WorldWideScience

Sample records for apres transplantation hepatique

  1. Sympathetic re-innervation of myocardium after liver transplant in the hereditary amyloid neuropathy; Reinnervation sympathique du myocarde apres transplantation hepatique dans la neuropathie amyloide hereditaire

    Energy Technology Data Exchange (ETDEWEB)

    Delahaye, N.; Le Guludec, D. [Medecine Nucleaire, Hopital Bichat, Paris (France); Slama, M. [Cardiologie, Hopital A.Beclere, Paris (France); Guyen, C.N. [SHFJ, DSV-CEA, Orsay (France); Dinanian, S. [Cardiologie, Hopital A.Beclere, Paris (France); Merlet, P. [SHFJ, DSV-CEA, Orsay (France)

    1997-12-31

    The hereditary amyloid neuropathy (HAN) is characterized by a progressive sensory-motor poly-neuropathy and a dysautonomia with myocardium sympathetic denervation. This is established by MIBL scintigraphy and may enhance the troubles of conduction and of cardiac rhythm. The amyloid deposits are constituted of anomalous pre-albumin fabricated by liver. The hepatic transplant (HT) is the only known treatment. Four patients (GI: 39 {+-} 5 years) have been studied by MIBG scintigraphy, 2.2 {+-} 0.7 years after HT, and compared with 12 patients (GII: 39 {+-} 12 years) studied before HT. The left ventricular function, the coronary arteries and the at-rest scintigraphy with thallium were normal for all of them. The cardiac capture of MIBG, evaluated by the cardio-mediastinal activity ratio (C/M), measured on an anterior thoracic planar acquisition performed 4 hours after the intravenous injection of 300 MBq, was higher for GI than for GII (1.49 {+-} 0.12 vs 1.29 {+-} 0.13, p 0.02). The washouts (4 h / 20 min) were not different. In tomography, the patients of GI presented focal anomalies with a more-or-less extended apical defect, a satisfying fixation of the basal half of the anterior wall, more-or-less overflowing the septal and lateral walls, and for 2 patients, a satisfying inferior fixation. On the contrary, 9/12 patients of GII have had a diffuse absence of fixation, the other three heaving a satisfying antero-basal fixation ({chi}{sup 2}, p = 0.05). The results are not explained by difference of severity or evolution duration of HAN. Thus, it appears that there exists a sympathetic re-innervation of myocardium after HT in the HAN, debuting by the heart base, similarly with the effect of anatomic interruption of innervation in cardiac transplants

  2. Role of imaging in preoperative assessment of liver transplant recipients. Bilan pre-transplantation hepatique. Apport de l'imagerie

    Energy Technology Data Exchange (ETDEWEB)

    Uzan, E. (Hopital Cochin, 75 - Paris (France))

    1994-01-01

    Medical imaging plays an essential role in the preoperative assessment of liver transplant patients to detect any lesions contra-indicating the operation or to detect any anatomical variants in the recipient likely to lower the chances of success of the transplantation. At the present time, the imaging techniques useful in the preoperative assessment are colour Doppler ultrasound, abdominal CT scan and coeliac and superior mesenteric arteriography. The calibre and patency of the portal trunk and its branches, the hepatic artery at the porta hepatis, the hepatis veins and their distribution and the inferior vena cava are systematically evaluated. Systematic identification of the various portosystemic shunts in the context of portal hypertension helps to define a veritable preoperative map. (author). 7 refs., 12 figs.

  3. Facteurs influençant le retour au travail après transplantation chez 61 patients rénaux ou hépatiques

    OpenAIRE

    Praz-Christinaz, S.-M.

    2014-01-01

    Enjeux La réussite d'une transplantation rénale ou hépatique intègre non seulement le succès de l'acte chirurgical et sa prise en charge médicale post-greffe, mais également pour le patient greffé l'assurance d'une nouvelle qualité de vie dont le retour au travail fait partie. Le retour au travail après greffe est cependant généralement peu étudié dans la littérature et peu discuté semble-t-il au niveau médical que ce soit avant ou après greffe, quand bien même d'un point de vue médico-...

  4. Déterminants moléculaires de la néphrotoxicité induite par le tacrolimus après transplantation rénale

    OpenAIRE

    Van Der Hauwaert , Cynthia

    2014-01-01

    Although widely prescribed in kidney transplantation, Tacrolimus use is limited by its nephrotoxic effects. Indeed, Tacrolimus contributes to the development of renal interstitial fibrosis lesions and tubular atrophy with a large variability between patients. Among the mechanisms involved in fibrogenesis, the epithelial-mesenchymal transition (EMT) has been proposed. EMT is a dynamic process by which a polarized epithelial cell loses its epithelial markers (E-cadherin, cytokeratin, membrane &...

  5. TRANSPLANTATION

    African Journals Online (AJOL)

    stage kidney disease. There is good evidence that transplantation improves both the quality and quantity of life in renal transplant recipients when compared with dialysis.1,2. Living donor kidney transplantation has gained popularity, not only owing ...

  6. 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,...

  7. APR-2 Tropical Cyclone Observations

    Science.gov (United States)

    Durden, S. L.; Tanelli, S.

    2011-01-01

    The Second Generation Airborne Precipitation Radar (APR-2) participated in the Genesis and Rapid Intensification Processes (GRIP) experiment in August and September of 2010, collecting a large volume of data in several tropical systems, including Hurricanes Earl and Karl. Additional measurements of tropical cyclone have been made by APR-2 in experiments prior to GRIP (namely, CAMEX-4, NAMMA, TC4); Table 1 lists all the APR-2 tropical cyclone observations. The APR-2 observations consist of the vertical structure of rain reflectivity at 13.4 and 35.6 GHz, and at both co-polarization and crosspolarization, as well as vertical Doppler measurements and crosswind measurements. APR-2 normally flies on the NASA DC-8 aircraft, as in GRIP, collecting data with a downward looking, cross-track scanning geometry. The scan limits are 25 degrees on either side of the aircraft, resulting in a roughly 10-km swath, depending on the aircraft altitude. Details of the APR-2 observation geometry and performance can be found in Sadowy et al. (2003).The multiparameter nature of the APR-2 measurements makes the collection of tropical cyclone measurements valuable for detailed studies of the processes, microphysics and dynamics of tropical cyclones, as well as weaker systems that are associated with tropical cyclone formation. In this paper, we give a brief overview of how the APR-2 data are processed. We also discuss use of the APR-2 cross-track winds to estimate various quantities of interest in in studies of storm intensification. Finally, we show examples of the standard products and derived information.

  8. 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

  9. Evaluation of hepatic functional gain by hepato-biliary scintigraphy (HBS) after portal embolization; Evaluation du gain functionnel hepatique par la scintigraphie hepato-biliaire (SHB) apres embolisation portale

    Energy Technology Data Exchange (ETDEWEB)

    Zerbib, E.; Azoulay, D.; Wartski, M.; Castaing, D.; Bismuth, H. [Medecine Nucleaire CCML, 92350 Le Plessis-Robinson, CHB, Hopital Paul Brousse, 94804 Villejuif Cedex (France)

    1997-12-31

    The partial hepatic extirpation is an alternative therapeutics in malign tumors of liver. The post-surgery risk of hepato-cellular insufficiency (HCI) is important when the extracted volume is higher than 70 - 80% of the total volume of a non-cirrhotic liver. In this case, sometimes, a homolateral-to-tumor portal embolization (PE) was proposed in order to induce an atrophy of the embolized side and a compensating hypertrophy of the contralateral side. The HBS was proposed as a method for evaluated the functional gain after PE. Six patients have benefited by 2 HBS: one of them before PE, the others, 3 weeks after. The dynamic acquisition was achieved after intravenous injection of 300 MBq of {sup 99m}Tc - tBIDA, on a DST (SMV) camera equipped with HRBE collimators. The regions of interest (ROI) corresponding to right and left liver, were drawn on an anterior and posterior image of the `parenchymatous` time (the forth or fifth minute), allowing the calculation of the functional ratio by arithmetic mean. The gain of the functional ratio of healthy liver was in average of 7% (ranging from 1 to 13%). These results appear to be comparable with those from scanner in 5 cases but different in one case (functional gain without volumetric gain at scanner); this last patient was finally successfully operated. Totally, the surgery indication was posed in these 6 patients, one of whom, solely, on arguments of scintigraphic quantification. The HBS allows estimating the variations in functional ratios before and after PE. This is a supplementary tool in the evaluation of the feasibility of a major hepatectomy after PE

  10. Complications biliaires après tranplantation hépatique

    OpenAIRE

    Veltchev, L.M.

    2005-01-01

    RESUME Après transplantation hépatique (TH), il persiste une morbidité et une mortalité liées aux complications immunologiques, infectieuses, rénales, vasculaires et, en particulier, aux complications biliaires - le "talon d'Achille" de la TH. Dans ce travail de thèse, nous avons analysé la fréquence et les caractéristiques des complications biliaires après TH dans l'expérience du CHUV à Lausanne entre 1988 et 2003. Au total 185 transplantations orthotopiques ont été réalisées chez 168 ...

  11. 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

  12. 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.

  13. Cross flow tests of APR+ core simulator

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kih Wan; Chu, In Cheol; Choi, Hae Seob; Euh, Dong Jin; Kwon, Tae Soon [KAERI, Daejeon (Korea, Republic of)

    2012-10-15

    An accurate prediction of an APR+ core flow is in demand since the APR+ has 257 fuel assemblies, unlike in the APR1400. The APR+ reactor flow distribution test facility, which was named ACOP (APR+ Core Flow and Pressure Test Facility), was developed to conduct various hydraulic tests. The 257 core simulators were installed in the ACOP to measure the hydraulic characteristics at the inlet and outlet of the fuel assemblies. The simulator was designed with a linear reduced scale of 1/5 to preserve a geometrically similar flow without hindering the dynamic similarity. The cross flow characteristic of the simulator may be regarded as of major importance to evaluate the pressure distribution at the outlet of the fuel assembly. This paper shows a cross flow test for each core simulator which are arranged in a row. The results are also compared with those of the HIPER and core simulators obtained from the CFD code, and are carefully examined.

  14. 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)

  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. NAMMA SECOND GENERATION AIRBORNE PRECIPITATION RADAR (APR-2) V1

    Data.gov (United States)

    National Aeronautics and Space Administration — The NAMMA Second Generation Airborne Precipitation Radar (APR-2) dataset was collected by using the Second Generation Airborne Precipitation Radar (APR-2), which is...

  17. GRIP AIRBORNE SECOND GENERATION PRECIPITATION RADAR (APR-2) V1

    Data.gov (United States)

    National Aeronautics and Space Administration — The GRIP Airborne Second Generation Precipitation Radar (APR-2) dataset was collected from the Second Generation Airborne Precipitation Radar (APR-2), which is a...

  18. APR1400 severe accident mitigation design

    Energy Technology Data Exchange (ETDEWEB)

    Jae Young, Lim; Jae Youb, Byun [Shin-Kori 3 and 4 NPP Project, Korea Power Engineering Company, Yongin-si, Gyeonggi-do (Korea, Republic of)

    2007-07-01

    APR1400, a Korean evolutionary advanced LWR, has been developed to meet the quantitative safety goals of mean core damage frequency to be less than one in one hundred thousand reactor years (10{sup -5}/y) and the expected overall mean frequency of occurrence of offsite doses in excess of 0.01 Sv within 24 hours at the site boundary to be less than one per million reactor years (10{sup -6}/y). In order to meet these quantitative goals, defense in depth, a long standing fundamental principle of reactor safety, was applied to ensure plant safety and to provide the balanced design between prevention and mitigation. And various advanced design features were reviewed to improve plant safety in the viewpoint of prevention and mitigation of design basis accident and severe accident. In this paper, 5 issues concerning severe accident mitigation features of the APR1400 are reviewed: 1) hydrogen control, 2) high pressure melt ejection and direct containment heating, 3) steam explosion, 4) molten corium concrete interaction, and 5) equipment survivability. It is shown that the APR1400 has been designed to withstand severe accidents.

  19. Kidney Transplant

    Science.gov (United States)

    ... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z Health ... Tests for Transplant Care After Kidney Transplant Common Organ Donation and Transplantation Terms The National Kidney Foundation (NKF) is the ...

  20. 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.

  1. Calibration Tests of Fuel Assembly Simulators of APR+ Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kih Wan; Chu, In Cheol; Euh, Dong Jin; Kwon, Tae Soon [KAERI, Daejeon (Korea, Republic of)

    2012-10-15

    A Reactor flow distribution is regarded to be major importance in improving the design margin of a flow distribution. The prediction of APR+ core fluid flow phenomena has been in demand, since 257 fuel assemblies are adapted in the APR+, unlike in the APR1400. The APR+ reactor flow test facility, the ACOP (APR+ Core Flow and Pressure Test Facility), was constructed to analyze the hydraulic characteristics. For the ACOP facility, the core simulator was designed with a scale analysis to simulate the real HIPER fuel assembly of an APR+. In this study, for all 257 core simulators, several calibration tests were conducted to verify their design performance before applying them to the ACOP facility. The inlet flow rate and the total pressure drop of the simulators were measured by varying flow rates to evaluate its compatibility. The discharge coefficients were also calculated from the experimental data to produce a statistical database for a further ACOP facility test.

  2. 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...

  3. Kidney Transplant

    Science.gov (United States)

    ... type matches or is compatible to your own. Blood-type incompatible transplants are also possible but require additional medical treatment before and after transplant to reduce the risk of organ rejection. These are known as ABO incompatible kidney transplants. ...

  4. Kidney transplant

    Science.gov (United States)

    ... place a healthy kidney into a person with kidney failure . ... Renal transplant; Transplant - kidney ... Becker Y, Witkowski P. Kidney and pancreas transplantation. In: Townsend CM ... Urology . 11th ed. Philadelphia, PA: Elsevier; 2016: ...

  5. 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

  6. 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.

  7. Revision of testing criteria for air cleaning unit of renovated APR-1000 and APR-1400 NPPS.

    Science.gov (United States)

    Jeong, Seung-Young

    2011-07-01

    Designing Air Cleaning Units (ACU) of an Engineered Safety Feature and normal atmosphere clean-up system at the renovated APR-1000 and APR-1400 NPP, and fuel cycle facilities in Korea, is required to meet the standards of ASME AG-1 (1997), ASME N509/N510 (1989) and KEPIC-MH (2001) to enhance the removal efficiency of aerosols and particulates from the effluents. The revised ACU testing criteria are allowed to use alternative challenge agents of the dioctyl phthalate and Refrigerant-11 for in situ testing of high efficiency particulate air filters and adsorption banks. The operability testing time of engineered safety feature (ESF) trains was changed from 10 h to 15 min. The activated carbon in adsorption banks should undergo laboratory tests at a temperature of 30 °C and relative humidity 95 %. The removal criteria of methyl iodide should be over 99.5 % for ESF and 99 % for normal systems. This paper provides the background of the changed criteria for designing and testing of the ACU system in nuclear facilities.

  8. Study of ciclosporine blood levels in patients after kidney or bone-marrow transplantation. Comparison between the two methods, fluorescence polarization immunoassay and radioimmunoassay. Etude de la ciclosporinemie de patients traites apres greffe de rein ou de moelle. Comparaison entre les methodes par immunofluorescence et radio-immunologique

    Energy Technology Data Exchange (ETDEWEB)

    Sadeg, N.; Pham Huy, C.; Claude, J.R. (Paris-5 Univ., 75 (FR)); Postaire, M.; Lebrec, H.; Hamon, M. (Paris-11 Univ., 92 - Chatenay-Malabry (FR) Hopital Necker-Enfants Malades, 75 - Paris (FR)); Broyer, M.; Gagnadoux, M.F.; Fischer, A. (Hopital Necker-Enfants Malades, 75 - Paris (FR))

    1989-01-01

    The apparition of ciclosporine, immunodepressive drug, has largely improved the organ transplantations. However, the range of blood concentrations must be defined to allow the efficacity of ciclosporine therapy and to avoid toxic reactions, because there are very important variations for a same dosage according to the individuals and the diseases. Relative to the low concentrations to be determined (about one hundred ng/ml), the most useful methods for ciclosporine measurement are based on immunochemical assays. This work compares the two methods: radioimmunoassay (RIA) and fluorescence polarization immunoassay (FPIA) simultaneously performed on several hundred samples. A very significant correlation exists between the two techniques (r = 0.80). The advantages of immunofluorescent assay consists in rapidity, sensibility and facility to realize emergency analysis.

  9. GRIP AIRBORNE SECOND GENERATION PRECIPITATION RADAR (APR-2) 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...

  10. 888.pdf | 10apr2010 | currsci | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    2010-04-10

    Apr 10, 2010 ... Good Governance: Contribution of Vigilance · Vigilance Awareness Talk by K Jairaj, Former Additional Chief Secretary, Government of Karnataka. 17 November, 2017, 3:30 PM Auditorium, Raman Research Institute ...

