisfactory therapeutic option for advanced LAM, but the circumstances for pre-transplantation LAM patients are likely to alter with the use of sirolimus. PMID:26771878

  17. L’Allemagne : un non – lieu pour les exiles judéo-allemands après 1945 ?

    OpenAIRE

    Bohnekamp, Dorothea

    2017-01-01

    L’omniprésence de l’Allemagne dans les productions littéraires des exilés judéo-allemands en France après 1945 pose tout d’abord la question des différentes représentations de ce pays chez les rescapés. Le nombre important de métaphores spatiales interroge plus particulièrement le rôle de l’espace, matériel/urbain ou symbolique, dans la mémoire des émigrants et dans la reconstruction d’une Heimat souvent imaginaire. Après la guerre, cet attachement souvent ambivalent à l’Allemagne comme patri...

  18. Pre-transplant soluble CD30 in combination with total DSA but not pre-transplant C1q-DSA predicts antibody-mediated graft loss in presensitized high-risk kidney transplant recipients.

    Science.gov (United States)

    Schaefer, S M; Süsal, C; Opelz, G; Döhler, B; Becker, L E; Klein, K; Sickmüller, S; Waldherr, R; Macher-Goeppinger, S; Schemmer, P; Beimler, J; Zeier, M; Morath, C

    2016-02-01

    Presensitized kidney transplant recipients are at high-risk for early antibody-mediated rejection. We studied the impact of pre- and post-transplant donor-specific human leukocyte antigen (HLA) antibodies (DSA) and T-cell-activation on the occurrence of antibody-mediated rejection episodes (AMR) and graft loss (AMR-GL) in a unique cohort of 80 desensitized high-risk kidney transplant recipients. Patients with pre-transplant DSA demonstrated more AMR episodes than patients without DSA, but did not show a significantly increased rate of AMR-GL. The rates of AMR and AMR-GL were not significantly increased in patients with complement split product (C1q)-binding pre-transplant DSA. Pre-transplant C1q-DSA became undetectable post-transplant in 11 of 13 (85%) patients; 2 (18%) of these 11 patients showed AMR but no AMR-GL. In contrast, the post-transplant presence of C1q-DSA was associated with significantly higher rates of AMR (86 vs 33 vs 0%; P transplant DSA without C1q-binding or the absence of DSA. Patients with both pre-transplant DSA and evidence of pre-transplant T-cell-activation as indicated by soluble CD30-positivity showed a significantly increased risk for AMR-GL [HR = 11.1, 95% confidence interval (CI) = 1.68-73.4; log-rank P = 0.013]. In these high-risk patients, AMR-GL was associated with total DSA in combination with T-cell-activation pre-transplant, and de novo or persistent C1q-binding DSA post-transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Liver transplantation in the Nordic countries – An intention to treat and post-transplant analysis from The Nordic Liver Transplant Registry 1982–2013

    Science.gov (United States)

    Fosby, Bjarte; Melum, Espen; Bjøro, Kristian; Bennet, William; Rasmussen, Allan; Andersen, Ina Marie; Castedal, Maria; Olausson, Michael; Wibeck, Christina; Gotlieb, Mette; Gjertsen, Henrik; Toivonen, Leena; Foss, Stein; Makisalo, Heikki; Nordin, Arno; Sanengen, Truls; Bergquist, Annika; Larsson, Marie E.; Soderdahl, Gunnar; Nowak, Greg; Boberg, Kirsten Muri; Isoniemi, Helena; Keiding, Susanne; Foss, Aksel; Line, Pål-Dag; Friman, Styrbjörn; Schrumpf, Erik; Ericzon, Bo-Göran; Höckerstedt, Krister; Karlsen, Tom H.

    2015-01-01

    Abstract Aim and background. The Nordic Liver Transplant Registry (NLTR) accounts for all liver transplants performed in the Nordic countries since the start of the transplant program in 1982. Due to short waiting times, donor liver allocation has been made without considerations of the model of end-stage liver disease (MELD) score. We aimed to summarize key outcome measures and developments for the activity up to December 2013. Materials and methods. The registry is integrated with the operational waiting-list and liver allocation system of Scandiatransplant (www.scandiatransplant.org) and accounted at the end of 2013 for 6019 patients out of whom 5198 were transplanted. Data for recipient and donor characteristics and relevant end-points retransplantation and death are manually curated on an annual basis to allow for statistical analysis and the annual report. Results. Primary sclerosing cholangitis, acute hepatic failure, alcoholic liver disease, primary biliary cirrhosis and hepatocellular carcinoma are the five most frequent diagnoses (accounting for 15.3%, 10.8%, 10.6%, 9.3% and 9.0% of all transplants, respectively). Median waiting time for non-urgent liver transplantation during the last 10-year period was 39 days. Outcome has improved over time, and for patients transplanted during 2004–2013, overall one-, five- and 10-year survival rates were 91%, 80% and 71%, respectively. In an intention-to-treat analysis, corresponding numbers during the same time period were 87%, 75% and 66%, respectively. Conclusion. The liver transplant program in the Nordic countries provides comparable outcomes to programs with a MELD-based donor liver allocation system. Unique features comprise the diagnostic spectrum, waiting times and the availability of an integrated waiting list and transplant registry (NLTR). PMID:25959101

  20. Analysis of MSGTR events for APR1400 by means of best estimate thermal-hydraulic system code

    International Nuclear Information System (INIS)

    Jeong, Ji Hwan; Kim, Sang Jae; Chang, Keun Sun; Lee, Jae Hun

    2001-01-01

    A multiple steam generator tube rupture (MSGTR) event has never occurred in the history of commercial nuclear reactor operation while single steam generator tube rupture (SGTR) event is reported to occur every two years. As there is no history of MSGTR event, the understandings of transients and consequences of this event are not so much. In this study, a postulated MSGTR event in advanced power reactor 1400 (APR1400) is analyzed using thermal-hydraulic system code. The APR 1400 is a two-loop, 1000 MWe, PWR supposed to be built in 2009. MARS1.4 is used in this study. The present study aims to understand the effects of rupture location in heat transfer tubes and selection of affected steam generator following a MSGTR event. The effects of five tube rupture locations are compared with each other. The comparison shows that the response of APR1400 is to allow shortest time for operator action following a tubes rupture in the vicinity of hot-leg side tube sheet and to allow longest time following a tube ruptures at the tube top. The MSSV lift time for rupture at tube-top is evaluated as 24.5% larger than that for rupture at hot-leg side tube sheet. Also, the MSSV lift time for four cases are compared in order to examine how long operator response time is allowed depending on which steam generator is affected. The comparison shows that the cases for both of two steam generators are affected allow longer time for operator action compared with the cases that a single steam generator is affected. Further more, the tube ruptures in the steam generator where a pressurizer is linked leads to the shortest operator response time

  1. Pancreas transplantation: an overview

    Directory of Open Access Journals (Sweden)

    Andre Ibrahim David

    2010-12-01

    Full Text Available Pancreas transplantation is the only treatment able to reestablish normal glucose and glycated hemoglobin levels in insulin-dependent diabetic patients without the use of exogenous insulin. The evolution of pancreas transplantation in treatment of diabetes was determined by advances in the fields of surgical technique, organ preservation and immunosuppressants. The main complication leading to graft loss is technical failure followed by acute or chronic rejection. Technical failure means graft loss within the first three months following transplantation due to vascular thrombosis (50%, pancreatitis (20%, infection (18%, fistula (6.5% and bleeding (2.4%. Immunological complications still affect 30% of patients, and rejection is the cause of graft loss in 10% of cases. Chronic rejection is the most common late complication. Cardiovascular diseases are the most common causes of late mortality in pancreas transplantation, so it remains the most effective treatment for type 1 diabetes patients. There is a significant improvement in quality of life and in patient’s survival rates. The development of islet transplantation could eliminate or minimize surgical complications and immunosuppression.

  2. Risk factors of post renal transplant anaemia among Sudanese patients, a study in three renal transplant centres

    Directory of Open Access Journals (Sweden)

    Elmusharaf Khalifa

    2011-08-01

    Full Text Available Abstract Background There is a relative lack of recent information about late post kidney transplantation anaemia (PTA, especially in the developing countries; data are scarce about the prevalence and risk factors of PTA. Sudan was a leading country in Africa and Arab world in kidney transplantation. The first kidney transplantation in Sudan was in 1973. Methods This is a cross-sectional hospital analytic study enrolling all kidney transplanted recipients following in the transplant referral clinics at Ahmed Gassim, Selma and Ibn Sina Hospitals, Khartoum/Sudan, in the period from 1/8/2010 to 1/9/2010, clinical and laboratory data were obtained from 114 patients, anaemia was defined as Hb levels of Results The study showed that 39.5% of the patients were anaemic. Univariate analysis showed that late PTA is significantly associated with not using Erythropoietin (EPO in the pre-transplant period (p = Conclusion The study concluded that late PTA is common and under recognized. Risk factors for late PTA include renal dysfunction, history of rejection, longer duration of transplantation and not using EPO in the pre-transplant period. Renal dysfunction and not using EPO in the pre-transplant period are major predictors of late PTA.

  3. Epstein-Barr virus associated central nervous system leiomyosarcoma occurring after renal transplantation: case report and review of the literature; Leiomyosarcome primitif du systeme nerveux central associe au virus d'Epstein-Barr (EBV) et survenu apres transplantation renale: a propos d'un cas et revue de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Tahri, A.; Noel, G.; Feuvret, L.; Jauffret, E.; Brun, B.; Mazeron, J.J.; Baillet, F. [Centre des Tumeurs, Groupe Hospitalier Universitaire Pitie-Salpetriere, 75 - Paris (France); Feuvret, L. [Centre de Protontherapie d' Orsay, 91 (France); Figuerella-Branger, D. [Hopital de la Timone, Service d' Anatomopathologie, 13 - Marseille (France); Goncalves, A. [Institut Paoli-Calmettes, Service d' Oncologie Medicale, 13 - Marseille (France)

    2003-10-01

    Central nervous system leiomyosarcomas are extremely rare, however, they became more frequent among immuno-deficient patients, either in a patients infected with human immunodeficiency virus (HIV), or after organ transplantation. The data of the literature indicate that the infection by Epstein-Barr virus (EBV) plays a causal role in the development of these tumours but its precise role in the onco-genesis remains unresolved. We report a new case of EBV associated leiomyosarcoma of the left cavernous sinus occurring after renal transplantation. The epidemiological, clinical, pathological and therapeutic characteristics of these tumours are discussed. (authors)

  4. Transplant organizational structures: viewpoints from established centers.

    Science.gov (United States)

    Abouljoud, M; Klintmalm, G; Whitehouse, S

    2012-10-01

    This personal viewpoint report summarizes the responses of a survey targeting established transplant programs with a structured framework, such as center, institute, or department, and stability of leadership to assure valuable experiential observations. The 18-item survey was sent to 20 US institutions that met inclusion criteria. The response rate was 100%. Seventeen institutions had a distinct transplant governance structure. A majority of respondents perceived that their type of transplant structure was associated with enhanced recognition within their institution (85%), improved regulatory compliance (85%), transplant volume growth (75%), improved quality outcomes (75%) and increased funding for transplant-related research (75%). The prevailing themes in respondents' remarks were the perceived need for autonomy of the transplant entity, alignment among services and finances and alignment of authority with responsibility. Many respondents suggested that a dialogue be opened about effective transplant infrastructure that overcomes the boundaries of traditional academic department silos. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients - BCSH and BTS Guidelines.

    Science.gov (United States)

    Parker, Anne; Bowles, Kristin; Bradley, J Andrew; Emery, Vincent; Featherstone, Carrie; Gupte, Girish; Marcus, Robert; Parameshwar, Jayan; Ramsay, Alan; Newstead, Charles

    2010-06-01

    A joint working group established by the Haemato-oncology subgroup of the British Committee for Standards in Haematology (BCSH) and the British Transplantation Society (BTS) has reviewed the available literature and made recommendations for the diagnosis and management of post-transplant lymphoproliferative disorder in adult recipients of solid organ transplants. This review details the therapeutic options recommended including reduction in immunosuppression (RIS), transplant organ resection, radiotherapy and chemotherapy. Effective therapy should be instituted before progressive disease results in declining performance status and multi-organ dysfunction. The goal of treatment should be a durable complete remission with retention of transplanted organ function with minimal toxicity.

  6. Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation

    OpenAIRE

    Cho, P. S.; Saidi, R. F.; Cutie, C. J.; Ko, D. S. C.

    2015-01-01

    Background: There are over 250 kidney transplant programs in the USA. Objective: To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent incidence and prevalence of ESRD nationwide. Methods: ESRD Network and OPTN data completed in 2011 were obtained from all transplant centers including listing data, market saturation, market share, org...

  7. Stem Cell Transplantation from Bench to Bedside

    Indian Academy of Sciences (India)

    Table of contents. Stem Cell Transplantation from Bench to Bedside · Slide 2 · Slide 3 · Slide 4 · Principles of an allogeneic stem cell transplant · Principle of an allogeneic stem cell transplant · Principle of an autologous Stem Cell Transplant · Slide 8 · Conditioning · Slide 10 · Slide 11 · Stem Cell Transplantation · Slide 13.

  8. A Study on the Directed Living Non-Related Donor Kidney Transplantation Submitted to the Hospital Transplant Ethics Committee at the National Kidney and Transplant Institute.

    Science.gov (United States)

    Suguitan, G; Arakama, M-H I; Danguilan, R

    2017-03-01

    In the latter part of 2009, the Department of Health of the Philippines prohibited kidney transplantation with non-related kidney donors. Hence, the National Kidney and Transplant Institute created a Hospital Transplant Ethics Committee. This study describes directed non-related kidney donation at the National Kidney and Transplant Institute. This retrospective study reviewed the profiles of recipients and directed living non-related kidney transplant donors submitted to the Hospital Transplant Ethics Committee. A total 74 recipients and donors were reviewed by the Hospital Transplant Ethics Committee in 2014. Donors initiated the talks about being a donor (75%) to repay the good deeds that were done by the recipient for them or their families; examples of which are: sometime in their lives they needed financial assistance for hospitalization for their relatives and it was the patient who paid the hospital bill; or because they pitied the recipient, whom they found to be a good person, thus they would want to give one of their kidneys. Seventy-four (100%) said that they were not expecting anything in return for this act but wanted to be of help to the recipient. Of these 74 cases, 70 cases (95%) were approved and the others were disapproved. With a Hospital Transplant Ethics Committee in place, directed kidney donation is a valuable tool as an additional source of kidney donor without violating any ethical issues. Copyright © 2016. Published by Elsevier Inc.

  9. Face time: educating face transplant candidates.

    Science.gov (United States)

    Lamparello, Brooke M; Bueno, Ericka M; Diaz-Siso, Jesus Rodrigo; Sisk, Geoffroy C; Pomahac, Bohdan

    2013-01-01

    Face transplantation is the innovative application of microsurgery and immunology to restore appearance and function to those with severe facial disfigurements. Our group aims to establish a multidisciplinary education program that can facilitate informed consent and build a strong knowledge base in patients to enhance adherence to medication regimes, recovery, and quality of life. We analyzed handbooks from our institution's solid organ transplant programs to identify topics applicable to face transplant patients. The team identified unique features of face transplantation that warrant comprehensive patient education. We created a 181-page handbook to provide subjects interested in pursuing transplantation with a written source of information on the process and team members and to address concerns they may have. While the handbook covers a wide range of topics, it is easy to understand and visually appealing. Face transplantation has many unique aspects that must be relayed to the patients pursuing this novel therapy. Since candidates lack third-party support groups and programs, the transplant team must provide an extensive educational component to enhance this complex process. As face transplantation continues to develop, programs must create sound education programs that address patients' needs and concerns to facilitate optimal care.

  10. Real-Time PCR Quantification and Diversity Analysis of the Functional Genes aprA and dsrA of Sulfate-Reducing Prokaryotes in Marine Sediments of the Peru Continental Margin and the Black Sea.

    Science.gov (United States)

    Blazejak, Anna; Schippers, Axel

    2011-01-01

    Sulfate-reducing prokaryotes (SRP) are ubiquitous and quantitatively important members in many ecosystems, especially in marine sediments. However their abundance and diversity in subsurface marine sediments is poorly understood. In this study, the abundance and diversity of the functional genes for the enzymes adenosine 5'-phosphosulfate reductase (aprA) and dissimilatory sulfite reductase (dsrA) of SRP in marine sediments of the Peru continental margin and the Black Sea were analyzed, including samples from the deep biosphere (ODP site 1227). For aprA quantification a Q-PCR assay was designed and evaluated. Depth profiles of the aprA and dsrA copy numbers were almost equal for all sites. Gene copy numbers decreased concomitantly with depth from around 10(8)/g sediment close to the sediment surface to less than 10(5)/g sediment at 5 mbsf. The 16S rRNA gene copy numbers of total bacteria were much higher than those of the functional genes at all sediment depths and used to calculate the proportion of SRP to the total Bacteria. The aprA and dsrA copy numbers comprised in average 0.5-1% of the 16S rRNA gene copy numbers of total bacteria in the sediments up to a depth of ca. 40 mbsf. In the zone without detectable sulfate in the pore water from about 40-121 mbsf (Peru margin ODP site 1227), only dsrA (but not aprA) was detected with copy numbers of less than 10(4)/g sediment, comprising ca. 14% of the 16S rRNA gene copy numbers of total bacteria. In this zone, sulfate might be provided for SRP by anaerobic sulfide oxidation. Clone libraries of aprA showed that all isolated sequences originate from SRP showing a close relationship to aprA of characterized species or form a new cluster with only distant relation to aprA of isolated SRP. For dsrA a high diversity was detected, even up to 121 m sediment depth in the deep biosphere.

  11. Use of hematopoietic cell transplants to achieve tolerance in patients with solid organ transplants

    OpenAIRE

    Strober, Samuel

    2016-01-01

    The goals of tolerance in patients with solid organ transplants are to eliminate the lifelong need for immunosuppressive (IS) drugs and to prevent graft loss due to rejection or drug toxicity. Tolerance with complete withdrawal of IS drugs has been achieved in recipients of HLA-matched and mismatched living donor kidney transplants in 3 medical centers using hematopoietic cell transplants to establish mixed or complete chimerism.

  12. The perception of sleep quality in kidney transplant patients during the first year of transplantation

    Directory of Open Access Journals (Sweden)

    Dnyelle Souza Silva

    2012-12-01

    Full Text Available OBJECTIVE: Poor sleep quality is one of the factors that adversely affects patient quality of life after kidney transplantation, and sleep disorders represent a significant cardiovascular risk factor. The objective of this study was to investigate the prevalence of changes in sleep quality and their outcomes in kidney transplant recipients and analyze the variables affecting sleep quality in the first years after renal transplantation. METHODS: Kidney transplant recipients were evaluated at two time points after a successful transplantation: between three and six months (Phase 1 and between 12 and 15 months (Phase 2. The following tools were used for assessment: the Pittsburgh Sleep Quality Index; the quality of life questionnaire Short-Form-36; the Hospital Anxiety and Depression scale; the Karnofsky scale; and assessments of social and demographic data. The prevalence of poor sleep was 36.7% in Phase 1 and 38.3% in Phase 2 of the study. RESULTS: There were no significant differences between patients with and without changes in sleep quality between the two phases. We found no changes in sleep patterns throughout the study. Both the physical and mental health scores worsened from Phase 1 to Phase 2. CONCLUSION: Sleep quality in kidney transplant recipients did not change during the first year after a successful renal transplantation.

  13. Autogenous transplantation of maxillary and mandibular molars.

    Science.gov (United States)

    Reich, Peter P

    2008-11-01

    Autogenous tooth transplantation has been used as a predictable surgical approach to correct malocclusion and replace edentulous areas. This article focuses on the surgical approach and technique for molar transplantation. Thirty-two patients aged between 11 and 25 years underwent 44 autogenous molar transplantations. The procedure involved transplantation of impacted or newly erupted third molars into the extraction sockets of nonrestorable molars and surgical removal and replacement of horizontally impacted molars into their proper vertical alignment. Five basic procedural concepts were applied: 1) atraumatic extraction, avoiding disruption of the root sheath and root buds; 2) apical contouring of bone at the transplantation site and maxillary sinus lift via the Summers osteotome technique, when indicated, for maxillary molars; 3) preparation of a 4-wall bony socket; 4) avoidance of premature occlusal interferences; and 5) stabilization of the tooth with placement of a basket suture. All 32 patients successfully underwent the planned procedure. To date, 2 patients have had localized infection that resulted in loss of the transplant. The remaining 42 transplants remain asymptomatic and functioning, with a mean follow-up period of 19 months. No infection, ankylosis, loss of the transplant, or root resorption has been noted. In addition, endodontic therapy has not been necessary on any transplanted teeth. Autogenous tooth transplantation has been discussed and described in the literature previously, with a primary focus on cuspid and bicuspid transplantation. The molar transplant is infrequently discussed in today's literature, possibly because of the preponderance of titanium dental implants. Autogenous molar transplantation is a viable procedure with low morbidity and excellent functional and esthetic outcomes. This report shows the successful transplantation of 42 of 44 molars in 32 patients with a mean follow-up period of 19 months.

  14. Four decades of kidney transplantation in Cuba.

    Science.gov (United States)

    Alfonzo, Jorge P

    2013-01-01

    This article describes the background, beginnings, development, evolution and outcomes of kidney transplantation in Cuba. Nephrology as a medical specialty in Cuba began in 1962 and was formalized in 1966. Conditions were created to implement renal replacement therapy (including transplants), bring nephrology care to the entire country and train human resources who would assume this responsibility, making Cuba one of the first countries with a comprehensive program for renal patient care. After three unsuccessful cadaveric-donor kidney transplantations in 1968-69, the ensuing history of kidney transplantation can be summarized in the following three stages. 1970-1975: In January 1970, cadaveric-donor kidney transplantation began at the Nephrology Institute. That year, 17 kidney transplantations were performed; four of these patients lived with functional kidneys for 15-25 years; 10-year graft survival was 23.5% (Kaplan-Meier survival curve); HLA typing began in 1974. By December 1975, 170 grafts had been done in three hospitals. 1976-1985: Seven transplantation centers performed 893 grafts during this period. HLA-DR typing was introduced in 1976 and the National Histocompatibility Laboratory Network was founded in 1978. The first related living-donor kidney transplantation was done in 1979. 1986-2011: The National Kidney Transplantation Coordinating Center and the National Kidney Transplantation Program were created in 1986; the first combined kidney-pancreas transplantation was performed the same year. In 1990, cyclosporine and the Cuban monoclonal antibody IOR-T3 were introduced for immunosuppression to prevent rejection, as were other Cuban products (hepatitis B vaccine and recombinant human erythropoietin) for transplant patients. By December 2011, the cumulative number of transplants was 4636 (384 from related living donors). With over 40 years of experience, kidney transplantation is now well established in Cuba; it is free and universally accessible, on the

  15. Manipulating transplant morphology to advance post-transplant growth and yield in strawberry

    NARCIS (Netherlands)

    Reekie, J.Y.

    2005-01-01

    Two methods were developed to enhance transplant success and minimize water use of strawberry transplants harvested in Canadian nurseries for use in the annual strawberry production system in the Southern United States: mechanical leaf removal by mowing, and chemical control of growth and

  16. International Transplant Nurses Society

    Science.gov (United States)

    ... Expanded and updated to reflect today's thinking, this brand-new edition offers crucial, real-life direction on ... reduced rates in countries with emerging economies • Build awareness of World Organ Day, Transplant Games, and Transplant ...

  17. Four-Way Kidney Exchange Transplant With Desensitization Increases Access to Living-Donor Kidney Transplant: First Report From India.

    Science.gov (United States)

    Kute, Vivek B; Patel, Himanshu V; Shah, Pankaj R; Modi, Pranjal R; Shah, Veena R; Kasat, Govind S; Patil, Mayur V; Patel, Jaydeep C; Kumar, Deepak P; Trivedi, Hargovind L

    2017-09-26

    This study reports our experience of the first 4-way kidney exchange transplant combined with desensitization in India, which allows increased access to living-donor kidney transplant for sensitized patients. Four-way kidney exchange transplant procedures were approved by the ethics committee of our institution and the Organ Transplantation Authorization Committee of state governments of India (as per the Transplantation of Human Organs Act of India). The protocols conformed to Declaration of Istanbul principles and the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from patients, donors, and their guardians. In April 2016, our transplant team completed simultaneous 4-way kidney exchange transplant procedures without any medical (rejection and infections) or surgical complications. Reasons for being included for kidney exchange transplant were ABO incom-patible (2 recipients) and sensitization (2 recipients). All 4 recipients had stable graft function with no proteinuria and donor-specific antibody at 11-month follow-up on standard triple immunosup-pression. Patient and graft survival rates were both 100%. To the best of our knowledge, this is the first single-center report of 4-way kidney exchange transplant combined with desensitization from India. This procedure has the potential to expand living-donor kidney transplant in disadvantaged groups (eg, sensitized patients). Recipients who are hard to match due to high panel reactive antibody and difficult to desensitize due to strong donor-specific antibodies can receive a transplant with a combination of kidney exchange and desensitization. Our study suggests that 4-way kidney exchange transplant can be performed in developing countries (India) similar to that shown in programs in developed countries with team work, kidney exchange registry, and counseling.