  11. APR-2 Dual-frequency Airborne Radar Observations, Wakasa Bay

    Data.gov (United States)

    National Aeronautics and Space Administration — In January and February 2003, the Airborne Second Generation Precipitation Radar (APR-2) collected data in the Wakasa Bay AMSR-E validation campaign over the sea of...

  12. 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.

  13. Hair transplant

    Science.gov (United States)

    ... this procedure: Scarring Unnatural-looking tufts of new hair growth It is possible that the transplanted hair will ... Most hair transplants result in excellent hair growth within several ... may be needed to create best results. The replaced hairs are ...

  14. Transplant rejection

    Science.gov (United States)

    ... Shortness of breath and less ability to exercise (heart transplant) Yellow skin color and easy bleeding (liver transplant) ... accountability. A.D.A.M. is among the first to achieve this important distinction for online health ...

  15. Intestine Transplant

    Science.gov (United States)

    ... to know FAQ Living donation What is living donation? Organs Types Being a living donor First steps Being ... Nursing Care of the Renal Transplant Recipient." UNOS Donation and Transplantation Nursing Curriculum . 1996 This Web site is intended ...

  16. Islet Transplantation

    Science.gov (United States)

    ... be successful. However, transplanting islet cells has several advantages over transplanting a pancreas. First, unlike the pancreas ... Email: Sign Up Thank you for signing up ' + ' '); $('.survey-form').show(); }, success: function (data) { $('#survey-errors').remove(); $('. ...

  17. Komandas darbs - JIT pacientu aprūpē

    OpenAIRE

    Stramkale, Ilze

    2014-01-01

    Pētniecības darbs „Komandas darbs – Jaundzimušo intensīvās terapijas pacientu aprūpē” tika veikts ar mērķi noskaidrot komandas darba priekšnosacījumus un pielietojumu Jaundzimušo intensīvās terapijas pacientu aprūpē. Darbā tika izvirzīti divi pētnieciskie jautājumi – kā tiek realizēts komandas darbs Jaundzimušo Intensīvās terapijas nodaļā, un vai komandas darbs Jaundzimušo intensīvās terapijas nodaļā ir kvalitatīvas aprūpes priekšnosacījums? Mērķa sasniegšanai izmantota kvalitatīvā pētnie...

  18. 968.pdf | apr102007 | currsci | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; currsci; apr102007; 968.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. Theory Of Evolution. Posted on 23 January 2018. Joint Statement by the Three Science Academies of India ...

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

    Indian Academy of Sciences (India)

    2010-04-10

    Apr 10, 2010 ... ASTROPHYSICS: An Observational View of the Universe. Math Art and Design: MAD about Math, Math Education and Outreach. Math and Finance. Summer Research Fellowship Programme 2018. Posted on 16 December 2017. REGISTRATIONS CLOSED. Announcement of selected candidates will ...

  20. 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 ...

  1. 935.pdf | apr102008 | currsci | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; currsci; apr102008; 935.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. Ethical Guidelines and Procedures document. Posted on 17 January 2017. A revised version of the ...

  2. 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

  3. 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...

  4. Liver Transplant

    Science.gov (United States)

    ... Nutrition Clinical Trials Primary Biliary Cholangitis Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Wilson Disease Liver Transplant View or Print All Sections Definition & ...

  5. 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.

  6. Corneal Transplantation

    DEFF Research Database (Denmark)

    Hjortdal, Jesper Østergaard

    Corneal transplantation has been performed for more than 100 years. Until 15 years ago the state-of-the art type of transplantation was penetrating keratoplasty, but since the start of this millennium, newly designed surgical techniques have developed considerably. Today, the vast majority of ker...

  7. Heart transplant

    Science.gov (United States)

    ... hospital for 7 to 21 days after a heart transplant. The first 24 to 48 hours will likely be in ... follow your self-care instructions. Biopsies of the heart muscle are ... after transplant, and then less often after that. This helps ...

  8. Lung transplant

    Science.gov (United States)

    ... transplant surgery include: You are placed on the heart-lung machine. One or both of your lungs are removed. For people who are having a double lung transplant, most or all of the steps from the first side are completed before the second side is ...

  9. Data of evolutionary structure change: 1APWE-3APRE [Confc[Archive

    Lifescience Database Archive (English)

    Full Text Available 1APWE-3APRE 1APW 3APR E E AASGVATNTPTANDEEYITPVTIGG--TTLNLNFDTGSA...VFDCST-NLPDFSVSISGYTATVPGSLINYGPSGDGSTCLGGIQSNSGIGFSIFGDIFLKSQYVVFDSDGPQLGFAPQA-VAE EEEEEEEEEEGGG EEEEEEEE --EEEEEEEE EEEE HHH...EEEEEE EEEEE 0 1APW E 1APWE YNPSA--

  10. Data of evolutionary structure change: 1APUE-3APRE [Confc[Archive

    Lifescience Database Archive (English)

    Full Text Available 1APUE-3APRE 1APU 3APR E E AASGVATNTPTANDEEYITPVTIGG--TTLNLNFDTGSA...VFDCSTN-LPDFSVSISGYTATVPGSLINYGPSGDGSTCLGGIQSNSGIGFSIFGDIFLKSQYVVFDSDGPQLGFAPQA-VAE EEEEEEEEEEGGG EEEEEEEE --EEEEEEEE EEEE -- ...EEEEE 0 1APU E 1APUE YNPSA--TGKEL

  11. 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

  12. 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)

  13. 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

  14. Development of the APR+ Reactor Containment Building General Arrangement (GA)

    International Nuclear Information System (INIS)

    Moon, Hyung Keun; Kim, Dae Hun; Park, Young Sheop

    2011-01-01

    The general arrangement (GA) drawing of a nuclear power plant is the most basic drawing, containing 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 the APR+ (Advanced Power Reactor+), as a model to succeed the APR1400 (Advanced Power Reactor 1400) design, has its own GA that encompasses all of its power buildings. This drawing was developed starting in October of 2009. Among several of the buildings in this design, the Reactor Containment Building (RCB), Auxiliary Building (AB), and EDG (Emergency Diesel Generator) Building are some 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 RCB

  15. 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 ...

  16. 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)

  17. Issue reproductive des femmes apres traitement chirurgical de la ...

    African Journals Online (AJOL)

    La grossesse extra-utérine, est une pathologie obstétricale qui porte une atteinte profonde à l\\'intégrité de l\\'appareil reproducteur de la femme. Cette étude vise à apprécier l\\'issue reproductive après traitement chirurgical et identifier les facteurs de risque de infertilité secondaire. Cette étude, descriptive et rétrospective, ...

  18. 990.pdf | apr252001 | currsci | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; currsci; apr252001; 990.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 ...

  19. Grossesse apres myomectomie a Libreville, Gabon | Bang Ntamack ...

    African Journals Online (AJOL)

    Cette étude avait pour but de déterminer la proportion des femmes ayant eu une grossesse menée à terme après myomectomie dans notre service. C'était une étude rétrospective et descriptive portant sur tous les cas de grossesse menée à terme chez des patientes ayant eu une myomectomie à la maternité Joséphine ...

  20. grossesse apres myomectomie a libreville, gabon. pregnancy after ...

    African Journals Online (AJOL)

    19 déc. 2009 ... Cette étude avait pour but de déterminer la proportion des femmes ayant eu une grossesse menée à terme après myomectomie dans notre service. C'était une étude rétrospective et descriptive portant sur tous les cas de grossesse menée à terme chez des patientes ayant eu une myomectomie à la ...

  1. 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 ...

  2. 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...

  3. Organ Transplantation

    Science.gov (United States)

    ... here for a deeper conversation on this topic led by Hastings Director of Research Josephine Johnston. Sorry, ... accept people without insurance. Transplant teams rarely consider anyone over 75 years of age. Some centers exclude ...

  4. Hair Transplants

    Science.gov (United States)

    ... for Every Season How to Choose the Best Skin Care Products In This Section Dermatologic Surgery What is dermatologic ... for Every Season How to Choose the Best Skin Care Products Hair Transplants Before (left) and after (right) - top ...

  5. Cornea Transplant

    Science.gov (United States)

    ... Swelling of the cornea Signs and symptoms of cornea rejection In some cases, your body's immune system ... the risks of the procedure. Finding a donor cornea Most corneas used in cornea transplants come from ...

  6. Liver Transplant

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now Liver Transplant Back In ...

  7. Kidney-Pancreas Transplant

    Science.gov (United States)

    ... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z Health ... Tests for Transplant Care After Kidney Transplant Common Organ Donation and Transplantation Terms The National Kidney Foundation (NKF) is the ...

  8. Review of APR+ Level 2 PSA. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, John R. [Brookhaven National Lab. (BNL), Upton, NY (United States); Mubayi, Vinod [Brookhaven National Lab. (BNL), Upton, NY (United States); Pratt, W. Trevor [Brookhaven National Lab. (BNL), Upton, NY (United States); Kim, Do Sam [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of); Cho, Yong Jin [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of); Cho, Sang Jin [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of); Kim, In Goo [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of)

    2012-02-17

    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 & Nuclear Power Co., Ltd (KHNP) and KEPCO Engineering & Construction Co., Inc. (KEPCO-E&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&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&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.

  9. Application of Nuclear Application Programs to APR1400 Simulator

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Do Hyun; Lee, Myeong Soo; Hong, Jin Hyuk [Korea Hydro and Nuclear Power Co., Daejeon (Korea, Republic of)

    2012-05-15

    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

  10. Severe Accident Management Strategy for EU-APR1400

    International Nuclear Information System (INIS)

    Hwang, Do Hyun; Kim, Yong Soo; Yoon, Sun Hong

    2013-01-01

    In EU-APR1400, the dedicated instrumentation and mitigation features for SAM are being developed to keep the integrity of containment and to prevent the uncontrolled release of fission products. In this paper, SAM strategy for EU-APR1400 was introduced in stages. It is still under development and finally the Severe Accident Management Guidance will be completed based on this SAM Strategy. Severe accidents in a nuclear power plant are defined as certain unlikely event sequences involving significant core damage with the potential to lead to significant releases according to EUR 2.1.4.4. Even though the probability of severe accidents is extremely low, the radiation release may cause serious effect on people as well as environment. Severe Accident Management (SAM) encompasses those actions which could be considered in recovering from a severe accident and preventing or mitigating the release of fission products to the environment. Whether those actions are successful or not, depending on a progression status of a severe accident to mitigate the consequences of severe accident phenomena to limit the release of radioactive materials keeping the leak tightness of the Primary Containment, and finally to restore transient severe accident progression into a controlled and safe states

  11. 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

  12. Cadaveric transplantation.

    Directory of Open Access Journals (Sweden)

    Gokal R

    1993-10-01

    Full Text Available Transplantation is already the optimum treatment for terminal renal failure. Donor organ shortage means that there are large number of patients on dialysis awaiting this treatment. This has in some countries led to unacceptable unscrupulous practices of live non-related graft donation. The outcome of graft and patient after transplantation has improved significantly based on a better understanding of immunopathology, immunosuppression and tissue typing. The future is promising and xenografting may well solve the organ shortage but undoubtedly will raise other issues.

  13. 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

  14. Eyebrow transplantation.

    Science.gov (United States)

    Goldman, G D

    2001-04-01

    Reconstruction of the eyebrow has historically been accomplished with temporal scalp pedicle flap formation or free composite scalp grafts. These two techniques may be associated with substantial morbidity and a false, overly dense eyebrow appearance. Hair transplantation of the eyebrows has been described with excellent results, but is relatively underreported in the literature. To determine whether modern techniques of micrograft hair transplantation can suitably re-create an aesthetic eyebrow in a case of iatrogenic eyebrow alopecia. A 33-year-old woman with iatrogenic eyebrow alopecia underwent four sessions of eyebrow micrograft hair transplantation to re-create both eyebrows. Suitable aesthetic eyebrows were re-created in a symmetric fashion with proper hair orientation. The process was time consuming and tedious, but highly effective. Eyebrow transplantation is a suitable alternative to pedicle flap formation and composite scalp grafting. It is a straightforward procedure that can be performed in the office under local anesthesia with minimal attendant morbidity. The result may be superior to that seen with more involved eyebrow replacement procedures.

  15. Intestine transplantation

    Directory of Open Access Journals (Sweden)

    Tadeja Pintar

    2011-02-01

    Conclusion: Intestine transplantation is reserved for patients with irreversible intestinal failure due to short gut syndrome requiring total paranteral nutrition with no possibility of discontinuation and loss of venous access for patient maintenance. In these patients complications of underlying disease and long-term total parenteral nutrition are present.

  16. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  17. Deterministic Hydraulic Load Analysis on Reactor Internals of APR1400

    International Nuclear Information System (INIS)

    Kim, Kyu Hyung; Ko, Do Young; Gu, Ja Yeong

    2011-01-01

    The structural integrity of the reactor vessel internals (RVI) of the nuclear power plants that have been constructed should be verified in accordance with the US Nuclear Regulatory Commission Regulatory Guide 1.20 (RG1.20) comprehensive vibration assessment program (CVAP) during preoperational and initial startup testing. The program consists of a vibration and stress analysis, a vibration measurement, an inspection, and an assessment of each program. The vibration and stress analysis program is comprised of a hydraulic load analysis and a structural response analysis. The hydraulic loads include the random hydraulic loads induced by turbulent flow and deterministic hydraulic loads induced by pump pulsation. This paper describes a developed full scope 3-D model and the deterministic hydraulic loads for the RVI of the APR1400

  18. Transplant Ethics.

    Science.gov (United States)

    Altınörs, Nur; Haberal, Mehmet

    2016-11-01

    The aim of this study was to review and discuss the great variety of ethical issues related to organ donation, organ procurement, transplant activities, and new ethical problems created as a result of technologic and scientific developments. An extensive literature survey was made, and expert opinions were obtained. The gap between demand and supply of organs for transplant has yielded to organ trafficking, organ tourism, and commercialism. This problem seems to be the most important issue, and naturally there are ethical dilemmas related to it. A wide number of ideas have been expressed on the subject, and different solutions have been proposed. The struggle against organ trafficking and commercialism should include legislation, efforts to increase deceased-donor donations, and international cooperation. China's policy to procure organs from prisoners sentenced to death is unethical, and the international community should exert more pressure on the Chinese government to cease this practice. Each particular ethical dilemma should be taken separately and managed.

  19. 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

  20. 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

  1. Design of Electric Power System for EU-APR1400 according to EUR

    International Nuclear Information System (INIS)

    Kin, Yong Soo; Kim, Dong Hwan; Kim, Yong Soo

    2014-01-01

    The APR1400 design was developed to comply with the US regulations for advanced light water reactor and the EPRI URD. It is an evolutionary advanced light water reactor whose design includes technologies proven through experiences and lessons learned of OPR1000(optimized power reactor 1000) construction and operation. In order to enlarge and diversify the export market of APR1400, the EU-APR1400 design has been developed on the basis of APR1400 design to comply with European Utility Requirements(EUR). This paper describes the major European design requirements of electric power system and the design characteristics of EU-APR1400 power system which is based on the European design requirements. In this paper, the European design requirements associated with electric power system were introduced and corresponding design characteristics of EU-APR1400 power system were described. Through the redundancy, independence and diversity design of EU-APR1400 power system, the safety and reliability for supplying electric power were improved. And through the design of dedicated SAs power supply system, EU-APR1400 on-site power system became to be able to mitigate the SAs. The plant safety was also enhanced by designing emergency power supply system in various ways

  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. Modal analysis of an ECC duct for APR+ reactor barrel

    International Nuclear Information System (INIS)

    Kang, H.S.; Lee, K.H.; Kwon, T.S.

    2011-01-01

    Advanced Power Reactor Plus (APR+) provides four Direct Vessel Injection (DVI) ducts on the reactor barrel to enhance the performance of Emergency Core Cooling System (ECCS). Several studies on safety analysis have verified the excellent performance of the DVI duct. In this study, from the viewpoint of mechanical integrity, modal analyses of two full-scaled DVI ducts have been presented; both numerical analysis and modal tests have been performed in air and water. It was found that the numerical simulation and modal test coincide with each other. The DVI duct is a thin shell of 5 mm thickness, so that harmonic responses to RCP blade passing frequencies should be checked. The dominant passing frequencies are known to be 20, 40, 60, 120 and 240 Hz. In addition, an interesting thing in this study is that added mass effect by coolant seems to be so significant that the natural frequency of the ducts under water could be considerably low as compared with those in air; the natural frequency under water is 60 % lower than that in air. (author)

  4. Extended Station Blackout Coping Capabilities of APR1400

    Directory of Open Access Journals (Sweden)

    Sang-Won Lee

    2014-01-01

    Full Text Available The Fukushima Dai-ichi nuclear power plant accident shows that an extreme natural disaster can prevent the proper restoration of electric power for several days, so-called extended SBO. In Korea, the government and industry performed comprehensive special safety inspections on all domestic nuclear power plants against beyond design bases external events. One of the safety improvement action items related to the extended SBO is installation of external water injection provision and equipment to RCS and SG. In this paper, the extended SBO coping capability of APR1400 is examined using MAAP4 to assess the effectiveness of the external water injection strategy. Results show that an external injection into SG is applicable to mitigate an extended SBO scenario. However, an external injection into RCS is only effective when RCS depressurization capacity is sufficiently provided in case of high pressure scenarios. Based on the above results, the technical basis of external injection strategy will be reflected on development of revised severe accident management guideline.

  5. Analysis on Containment Response Following a LBLOCA of APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kyu Hyun [KINS, Daejeon (Korea, Republic of)

    2016-05-15

    The predictions are in good agreements with the final safety analysis report, which implies the containment integrity is maintained during or after an accident like loss of coolant accident. In this study, the CONTEMPT-LT/028 was used to calculate the pressure and temperature, and in the follow-up study, CONTAIN 2.0 will be used for the pressure and temperature predictions in APR1400 reactors. Shin-Hanul Units 1 and 2 may possess different characteristics of peak pressure and temperature in containment following a large break loss-of-coolant-accident. To assess the important performance independently and to compare with prediction results presented in the final safety analysis report (FSAR) of Shin-Hanul Units 1 and 2 might be helpful to regulatory review for identifying validity of the FSAR. The end of blowdown (EOB) time during a LOCA could largely affect the peak pressure and temperature in the containment. This paper provides CONTEMPT-LT/028 prediction of the peak pressure and temperature of Shin-Hanul Units 1 and 2 following a large break loss-of-coolant-accident and compares with licensee's prediction results.

  6. Transplante uterino

    OpenAIRE

    Carvalho, Margarida Teixeira Farias Meira de, 1992-

    2016-01-01

    Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016 A infertilidade de causa uterina afecta cerca de 3-5% da população geral, sendo a adopção e a gestação de substituição as únicas opções para estes casais atingirem a parentalidade, dado que é um problema ainda sem tratamento. Nas últimas décadas, foram realizados diversos estudos animais com o objectivo de demonstrar a viabilidade, segurança e eficácia do transplante uterino como ...

  7. 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

  8. Fuel assembly design for APR1400 with low CBC

    Science.gov (United States)

    Hah, Chang Joo

    2015-04-01

    APR 1400 is a PWR (Pressurized Water Reactor) with rated power of 3983 MWth and 241 assemblies. Recently, demand for extremely longer cycle up to 24 months is increasing with challenge of higher critical boron concentration (CBC). In this paper, assembly design method of selecting Gd-rods is introduced to reduce CBC. The purpose of the method is to lower the critical boron concentration of the preliminary core loading pattern (PLP), and consequently to achieve more negative or less positive moderator temperature coefficient (MTC). In this method, both the ratio of the number of low-Gd rod to the number of high-Gd rod (r) and assembly average Gd wt% (w) are the decision variables. The target function is the amount of soluble boron concentration reduction, which can be converted to ΔkTARGET. A set of new designed fuel assembly satisfies an objective function, min [f =∑i (ΔkF A-Δki ) ] , and enables a final loading pattern to reach a target CBC. The constraints required to determine a set of Δk are physically realizable pair, (r,w), and the sum of Δk of new designed assemblies as close to ΔkTARGET as possible. New Gd-bearing assemblies selected based on valid pairs of (r,w) are replaced with existing assemblies in a PLP. This design methodology is applied to Shin-Kori Unit 3 Cycle 1 used as a reference model. CASMO-3/MASTER code is used for depletion calculation. CASMO-3/MASTER calculations with new designed assemblies produce lower CBC than the expected CBC, proving that the proposed method works successful.

  9. Fuel assembly design for APR1400 with low CBC

    Energy Technology Data Exchange (ETDEWEB)

    Hah, Chang Joo, E-mail: changhah@kings.ac.kr [Department of NPP Engineering, KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2015-04-29

    APR 1400 is a PWR (Pressurized Water Reactor) with rated power of 3983 MWth and 241 assemblies. Recently, demand for extremely longer cycle up to 24 months is increasing with challenge of higher critical boron concentration (CBC). In this paper, assembly design method of selecting Gd-rods is introduced to reduce CBC. The purpose of the method is to lower the critical boron concentration of the preliminary core loading pattern (PLP), and consequently to achieve more negative or less positive moderator temperature coefficient (MTC). In this method, both the ratio of the number of low-Gd rod to the number of high-Gd rod (r) and assembly average Gd wt% (w) are the decision variables. The target function is the amount of soluble boron concentration reduction, which can be converted to Δk{sub TARGET}. A set of new designed fuel assembly satisfies an objective function, min [f=∑{sub i}(Δk{sub FA}−Δk{sub i})], and enables a final loading pattern to reach a target CBC. The constraints required to determine a set of Δk are physically realizable pair, (r,w), and the sum of Δk of new designed assemblies as close to Δk{sub TARGET} as possible. New Gd-bearing assemblies selected based on valid pairs of (r,w) are replaced with existing assemblies in a PLP. This design methodology is applied to Shin-Kori Unit 3 Cycle 1 used as a reference model. CASMO-3/MASTER code is used for depletion calculation. CASMO-3/MASTER calculations with new designed assemblies produce lower CBC than the expected CBC, proving that the proposed method works successful.

  10. 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...

  11. Disjonction symphysaire après un accouchement par voie basse ...

    African Journals Online (AJOL)

    Disjonction symphysaire après un accouchement par voie basse dystocique: à propos d'un cas. Meriem Laadioui, Wafae Slimani, Sofia Jayi, Fatimazahra Fdili Alaoui, Hakima Bouguern, Hikmat Chaara, Moulay Aabdelilah Melhouf ...

  12. GPM Ground Validation Airborne Precipitation Radar 3rd Generation (APR-3) OLYMPEX V2.3

    Data.gov (United States)

    National Aeronautics and Space Administration — The GPM Ground Validation Airborne Precipitation Radar 3rd Generation (APR-3) OLYMPEX dataset was collected from November 12, 2015 to December 19, 2015 during the...

  13. 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...

  14. Studi Unjuk Kerja Sistem Proteksi Pada Pembangkit Listrik Tenaga Nuklir Tipe Apr 1400

    OpenAIRE

    Feridian, Nafi; Sriyana, Sriyana

    2008-01-01

    NUCLEAR POWER PROTECTION SYSTEMS PERFORMANCE STUDY FOR APR 1400. A study on plant protection system (PPS) of advanced power reactor (APR) 1400 which is one of the system to maintain nuclear power plant (NPP) operation safe and controllable has been conducted. The controllability aspect of NPP operation is an important aspect to assure the NPP operation safe and reliable. Accordingly, the study is limited in the performance of PPS. The method used in the study includes literature study, data c...

  15. Expression and mechanism of regulation of PP2A/Pr65 in ameloblastoma.

    Science.gov (United States)

    Gao, Xiuqiu; Wang, Guannan; Zhang, Yun-Kai; Zhong, Ming

    2014-06-01

    This study aimed to investigate the expression of PP2A/PR65 protein in ameloblastoma and the molecular mechanisms underlying the regulation of PP2A/PR65. The association between PP2A/PR65 and the clinicopathological characteristics of tumor specimens in ameloblastoma were to provide a theoretical basis for the diagnosis, therapy and prognosis of ameloblastoma. Streptavidin-peroxidase (S-P) immunohistochemical staining was used to detect PP2A/Pr65 expression changes in a total of 68 cases of ameloblastoma, six ameloblastic carcinomas, 21 squamous cell carcinomas and seven normal oral mucosas. Western blot was used to analyze PP2A/PR65 protein expression in 15 cases of ameloblastoma and three cases of normal oral mucosa. Of the 68 cases analyzed, four cases were negative, 25 cases were weakly positive, 20 cases were moderately positive and 19 cases were strongly positive. In six cases of ameloblastic carcinoma, three cases were weak positive, one case was positive, two cases were strongly positive and none were negative. In 21 cases of squamous cell carcinomas, three cases were negative, 17 cases were weakly positive, one case was moderately positive and none were strongly positive. Western blot analysis showed that, PP2A/Pr65 protein expression was lower in ameloblastoma tissue compared with normal oral mucosa. Reduced expression of PP2A/PR65 in ameloblastoma compared with normal oral mucosa indicates that PP2A/PR65 is involved in the occurrence and development of ameloblastoma. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  16. Organ transplantation in Tunisia.

    Science.gov (United States)

    El Matri, Aziz; Ben Abdallah, Taieb

    2015-04-01

    Kidney transplants were first performed in Tunisia in 1986, and transplants soon extended to other organs including the heart, liver, and pancreas. Live-related donor and deceased-donor kidney transplants were both began in the summer of 1986. An organ procurement and transplant law was passed in March 1991, and the National Centre for Advancement of Organ Transplantation was created in 1995. The number of transplantation units has increased to 7 throughout the country, and the yearly transplant number has progressively increased to 139 in 2010, including 20% from deceased kidney donors. Despite these gains, the need continues to grow. Heart transplants began in January 1993, and Tunisia and Jordan are currently the only Arab countries where it is practiced. However, only 16 patients have received a heart transplant as of 2004, and the number of recipients has decreased in the past 10 years. Liver transplants are rare in other Arab countries, but began in Tunisia in January 1998. Over 10 years, 38 patients benefited from this procedure. After a few years of stagnation, the number of liver transplants is increasing. While all types of transplantation are needed, kidney transplantation is a priority in Tunisia. The target is to perform 400 transplants annually, which would require a long-term strategy to provide full financial coverage using the National Health Insurance Funds in both the public and private sectors.

  17. 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

  18. 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

  19. [Promoting Living Kidney Transplantation].

    Science.gov (United States)

    Lin, Chiu-Chu

    2016-04-01

    Kidney transplantation is the best approach for treating patients with end stage renal disease, offering patients the best chance of returning to normal health. While the techniques used in kidney transplantation surgery are mature and highly successful, there is a severe shortage of donor organs. Statistics show a serious imbalance between organ donations and patients on the waiting list for organ transplantation. Moreover, evidence from empirical studies has shown a better transplantation outcome for patients who receive living donor transplantation than for those who receive organs from cadavers. Although using relatives as donors offers an effective way to reduce the problem of organ shortage, this strategy faces many challenges and many other factors affect the promotion of living donor transplantation. This article elaborates how cultural and psychological factors, kidney transplantation awareness, and ethics and laws impact upon living kidney donations and then proposes coping strategies for promoting living kidney transplantation.

  20. BONE MARROW TRANSPLANTATION

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. BONE MARROW TRANSPLANTATION. AUTOLOGOUS TRANSPLANTS: Oct 1986 - Dec 2007. Multiple Myeloma 90. NHL 39. Hodgkins lymphoma 19. AML 36. APML 9. ALL 2. Amyloidosis 2. Granulocytic Sarcoma 1.

  1. Life After Transplant

    Science.gov (United States)

    ... however you can Daughter's dying wish became mother's motivation Be The Match Blog Stories Anna, transplant recipient ... Jobs Job application FAQs E-Verify Career events Employee benefits About us Bea, transplant recipient Be The ...

  2. 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 ... Jobs Job application FAQs E-Verify Career events Employee benefits About us Bea, transplant recipient Be The ...

  3. Treatment Before Transplant

    Science.gov (United States)

    ... however you can Daughter's dying wish became mother's motivation Be The Match Blog Stories Anna, transplant recipient ... Jobs Job application FAQs E-Verify Career events Employee benefits About us Bea, transplant recipient Be The ...

  4. Cord Blood and Transplants

    Science.gov (United States)

    ... however you can Daughter's dying wish became mother's motivation Be The Match Blog Stories Anna, transplant recipient ... Jobs Job application FAQs E-Verify Career events Employee benefits About us Bea, transplant recipient Be The ...

  5. Blood and Bone MarrowTransplant?

    Science.gov (United States)

    ... Topics / Blood and Bone Marrow Transplant Blood and Bone Marrow Transplant Also known as Hematopoietic Stem Cell Transplant , Hematopoietic Cell Transplant , Autologous Transplant , Allogeneic Transplant A blood or bone marrow ...

  6. 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.

  7. 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

  8. Pediatric Liver Transplantation.

    Science.gov (United States)

    Rawal, Nidhi; Yazigi, Nada

    2017-06-01

    Excellent outcomes over the last 3 decades have made liver transplantation the treatment of choice for many advanced liver disorders. This success also opened liver transplantation to new indications such as liver tumors and metabolic disorders. The emergence of such new indications for liver transplantation is bringing a new stream of patients along with disease-specific challenges. The cumulative number of liver transplant recipients is peaking, requiring novel systems of health care delivery that meet the needs of this special patient population. This article reviews updates and new development in pediatric liver transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. 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.

  10. 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.

  11. TRANSPLANTATION EN MASSE DES ORGANES ABDOMINAUX

    Science.gov (United States)

    STARZL, T.

    2010-01-01

    Les transplantations multi-organes, comprenant les blocs foie-duodénum-pancréas, foie-estomac-duodénum-pancréas, et foie-intestin sont réalisées avec un succés croissant Ces techniques et leurs combinaisons variées de transplantation monobloc ne sont pas de pratique courante. Les techniques de prélévement, de conservation et de soins post-opératoires sont décrites pour la transplantation multi-organes compléte ainsi que pour les variantes incomplétes. Le probléme particulier à ce type de transplantation est celui de la transplantation intestinale, c’est-à-dire la transplantation d’un organe à composante lymphoréticulaire complexe ce qui peut provoquer un syndrome greffon contre hôte. Par erreur de conception, et un peu par esprit de systéme, les efforts par le passé étaient dirigés sur la modification et la destruction des systémes lymphoréticulaires grâce au traitement préalable du donneur ou des organes transplantés, par médicaments, radiation ou autres moyens. Actuellement, I’idée directrice est de garder intacte les systémes lymphoréticulaires qui deviennent alors le site d’une circulation à double sens aprés transplantation. Avec la puissante immunodépression que fournit le FK 506, les cellules lymphoréticulaires du donneur peuvent circuler chez le receveur sans créer de syndrome du greffon contre hôte clinique et les cellules de la greffe s’assimilent à celles du receveur (chimérisme local) sans provoquer de rejet. Même si I’on évite le rejet ou le syndrome greffon contre hôte, il existe, à côté de ces entités, des relations métaboliques entre les organes greffés ainsi qu’entre les organes greffés et les viscéres du receveur laissés en place, qui peuvent influencer I’avenir soit des organes greffés, soit des organes laissés en place. Parmi les échanges métaboliques les mieux connus actuellement, il y a les facteurs splanchniques hépatotrophes endogénes, dont I’insuline est la mieux

  12. MRI of pancreatic transplants

    International Nuclear Information System (INIS)

    Studniarek, M.; Deschamps, P.Y.; Finas, B.; Pinet, A.

    1993-01-01

    The value of MRI in assessing pancreatic transplants was studied in 37 patients. Sixty-seven MRI examinations were performed in patients with an uncomplicated transplant, 14 in patients with poorly functioning transplant, and 10 in patients with a non-functioning graft. On the basis of 54 follow-up studies, it was shown that the volume of the graft decreased systematically during the 8 months after transplantation. On T1-weighted images the normal transplant was poorly delineated, with an almost homogeneous isointense or slightly hyperintense structure when compared with either renal transplant cortex or muscle. On T2-weighted images the organ was isointense or slightly hypointense compared with fat and hyperintense compared with muscle. T2-weighted delayed echo time image (TR = 2000 ms, TE = 150-200 ms) showed transplanted pancreas as well-delineated, hypointense and with a lobulated structure. This structure was characteristic of normal whole pancreatic grafts. Patent transplant vessels were seen as tubular structures of low signal intensity on T2-weighted short echo time images (TR = 2000 ms, TE = 50 ms). In the 10 patients with a non-functioning pancreatic transplant there were: 4 cases of focal intraparenchymal abnormalities, 6 cases in which the lobular structure was absent, and 4 cases of absence of patent graft main vessels (3 thromboses). There was no configuration of signal intensity of pancreatic parenchyma on MRI which could be considered typical for normal or non-functioning transplant. (orig.)

  13. 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…

  14. 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

  15. 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

  16. 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

  17. 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).

  18. 14 CFR Appendix H to Part 23 - Installation of An Automatic Power Reserve (APR) System

    Science.gov (United States)

    2010-01-01

    ... failure, transmit signals, actuate fuel controls or power levers on operating engines, including power... power lever position; and (c) That shown to be free of hazardous engine response characteristics when...; (3) Prevent deactivation of the APR by manual adjustment of the power levers following an engine...

  19. 48 CFR 1552.235-75 - Access to Toxic Substances Control Act Confidential Business Information (APR 1996).

    Science.gov (United States)

    2010-10-01

    ...: Access to Toxic Substances Control Act Confidential Business Information (APR 1996) In order to perform... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Access to Toxic Substances Control Act Confidential Business Information (APR 1996). 1552.235-75 Section 1552.235-75 Federal...

  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. 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...