  18. Lung transplantation: overall approach regarding its major aspects

    Science.gov (United States)

    de Camargo, Priscila Cilene León Bueno; Teixeira, Ricardo Henrique de Oliveira Braga; Carraro, Rafael Medeiros; Campos, Silvia Vidal; Afonso, José Eduardo; Costa, André Nathan; Fernandes, Lucas Matos; Abdalla, Luis Gustavo; Samano, Marcos Naoyuki; Pêgo-Fernandes, Paulo Manuel

    2015-01-01

    ABSTRACT Lung transplantation is a well-established treatment for patients with advanced lung disease. The evaluation of a candidate for transplantation is a complex task and involves a multidisciplinary team that follows the patient beyond the postoperative period. Currently, the mean time on the waiting list for lung transplantation in the state of São Paulo, Brazil, is approximately 18 months. For Brazil as a whole, data from the Brazilian Organ Transplant Association show that, in 2014, there were 67 lung transplants and 204 patients on the waiting list for lung transplantation. Lung transplantation is most often indicated in cases of COPD, cystic fibrosis, interstitial lung disease, non-cystic fibrosis bronchiectasis, and pulmonary hypertension. This comprehensive review aimed to address the major aspects of lung transplantation: indications, contraindications, evaluation of transplant candidates, evaluation of donor candidates, management of transplant recipients, and major complications. To that end, we based our research on the International Society for Heart and Lung Transplantation guidelines and on the protocols used by our Lung Transplant Group in the city of São Paulo, Brazil. PMID:26785965

  19. The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility.

    Science.gov (United States)

    Williams, Allison; Low, Jac Kee; Manias, Elizabeth; Crawford, Kimberley

    2016-08-01

    To obtain an understanding of how health professionals support the kidney transplant patient to take their medications as prescribed long term. Kidney transplantation requires stringent adherence to complex medication regimens to prevent graft rejection and to maintain general well-being. Medication nonadherence is common in kidney transplantation, emerging in the first few months post-transplantation, leading to poor patient outcomes. Exploratory qualitative design. Five focus groups were conducted with a total of seven renal nurse transplant coordinators, two renal transplant nurse unit managers, seven nephrologists, seven pharmacists, four social workers, and one consumer representative representing all five hospitals offering adult kidney transplantation in Victoria, Australia in 2014. The views of two general practitioners who were unable to attend the focus groups were incorporated into the data set. All data underwent thematic analysis. Analysis revealed that adherence was a collective responsibility involving the whole of the transplant team and the patient via education blitz in hospital, identifying and managing nonadherence, promotion of self-advocacy, and the partnership between the patient and health professional. Patients were directed how to take their complex medications to be self-empowered, yet the partnership between the patient and health professional limited the patient's voice. Although medication adherence was a collective responsibility, communication was often one-way chiefly as a result of staffing and time constraints, hindering effective partnerships necessary for medication adherence. Expert skills in communication and adherence counselling are necessary to identify barriers affecting medication adherence. Patients need to be systematically screened, prepared and supported long-term within an accommodating healthcare system for the reality of caring for their transplanted kidney. Kidney transplant recipients require systematic

  20. The UNOS renal transplant registry.

    Science.gov (United States)

    Cecka, J M

    2001-01-01

    The shortage of cadaver kidneys relative to increasing demand for transplantation has lead to a remarkable rise in transplantation from living donors. Based upon data reported to UNOS, the number of living donor kidneys transplanted in 2000 (5,106) nearly equaled the number of cadaver kidneys from preferred donors aged 6-50. HLA-mismatched siblings, offspring, spouses and other genetically unrelated donors accounted for nearly 80% of increased living donor transplantation during 1994-2000. Despite the increased use of poorly HLA-matched living donor kidneys, the actuarial 10-year graft survival rates for transplants between 1988-2000 were clustered between 53-57% for HLA-mismatched living donor grafts, except for offspring-to-parent transplants (49%) when the recipients were generally older. The 10-year survival rate for 96,053 cadaver grafts was 38% during the same period. The 5-year graft survival rates for more recent (1996-2000) cadaver donor transplants were 66%, 62% and 56% for recipients of first, second and multiple grafts, respectively (p < 0.001). The comparable results among recipients of living donor kidneys were 67%, 66% and 59% (p = ns). The 5-year graft survival rates for HLA-matched first grafts were 7% higher than those for HLA-mismatched transplants when the kidney was from a living or cadaver donor. HLA-identical sibling transplants provided the best long-term graft survival (85% at 5 years and a 32 year half-life). Even with improved crossmatch tests and stronger immunosuppression, sensitization was associated with 8% lower graft survival at 5 years and with a higher rate of late graft loss among first cadaver kidney recipients. Sensitization also was associated with an increase in delayed graft function from 22% of unsensitized first transplant recipients to as much as 36% among multiply retransplanted patients. Recipient race was a key factor in long-term graft survival of both living and cadaver donor kidneys. The rate of late graft loss was

  1. Lung transplantation for chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Liou TG

    2013-07-01

    Full Text Available Theodore G Liou, Sanjeev M Raman, Barbara C CahillDivision of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USAAbstract: Patients with end-stage chronic obstructive pulmonary disease (COPD comprise the largest single lung disease group undergoing transplantation. Selection of appropriate candidates requires consideration of specific clinical characteristics, prognosis in the absence of transplantation, and likely outcome of transplantation. Increased availability of alternatives to transplantation for end-stage patients and the many efforts to increase the supply of donor organs have complicated decision making for selecting transplant candidates. Many years of technical and clinical refinements in lung transplantation methods have improved survival and quality of life outcomes. Further advances will probably come from improved selection methods for the procedure. Because no prospective trial has been performed, and because of confounding and informative censoring bias inherent in the transplant selection process in studies of the existing experience, the survival effect of lung transplant in COPD patients remains undefined. There is a lack of conclusive data on the impact of lung transplantation on quality of life. For some patients with end-stage COPD, lung transplantation remains the only option for further treatment with a hope of improved survival and quality of life. A prospective trial of lung transplantation is needed to provide better guidance concerning survival benefit, resource utilization, and quality of life effects for patients with COPD.Keywords: outcomes, emphysema, COPD, alpha-1-antitrypsin deficiency, survival, single lung transplant, bilateral sequential single lung transplant, lung volume reduction, referral, guidelines, health related quality of life

  2. Viral infections in transplant recipients.

    Science.gov (United States)

    Razonable, R R; Eid, A J

    2009-12-01

    Solid organ and hematopoietic stem cell transplant recipients are uniquely predisposed to develop clinical illness, often with increased severity, due to a variety of common and opportunistic viruses. Patients may acquire viral infections from the donor (donor-derived infections), from reactivation of endogenous latent virus, or from the community. Herpes viruses, most notably cytomegalovirus and Epstein Barr virus, are the most common among opportunistic viral pathogens that cause infection after solid organ and hematopoietic stem cell transplantation. The polyoma BK virus causes opportunistic clinical syndromes predominantly in kidney and allogeneic hematopoietic stem cell transplant recipients. The agents of viral hepatitis B and C present unique challenges particularly among liver transplant recipients. Respiratory viral illnesses due to influenza, respiratory syncytial virus, and parainfluenza virus may affect all types of transplant recipients, although severe clinical disease is observed more commonly among lung and allogeneic hematopoietic stem cell transplant recipients. Less common viral infections affecting transplant recipients include those caused by adenoviruses, parvovirus B19, and West Nile virus. Treatment for viruses with proven effective antiviral drug therapies should be complemented by reduction in the degree of immunosuppression. For others with no proven antiviral drugs for therapy, reduction in the degree of immunosuppression remains as the sole effective strategy for management. Prevention of viral infections is therefore of utmost importance, and this may be accomplished through vaccination, antiviral strategies, and aggressive infection control measures.

  3. Clinical outcome of combined conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery

    OpenAIRE

    Tejsu Malla; Jing Jiang; Kai Hu

    2018-01-01

    AIM: To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques: combined conjunctival autograft and overlay amniotic membrane transplantation (CAT with AMT), conjunctival autograft transplantation (CAT) alone and amniotic membrane transplantation (AMT) alone. METHODS: In this retrospective study, 142 eyes of 142 pterygium patients (104 primary, 38 recurrent) who underwent CAT (group A), AMT (group B) or CAT with AMT (group C) respectively follo...

  4. The Experience of Staging Nijinsky's "L'Apres-Midi d'un Faune" in a Higher Education Dance Program

    Science.gov (United States)

    Curran, Tina

    2010-01-01

    This study documented the experiences of staging Vaslav Nijinsky's "L'Apres-midi d'un Faune" in a higher education dance program. The ballet was staged from Labanotation. Research questions focused on teaching and learning pedagogy, characterization of the process over time, experiences of the participants and teaching approaches. The project…

  5. Verification of SAMG entry condition for APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Junghyun; Kim, Taewan; Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-10-15

    In the wake of the Fukushima accident, severe accident management has become important more than ever. While Emergency Operating Procedures (EOPs) focuses on cooling down the core during a design basis accident, the prime objective of severe accident management guideline (SAMG) is to prevent the release of radioactive material into the environment during a severe accident. Only one fixed value of core exit temperature (CET) has been applied for several decades to different types of nuclear power plants (NPPs) in Korea. Although the different types of NPPs have different cladding materials and system designs, the identical CET, i. e., 650 .deg. C, is applied as the entry condition to the SAMG of all the NPPs (except CANDU plants), i. e., Westinghouse type, OPR1000, and APR1400. In this paper, the transition point is re-evaluated for dominant severe accident sequences; station black-out (SBO), small break loss of coolant accident (SBLOCA), and me dium break loss of coolant accident (MBLOCA). In cases of SBO and SBLOCA, the current SAMG entry condition seems proper, while it needs to be reconsidered for MBLOCA case.

  6. Analysis Of Feedwater Line Break Of APR1400 By MARS Code

    International Nuclear Information System (INIS)

    Nguyen Thi Thanh Thuy; Le Dai Dien, Hoang Minh Giang

    2011-01-01

    This paper will deal with analysis of Feed water Line Break problem (FWLB) of the APR 1400 NPP with initial conditions: operation at 100% of power, double-ended break area of 0.058 m 2 and the break location of the feedwater line between the check valve and the steam generator. The analysis was simulated by MARS code through two step: calculation for steady state and calculation for transient state with initial condition mentioned. Some output result were presented with explanation: sequence of events corresponding to the time of the accident, the system behavior as temperature, pressure, steam generator water levels as well as DNBR, etc. before and after the accident. (author)

  7. Analysis Of Control Rod Ejection Of APR1400 By RELAP5

    International Nuclear Information System (INIS)

    Le Thi Thu; Hoang Minh Giang; Vo Thi Huong; Le Dai Dien

    2011-01-01

    This paper presents the analysis of Reactivity Induced Accident caused by ejection of a Control Element Assembly (CEA) from APR 1400 reactor vessel within 0.05 second. The initial condition were assumed as following: power level at 102%, delayed neutron fraction β = 412 pcm and CEA worth = 110 pcm. The analysis was simulated by RELAP5 code through two step: calculation of steady state and calculation of transient with initial condition mentioned as above. Some output results were presented with explanation: sequence of events corresponding to the time of the accident, the system behavior as power, reactivity feedback from fuel temperature changes (Doppler) as well as temperature, pressure, DNBR within 6 second of the accident. (author)

  8. Proteinuria in Egyptian renal transplant recipients

    Directory of Open Access Journals (Sweden)

    Essam Khedr

    2015-01-01

    Full Text Available To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8% patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2% patients, acute rejection in 40 (32% patients, transplant glomerulopathy in eight (6.4% patients, glomerular disease in 16 (12.8% patients and other etiology in 17 (13.6% patients. Proteinuric patients demonstrated significantly lower graft survival rates than did those without proteinuria (48.3% versus 51.7%, respectively; P = 0.017; Risk Ratio = 0.403; 95% confidence interval 0.188-0.862. We conclude that proteinuria is prevalent after kidney transplant in our population, and that it is most commonly associated with chronic allograft nephropathy, transplant glomerulopathy, glomerulonephritis and acute rejection. Post-transplant proteinuria is associated with decreased allograft survival.

  9. [Danish experience with physical and occupational rehabilitation after heart transplantation. The heart transplantation group at Rigshospitalet].

    Science.gov (United States)

    Aldershvile, J; Boesgaard, S; Kirchoff, G; Arendrup, H; Høyer, S

    1993-01-11

    Heart transplantations have been carried out for one year (1.9.1990-1.9.1991) in Denmark. Twenty-three out of 27 patients survived at the end of this period. Prior to transplantation, all of the patients were in NYHA groups III or IV. On discharge, all of the patients could manage a 45-60 minutes training programme followed by a stair test (two to six floors up). Prior to transplantation, 17 patients received financial aid in one form or another and one child received special schooling. On an average 165 days (1.9.1991) after transplantation, nine patients were in full or part-time employment, two were students, seven received financial aid and five were still in hospital. A correlation between the duration of financial aid before transplantation and return to work after transplantation was found. In addition, age was found to be of significance. It is concluded that physical status and return to work are satisfactory.

  10. Growth in pediatric renal transplant recipients.

    Science.gov (United States)

    Vasudevan, A; Phadke, K

    2007-04-01

    One of the fundamental challenges in managing pediatric renal transplant recipient is to ensure normal growth and development. The goal of renal transplant is not just to prolong life but to optimize quality of life. Short stature during childhood may be associated with academic underachievement and development of comorbidities such as attention deficit hyperactivity disorder, learning disability, and mood disorders. The most important factors affecting growth are use of corticosteroids, allograft function, and age and height deficit at the time of transplant. Aggressive conservative management of chronic renal failure and early use of growth hormone therapy will help in optimizing height at time of transplant. Early transplant, steroid minimization or withdrawal, and growth hormone therapy will help in achieving normal adult height in a majority of renal post transplant population. Steroid avoidance to achieve good growth still needs to be validated.

  11. Antibody induction therapy for lung transplant recipients

    DEFF Research Database (Denmark)

    Penninga, Luit; Møller, Christian H; Penninga, Ida Elisabeth Irene

    2013-01-01

    Lung transplantation has become a valuable and well-accepted treatment option for most end-stage lung diseases. Lung transplant recipients are at risk of transplanted organ rejection, and life-long immunosuppression is necessary. Clear evidence is essential to identify an optimal, safe and effect...... and effective immunosuppressive treatment strategy for lung transplant recipients. Consensus has not yet been achieved concerning use of immunosuppressive antibodies against T-cells for induction following lung transplantation....

  12. Inflammatory Response in Islet Transplantation

    Directory of Open Access Journals (Sweden)

    Mazhar A. Kanak

    2014-01-01

    Full Text Available Islet cell transplantation is a promising beta cell replacement therapy for patients with brittle type 1 diabetes as well as refractory chronic pancreatitis. Despite the vast advancements made in this field, challenges still remain in achieving high frequency and long-term successful transplant outcomes. Here we review recent advances in understanding the role of inflammation in islet transplantation and development of strategies to prevent damage to islets from inflammation. The inflammatory response associated with islets has been recognized as the primary cause of early damage to islets and graft loss after transplantation. Details on cell signaling pathways in islets triggered by cytokines and harmful inflammatory events during pancreas procurement, pancreas preservation, islet isolation, and islet infusion are presented. Robust control of pre- and peritransplant islet inflammation could improve posttransplant islet survival and in turn enhance the benefits of islet cell transplantation for patients who are insulin dependent. We discuss several potent anti-inflammatory strategies that show promise for improving islet engraftment. Further understanding of molecular mechanisms involved in the inflammatory response will provide the basis for developing potent therapeutic strategies for enhancing the quality and success of islet transplantation.

  13. Inflammatory Response in Islet Transplantation

    Science.gov (United States)

    Kanak, Mazhar A.; Kunnathodi, Faisal; Lawrence, Michael C.; Levy, Marlon F.

    2014-01-01

    Islet cell transplantation is a promising beta cell replacement therapy for patients with brittle type 1 diabetes as well as refractory chronic pancreatitis. Despite the vast advancements made in this field, challenges still remain in achieving high frequency and long-term successful transplant outcomes. Here we review recent advances in understanding the role of inflammation in islet transplantation and development of strategies to prevent damage to islets from inflammation. The inflammatory response associated with islets has been recognized as the primary cause of early damage to islets and graft loss after transplantation. Details on cell signaling pathways in islets triggered by cytokines and harmful inflammatory events during pancreas procurement, pancreas preservation, islet isolation, and islet infusion are presented. Robust control of pre- and peritransplant islet inflammation could improve posttransplant islet survival and in turn enhance the benefits of islet cell transplantation for patients who are insulin dependent. We discuss several potent anti-inflammatory strategies that show promise for improving islet engraftment. Further understanding of molecular mechanisms involved in the inflammatory response will provide the basis for developing potent therapeutic strategies for enhancing the quality and success of islet transplantation. PMID:24883060

  14. Use of hematopoietic cell transplants to achieve tolerance in patients with solid organ transplants.

    Science.gov (United States)

    Strober, Samuel

    2016-03-24

    The goals of tolerance in patients with solid organ transplants are to eliminate the lifelong need for immunosuppressive (IS) drugs and to prevent graft loss due to rejection or drug toxicity. Tolerance with complete withdrawal of IS drugs has been achieved in recipients of HLA-matched and mismatched living donor kidney transplants in 3 medical centers using hematopoietic cell transplants to establish mixed or complete chimerism. © 2016 by The American Society of Hematology.

  15. MELD score measured day 10 after orthotopic liver transplantation predicts death and re-transplantation within the first year

    DEFF Research Database (Denmark)

    Rostved, Andreas A; Lundgren, Jens D; Hillingsø, Jens

    2016-01-01

    -transplantation. MATERIAL AND METHODS: Retrospective cohort study on adults undergoing orthotopic deceased donor liver transplantation from 2004 to 2014. The MELD score was determined prior to transplantation and daily until 21 days after. The risk of mortality or re-transplantation within the first year was assessed...... day 1 the MELD score significantly diversified and was higher in the poor outcome group (MELD score quartile 4 versus quartile 1-3 at day 10: HR 5.1, 95% CI: 2.8-9.0). This association remained after adjustment for non-identical blood type, autoimmune liver disease and hepatocellular carcinoma...... (adjusted HR 5.3, 95% CI: 2.9-9.5 for MELD scores at day 10). The post-transplant MELD score was not associated with pre-transplant MELD score or the Eurotransplant donor risk index. CONCLUSION: Early determination of the MELD score as an indicator of early allograft dysfunction after liver transplantation...

  16. Heart transplantation and arterial elasticity

    Directory of Open Access Journals (Sweden)

    Colvin-Adams M

    2013-12-01

    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a

  17. Post-transplantation Infections in Bolivia.

    Science.gov (United States)

    Arze, S; Arze, L; Abecia, C

    2016-03-01

    Over 26 years, we found 46 infectious episodes in 350 kidney transplant recipients. Fifteen were urinary tract infections, recurrent in 4 patients. There were 8 cytomegalovirus infections, three of them fatal when intravenous (IV) ganciclovir was not available. Seven patients had a reactivation of tuberculosis (TB) in the pleura, cervical spine, lumbar spine, knee, ankle, skin and peritoneum, respectively, and were all resolved satisfactorily with conventional anti-TB therapy. Three patients transplanted before routine prophylaxis with the use of acyclovir developed an extensive herpes zoster infection in the 1st 6 months after transplantation, which was resolved with the use of oral acyclovir, and 1 had a disseminated herpes simplex infection resolved with the use of IV acyclovir. Three patients transplanted before routine prophylaxis with trimethoprim sulfa developed Pneumocystis carinii pneumonia in the 1st 6 months after transplantation, which was fatal in one of them. In 2 patients, we found a Nocardia infection, confined to the lung, which was cured in one of the cases and systemic and fatal in the other. Two patients transplanted before routine prophylaxis with the use of nystatin developed esophageal candidiasis in the 1st 6 months after transplantation. One patient developed infective endocarditis in a stenotic bicuspid aortic valve and died 10 years later after another incident of infective endocarditis at the prosthetic aortic valve. Two patients developed an extensive condyloma at the penis, perianal region, and perineum owing to human papillomavirus, requiring extensive surgical resection and podophyllin applications. Another patient developed fatal post-transplantation lymphoproliferative disease due to Epstein-Barr virus infection 15 years after transplantation. One patient developed a severe and fatal mucocutaneous leishmaniasis with no response to conventional antimonial therapy. It is interesting to note that despite Chagas disease being endemic

  18. De novo malignancy after pancreas transplantation in Japan.

    Science.gov (United States)

    Tomimaru, Y; Ito, T; Marubashi, S; Kawamoto, K; Tomokuni, A; Asaoka, T; Wada, H; Eguchi, H; Mori, M; Doki, Y; Nagano, H

    2015-04-01

    Long-term immunosuppression is associated with an increased risk of cancer. Especially, the immunosuppression in pancreas transplantation is more intensive than that in other organ transplantation because of its strong immunogenicity. Therefore, it suggests that the risk of post-transplant de novo malignancy might increase in pancreas transplantation. However, there have been few studies of de novo malignancy after pancreas transplantation. The aim of this study was to analyze the incidence of de novo malignancy after pancreas transplantation in Japan. Post-transplant patients with de novo malignancy were surveyed and characterized in Japan. Among 107 cases receiving pancreas transplantation in Japan between 2001 and 2010, de novo malignancy developed in 9 cases (8.4%): post-transplant lymphoproliferative disorders in 6 cases, colon cancer in 1 case, renal cancer in 1 case, and brain tumor in 1 case. We clarified the incidence of de novo malignancy after pancreas transplantation in Japan. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Beta-Cell Replacement: Pancreas and Islet Cell Transplantation.

    Science.gov (United States)

    Niclauss, Nadja; Meier, Raphael; Bédat, Benoît; Berishvili, Ekaterine; Berney, Thierry

    2016-01-01

    Pancreas and islet transplantation are 2 types of beta-cell replacement therapies for type 1 diabetes mellitus. Since 1966, when pancreas transplantation was first performed, it has evolved to become a highly efficient procedure with high success rates, thanks to advances in surgical technique and immunosuppression. Pancreas transplantation is mostly performed as simultaneous pancreas-kidney transplantation in patients with end-stage nephropathy secondary to diabetes. In spite of its efficiency, pancreas transplantation is still a major surgical procedure burdened by high morbidity, which called for the development of less invasive and hazardous ways of replacing beta-cell function in the past. Islet transplantation was developed in the 1970s as a minimally invasive procedure with initially poor outcomes. However, since the report of the 'Edmonton protocol' in 2000, the functional results of islet transplantation have substantially and constantly improved and are about to match those of whole pancreas transplantation. Islet transplantation is primarily performed alone in nonuremic patients with severe hypoglycemia. Both pancreas transplantation and islet transplantation are able to abolish hypoglycemia and to prevent or slow down the development of secondary complications of diabetes. Pancreas transplantation and islet transplantation should be seen as two complementary, rather than competing, therapeutic approaches for beta-cell replacement that are able to optimize organ donor use and patient care. © 2016 S. Karger AG, Basel.

  20. Liver transplantation:Yesterday,today and tomorrow

    Institute of Scientific and Technical Information of China (English)

    Osman Abbasoglu

    2008-01-01

    With the advances in technical skills,management of postoperative complications and improvements in immunosuppressive drugs,liver transplantation is the standard treatment for many patients with chronic liver disease.Today,shortage of donor organs seems to be the major limiting factor for the application of liver transplantation.This review focuses on five issues that are challenging to clinical practice of liver transplantation and relevant to gastroenterologists.These include living donor liver transplantation,recurrent viral hepatitis,non-heart-beating donors,hepatocellular carcinoma,and ABO incompatible livertransplantation.Living donor and non-heart beating donor transplantations were initiated as a solution to increase the donor organ pool and it is expected that there will be an increase in the number of these donors.Recurrent hepatitis C and hepatocellular carcinoma following liver transplantation are among major problems and ongoing research in these diseases may lead to better outcomes in these recipients.

  1. Pediatric renal transplant practices in India.

    Science.gov (United States)

    Sethi, Sidharth Kumar; Sinha, Rajiv; Rohatgi, Smriti; Kher, Vijay; Iyengar, Arpana; Bagga, Arvind

    2017-05-01

    Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India. A designed questionnaire formulated by a group of pediatric nephrologists with the aim of understanding the current practice of pediatric renal transplantation was circulated to all adult and pediatric nephrologists of the country. Of 26 adult nephrologists who responded, 16 (61.5%) were involved in pediatric transplantation, and 10 of 15 (66.6%) pediatric nephrologists were involved in pediatric transplantation. Most of the centers doing transplants were private/trust institution with only three government institutions undertaking it. Induction therapy was varied among pediatric and adult nephrologists. There were only a few centers (n=5) in the country routinely doing >5 transplants per year. Preemptive transplants and protocol biopsies were a rarity. The results demonstrate lower incidence of undertaking pediatric transplants in children below 6 years, paucity of active cadaveric programs and lack of availability of trained pediatric nephrologists and staff. In contrast to these dissimilarities, the immunosuppressant use seems to be quite similar to Western registry data with majority favoring induction agent and triple immunosuppressant (steroid, mycophenolate mofetil and tacrolimus) for maintenance. The survey also identifies major concerns in availability of this service to all regions of India as well as to all economic segments. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. [Personalized medicine in transplantation therapy].

    Science.gov (United States)

    Nakatani, Kaname

    2013-05-01

    Personalized medicine based on pharmacogenomics is being developed at the clinical stage. Various evidence is accumulating in transplantation therapy. Tacrolimus, a calcineurin inhibitor, is usually used for immunosuppressive therapy after transplantation. Tacrolimus is mainly metabolized by cytochrome P450 isozymes, CYP3A4 and CYP3A5, expressed in the intestine as well as in the liver. Recent studies of pharmacogenomics have reported that several single nucleotide polymorphisms (SNPs) of CYP3A5 are correlated with gene expression and enzyme activity. Phenotypes of CYP3A5 are typed as expressors (*1/*1 and *1/*3) or non-expressors (*3/*3) . In living-donor liver transplantation, CYP3A5 phenotypes could predict the blood concentration of tacrolimus. In particular, preoperative assessment of CYP3A5 genotypes in both recipients (intestine) and donors (graft liver) is required for predicting tacrolimus pharmacokinetics. In kidney transplantation, blood tacrolimus concentrations were significantly different between expressors and non-expressors. Genotyping and phenotyping of recipients were useful to predict blood tacrolimus levels in early phase of post-transplantation. Furthermore, phenotypes of CYP3A5 could predict the initial dose of tacrolimus. Combination therapy was performed after bone marrow transplantation to prevent complications. Genotyping and phenotyping of metabolic enzymes for combination dugs would be useful for predicting drug actions. In conclusion, phenotyping based on pharmacogenomics supports personalized medicine in transplantation therapy. In future, multiplex testing should be developed to support personalized medicine in various fields.

  3. Predicting adherence to health care recommendations using health promotion behaviours in kidney transplant recipients within 1-5 years post-transplant.

    Science.gov (United States)

    Lin, Su-Yueh; Fetzer, Susan J; Lee, Po-Chang; Chen, Ching-Huey

    2011-12-01

    This study examined health promotion behaviours of kidney transplant recipients, 1-5 years after transplant and identified the risk factors predicting non-adherence to post-transplant recommendations. Non-adherence to health care recommendations and health promotion behaviours is one of the top three reasons for graft loss following kidney transplantation. A cross-sectional study. Kidney transplant recipients (n=101) in southern Taiwan completed a self reported survey, the Kidney Transplant Health Promotion Behavior and Healthcare Provider Support survey. Kidney transplant patients had better adherence with medication and least adherence with regular exercise health promotion behaviours. Age, post kidney transplant time, health care provider support and financial satisfaction accounted for 37·2% of the explained variance in monitoring and management for rejection and infection. Marital status, post kidney transplant time and gender accounted for 16·2% of the explained variance in infection prevention. Age was the sole predictor of exercise (odds ratio=1·08, p=0·025). Health promotion behaviours declined with time and perceived healthcare provider support decreased at the third (p=0·04) post kidney transplant year. In this study, young, single, males were identified as requiring specific strategies to improve post kidney transplant health promotion behaviours. The need for health promotion must be continually reinforce by healthcare providers throughout the lifespan of a kidney transplant recipient. Understanding the changes of health behaviours of post kidney transplant recipients and their risk factors, healthcare providers can be more aware of the needs of patients in maintaining health promotion behaviours. © 2011 Blackwell Publishing Ltd.

  4. Pancreas transplants

    International Nuclear Information System (INIS)

    Chandra, J.; Phillips, R.R.; Boardman, P.; Gleeson, F.V.; Anderson, E.M.

    2009-01-01

    Cadaveric, whole pancreas transplantation has proved an effective therapy in the treatment of long-standing type 1 diabetes mellitus and is capable of achieving an insulin-independent eugyclaemic state. As a result, this procedure is being increasingly performed. However, the surgical procedure is complex and unfamiliar to many radiologists. Imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gives excellent results and can be used confidently to diagnose vascular, enteric, and immune-mediated complications. We present a review of the normal post-transplantation appearance and the features of early and late complications.

  5. Pancreas transplants

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, J.; Phillips, R.R.; Boardman, P.; Gleeson, F.V. [Department of Radiology, Churchill Hospital, Headington, Oxford (United Kingdom); Anderson, E.M. [Department of Radiology, Churchill Hospital, Headington, Oxford (United Kingdom)], E-mail: ewan.anderson@orh.nhs.uk

    2009-07-15

    Cadaveric, whole pancreas transplantation has proved an effective therapy in the treatment of long-standing type 1 diabetes mellitus and is capable of achieving an insulin-independent eugyclaemic state. As a result, this procedure is being increasingly performed. However, the surgical procedure is complex and unfamiliar to many radiologists. Imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gives excellent results and can be used confidently to diagnose vascular, enteric, and immune-mediated complications. We present a review of the normal post-transplantation appearance and the features of early and late complications.

  6. Neurologic Complications of Transplantation.

    Science.gov (United States)

    Dhar, Rajat

    2018-02-01

    Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

  7. Employment outcomes following successful renal transplantation.

    Science.gov (United States)

    Eng, Mary; Zhang, Jie; Cambon, Alexander; Marvin, Michael R; Gleason, John

    2012-01-01

    Data on employment outcomes after successful renal transplantation are few. We conducted this study to identify favorable factors for employment after transplantation. Adult patients rate was obtained where 56% of respondents were employed after transplantation. Race, marital status, previous transplant, and complicated post-operative course did not influence employment. Favorable factors include male gender (p=0.04), younger age (employment (pemployment was 4.9±6.3 months (median three months). Common reasons for unemployment were disability (59%) and retirement (27%). Finally, 7% correctly responded that Medicare benefits end 36 months following transplantation. Potentially modifiable factors to improve employment are earlier referral and better education regarding Medicare eligibility. © 2011 John Wiley & Sons A/S.

  8. Extravascular complications following abdominal organ transplantation

    International Nuclear Information System (INIS)

    Low, G.; Jaremko, J.L.; Lomas, D.J.

    2015-01-01

    A variety of transplants have been performed in the abdomen including liver, kidney, pancreas and islet, bowel, and multivisceral transplants. Imaging plays an important role in graft surveillance particularly to exclude post-transplant complications. When complications occur, therapeutic image-guided interventions are invaluable as these may be graft-saving and even life-saving. Vascular complications following transplantation have been extensively reported in recent reviews. The focus of this review is to discuss post-transplant complications that are primarily extravascular in location. This includes biliary, urological, intestinal, malignancy, infections, and miscellaneous complications. Familiarity with the imaging appearances of these complications is helpful for radiologists as accurate diagnosis and expedient treatment has an impact on graft and patient survival

  9. Unit Risk Quotient (RQ) and Relative Significance of Radionuclide on Flora and Fauna to the EU-APR Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Keunsung [KHNP-CRI, Daejeon (Korea, Republic of); Kim, Sukhoon [FNC Technology Co., Ltd., Yongin (Korea, Republic of); Lee, Chonghui [KEPCO E and C, Yongin (Korea, Republic of)

    2015-05-15

    As part of the project for acquiring the certification from EUR organization, in accordance with Articles 4.8 and 5.5 specified in Section 2.20 of EUR Volume 2, the effects of ionizing radiation from the standard design of EU-APR on biota and ecosystems during operation and decommissioning phases shall be assessed. This assessment must be carried out according to the ERICA (i.e. Environmental Risk from Ionizing Contaminants: Assessment and management) integrated approach. This paper describes the evaluation results for unit risk quotient and relative significance by radionuclide derived from performing Tier 1 assessment on flora and fauna for the EU-APR design using ERICA Tool. As specified previously, Pa-231 and Th-228 are the most significant for the terrestrial and for the marine/freshwater ecosystems, respectively. And, in terms of environmental risk, those radionuclides having the most impact on flora and fauna are relatively more significant than isotope having the least impact by about 7 to 10 orders of magnitude.

  10. Unit Risk Quotient (RQ) and Relative Significance of Radionuclide on Flora and Fauna to the EU-APR Optimization

    International Nuclear Information System (INIS)

    Lee, Keunsung; Kim, Sukhoon; Lee, Chonghui

    2015-01-01

    As part of the project for acquiring the certification from EUR organization, in accordance with Articles 4.8 and 5.5 specified in Section 2.20 of EUR Volume 2, the effects of ionizing radiation from the standard design of EU-APR on biota and ecosystems during operation and decommissioning phases shall be assessed. This assessment must be carried out according to the ERICA (i.e. Environmental Risk from Ionizing Contaminants: Assessment and management) integrated approach. This paper describes the evaluation results for unit risk quotient and relative significance by radionuclide derived from performing Tier 1 assessment on flora and fauna for the EU-APR design using ERICA Tool. As specified previously, Pa-231 and Th-228 are the most significant for the terrestrial and for the marine/freshwater ecosystems, respectively. And, in terms of environmental risk, those radionuclides having the most impact on flora and fauna are relatively more significant than isotope having the least impact by about 7 to 10 orders of magnitude

  11. Current issues in allogeneic islet transplantation.

    Science.gov (United States)

    Chang, Charles A; Lawrence, Michael C; Naziruddin, Bashoo

    2017-10-01

    Transplantation of allogenic pancreatic islets is a minimally invasive treatment option to control severe hypoglycemia and dependence on exogenous insulin among type 1 diabetes (T1D) patients. This overview summarizes the current issues and progress in islet transplantation outcomes and research. Several clinical trials from North America and other countries have documented the safety and efficacy of clinical islet transplantation for T1D patients with impaired hypoglycemia awareness. A recently completed phase 3 clinical trial allows centres in the United States to apply for a Food and Drug Administration Biologics License for the procedure. Introduction of anti-inflammatory drugs along with T-cell depleting induction therapy has significantly improved long-term function of transplanted islets. Research into islet biomarkers, immunosuppression, extrahepatic transplant sites and potential alternative beta cell sources is driving further progress. Allogeneic islet transplantation has vastly improved over the past two decades. Success in restoration of glycemic control and hypoglycemic awareness after islet transplantation has been further highlighted by clinical trials. However, lack of effective strategies to maintain long-term islet function and insufficient sources of donor tissue still impose limitations to the widespread use of islet transplantation. In the United States, wide adoption of this technology still awaits regulatory approval and, importantly, a financial mechanism to support the use of this technology.

  12. Transplantation tolerance after total lymphoid irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Strober, S.; Slavin, S.; Fuks, Z.; Kaplan, H.S.; Gottlieb, M.; Bieber, C.; Hoppe, R.T.; Grumet, F.C.

    1979-03-01

    We have presented an animal model of tissue transplantation tolerance using the unusual effects of TLI on the immune system. The application of TLI to bone marrow and whole-organ transplantation in humans merits further study, since TLI offers several advantages over presently used therapeutic modalities. Current regimens used to prepare patients for marrow transplantation are lethal in the absence of allogeneic marrow engraftment, and marrow donors are restricted to HLA-matched siblings due to the danger of GHVD. On the other hand, TLI is a nonlethal procedure that has been used successfully in animals to transplant allogeneic marrow from unmatched donors without the development of GHVD. Thus, TLI might allow for marrow transplantation in all patients with a single sibling, whereas conventional procedures are feasible in only one of four such cases (probability of finding a single HLA-matched sibling). In addition, the induction of transplantation tolerance with TLI would obviate the requirement for the use of maintenance immunosuppressive drugs after whole-organ transplantation. Systemic infections associated with the use of these drugs currently account for the majority of deaths in heart transplant patients. Serious infectious complications associated with TLI are rare; thus this therapeutic regimen may offer considerable improvement in the long-term survival of organ graft recipients as compared to that presently obtained with immunosuppressive drugs.

  13. Transplantation in autoimmune liver diseases

    Institute of Scientific and Technical Information of China (English)

    Marcus Mottershead; James Neuberger

    2008-01-01

    Liver transplantation remains an effective treatment for those with end-stage disease and with intractable liver-related symptoms.The shortage of organs for transplantation has resulted in the need for rationing.A variety of approaches to selection and allocation have been developed and vary from country to country.The shortage of donors has meant that new approaches have to be adopted to make maximal use of the available organs;these include splitting grafts,use of extended criteria livers,livers from nonheart-beating donors and from living donors.Post transplantation, most patients will need life-long immunosuppression,although a small proportion can have immunosuppression successfully withdrawn.Newer immunosuppressive drugs and different strategies may allow a more targeted approach with a reduction in sideeffects and so improve the patient and graft survival.For autoimmune diseases, transplantation is associated with significant improvement in the quality and length of life.Disease may recur after transplantation and may affect patient and graft survival.

  14. Nutritional Therapy in Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Ahmed Hammad

    2017-10-01

    Full Text Available Protein-energy malnourishment is commonly encountered in patients with end-stage liver disease who undergo liver transplantation. Malnutrition may further increase morbidity, mortality and costs in the post-transplantation setting. The importance of carefully assessing the nutritional status during the work-up of patients who are candidates for liver replacement is widely recognized. The metabolic abnormalities induced by liver failure render the conventional assessment of nutritional status to be challenging. Preoperative loss of skeletal muscle mass, namely, sarcopenia, has a significant detrimental impact on post-transplant outcomes. It is essential to provide sufficient nutritional support during all phases of liver transplantation. Oral nutrition is preferred, but tube enteral nutrition may be required to provide the needed energy intake. Herein, the latest currently employed perioperative nutritional interventions in liver transplant recipients are thoroughly illustrated including synbiotics, micronutrients, branched-chain amino acid supplementation, immunonutrition formulas, fluid and electrolyte balance, the offering of nocturnal meals, dietary counselling, exercise and rehabilitation.

  15. Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually.

    Science.gov (United States)

    Passweg, J R; Baldomero, H; Bader, P; Bonini, C; Cesaro, S; Dreger, P; Duarte, R F; Dufour, C; Kuball, J; Farge-Bancel, D; Gennery, A; Kröger, N; Lanza, F; Nagler, A; Sureda, A; Mohty, M

    2016-06-01

    A record number of 40 829 hematopoietic stem cell transplantation (HSCT) in 36 469 patients (15 765 allogeneic (43%), 20 704 autologous (57%)) were reported by 656 centers in 47 countries to the 2014 survey. Trends include: continued growth in transplant activity, more so in Eastern European countries than in the west; a continued increase in the use of haploidentical family donors (by 25%) and slower growth for unrelated donor HSCT. The use of cord blood as a stem cell source has decreased again in 2014. Main indications for HSCT were leukemias: 11 853 (33%; 96% allogeneic); lymphoid neoplasias; 20 802 (57%; 11% allogeneic); solid tumors; 1458 (4%; 3% allogeneic) and non-malignant disorders; 2203 (6%; 88% allogeneic). Changes in transplant activity include more allogeneic HSCT for AML in CR1, myeloproliferative neoplasm (MPN) and aplastic anemia and decreasing use in CLL; and more autologous HSCT for plasma cell disorders and in particular for amyloidosis. In addition, data on numbers of teams doing alternative donor transplants, allogeneic after autologous HSCT, autologous cord blood transplants are presented.

  16. Intravenous versus oral iron supplementation for correction of post-transplant anaemia in renal transplant patients

    Directory of Open Access Journals (Sweden)

    Mudge David W

    2009-06-01

    Full Text Available Abstract Background Post-transplant anaemia remains a common problem after kidney transplantation, with an incidence ranging from nearly 80% at day 0 to about 25% at 1 year. It has been associated with poor graft outcome, and recently has also been shown to be associated with increased mortality. Our transplant unit routinely administers oral iron supplements to renal transplant recipients but this is frequently accompanied by side effects, mainly gastrointestinal intolerance. Intravenous iron is frequently administered to dialysis patients and we sought to investigate this mode of administration in transplant recipients after noticing less anaemia in several patients who had received intravenous iron just prior to being called in for transplantation. Methods This study is a single-centre, prospective, open-label, randomised, controlled trial of oral versus intravenous iron supplements in renal transplant recipients and aims to recruit approximately 100 patients over a 12-month period. Patients will be randomised to receive a single dose of 500 mg iron polymaltose (intravenous iron group or 2 ferrous sulphate slow-release tablets daily (oral iron group. The primary outcome is time to normalisation of haemoglobin post-transplant. Prospective power calculations have indicated that a minimum of 48 patients in each group would have to be followed up for 3 months in order to have a 90% probability of detecting a halving of the time to correction of haemoglobin levels to ≥110 g/l in iron-treated patients, assuming an α of 0.05. All eligible adult patients undergoing renal transplantation at the Princess Alexandra Hospital will be offered participation in the trial. Exclusion criteria will include iron overload (transferrin saturation >50% or ferritin >800 μg/l, or previous intolerance of either oral or intravenous iron supplements. Discussion If the trial shows a reduction in the time to correction of anaemia with intravenous iron or less side

  17. T cell depleted haploidentical transplantation: positive selection

    Directory of Open Access Journals (Sweden)

    Franco Aversa

    2011-06-01

    Full Text Available Interest in mismatched transplantation arises from the fact that a suitable one-haplotype mismatched donor is immediately available for virtually all patients, particularly for those who urgently need an allogenic transplant. Work on one haplotype-mismatched transplants has been proceeding for over 20 years all over the world and novel transplant techniques have been developed. Some centres have focused on the conditioning regimens and post transplant immune suppression; others have concentrated on manipulating the graft which may be a megadose of extensively T celldepleted or unmanipulated progenitor cells. Excellent engraftment rates are associated with a very low incidence of acute and chronic GVHD and regimen-related mortality even in patients who are over 50 years old. Overall, event-free survival and transplant-related mortality compare favourably with reports on transplants from sources of stem cells other than the matched sibling.

  18. Ethnic Disparities in Liver Transplantation

    OpenAIRE

    Kemmer, Nyingi

    2011-01-01

    End-stage liver disease is a major cause of morbidity and mortality among ethnic minorities. In the United States, ethnic minorities comprise approximately 30% of all adult liver transplantations performed annually. Several studies have suggested that ethnic populations differ with respect to access and outcomes in the pre- and post-transplantation setting. This paper will review the existing literature on ethnic variations in the adult liver transplantation population.

  19. CFD Analysis of Random Turbulent Flow Load in Steam Generator of APR1400 Under Normal Operation Condition

    International Nuclear Information System (INIS)

    Lim, Sang Gyu; You, Sung Chang; Kim, Han Gon

    2011-01-01

    Regulatory guide 1.20 revision 3 of the Nuclear Regulatory Committee (NRC) modifies guidance for vibration assessments of reactor internals and steam generator internals. The new guidance requires applicants to provide a preliminary analysis and evaluation of the design and performance of a facility, including the safety margins of during normal operation and transient conditions anticipated during the life of the facility. Especially, revision 3 require rigorous assessments of adverse flow effects in the steam dryer cased by flow-excited acoustic and structural resonances such as the abnormality from power-uprated BWR cases. For two nearly identical nuclear power plants, the steam system of one BWR plant experienced failure of steam dryers and the main steam system components when steam flow was increased by 16 percent for extended power uprate (EPU). The mechanisms of those failures have revealed that a small adverse flow changing from the prototype condition induced severe flow-excited acoustic and structural resonances, leading to structural failures. In accordance with the historical background, therefore, potential adverse flow effects should be evaluated rigorously for steam generator internals in both BWR and Pressurized Water Reactor (PWR). The Advanced Power Reactor 1400 (APR1400), an evolutionary light water reactor, increased the power by 7.7 percent from the design of the 'Valid Prototype', System80+. Thus, reliable evaluations of potential adverse flow effects on the steam generator of APR1400 are necessary according to the regulatory guide. This paper is part of the computational fluid dynamics (CFD) analysis results for evaluation of the adverse flow effect for the steam generator internals of APR1400, including a series of sensitivity analyses to enhance the reliability of CFD analysis and an estimation the effect of flow loads on the internals of the steam generator under normal operation conditions

  20. Challenges in renal transplantation in Yemen.

    Science.gov (United States)

    El-Nono, Ibrahiem H; Telha, Khaled A; Al-Alimy, Gamil M; Ghilan, Abdulilah M; Abu Asba, Nagieb W; Al-Zkri, Abdo M; Al-Adimi, Abdulilah M; Al-Ba'adani, Tawfiq H

    2015-02-16

    Background Renal replacement therapy was first introduced in Yemen in 1978 in the form of hemodialysis. Twenty years later, the first renal transplantation was performed. Kidney transplantations were started in socially and financially challenging circumstances in Yemen in 1998. A structured program was established and has been functioning regularly since 2005. A pediatric transplantation program was started in 2011. Material and Methods This was a prospective study of 181 transplants performed at the Urology and Nephrology Center between May 1998 and 2012. All transplants were from living related donors. The immunosuppressive protocol consisted initially of double therapy with steroid and mycophenolate mofetil (MMF). Subsequently, triple therapy with addition of a calcineurin inhibitor was introduced. Primary graft function was achieved in 176 (97.2%) recipients. Results Cold ischemia time was 48-68 min. Episodes of acute rejection in 12 patients were treated with high-dose steroids. Anti-thymocyte globulin (ATG) was used in cases of vascular or steroid-resistant rejection in 2 patients. The post-transplant complications, either surgical or medical, were comparable to those recorded in the literature. Conclusions Renal transplantation is a good achievement in our country. The patients and graft survival rates are comparable to other reports.

  1. Pre-transplant and post-transplant soluble CD30 for prediction and diagnosis of acute kidney allograft rejection.

    Science.gov (United States)

    Nafar, Mohsen; Farrokhi, Farhat; Vaezi, Mohammad; Entezari, Amir-Ebrahim; Pour-Reza-Gholi, Fatemeh; Firoozan, Ahmad; Eniollahi, Behzad

    2009-01-01

    Serum levels of soluble CD30 (sCD30) have been considered as a predictor of acute kidney allograft rejection. We have evaluated the pre-transplant and post-transplant levels of sCD30 with the aim of determining its value in predicting and diagnosing kidney rejection. We measured sCD30 serum levels before kidney transplantation, 5 days post-operatively, and at creatinine elevation episodes. The predictive value of sCD30 for diagnosing acute rejection (AR) within the first 6 post-operative months was assessed in 203 kidney recipients from living donors. Pre-transplant and post-operative levels of serum sCD30 were 58.10 +/- 52.55 and 51.55 +/- 49.65 U/ml, respectively (P = 0.12). Twenty-three patients experienced biopsy-proven acute rejection, and 28 had acute allograft dysfunction due to non-immunologic diseases. The pre-transplant sCD30 level was not different between patients with and without AR. However, post-transplant sCD30 was higher in the AR group. The median serum level of post-transplant sCD30 was 52 U/ml in the AR group and 26.3 U/ml in a control group (P sCD30 on day 5 were higher in patients with AR (P = 0.003). Based on post-transplant sCD30 levels, we were able to differentiate between kidney recipients who experienced an AR within 6 months post-surgery and those without an AR (cutoff value 41 U/ml; sensitivity 70%; specificity 71.7%). The level of sCD30 during periods of elevated serum creatinine was not independently associated with the diagnosis of AR. Post-transplant sCD30 levels and their relative changes are higher in patients experiencing AR. We propose further studies on the post-transplant trend of this marker for the prediction of AR.

  2. Laparoscopic cholecystectomy in a cardiac transplant recipient.

    Science.gov (United States)

    Pandya, Seema R; Paranjape, Saloni

    2014-04-01

    An increasing number of cardiac transplants are being carried out around the world. With increasing longevity, these patients present a unique challenge to non-transplant anesthesiologists for a variety of transplant related or incidental surgeries. The general considerations related to a cardiac transplant recipient are the physiological and pharmacological problems of allograft denervation, the side-effects of immunosuppression, the risk of infection and the potential for rejection. A thorough understanding of the physiology of a denervated heart, need for direct vasoactive agents and post-transplant morbidities is essential in anesthetic management of such a patient. Here, we describe a case of a heart transplant recipient who presented for a cholecystectomy at our center.

  3. Pediatric liver transplantation in 31 consecutive children

    Institute of Scientific and Technical Information of China (English)

    SHEN Zhong-yang; WANG Zi-fa; ZHU Zhi-jun; ZANG Yun-jin; ZHENG Hong; DENG Yong-lin; PAN Cheng; CHEN Xin-guo

    2008-01-01

    Background Although liver transplantation has become a standard therapy for end-stage liver diseases, the experience of pediatric liver transplantation is limited in China. In this article we report our experience in pediatric liver transplantation, and summarize its characters in their indications, surgical techniques, and postoperative managements. Methods Thirty-one children (≤18 years old) underwent liver transplantation in our centers. The mean age at transplantation was 12.4 years old (ranged from 5 months to 18 years) with 7 children being less than 4 years of age at transplantation. The most common diagnosis of patients who underwent liver transplantation were biliary atresia, Wilson's disease, primary biliary cirrhosis, glycogen storage disease, hepatoblastoma, urea cycle defects, fulminant hepatic failure, etc. The surgical procedures included 12 standard (without venovenous bypass), 6 pigyback, 6 reduced-size, 3 split, 3 living donor liver transplantation, and 1 Domino liver transplantation. The triple-drug (FK506, steroid, and mycophenolate mofetil) immunosuppressive regimen was used in most of patients. Patients were followed up for a mean of 21.8 months. Results Five of the 31 patients died during perioperative time; mortality rate was 16.1%. The reasons of death were infections, primary non-function, heart failure, and hypovolemic shock. Postoperative complications in 10 patients included biliary leakage, acute rejection, abdominal infection, hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, and pulmonary infection. Overall patient cumulative survival rate at 1-, 3-, and 5-year was 78.1%, 62.6%, 62.6%, respectively.Conclusions The most common indications of pediatric liver transplantation were congenital end-stage liver diseases. According to patients' age and body weight, standard, piggyback, reduced-size, split, or living donor liver transplantation should be performed. Pediatric liver transplantation especially requires higher

  4. Renal transplant scintigraphy (Part 1)

    International Nuclear Information System (INIS)

    Chew, Ghee

    2005-01-01

    Renal transplantation is the most effective mode of renal replacement therapy for correction of renal failure. Renal donors can either be: a. a deceased person - the kidneys being removed when brain death or absence of cerebral cortical function / perfusion is confirmed - the cadaveric kidney is packed in ice and nutrient solution and transplanted within 24 hours of removal ('cold ischemia') ob. a living donor - the donor may or may not be related to the recipient. Due to the limited length of the renal vessels and ureter of the donor kidney, it is implanted close to the bladder of the recipient. The donor vessels are anastomosed to the iliac artery and vein of the recipient. Transplant variants: a. 2 kidneys maybe transplanted because: - an old donor with less kidney reserve from atrophy due to age or disease (e.g. hypertension) - an infant donor when both kidneys are removed en bloc, b. Donor kidneys with more than 1 artery, vein or ureter. c. Donor horse shoe kidney d. Combined renal and pancreas transplant for type I diabetics -a short segment of duodenum transplanted with the pancreas maybe implanted into the bladder. Copyright (2005) The Australian and New Zealand Society of Nuclear Medicine

  5. Sociological and ethical issues in transplant commercialism.

    Science.gov (United States)

    Epstein, Miran

    2009-04-01

    'Global transplant commercialism' (practices and policies involving international trade in organs from living vendors, e.g., 'transplant tourism') is currently subjected to unprecedented criticism. In parallel, the debate around 'local transplant commercialism' (practices and policies that confine trade in organs from living vendors to national markets or economic unions) is heating up. In an attempt to assess the potential outcomes of these trends, this article reviews and discusses some sociological and ethical issues, ending with a proposal for a reinvigorated anticommercialist strategy. The current international campaign against global transplant commercialism is conducted by an ad hoc alliance between strange bedfellows, proponents of local transplant commercialism on the one hand and opponents of any transplant commercialism on the other. Disparities in the rigor of the respective ethical discourses, the expanding list of precedents of legitimized commerce in the human body, and the political economy of transplantation, all suggest that the former have the upper hand. Recent achievements in the struggle against international organ trafficking may not herald the abolition of transplant commercialism but rather presage its reconfiguration in deglobalized forms. In light of such a prospect, those who wish to prevent the pervasive commodification of the human body from entering the gates of transplant medicine should consider devising a new, perhaps more radical, strategy.

  6. [Lung transplantation: supply and demand in France].

    Science.gov (United States)

    Stern, M; Souilamas, R; Tixier, D; Mal, H

    2008-10-01

    For a decade lung transplantation has suffered from a lack of donor organs which aroused a national debate and led to planned action in collaboration with The French National Agency for Transplantation. Analysis of the stages of the process from potential donor to lung transplantation identified lung procurement as the main priority. An increase in the number of potential lung donors and revision of the acceptance criteria led to a doubling of the annual rate of lung transplantation in less than two years. In the near future we may solve the problem of donor family refusals and establish scientifically based criteria for lung acceptance to increase the rate of lung transplantation. Transplantation from non heart-beating donors and the reconditioning of ex vivo non acceptable lungs might supply additional organs to fulfill demand in the long term. The rate of lung transplantation activity in France doubled as the result of a dramatic increase of donor lung proposals. The current improvement in the results of lung transplantation might create new demands and generate future difficulties in the supply of donor lungs. New approaches, such as transplantation from non heart-beating donors and reconditioning ex vivo non acceptable lungs, should be examined in the near future.

  7. Diabetic Foot Complications Despite Successful Pancreas Transplantation.

    Science.gov (United States)

    Seo, Dong-Kyo; Lee, Ho Seong; Park, Jungu; Ryu, Chang Hyun; Han, Duck Jong; Seo, Sang Gyo

    2017-06-01

    It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes. The mean age was 40.7 (range, 15-76) years. Diabetes type, transplantation type, body mass index, and diabetes duration before transplantation were confirmed. After pancreas transplantation, the occurrence and duration of foot and ankle complications were assessed. Twenty-two patients (10.1%) had diabetic foot complications. Fifteen patients (6.9%) had diabetic foot ulcer and 7 patients (3.2%) had Charcot arthropathy. Three patients had both diabetic foot ulcer and Charcot arthropathy. Three insufficiency fractures (1.4%) were included. Mean time of complications after transplantation was 18.5 (range, 2-77) months. Creatinine level 1 year after surgery was higher in the complication group rather than the noncomplication group ( P = .02). Complications of the foot and ankle still occurred following pancreas transplantation in patients with diabetes. Level III, comparative study.

  8. An examination of photoacclimatory responses of Zostera marina transplants along a depth gradient for transplant-site selection in a disturbed estuary

    Science.gov (United States)

    Li, Wen-Tao; Kim, Seung Hyeon; Kim, Jae Woo; Kim, Jong-Hyeob; Lee, Kun-Seop

    2013-02-01

    Growth and photosynthetic responses of Zostera marina transplants along a depth gradient were examined to determine appropriate transplanting areas for seagrass restoration. Seagrass Z. marina was once widely distributed in the Taehwa River estuary in southeastern Korea, but has disappeared since the 1960s due to port construction and large scale pollutant inputs from upstream industrial areas. Recently, water quality has been considerably improved as a result of effective sewage treatment, and the local government is attempting to restore Z. marina to the estuary. For seagrass restoration in this estuary, a pilot transplantation trial of Z. marina at three water depths (shallow: 0.5 m; intermediate: 1.5 m; deep: 2.5 m relative to MLLW) was conducted in November 2008. The transplant shoot density increased gradually at the intermediate and deep sites, whereas the transplants at the shallow site disappeared after 3 months. To find the optimal transplantation locations in this estuary, the growth and photosynthetic responses of the transplants along a depth gradient were examined for approximately 4 months following transplantation in March 2009. In the 2009 experimental transplantation trial, shoot density of transplants at the shallow site was significantly higher than those at the intermediate and deep sites during the first 3 months following transplantation, but rapidly decreased approximately 4 months after transplantation. The chlorophyll content, photosynthetic efficiency (α), and maximum quantum yield (Fv/Fm) of the transplants were significantly higher at the deep site than at the shallow site. Shoot size, biomass and leaf productivity were also significantly higher at the deep site than at the shallow site. Although underwater irradiance was significantly lower at the deep site than at the shallow site, transplants at the deep site were morphologically and physiologically acclimated to the low light. Transplants at the shallow site exhibited high

  9. Bone marrow transplantation immunology

    International Nuclear Information System (INIS)

    Trentin, J.J.; Kiessling, R.; Wigzell, H.; Gallagher, M.T.; Datta, S.K.; Kulkarni, S.S.

    1977-01-01

    Tests were made to determine whether genetic resistance (GR) to bone marrow transplantation represents a natural lymphoma-leukemia defense mechanism, as follows: (C57 x AKR) F 1 hybrid mice show GR to C57 parental bone marrow cells, but not to AKR parental bone marrow cells (C3H x AKR) F 1 hybrids show no GR to bone marrow transplantation from either parental strain. However, transplantation of AKR lymphoma cells into lethally irradiated ''resistant'' (C57 x AKR) F 1 and ''nonresistant'' (C3H x AKR) F 1 hybrids produced lymphomatous spleen colonies in ''nonresistant'' hybrids but not in ''resistant'' hybrids. Thus ''resistant'' (C57 x AKR) F 1 hybrids can recognize and reject AKR lymphoma cells, but not normal AKR bone marrow cells. A normal biologic role of leukemia-lymphoma surveillance was postulated for genetic resistance to marrow transplantation, directed at antigens which, like TL, are expressed on normal hemopoietic cells of some strains, but only on leukemic cells of other strains

  10. Clinical aspects of bone marrow transplantation

    International Nuclear Information System (INIS)

    Shmitts, N.; Gassmann, V.; Leffler, G.

    1986-01-01

    Experience of bone marrow transplantation into patients with myeloproliferative syndromes, myelodysplasias and highly malignant lymphomas is presented. Side early and late effects of transplantation are described. The frequency and severity of complications of bone marrow transplantation depend sufficiently on the disease as well as on patient's age and general condition

  11. Medicine non-adherence in kidney transplantation.

    Science.gov (United States)

    Williams, Allison Fiona; Manias, Elizabeth; Gaskin, Cadeyrn J; Crawford, Kimberley

    2014-06-01

    The increasing prevalence of chronic kidney disease, the relative shortage of kidney donors and the economic- and health-related costs of kidney transplant rejection make the prevention of adverse outcomes following transplantation a healthcare imperative. Although strict adherence to immunosuppressant medicine regimens is key to preventing kidney rejection, evidence suggests that adherence is sub-optimal. Strategies need to be developed to help recipients of kidney transplants adhere to their prescribed medicines. This review has found that a number of factors contribute to poor adherence, for example, attitudes towards medicine taking and forgetfulness. Few investigations have been conducted, however, on strategies to enhance medicine adherence in kidney transplant recipients. Strategies that may improve adherence include pharmacist-led interventions (incorporating counselling, medicine reviews and nephrologist liaison) and nurse-led interventions (involving collaboratively working with recipients to understand their routines and offering solutions to improve adherence). Strategies that have shown to have limited effectiveness include supplying medicines free of charge and providing feedback on a participant's medicine adherence without any educational or behavioural interventions. Transplantation is the preferred treatment option for people with end-stage kidney disease. Medicine non-adherence in kidney transplantation increases the risk of rejection, kidney loss and costly treatments. Interventions are needed to help the transplant recipient take all their medicines as prescribed to improve general well-being, medicine safety and reduce healthcare costs. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  12. Small Bowel Transplantation: Current Clinical Status

    Directory of Open Access Journals (Sweden)

    David Sigalet

    1991-01-01

    Full Text Available With recent refinements in immunosuppression techniques, the first successful reports of small bowel transplantation in humans have now been made, increasing interest in bowel transplantation among clinicians and patients alike. This article reviews recent developments in understanding of the functional capabilities and requirements for effective immune suppression in bowel transplantation. Both experimental and clinical experience with transplantation are discussed, as are the areas which appear to offer the most promise for future developments. Finally guidelines for consideration of patient selection for this procedure are reviewed.