  2. 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.

  3. 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

  4. Experimental study of the APR+ reactor core flow and pressure distributions under 4-pump running conditions

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kihwan, E-mail: kihwankim@kaeri.re.kr; Euh, Dong-Jin; Chu, In-Cheol; Youn, Young-Jung; Choi, Hae-Seob; Kwon, Tae-Soon, E-mail: tskwon@kaeri.re.kr

    2013-12-15

    Highlights: • Experimental facility with a 1/5 scale was designed to perform various hydraulic tests of an APR+ reactor. • Two kinds of experiments, balanced and unbalanced flows under 4-pump running conditions were carried out. • The core inlet flow rates and exit pressure distributions were measured and analyzed at 257 discrete points. • The coolant mixing characteristics were investigated with the sectional pressure loss coefficients. - Abstract: The core inlet flow rates and exit pressure distributions of an APR+ (Advanced Power Reactor Plus) reactor were evaluated experimentally with the ACOP (APR+ Core Flow and Pressure) test facility. The ACOP test facility was constructed with a linear reduced scale of 1/5 referring to the APR+ reactor. The major flow path from the clod leg to hot leg was preserved with a principle of similarity. The core region was simulated using 257 core simulators, which are representative of the real HIPER fuel assemblies that APR+ reactor adopted. The core inlet flow rates and pressure distributions along the main flow path, which are significant information as an input data to evaluate the core thermal margin and reactor safety, were obtained by differential pressures measured at core simulators representing 257 fuel assemblies, and the static or differential pressures at 584 points, respectively. Two kinds of experiments, 4-pump balanced and unbalanced flow conditions, were conducted to examine the hydraulic characteristics of the reactor coolant flow. The mass balance and overall pressure drop were carefully examined to check the reliability of the obtained values. The inlet flow rates of the two test results showed similar distributions, which met the hydraulic performance requirement. The details of these experiments, the facility, and a data analysis are also described in this paper.

  5. 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.

  6. Evolution de la rétinopathie diabétique et de la qualité de la fonction visuelle après greffe combinée rein-pancréas ou rein-ilôts de Langerhans

    OpenAIRE

    AbouZeid, Hana

    2002-01-01

    L'influence de la transplantation combinée rein-pancréas ou rein-îlots de Langerhans sur la rétinopathie diabétique est observée dans une étude rétrospective comprenant vingt-sept patients (53 yeux). Dix-sept patients (34 yeux) aux mêmes critères de sélection ont bénéficié d'une transplantation rénale seule et constituent le groupe contrôle. Une stabilisation de la rétinopathie et de l'acuité visuelle est décrite après la transplantation à un pourcentage similaire dans les deux groupes. Aucun...

  7. Evolution de la rétinopathie diabétique et de la qualité de la fonction visuelle après greffe combinée rein-pancréas ou rein-ilôts de Langerhans

    OpenAIRE

    AbouZeid, Hana; Dosso, André

    2004-01-01

    L'influence de la transplantation combinée rein-pancréas ou rein-îlots de Langerhans sur la rétinopathie diabétique est observée dans une étude rétrospective comprenant vingt-sept patients (53 yeux). Dix-sept patients (34 yeux) aux mêmes critères de sélection ont bénéficié d'une transplantation rénale seule et constituent le groupe contrôle. Une stabilisation de la rétinopathie et de l'acuité visuelle est décrite après la transplantation à un pourcentage similaire dans les deux groupes. Aucun...

  8. Kidney transplantation after previous liver transplantation: analysis of the organ procurement transplant network database.

    Science.gov (United States)

    Gonwa, Thomas A; McBride, Maureen A; Mai, Martin L; Wadei, Hani M

    2011-07-15

    Patients after liver transplant have a high incidence of chronic kidney disease and end-stage renal disease (ESRD). We investigated kidney transplantation after liver transplantation using the Organ Procurement Transplant Network database. The Organ Procurement Transplant Network database was queried for patients who received kidney transplantation after previous liver transplantation. These patients were compared with patients who received primary kidney transplantation alone during the same time period. Between 1997 and 2008, 157,086 primary kidney transplants were performed. Of these, 680 deceased donor kidney transplants and 410 living donor kidney transplants were performed in previous recipients of liver transplants. The number of kidney after liver transplants performed each year has increased from 37 per year to 124 per year in 2008. The time from liver transplant to kidney transplant increased from 8.2 to 9.0 years for living donor transplants and from 5.4 to 9.6 years for deceased donor. The 1, 3, and 5 year actuarial graft survival in both living donor kidney after liver transplant and deceased donor kidney after liver transplant are less than the kidney transplant alone patients. However, the death-censored graft survivals are equal. The patient survival is also less but is similar to what would be expected in liver transplant recipients who did not have ESRD. In 2008, kidney after liver transplantation represented 0.9% of the total kidney alone transplants performed in the United States. Kidney transplantation is an appropriate therapy for selected patients who develop ESRD after liver transplantation.

  9. Pancreatic Islet Transplantation

    Science.gov (United States)

    ... in Edmonton, Canada, reported their findings in the New England Journal of Medicine . Their transplant protocol, known as the Edmonton protocol, has since been adapted by transplant centers around the world and continues ... new combination of immunosuppressive medications, also called anti-rejection ...

  10. Liver transplantation : an update

    NARCIS (Netherlands)

    Verdonk, R. C.; Van den Berg, A. P.; Slooff, M. J. H.; Porte, R. J.; Haagsma, E. B.

    2007-01-01

    Liver transplantation has been an accepted treatment for end-stage liver disease since the 1980s. Currently it is a highly successful treatment for this indication. The aim of this review is to give a general update on recent developments in the field of liver transplantation. In the last decades

  11. Rehabilitation following hand transplantation.

    Science.gov (United States)

    Bueno, Ericka; Benjamin, Marie-Jose; Sisk, Geoffroy; Sampson, Christian E; Carty, Matthew; Pribaz, Julian J; Pomahac, Bohdan; Talbot, Simon G

    2014-03-01

    Hand allotransplantation can restore motor, sensory and cosmetic functions to upper extremity amputees. Over 70 hand transplant operations have been performed worldwide, but there is little published regarding post-hand transplant rehabilitation. The Brigham and Women's Hospital (BWH) Hand Transplantation Team's post-hand transplant rehabilitation protocol is presented here. The protocol must be modified to address each transplant recipient's unique needs. It builds on universally used modalities of hand rehabilitation such as splinting, edema and scar management, range of motion exercises, activities of daily living training, electrical stimulation, cognitive training and strengthening. The BWH hand transplant rehabilitation protocol consists of four phases with distinct goals, frequency, and modalities. (1) Pre-operative: functional assessments are completed and goals and expectations of transplantation are established. (2) Initial post-operative (post-operative weeks 1-2): hand protection, minimization of swelling, education, and discharge. (3) Intermediate (post-operative weeks 2-8): therapy aims to prevent and/or decrease scar adhesion, increase tensile strength, flexibility and function, and prevent joint contractures. (4) Late (from 8 weeks forward): maximization of function and strength, and transition to routine activities. The frequency of rehabilitation therapy decreases gradually from the initial to late phases. Rehabilitation therapy after hand transplantation follows a progressive increase in activity in parallel with wound healing and nerve regeneration. Careful documentation of progress and outcomes is essential to demonstrate the utility of interventions and to optimize therapy protocols.

  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. 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.

  14. Bioethics of Organ Transplantation

    Science.gov (United States)

    Caplan, Arthur

    2014-01-01

    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. PMID:24478386

  15. 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

  16. MODAL CHARACTERISTIC ANALYSIS OF THE APR1400 NUCLEAR REACTOR INTERNALS FOR SEISMIC ANALYSIS

    OpenAIRE

    JONG-BEOM PARK; YOUNGIN CHOI; SANG-JEONG LEE; NO-CHEOL PARK; KYOUNG-SU PARK; YOUNG-PIL PARK; CHAN-IL PARK

    2014-01-01

    Reactor internals are sensitive to dynamic loads such as earthquakes and flow induced vibration. Thus, it is essential to identify the dynamic characteristics to evaluate the seismic integrity of the structures. However, a full-sized system is too large to perform modal experiments, making it difficult to extract data on its modal characteristics. In this research, we constructed a finite element model of the APR1400 reactor internals to identify their modal characteristics. The commercial re...

  17. 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.

  18. 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.

  19. Conflit, déplacements et reconstruction après-guerre : le cas de ...

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

    30 nov. 2015 ... Financés par le CRDI, des chercheurs du Centre international des études ethniques du Sri Lanka analysent les défis de reconstruction et de réinstallation des collectivités dans un contexte d'après-conflit. La guerre cause des pertes aux personnes, aux familles et aux collectivités. Les survivants ont ...

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kihwan; Euh, Dong-Jin; Choi, Hae-Seob; Kwon, Tae-Soon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-10-15

    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.

  1. Development of Extended Station Blackout Recovery Guideline for OPR1000 and APR1400

    International Nuclear Information System (INIS)

    Lee, Chang Gyun; Cho, Dong Hyun; Park, Ki Moon; Huh, Jae Young; Lee, Gyu Cheon

    2016-01-01

    Many regulatory requirements and recommendations following the Fukushima accident have been issued to cope with the extended station blackout (SBO) by the NRC, INPO, IAEA, ENSREG, WENRA, etc., and the nuclear safety improvement design features of each country have been enhanced to incorporate the lessons learned from the Fukushima accident. There have been many evaluations to cope with the extended loss of alternating current (AC) power (ELAP) event after the Fukushima accident. PWROG has developed the FLEX support guideline (FSG) that provides the guidance to mitigate the consequences of ELAP event based on the FLEX. The FSG is interfaced with emergency operating guidelines (EOGs) and severe accident management guidelines (SAMGs). However, the FSG developed by PWROG is not compatible with EOGs for both OPR1000 and APR1400 NPPs. Therefore, it is necessary to develop an extended station blackout recovery guideline (ESRG) to cope with an extended SBO event utilizing the newly adopted safety improvement design features against Fukushima accident for OPR1000 and APR1400 NPPs. The ESRG is also performed to satisfy all safety functions and to prevent from entering SAMGs during an extended SBO event. Therefore, this ESRG is entirely appropriate to cope with an extended SBO event by utilizing the newly adopted safety improvement design features following Fukushima accident for OPR1000 and APR1400 NPPs. This guideline will be considered in the establishment of accident management planning in near future.

  2. 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.

  3. A feasibility study on reducing EPZ for APR-1400 in societal implications

    International Nuclear Information System (INIS)

    Lee, Y.W.; Kim, S.H.; Kang, C.S.; Moon, J.H.

    2004-01-01

    For the APR-1400 (Advanced Pressurized Reactor) in Korea, based upon a large enhancement of safety, the reduction of EPZ (Emergency Planning Zone) radius and the concept of eventual elimination of EPZ have been being seriously considered. Technical justification for the reduction of EPZ had been considered in the previous study. The reduction of an EPZ, however, must not only be justified from a technical perspective, but include recognition of public policy and societal implications. So, in this study, a on-spot survey of the public acceptances on the workers and the nearby public was conducted. The survey was performed for June 25 to July 13 in 2001, in which the respondents were requested to answer the questions in the questionnaire that were related to radiological emergency exercises, emergency measures, regulatory status for EPZ, criteria for determining the distance of EPZ, ways to reduce the distance of EPZ for APR-1400, and method to collect the public opinion. While the reduction of the EPZ for the APR-1400 is technically justified, it appears that this reduction is not accepted by the public. The survey has showed that the key factor for reducing EPZ area is linked to the manner to obtain acceptance by the public. A way to do that would be to increase the credibility of the utility company towards the public which implies time, patience and public information

  4. 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.

  5. 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...

  6. [Surgical techniques of organ transplants].

    Science.gov (United States)

    Froněk, Jiří

    2015-01-01

    The list of surgical procedures of solid organ transplantations appears very interesting and colorful, even with overlap among techniques. Liver transplantation is a life-saving procedure in a majority of cases, the liver can be transplanted as a full or partial graft. The liver graft can be split for two recipients; it can also be reduced for a small recipient if splitting is not indicated. Kidney transplantation is the most common solid organ transplant procedure, the majority of kidney grafts come from brain-dead donors whereas the number of live donor transplants is increasing, also thanks to paired donation and blood group incompatible transplantation methods. The small bowel and multivisceral transplantation are rare procedures; they serve selected patients with short bowel syndrome, some patients with retroperitoneal tumors or with extensive visceral thrombosis. Solid organ transplants are well established treatment methods with good and proven outcomes. A majority of patients can return to a normal life after their transplants.

  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. [Pregnancy after renal transplantation].

    Science.gov (United States)

    Zech, H; Bichler, A; Ortner, A

    1981-12-01

    Since the number of women with renal cadaver transplantation is increasing, the obstetrician seems himself more often confronted with the situation: pregnancy after renal transplantation. The purpose of this paper is to report about our own case, to give a review of international studies written on this subject, and to inform the obstetrician, the surgeon and the pediatrician about the following points: - Common aspects of renal transplantation in fertile women and the information to be given to the patient. - Selection criteria and anticonception. - Pregnancy assessment and delivery - Pediatric problems.

  9. 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

  10. 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.

  11. Torsion d'annexe après hystérectomie abdominale: une première ...

    African Journals Online (AJOL)

    La torsion d'annexes survient classiquement sur ovaires kystiques ou tumoraux. De rares cas de torsion ont été rapports dans la littérature après hystérectomie laparoscopique. Nous rapportons la première observation de torsion d'annexe survenant sur annexe normale après hystérectomie bdominale et décrivons les ...

  12. Bone marrow transplant

    Science.gov (United States)

    ... cure your illness. If the transplant is a success, you can go back to most of your ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  13. Kidney Transplantation in Iran

    Directory of Open Access Journals (Sweden)

    Behzad Einollahi

    2010-03-01

    Full Text Available 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, clearly it has advantages over other organ procurementsystems primarily that thousands in need do not diewhile waiting for a compatible donor.In the present review I discuss the history of renal transplantationin Iran, "Iranian model" protocol, the situation ofIran’s kidney transplantation from either living or deceaseddonors compared with the Middle East countries, and our experiencesof unrelated renal transplantation.

  14. Rabies in Transplant Recipients

    Centers for Disease Control (CDC) Podcasts

    2016-09-19

    Dr. Richard Franka, a CDC scientist, discusses rabies in organ transplant recipients.  Created: 9/19/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/19/2016.

  15. Frailty and Transplantation

    NARCIS (Netherlands)

    Exterkate, Leonie; Slegtenhorst, Bendix R.; Kelm, Matthias; Seyda, Midas; Schuitenmaker, Jeroen M.; Quante, Markus; Uehara, Hirofumi; El Khal, Abdala; Tullius, Stefan G.

    Consequences of aging are gaining clinical relevance. In transplantation, aging and immunosenescence impact treatment and outcomes. The impact of aging, however, will critically depend on distinguishing healthy, chronological aging from biological aging that may result into frailty. Approximately

  16. Liver transplant - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100090.htm Liver transplant - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The liver is in the right upper abdomen. The liver ...

  17. 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.)

  18. International Transplant Nurses Society

    Science.gov (United States)

    ... The term "clinical ladder" refers to a "grading structure which facilitates career progression and associated differentiation of ... 20-1589538 Copyright © 2006 - 2014 International Transplant Nurses Society (ITNS). No materials, including graphics, may be reused, ...

  19. Experimental uterus transplantation.

    Science.gov (United States)

    Johannesson, Liza; Enskog, Anders

    2014-11-01

    Today, most causes of infertility are successfully treated. Yet there is still a subgroup of female infertility affecting around 4%, which so far is untreatable because of an absolute uterine factor. To acquire motherhood, these women are today referred to either adoption or surrogacy. Research in the field of uterus transplantation has been evaluated in different animal models for decades and has presently reached a human clinical application as a possible treatment for absolute uterine factor infertility. Organ transplantation is no longer reserved to those with a life-threatening disease and neither is organ transplantation together with concurrent immunosuppression prohibiting pregnancy. Uterus transplantation involves four parties - recipient, donor, partner of recipient and future child - and is a subject of ethical controversies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Bone marrow transplant - discharge

    Science.gov (United States)

    ... lymphoblastic leukemia (ALL) Acute myeloid leukemia - adult Aplastic anemia Bone marrow transplant Chronic lymphocytic leukemia (CLL) Chronic myelogenous leukemia (CML) Graft-versus-host disease Hodgkin lymphoma Multiple myeloma Non-Hodgkin lymphoma Patient ...

  1. Fecal microbiota transplant

    Science.gov (United States)

    ... nih.gov/pubmed/26344412 . Surawicz CM, Brandt LJ. Probiotics and fecal microbiota transplantation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier ...