  13. Preliminary design of S-CO{sub 2} Brayton cycle for APR-1400 with power generation and desalination process

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Seong Jun; Lee, Won Woong; Jeong, Yong Hoon; Lee, Jeong Ik [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [KUSTAR, Abu Dhabi (United Arab Emirates)

    2015-10-15

    This study was conducted to explore the capabilities of the S-CO{sub 2} Brayton cycle for a cogeneration system for APR-1400 application. Three concepts of the S-CO{sub 2} simple recuperated co-generation cycle were designed. A supercritical CO{sub 2} (S-CO{sub 2}) Brayton cycle is recently receiving significant attention as a promising power conversion system in wide range of energy applications due to its high efficiency and compact footprint. The main reason why the S-CO{sub 2} Brayton cycle has these advantages is that the compressor operates near the critical point of CO{sub 2} (30.98 .deg. C, 7.38MPa) to reduce the compression work significantly compared to the other Brayton cycles. In this study, the concept of replacing the entire steam cycle of APR-1400 with the S-CO{sub 2} Brayton cycle is evaluated. The power generation purpose S-CO{sub 2} Brayton cycles are redesigned to generate power and provide heat to the desalination system at the same time. The performance of these newly suggested cycles are evaluated in this paper. The target was to deliver 147MW heat to the desalination process. The thermal efficiencies of the three concepts are not significantly different, but the 3{sup rd} concept is relatively simpler than other cycles because only an additional heat exchanger is required. Although the 2{sup nd} concept is relatively complicated in comparison to other concepts, the temperatures at the inlet and outlet of the DHX are higher than that of the others. As shown in the results, the S-CO{sub 2} Brayton cycles are not easy to outperform the steam cycle with very simple layout and general design points under APR-1400 operating condition. However, this study shows that the S-CO{sub 2} Brayton cycles can be designed as a co-generation cycle while producing the target desalination heat with a simple configuration. In addition, it was also found that the S-CO{sub 2} Brayton cycle can achieve higher cycle thermal efficiency than the steam power cycle under

  14. Social participation after successful kidney transplantation.

    Science.gov (United States)

    van der Mei, Sijrike F; van Sonderen, Eric L P; van Son, Willem J; de Jong, Paul E; Groothoff, Johan W; van den Heuvel, Wim J A

    2007-03-30

    To explore and describe the degree of social participation after kidney transplantation and to examine associated factors. A cross-sectional study on 239 adult patients 1-7.3 years after kidney transplantation was performed via in-home interviews on participation in obligatory activities (i.e., employment, education, household tasks) and leisure activities (volunteer work, assisting others, recreation, sports, clubs/associations, socializing, going out). Kidney transplantation patients had a lower educational level, spent less time on obligatory activities, had part-time jobs more often, and participated less in sports compared to a control group from the general population. No difference was found in socializing, church attendance, volunteer work and going out. Multivariate regression analysis showed a negative association of age and a positive association of educational status and time since transplantation with obligatory participation. Multivariate logistic regression showed positive associations of education and time since transplantation with volunteer work; age was negatively and education positively associated with sports and going out, whereas living arrangement was also associated with going out. Although kidney transplantation patients participate less in employment and sports, they do participate in household tasks, volunteer work, going out, socializing and other leisure activities. Participation is associated with factors as age, educational status and time since transplantation.

  15. Pulmonary Infection In Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Rassulineiad M

    2003-11-01

    Full Text Available Renal transplantation is ideal treatment of chronic renal failure. Pulmonary infection is a common and serious post transplant infection requiring hospitalization and is associated with high mortality. Increased susceptibility to infection is due to a decrease in the patients' immunological response caused by immunosuppression through drug administration, and by other influences."nMaterials and Methods: This study was case series and prospective, from July 2001 to July 2002 in Imam Khomeini hospital of Tehran."nResults: 164 renal transplant recipients were studied, 14 patients (8.5% had pulmonary infection, 11 of them (78.6% were female and 3 (21.4% were male. The mean age of them was 42.6 years. The patients were followed up for 9 to 12 months. All patients were on triple immunosuppressive regimens. The interval between transplantation and the appearance of pneumonia was 2 months to 10 years. The time of beginning infection in 3 cases (21.4% was between 1 to 6 months post transplantation, 11 cases (78.6% were occurred beyond 6 months after transplantation. In 7 cases (50%, pulmonary infection was occurred during first year after transplantation. None of the 14 patients developed pulmonary infection in first month after transplantation. BAL were used in 6 cases (42.8% of pulmonary infection, and organism were detected in 5 of them (83.3%. The most common clinical feature was fever. Six cases were due to mycobacterium tuberculosis (42.9%, this organism was the most common ethiology of pneumonia. In this study tuberculosis was seen in 3.6% of renal transplant recipients. One patient had pulmonary mucormycosis. All patients with pulmonary TB were cured, and other cases with unknown case, were cured with empirical treatment."nConclusion: Our finding indicate the invasive diagnostic procedures are required in order to earlier and reliable diagnosis and then better outcome of transplantation."n"n"n"n"n"n"n 

  16. Appraisal of the coordinator-based transplant organizational model.

    Science.gov (United States)

    Filipponi, F; De Simone, P; Mosca, F

    2005-01-01

    In 1999, the Italian Parliament passed a law aimed at setting the standards of practice and quality in organ, tissue and cell donation, and transplantation. For the first time in the history of Italian transplantation, a coordinator-based model reproducing some of the basic principles of the Spanish system was officially enacted by the Parliament, bringing to an end years of lacking regulation. What differentiates those coordinator-based systems adopted in Southern Europe from Northern European national and multinational transplant organizations is the functional integration of donor and transplant care activities enacted by national governments. The Italian model of transplant health care consists of four levels of transplant coordination: local, regional, interregional, and national. The latter is represented by Centro Nazionale Trapianti (CNT; the Italian National Center for Transplantation). CNT objectives consist of ensuring equitable access to donation and transplant care for all citizens according to the principles of the Italian National Health System. In achieving these goals, CNT acts in cooperation with three interregional transplant agencies: the Nord Italia Transplant program, the Associazione InterRegionale Trapianti, and the Organizzazione Centro Sud Trapianti. Whereas local and interregional coordinators are at the front line of all donation and transplant activities, regional and national coordinators function to monitor, direct, and plan donation and transplant health care activities. Based on the increase in donation and transplant activities recently achieved in those countries that have adopted a governmental coordinator-based transplant care model, we believe that such a system is appropriate to serve patients' interests according to the principles of subsidiary and equity. However, it should further be improved by expansion of the governance model throughout Europe, through implementation of current standards of care, and by adopting the

  17. An economic assessment of contemporary kidney transplant practice.

    Science.gov (United States)

    Axelrod, David A; Schnitzler, Mark A; Xiao, Huiling; Irish, William; Tuttle-Newhall, Elizabeth; Chang, Su-Hsin; Kasiske, Bertram L; Alhamad, Tarek; Lentine, Krista L

    2018-05-01

    Kidney transplantation is the optimal therapy for end-stage renal disease, prolonging survival and reducing spending. Prior economic analyses of kidney transplantation, using Markov models, have generally assumed compatible, low-risk donors. The economic implications of transplantation with high Kidney Donor Profile Index (KDPI) deceased donors, ABO incompatible living donors, and HLA incompatible living donors have not been assessed. The costs of transplantation and dialysis were compared with the use of discrete event simulation over a 10-year period, with data from the United States Renal Data System, University HealthSystem Consortium, and literature review. Graft failure rates and expenditures were adjusted for donor characteristics. All transplantation options were associated with improved survival compared with dialysis (transplantation: 5.20-6.34 quality-adjusted life-years [QALYs] vs dialysis: 4.03 QALYs). Living donor and low-KDPI deceased donor transplantations were cost-saving compared with dialysis, while transplantations using high-KDPI deceased donor, ABO-incompatible or HLA-incompatible living donors were cost-effective (<$100 000 per QALY). Predicted costs per QALY range from $39 939 for HLA-compatible living donor transplantation to $80 486 for HLA-incompatible donors compared with $72 476 for dialysis. In conclusion, kidney transplantation is cost-effective across all donor types despite higher costs for marginal organs and innovative living donor practices. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

  18. HLA in bone marrow transplantation

    International Nuclear Information System (INIS)

    Tsuji, Kimiyoshi

    1989-01-01

    It has been well understood that human major histocompatibility antigen system, HLA is the most important role in the allo transplantation. Therefore, the structure of HLA genes was presented by the recent information (1987). Moreover, their functions in vitro and in vivo also were described. Finally, bone marrow transplantation and HLA network system in Japan against HLA mismatched case was proposed. It is eagerly expected that functional and clinical bone marrow transplantation in Japan could be succeeded. (author)

  19. Fixing Flawed Body Parts: Engineering New Tissues and Organs

    Science.gov (United States)

    ... Nat Commun . 2014 Jun 10;5:4047. doi: 10.1038/ncomms5047. PMID: 24915161. Regeneration and experimental orthotopic transplantation ... Med. 2013 May;19(5):646-51. doi: 10.1038/nm.3154. Epub 2013 Apr 14. PMID: 23584091. ...

  20. Transplantation of Hearts Donated after Circulatory Death

    Directory of Open Access Journals (Sweden)

    Christopher W. White

    2018-02-01

    Full Text Available Cardiac transplantation has become limited by a critical shortage of suitable organs from brain-dead donors. Reports describing the successful clinical transplantation of hearts donated after circulatory death (DCD have recently emerged. Hearts from DCD donors suffer significant ischemic injury prior to organ procurement; therefore, the traditional approach to the transplantation of hearts from brain-dead donors is not applicable to the DCD context. Advances in our understanding of ischemic post-conditioning have facilitated the development of DCD heart resuscitation strategies that can be used to minimize ischemia-reperfusion injury at the time of organ procurement. The availability of a clinically approved ex situ heart perfusion device now allows DCD heart preservation in a normothermic beating state and minimizes exposure to incremental cold ischemia. This technology also facilitates assessments of organ viability to be undertaken prior to transplantation, thereby minimizing the risk of primary graft dysfunction. The application of a tailored approach to DCD heart transplantation that focuses on organ resuscitation at the time of procurement, ex situ preservation, and pre-transplant assessments of organ viability has facilitated the successful clinical application of DCD heart transplantation. The transplantation of hearts from DCD donors is now a clinical reality. Investigating ways to optimize the resuscitation, preservation, evaluation, and long-term outcomes is vital to ensure a broader application of DCD heart transplantation in the future.

  1. The ethics of uterus transplantation.

    Science.gov (United States)

    Catsanos, Ruby; Rogers, Wendy; Lotz, Mianna

    2013-02-01

    Human uterus transplantation (UTx) is currently under investigation as a treatment for uterine infertility. Without a uterus transplant, the options available to women with uterine infertility are adoption or surrogacy; only the latter has the potential for a genetically related child. UTx will offer recipients the chance of having their own pregnancy. This procedure occurs at the intersection of two ethically contentious areas: assisted reproductive technologies (ART) and organ transplantation. In relation to organ transplantation, UTx lies with composite tissue transplants such as face and limb grafts, and shares some of the ethical concerns raised by these non-life saving procedures. In relation to ART, UTx represents one more avenue by which a woman may seek to meet her reproductive goals, and as with other ART procedures, raises questions about the limits of reproductive autonomy. This paper explores the ethical issues raised by UTx with a focus on the potential gap between women's desires and aspirations about pregnancy and the likely functional outcomes of successful UTx. © 2011 Blackwell Publishing Ltd.

  2. Post-transplant survival in idiopathic pulmonary fibrosis patients concurrently listed for single and double lung transplantation.

    Science.gov (United States)

    Chauhan, Dhaval; Karanam, Ashwin B; Merlo, Aurelie; Tom Bozzay, P A; Zucker, Mark J; Seethamraju, Harish; Shariati, Nazly; Russo, Mark J

    2016-05-01

    Lung transplantation is a widely accepted treatment for patients with end-stage lung disease related to idiopathic pulmonary fibrosis (IPF). However, there are conflicting data on whether double lung transplant (DLT) or single lung transplant (SLT) is the superior therapy in these patients. The purpose of this study was to determine whether actuarial post-transplant graft survival among IPF patients concurrently listed for DLT and SLT is greater for recipients undergoing the former or the latter. The United Network for Organ Sharing provided de-identified patient-level data. Analysis included lung transplant candidates with IPF listed between January 1, 2001 and December 31, 2009 (n = 3,411). The study population included 1,001 (29.3%) lung transplant recipients concurrently listed for DLT and SLT, all ≥18 years of age. The primary outcome measure was actuarial post-transplant graft survival, expressed in years. Among the study population, 433 (43.26%) recipients underwent SLT and 568 (56.74%) recipients underwent DLT. The analysis included 2,722.5 years at risk, with median graft survival of 5.31 years. On univariate (p = 0.317) and multivariate (p = 0.415) regression analyses, there was no difference in graft survival between DLT and SLT. Among IPF recipients concurrently listed for DLT and SLT, there is no statistical difference in actuarial graft survival between recipients undergoing DLT vs SLT. This analysis suggests that increased use of SLT for IPF patients may increase the availability of organs to other candidates, and thus increase the net benefit of these organs, without measurably compromising outcomes. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Technology and outcomes assessment in lung transplantation.

    Science.gov (United States)

    Yusen, Roger D

    2009-01-15

    Lung transplantation offers the hope of prolonged survival and significant improvement in quality of life to patients that have advanced lung diseases. However, the medical literature lacks strong positive evidence and shows conflicting information regarding survival and quality of life outcomes related to lung transplantation. Decisions about the use of lung transplantation require an assessment of trade-offs: do the potential health and quality of life benefits outweigh the potential risks and harms? No amount of theoretical reasoning can resolve this question; empiric data are needed. Rational analyses of these trade-offs require valid measurements of the benefits and harms to the patients in all relevant domains that affect survival and quality of life. Lung transplant systems and registries mainly focus outcomes assessment on patient survival on the waiting list and after transplantation. Improved analytic approaches allow comparisons of the survival effects of lung transplantation versus continued waiting. Lung transplant entities do not routinely collect quality of life data. However, the medical community and the public want to know how lung transplantation affects quality of life. Given the huge stakes for the patients, the providers, and the healthcare systems, key stakeholders need to further support quality of life assessment in patients with advanced lung disease that enter into the lung transplant systems. Studies of lung transplantation and its related technologies should assess patients with tools that integrate both survival and quality of life information. Higher quality information obtained will lead to improved knowledge and more informed decision making.

  4. Predictors of hyperparathyroidism in renal transplant recipients

    International Nuclear Information System (INIS)

    Houssaini, T.S.; Arrayahani, M.; Rhou, H.; Amar, Y.; Benamar, L.; Ouzeddoun, N.; Bayahia, R.

    2008-01-01

    The changes in parathyroid hormone secretion after successful renal transplantation remain to be clearly elucidated. Our study was aimed at identifying the predictors of hyperparathyroidism in renal transplant recipients. A retrospective single center study involving 37 renal transplant recipients, with a follow-up of at least one year, was performed. All transplants were performed using kidneys from living related donors. The average age of study patients was 30+-10 years, with a male-female ratio of 1.31. The mean duration on hemodialysis (HD) prior to transplantation was 25+-18 months. All the grafts but one were functional after a mean follow-up of 41+-21 months. We noted a rapid reduction of the mean parathyroid hormone (iPTH) level from 383+-265 pg/ml before transplantation to 125+-67 pg/ml at one year and 108+-66 pg/ml at two years after transplantation (p=0.01). Bivariate analysis revealed that the level of iPTH obtained during follow-up correlated with the duration on HD (p=0.03), the serum creatinine at 24-months (p=0.013), and to the level of iPTH in the first year post transplantation (P=<0.001). Other clinical or laboratory parameters were not predictive of hyperparathyroidism after kidney transplantation. Liner regression showed that only the serum creatinine at 24-months independently correlated with the level of iPTH at last follow-up (p=0.02). Our study suggests that short duration on HD and a functional graft are the main predictors of correction of hyperparathyroidism after renal transplantation. (author)

  5. Native kidney reincarnation following a failed transplant

    International Nuclear Information System (INIS)

    Mansberg, R.; Roberts, J.M.

    2002-01-01

    Full text: A 51-year-old woman with end stage renal failure secondary to Haemolytic Uraemic syndrome underwent a cadaveric renal transplant. A routine post transplant DTPA scan was performed which demonstrated satisfactory renal transplant perfusion and function. Incidental note was made of tracer uptake in the pelvis in the mid-line, which was suspected to be a uterine fibroid. This was confirmed on ultrasonography and at surgery. One week post transplantation the patient became acutely unwell and at laparotomy a perforated diverticular abscess was drained. Intraoperatively the transplant kidney was examined and the surgeon thought there was a area of infarction. This was confirmed on biopsy. As the patient's creatinine was rising a repeat DTPA study was performed. Perfusion and function of the transplant kidney was virtually absent while Doppler studies showed no flow. The patient however continued to produce urine and the creatinine was stable. Subsequently a mercaptoacetyltriglycine (MAG) 3 study was performed which again confirmed absent perfusion and function by the the transplanted kidney as well as the previous noted uterine fibroid. The native kidneys however demonstrated good perfusion and function. The patient's renal function remained stable and she did not require dialysis. A necrotic infarcted transplant kidney was removed uneventfully. This case illustrates the importance of imaging the native kidneys as well as the transplant kidney when there are puzzling clinical features. The presumed cause of the recovery of native renal function was the immunosuppression given for the transplant. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  6. Faecal microbiota transplantation

    DEFF Research Database (Denmark)

    Jørgensen, Simon M D; Hansen, Mette Mejlby; Erikstrup, Christian

    2017-01-01

    BACKGROUND: Faecal microbiota transplantation (FMT) is currently being established as a second-line treatment for recurrent Clostridium difficile infection. FMT is further being considered for other infectious and inflammatory conditions. Safe and reproducible methods for donor screening, laborat......BACKGROUND: Faecal microbiota transplantation (FMT) is currently being established as a second-line treatment for recurrent Clostridium difficile infection. FMT is further being considered for other infectious and inflammatory conditions. Safe and reproducible methods for donor screening...

  7. [Melanoma in organ transplant patients].

    Science.gov (United States)

    Lévêque, L; Dalac, S; Dompmartin, A; Louvet, S; Euvrard, S; Catteau, B; Hazan, M; Schollhamer, M; Aubin, F; Dreno, B; Daguin, P; Chevrant-Breton, J; Frances, C; Bismuth, M J; Tanter, Y; Lambert, D

    2000-02-01

    The incidence of cutaneous melanoma has rapidly increased in the white population over the last decades. It has been estimated that the incidence doubles world-wide every 10 years. Different risk factors have been identified, including immunosuppression. The aim of our study-was to determine the relative risk of developing melanoma in the organ transplant population and the clinical and histological features of their melanomas. This retrospective study was conducted with the collaboration of 9 University Hospital Centers: Besançon, Brest, Caen, Dijon, Lille, Lyon, Nantes, Paris (Pitié-Salpétrière) and Rennes. A questionnaire was sent to the different departments of dermatology of these hospitals to obtain information on patients who had presented a melanoma after a transplantation between 1971 and 1997. During this period, there were 12,477 organ transplant recipients in the transplantation units of these 9 hospitals. Average follow-up for these patients was about 5 years and the average duration of immunosuppressive therapy was about 4.5 years. Among 12,477 organ transplant recipients, we found 17 cases of melanoma but no data could be obtain on one case: 14 occurred in renal transplant recipients and 3 in cardiac transplant recipients. Clinical and histological data were only available in 16 patients. The average time between transplantation and diagnosis of melanoma was 63 months, but it was 5 times shorter for 2 patients who had a past history of melanoma before transplantation. Two patients had a mucosal melanoma; for the cutaneous melanomas, 2 appeared on Dubreuilh melanosis, 2 were in situ melanomas, 7 were superficial spreading melanomas and 3 were nodular melanomas. The histological review of 11 cutaneous melanomas revealed a precursor nevus in 6 cases and a weak or no stroma reaction in 7/7 cases. Complete excision of the melanoma was performed in all patients except one with anorectal melanoma. Four patients died of visceral metastasis within a mean

  8. Post-transplantation Development of Food Allergies.

    Science.gov (United States)

    Newman, Erik N; Firszt, Rafael

    2018-01-29

    The development of food allergies is increasingly being recognized as a post-solid organ transplant complication. In this article, we review the spectrum of post-transplant food allergy development and the proposed mechanisms for de novo food allergies and the clinical significance they pose. The development of new food allergies is disproportionately associated with pediatric liver transplants, where it occurs in up to 38% of select populations. The mechanism of food allergy development is not completely understood; however, it is likely promoted by unbalanced immune suppression. De novo food allergy development is a common complication of solid organ transplants with the highest risk occurring in pediatric liver transplant recipients. There are likely multiple mechanisms for food allergy development including passive transfer of membrane-bound IgE and lymphocytes from donor to recipient, as well as loss of food tolerance and active development of new food allergies. The optimal management of food allergies following organ transplants has not been well researched but may include changing the immune suppression regimen if the food allergy does not resolve without intervention.

  9. Overview of marrow transplantation

    International Nuclear Information System (INIS)

    Thomas, E.D.

    1985-01-01

    Bone marrow transplantation is now an accepted form of therapy for many hematologic disorders including aplastic anemia, genetically determined diseases and malignant diseases, particularly leukemia, and for rescue of patients given intensive chemoradiotherapy for malignant disease. The donor may be a healthy identical twin, a family member or even an unrelated person. Selection is made on the basis of human leukocyte antigen tissue typing. Intensive chemoradiotherapy is used to suppress patients' immune systems to facilitate engraftment and destroy diseased marrow. Transfusion of platelets, erythrocytes and granulocytes (or all of these), antibiotic coverage and protection from infection are necessary during the pancytopenic period. Survival rates vary considerably depending on a patient's disease, clinical state and age. Patients with aplastic anemia transplanted early in the course of their disease have a survival rate of approximately 80%. Patients with acute lymphoblastic leukemia are usually transplanted in a second or subsequent remission and have a survival rate of 25% to 40%. Patients with acute nonlymphoblastic leukemia in remission have survivals ranging from 45% to 70%. More than 200 patients in the chronic phase of chronic granulocytic leukemia have been transplanted with survival ranging from 50% to 70%. Complications of marrow transplantation include marrow graft rejection, graft-versus-host disease, immunologic insufficiency and the possibility of recurrence of the leukemia. 14 references

  10. Depression and Liver Transplant Survival.

    Science.gov (United States)

    Meller, William; Welle, Nicole; Sutley, Kristen; Thurber, Steven

    Patients who underwent liver transplantation and experienced clinical depression have heretofore evinced lower survival rates when compared to nondepressed counterparts. To investigate the hypothesis that transplant patients who seek and obtain medical treatment for depression would circumvent the prior reduced survival findings. A total of 765 patients with liver transplants were scrutinized for complications following transplantation. Further, 104 patients experienced posttransplant depression as manifested by diagnosis and treatment by medical personnel. Survival analyses were conducted comparing hazard and survival curves for these selected individuals and the remainder of transplant patients. Contrary to prior data and consistent with the aforementioned hypothesis, median survival durations, survival curves, and hazard functions (controlling for age and prolonged posttransplant survival for the depressed patients were better. The improved survival for the depressed patients may simply be related to an amelioration of depressed symptoms via antidepressant medications. However, this interpretation would only be congruent with reduced hazard, not elevated survival, beyond the norm (median) for other transplant participants. Assuming the reliability and generalization of our findings, perhaps a reasonable and compelling interpretation is that combined with the effectiveness of antidepressant medications, the seeking and receiving treatment for depression is a type of proxy measure of a more global pattern of adherence to recommended posttransplant medical regimens. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  11. Bone Marrow Transplantation: MedlinePlus Health Topic

    Science.gov (United States)

    ... marrow transplant - discharge (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Bone Marrow Transplantation ... transplant - slideshow Graft-versus-host disease Related Health Topics Bone Marrow Diseases Stem Cells National Institutes of ...

  12. Liver Transplantation: Evolving Patient Selection Criteria

    Directory of Open Access Journals (Sweden)

    Andy S Yu

    2001-01-01

    Full Text Available The widespread recognition of the success of liver transplantation as a treatment for most types of acute and chronic liver failure has led to increased referrals for transplantation in the setting of a relatively fixed supply of cadaver donor organs. These events have led to a marked lengthening of the waiting time for liver transplantation, resulting in increased deaths of those on the waiting list and sicker patients undergoing transplantation. Nearly 5000 liver transplantations were performed in the United States in 2000, while the waiting list grew to over 17,000 patients. The mounting disparity between the number of liver transplant candidates and the limited supply of donor organs has led to reassessment of the selection and listing criteria for liver transplantation, as well as revision of organ allocation and distribution policies for cadaver livers. The development of minimal listing criteria for patients with chronic liver disease based on a specific definition for decompensation of cirrhosis has facilitated the more uniform listing of patients at individual centres across the United States. The United Network for Organ Sharing, under pressure from transplant professionals, patient advocacy groups and the federal government, has continuously revised allocation and distribution policies based on the ethical principles of justice for the individual patient versus optimal utility of the limited organ supply available annually. Beginning in 2002, it is likely that the Model for End-stage Liver Disease (MELD score will be implemented to determine disease severity and direct donor organs to the sickest patients rather than to those with the longest waiting times.

  13. Types of Cancer Associated with Transplant Recipients

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  14. Efficacy of highland production of strawberry transplants

    African Journals Online (AJOL)

    STORAGESEVER

    2009-04-20

    Apr 20, 2009 ... Figure 1. Number of runners per mother plant with bare root propagation system under lowland and highland conditions. ... Containerized plugs (58 x 29 cm, 32 cells), filled with .... and Utilization for a New Century. Larson KD ...

  15. Prognostic significance of del 17p, ZAP-70 and CD38 as ...

    African Journals Online (AJOL)

    Nihal S. El-Kinawy

    2012-04-29

    Apr 29, 2012 ... found to be associated with the B-cell receptor (BCR) in. CLL. ... counts, PB and bone marrow (BM) lymphocytes, patients were classified into ..... autologous stem cell transplantation. .... Leuk Lymphoma 2004;45(8):1595–603.

  16. A Metabolomic Approach (1H HRMAS NMR Spectroscopy) Supported by Histology to Study Early Post-transplantation Responses in Islet-transplanted Livers

    OpenAIRE

    Vivot, Kevin; Benahmed, Malika A.; Seyfritz, Elodie; Bietiger, William; Elbayed, Karim; Ruhland, Elisa; Langlois, Allan; Maillard, Elisa; Pinget, Michel; Jeandidier, Nathalie; Gies, Jean-Pierre; Namer, Izzie-Jacques; Sigrist, S?verine; Reix, Nathalie

    2016-01-01

    Intrahepatic transplantation of islets requires a lot of islets because more than 50% of the graft is lost during the 24 hours following transplantation. We analyzed, in a rat model, early post-transplantation inflammation using systemic inflammatory markers, or directly in islet-transplanted livers by immunohistochemistry. 1H HRMAS NMR was employed to investigate metabolic responses associated with the transplantation. Inflammatory markers (Interleukin-6, ?2-macroglobulin) are not suitable t...

  17. Young transplant surgeons and NIH funding.

    Science.gov (United States)

    Englesbe, M J; Sung, R S; Segev, D L

    2011-02-01

    Transplant surgeons have historically been instrumental in advancing the science of transplantation. However, research in the current environment inevitably requires external funding, and the classic career development pathway for a junior investigator is the NIH K award. We matched transplant surgeons who completed fellowships between 1998 and 2004 with the NIH funding database, and also queried them regarding research effort and attitudes. Of 373 surgeons who completed a fellowship, only 6 (1.8%) received a K award; of these, 3 subsequently obtained R-level funding. An additional 5 individuals received an R-level grant within their first 5 years as faculty without a K award, 3 of whom had received a prior ASTS-sponsored award. Survey respondents reported extensive research experience during their training (78.8% spent median 24 months), a high proportion of graduate research degrees (36%), and a strong desire for more research time (78%). However, they reported clinical burdens and lack of mentorship as their primary perceived barriers to successful research careers. The very low rate of NIH funding for young transplant surgeons, combined with survey results that indicate their desire to participate in research, suggest institutional barriers to access that may warrant attention by the ASTS and the transplant surgery community. ©2010 The Authors Journal compilation©2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

  18. Optical Coherence Tomography in Kidney Transplantation

    Science.gov (United States)

    Andrews, Peter M.; Wierwille, Jeremiah; Chen, Yu

    End-stage renal disease (ESRD) is associated with both high mortality rates and an enormous economic burden [1]. The preferred treatment option for ESRD that can extend patients' lives and improve their quality of life is kidney transplantation. However, organ shortages continue to pose a major problem in kidney transplantation. Most kidneys for transplantation come from heart-beating cadavers. Although non-heart-beating cadavers represent a potentially large pool of donor kidneys, these kidneys are not often used due to the unknown extent of damage to the renal tubules (i.e., acute tubular necrosis or "ATN") induced by ischemia (i.e., lack of blood flow). Also, ischemic insult suffered by kidneys awaiting transplantation frequently causes ATN that leads to varying degrees of delayed graft function (DGF) after transplantation. Finally, ATN represents a significant risk for eventual graft and patient survival [2, 3] and can be difficult to discern from rejection. In present clinical practice, there is no reliable real-time test to determine the viability of donor kidneys and whether or not donor kidneys might exhibit ATN. Therefore, there is a critical need for an objective and reliable real-time test to predict ATN to use these organs safely and utilize the donor pool optimally. In this review, we provided preliminary data indicating that OCT can be used to predict the post-transplant function of kidneys used in transplantation.

  19. Best-estimated multi-dimensional calculation during LB LOCA for APR1400

    International Nuclear Information System (INIS)

    Oh, D. Y.; Bang, Y. S.; Cheong, A. J.; Woong, S.; Korea, W.

    2010-01-01

    Best-estimated (BE) calculation with uncertainty quantification for the emergency core cooling system (ECCS) performance analysis during Loss of Coolant Accident (LOCA) is more broadly used in nuclear industries and regulations. In Korea, demand on regulatory audit calculation is continuously increasing to support the safety review for life extension, power up-rating and advanced nuclear reactor design. The thermal-hydraulic system code, MARS (Multi-dimensional Analysis of Reactor Safety), with multi-dimensional capability is used for audit calculation. It achieves to describe the complicated phenomena in reactor coolant system by very effectively consolidating the one dimensional RELAP5/MOD3 with the multidimensional COBRA-TF codes. The advanced power reactors (APR1400) to be evaluated has four separated hydraulic trains of the high pressure injection system (HPSI) with direct vessel injection (DVI) which is different from the existing commercial PWRs. Also, the therma-hydraulic behavior of DVI plant would be considerably different from that of a cold-leg safety injection since the low pressure safety injection system are eliminated and the high pressure safety flow are injected into the specific elevation of reactor vessel downcomer. The ECCS bypass induced by the downcomer boiling due to hot wall heating of reactor vessel during reflooding phase is one of the important phenomena which should be considered in DVI plants. Therefore, in this study, BE calculation with one-dimensional (1-D) and multi-dimensional (multi-D) MARS models during LBLOCA are performed for APR1400 plant. In the multi-D evaluation, the reactor vessel is modeled by multi-D components and the specific treatment of flow path inside reactor vessel, e.g., upper guide structure, is essential. The concept of hot zone is adopted to simulate the limiting thermal-hydraulic conditions surrounding hot rod, which is similar to hot channel in 1-D. Also, alternative treatment of the hot rods in multi-D is

  20. Recovery and radio-resistance in mice after external irradiation; Restauration et radio-resistance chez la souris apres irradiation externe

    Energy Technology Data Exchange (ETDEWEB)

    Le Guillou, S [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1965-07-01

    The author presents a literature study concerning recovery from external irradiation and an analysis of experimental data (which appear to suggest the idea of a radio-resistance in animals), as well as the hypotheses put forward for explaining this phenomenon. The author then describes an experiment carried out on mice whose LD 50/30 days increased from 1005 to 1380 rads and for which it was shown that an increase occurs in the number of certain anti-bodies circulating after a low dose of {gamma} irradiation. (author) [French] L'auteur presente une etude bibliographique de la restauration apres irradiation externe et une analyse des donnees experimentales qui paraissent suggerer la notion de radioresistance chez les animaux ainsi que les hypotheses cherchant a expliquer ce phenomene. Il relate ensuite une experience realisee sur des souris dont la DL 50/30 jours est passee de 1005 a 1380 rads et dans laquelle est montree l'augmentation de certains anticorps circulant apres une faible dose d'irradiation gamma. (auteur)

  1. [Transplantation-associated infections].

    Science.gov (United States)

    Würzner, R

    2004-01-01

    Transplantation-associated infections are caused by an infected transplanted organ or the endogenic or exogenic environment of the recipient in a state of induced immunodeficiency. The best therapy would be to reconstitute the immunodeficiency, but this is usually impossible as it endangers the transplanted organ. Thus, a specific, standardised anti-infectious therapy is needed even in the absence of clearly identified micro-organisms [bacteria (in two thirds gram-positive rods), parasites (in central Europe predominantly Toxoplasma), fungi (especially Candida spp. or Aspergillus spp.) or viruses (such as Parvovirus B19 and Cytomegalovirus)]. Origins of infection (e.g., hygiene), types of infection (e.g., reactivation), typical localisations, diagnostic tools (e.g., blood cultures, antigenic tests, PCR, CT, advantages and disadvantages of antibody assays) and possible therapies are briefly discussed. The take home messages are to avoid economy measures in microbial diagnostics and to use CMV-seronegative donors whenever possible.

  2. Infection in the bone marrow transplant recipient and role of the microbiology laboratory in clinical transplantation.

    OpenAIRE

    LaRocco, M T; Burgert, S J

    1997-01-01

    Over the past quarter century, tremendous technological advances have been made in bone marrow and solid organ transplantation. Despite these advances, an enduring problem for the transplant recipient is infection. As immunosuppressive regimens have become more systematic, it is apparent that different pathogens affect the transplant recipient at different time points in the posttransplantation course, since they are influenced by multiple intrinsic and extrinsic factors. An understanding of ...

  3. SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2011-01-01

    Full Text Available Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

  4. Osteonecrosis or spontaneous fractures following renal transplantation

    International Nuclear Information System (INIS)

    Andresen, J.; Nielsen, H.E.; Aarhus Univ.

    1981-01-01

    31 renal transplant recipients with posttransplant development of osteonecrosis or spontaneous fractures were evaluated with regard to age, duration of dialysis before transplantation. Determination of metacarpal bone mass at the time of transplantation and registration of bone resorption and soft tissue calcification at the time of transplantation and at the time of onset of osteonecrosis and spontaneous fractures were made. Apart from the increased mean age in patients with spontaneous fractures no difference was seen between the groups. Osteonecrosis and spontaneous fractures occurred in areas of trabecular bone. It seems most likely that after renal transplantation the patients show bone complications of different localization. (orig.) [de

  5. Cross-border quest: the reality and legality of transplant tourism.

    Science.gov (United States)

    Ambagtsheer, Frederike; Zaitch, Damián; van Swaaningen, René; Duijst, Wilma; Zuidema, Willij; Weimar, Willem

    2012-01-01

    Background. Transplant tourism is a phenomenon where patients travel abroad to purchase organs for transplants. This paper presents the results of a fieldwork study by describing the experiences of Dutch transplant professionals confronted by patients who allegedly purchased kidney transplants abroad. Second, it addresses the legal definition and prohibition of transplant tourism under national and international law. The final part addresses the legal implications of transplant tourism for patients and physicians. Methods. The study involved seventeen interviews among transplant physicians, transplant coordinators and policy-experts and a review of national and international legislation that prohibit transplant tourism. Results. All Dutch transplant centers are confronted with patients who undergo transplants abroad. The estimated total number is four per year. Transplant tourism is not explicitly defined under national and international law. While the purchase of organs is almost universally prohibited, transplant tourism is hardly punishable because national laws generally do not apply to crimes committed abroad. Moreover, the purchase of organs (abroad) is almost impossible to prove. Conclusions. Transplant tourism is a legally complex phenomenon that warrants closer research and dialogue. The legal rights and obligations of patients and physicians confronted with transplant tourism should be clarified.

  6. A combination of p53-activating APR-246 and phosphatidylserine-targeting antibody potently inhibits tumor development in hormone-dependent mutant p53-expressing breast cancer xenografts

    Directory of Open Access Journals (Sweden)

    Liang Y

    2018-03-01

    Full Text Available Yayun Liang,1 Benford Mafuvadze,1 Cynthia Besch-Williford,2 Salman M Hyder1 1Deparment of Biomedical Sciences and Dalton Cardiovascular Research Center, Columbia, MO, USA; 2IDEXX BioResearch, Columbia, MO, USA Background: Between 30 and 40% of human breast cancers express a defective tumor suppressor p53 gene. Wild-type p53 tumor suppressor protein promotes cell-cycle arrest and apoptosis and inhibits vascular endothelial growth factor–dependent angiogenesis, whereas mutant p53 protein (mtp53 lacks these functions, resulting in tumor cell survival and metastasis. Restoration of p53 function is therefore a promising drug-targeted strategy for combating mtp53-expressing breast cancer. Methods: In this study, we sought to determine whether administration of APR-246, a small-molecule drug that restores p53 function, in combination with 2aG4, an antibody that targets phosphatidylserine residues on tumor blood vessels and disrupts tumor vasculature, effectively inhibits advanced hormone-dependent breast cancer tumor growth. Results: APR-246 reduced cell viability in mtp53-expressing BT-474 and T47-D human breast cancer cells in vitro, and significantly induced apoptosis in a dose-dependent manner. However, APR-246 did not reduce cell viability in MCF-7 breast cancer cells, which express wild-type p53. We next examined APR-246’s anti-tumor effects in vivo using BT-474 and T47-D tumor xenografts established in female nude mice. Tumor-bearing mice were treated with APR-246 and/or 2aG4 and tumor volume followed over time. Tumor growth was more effectively suppressed by combination treatment than by either agent alone, and combination therapy completely eradicated some tumors. Immunohistochemistry analysis of tumor tissue sections demonstrated that combination therapy more effectively induced apoptosis and reduced cell proliferation in tumor xenografts than either agent alone. Importantly, combination therapy dramatically reduced the density of blood

  7. Uterine transplantation: Review in human research.

    Science.gov (United States)

    Favre-Inhofer, A; Rafii, A; Carbonnel, M; Revaux, A; Ayoubi, J M

    2018-06-01

    Uterine transplantation is the solution to treat absolute uterine fertility. In this review, we present the historical, medical, technical, psychological and ethical perspectives in human uterine transplantation research. We reviewed the PubMed database following PRISMA guidelines and added data presented by several research teams during the first international congress on uterine transplantation. Copyright © 2018. Published by Elsevier Masson SAS.

  8. [Hepatic cell transplantation: a new therapy in liver diseases].

    Science.gov (United States)

    Pareja, Eugenia; Cortés, Miriam; Martínez, Amparo; Vila, Juan José; López, Rafael; Montalvá, Eva; Calzado, Angeles; Mir, José

    2010-07-01

    Liver transplantation has been remarkably effective in the treatment in patients with end-stage liver disease. However, disparity between solid-organ supply and increased demand is the greatest limitation, resulting in longer waiting times and increase in mortality of transplant recipients. This situation creates the need to seek alternatives to orthotopic liver transplantation.Hepatocyte transplantation or liver cell transplantation has been proposed as the best method to support patients. The procedure consists of transplanting individual cells to a recipient organ in sufficient quantity to survive and restore the function. The capacity of hepatic regeneration is the biological basis of hepatocyte transplantation. This therapeutic option is an experimental procedure in some patients with inborn errors of metabolism, fulminant hepatic failure and acute and chronic liver failure, as a bridge to orthotopic liver transplantation. In the Hospital La Fe of Valencia, we performed the first hepatocyte transplantation in Spain creating a new research work on transplant program. Copyright 2009 AEC. Published by Elsevier Espana. All rights reserved.

  9. TRANSPLANTATION

    African Journals Online (AJOL)

    stage ... renal artery thrombosis, renal vein thrombosis, ureteric leak or stenosis ... alternative organ source for patients with end-stage renal disease. Kidney ... status.27,28 Post-transplant acute tubular necrosis is caused by ischaemic injury to the ...

  10. Blood pressure control in hypertensive pediatric renal transplants: role of repeated ABPM following transplantation.

    Science.gov (United States)

    Krmar, Rafael T; Berg, Ulla B

    2008-10-01

    Hypertension in pediatric renal transplants is a widespread condition associated with high mortality risk in early adult life. Ambulatory blood pressure monitoring (ABPM) was found to be superior to office blood pressure (BP) in identifying true hypertensive and responders to treatment. The aim of this study was to investigate the role of repeated ABPM, performed at yearly intervals following transplantation, in the assessment and decision-making processes of post-transplant hypertension. Thirty-seven recipients (23 males; aged 10.5 +/- 4.3 years) who were followed for 4.3 +/- 2.2 years (range 2-9) after transplantation were eligible for analysis. The mean follow-up time between the baseline (1 year post-transplantation) and the most recent ABPM examination was 3.3 +/- 2.2 years (range 1-8). Throughout the follow-up period, antihypertensive therapy was either started or intensified in 27 recipients. These interventions were decided based on ABPM results obtained on 40 of 44 occasions. At last follow-up, 24 of 29 treated hypertensive recipients displayed controlled BP. This figure was significantly higher compared to our historical hypertensive control recipients in whom ABPM was applied for the first time in treatment at 6 +/- 3.3 years (range 2-15) after transplantation, while therapeutic decisions were driven by office BP measurements (95 % confidence interval (95% CI) for the difference between proportions (80.6-32 %) 36-60 %, P = 0.001). Our study shows that, in a population with high risk for hypertension, repeated ABPM may significantly help to improve BP control.

  11. Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients - BCSH and BTS Guidelines.

    Science.gov (United States)

    Parker, Anne; Bowles, Kristin; Bradley, J Andrew; Emery, Vincent; Featherstone, Carrie; Gupte, Girish; Marcus, Robert; Parameshwar, Jayan; Ramsay, Alan; Newstead, Charles

    2010-06-01

    A joint working group established by the Haemato-oncology subgroup of the British Committee for Standards in Haematology (BCSH) and the British Transplantation Society (BTS) has reviewed the available literature and made recommendations for the diagnosis and management of post-transplant lymphoproliferative disorder (PTLD) in adult recipients of solid organ transplants. This review details the risk factors predisposing to development, initial features and diagnosis. It is important that the risk of developing PTLD is considered when using post transplant immunosuppression and that the appropriate investigations are carried out when there are suspicions of the diagnosis. These must include tissue for histology and computed tomography scan to assess the extent of disease. These recommendations have been made primarily for adult patients, there have been some comments made with regard to paediatric practice.

  12. Pancreas transplantation

    International Nuclear Information System (INIS)

    Snider, J.F.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Letourneau, J.G.

    1989-01-01

    Pancreas transplantation can be complicated by vascular thrombosis, stenosis, or anastomotic leak, complications that predispose to transplant pancreatectomy. The relative roles of noninvasive radiologic studies in such vascular complications have been correlated with angiographic or pathologic data. The results of 54 scintigraphic studies, 25 CT studies, 16 sonograms, and 23 color Doppler examinations have been correlated with those of 40 angiograms and 28 pathologic studies in a population of 185 recipients. CT (sensitivity, 100%; specificity, 75%; accuracy, 92%) and US (sensitivity, 88%; specificity, 80%; accuracy, 85%) were most helpful in noninvasive screening for vascular complications, while angiography remains nearly definite in the radiographic diagnosis of these problems

  13. Stem Cell Transplants (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Stem Cell Transplants KidsHealth / For Teens / Stem Cell Transplants What's ... Take to Recover? Coping Print What Are Stem Cells? As you probably remember from biology class, every ...

  14. TRANSPLANTATION AND POTENTIAL IMMORTALITY OF MAMMALIAN TISSUES.

    Science.gov (United States)

    Loeb, L

    1926-06-20

    1. Serial transplantation of tumors made it possible in 1901 and following years to draw the conclusion that various mammalian tissues have potential immortality. Serial transplantations of normal tissues did not succeed at first, because the homoioreaction on the part of the lymphocytes and connective tissue of the host injures the transplant. 2. In continuation of these experiments we found that cartilage of the rat can be transplanted serially to other rats at least for a period of 3 years. At the end of that time great parts of the transplanted cartilage and perichondrium are alive. 3. Not only the cartilage of young rats can be homoiotransplanted, but also the cartilage of very old rats which are nearing the end of life. By using such animals we have been able to obtain cartilage and perichondrium approaching an age of 6 years which is almost double the average age of a rat. 4. We found that cartilage can be homoiotransplanted more readily than other tissues for the following reasons: (a) While in principle the homoioreaction towards cartilage is the same as against other tissues, cartilage elicits this reaction with less intensity; (b) cartilage is better able to resist the invasion of lymphocytes and connective tissue than the majority of other tissues; (c) a gradual adaptation between transplant and host seems to take place in the case of cartilage transplantation, as a result of which the lymphocytic reaction on the part of the host tissue decreases progressively the longer the cartilage is kept in the strange host. 5. At time of examination we not only found living transplanted cartilage tissue, but also perichondrial tissue, which in response to a stimulus apparently originating in the necrotic central cartilage, had been proliferating and replacing it. These results suggest that it may perhaps be possible under favorable conditions to keep cartilage alive indefinitely through serial transplantations. 6. At the same time these experiments permit the

  15. Decreased cerebral blood flow in renal transplant recipients

    International Nuclear Information System (INIS)

    Kamano, Chisako; Komaba, Yuichi; Sakayori, Osamu; Iino, Yasuhiko; Katayama, Yasuo

    2002-01-01

    We performed single-photon emission computed tomography (SPECT) to investigate the influence of renal transplantation on cerebral blood flow (CBF). Fifteen renal transplant recipients and twelve normal subjects underwent cerebral SPECT with N-isopropyl-p-[ 123 I] iodoamphetamine ( 123 I-IMP). All transplant recipients received prednisolone and cyclosporine (CyA). Regional CBF (rCBF) was measured by defining regions of interest in the cerebral cortex, deep white matter, striatum, thalamus, and cerebellum. In transplant recipients, correlations to the mean overall cortical CBF were assessed using the interval from transplantation to measurement of SPECT, as well as the serum creatinine concentration. Moreover, to investigate the influence of CyA on CBF, the correlation between mean overall cortical CBF and CyA trough concentrations was assessed. In all regions, CBF in renal transplant recipients was significantly lower than in normal subjects. No significant correlation was seen between serum creatinine, interval from transplantation, or CyA trough concentrations and mean overall cortical CBF. Renal transplant recipients demonstrated a decrease in CBF, that can have an associated secondary pathology. Therefore, renal transplant recipients may benefit from post-operative MRI or CT. (author)

  16. De novo malignancy is associated with renal transplant tourism.

    Science.gov (United States)

    Tsai, Meng-Kun; Yang, Ching-Yao; Lee, Chih-Yuan; Yeh, Chi-Chuan; Hu, Rey-Heng; Lee, Po-Huang

    2011-04-01

    Despite the objections to transplant tourism raised by the transplant community, many patients continue travel to other countries to receive commercial transplants. To evaluate some long-term complications, we reviewed medical records of 215 Taiwanese patients (touring group) who received commercial cadaveric renal transplants in China and compared them with those of 321 transplant recipients receiving domestic cadaveric renal transplants (domestic group) over the same 20-year period. Ten years after transplant, the graft and patient survival rates of the touring group were 55 and 81.5%, respectively, compared with 60 and 89.3%, respectively, of the domestic group. The difference between the two groups was not statistically significant. The 10-year cumulative cancer incidence of the touring group (21.5%) was significantly higher than that of the domestic group (6.8%). Univariate and multivariate stepwise regression analyses (excluding time on immunosuppression, an uncontrollable factor) indicated that transplant tourism was associated with significantly higher cancer incidence. Older age at transplantation was associated with a significantly increased cancer risk; however, the risk of de novo malignancy significantly decreased with longer graft survival. Thus, renal transplant tourism may be associated with a higher risk of post-transplant malignancy, especially in patients of older age at transplantation. © 2011 International Society of Nephrology

  17. Renal transplantation: Sonography and Doppler assessment of transplanted kidneys in adult Sudanese patients

    Directory of Open Access Journals (Sweden)

    Moawia Gameraddin

    2017-06-01

    Full Text Available Background Every year, thirty-five thousand patients receive renal transplants worldwide. Kidney transplant provides better quality of life and reduced morbidity. Doppler and sonography were the best imaging modalities for evaluation. Aims To assess the sonographic findings of renal allograft and to determine the correlation between Doppler resistive index and size of allograft and echogenicity. Methods This was a cross-sectional study conducted in Khartoum State from January to August 2016. A total of 86 patients with known transplanted kidneys were scanned with ultrasound using 3MHz and 5MHz transducers. The age was categorized into four groups and so the Doppler indices. Descriptive statistics used to analyse quantitative and qualitative variables (percent and means ± SD. Spearman's rho test was used to find the correlation between RI of renal vessels and allograft size. The Qui-square test was used to find an association between RI and echogenicity of the graft. Results Renal transplantation was common at the age of 20 to 50 years. The mean Doppler index of the renal artery was 0.68±0.11 in renal allografts. Renal transplantation was common in professionals and homemakers (30.2 per cent and 20.93 per cent respectively. Hypertension and diabetes were the most common causes (44.1 per cent and 18.6 per cent. A significant correlation was found between RI and allograft size (p-value=0.012. There was no statistical association between RI and echogenicity of allograft (pvalue=0.106. Conclusion The Doppler resistive index is significantly correlated with allograft size and had no association with echogenicity. Patients with enlarged allograft had raised resistive indices. The study recommended that Duplex ultrasound should be used in the initial assessment and follow-up of renal transplant.

  18. Stem Cell Transplants (For Parents)

    Science.gov (United States)

    ... of Transplants Transplantation Recovery Coping Print en español Trasplantes de células madre Stem cells are cells in ... finding a match is called tissue typing (or HLA [human leukocyte antigen] typing). HLA is a protein ...

  19. Waiting narratives of lung transplant candidates.

    Science.gov (United States)

    Yelle, Maria T; Stevens, Patricia E; Lanuza, Dorothy M

    2013-01-01

    Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman's concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients' stories and hear what is most meaningful in their lives.

  20. Waiting Narratives of Lung Transplant Candidates

    Directory of Open Access Journals (Sweden)

    Maria T. Yelle

    2013-01-01

    Full Text Available Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman’s concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients’ stories and hear what is most meaningful in their lives.

  1. Perception of Hair Transplant for Androgenetic Alopecia.

    Science.gov (United States)

    Bater, Kristin L; Ishii, Masaru; Joseph, Andrew; Su, Peiyi; Nellis, Jason; Ishii, Lisa E

    2016-12-01

    Hair transplant is among the most common cosmetic services sought by men, with more than 11 000 procedures performed in 2014. Despite its growing popularity, the effect of hair transplant on societal perceptions of youth, attractiveness, or facets of workplace and social success is unknown. To determine whether hair transplant improves observer ratings of age, attractiveness, successfulness, and approachability in men treated for androgenetic alopecia and to quantify the effect of hair transplant on each of these domains. A randomized controlled experiment was conducted from November 10 to December 6, 2015, using web-based surveys featuring photographs of men before and after hair transplant. One hundred twenty-two participants recruited through various social media platforms successfully completed the survey. Observers were shown 2 side-by-side images of each man and asked to compare the image on the left with the one on the right. Of 13 pairs of images displayed, 7 men had undergone a hair transplant procedure and 6 had served as controls. Observers evaluated each photograph using various metrics, including age, attractiveness, successfulness, and approachability. A multivariate analysis of variance was performed to understand the effect of hair transplant on observer perceptions. Planned posthypothesis testing was used to identify which variables changed significantly as a result of the transplant. Observer ratings of age (in number of years younger) and attractiveness, successfulness, and approachability (on a scale of 0 to 100; scores higher than 50 indicate a positive change). Of the 122 participants in the survey, 58 were men (47.5%); mean (range) age was 27.1 (18-52) years. The initial multivariate analysis of variance revealed a statistically significant multivariate effect for transplant (Wilks λ = 0.9646; P hair transplant on observers' perceptions of age (mean [SD] number of years younger, 3.6 [2.9] years; P hair transplant. Participants also

  2. [Early human transplants: 60th anniversary of the first successful kidney transplants].

    Science.gov (United States)

    Gentili, Marc E

    2015-11-01

    First kidney transplant attempts begin with the 20th century: improving vascular sutures, understanding the phenomena of rejection or tolerance, then progress in HLA groups enable early success in the second half of the century. Definition of brain death, use of corticosteroids, radiotherapy and prime immunosuppressors promote the development of transplants. Discover of cyclosporine in the 1980s, and legislative developments augur a new era. Many advances are arising: use of stem cells from the donor, enhancement of Maastricht 3 donor or living donation. Finally organ transplantation remains an immense human adventure, but also scientific and ethic. Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  3. Imaging in haematopoietic stem cell transplantation

    International Nuclear Information System (INIS)

    Evans, A.; Steward, C.G.; Lyburn, I.D.; Grier, D.J.

    2003-01-01

    Haematopoietic stem cell transplantation (SCT) is used to treat a wide range of malignant and non-malignant haematological conditions, solid malignancies, and metabolic and autoimmune diseases. Although imaging has a limited role before SCT, it is important after transplantation when it may support the clinical diagnosis of a variety of complications. It may also be used to monitor the effect of therapy and to detect recurrence of the underlying disease if the transplant is unsuccessful. We present a pictorial review of the imaging of patients who have undergone SCT, based upon 15 years experience in a large unit performing both adult and paediatric transplants

  4. Imaging in haematopoietic stem cell transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A.; Steward, C.G.; Lyburn, I.D.; Grier, D.J

    2003-03-01

    Haematopoietic stem cell transplantation (SCT) is used to treat a wide range of malignant and non-malignant haematological conditions, solid malignancies, and metabolic and autoimmune diseases. Although imaging has a limited role before SCT, it is important after transplantation when it may support the clinical diagnosis of a variety of complications. It may also be used to monitor the effect of therapy and to detect recurrence of the underlying disease if the transplant is unsuccessful. We present a pictorial review of the imaging of patients who have undergone SCT, based upon 15 years experience in a large unit performing both adult and paediatric transplants.

  5. Bone marrow transplantation

    International Nuclear Information System (INIS)

    Storb, R.; Santos, G.W.

    1979-01-01

    Bone marrow transplantation has been increasingly used to treat patients with severe combined immunodeficiency diseases, severe aplastic anemia, and malignant hematologic diseases, especially leukemia. At the Workshop a number of problems were discussed, e.g., conditioning regimens aimed at overcoming the problem of marrow graft rejection and reducing the incidence of recurrent leukemia, prevention of graft-versus-host disease (GVHD), possible mechanisms involved in stable graft-host tolerance, graft-versus-leukemia effect in mice, and finally, the possible use of autologous marrow transplantation

  6. Hematopoietic Stem Cell Transplantation in India-2017 Annual Update.

    Science.gov (United States)

    Naithani, Rahul

    2018-01-01

    There has been a steady rise in number of transplant centers in India over last few years. This year many papers related to bone marrow transplants were presented in annual conference of Indian society of Hematology and Transfusion Medicine. All oral and poster presentations which were published were reviewed. There were many publications on autologous transplant, allogeneic transplant and lab aspects of transplant. Centers shared their data on autologous transplants in newly set-up units with resource constraints with good outcomes. Encouraging data from across India is likely to boost more centers to set up transplant centers.

  7. Renal transplantation in high cardiovascular risk patients.

    Science.gov (United States)

    Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

    2009-10-01

    Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

  8. Other women's wombs: uterus transplants and gestational surrogacy

    Science.gov (United States)

    Robertson, John A.