  2. Livebirth after uterus transplantation.

    Science.gov (United States)

    Brännström, Mats; Johannesson, Liza; Bokström, Hans; Kvarnström, Niclas; Mölne, Johan; Dahm-Kähler, Pernilla; Enskog, Anders; Milenkovic, Milan; Ekberg, Jana; Diaz-Garcia, Cesar; Gäbel, Markus; Hanafy, Ash; Hagberg, Henrik; Olausson, Michael; Nilsson, Lars

    2015-02-14

    Uterus transplantation is the first available treatment for absolute uterine infertility, which is caused by absence of the uterus or the presence of a non-functional uterus. Eleven human uterus transplantation attempts have been done worldwide but no livebirth has yet been reported. In 2013, a 35-year-old woman with congenital absence of the uterus (Rokitansky syndrome) underwent transplantation of the uterus in Sahlgrenska University Hospital, Gothenburg, Sweden. The uterus was donated from a living, 61-year-old, two-parous woman. In-vitro fertilisation treatment of the recipient and her partner had been done before transplantation, from which 11 embryos were cryopreserved. The recipient and the donor had essentially uneventful postoperative recoveries. The recipient's first menstruation occurred 43 days after transplantation and she continued to menstruate at regular intervals of between 26 and 36 days (median 32 days). 1 year after transplantation, the recipient underwent her first single embryo transfer, which resulted in pregnancy. She was then given triple immunosuppression (tacrolimus, azathioprine, and corticosteroids), which was continued throughout pregnancy. She had three episodes of mild rejection, one of which occurred during pregnancy. These episodes were all reversed by corticosteroid treatment. Fetal growth parameters and blood flows of the uterine arteries and umbilical cord were normal throughout pregnancy. The patient was admitted with pre-eclampsia at 31 full weeks and 5 days, and 16 h later a caesarean section was done because of abnormal cardiotocography. A male baby with a normal birthweight for gestational age (1775 g) and with APGAR scores 9, 9, 10 was born. We describe the first livebirth after uterus transplantation. This report is a proof-of-concept for uterus transplantation as a treatment for uterine factor infertility. Furthermore, the results show the feasibility of live uterus donation, even from a postmenopausal donor. Jane and

  3. 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...

  4. Immunosuppression in lung transplantation.

    Science.gov (United States)

    Scheffert, Jenna L; Raza, Kashif

    2014-08-01

    Lung transplantation can be a life-saving procedure for those with end-stage lung diseases. Unfortunately, long term graft and patient survival are limited by both acute and chronic allograft rejection, with a median survival of just over 6 years. Immunosuppressive regimens are employed to reduce the rate of rejection, and while protocols vary from center to center, conventional maintenance therapy consists of triple drug therapy with a calcineurin inhibitor (cyclosporine or tacrolimus), antiproliferative agents [azathioprine (AZA), mycophenolate, sirolimus (srl), everolimus (evl)], and corticosteroids (CS). Roughly 50% of lung transplant centers also utilize induction therapy, with polyclonal antibody preparations [equine or rabbit anti-thymocyte globulin (ATG)], interleukin 2 receptor antagonists (IL2RAs) (daclizumab or basiliximab), or alemtuzumab. This review summarizes these agents and the data surrounding their use in lung transplantation, as well as additional common and novel therapies in lung transplantation. Despite the progression of the management of lung transplant recipients, they continue to be at high risk of treatment-related complications, and poor graft and patient survival. Randomized clinical trials are needed to allow for the development of better agents, regimens and techniques to address above mentioned issues and reduce morbidity and mortality among lung transplant recipients.

  5. Hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Eleftheria Hatzimichael

    2010-08-01

    Full Text Available Eleftheria Hatzimichael1, Mark Tuthill21Department of Haematology, Medical School of Ioannina, University of Ioannina, Ioannina, Greece; 2Department of Medical Oncology, Hammersmith Hospital, Imperial College National Health Service Trust, London, UKAbstract: More than 25,000 hematopoietic stem cell transplantations (HSCTs are performed each year for the treatment of lymphoma, leukemia, immune-deficiency illnesses, congenital metabolic defects, hemoglobinopathies, and myelodysplastic and myeloproliferative syndromes. Before transplantation, patients receive intensive myeloablative chemoradiotherapy followed by stem cell “rescue.” Autologous HSCT is performed using the patient’s own hematopoietic stem cells, which are harvested before transplantation and reinfused after myeloablation. Allogeneic HSCT uses human leukocyte antigen (HLA-matched stem cells derived from a donor. Survival after allogeneic transplantation depends on donor–recipient matching, the graft-versus-host response, and the development of a graft versus leukemia effect. This article reviews the biology of stem cells, clinical efficacy of HSCT, transplantation procedures, and potential complications.Keywords: hematopoietic stem cell transplantation, complications

  6. Indian transplant registry

    Directory of Open Access Journals (Sweden)

    Sunil Shroff

    2007-01-01

    Full Text Available An ′Indian transplant registry′ has been established over the past two years due to the efforts of the Indian Society of Organ Transplantation. This society is about 20 years old with over 450 members who are doctors and basic scientist. The registry is currently in the first phase of its development and can be partly viewed at www.transplantindia.com. The endeavor has been undertaken with the objective of having a centralized repository of information of the various transplants that are being undertaken in India. In its first phase of the registry ′Fast Fact′ retrospective short datasets are being captured that include the essential details of the transplant programme. The fast fact data includes the number of transplant done yearly, the sex ratio and type of transplant. So far thirteen major institutional data has been entered in the registry. In the second phase of the registry, over twenty fields are likely to be captured and all member institutions would be encouraged to enter the data prospectively. In the third phase data would be derived with ongoing audit features.. The society and its members have supported the formation of the registry and are enthusiastic about its potential.

  7. 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.

  8. 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.

  9. DEVELOPMENT OF AN AMPHIBIOUS ROBOT FOR VISUAL INSPECTION OF APR1400 NPP IRWST STRAINER ASSEMBLY

    OpenAIRE

    YOU HYUN JANG; JONG SEOG KIM

    2014-01-01

    An amphibious inspection robot system (hereafter AIROS) is being developed to visually inspect the in-containment refueling storage water tank (hereafter IRWST) strainer in APR1400 instead of a human diver. Four IRWST strainers are located in the IRWST, which is filled with boric acid water. Each strainer has 108 sub-assembly strainer fin modules that should be inspected with the VT-3 method according to Reg. guide 1.82 and the operation manual. AIROS has 6 thrusters for submarine voyage and ...

  10. Acute exercise does not induce an acute phase response (APR) in Standardbred trotters

    DEFF Research Database (Denmark)

    Kristensen, Lena; Buhl, Rikke; Nostell, Katarina

    2014-01-01

    The purpose of the study was to investigate whether acute strenuous exercise (1600- to 2500-m race) would elicit an acute phase response (APR) in Standardbred trotters. Blood levels of several inflammatory markers [serum amyloid A (SAA), haptoglobin, fibrinogen, white blood cell count (WBC......), and iron], muscle enzymes [creatinine kinase (CK) and aspartate transaminase (AST)], and hemoglobin were assessed in 58 Standardbred trotters before and after racing. Hemoglobin levels increased and iron levels decreased 12 to 14 h after racing and haptoglobin concentrations, white blood cell counts...

  11. 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

  12. Heart Transplantation in Asia.

    Science.gov (United States)

    Lee, Hae-Young; Oh, Byung-Hee

    2017-04-25

    Heart transplantation (HTx) is the effective way to improve quality of life as well as survival in terminal heart failure (HF) patients. Since the first heart transplant in 1968 in Japan and in earnest in 1987 at Taiwan, HTx has been continuously increasing in Asia. Although the current percentage of heart transplants from Asia comprises only 5.7% of cases in the International Society of Heart and Lung Transplantation (ISHLT) registry, the values were under-reported and soon will be greatly increased. HTx in Asia shows comparable with or even better results compared with ISHLT registry data. Several endemic infections, including type B hepatitis, tuberculosis, and cytomegalovirus, are unique aspects of HTx in Asia, and need special attention in transplant care. Although cardiac allograft vasculopathy (CAV) is considered as a leading cause of death after HTx globally, multiple observations suggest less prevalence and benign nature of CAV among Asian populations. Although there are many obstacles such as religion, social taboo or legal process, Asian countries will keep overcoming obstacles and broaden the field of HTx.

  13. Uterus transplantation and beyond.

    Science.gov (United States)

    Brännström, Mats

    2017-05-01

    Uterus transplantation is today the only available treatment for absolute uterine factor infertility which is caused by either congenital/surgical uterine absence or that a present uterus is non-functioning. Structured animal-based research, from rodents to nonhuman primates, was the scientific basis for a successful introduction of uterus transplantation as a clinical procedure. The patient groups for uterus transplantation, the preclinical research and data from the published human cases will be covered herein. During recent years the concept of bioengineering of organs and tissues has emerged. Creation of a bioengineered uterus is in the initial research state, with experiments performed in rodents. The research that has been performed to create a bioengineered uterus will be summarized. In conclusion, uterus transplantation is now a clinical experimental procedure for treatment of uterine factor infertility. In parallel to the establishment of this combined assisted reproduction technique and transplantation procedure as a routine clinical procedure, we predict that uterus bioengineering will develop further towards introduction within the human setting, but that this process will take several years.

  14. Everolimus in kidney transplantation

    Directory of Open Access Journals (Sweden)

    Cooper JE

    2011-07-01

    Full Text Available James E Cooper¹, Uwe Christians², Alexander C Wiseman¹¹Division of Renal Diseases and Hypertension, Transplant Center, ²iC42 Integrated Solutions in Systems Biology for Clinical Research and Development, University of Colorado Denver, Aurora, CO, USAAbstract: Everolimus is a novel target of rapamycin (mTOR-I analog that has recently been approved in combination with cyclosporine A and steroids for use in the prevention of organ rejection in kidney transplant recipients. Compared with rapamycin, everolimus is characterized by a shorter half-life and improved bioavailability. Prior to US Food and Drug Administration approval, a number of Phase II and III clinical trials were undertaken to evaluate the effectiveness of everolimus in combination with calcineurin inhibitors for preventing acute rejection and promoting allograft survival in kidney transplant recipients. In this report, we review the pharmacokinetic properties of everolimus, the clinical efficacy studies that led to its approval for use in kidney transplantation, as well as reported data on patient safety and tolerability associated with its use.Keywords: mTOR inhibitors, kidney transplantation, everolimus

  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. 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 ...

  17. 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.

  18. About the Operation: Heart Transplant

    Science.gov (United States)

    ... to know FAQ Living donation What is living donation? Organs Types Being a living donor First steps Being ... Nursing Care of the Renal Transplant Recipient.” UNOS Donation and Transplantation Nursing Curriculum . 1996 This Web site is intended ...

  19. Gut microbiota and allogeneic transplantation.

    Science.gov (United States)

    Wang, Weilin; Xu, Shaoyan; Ren, Zhigang; Jiang, Jianwen; Zheng, Shusen

    2015-08-23

    The latest high-throughput sequencing technologies show that there are more than 1000 types of microbiota in the human gut. These microbes are not only important to maintain human health, but also closely related to the occurrence and development of various diseases. With the development of transplantation technologies, allogeneic transplantation has become an effective therapy for a variety of end-stage diseases. However, complications after transplantation still restrict its further development. Post-transplantation complications are closely associated with a host's immune system. There is also an interaction between a person's gut microbiota and immune system. Recently, animal and human studies have shown that gut microbial populations and diversity are altered after allogeneic transplantations, such as liver transplantation (LT), small bowel transplantation (SBT), kidney transplantation (KT) and hematopoietic stem cell transplantation (HTCT). Moreover, when complications, such as infection, rejection and graft versus host disease (GVHD) occur, gut microbial populations and diversity present a significant dysbiosis. Several animal and clinical studies have demonstrated that taking probiotics and prebiotics can effectively regulate gut microbiota and reduce the incidence of complications after transplantation. However, the role of intestinal decontamination in allogeneic transplantation is controversial. This paper reviews gut microbial status after transplantation and its relationship with complications. The role of intervention methods, including antibiotics, probiotics and prebiotics, in complications after transplantation are also discussed. Further research in this new field needs to determine the definite relationship between gut microbial dysbiosis and complications after transplantation. Additionally, further research examining gut microbial intervention methods to ameliorate complications after transplantation is warranted. A better understanding of the

  20. Solid organ donation and transplantation.

    Science.gov (United States)

    Furlow, Bryant

    2012-01-01

    Medical imaging plays a key role in solid organ donation and transplantation. In addition to confirming the clinical diagnosis of brain death, imaging examinations are used to assess potential organ donors and recipients, evaluate donated organs, and monitor transplantation outcomes. This article introduces the history, biology, ethics, and institutions of organ donation and transplantation medicine. The article also discusses current and emerging imaging applications in the transplantation field and the controversial role of neuroimaging to confirm clinically diagnosed brain death.

  1. 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

  2. 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...

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. Mūzikas terapija bērnu aprūpes praksē

    OpenAIRE

    Dulberga, Sarmīte

    2016-01-01

    A N O T Ā C I J A Bakalaura darba “ Mūzikas terapija bērnu aprūpes praksē” mērķis– iegūt papildus zināšanas un noskaidrot, mūzikas terapijas pasīvās formas izmantošanas efektivitāti perifērās vēnas kanilēšanas laikā jaunākā skolas vecuma bērniem. Mērķa sasniegšanai veikts pētījums, kura īstenošanai pielietota kombinētā pētniecības metode – daļēji strukturēta intervija un protokols ar mērījumiem bērniem. Pētījuma dalībnieki ir 20 jaunākie skolas vecuma pacienti, un 5 bērnu aprūpes māsas. Pēt...

  9. Tolerogenic therapies in transplantation

    Directory of Open Access Journals (Sweden)

    Eugenia K Page

    2012-07-01

    Full Text Available Since the concept of immunologic tolerance was discovered in the 1940s, the pursuit of tolerance induction in human transplantation has led to a rapid development of pharmacologic and biologic agents. Short-term graft survival remains an all-time high, but successful withdrawal of immunosuppression to achieve operational tolerance rarely occurs outside of liver transplantation. Collaborative efforts through the NIH sponsored Immune Tolerance Network and the European Commission sponsored Reprogramming the Immune System for Establishment of Tolerance consortia have afforded researchers opportunity to evaluate the safety and efficacy of tolerogenic strategies, investigate mechanisms of tolerance, and identify molecular and genetic markers that distinguish the tolerance phenotype. In this article, we review traditional and novel approaches to inducing tolerance for organ transplantation, with an emphasis on their translation into clinical trials.

  10. Lung transplantation for cystic fibrosis

    NARCIS (Netherlands)

    Adler, Frederick R; Aurora, Paul; Barker, David H; Barr, Mark L; Blackwell, Laura S; Bosma, Otto H; Brown, Samuel; Cox, D R; Jensen, Judy L; Kurland, Geoffrey; Nossent, George D; Quittner, Alexandra L; Robinson, Walter M; Romero, Sandy L; Spencer, Helen; Sweet, Stuart C; van der Bij, Wim; Vermeulen, J; Verschuuren, Erik A M; Vrijlandt, Elianne J L E; Walsh, William; Woo, Marlyn S; Liou, Theodore G

    2009-01-01

    Lung transplantation is a complex, high-risk, potentially life-saving therapy for the end-stage lung disease of cystic fibrosis (CF). The decision to pursue transplantation involves comparing the likelihood of survival with and without transplantation as well as assessing the effect of wait-listing

  11. Pancreatic transplant imaging

    International Nuclear Information System (INIS)

    Yuh, W.T.C.; Wiese, J.A.; Abu-Yousef, M.M.; Rezai, K.; Sato, Y.; Kao, S.C.S.; Hunsicker, L.G.; Corry, R.J.

    1987-01-01

    Forty-two MR studies, 162 radionuclide scintigraphic studies, and 57 sonographic studies were performed on 15 pancreatic transplant patients for evaluation of suspected graft rejection. The results of these studies were correlated with clinical presentations, laboratory data, and pathologic specimens when available. Radionuclide studies provide excellent information for estimating graft size and for evaluation of perfusion. Sonography is valuable for evaluation of the gland texture and peripancreatic abnormalities. MR provides useful information regarding parenchymal changes in rejection and response of the graft to treatment. These three imaging modalities are therefore complementary in the evaluation of pancreatic transplantation

  12. 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

  13. 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.

  14. 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.

  15. Après-Coup in French Psychoanalysis: The Long Afterlife of Nachträglichkeit: The First Hundred Years, 1893 to 1993.

    Science.gov (United States)

    House, Jonathan; Slotnick, Julie

    2015-10-01

    Après-coup finds its origins in Freud's earliest psychoanalytic writings, but it was only half a century ago that French psychoanalysts rediscovered, clarified, and developed the concept and so brought it recognition as an essential Freudian concept. Because the history of après-coup is embedded in the French reading of Freud, this article will give an account of that reading in relation to après-coup.

  16. Clazakizumab in Highly-HLA Sensitized Patients Awaiting Renal Transplant

    Science.gov (United States)

    2018-02-26

    Kidney Failure, Chronic; End-Stage Renal Disease; Transplant Glomerulopathy; Transplant;Failure,Kidney; Kidney Transplant Failure and Rejection; Antibody-mediated Rejection; Kidney Transplant; Complications

  17. 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.

  18. Immune Exhaustion and Transplantation.

    Science.gov (United States)

    Sanchez-Fueyo, A; Markmann, J F

    2016-07-01

    Exhaustion of lymphocyte function through chronic exposure to a high load of foreign antigen is well established for chronic viral infection and antitumor immunity and has been found to be associated with a distinct molecular program and characteristic cell surface phenotype. Although exhaustion has most commonly been studied in the context of CD8 viral responses, recent studies indicate that chronic antigen exposure may affect B cells, NK cells and CD4 T cells in a parallel manner. Limited information is available regarding the extent of lymphocyte exhaustion development in the transplant setting and its impact on anti-graft alloreactivity. By analogy to the persistence of a foreign virus, the large mass of alloantigen presented by an allograft in chronic residence could provide an ideal setting for exhausting donor-reactive T cells. The extent of T cell exhaustion occurring with various allografts, the kinetics of its development, whether exhaustion is influenced positively or negatively by different immunosuppressants, and the impact of exhaustion on graft survival and tolerance development remains a fertile area for investigation. Harnessing or encouraging the natural processes of exhaustion may provide a novel means to promote graft survival and transplantation tolerance. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  19. Organ Harvesting and Transplants

    Science.gov (United States)

    Baskette, Kimberly G.; Ritz, John M.

    2010-01-01

    Humans and animals need healthy organs to live. Due to medical conditions and accidents, some organs fail to function properly. For these reasons, the medical community has experimented and can now perform successful organ transplants, allowing patients to continue to live their lives. Many countries have medical programs where individuals can…

  20. Bone Marrow Transplantation

    Science.gov (United States)

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The ... platelets, which help the blood to clot. A bone marrow transplant is a procedure that replaces a ...

  1. American Society of Transplantation

    Science.gov (United States)

    ... that thrives by connecting organisations seeking to fill positions and transplant professionals searching for career opportunities. Patient Information Patient Information It’s all about healthy living The AST has put together a list of resources for patients and patient families. Contact ...

  2. REPEAT KIDNEY TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    A. I. Sushkov

    2016-01-01

    Full Text Available Nowadays, kidney transplantation is the best approach of renal replacement therapy for the majority of patients with end-stage renal disease that significantly improves the quality and length of life. Advances in the field of organ donation, immunosuppression, transplant surgery and immunology have improved short-term graft and patient survival. But the long-term graft survival remains static over last two decades. The disparity between low graft and high patient long-term survival led to increasing number of transplant recipients with failed grafts. Repeat renal transplant is presumed to be a good option for many patients losing their grafts, but it is associated with higher complication rates. Unfortunately, there are no evidence-based recommendations or guidelines for renal retransplantation procedure. This review is based on 100 scientifi c publications related to various aspects of the kidney retransplantation and provides the recent data on this matter.

  3. Body image in kidney transplantation.

    Science.gov (United States)

    De Pasquale, C; Pistorio, M L; Sorbello, M; Parrinello, L; Corona, D; Gagliano, M; Giuffrida, G; Giaquinta, A; Sinagra, N; Zerbo, D; Veroux, P; Veroux, M

    2010-05-01

    Psychologic disturbances are becoming more common in kidney transplantation, owing to effects of immunosuppressive therapy. In this study, we explored the incidence and specifity of psychopathology among kidney transplant patients. Twenty kidney transplant recipients underwent the Machover Draw-A-person test to detect significant variables (V1=V6) hypothetically related to chronologic age, education, years from transplantation, and gender differences. Emotional coarctation (V1) in the sense of "mental rigidity," "egocentrism," and "hypercontrol" were present in all transplant recipients (100%), followed by difficulty in interpersonal relationships (V3; 70%) and anxiety (V5; 70%). This research confirmed the hypothesis that transplantation can display a potential risk to the psychologic balance of the patient. Psychologic evaluation may be a fundamental step together with surgical aspects and management of immunosuppression to achieve well-being of kidney transplant recipients. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  4. Tissue transplantation in plastic surgery.

    Science.gov (United States)

    Siemionow, Maria; Agaoglu, Galip

    2007-04-01

    The functional and aesthetic outcome following application of conventional reconstructive procedures or prosthetic materials is not satisfactory, especially in patients who have severe deformities and disabilities. Since the first successful hand transplantation in France in 1998, composite tissue allograft transplantation has gained a great deal of interest in the field of plastic surgery. It is obvious that composite tissue allograft transplantation will improve patients' life quality, but this might be at the expense of decreasing life expectancy. Currently, the main obstacle for composite tissue allograft transplantation is the use of life-long immunosuppression therapy because of their well-known side effects. In addition, the ethical, social, and psychologic issues are raised when discussing face transplantation. The long-term results of the recently performed partial face transplantations will be critical to judge the future applications of partial or total face transplantation.

  5. Early laparotomy after lung transplantation

    DEFF Research Database (Denmark)

    Bredahl, Pia; Zemtsovski, Mikhail; Perch, Michael

    2014-01-01

    BACKGROUND: Gastrointestinal complications after lung transplantation have been reported with incidence rates ranging from 3% to 51%, but the reasons are poorly understood. We aimed to investigate the correlations between pulmonary diseases leading to lung transplantation and early gastrointestinal...... complications requiring laparotomy after transplantation with outcomes for patients at increased risk. METHODS: In this study we performed a retrospective analysis of data of patients who underwent lung transplantation at our institution from 2004 to 2012. The study period was limited to the first 90 days after...... transplantation. RESULTS: Lung transplantation was performed in 258 patients, including 51 patients with α1-anti-trypsin deficiency (A1AD). Seventy-eight patients (30%) had an X-ray of the abdomen, and 23 patients (9%) required laparotomy during the first 90 days after transplantation. Patients with A1AD...

  6. GRACE Accelerometer data transplant

    Science.gov (United States)

    Bandikova, T.; McCullough, C. M.; Kruizinga, G. L. H.

    2017-12-01

    The Gravity Recovery and Climate Experiment (GRACE) has recently celebrated its 15th anniversary. The aging of the satellites brings along new challenges for both mission operation and science data delivery. Since September 2016, the accelerometer (ACC) onboard GRACE-B has been permanently turned off in order to reduce the battery load. The absence of the information about the non-gravitational forces acting on the spacecraft dramatically decreases the accuracy of the monthly gravity field solutions. The missing GRACE-B accelerometer data, however, can be recovered from the GRACE-A accelerometer measurement with satisfactory accuracy. In the current GRACE data processing, simple ACC data transplant is used which includes only attitude and time correction. The full ACC data transplant, however, requires not only the attitude and time correction, but also modeling of the residual accelerations due to thruster firings, which is the most challenging part. The residual linear accelerations ("thruster spikes") are caused by thruster imperfections such as misalignment of thruster pair, force imbalance or differences in reaction time. The thruster spikes are one of the most dominant high-frequency signals in the ACC measurement. The shape and amplitude of the thruster spikes are unique for each thruster pair, for each firing duration (30 ms - 1000 ms), for each x,y,z component of the ACC linear acceleration, and for each spacecraft. In our approach, the thruster spike model is an analytical function obtained by inverse Laplace transform of the ACC transfer function. The model shape parameters (amplitude, width and time delay) are estimated using Least squares method. The ACC data transplant is validated for days when ACC data from both satellites were available. The fully transplanted data fits the original GRACE-B measurement very well. The full ACC data transplant results in significantly reduced high frequency noise compared to the simple ACC transplant (i.e. without

  7. Liver Transplantation Update: 2014.

    Science.gov (United States)

    Dogan, Serkan; Gurakar, Ahmet

    2015-01-01

    The first liver transplantation (LT) was performed by Thomas E Starzl five decades ago, and yet it remains the only therapeutic option offering gold standard treatment for end-stage liver disease (ESLD) and acute liver failure (ALF) and certain early-stage liver tumors. Post-liver transplantation survival has also dramatically improved over the last few decades despite increasing donor and recipient age and more frequent use of marginal organs to overcome the organ shortage. Currently, the overall 1 year survival following LT in the United States is reported as 85 to 90%, while the 10 years survival rate is ~50% (http://www.unos.org). The improvements are mainly due to progress in surgical techniques, postoperative intensive care, and the advent of new immunosuppressive agents. There are a number of factors that influence the outcomes prior to transplantation. Since 2002, the model for end-stage liver disease (MELD) score has been considered a predicting variable. It has been used to prioritize patients on the transplant waiting list and is currently the standard method used to assess severity in all etiologies of cirrhosis. Hepatocellular carcinoma (HCC) is the most common standard MELD exception because the MELD does not necessarily reflect the medical urgency of patients with HCC. The criteria for candidates with HCC for receiving LT have evolved over the past decade. Now, patients with HCC who do not meet the traditional Milan (MC) or UCSF criteria for LT often undergo downstaging therapy I an effort to shrink the tumor size. The shortage of donor organs is a universal problem. In some countries, the development of a deceased organ donation program has been prevented due to socioeconomic, cultural, legal and other factors. Due to the shortage of cadaveric donors, several innovative techniques have been developed to expand the organ donor pool, such as split liver grafts, marginal- or extended-criteria donors, live donor liver transplantation (LDLT), and the use

  8. 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.

  9. Key issues in transplant tourism

    Science.gov (United States)

    Akoh, Jacob A

    2012-01-01

    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. PMID:24175191

  10. 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

  11. 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 ...

  12. 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.

  13. Edward Bellamy, Cent ans après ou l’an 2000 [1888

    Directory of Open Access Journals (Sweden)

    Léa Vidal

    2010-12-01

    Full Text Available Le rêve d’Edward Bellamy (1850-1898, Cent ans après ou l’an 2000, parut pour la première fois en édition originale anglaise (Looking Backward : from 2000 to 1887, 1888, avant de connaître une première traduction française chez Dentu en 1891. Cette utopie expose la vie telle qu’elle aurait pu être de nos jours. Ce qui nous vaut de pouvoir comparer la fiction futuriste avec la réalité d’aujourd’hui. À la lecture de ce roman, ce n’est pas un monde aux couleurs des néons fluo que l’on découvre,...

  14. Analysis and improvements of Adaptive Particle Refinement (APR) through CPU time, accuracy and robustness considerations

    Science.gov (United States)

    Chiron, L.; Oger, G.; de Leffe, M.; Le Touzé, D.

    2018-02-01

    While smoothed-particle hydrodynamics (SPH) simulations are usually performed using uniform particle distributions, local particle refinement techniques have been developed to concentrate fine spatial resolutions in identified areas of interest. Although the formalism of this method is relatively easy to implement, its robustness at coarse/fine interfaces can be problematic. Analysis performed in [16] shows that the radius of refined particles should be greater than half the radius of unrefined particles to ensure robustness. In this article, the basics of an Adaptive Particle Refinement (APR) technique, inspired by AMR in mesh-based methods, are presented. This approach ensures robustness with alleviated constraints. Simulations applying the new formalism proposed achieve accuracy comparable to fully refined spatial resolutions, together with robustness, low CPU times and maintained parallel efficiency.

  15. Signoles Aude, Le Hamas au pouvoir et après ?, Toulouse, Editions Milan, 2006.

    Directory of Open Access Journals (Sweden)

    Jean-François Legrain

    2007-11-01

    Full Text Available Dans les étroites limites imposées par la collection (absence totale de notes et de bibliographie, 112 p. en format réduit, le petit livre d’Aude Signoles, Le Hamas au pouvoir et après ?, commence à combler un vide de l’édition française. Le seul livre jusque là disponible en français et entièrement consacré à Hamas remonte à 7 années maintenant ; doté de nombreuses erreurs factuelles et faisant comme si Hamas était apparu avec l’autonomie des années 1990, il ignorait tout de son passé d’Ass...

  16. 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

  17. Response Time Analysis and Test of Protection System Instrument Channels for APR1400 and OPR1000

    International Nuclear Information System (INIS)

    Lee, Chang Jae; Han, Seung; Yun, Jae Hee; Baek, Seung Min; Lee, Sang Jeong

    2015-01-01

    Safety limits are required to maintain the integrity of physical barriers designed to prevent the uncontrolled release of radioactive materials in nuclear power plants. The safety analysis establishes two critical constraints that include an analytical limit in terms of a measured or calculated variable, and a specific time after the analytical limit is reached to begin protective action. Keeping with the nuclear regulations and industry standards, satisfying these two requirements will ensure that the safety limit will not be exceeded during the design basis event, either an anticipated operational occurrence or a postulated accident. Various studies on the setpoint determination methodology for the safety-related instrumentation have been actively performed to ensure that the requirement of the analytical limit is satisfied. In particular, the protection setpoint methodology for the advanced power reactor 1400 (APP1400) and the optimized power reactor 1000 (OPR1000) has been recently developed to cover both the design basis event and the beyond design basis event. The developed setpoint methodology has also been quantitatively validated using specific computer programs and setpoint calculations. However, the safety of nuclear power plants cannot be fully guaranteed by satisfying the requirement of the analytical limit. In spite of the response time verification requirements of nuclear regulations and industry standards, it is hard to find the studies on the systematically integrated methodology regarding the response time evaluation. In cases of APR1400 and OPR1000, the response time analysis for the plant protection system is partially included in the setpoint calculation and the response time test is separately performed via the specific plant procedure. The test technique has a drawback which is the difficulty to demonstrate completeness of timing test. The analysis technique has also a demerit of resulting in extreme times that not actually possible. Thus

  18. Evaluation of the Layer Inversion of Melt Pool during the Severe Accident in the APR1400

    International Nuclear Information System (INIS)

    Kang, Kyoung-Ho; Park, Rae-Joon; Hong, Seong-Wan

    2008-01-01

    During the severe accidents, thermal load from the oxidic pool can be concentrated on the side wall of the RPV due to the thermal barrier effect in the thin metallic layer. The focusing effect of the metallic layer is mainly determined by the molten pool configuration in the lower head of the RPV. Therefore, for the precise evaluations on the coolability through the in-vessel retention of corium during the severe accident, the melt pool configuration should be accurately defined. The melt pool configurations inside the lower head of the reactor vessel affect the initial thermal load to the vessel and play a key role in determining the integrity of the reactor vessel. In this study, thermodynamic analyses were performed to examine the final melt pool configuration during the severe accidents in the APR1400. As the representative accident scenarios, Large Break Loss of Coolant Accident (LBLOCA), Medium Break Loss of Coolant Accident (MBLOCA), Station Black Out (SBO), and Total Loss of Feed Water (TLFW) were considered. The initial melt pool conditions, such as melt mass and melt pool temperature etc., were calculated using the SCDAP/RELAP5/MOD3.3 code for each accident scenario of the APR1400. The thermodynamic analyses were performed using the GEMINI code. Combined with the GEMINI code calculations and the peer review on the RASPLAV/ MASCA experimental results, the final melt pool configuration in case of MBLOCA sequence was determined as a first step. Based on the thermodynamic analyses for the melt pool compositions, the possibility of the layer inversion between the oxidic pool and the metallic layer was examined

  19. Pediatric kidney transplantation: a review

    Directory of Open Access Journals (Sweden)

    Sharma A

    2013-07-01

    Full Text Available Amit Sharma, Rajesh Ramanathan, Marc Posner, Robert A Fisher Hume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA Abstract: Pediatric kidney transplantation is the preferred treatment for children with end-stage renal disease. The most common indications for transplantation in children are renal developmental anomalies, obstructive uropathy, and focal segmental glomerulosclerosis. Living donor kidney transplants are often performed pre-emptively and offer excellent graft function. Policy changes in deceased-donor kidney allocation have increased the proportion of such transplants in pediatric recipients. Adequate pretransplant workup along with evaluation of urologic abnormalities is imperative in achieving good outcomes. Overall, patient and graft outcomes after kidney transplantation have improved, with five-year deceased donor and living donor graft survivals of 78.8% and 84.3%, respectively. Improvements in induction and maintenance immunosuppression have contributed to the gradual improvement in outcomes. Unique challenges in pediatric recipients include increased graft thrombosis, adverse growth, and abnormal development relating to immunosuppression, increased rejection due to nonadherence, increased susceptibility to opportunistic infections, and post-transplant malignancy. This review focuses on the current practices and outcomes in pediatric kidney transplantation in North America. We discuss the indications for transplantation, the evaluation process, some key surgical and immunologic considerations, and the common risk factors for graft dysfunction. Keywords: pediatric kidney transplantation, end-stage renal disease, dialysis, organ donors, immunosuppression

  20. 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.

  1. Stem Cell Transplantation from Bench to Bedside

    Indian Academy of Sciences (India)

    ... 1986 - DEC 2007) Allogenic transplant · BONE MARROW TRANSPLANTATION VELLORE OCT 1986- DEC 2007 Allogenic transplant · BMT-CMCH Vellore: Miscellaneous Indications – Dec 2006 · BONE MARROW TRANSPLANTATION · INDICATIONS FOR BMT CMC (OCT 1986 - DEC 2007) Autologous Transplant.