    2016-01-01

    The birth of a child after uterus transplant from a living donor in Sweden in October, 2013 has spurred reproductive and transplant physicians in Europe and North America to investigate whether uterus transplants, from living or cadaveric donors, will be a safe and effective therapy for women with uterine insufficiency. While progress with uterus transplant depends on medical factors, there are also important ethical and legal concerns. Uterus transplant is essential for women without access to surrogacy. It may also be sought by infertile women who dislike surrogacy. This article examines medical, ethical, legal, and policy issues that arise with womb transplant, including the role of surrogacy policies that make them necessary. The conclusion is that there is a clear ethical path for either surrogacy or uterus transplant to be used by women with uterine insufficiency. PMID:27774233

  9. Other women's wombs: uterus transplants and gestational surrogacy.

    Science.gov (United States)

    Robertson, John A

    2016-04-01

    The birth of a child after uterus transplant from a living donor in Sweden in October, 2013 has spurred reproductive and transplant physicians in Europe and North America to investigate whether uterus transplants, from living or cadaveric donors, will be a safe and effective therapy for women with uterine insufficiency. While progress with uterus transplant depends on medical factors, there are also important ethical and legal concerns. Uterus transplant is essential for women without access to surrogacy. It may also be sought by infertile women who dislike surrogacy. This article examines medical, ethical, legal, and policy issues that arise with womb transplant, including the role of surrogacy policies that make them necessary. The conclusion is that there is a clear ethical path for either surrogacy or uterus transplant to be used by women with uterine insufficiency.

  10. Laparoscopic robot-assisted pancreas transplantation: first world experience.

    Science.gov (United States)

    Boggi, Ugo; Signori, Stefano; Vistoli, Fabio; D'Imporzano, Simone; Amorese, Gabriella; Consani, Giovanni; Guarracino, Fabio; Marchetti, Piero; Focosi, Daniele; Mosca, Franco

    2012-01-27

    Surgical complications are a major disincentive to pancreas transplantation, despite the undisputed benefits of restored insulin independence. The da Vinci surgical system, a computer-assisted electromechanical device, provides the unique opportunity to test whether laparoscopy can reduce the morbidity of pancreas transplantation. Pancreas transplantation was performed by robot-assisted laparoscopy in three patients. The first patient received a pancreas after kidney transplant, the second a simultaneous pancreas kidney transplantation, and the third a pancreas transplant alone. Operations were carried out through an 11-mm optic port, two 8-mm operative ports, and a 7-cm midline incision. The latter was used to introduce the grafts, enable vascular cross-clamping, and create exocrine drainage into the jejunum. The two solitary pancreas transplants required an operating time of 3 and 5 hr, respectively; the simultaneous pancreas kidney transplantation took 8 hr. Mean warm ischemia time of the pancreas graft was 34 min. All pancreatic transplants functioned immediately, and all recipients became insulin independent. The kidney graft, revascularized after 35 min of warm ischemia, also functioned immediately. No patient had complications during or after surgery. At the longer follow-up of 10, 8, and 6 months, respectively, all recipients are alive with normal graft function. We have shown the feasibility of laparoscopic robot-assisted solitary pancreas and simultaneous pancreas and kidney transplantation. If the safety and feasibility of this procedure can be confirmed by larger series, laparoscopic robot-assisted pancreas transplantation could become a new option for diabetic patients needing beta-cell replacement.

  11. Transplanting oligodendrocyte progenitors into the adult CNS

    International Nuclear Information System (INIS)

    Franklin, R.J.M.; Blakemore, W.F.; Cambridge Univ.

    1997-01-01

    This review covers a number of aspects of the behaviour of oligodendrocyte progenitors following transplantation into the adult CNS. First, an account is given of the ability of transplanted oligodendrocyte progenitors, grown in tissue culture in the presence of PDGF and bFGF, to extensively remyelinate focal areas of persistent demyelination. Secondly, we describe how transplanted clonal cell lines of oligodendrocyte progenitors will differentiate in to astrocytes as will oligodendrocytes following transplantation into pathological environments in which both oligodendrocytes and astrocytes are absent, thereby manifesting the bipotentially demonstrable in vitro but not during development. Finally, a series of studies examining the migratory behaviour of transplanted oligodendrocyte progenitors (modelled using the oligodendrocyte progenitor cell line CG4) are described. (author)

  12. The significance of renoscintigraphy for renal transplantation

    International Nuclear Information System (INIS)

    Oei Hong Yoe.

    1981-01-01

    The aim of the study reported here was to evaluate the contribution of renoscintigraphy performed frequently and systematically, for differentiation between the various complications occurring after renal transplantation. Relevant complications of renal transplantation are described, with special attention to the diagnostic methods available at present, and the methods used for radionuclide investigations in renal transplantation are reviewed. The abnormalities seen on the sequential images in ten cases complicated by urine leakage or urinary tract obstruction are described. These are illustrated by the scintigrams and the corresponding radiograms. The results in eight patients whose transplant did not show Hippuran uptake are also described. Transplant failure in five of these eight patients was clearly demonstrated by perfusion scintigraphy. (Auth.)

  13. Mycobacterium tuberculosis Infection following Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    Karima Boubaker

    2013-01-01

    Full Text Available Introduction and Aims. Post-transplant tuberculosis (TB is a problem in successful long-term outcome of renal transplantation recipients. Our objective was to describe the pattern and risk factors of TB infection and the prognosis in our transplant recipients. Patients and Methods. This study was a retrospective review of the records of 491 renal transplant recipients in our hospital during the period from January 1986 to December 2009. The demographic data, transplant characteristics, clinical manifestations, diagnostic criteria, treatment protocol, and long-term outcome of this cohort of patients were analyzed. Results. 16 patients (3,2% developed post-transplant TB with a mean age of 32,5 ± 12,7 (range: 13–60 years and a mean post-transplant period of 36,6months (range: 12,3 months–15,9 years. The forms of the diseases were pulmonary in 10/16 (62,6%, disseminated in 3/16 (18,7%, and extrapulmonary in 3/16 (18,7%. Graft dysfunction was observed in 7 cases (43,7% with tissue-proof acute rejection in 3 cases and loss of the graft in 4 cases. Hepatotoxicity developed in 3 patients (18,7% during treatment. Recurrences were observed in 4 cases after early stop of treatment. Two patients (12.5% died. Conclusion. Extra pulmonary and disseminated tuberculosis were observed in third of our patients. More than 9months of treatment may be necessary to prevent recurrence.

  14. Comparison of APR1400 safety between brake site and shin-Kori site Due to the difference in the climate conditions

    International Nuclear Information System (INIS)

    Yoon, Ho Joon; Lee, Jeong Ik; Lee, Jeong Ik

    2012-01-01

    Brake Nuclear Power Plant (BNPP) is now under the construction based on APR1400 designed by Korean Electric Power Corporation (KEPCO). APR1400 is a two loop pressurized water reactor, the nuclear steam supply system (NSSS) US designed for about put of 4,000 MWt, with a corresponding electrical output of approximately 1,390 MWe. The first APR1400 (SKN 3 and 4) constructed in Shin-Kori, Korea has been modified according to the surrounding environment of the United Arab Emirates. In this paper, authors would like to compare safety issues between B NPP and Skin due to the changes of surroundings, since the site characteristics are very different. For instance, the mean annual air temperature in the UAE is 28 .deg. C and the peak air temperature was recorded as 48.8 .deg. C. Sea temperatures are varying from 17. deg. C in January to 35. deg. C in August, while that of Korea is in 9-16. deg. C range. Hot climate of UAE and the malfunction of HVAC system can lead the increasing of the water temperature in safety injection system (SIS). The heated water in SIS may affect the safety margin of the peak cladding temperature (PCT). The change of PCT and response time according to design basis accident scenarios such as large break LOCA are analyzed in detail. To evaluate such effect, Mars code was utilized to evaluate assumed condition by KAIST and the analyses of the results were carried out by Khalifa Univ.

  15. Local expansion in circulatory death kidney transplant activity improves wait-listed outcomes and addresses inequities of access to transplantation

    OpenAIRE

    Mirshekar-Syahkal, Bahar; Summers, Dominic; Bradbury, Lisa L; Aly, Mohamed; Bardsley, Victoria; Berry, Miriam; Norris, Joseph M; Torpey, Nick; Clatworthy, Menna Ruth; Bradley, J Andrew; Pettigrew, Gavin John

    2016-01-01

    In the UK, circulatory death (DCD) kidney transplant activity has increased rapidly, but marked regional variation persists. We report how increased DCD kidney transplant activity influenced wait-listed outcomes for a single centre. Between 2002/03 and 2011/12, 430 (54%) DCD and 361 (46%) DBD kidney-only transplants were performed in the Cambridge Transplant Centre, with a higher proportion of DCD donors fulfilling expanded criteria status (41% DCD vs 32% DBD; $\\small \\textit{P}$=0.01). Compa...

  16. Organ transplantation and replacement

    Energy Technology Data Exchange (ETDEWEB)

    Cerilli, G.J.

    1988-01-01

    This book contains 49 chapters. Some of the titles are: Molecular, Genetic, and Clinical Aspects of the HLA System; The Normal Immune Response; Significance of the ABO Antigen System; The Role of Dialysis in the Management of End-Stage Renal Disease; Access for Dialysis; Patient Selection for Renal Transplantation; The Living Donor in Kidney Transplantation; and Kidney Preservation by Cold Storage.

  17. Restoration of vision after transplantation of photoreceptors.

    Science.gov (United States)

    Pearson, R A; Barber, A C; Rizzi, M; Hippert, C; Xue, T; West, E L; Duran, Y; Smith, A J; Chuang, J Z; Azam, S A; Luhmann, U F O; Benucci, A; Sung, C H; Bainbridge, J W; Carandini, M; Yau, K-W; Sowden, J C; Ali, R R

    2012-05-03

    Cell transplantation is a potential strategy for treating blindness caused by the loss of photoreceptors. Although transplanted rod-precursor cells are able to migrate into the adult retina and differentiate to acquire the specialized morphological features of mature photoreceptor cells, the fundamental question remains whether transplantation of photoreceptor cells can actually improve vision. Here we provide evidence of functional rod-mediated vision after photoreceptor transplantation in adult Gnat1−/− mice, which lack rod function and are a model of congenital stationary night blindness. We show that transplanted rod precursors form classic triad synaptic connections with second-order bipolar and horizontal cells in the recipient retina. The newly integrated photoreceptor cells are light-responsive with dim-flash kinetics similar to adult wild-type photoreceptors. By using intrinsic imaging under scotopic conditions we demonstrate that visual signals generated by transplanted rods are projected to higher visual areas, including V1. Moreover, these cells are capable of driving optokinetic head tracking and visually guided behaviour in the Gnat1−/− mouse under scotopic conditions. Together, these results demonstrate the feasibility of photoreceptor transplantation as a therapeutic strategy for restoring vision after retinal degeneration.

  18. Transplantation with positive complement-dependent microcytotoxicity crossmatch in contemporary kidney transplantation: Practice patterns and associated outcomes

    Directory of Open Access Journals (Sweden)

    Ralph J Graff

    2012-01-01

    Full Text Available We analyzed clinical factors and graft survival associated with complement-dependent microcytotoxicity (CDC crossmatch (XM positive (+ kidney transplants in 1995 to 2009 United Network of Sharing (UNOS registry data. CDCXM negative (- transplants were selected from centers and years in which at least one CDCXM+ transplant was performed at a given center in a given year. CDCXM+ and CDCXM- results were compared with bivariate and multivariate survival analysis. Our observations are as follows: (1 The risk of graft loss with CDCXM+ vs. CDCXM- results was markedly lower than the risk observed historically, e.g., living donor (LD-CDCXM+ absolute all-cause graft survival reductions were 0.7% at 24 hours (P=0.007, 2.9% at one year (P <0.0001, 3.7% at five years (P<0.0001; deceased donor (DD-CDCXM+ absolute graft survival reductions were 0.7% at 24 hours (P=0.02, 3.5% at one year (P <0.0001, 2.7% at five years (P=0.0009. On covariate adjustment, the only significant association of CDCXM+ vs. CDCXM- results was with one-year graft loss risk: LD aHR 1.44 (95% CI 1.05-1.96, DD aHR 1.33 (CI 1.10-1.61. (2 CDCXM+ transplantation was more commonly performed among groups disadvantaged with respect to transplant access, including sensitized, previously transplanted women and black recipients. (3 In CDCXM+ recipients, there was a high percentage of flow cytometry (FC XM- and autoXM+ results. After removing these groups, outcomes with CDCXM+ results were relatively good. (4 CDCXM+/FCXM+ vs. CDCXM-/FCXM- graft loss risk was observed only in LD recipients transplanted at centers performing fewer than 10 such transplants during the study period: 11.0% reduction (P<0.0001 and aHR of 2.86 (CI 1.18-6.94 at one year; 14.7% reduction (P<0.0001 and aHR of 1.77 (CI 0.88-3.58 at five years. Although using CDCXM+ as a contraindication to transplantation has been associated with virtual elimination of hyperacute rejection, the negative effect of a CDCXM+ in contemporary

  19. Artificial organs and transplantation.

    Science.gov (United States)

    Splendiani, G; Cipriani, S; Vega, A; Casciani, C U

    2003-05-01

    Nowadays artificial devices are not able to totally and undefinitely replace the loss of function of all vital organs and artificial organs can be used only to bridge the time to transplantation, which must be considered the first choice in the therapeutical approach for many chronic diseases. Since general population aging process is leading to an increase of organ demand, the gap between performed and requested transplantation is hard to fill. Xenotransplantation is nowadays only an experimental alternative solution and we have to do our best using available artificial organs to increase and improve the survival of patients waiting for transplantation. In this meeting we particularly dealt about organ function replacing therapy, especially regarding the kidney, heart, liver, pancreas and ear.

  20. Réduction des pertes de mangues après la récolte en Asie du Sud ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    29 avr. 2016 ... Près de 70 % de la production mondiale de mangues provient de l'Inde, mais les pertes après récolte en raison d'une manutention, d'un transport et d'une transformation inadéquats peuvent atteindre 35 %. De plus, les prix obtenus par les producteurs sont souvent peu élevés à cause de la saturation du ...

  1. Investigation of Growth and Survival of Transplanted Plane and Pine Trees According to IBA Application, Tree Age, Transplanting Time and Method

    Directory of Open Access Journals (Sweden)

    N. Etemadi

    2015-03-01

    Full Text Available The major problems in transplanting the landscape trees are high level of mortality and low establishment rate of transplanted trees, especially in the first year. In order to achieve the best condition for successful transplanting of pine and plane trees in Isfahan landscape, the present study was carried out based on a completely randomized block design with four replicates and three treatments including transplanting method (balled and burlapped and bare root, tree age (immature and mature and IBA application (0 and 150 mg/L. Trees were transplanted during 2009 and 2010 in three times (dormant season, early and late growing season. Survival rate and Relative Growth Rate index based on tree height (RGRH and trunk diameter (RGRD were measured during the first and second years. Trees transplanted early in the growing season showed the most survival percentage during the two years, as compared to other transplanting dates. Survival of Balled and burlapped and immature transplanted trees was significantly greater than bare root or mature trees. The significant effect of age treatment was continued in the second year. IBA treatment had no effect on survival rate of the studied species. Balled and burlapped and immature transplanted pine trees also had higher RGRH and RGRD compared to bare root or mature trees. According to the results of this study, early growing season is the best time for transplanting pine and plane trees. Also, transplanting of immature trees using balled and burlapped method is recommended to increase the survival and establishment rate.

  2. Transplant results in adults with Fanconi anaemia

    NARCIS (Netherlands)

    Bierings, Marc; Bonfim, Carmem M.; Peffault De Latour, Regis; Aljurf, Mahmoud; Mehta, Parinda A.; Knol, Cora; Boulad, Farid; Tbakhi, Abdelghani; Esquirol, Albert; Mcquaker, Grant; Sucak, Gulsan A.; Othman, Tarek B.; Halkes, Constantijn J.M.; Carpenter, Ben; Niederwieser, Dietger; Zecca, Marco; Kro¨ger, Nicolaus; Michallet, Mauricette; Risitano, Antonio M.; Ehninger, Gerhard; Porcher, Raphael; Dufour, Carlo

    The outcomes of adult patients transplanted for Fanconi anaemia (FA) have not been well described. We retrospectively analysed 199 adult patients with FA transplanted between 1991 and 2014. Patients were a median of 16 years of age when diagnosed with FA, and underwent transplantation at a median

  3. Chronic transplant dysfunction: Etiological and pathophysiological aspects

    NARCIS (Netherlands)

    E.A. Kouwenhoven (Ewout)

    1999-01-01

    textabstractOrgan transplantation has saved the life of many people throughout the world, who suffered from end·stage organ failure. The University Hospital Rotterdam·Dijkzigt, is one of the Dutch organ transplant centers, in which kidney, heart and liver transplantation are performed. In close

  4. Post-transplantation diabetes mellitus: an overview

    Directory of Open Access Journals (Sweden)

    Igor Aleksandrovich Sklyanik

    2015-04-01

    Full Text Available This review presents an analysis of clinical and experimental studies related to post-transplantation diabetes mellitus (PTDM – a specific complication after solid organ transplantation.A search of the databases eLibrary, PubMed and Scopus using the keywords «posttransplantation diabetes mellitus», «new onset diabetes after transplantation», «transplantation» and «immunosuppression» yielded in 523 results, including four from Russian literature (one original research manuscript. The analysis included original research, reviews, meta-analyses and monographs published not before 2005 in Russian and English. A total of 60 relevant original researches and reviews were included in this review.Diagnostic criteria, disease risk factors and potential pathogenic mechanisms were all considered. The mechanisms of the diabetogenic effect of modern immunosuppressive drugs were analysed. The principles of pre- and post-transplantation screening for PTDM and optimal management strategies for patients with PTDM are presented. The current controversial issues concerning the various aspects of PTDM are discussed.

  5. Suicidal hanging donors for lung transplantation

    Science.gov (United States)

    Ananiadou, Olga; Schmack, Bastian; Zych, Bartlomiej; Sabashnikov, Anton; Garcia-Saez, Diana; Mohite, Prashant; Weymann, Alexander; Mansur, Ashham; Zeriouh, Mohamed; Marczin, Nandor; De Robertis, Fabio; Simon, Andre Rüdiger; Popov, Aron-Frederik

    2018-01-01

    Abstract In the context of limited donor pool in cardiothoracic transplantation, utilization of organs from high risk donors, such as suicidal hanging donors, while ensuring safety, is under consideration. We sought to evaluate the outcomes of lung transplantations (LTx) that use organs from this group. Between January 2011 and December 2015, 265 LTx were performed at our center. Twenty-two recipients received lungs from donors after suicidal hanging (group 1). The remaining 243 transplantations were used as a control (group 2). Analysis of recipient and donor characteristics as well as outcomes was performed. No statistically significant difference was found in the donor characteristics between analyzed groups, except for higher incidence of cardiac arrest, younger age and smoking history of hanging donors (P donor cause of death is not associated with poor mid-term survival or chronic lung allograft dysfunction following transplantation. These results encourage assessment of lungs from hanging donors, and their consideration for transplantation. PMID:29620623

  6. THE ISLAMIC ETHICS OF MITOCHONDRIA TRANSPLANTATION

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    Anke Iman Bouzenita

    2017-12-01

    Full Text Available ABSTRACT: Biotechnology has opened a new chapter with the advent of mitochondria transplantation for cell-based therapy. Mitochondrial transplantation was successfully led to birth; however, cytoplasmic transplantation has caused apprehension, since the mixing of human ooplasm from two different maternal sources may generate mitochondrial DNA (mtDNA heteroplasmy in the offspring. Islamic legal verdicts on human cloning and somatic cell transfer have been overweighing explicit as to its prohibition, due to the change of creation, mixing of lineage and other evaluations. Is mitochondria transplantation equivalent to human cloning in that genetic information is proliferated and does it, therefore, take the same legal rule? Are there possible benefits (masalih for medical treatment that may render mitochondria transplantation permissible, or are possible harms (mafasid overweighing? Or is it a completely different procedure, taking a different rule? The paper will investigate into these questions and discuss the dimensions of Islamic ethics on the issue.

  7. Clinical Allogeneic and Autologous Islet Cell Transplantation: Update

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    Shinichi Matsumoto

    2011-06-01

    Full Text Available Islet cell transplantation is categorized as a β-cell replacement therapy for diabetic patients who lack the ability to secrete insulin. Allogeneic islet cell transplantation is for the treatment of type 1 diabetes, and autologous islet cell transplantation is for the prevention of surgical diabetes after a total pancreatectomy. The issues of allogeneic islet cell transplantation include poor efficacy of islet isolation, the need for multiple donor pancreata, difficulty maintaining insulin independence and undesirable side effects of immunosuppressive drugs. Those issues have been solved step by step and allogeneic islet cell transplantation is almost ready to be the standard therapy. The donor shortage will be the next issue and marginal and/or living donor islet cell transplantation might alleviate the issue. Xeno-islet cell transplantation, β-cell regeneration from human stem cells and gene induction of the naïve pancreas represent the next generation of β-cell replacement therapy. Autologous islet cell transplantation after total pancreatectomy for the treatment of chronic pancreatitis with severe abdominal pain is the standard therapy, even though only limited centers are able to perform this treatment. Remote center autologous islet cell transplantation is an attractive option for hospitals performing total pancreatectomies without the proper islet isolation facilities.

  8. Neuromuscular diseases after cardiac transplantation

    NARCIS (Netherlands)

    Mateen, Farrah J.; van de Beek, Diederik; Kremers, Walter K.; Daly, Richard C.; Edwards, Brooks S.; McGregor, Christopher G. A.; Wijdicks, Eelco F. M.

    2009-01-01

    BACKGROUND: Cardiac transplantation is a therapeutic option in end-stage heart failure. Peripheral nervous system (PNS) disease is known to occur in cardiac transplant recipients but has not been fully characterized. METHODS: This retrospective cohort review reports the PNS-related concerns of 313

  9. Food allergies developing after solid organ transplant.

    Science.gov (United States)

    Needham, J M; Nicholas, S K; Davis, C M

    2015-12-01

    The development of food allergy is an increasingly recognized form of morbidity after solid organ transplant. It occurs more commonly in liver transplant recipients, although it has also been reported in heart, lung, kidney, and intestinal transplants. Pediatric transplant recipients are more likely to develop symptoms compared to adults, and reports of frequency vary widely from 5% to 38% in pediatric liver transplant recipients. Multiple mechanisms have been proposed in the literature, although no single mechanism can yet account for all reported observations. As food allergy can have at worst potentially fatal consequences, and at best require lifestyle adjustment through food avoidance, it is important for recipients to be aware of the donor's food allergies and particularly in pediatrics, the possibility of completely de novo allergies. This review explores the recent reports surrounding food allergy after solid organ transplant, including epidemiology, proposed mechanisms, and implications for practice. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Xenon-computed tomography of kidney transplants

    International Nuclear Information System (INIS)

    Mutze, S.; Reichmuth, B.; Suess, C.; Lippert, J.; Ewert, R.

    1994-01-01

    Xenon-CT is an established method for determining cerebral perfusion, while applications in other organs are rare. We evaluated the diagnostic potential of measuring the regional Renal Blood Flow (rRBF) in 10 patients with transplanted kidneys by xenon-CT. We found significant differences in the rRBF between the renal medulla and the cortex. There were no differences between normal renal transplants and transplants with chronic rejection. (orig.) [de

  11. Nonmelanoma Skin Cancer in Nonwhite Organ Transplant Recipients.

    Science.gov (United States)

    Pritchett, Ellen N; Doyle, Alden; Shaver, Christine M; Miller, Brett; Abdelmalek, Mark; Cusack, Carrie Ann; Malat, Gregory E; Chung, Christina Lee

    2016-12-01

    Organ transplant recipients have a higher incidence of skin cancer. This risk is magnified over time and with continued exposure to immunosuppression. Skin cancer in nonwhite patients is associated with greater morbidity and mortality owing to diagnosis at a more advanced stage, which suggests that nonwhite organ transplant recipients are at even higher risk. To describe demographic and clinical factors and the incidence of skin cancer in nonwhite organ transplant recipients. We performed a retrospective medical record review of patients who were organ transplant recipients (154 were white and 259 nonwhite [black, Asian, Hispanic, Pacific Islander]) seen from November 1, 2011, to April 18, 2016 at an academic referral center. Variables were analyzed and compared between racial groups, including sex, age, race/ethnicity, Fitzpatrick type, type and location of skin cancer, type of organ transplanted, time to diagnosis of skin cancer after transplantation, and history of condyloma acuminata and/or verruca vulgaris. Most of the 413 patients (62.7%) evaluated were nonwhite organ transplant recipients; 264 were men, and 149 were women. Their mean (SD) age was 60.09 (13.59) years. Nineteen skin cancers were identified in 15 patients (5.8%) representing 3 racial/ethnic groups: black (6 patients), Asian (5), and Hispanic (4). All squamous cell carcinomas in blacks were diagnosed in the in situ stage, located on sun-protected sites, and occurred in patients whose lesions tested positive for human papilloma virus (HPV) and/or who endorsed a history of condyloma acuminata or verruca vulgaris. Most skin cancers in Asians were located on sun-exposed areas and occurred in individuals who emigrated from equatorial locations. Nonwhite organ transplant recipients are at risk for developing skin cancer posttransplantation. Follow-up in a specialized transplant dermatology center and baseline total-body skin examination should be part of posttransplantation care in all organ

  12. Impact of fixed pulmonary hypertension on post-heart transplant outcomes in bridge-to-transplant patients

    DEFF Research Database (Denmark)

    Alba, Ana Carolina; Rao, Vivek; Ross, Heather J

    2010-01-01

    Fixed pulmonary hypertension (FPH) is considered a contraindication to cardiac transplantation. Ventricular assist device (VAD) therapy through prolonged left ventricular unloading may reverse FPH. Our aim was to assess post-transplant outcomes and survival in patients with and without FPH...

  13. A German survey of the abdominal transplantation surgical work force.

    Science.gov (United States)

    Thomas, Michael N; Nadalin, Silvio; Schemmer, Peter; Pascher, Andreas; Kaiser, Gernot M; Braun, Felix; Becker, Thomas; Nashan, Björn; Guba, Markus

    2015-07-01

    This manuscript reports the results of a nationwide survey of transplant surgeons in Germany, including the demographics, training, position, individual case loads, center volumes, program structure, professional practice, grade of specialization, workload, work hours, salary, and career expectations. We contacted all 32 German transplant centers that perform liver, kidney, and pancreas transplantation. Surgeons engaged in transplantation were asked to reply to the survey. Eighty-five surgeons responded, with a mean age of 44 ± 8 years, 13% of whom were female. The median transplant frequency per active transplant surgeon was relatively low, with 16 liver transplants, 15 kidney transplants, and three pancreas transplants. The median reported center volumes were 45 liver transplants, 90 kidney transplants, and five pancreas transplants per year. Most of the surgeons reported a primary focus on hepato-pancreato-biliary surgery, and only 10% of effective work time was actually dedicated to perform transplant surgeries. The majority of respondents estimated their weekly work hours to be between 55 and 66 h. When asked about their career satisfaction and expectations, most respondents characterized their salaries as inappropriately low and their career prospects as inadequate. This survey provides a first impression of the transplant surgery work force in Germany. © 2015 Steunstichting ESOT.

  14. Hematopoietic Stem Cell Transplantation Activity and Trends at a Pediatric Transplantation Center in Turkey During 1998-2008

    Directory of Open Access Journals (Sweden)

    Volkan Hazar

    2012-06-01

    Full Text Available OBJECTIVE: The aim of this study was to document hematopoietic stem cell transplantation (HSCT activity and trends at our treatment center. METHODS: Data collected over a 10-year period were retrospectively analyzed, concentrating primarily on types of HSCT, transplant-related mortality (TRM, stem cell sources, indications for HSCT, and causes of death following HSCT. RESULTS: In total, 222 allogeneic (allo-HSCT (87.4% and 32 autologous (auto-HSCT (12.6% procedures were performed between 1998 and 2008. Stem cells obtained from unrelated donors were used in 22.6% (50/222 of the allo- HSCTs. Cord blood was the source of hematopoietic stem cells (HSC in 12.2% of all transplants. The most common indication for allo-HSCT was hemoglobinopathy (43.2%, versus neuroblastoma (53.1% for auto-HSCT. The TRM rate 1 year post transplantation was 18.3% ± 2.5% for all transplants, but differed according to transplantation type (23.5% ± 7.9% for auto-HSCT and 17.5% ± 2.6% for allo-HSCT. The most common cause of death 1 year post HSCT was infection (35.9%. CONCLUSION: The TRM rate in the patients that underwent allo-HSCT was similar to that which has been previously reported; however, the TRM rate in the patients that underwent auto-HSCT was higher than previously reported in developed countries. The selection of these patients to be transplanted must be made attentively.