  2. Transplant Information Portal for Patient Management in Organ Transplant

    Science.gov (United States)

    Vari, Sandor G.; Godo, Ferenc; Nagy, Geza; Fehervari, Imre; Markovics, Gyula; Brugal, Gerard

    2001-01-01

    The RETRANSPLANT (HC 4028 & IN 4028) project sponsored by European Commission - Directorate General XIII, Telecommunications, Information Market and Exploitation of Research, Telematics Application for Health, aimed to develop a portal to bridge the various and geographically dispersed institutions playing a role in the complex process of organ collection from a donor and transplantation into one or several recipients. The generic model used was kidney transplantation and the information and communication technologies developed so far networked dialysis centers, organ transplant surgery clinics, tissue typing laboratories, organizations coordinating recipient to donor selection, and other health care facilities for organ transplant services in the Central and Eastern European Countries using XML technologies.

  3. Post-transplant lymphoproliferative disorder following kidney transplantation

    DEFF Research Database (Denmark)

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

    2016-01-01

    Post-transplant lymphoproliferative disorder (PTLD) incidence is difficult to determine, mainly because both early and other lesions may go unrecognized and unregistered. Few studies have included systematic pathology review to maximize case identification and decide more accurately PTLD frequency...... 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...

  4. Tuberculosis After Renal Transplant.

    Science.gov (United States)

    Barbouch, Samia; Hajji, Meriam; Helal, Imed; Ounissi, Mondher; Bacha, Mohammed Mongi; Ben Hamida, Fathi; Abderrahim, Ezzedine; Ben Abdallah, Taieb

    2017-02-01

    Tuberculosis is one of the leading infections after renal transplant, particularly in developing countries where the incidence and prevalence in the general population are high. Diagnosis requires bacteriologic and histologic confirmation. Interactions among the antitubercular drugs and the immunosuppressive agents have to be considered while prescribing, and surveillance for adverse effects is required. Although rare, case reports are available on extrapulmonary tuberculosis in allograft recipients. Here, we present a 25-year-old kidney transplant recipient who was diagnosed with lymph node tuberculosis under uncommon circumstances but who had a good outcome. This case report illustrates the difficulties in diagnosis of tuberculosis, changes in therapeutic protocols, and prognostic factors and highlights the effects of infectious complications with immunosuppressive therapy in this particular patient population.

  5. Small intestinal transplantation.

    LENUS (Irish Health Repository)

    Quigley, E M

    2012-02-03

    The past few years have witnessed a considerable shift in the clinical status of intestinal transplantation. A great deal of experience has been gained at the most active centers, and results comparable with those reported at a similar stage in the development of other solid-organ graft programs are now being achieved by these highly proficient transplant teams. Rejection and its inevitable associate, sepsis, remain ubiquitous, and new immunosuppressant regimes are urgently needed; some may already be on the near horizon. The recent success of isolated intestinal grafts, together with the mortality and morbidity attendant upon the development of advanced liver disease related to total parenteral nutrition, has prompted the bold proposal that patients at risk for this complication should be identified and should receive isolated small bowel grafts before the onset of end-stage hepatic failure. The very fact that such a suggestion has begun to emerge reflects real progress in this challenging field.

  6. Bortezomib in Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    Rajeev Raghavan

    2010-01-01

    Full Text Available Although current therapies for pretransplant desensitization and treatment of antibody-mediated rejection (AMR have had some success, they do not specifically deplete plasma cells that produce antihuman leukocyte antigen (HLA antibodies. Bortezomib, a proteasome inhibitor approved for the treatment of multiple myeloma (a plasma cell neoplasm, induces plasma cell apoptosis. In this paper we review the current body of literature regarding the use of this biological agent in the field of transplantation. Although limited experience with bortezomib may seem to show promise in the realm of transplant recipients desensitization and treatment of AMR, there is also experience that may suggest otherwise. Bortezomib's role in desensitization protocols and treatment of AMR will be defined better as more clinical data and trials become available.

  7. Technologies de gestion d'après-récolte pour réduire la ...

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

    aflatoxine du maïs et le degré d'exposition pour les humains au Zimbabwe. Ce projet examine des solutions d'après-récolte novatrices pour éviter la contamination du grain par l'aflatoxine. L'objectif est de limiter l'exposition aux toxines des enfants ...

  8. 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…

  9. Pediatric Liver Transplant

    Directory of Open Access Journals (Sweden)

    SM Dehghani

    2014-04-01

    Full Text Available The goals of post-transplant management are to manage and treat postoperative complications, and develop a balanced long-term immunotherapy regimen that minimizes infection and side effects but controls rejection. While modern immunosuppressant regimes have reduced rates of graft loss due to rejection, they impart major risks for infection, growth failure, metabolic complications, and malignancy. There is significantly more post-transplant morbidity and mortality from infection than from rejection, particularly in infants. This has led to a trend toward minimization of immunosuppression, which is supported by evidence that some rejection facilitates graft tolerance and thus is not necessarily always harmful. Post-transplant complications are divided into those that occur in the first 3–12 months (“early”, and these are relatively common, and those occurring after 12 months (“late”, which are generally uncommon. Most “early” complications relate to surgical issues, and/or immunosuppression, most notably infection, vascular complications of the graft, and biliary leaks. Infection is the most common cause of post-transplant mortality. Rejection does occur but usually responds to treatment with steroid pulse dosing, and appears not to contribute to either graft or patient mortality. “Late” complications include biliary strictures, which are uncommon and generally respond to percutaneous biliary dilatation and stent procedures. Most late complications are primarily related to the effects of long-term immunosuppression, notably infections such as EBV and associated PTLD, and side effects of immunosuppression such as renal dysfunction, hypertension, and immune dysregulation.  

  10. Post liver transplant tuberculosis

    OpenAIRE

    Rodrigues, Luis Vaz; Gandara, Judit; Pires, João; Duarte, Raquel; Calvário, Fernando; Dominguez, Miguel; Carvalho, Aurora; Seca, Rui

    2009-01-01

    We report on a patient diagnosed with disseminated (hepatic and pulmonary) tuberculosis in the context of immunosuppression following liver transplant. During the administration of anti-tuberculosis drugs an abrupt elevation of liver enzymes was detected leading us to suspect drug toxicity rather than graft rejection. Nevertheless, careful surveillance and adjustment of serum levels of immunosuppressant drugs permitted continuance of tuberculosis treatment with no further side effects.

  11. 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

  12. [Coping in transplantated patients].

    Science.gov (United States)

    Telles-Correia, Diogo; Mega, Inês; Barbosa, António; Barroso, Eduardo; Monteiro, Estela

    2008-01-01

    The theoretical model of coping mechanisms (CM), is based on a discussion between it's main determinant factors: individual and situational (related to the 2 approaches of coping: dispositional and constitutional). Actually the most used classification of CM is based on the division of CM in two main dimensions: coping focused on emotions and coping focused on problem resolution. It is essential that classification methods of CM have in consideration the coexistence of stable dispositional elements with a situational variability. Some instruments to evaluate CM are introduced, based on different theories. Coping can influence health threw different mechanisms (neuroendocrine system, health threatening behaviours and adherence) and is included in two of the more important theoretical models applied to health (Moos & Schafer's and Leventhal's). Based on a systematic literature review we concluded that the most prevalent CM in pre transplantation period are acceptance, active coping, seeking support, and the less used are self-blame and avoidance. In post transplantation period the more prevalent CM continue to be active coping and seeking support associated to confrontation, selfconfidence, religion and coping focused in the problem. Evasive, emotive and fatalistic CM are associated to less control sensed by patients. Confrontation is associated to a better quality of life and avoidance to a reduction of quality of life and higher depression levels and denial to non-adherence increase. Control sensed by patients, CM related to the expression of emotions and denial change threw clinical evolution of transplanted patients.

  13. [Innate immunity and transplantation].

    Science.gov (United States)

    Ponticelli, Claudio

    2015-01-01

    Innate immunity is the first barrier against pathogen infection and has also the important function of activating the adaptive immunity. The receptors of innate immunity, such as toll-like receptors and other receptors, recognize as danger signals the molecular patterns of pathogens as well as those of endogenous molecules released by dying cells. The information is transmitted to adapter proteins that, through a chain of kinases that translate the signal to transcription factors regulating inflammatory genes. In the inflammatory milieu dendritic cells become mature, intercept the antigen and migrate to lymphoid organs where they present the antigen to naïve T cells. Complement also exerts an important role of bridge between innate and adaptive immunity. In donor-deceased kidney transplantation, the innate immunity is triggered in the donor by brain death and is aggravated by the cold ischemia and even more by reperfusion. Once activated, innate immunity produces a local inflammatory environment leading to dendritic cell maturation and complement activation. Dendritic cells present the alloantigen to T cells and induce their differentiation towards effector Th1 and Th17 while inhibiting Th2 and T regulatory cells. A main goal of the current research in transplantation is to obtain an immunological tolerance. Experimental studies showed the possibility of inducing operative tolerance in murine models and even in primates with the infusion of regulatory dendritic cells. However, there are no data with this technique in clinical transplantation.

  14. Allogeneic transplantation in multiple myeloma

    OpenAIRE

    Majolino,Ignazio; Severino,Alessandro

    2009-01-01

    In this review the authors present a state of art tretment of multiple myeloma.High dose chemo-radiotherapy followed by autologous hematopoietic stem cell transplantation has been show to be superior a conventional chemotherapy and a double transplantation. The authors discuss too, the allogeneic transplantation with reduced intensity conditioning, allogeneic versus tandem autologous, results the patients long term outcome and a approach about the use of donor lymphocytes, anti thimocyte glob...

  15. 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)

  16. BONE MARROW TRANSPLANTATION CMC (Oct 1986 – Dec 2007)

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. BONE MARROW TRANSPLANTATION CMC (Oct 1986 – Dec 2007). Allogeneic transplants. Total Transplant 717. I – Transplant 683. II – Transplant 31. III – Transplant 3. Autologous transplants (1992-2007) 198. (Autologous failure proceeded to Allogeneic transplant ...

  17. Transfusion Support of the Transplant Patient

    OpenAIRE

    Nisbet-Brown, Eric

    1988-01-01

    Organ transplant has become a much more common procedure in recent years. Data suggest that blood transfusions prior to transplant can affect allograph survival. The author discusses blood transfusion in kidney and liver transplantation.

  18. Transfusion support of the transplant patient.

    Science.gov (United States)

    Nisbet-Brown, E

    1988-11-01

    Organ transplant has become a much more common procedure in recent years. Data suggest that blood transfusions prior to transplant can affect allograph survival. The author discusses blood transfusion in kidney and liver transplantation.

  19. 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.

  20. Megakaryocytopoiesis in Stem Cell Transplantation

    National Research Council Canada - National Science Library

    Cohen, IIsaac

    1998-01-01

    Mobilized peripheral blood progenitor cell transplant, used to reconstitute hematopoiesis following high-dose chemotherapy in breast cancer patients, is associated with a requisite period of profound thrombocytopenia...

  1. Apreçamento de opções de IDI usando o modelo CIR

    Directory of Open Access Journals (Sweden)

    José Santiago Fajardo Barbachan

    2003-06-01

    Full Text Available A opção de IDI da BM&F possui características peculiares que torna o seu apreçamento diferente das opções de taxa de juros mais comuns, como as de títulos de renda fixa. Este artigo desenvolve uma fórmula para apreçamento dessas opções de IDI, utilizando a precificação livre de arbitragem. O modelo utilizado considera apenas um fator estocástico: a taxa de juros livre de risco de curto prazo. A equação diferencial usada para modelar o comportamento da taxa de juros é a do modelo CIR (COX INGERSOLL & ROSS, 1985, que possui reversão à média e não permite a existência de taxas de juros nominais negativas. Também é feita uma estimação dos parâmetros do modelo proposto baseando-se em dados históricos, para então comparar o preço teórico da opção baseado nestes parâmetros com os preços de mercado e com o preço teórico considerando a modelagem de Vasicek (1977.The IDI option from the BM&F (Commodities and Futures Exchange has unusual characteristics, that make its pricing different from common interest rate options. This paper develops a closed form formula for the pricing of these IDI options, using an arbitrage-free pricing approach. The model used considers only one stochastic factor: the short-term risk-free interest rate. The differential equation used to model the behavior of the interest rate comes from the CIR (COX INGERSOLL & ROSS, 1985 model, which has mean reversion property and does not allow negative nominal interest rates. It is also done a parameter estimation of the proposed model based on historic data, and then compares the theoretical price of the option based on these parameters with the market price and with the theoretical price considering the Vasicek (1977 model.

  2. Analysis of steam condensation in APR1400 IRWST for loss of coolant accident

    International Nuclear Information System (INIS)

    Oh, Young Suk

    2006-02-01

    The In-Containment Refueling Water Storage Tank (IRWST) of APR1400 is installed at the bottom of containment building to promote the plant safety functions during an accident. This design feature brings about uncertainty factors which may necessitate conventional prediction of temperature and pressure of containment building improved or revised when an accident occurs. The hot steam which is released from RCS break enters the IRWST through four Pressure Relief Dampers (PRDs). It is expected to be condensed with water stored in IRWST, in which water is colder than incoming steam. The purpose of this study is to investigate the influence of IRWST and pressure relief damper on back pressure and temperature in APR1400 containment codes such as CONTEMPT-LT and GOTHIC. The comparison of codes showed that GOTHIC code be more appropriate for the prediction of containment pressure and temperature under the condition of steam condensation occurring in confined water pool. Especially, the GOTHIC has superior capability to treat multi-compartmentalized geometry This study developed one-compartment (single) model, two-compartment (separated) model, and three-dimension (3-D) model, respectively. Two compartment model separates the IRWST from the other containment compartments. In 3-D model, only the IRWST is nodalized with Cartesian modeling. The single model is developed for comparison with two-compartment model which can analyze PRD's influence. The separated model for predicting PRD's influence divides the space between containment and IRWST. 3-D model for IRWST was generated because it is not symmetric considering location of sparger, pump, and suction sump. Therefore, IRWST is simulated with not only detailed three-dimensional behavior but also independent flow paths for four PRDs. Many experimental studies for the direct-contact heat transfer in stratified steam water flows, cocurrent or countercurrent, have been performed (Segev et al., 1981; Lim et al., 1981; Kim and

  3. Analysis of steam condensation in APR1400 IRWST for loss of coolant accident

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Young Suk

    2006-02-15

    The In-Containment Refueling Water Storage Tank (IRWST) of APR1400 is installed at the bottom of containment building to promote the plant safety functions during an accident. This design feature brings about uncertainty factors which may necessitate conventional prediction of temperature and pressure of containment building improved or revised when an accident occurs. The hot steam which is released from RCS break enters the IRWST through four Pressure Relief Dampers (PRDs). It is expected to be condensed with water stored in IRWST, in which water is colder than incoming steam. The purpose of this study is to investigate the influence of IRWST and pressure relief damper on back pressure and temperature in APR1400 containment codes such as CONTEMPT-LT and GOTHIC. The comparison of codes showed that GOTHIC code be more appropriate for the prediction of containment pressure and temperature under the condition of steam condensation occurring in confined water pool. Especially, the GOTHIC has superior capability to treat multi-compartmentalized geometry This study developed one-compartment (single) model, two-compartment (separated) model, and three-dimension (3-D) model, respectively. Two compartment model separates the IRWST from the other containment compartments. In 3-D model, only the IRWST is nodalized with Cartesian modeling. The single model is developed for comparison with two-compartment model which can analyze PRD's influence. The separated model for predicting PRD's influence divides the space between containment and IRWST. 3-D model for IRWST was generated because it is not symmetric considering location of sparger, pump, and suction sump. Therefore, IRWST is simulated with not only detailed three-dimensional behavior but also independent flow paths for four PRDs. Many experimental studies for the direct-contact heat transfer in stratified steam water flows, cocurrent or countercurrent, have been performed (Segev et al., 1981; Lim et al., 1981

  4. Biomarkers in solid organ transplantation: establishing personalized transplantation medicine

    Science.gov (United States)

    2011-01-01

    Technological advances in molecular and in silico research have enabled significant progress towards personalized transplantation medicine. It is now possible to conduct comprehensive biomarker development studies of transplant organ pathologies, correlating genomic, transcriptomic and proteomic information from donor and recipient with clinical and histological phenotypes. Translation of these advances to the clinical setting will allow assessment of an individual patient's risk of allograft damage or accommodation. Transplantation biomarkers are needed for active monitoring of immunosuppression, to reduce patient morbidity, and to improve long-term allograft function and life expectancy. Here, we highlight recent pre- and post-transplantation biomarkers of acute and chronic allograft damage or adaptation, focusing on peripheral blood-based methodologies for non-invasive application. We then critically discuss current findings with respect to their future application in routine clinical transplantation medicine. Complement-system-associated SNPs present potential biomarkers that may be used to indicate the baseline risk for allograft damage prior to transplantation. The detection of antibodies against novel, non-HLA, MICA antigens, and the expression of cytokine genes and proteins and cytotoxicity-related genes have been correlated with allograft damage and are potential post-transplantation biomarkers indicating allograft damage at the molecular level, although these do not have clinical relevance yet. Several multi-gene expression-based biomarker panels have been identified that accurately predicted graft accommodation in liver transplant recipients and may be developed into a predictive biomarker assay. PMID:21658299

  5. 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.