  15. Physicians attitudes toward living non-related renal transplantation (LNRRT). The Living non-Related Renal Transplant Study Group.

    Science.gov (United States)

    1993-06-01

    Renal transplantation is considered now the definitive treatment for patients with end-stage renal disease (ESRD). Unfortunately, the worldwide shortage of kidneys remains the most important obstacle to transplantation. In developing countries, including those of the Middle East, the shortage is even more dramatic. Despite great efforts to establish and maintain successful transplant centers, the number of kidneys that have been transplanted in the last few years has actually declined. The lack of a dependable kidney source played well into the hands of unscrupulous entrepreneurs who started brokerage of organs for profit. In this practice, patients with ESRD travel to India and other countries to purchase kidneys from living genetically non-related poor donors. Patient care was therefore relegated to the laws of the marketplace and both patients and donors were exploited to maximize profit. Additionally, reported results of this type of transplantation were inferior to those of other types of transplantation. Not unexpectedly, these issues have created intense controversy among transplant physicians and the general public in which moral, ethical and medical issues were debated. To investigate these issues, we conducted a large multicenter study in Saudi Arabia, Bahrain and Egypt. In the first phase of this study, we surveyed 50 institutions regarding their attitude toward LNRRT, of which 22 responded. The results of our survey clearly show that patients with ESRD take the initiative in seeking LNRRT despite physician discouragement and significant financial burden.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Islet transplantation as safe and efficacious method to restore glycemic control and to avoid severe hypoglycemia after donor organ failure in pancreas transplantation.

    Science.gov (United States)

    Gerber, Philipp A; Hochuli, Michel; Benediktsdottir, Bara D; Zuellig, Richard A; Tschopp, Oliver; Glenck, Michael; de Rougemont, Olivier; Oberkofler, Christian; Spinas, Giatgen A; Lehmann, Roger

    2018-01-01

    The aim of this study was to assess safety and efficacy of islet transplantation after initial pancreas transplantation with subsequent organ failure. Patients undergoing islet transplantation at our institution after pancreas organ failure were compared to a control group of patients with pancreas graft failure, but without islet transplantation and to a group receiving pancreas retransplantation. Ten patients underwent islet transplantation after initial pancreas transplantation failed and were followed for a median of 51 months. The primary end point of HbA1c islet transplantation and in all three patients in the pancreas retransplantation group, but by none of the patients in the group without retransplantation (n = 7). Insulin requirement was reduced by 50% after islet transplantation. Kidney function (eGFR) declined with a rate of -1.0 mL ± 1.2 mL/min/1.73 m 2 per year during follow-up after islet transplantation, which tended to be slower than in the group without retransplantation (P = .07). Islet transplantation after deceased donor pancreas transplant failure is a method that can safely improve glycemic control and reduce the incidence of severe hypoglycemia and thus establish similar glycemic control as after initial pancreas transplantation, despite the need of additional exogenous insulin. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Kidney transplantation and hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    O. N. Vetchinnikova

    2017-01-01

    Full Text Available Successful kidney transplantation eliminates endocrine and metabolic disorders that predispose to the development of hyperparathyroidism, the complication typical for the chronic kidney disease; but the process of recovery from mineral and bone disorders is slowed down. The highest incidence of post-transplant hyperparathyroidism is recorded in the first postoperative year. The risk factors for its development or persistence include the high blood levels of parathyroid hormone, calcium, phosphorus, and/or alkaline phosphatase, a prolonged dialysis therapy, severe hyperparathyroidism in the preoperative period, vitamin D deficiency, a suboptimal transplanted kidney function, and also the recipient's previous history of subtotal or incomplete parathyroidectomy. The characteristic clinical and laboratory signs of posttransplant hyperparathyroidism are bone lesions, kidney graft abnormalities, hypercalcemia, and hypophosphatemia. The diagnostic algorithm includes monitoring the markers of mineral and bone metabolism, determining the bone mineral density, and imaging of thyroid glands. Correction of post-transplant hyperparathyroidism is performed surgically or pharmacologically. The article specifies the indications to, the extent and timing of parathyroidectomy, discusses the use of native vitamin D formulations, its analogues, and calcimimetics.

  18. In Vivo Imaging of Transplanted Pancreatic Islets

    Directory of Open Access Journals (Sweden)

    Donghee Kim

    2018-01-01

    Full Text Available The beta-cells in the islets of Langerhans in the pancreas secrete insulin and play an important role in glucose homeostasis. Diabetes, characterized by hyperglycemia, results from an absolute or a relative deficiency of the pancreatic beta-cell mass. Islet transplantation has been considered to be a useful therapeutic approach, but it is largely unsuccessful because most of the transplanted islets are lost in the early stage of transplantation. To evaluate the efficacy of intervention methods for the improvement of islet survival, monitoring of the functional islet mass is needed. Various techniques to image and track transplanted islets have been investigated to assess islets after transplantation. In this review, recent progresses in imaging methods to visualize islets are discussed.

  19. Pancreatic islet transplantation. Experimental and clinical aspects

    DEFF Research Database (Denmark)

    Yderstræde, Knud Bonnet

    1987-01-01

    interest has been shown in transplantation of isolated islets either directly, introduced intraportally, intramuscularly, inter alia, or encapsulated in artificial devices providing an immuno-isolation. Clinical application has revealed promising results concerning the immunological aspects. However......, quantitative assessment points to a difficulty in achieving satisfactory amounts of islets to attain normoglycaemia. Work with fetal pancreata has shown these to possess a growth potential in vitro thus, possibly, aiding the quantification of islets in transplantation models. In the field of pancreatic islet...... transplantation, future models include microencapsulation and hybrid artificial devices, both of which provide immuno-isolation - thus the ability of allo- as well as xeno-transplantation. The obvious advantage of immuno-isolated islet transplant, as opposed to segmentally engrafted pancreas, is stressed...

  20. ACUTE APENDICITIS IN LIVER TRANSPLANT RECIPIENTS.

    Science.gov (United States)

    Fonseca-Neto, Olival Cirilo Lucena da; Lima, Heloise Caroline de Souza; Melo, Paulo Sérgio Vieira de; Lemos, Roberto; Leitão, Laércio; Amorim, Américo Gusmão; Lacerda, Cláudio Moura

    2016-03-01

    Appendicitis is a common cause of emergency surgery that in the population undergoing organ transplantation presents a rare incidence due to late diagnosis and treatment. To report the occurrence of acute appendicitis in a cohort of liver transplant recipients. Retrospective analysis in a period of 12 years among 925 liver transplants, in witch five cases of acute appendicitis were encountered. Appendicitis occurred between three and 46 months after liver transplantation. The age ranged between 15 and 58 years. There were three men and two women. The clinical presentations varied, but not discordant from those found in non-transplanted patients. Pain was a symptom found in all patients, in two cases well located in the right iliac fossa (40%). Two patients had symptoms characteristic of peritoneal irritation (40%) and one patient had abdominal distention (20%). All patients were submitted to laparotomies. In 20% there were no complications. In 80% was performed appendectomy complicated by suppuration (40%) or perforation (40%). Superficial infection of the surgical site occurred in two patients, requiring clinical management. The hospital stay ranged from 48 h to 45 days. Acute appendicitis after liver transplantation is a rare event being associated with a high rate of drilling, due to delays in diagnosis and therapy, and an increase in hospital stay.

  1. ALLOGENEIC TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA

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    Luca Laurenti

    2010-08-01

    Full Text Available Even if Chronic lymphocytic leukemia (CLL often has an indolent behavior with good responsiveness to cytoreductive treatment, about 20% of the patients, so called "poor-risk" patients, show an aggressive course and die within a few years despite early intensive therapies. Criteria for poor-risk disease according to the European Bone Marrow Transplantation (EBMT CLL Transplant Consensus are: purine analogue refractoriness, early relapse after purine analogue combination therapy, CLL with p53 lesion requiring treatment. Allogeneic transplant has potential curative role in CLL, however burden with very  high transplant related mortality (TRM rates of 38-50%: A major advance in reducing the short-term morbidity and mortality of allogeneic stem cell transplantation (SCT has been the introduction of non-myeloablative or reduced intensity conditioning (RIC regimens to allow engraftment of allogeneic stem cells. There is no doubt that the crucial therapeutic principle of allo-SCT in CLL is graft versus leukemia (GVL activity. The major complications of allogeneic SCT in CLL are: chronic graft-versus-host-disease (GVHD affecting quality of life, high graft rejection and infection rates rates correlated with preexisting immunosuppression. Disease relapse remains the major cause of failure after RIC allo-HCT in CLL patients. Sensitive minimal residual disease (MRD quantification has strong prognostic impact after transplant.

  2. The Global Role of Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    Guillermo Garcia Garcia

    2012-01-01

    Full Text Available World Kidney Day on March 8 th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.

  3. Bilateral Psoas Haematomata Complicating Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Jacob A. Akoh

    2014-01-01

    Full Text Available Background. The challenge in managing patients undergoing renal transplantation is how to achieve optimum levels of anticoagulation to avoid both clotting and postoperative bleeding. We report a rare case of severe postoperative retroperitoneal bleeding including psoas haematomata complicating renal transplantation. Case Report. SM, a 55-year-old female, had a past history of aortic valve replacement, cerebrovascular event, and thoracic aortic aneurysm and was on long-term warfarin that was switched to enoxaparin 60 mg daily a week prior to her living donor transplantation. Postoperatively, she was started on a heparin infusion, but this was complicated by a large retroperitoneal bleed requiring surgical evacuation on the first postoperative day. Four weeks later, she developed features compatible with acute femoral neuropathy and a CT scan revealed bilateral psoas haematomata. Following conservative management, she made steady progress and was discharged home via a community hospital 94 days after transplantation. At her last visit 18 months after transplantation, she had returned to full fitness with excellent transplant function. Conclusion. Patients in established renal failure who require significant anticoagulation are at increased risk of bleeding that may involve prolonged hospitalisation and more protracted recovery and patients should be carefully counselled about this.

  4. Effects of delaying transplanting on agronomic traits and grain yield of rice under mechanical transplantation pattern.

    Directory of Open Access Journals (Sweden)

    Qihua Liu

    Full Text Available A delay in the mechanical transplantation (MT of rice seedlings frequently occurs in Huanghuai wheat-rice rotation cropping districts of China, due to the late harvest of wheat, the poor weather conditions and the insufficiency of transplanters, missing the optimum transplanting time and causing seedlings to age. To identify how delaying transplanting rice affects the agronomic characteristics including the growth duration, photosynthetic productivity and dry matter remobilization efficiency and the grain yield under mechanical transplanting pattern, an experiment with a split-plot design was conducted over two consecutive years. The main plot includes two types of cultivation: mechanical transplanting and artificial transplanting (AT. The subplot comprises four japonica rice cultivars. The results indicate that the rice jointing, booting, heading and maturity stages were postponed under MT when using AT as a control. The tiller occurrence number, dry matter weight per tiller, accumulative dry matter for the population, leaf area index, crop growth rate, photosynthetic potential, and dry matter remobilization efficiency of the leaf under MT significantly decreased compared to those under AT. In contrast, the reduction rate of the leaf area during the heading-maturity stage was markedly enhanced under MT. The numbers of effective panicles and filled grains per panicle and the grain yield significantly decreased under MT. A significant correlation was observed between the dry matter production, remobilization and distribution characteristics and the grain yield. We infer that, as with rice from old seedlings, the decrease in the tiller occurrence, the photosynthetic productivity and the assimilate remobilization efficiency may be important agronomic traits that are responsible for the reduced grain yield under MT.

  5. Transplant Biology at a Crossroads

    OpenAIRE

    Sedwick, Caitlin

    2008-01-01

    Despite major advances in transplantation biology, allowing transplants not just of critical organs like heart and kidney but also of limbs and faces, researchers are still struggling to minimize the risks from achieving the level of immunosuppression needed to make the body accept foreign tissues.

  6. Side Effects of Transplant Immunosuppressive Therapy in Post Renal Transplant Recipients, Mazandaran, Northern Iran

    Directory of Open Access Journals (Sweden)

    Abazar Akbarzadeh Pasha

    2017-04-01

    Full Text Available Background Post-kidney transplant survival relies on patient adherence to the intake of immunosuppressive medication. This study was performed to investigate complications associated with immunosuppressive therapy in renal transplantation. Methods This cross-sectional study was conducted on 188 transplanted patients in Shahid Beheshti hospital of Babol in 2013. Check list and demographic questionnaire for data collecting were used. Then the data using were analyzed in SPSS.18 software by using chi-square test. Results A total of 188 transplanted patients, 115 (61.2% was male and mean age was 12.9 ± 42.9 years. 181 (96.3% of the subjects had at least one complication. The most common complication in 142 cases (75.5% was “excessive hair growth” and after this complication “increased blood sugar” had higher frequency and 119 (63.3% had this complication. Severe form of gingival overgrowth in women was significantly that more than men (22 (30.1, 14 (12.2, P = 0.004, and the other side effect was not significant difference between men and women or different age groups (P > 0.05 Conclusions Finding show that nearly all transplanted recipients suffered from one complication which need to recognize, control and treatment. It suggested that period visiting for early diagnosis and education to patient was recommend.

  7. [The kidney transplantation from the ABO-incompatible donors].

    Science.gov (United States)

    Goriaĭnov, V A; Kaabak, M M; Babenko, N N; Shishlo, L A; Morozova, M M; Ragimov, A A; Dashkova, N G; Salimov, É L

    2012-01-01

    The experience of 28 allotransplantations of ABO-incompatible kidneys was compared with the treatment results of 38 ABO-compatible renal transplantations. The transplanted kidney function, morphological changes of the transplanted kidney and the comparative analysis of actuary survival in both groups showed no significant difference. The results of the study prove the validity of the kidney transplantation from the ABO-incompatible donors.

  8. Irradiation for xenogeneic transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Halperin, E.C.; Knechtle, S.J.; Harland, R.C.; Yamaguchi, Yasua; Sontag, M.; Bollinger, R.R. (Duke Univ., Durham, NC (USA). Dept. of Radiology Duke Univ., Durham, NC (USA). Dept. of Microbiology and Immunology)

    1990-05-01

    Xenogeneic transplantation (XT) is the transplantation of organs or tissues from a member of one species to a member of another. Mammalian species frequently have circulating antibody which is directed against the foreign organ irrespective of known prior antigen exposure. This antibody may lead to hyperacute rejection once it ensues so efforts must be directed towards eliminating the pre-existing antibody. In those species in which hyperacute rejection of xenografts does not occur, cell-mediated refection, similar to allograft rejection, may occur. It is in the prevention of this latter form of refection that radiation is most likely to be beneficial in XT. Both total lymphoid irradiation (TLI) and selective lyphoid irradiation (LSI) have been investigated for use in conjunction with XT. TLI has contributed to the prolongation of pancreatic islet-cell xenografts from hamsters to rats. TLI has also markedly prolonged the survival of cardiac transplants from hamsters to rats. A more modest prolongation of graft survival has been seen with the use of TLI in rabbit-to-rat exchanges. Therapy with TLI, cyclosporine, and splenectomy has markedly prolonged the survival of liver transplants from hamsters to rats, and preliminary data suggest that TLI may contribute to the prolongation of graft survival in the transplantation of hearts from monkeys to baboons. SLI appears to have prolonged graft survival, when used in conjunction with anti-lymphocyte globulin, in hamster-to-rat cardiac graft exchanges. The current state of knowledge of the use of irradiaiton in experimental XT is reviewed. (author). 38 refs.; 1 fig.; 5 tabs.

  9. Irradiation for xenogeneic transplantation

    International Nuclear Information System (INIS)

    Halperin, E.C.; Knechtle, S.J.; Harland, R.C.; Yamaguchi, Yasua; Sontag, M.; Bollinger, R.R.; Duke Univ., Durham, NC

    1990-01-01

    Xenogeneic transplantation (XT) is the transplantation of organs or tissues from a member of one species to a member of another. Mammalian species frequently have circulating antibody which is directed against the foreign organ irrespective of known prior antigen exposure. This antibody may lead to hyperacute rejection once it ensues so efforts must be directed towards eliminating the pre-existing antibody. In those species in which hyperacute rejection of xenografts does not occur, cell-mediated refection, similar to allograft rejection, may occur. It is in the prevention of this latter form of refection that radiation is most likely to be beneficial in XT. Both total lymphoid irradiation (TLI) and selective lyphoid irradiation (LSI) have been investigated for use in conjunction with XT. TLI has contributed to the prolongation of pancreatic islet-cell xenografts from hamsters to rats. TLI has also markedly prolonged the survival of cardiac transplants from hamsters to rats. A more modest prolongation of graft survival has been seen with the use of TLI in rabbit-to-rat exchanges. Therapy with TLI, cyclosporine, and splenectomy has markedly prolonged the survival of liver transplants from hamsters to rats, and preliminary data suggest that TLI may contribute to the prolongation of graft survival in the transplantation of hearts from monkeys to baboons. SLI appears to have prolonged graft survival, when used in conjunction with anti-lymphocyte globulin, in hamster-to-rat cardiac graft exchanges. The current state of knowledge of the use of irradiaiton in experimental XT is reviewed. (author). 38 refs.; 1 fig.; 5 tabs

  10. Kidney Transplantation in Iran

    OpenAIRE

    Behzad Einollahi

    2010-01-01

    Kidney transplantation in patients with end stage renal diseaseis preferred to dialysis because transplantation provides a betterquality of life and improved survival. However, the gapbetween the supply and demand for a renal allograft is wideningand the waiting time is increasing. Iranian protocol, a controlledtransplant program supported by the government forliving unrelated donors, was initiated for solving the problemof organ shortage. Although this system might experiencechallenges, clea...

  11. Função sexual e reprodutiva em receptoras de transplante hepático Sexual and reproductive function in female liver transplant recipients

    Directory of Open Access Journals (Sweden)

    Mônica Beatriz Parolin

    2004-03-01

    Full Text Available RACIONAL: Anormalidades na função sexual e reprodutiva são comuns em pacientes com hepatopatia crônica avançada e podem ser revertidas após transplante hepático bem-sucedido. OBJETIVO: Avaliar aspectos da função sexual e reprodutiva em mulheres submetidas a transplante de fígado no Serviço de Transplante Hepático do Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR. PACIENTES E MÉTODOS: Entre setembro de 1991 e dezembro de 2001, 94 mulheres foram submetidas a transplante hepático. Vinte e oito delas (idade média 44,17 ± 13,60 anos preencheram os seguintes critérios de inclusão: idade > 16 anos na época do transplante, sobrevida pós-transplante > 6 meses, estar em acompanhamento regular no Serviço na época do estudo e concordância em participar do mesmo. Os prontuários médicos foram revisados e as pacientes responderam a um questionário abordando padrão dos ciclos menstruais no pré e pós-transplante, gravidez no pós-transplante, métodos contraceptivos no pré e pós-transplante, freqüência de realização de citologia oncótica cervical no pré e pós-transplante, ocorrência de neoplasia ginecológica pós-transplante, além de questionário específico para o domínio da sexualidade no período pós-transplante. RESULTADOS: A mediana do tempo de seguimento pós-transplante das 28 pacientes foi de 36,5 meses (6-110 meses e a principal indicação para o transplante foi cirrose associada à hepatite C (25%. Todas as pacientes apresentavam função normal do enxerto. Excluindo-se 6 pacientes em menopausa (natural ou cirúrgica, 13 das 22 pacientes (59,1% com potencial de menstruar apresentavam amenorréia no ano anterior ao transplante. Dezenove dessas 22 pacientes (86,4% reassumiram os ciclos menstruais após o transplante, com mediana de 1 mês pós-transplante (1 a 7 meses. Todas as pacientes com idade inferior a 45 anos voltaram a menstruar após o transplante. Quatro gestações bem

  12. Preliminary Analysis of Ex-Vessel Steam Explosion using TEXAS-V code for APR1400

    International Nuclear Information System (INIS)

    Song, Sung Chu; Lee, Jung Jae; Cho, Yong Jin; Hwang, Taesuk

    2013-01-01

    The purpose of this study is to explore input development and the audit calculation using TEXAS-V code for ex-vessel steam explosion for a flooded reactor cavity of APR1400. TEXAS computational models are one of the simplified tools for simulations of fuel-coolant interaction during mixing, triggering and explosion phase. The models of TEXAS code were validated by performing the fundamental experimental investigation in the KROTOS facility at JRC, Ispra. The experiments such as KROTOS and FARO experiment are aimed at providing benchmark data to examine the effect of fuel-coolant initial conditions and mixing on explosion energetics with alumina and prototypical core material. TEXAS-V code used in this study was to analyze and predict the ex-vessel steam explosion for a reactor scale. The input deck to simulate the flooded reactor cavity of APR1400 is developed and base case calculation is performed. This study will provide a base for further study. The code will be of use for the evaluation and sensitivity study of ex-vessel steam explosion for ERVC strategy in the future studies. Analysis result of this study is similar to the result of other study. Through this study, it is found that TEXAS-V could be the used as a tool for predicting the steam explosion load on a reactor scale, as fast running computer code. In addition, TEXAS-V code could be to evaluate the impact of various uncertainties, which are not clearly understood yet, to provide a conservative envelope for the steam explosion

  13. Preliminary Analysis of Ex-Vessel Steam Explosion using TEXAS-V code for APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sung Chu; Lee, Jung Jae; Cho, Yong Jin; Hwang, Taesuk [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2013-10-15

    The purpose of this study is to explore input development and the audit calculation using TEXAS-V code for ex-vessel steam explosion for a flooded reactor cavity of APR1400. TEXAS computational models are one of the simplified tools for simulations of fuel-coolant interaction during mixing, triggering and explosion phase. The models of TEXAS code were validated by performing the fundamental experimental investigation in the KROTOS facility at JRC, Ispra. The experiments such as KROTOS and FARO experiment are aimed at providing benchmark data to examine the effect of fuel-coolant initial conditions and mixing on explosion energetics with alumina and prototypical core material. TEXAS-V code used in this study was to analyze and predict the ex-vessel steam explosion for a reactor scale. The input deck to simulate the flooded reactor cavity of APR1400 is developed and base case calculation is performed. This study will provide a base for further study. The code will be of use for the evaluation and sensitivity study of ex-vessel steam explosion for ERVC strategy in the future studies. Analysis result of this study is similar to the result of other study. Through this study, it is found that TEXAS-V could be the used as a tool for predicting the steam explosion load on a reactor scale, as fast running computer code. In addition, TEXAS-V code could be to evaluate the impact of various uncertainties, which are not clearly understood yet, to provide a conservative envelope for the steam explosion.

  14. Benefits of PEGylation in the early post-transplant period of intraportal islet transplantation as assessed by magnetic resonance imaging of labeled islets.

    Science.gov (United States)

    Jin, Sang-Man; Oh, Seung-Hoon; Oh, Bae Jun; Suh, Sunghwan; Bae, Ji Cheol; Lee, Jung Hee; Lee, Myung-Shik; Lee, Moon-Kyu; Kim, Kwang-Won; Kim, Jae Hyeon

    2014-01-01

    While a few studies have demonstrated the benefit of PEGylation in islet transplantation, most have employed renal subcapsular models and none have performed direct comparisons of islet mass in intraportal islet transplantation using islet magnetic resonance imaging (MRI). In this study, our aim was to demonstrate the benefit of PEGylation in the early post-transplant period of intraportal islet transplantation with a novel algorithm for islet MRI. Islets were PEGylated after ferucarbotran labeling in a rat syngeneic intraportal islet transplantation model followed by comparisons of post-transplant glycemic levels in recipient rats infused with PEGylated (n = 12) and non-PEGylated (n = 13) islets. The total area of hypointense spots and the number of hypointense spots larger than 1.758 mm(2) of PEGylated and non-PEGylated islets were quantitatively compared. The total area of hypointense spots (P islet group 7 and 14 days post translation (DPT). These results translated into better post-transplant outcomes in the PEGylated islet group 28 DPT. In validation experiments, MRI parameters obtained 1, 7, and 14 DPT predicted normoglycemia 4 wk post-transplantation. We directly demonstrated the benefit of islet PEGylation in protection against nonspecific islet destruction in the early post-transplant period of intraportal islet transplantation using a novel algorithm for islet MRI. This novel algorithm could serve as a useful tool to demonstrate such benefit in future clinical trials of islet transplantation using PEGylated islets.

  15. Reliability analysis of protection system of advanced pressurized water reactor - APR 1400

    International Nuclear Information System (INIS)

    Varde, P. V.; Choi, J. G.; Lee, D. Y.; Han, J. B.

    2003-04-01

    Reliability analysis was carried out for the protection system of the Korean Advanced Pressurized Water Reactor - APR 1400. The main focus of this study was the reliability analysis of digital protection system, however, towards giving an integrated statement of complete protection reliability an attempt has been made to include the shutdown devices and other related aspects based on the information available to date. The sensitivity analysis has been carried out for the critical components / functions in the system. Other aspects like importance analysis and human error reliability for the critical human actions form part of this work. The framework provided by this study and the results obtained shows that this analysis has potential to be utilized as part of risk informed approach for future design / regulatory applications

  16. Lung Cancer in Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Jozicic Mirela

    2016-06-01

    Full Text Available Introduction. Although the incidence of malignancy has increased after solid organ transplantation, data on lung cancer in this group of patients is scarce. The aim of this study was to determine clinical characteristics and outcome of patients who developed lung cancer after renal transplantation. Methods. Among a cohort of 1658 patients who received a transplant at our institution and were followedup between 1973 and 2014, five patients developed lung cancer. We analyzed risk factors, transplantation characteristics, treatment options and survival. Results. Lung cancer was diagnosed in 5 patients (0.3%. Time to diagnosis after the transplant procedure ranged from 26 to 156 months (mean 115 months. All of them had a smoking history. Tumors were classified as IIB (20%, IIIA (40%, and IV (40%. Histological types included adenocarcinoma (80% and there was one case of sarcomatoid carcinoma (20%. One patient had concomitant thyroid papillary carcinoma. Radiotherapy was applied in 2 patients, 2 underwent chemotherapy (erlotinib and combination of carboplatinum and etopozide in one patient each, and 2 died within one month after the diagnosis from disseminated malignant disease. Patients with stage IIIA survived 14 and 24 months after the diagnosis. The patient with sarcomatoid cancer underwent thoracotomy with a complete resection, lost his graft function and died 7 months after the diagnosis. Conclusion. Lung cancer is relatively rare malignancy in renal transplant recipients, but associated with high mortality. Smoking is a significant risk factor, thus smoking cessation should be promoted among renal transplant recipients, as well as regular screening for lung cancer.

  17. Successful repigmentation of vitiligo after allogeneic bone marrow transplantation for Hodgkin′s lymphoma by autologous noncultured melanocyte-keratinocyte transplantation

    Directory of Open Access Journals (Sweden)

    Huijuan Tang

    2015-01-01

    Full Text Available The treatment of vitiligo is derisory since the pathogenesis of vitiligo is not clear at present. Most conservative treatments are difficult to approach satisfactory therapy. So transplantation is the only way left when the disease becomes insensitive to those conservative treatments. Here we describe an 18-year-old patient who developed vitiligo, which was triggered by graft-versus-host disease after a allogeneic bone marrow transplantation for the treatment of Hodgkin′s lymphoma from his sister. In the following treatment to vitiligo, the patient successfully performed the transplantation of autologous uncultured melanocyte on the premise of poor reaction to other conservative methods. We infer that transplantation can be a treatment of the vitiligo after allogeneic bone marrow transplantation.

  18. [Rare diagnostics of infective endocarditis after kidney transplantation].

    Science.gov (United States)

    Dedinská, Ivana; Skalová, Petra; Mokáň, Michal; Martiaková, Katarína; Osinová, Denisa; Pindura, Miroslav; Palkoci, Blažej; Vojtko, Marián; Hubová, Janka; Kadlecová, Denisa; Lendová, Ivona; Zacharovský, Radovan; Pekar, Filip; Kaliská, Lucia

    2016-01-01

    Infective endocarditis in a patient after kidney transplantation is a serious infective complication which increases the risk of loss of the graft and also the mortality of patients. The most important predisposing factor is the immunosuppressive therapy - mainly induction immunosuppression.Material and case description: 250 patients underwent kidney transplantation throughout the period of 12 years in the Transplant Center Martin. This set of patients included 5 patients (2 %) after heart valve replacement. We present the case of a patient after kidney transplantation with development of endocarditis of the bioprosthesis of the aortic valve one month after successful kidney transplantation. Diagnostics of endocarditis by standard procedures (examination by transthoracic echocardiogram, transesophageal echocardiography, hemocultures) was unsuccessful. We rarely diagnosed endocarditis only by PET-CT examination with a consequent change of the antibiotic treatment and successful managing of this post-transplant complication. Endocarditis after kidney transplantation is a serious complication which significantly worsens the mortality of patients. The risk of development of infective endocarditis after transplantation is also increased by induction, mainly by antithymocyte globulin. Diagnostics only by PET-CT examination is rare; however, in this case it fundamentally changed the approach to the patient and led to a successful treatment.

  19. Treatment of post-transplantation lymphoproliferative disorders after kidney transplant with rituximab and conversion to m-TOR inhibitor.

    Science.gov (United States)

    Nieto-Rios, John Fredy; Gómez de Los Ríos, Sandra Milena; Serna-Higuita, Lina María; Ocampo-Kohn, Catalina; Aristizabal-Alzate, Arbey; Gálvez-Cárdenas, Kenny Mauricio; Zuluaga-Valencia, Gustavo Adolfo

    2016-12-30

    Post-transplantation lymphoproliferative disorders are serious complications of organ transplantation which treatment is not yet standardized. To describe the clinical response, overall and graft survival of patients in our center with this complication after kidney transplantation, which received rituximab as part of their treatment as well as conversion to m-TOR. Retrospective study, which included patients, diagnosed with post-transplant lymphoproliferative disorders after kidney transplantation from January 2011 to July 2014. Eight cases were found with a wide spectrum of clinical presentations. Most had monomorphic histology, 85% were associated with Epstein-Barr virus, 25% of patients had tumor involvement of the renal graft, and 12.5% ​​had primary central nervous system lymphoma. All patients were managed with reduction of immunosuppression, conversion to m-TOR (except one who lost the graft at diagnosis) and rituximab-based therapy. The overall response rate was 87.5% (62.5% complete response, 25% partial response). Survival was 87.5% with a median follow-up of 34 months. An additional patient lost the graft, with chronic nephropathy already known. All the remaining patients had stable renal function. There are no standardized treatment regimens for lymphoproliferative disorders after kidney transplantation, but these patients can be managed successfully with reduction of immunosuppression, conversion to m-TOR and rituximab-based schemes.

  20. Low-Grade Persistent Hyperparathyroidism After Pediatric Renal Transplant.

    Science.gov (United States)

    Gulleroglu, Kaan; Baskin, Esra; Moray, Gokhan; Haberal, Mehmet

    2016-06-01

    Hyperparathyroidism, a frequent complication of chronic kidney disease, persists after renal transplant. Our aims were to examine the status of parathyroid hormone levels and to determine the clinical and biochemical risk factors of persistent hyperparathyroidism after transplant. Our study included 44 pediatric renal transplant recipients with stable graft function. Median follow-up after transplant was 17.5 months (range, 12-126 mo). Patients did not receive routine vitamin D or calcium supplements after transplant, and none had undergone previous parathyroidectomy. Bone mineral densitometry of the lumbar spine was measured. Fifteen patients (34%) had parathyroid hormone levels greater than 70 pg/mL (normal range, 10-70 pg/mL). Duration of dialysis before transplant was longer in patients with persistent hyperparathyroidism. Mean serum bicarbonate levels were significantly lower in patients with persistent hyperparathyroidism than in patients without persistent hyperparathyroidism after transplant. A significant negative correlation was noted between parathyroid hormone level and serum bicarbonate level. Another significant negative correlation was shown between parathyroid hormone level and z score. We found that persistent hyperparathyroidism is related to longer dialysis duration, lower serum bicarbonate level, and lower z score. Pretransplant dialysis duration is an important predictor of persistent hyperparathyroidism. Early identification of factors that contribute to persistent hyperparathyroidism after transplant could lead to treatment strategies to minimize or prevent its detrimental effects on bone health and growth in pediatric transplant recipients.

  1. Scintigraphy of renal transplant

    International Nuclear Information System (INIS)

    Ramackers, J.M.; Marrast, A.C.; Touraine, J.L.; Peyrin, J.O.

    1995-01-01

    Scintigraphy is useful for monitoring perfusion and function of renal transplant, as well as for diagnosing miscellaneous surgical. This non-invasive imaging technique, which uses no deleterious products, is an attractive alternative for patients. This is especially true for those patients in early post-transplant course, with immunity depression and often impairment of renal function. Otherwise, multiple indices with a large range of inter-patient values has not favoured a methodological and interpretative consensus. Furthermore, the poor specificity of renogram patterns does not allow for discrimination of all etiologies with only one scintigraphy. Nevertheless, follow-up with iterative scintigraphy may be helpful due to the high intra-patient reproducibility and to the early appreciate change of parameters, according to clinical and histological renal post-transplant outcome. (authors). 43 refs., 8 figs

  2. Spirometric assessment of lung transplant patients: one year follow-up

    Directory of Open Access Journals (Sweden)

    Paulo M. Pêgo-Fernandes

    2009-06-01

    Full Text Available OBJECTIVE: The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation. INTRODUCTION: Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections. METHODS: We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed. RESULTS: The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1 and the forced vital capacity (FVC in comparison to the pre-transplant values (p <0.05. Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation. DISCUSSION: The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery. CONCLUSION: Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function.

  3. Physical activity levels early after lung transplantation.

    Science.gov (United States)

    Wickerson, Lisa; Mathur, Sunita; Singer, Lianne G; Brooks, Dina

    2015-04-01

    Little is known of the early changes in physical activity after lung transplantation. The purposes of this study were: (1) to describe physical activity levels in patients up to 6 months following lung transplantation and (2) to explore predictors of the change in physical activity in that population. This was a prospective cohort study. Physical activity (daily steps and time spent in moderate-intensity activity) was measured using an accelerometer before and after transplantation (at hospital discharge, 3 months, and 6 months). Additional functional measurements included submaximal exercise capacity (measured with the 6-Minute Walk Test), quadriceps muscle torque, and health-related quality of life (measured with the Medical Outcomes Study 36-Item Short-Form Health Survey 36 [SF-36] and the St George's Respiratory Questionnaire). Thirty-six lung transplant recipients (18 men, 18 women; mean age=49 years, SD=14) completed posttransplant measurements. Before transplant, daily steps were less than a third of the general population. By 3 months posttransplant, the largest improvement in physical activity had occurred, and level of daily steps reached 55% of the general population. The change in daily steps (pretransplant to 3 months posttransplant) was inversely correlated with pretransplant 6-minute walk distance (r=-.48, P=.007), daily steps (r=-.36, P=.05), and SF-36 physical functioning (SF-36 PF) score (r=-.59, P=.0005). The SF-36 PF was a significant predictor of the change in physical activity, accounting for 35% of the variation in change in daily steps. Only individuals who were ambulatory prior to transplant and discharged from the hospital in less than 3 months were included in the study. Physical activity levels improve following lung transplantation, particularly in individuals with low self-reported physical functioning. However, the majority of lung transplant recipients remain sedentary between 3 to 6 months following transplant. The role of exercise

  4. Hypertension in Renal Transplantation: Saudi Arabian Experience

    Directory of Open Access Journals (Sweden)

    Souqiyyeh Muhammad

    1999-01-01

    Full Text Available To evaluate the prevalence, etiologic factors and therapy of hypertension in actively followed up transplant population in Saudi Arabia; we retrospectively reviewed the records of the active renal transplant patients at two large transplant centers in Riyadh and Jeddah in Saudi Arabia. These subjects were transplanted between January 1979 and November 1998. The patients were grouped according to the measurement of blood pressure; group 1 (considered normo-tensive: blood pressure below 140/90 mmHg, group2: blood pressure between 140-159/90-99, group 3: blood pressure 160-179/100-109 group 4: equal to or above 180/110. There were 1115 patients′ records included in the study. The mean duration of transplantation was 66.9 ± 50.1 months. According to the level of measured blood pressure, there were 641 (57.5% patients in the normotensive group (group 1, 404 (36.3% patients in the mildly hypertensive group (group 2 64 (5.7% patients in the moderately severe hypertension group (group 3 and only six (0.5% patients in the severe hypertension group (group 4. The estimated prevalence of hypertension in this study was almost 85%. We found no significant difference in the prevalence of hypertension in terms of gender, year of transplantation, duration of transplantation, type of donor, number of previous transplants, diagnosis of renal artery stenosis, etiology of kidney disease, diagnosis of diabetes after transplantation, diagnosis of cerebrovascular accidents, or mean dose of prednisolone and cyclosporine. There was a statistically significant association between increased level of blood pressure and old age (above 50 years, original disease associated with hypertension, history of hypertension on dialysis, acute rejection (once or more, presence of protienuria (more than 0.3 mg/day, abnormality of ECG, or serum creatinine above 300 µmol/L. We conclude that hypertension is highly prevalent in the renal transplant population in Saudi Arabia. Risk

  5. [Intestinal transplant: in what phase are we?].

    Science.gov (United States)

    Andrés Moreno, A M; Ramos, E; Hernández, F; Encinas, J L; Leal, N; Gámez, M L; Martínez, L; Sarriá, J; Molina, M; Martínez-Ojinaga, E; Murcia, J; Frauca, E; Delgado, M; Prieto, G; López Santamaría, M; Tovar, J A

    2010-07-01

    To analyze the evolution of Small Bowel Transplantation program since the beginning of the program. [corrected] All children who underwent intestinal transplantation between 1997 and 2009 were retrospectively reviewed: epidemiological data, status before transplant, surgical technique, immunosupression, results, survival and long.term quality of life were analysed. Fifty-two intestinal transplants were performed in 46 children (20 isolated bowel, 20 combined liver and intestine, and 12 multivisceral); median age was 32m (range 7m-19a); weight 12,3 kg (range 3,9-60); 31 had short gut syndrome, 8 dismotility, 5 intractable diarrhea, and two were miscellaneous. Intestinal adaptation was initially attempted in 26 patients, without success, 20 were directly listed for transplant. The modality of transplant was modified in 17 while listed. Baseline immunosupression consisted of tacrolimus and steroids, although 5 required conversion to Sirolimus later. Six died during the first month, due to sepsis/multiorganic failure (poor status at transplant); 13 died during the long-term follow-up. Acute rejection was seen in 20, chronic rejection in 3, PTLD in 8 (6 died) and GVHD in 5 patients (3 died). Overall survival after 5 years of follow-up is 65,2 % (51,7% for the graft). From 2006 to 2008, overall patient/graft survival at 6 m, 1 and 3 years after transplant is 88,7/84,1, 81,2/81,2 and 81,2/71,1%, respectively. After a median follw-up of 39 +/- 29 months, 27 patients are alive (59%), off TPN, (70% had their ostomy taken down), go to school, are scarcely hospitalized and enjoy a good quality of life. Intestinal transplantation has consolided itself as a good choice for irreversible intestinal failure, being feasible to achieve a normal life. Although overall survival diminishes over time, the center experience has improved the results. These patients need a very close follow-up, once transplant is over, in order to get an early diagnose of immunological complications.

  6. Ultrasonic microbubble contrast agents and the transplant kidney

    Energy Technology Data Exchange (ETDEWEB)

    Kay, D.H., E-mail: davidhkay@doctors.org.u [Department of Radiology, Western Infirmary, Glasgow (United Kingdom); Mazonakis, M.; Geddes, C. [Department of Renal Medicine, Western Infirmary, Glasgow (United Kingdom); Baxter, G. [Department of Radiology, Western Infirmary, Glasgow (United Kingdom)

    2009-11-15

    Aim: To evaluate the potential application of microbubble agents in the immediate post-transplant period, by studying contrast uptake and washout, and to correlate these values with clinical indices, and thus, assess the potential prognostic value of this technique. Materials and methods: The study group comprised 20 consecutive renal transplant patients within 7 days of transplantation. Sonovue was administered as an intravenous bolus with continuous imaging of the transplant kidney at low mechanical index (MI) for 1 min post-injection. These data were analysed off-line by two observers, and time intensity curves (TIC) for the upper, mid, and lower poles constructed. Within each pole, a region of interest (5 mm square) was placed over the cortex, medullary pyramid, and interlobar artery, resulting in a total of nine TIC for each patient. TIC parameters included the arrival time (AT), time to peak (TTP), peak intensity (Max), gradient of the slope (M), and the area under curve (AUC). Results: For both observers there was good agreement for all values measured from the cortex and medulla, but poor interobserver correlation for the vascular values. In addition, there was only agreement for these values in the upper and mid-pole of the transplant with poor agreement for the lower pole values. The mid-pole of the transplant kidney was chosen as the point of measurement for subsequent studies. Mid-pole values were correlated with clinical data and outcome over the 3-month post-transplant period. Renal microbubble perfusion correlated with the transplant estimated glomerular filtration rate (eGFR) at 3 months post-transplantation (p = 0.016). Discussion: In conclusion, this is the first study to confirm reproducibility of the Sonovue TIC data in transplant patients and to quantify regional variation and perfusion. The statistically significant estimates of transplant perfusion may be of future benefit to transplant recipients and potentially utilized as a prognostic tool

  7. Mesenchymal Stem Cells in Organ Transplantation: Immunomodulatory properties of mesenchymal stem cells for application in organ transplantation

    OpenAIRE

    Crop, Meindert

    2010-01-01

    textabstractKidney transplantation is the only effective treatment for patients with end-stage renal disease. Transplantation of a donor organ, however, leads to recognition of the foreign donor antigens by the recipient’s immune system, resulting in rejection of the graft. In addition, ischemia-reperfusion injury leads to the initiation of immune responses. To prevent graft rejection, transplant recipients need to use life-long immunosuppressive medication. These drugs, however, can lead to ...

  8. African American kidney transplantation survival: the ability of immunosuppression to balance the inherent pre- and post-transplant risk factors.

    Science.gov (United States)

    Malat, Gregory E; Culkin, Christine; Palya, Aniruddha; Ranganna, Karthik; Kumar, Mysore S Anil

    2009-10-22

    Among organ transplant recipients, the African American population historically has received special attention. This is because secondary to their disposition to certain disease states, for example hypertension, an African American patient has a propensity to reach end-stage renal disease and require renal replacement earlier than a Caucasian patient. Regardless of the initiative to replace dialysis therapy with organ transplantation, the African American patient has many barriers to kidney transplantation, thus extending their time on dialysis and waiting time on the organ transplant list. These factors are among the many negative causes of decreased kidney graft survival, realized before kidney transplantation. Unfortunately, once the African American recipient receives a kidney graft, the literature documents that many post-transplant barriers exist which limit successful outcomes. The primary post-transplant barrier relates to designing proper immunosuppression protocols. The difficulty in designing protocols revolves around (i) altered genetic metabolism/lower absorption, (ii) increased immuno-active cytokines and (iii) detrimental effects of noncompliance. Based on the literature, dosing of immunosuppression must be aggressive and requires a diligent practitioner. Research has indicated that, despite some success with proven levels of immunosuppression, the African American recipient usually requires a higher 'dose per weight' regimen. However, even with aggressive immunosuppressant dosing, African Americans still have worse outcomes than Caucasian recipients. Additionally, many of the targeted sites of action that immunosuppression exerts its effects on have been found to be amplified in the African American population. Finally, noncompliance is the most discouraging inhibitor of long-term success in organ transplantation. The consequences of noncompliance are biased by ethnicity and affect the African American population more severely. All of these factors

  9. Evaluation of essential trace metals in female type 2 diabetes ...

    African Journals Online (AJOL)

    SAM

    2014-04-30

    Apr 30, 2014 ... levels of the elements were determined using atomic absorption spectrophotometer (AAS) after acid digestion. ... These included proteinuria, pregnancy, lactating mothers and .... insulin, it also enhance cells uptake of insulin and there- ... transplantation in newly diagnosed type 1 diabetic mellitus JAMA.

  10. Barriers to preemptive renal transplantation: a single center questionnaire study.

    Science.gov (United States)

    Knight, Richard J; Teeter, Larry D; Graviss, Edward A; Patel, Samir J; DeVos, Jennifer M; Moore, Linda W; Gaber, A Osama

    2015-03-01

    Preemptive transplantation results in excellent patient and graft survival yet most transplant candidates are referred for transplantation after initiation of dialysis. The goal of this study was to determine barriers to preemptive renal transplantation. A nonvalidated questionnaire was administered to prospective kidney transplant recipients to determine factors that hindered or favored referral for transplantation before the initiation of dialysis. One hundred ninety-seven subjects referred for a primary renal transplant completed the questionnaire. Ninety-one subjects (46%) had been informed of preemptive transplantation before referral, and 80 (41%) were predialysis at the time of evaluation. The median time from diagnosis of renal disease to referral was 60 months (range, 2-444 months). In bivariate analysis, among other factors, knowledge of preemptive transplantation was highly associated (odds ratio=94.69) with referral before initiation of dialysis. Given the strong association between knowledge of preemptive transplantation and predialysis referral, this variable was not included in the multivariate analysis. Using multivariate logistic regression analysis, white recipient race, referral by a transplant nephrologist, recipient employment, and the diagnosis of polycystic kidney disease were significantly associated with presentation to the pretransplant clinic before initiation of dialysis. The principle barrier to renal transplantation referral before dialysis was patient education regarding the option of preemptive transplantation. Factors significantly associated with referral before dialysis were the diagnosis of polycystic kidney disease, white recipient race, referral by a transplant nephrologist, and employed status. Greater effort should be applied to patient education regarding preemptive transplantation early after the diagnosis of end-stage renal disease.

  11. Trismus in Face Transplantation Following Ballistic Trauma.

    Science.gov (United States)

    Krezdorn, Nicco; Alhefzi, Muayyad; Perry, Bridget; Aycart, Mario A; Tasigiorgos, Sotirios; Bueno, Ericka M; Green, Jordan R; Pribaz, Julian J; Pomahac, Bohdan; Caterson, Edward J

    2018-06-01

    Trismus can be a challenging consequence of ballistic trauma to the face, and has rarely been described in the setting of face transplantation. Almost half of all current face transplant recipients in the world received transplantation to restore form and function after a ballistic injury. Here we report our experience and challenges with long standing trismus after face transplantation. We reviewed the medical records of our face transplant recipients whose indication was ballistic injury. We focused our review on trismus and assessed the pre-, peri- and postoperative planning, surgery and functional outcomes. Two patients received partial face transplantation, including the midface for ballistic trauma. Both patients suffered from impaired mouth opening, speech intelligibility, and oral competence. Severe scarring of the temporomandibular joint (TMJ) required intraoperative release in both patients, and additional total condylectomy on the left side 6 months posttransplant for 1 patient. Posttransplant, both patients achieved an improvement in mouth opening; however, there was persistent trismus. One year after transplantation, range of motion of the jaw had improved for both patients. Independent oral food intake was possible 1 year after surgery, although spillage of liquids and mixed consistency solids persisted. Speech intelligibility testing showed impairments in the immediate postoperative period, with improvement to over 85% for both patients at 1 year posttransplant. Ballistic trauma to the face and subsequent reconstructive measures can cause significant scarring and covert injuries to structures such as the TMJ, resulting in long standing trismus. Meticulous individual planning prior to interventions such as face transplantation must take these into account. We encourage intraoperative evaluation of these structures as well as peri- and postoperative treatment when necessary. Due to the nature of the primary injury, functional outcomes after face

  12. Long-term use of amiodarone before heart transplantation significantly reduces early post-transplant atrial fibrillation and is not associated with increased mortality after heart transplantation

    Directory of Open Access Journals (Sweden)

    Rivinius R

    2016-02-01

    Full Text Available Rasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Bastian Schmack,2 Christian Erbel,1 Christian A Gleissner,1 Mohammadreza Akhavanpoor,1 Lutz Frankenstein,1 Fabrice F Darche,1 Patrick A Schweizer,1 Dierk Thomas,1 Philipp Ehlermann,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology and Pneumology, 2Department of Cardiac Surgery, Heidelberg University Hospital, 3Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Background: Amiodarone is a frequently used antiarrhythmic drug in patients with end-stage heart failure. Given its long half-life, pre-transplant use of amiodarone has been controversially discussed, with divergent results regarding morbidity and mortality after heart transplantation (HTX.Aim: The aim of this study was to investigate the effects of long-term use of amiodarone before HTX on early post-transplant atrial fibrillation (AF and mortality after HTX.Methods: Five hundred and thirty patients (age ≥18 years receiving HTX between June 1989 and December 2012 were included in this retrospective single-center study. Patients with long-term use of amiodarone before HTX (≥1 year were compared to those without long-term use (none or <1 year of amiodarone. Primary outcomes were early post-transplant AF and mortality after HTX. The Kaplan–Meier estimator using log-rank tests was applied for freedom from early post-transplant AF and survival.Results: Of the 530 patients, 74 (14.0% received long-term amiodarone therapy, with a mean duration of 32.3±26.3 months. Mean daily dose was 223.0±75.0 mg. Indications included AF, Wolff–Parkinson–White syndrome, ventricular tachycardia, and ventricular fibrillation. Patients with long-term use of amiodarone before HTX had significantly lower rates of early post-transplant AF (P=0.0105. Further, Kaplan–Meier analysis of freedom from early post-transplant AF showed significantly lower rates of AF in this

  13. Kidney transplantation in the context of renal replacement therapy.

    Science.gov (United States)

    Pesavento, Todd E

    2009-12-01

    Kidney transplantation has dramatically evolved from a life-saving yet unproven therapy for patients with renal failure to a mature field that is the preferred treatment for those suffering from ESRD. Patients who receive a transplant experience a 68% lower risk of death compared with those waiting on dialysis for a transplant. This benefit is afforded to all patient subgroups including the elderly (> or =70 yr), and diabetics, who can gain 11 yr of extra life with transplantation. Prolonged transplant wait times result in a higher risk of death but this can be ameliorated with preemptive transplantation. Future challenges will focus on appropriate organ allocation and addressing long-term renal function and comorbid conditions so patients can enjoy the full benefits of transplantation.

  14. Culture and psychology in organ transplantation.

    Science.gov (United States)

    Daar, A S; Marshall, P

    1998-01-01

    The cultural and psychological dimensions of organ transplantation are often overlooked in the process of meeting its exacting technical requirements. This new branch of medicine has brought with it new ways of understanding death, human rights, commerce, gift giving, and ethics. It produces strong emotions in recipients, donors and transplanters alike. These factors need to be taken fully into consideration if organ transplantation is to evolve in ways that are felt to be beneficial for all concerned.

  15. Results of renal transplantation of the Hashemi Nejad Kidney Hospital--Tehran.

    Science.gov (United States)

    Ghods, A J; Ossareh, S; Savaj, S

    2000-01-01

    The first renal transplant in Iran was carried out in 1967. The renal transplant program severely lagged behind hemodialysis in growth until 1988. In 1988, a controlled LURD renal transplant program was adopted to provide kidneys for the large number of dialysis patients needing a renal transplant. There was no cadaveric donor transplant program. By the end of 1999, a total of 9,535 renal transplants were performed and the renal transplant waiting list of the country had been eliminated. In Iran's LURD renal transplant program, the Dialysis and Transplant Patients Association introduces the volunteer LURD to the recipient and the transplant team. There are no middlemen and no incentives for transplant teams. The government pays all of the hospital expenses for transplantation. Many poor patients are able to afford LURD transplantation and more than 50% of our LURD transplant recipients are from the poor socioeconomic class. Ethical issues within the program are under the strict observation of the transplant teams and the Iranian Society for Organ Transplantation. We have noted that many LURD transplant recipients had a potential LRD who did not donate for cultural reasons or who was reluctant to donate. In the presence of a controlled LURD renal transplant program, we feel it is more ethical to perform a paid renal transplant from volunteer LURD than a renal transplant from an LRD who may be under family pressure or coerced. The patient and graft survival rates reported from our unit are comparable to the results of renal transplants reported from centers of some other countries. Some patient deaths and graft losses could have been prevented if our transplant units were not deficient with respect to laboratory facilities and access to pharmaceutical agents. In April 2000, legislation recognizing brain death and cadaveric organ transplantation passed our parliament. Strong cultural barriers may limit the scale of cadaver donor transplantation in the coming years and

  16. Quality measurement and improvement in liver transplantation.

    Science.gov (United States)

    Mathur, Amit K; Talwalkar, Jayant

    2018-06-01

    There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  17. Analysis of a 12-Finger Rod Drop using RETRAN/MASTER Code System for APR1400

    International Nuclear Information System (INIS)

    Yu, Keuk Jong; You, Sung Chang; Kim, Han Gon

    2009-01-01

    The Optimized Power Reactor 1000 (OPR1000) has 4-finger and 12-finger Control Element Assemblies (CEAs). When the 12-finger CEA is dropped, Core Protection Calculator System (CPCS) shuts down the reactor to prevent fuel damage that could occur from the sudden reactor power peaking. By contrast, the improved CPCS of Advanced Power Reactor 1400 (APR1400), which has systems similar to those of the OPR1000, decreases reactor power rapidly using its Reactor Power Cutback System (RPCS) to avoid unwanted reactor trips caused by the CPCS during a 12- finger CEA drop event. RETRAN is a best-estimate code for transient analysis of Non-LOCA. The RETRAN control logic, which includes the function of reducing reactor power during a 12-Finger CEA drop, has been developed for the APR1400. A MATRAN program has also been developed. MATRAN is the interface program for realtime processing to connect RETRAN with MASTER code which is a nuclear analysis and design code. MATRAN supplies adequate feedback reactivities from the MASTER code to RETRAN code. The purpose of this study is to analyze the behavior of a nuclear reactor core and its primary system using conventional RETRAN analysis procedure and MATRAN program analysis procedure during a 12- finger CEA drop. In addition, the axial power distribution and Axial Shape Index (ASI) are produced by the MATRAN program and they are confirmed as within operation limits

  18. Unilateral lung transplantation for pulmonary fibrosis.

    Science.gov (United States)

    1986-05-01

    Improvements in immunosuppression and surgical techniques have made unilateral lung transplantation feasible in selected patients with end-stage interstitial lung disease. We report two cases of successful unilateral lung transplantation for end-stage respiratory failure due to pulmonary fibrosis. The patients, both oxygen-dependent, had progressive disease refractory to all treatment, with an anticipated life expectancy of less than one year on the basis of the rate of progression of the disease. Both patients were discharged six weeks after transplantation and returned to normal life. They are alive and well at 26 months and 14 months after the procedure. Pulmonary-function studies have shown substantial improvement in their lung volumes and diffusing capacities. For both patients, arterial oxygen tension is now normal and there is no arterial oxygen desaturation with exercise. This experience shows that unilateral lung transplantation, for selected patients with end-stage interstitial lung disease, provides a good functional result. Moreover, it avoids the necessity for cardiac transplantation, as required by the combined heart-lung procedure, and permits the use of the donor heart for another recipient.

  19. Uterus transplantation: ethical and regulatory challenges.

    Science.gov (United States)

    Arora, Kavita Shah; Blake, Valarie

    2014-06-01

    Moving forward rapidly in the clinical research phase, uterus transplantation may be a future treatment option for women with uterine factor infertility, which accounts for three per cent of all infertility in women. This new method of treatment would allow women, who currently rely on gestational surrogacy or adoption, to gestate and birth their own genetic offspring. Since uterus transplantation carries significant risk when compared with surrogacy and adoption as well as when compared with other organ transplants, it requires greater justification because its goals are quality of life, not life-saving, in their scope. It is important to address questions regarding the physical, psychosocial and ethical risks and benefits of uterus transplantation for all three parties involved--the patient, the donor and the potential child--as well as discuss the regulatory implications as research on uterus transplantations moves forward. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Tetanus after allogeneic bone-marrow transplantation

    International Nuclear Information System (INIS)

    Kendra, J.R.; Halil, O.; Barrett, A.J.; Selwyn, S.

    1982-01-01

    A brief report is presented of a case of tetanus after allogeneic bone-marrow transplantation complicated by radiation-induced pneumonitis. A 30-year-old army sergeant received a bone-marrow transplant from his brother for the treatment of a granulocytic sarcoma after local radiotherapy to the tumour. Six years earlier he had sustained an open, compound fracture of the left tibia and fibula while on army exercise. At the time a pin and plate had been inserted and booster anti-tetanus administered. Bone-marrow transplantation was performed after total body irradiation. Cyclosporin A was given against graft-versus-host disease. Fifty four days after transplantation tetanus was diagnosed and death followed 14 days later. Necropsy disclosed radiation-induced pneumonitis, but no organisms were cultured from the lungs or the old fracture site. It is suggested that spores were incorporated into the wound site before surgery and that oxygenation around the plate became compromised after transplantation, permitting germination of dormant spores, immunosuppression allowing development of the disease. (U.K.)