  6. 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.

  7. Uncertainty evaluation of the fission product release in the APR1400 core

    International Nuclear Information System (INIS)

    Song, Yong-Mann; Kim, Dong Ha

    2004-01-01

    The fission product core release in the MELCORE code is based on the CORSOR models developed by the Battelle Memorial Institute. This paper presents the core release analyses for selected representative volatile and non-volatile radionuclides during conservative high and low pressure sequences in the APR1400 plant. Three core release models (CORSOR, CORSOR-M, CORSOR-Booth) in the latest MELCOR 1.8.5 version and an updated model (ORNL-Booth) recommended lately in the ISP46 PHEBUS study are applied. In the analysis, the option of the fuel component surface-to-volume ratio in the CORSOR and CORSOR-M models and the option of the high and low burn-up in the CORSOR-Booth model are considered together. As a result, the CORSOR-M release rate is the highest for the volatile radionuclides, and the CORSOR release rate is the highest for the non-volatile radionuclides with an insufficient consistency. The updated ORNL-Booth case is between the CORSOR-M and CORSOR-Booth cases for the volatile and mid-volatile radionuclides while no significant correlations are found among the models for the non-volatile radionuclides. As the uncertainty range for the release rate expands from several times (volatile radionuclides) to more than a maximum of 10,000 times (non-volatile radionuclides), user's careful choice of the core release models is needed. (author)

  8. Design Improvement for the Reactor Trip Switchgear System for APR1400 Design Certification

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han Gyu; Choi, Woong Seock; Sohn, Se Do [KEPCO Engineering and Construction Co., Deajeon (Korea, Republic of)

    2016-10-15

    The Reactor Trip Switchgear System (RTSS) performs the function to open the Reactor Trip Circuit Breaker (RTCB) when the RTSS receives trip signals from the Plant Protection System (PPS). The RTSS for Shin-Hanul Nuclear Power Plant Units 1 and 2 (SHN 1 and 2) receives the reactor trip signals from four independent PPS divisions and performs the function to interrupt power from the Motor Generator Set (MG Set) to the Digital Rod Control System (DRCS). The RTSS for SHN 1 and 2 consists of four Reactor Trip Switchgears (RTSGs) which form the selective 2-out-of-4 logic. The RTSS design for APR 1400 DC has been changed from selective 2-out-of-4 to full 2-out-of-4 logic by configuring two independent sets of RTSS for diversity. The RTSS with the full 2-out-of-4 logic decreases the chances of generating an inadvertent reactor trip by a failure during maintenance or testing. We expect this design change to contribute to enhancing the plant availability. After all, the quantitative reliability analysis will be necessary to visualize the degree of the plant availability enhancement from the design change described in this paper.

  9. Development of Human Performance Measures for Human Factors Validation in the Advanced MCR of APR-1400

    Science.gov (United States)

    Ha, Jun Su; Seong, Poong Hyun; Lee, Myeong Soo; Hong, Jin Hyuk

    2007-12-01

    Main control room (MCR) man-machine interface (MMI) design of advanced nuclear power plants (NPPs) such as APR (advanced power reactor)-1400 can be validated through performance-based tests to determine whether it acceptably supports safe operation of the plant. In this paper, plant performance, personnel task performance, situation awareness, workload, teamwork, and anthropometric/physiological factor are considered for the human performance evaluation. For the development of human performance measures, attention is paid to considerations and constraints such as the changed environment in an advanced MCR, needs for a practical and economic evaluation, and suitability of evaluation criteria. Measures generally used in various industries and empirically proven to be useful are adopted as the main measures with some modifications. In addition, complementary measures are developed to overcome some of the limitations associated with the main measures. The development of the measures is addressed based on theoretical and empirical background. Finally we discuss the way in which the measures can be effectively integrated. The HUPESS (HUman Performance Evaluation Support System) which is in development is also briefly introduced.

  10. Les collections deux ans après le déménagement

    Directory of Open Access Journals (Sweden)

    Jacqueline Sanson

    2000-06-01

    Full Text Available Toutes les bibliothèques – et particulièrement les bibliothèques nationales dont la mission essentielle est de conserver le patrimoine – sont confrontées à des problèmes de place. Le bâtiment de Tolbiac a été en grande partie créé pour répondre aux besoins croissants de stockage de la Bibliothèque nationale et par conséquent assurer une meilleure conservation à ses collections. Mon exposé s’articulera en trois parties: en premier lieu, il me paraît nécessaire de donner un bref rappel de la situation antérieure; ensuite, seront abordées la logique d’implantation, les spécifications techniques de magasinage et de conservation dans les nouveaux bâtiments; enfin, le point sera fait sur les améliorations et les difficultés rencontrées à peine deux ans après le déménagement des collections.

  11. Consolidation and Decomposition of APR1400 NRC Design Certification Processes for Collaborative and Accelerated Processing

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Chul [FNC Technology Co., Yongin (Korea, Republic of); Kang, Deog Ji [KNHP, Daejeon (Korea, Republic of)

    2016-05-15

    KEPCO and KHNP are conducting APR1400 Design Certification from NRC. For the proper management of processes and information, a system called RIS (Regulatory Information management System) has been implemented by FNC from 2014, and it is on the final stage. In retaining the certification from NRC, RIS will be a very essential role by providing platform for collaborative and accelerated processing of responses to RAI (Request of Additional Information). Preparation of responses to RAI with this kind of systematic approach may be the first in the world. Westinghouse is doing manually and using MS Excel to collect the processing status. Where as, RIS will enable each member can do his own job and collect the status automatically. In this paper, how collaborative and accelerated processing of responses to RAI can be enabled will be described, and further enhancements will also be discussed. It handles MS Word directory with the help of VSTO. And with the help of Aspose.Total for .NET, the prepared response to RAI meets NRC's requirements. Through some further work and direct integration with requirement management solution, RIS can be expanded to cover a prior impact notice in case of DCD being altered.

  12. Recent Key Issues in New Reactors Licensing Program and APR1400 Design Upgrades

    International Nuclear Information System (INIS)

    Kim, Kwang Hong; Oh, Seong Jong; Park, Moon Ghu

    2012-01-01

    The new reactor licensing process consists of first a design certification rulemaking under the 10 CFR Part 52. Through the process the NRC would review and approve a complete nuclear power plant design. Utilities could also seek an Early Site Permit (ESP), which would resolve lots of site-related issues earlier. A utility could seek the Combined License (COL) in a single license both a construction permit and an operating license. A key feature of the combined license was its incorporation of specified Inspections, Tests, Analyses and Acceptance Criteria (ITAAC). The ITAAC would be the acceptance criteria which the licensee should demonstrated it would be sufficient to provide the reasonable assurance that the facility had been constructed and would be operated in conformity with the design certification. Westinghouse's Advanced Passive plant design AP1000 is the first design being built licensed under the 10 CFR Part 52. NRC has done a great deal under the new rules. The Commission has issued many regulations incorporating recent experience of new findings by experiments and measurements particularly emphasizing the security issues since the events of 911. These rulemaking will require applicants for design certifications to submit a safety and security assessment addressing the relevant requirements that have been established 6 months before its submittal of Design Control Documents. This paper describes the summary of recent rulemaking process and the gap between the key revised rules and current APR1400 design

  13. Mediastinitis after cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Noedir A. G. Stolf

    2000-05-01

    Full Text Available OBJECTIVE: Assessment of incidence and behavior of mediastinitis after cardiac transplantation. METHODS: From 1985 to 1999, 214 cardiac transplantations were performed, 12 (5.6% of the transplanted patients developed confirmed mediastinitis. Patient's ages ranged from 42 to 66 years (mean of 52.3±10.0 years and 10 (83.3% patients were males. Seven (58.3% patients showed sternal stability on palpation, 4 (33.3% patients had pleural empyema, and 2 (16.7% patients did not show purulent secretion draining through the wound. RESULTS: Staphylococcus aureus was the infectious agent identified in the wound secretion or in the mediastinum, or both, in 8 (66.7% patients. Staphylococcus epidermidis was identified in 2 (16.7% patients, Enterococcus faecalis in 1 (8.3% patient, and the cause of mediastinitis could not be determined in 1 (8.3% patient. Surgical treatment was performed on an emergency basis, and the extension of the débridement varied with local conditions. In 2 (16.7% patients, we chose to leave the surgical wound open and performed daily dressings with granulated sugar. Total sternal resection was performed in only 1 (8.3% patient. Out of this series, 5 (41.7% patients died, and the causes of death were related to the infection. Autopsy revealed persistence of mediastinitis in 1 (8.3% patient. CONCLUSION: Promptness in diagnosing mediastinitis and precocious surgical drainage have changed the natural evolution of this disease. Nevertheless, observance of the basic precepts of prophylaxis of infection is still the best way to treat mediastinitis.

  14. Kidney transplantation in obese patients

    Science.gov (United States)

    Tran, Minh-Ha; Foster, Clarence E; Kalantar-Zadeh, Kamyar; Ichii, Hirohito

    2016-01-01

    The World Health Organization estimated that in 2014, over 600 million people met criteria for obesity. In 2011, over 30% of individuals undergoing kidney transplant had a body mass index (BMI) 35 kg/m2 or greater. A number of recent studies have confirmed the relationship between overweight/obesity and important comorbidities in kidney transplant patients. As with non-transplant surgeries, the rate of wound and soft tissue complications are increased following transplant as is the incidence of delayed graft function. These two issues appear to contribute to longer length of stay compared to normal BMI. New onset diabetes after transplant and cardiac outcomes also appear to be increased in the obese population. The impact of obesity on patient survival after kidney transplantation remains controversial, but appears to mirror the impact of extremes of BMI in non-transplant populations. Early experience with (open and laparoscopic) Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy support excellent weight loss (in the range of 50%-60% excess weight lost at 1 year), but experts have recommended the need for further studies. Long term nutrient deficiencies remain a concern but in general, these procedures do not appear to adversely impact absorption of immunosuppressive medications. In this study, we review the literature to arrive at a better understanding of the risks related to renal transplantation among individuals with obesity. PMID:27011911

  15. 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

  16. Organs for transplantation.

    Science.gov (United States)

    1984-03-03

    The British government has printed 10 million organ donor cards--as well as posters, car stickers, and leaflets--for distribution in a campaign to increase the number of organ transplants in the United Kingdom. Norman Fowler, Secretary of State for Social Services, suggested at a February 22, 1984, press conference that signing of donor cards might become a family occasion, so that all concerned would know of a person's wishes in the event of sudden death. He made it clear that the government has no plans to introduce a system of presumed consent for organ donation. Mr. Fowler also announced a commitment of additional government funds for renal services.

  17. Transplantation immunity in annelids

    Science.gov (United States)

    Bailey, S.; Miller, Barbara J.; Cooper, E. L.

    1971-01-01

    The oligochaete annelids Lumbricus terrestris and Eisenia foetida were used to demonstrate adoptive transfer of transplantation immunity. Eisenia grafts were used as sensitizing antigen and test grafts. Host Lumbricus injected with coelomic fluid containing coelomocytes from Lumbricus donors previously sensitized to Eisenia grafts rejected test grafts in an accelerated fashion. The rejection time was shorter and significantly different from that of worms injected with saline or coelomocytes from unsensitized worms. Coelomocytes resemble various vertebrate leucocytes and immunocytes and seem equivalent to a hypothetical invertebrate precursor wandering cell which recognizes and reacts to antigen. ImagesFIG. 1 PMID:5558033

  18. [Fecal microbiota transplantation: review].

    Science.gov (United States)

    Barbut, F; Collignon, A; Butel, M-J; Bourlioux, P

    2015-01-01

    Fecal microbiota transplantation (FMT) has gained an increasing medical interest, since the recognition of the role of disturbed microbiota in the development of various diseases. To date, FMT is an established treatment modality for multiple recurrent Clostridium difficile infection (RCDI), despite lack of standardization of the procedure. Persisting normalization of the disturbed colonic microbiota associated with RCDI seems to be responsible for the therapeutic effect of FMT. For other diseases, FMT should be considered strictly experimental, only offered to patients in an investigational clinical setting. Although the concept of FMT is appealing, current expectations should be damped until future evidence arises. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  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. 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...

  1. 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.

  2. Post-transplantation Malignancy After Kidney Transplantation in Turkey.

    Science.gov (United States)

    Keles, Y; Tekin, S; Duzenli, M; Yuksel, Y; Yücetin, L; Dosemeci, L; Sengul, A; Demirbaş, A; Tuncer, M

    2015-06-01

    Kidney transplantation is the best treatment option for end-stage renal disease patients. Increased incidence of post-transplantation malignancy can be caused by immunosuppressive drugs and some oncogenic infections. The aim of this study is to show the incidence of post-transplantation malignancy in patients who had surgery and were followed up in the Organ Transplant Center, Medical Park Antalya, Antalya, Turkey. The study was based on 2100 kidney transplantation patients who had surgery between May 2008 and December 2012 and also on 1900 patients who had surgery by members of our team in other centers and who were followed up routinely. In all of our patients, the type of malignancy, the time that malignancy developed, immunosuppressive regimens, and viral status (Epstein-Barr virus and cytomegalovirus) were investigated. Malignancy was developed in 30 patients (60% of them were male, median age was 52.1 years). Post-transplantation malignancy development time was a median of 5.1 years. The types of malignancies were as follows: non-melanoma skin cancer in 12 patients (40%), urogenital cancer in 7 patients (24%), breast cancer in 4 patients (14%), lymphoproliferative disease in 3 patients (10%), thyroid cancer in 2 patients (6%), and lung cancer in 2 patients (6%). In this study, we did not find any increased post-transplantation malignancy risk in our patients. This finding could be due to the low-dosage immunosuppressive protocols that we used. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Limbal stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Fernandes Merle

    2004-01-01

    Full Text Available The past two decades have witnessed remarkable progress in limbal stem cell transplantation. In addition to harvesting stem cells from a cadaver or a live related donor, it is now possible to cultivate limbal stem cells in vitro and then transplant them onto the recipient bed. A clear understanding of the basic disease pathology and a correct assessment of the extent of stem cell deficiency are essential. A holistic approach towards management of limbal stem cell deficiency is needed. This also includes management of the underlying systemic disease, ocular adnexal pathology and dry eye. Conjunctival limbal autografts from the healthy contralateral eye are performed for unilateral cases. In bilateral cases, tissue may be harvested from a cadaver or a living related donor; prolonged immunosuppression is needed to avoid allograft rejection in such cases. This review describes the surgical techniques, postoperative treatment regimes (including immunosuppression for allografts, the complications and their management. The short and long-term outcomes of the various modalities reported in the literature are also described.

  4. Pediatric Liver Transplantation

    Science.gov (United States)

    Dominguez, Rodrigo; Young, Lionel W.; Ledesma-Medina, Jocyline; Cienfuegos, Javier; Gartner, J. Carlton; Bron, Klaus M.; Starzl, Thomas E.

    2010-01-01

    The postoperative diagnostic imaging examinations of 44 children who underwent 59 orthotopic liver transplantations were reviewed. The imaging modalities used for the evaluation of suspected complications include plain roentgenography, ultrasonography (US), computed tomography (CT), nuclear scintigraphy, arteriography, percutaneous and operative cholangiography, and endoscopic retrograde cholangiopancreatography. The main postoperative complications included ischemia, thrombosis (hepatic artery and portal vein), infarction, obstruction or leakage of the biliary anastomosis, hepatic and perihepatic infection, and allograft rejection. US, the most frequently used abdominal imaging modality, was best suited for detection of biliary duct dilatation, fluid collections in or around the transplanted liver, and hepatic arterial, inferior vena caval, and portal vein thrombosis. CT was especially helpful in corroborating findings of infection and in locating abscesses. Technetium 99m sulfur colloid (early- and late-phase imaging) provided a sensitive, although nonspecific, means of assessing allograft vascularization and morphology. Angiography showed vascularity most clearly, and cholangiography was the most useful In the assessment of bile duct patency. A diagnostic imaging algorithm is proposed for evaluation of suspected complications. PMID:3901104

  5. Organ transplantation in Egypt.

    Science.gov (United States)

    Paris, Wayne; Nour, Bakr

    2010-09-01

    Concern has increasingly been expressed about the growing number of reports of medical personnel participating in the transplantation of human organs or tissues taken from the bodies of executed prisoners, handicapped patients, or poor persons who have agreed to part with their organs for commercial purposes. Such behavior has been universally considered as ethically and morally reprehensible, yet in some parts of the world the practice continues to flourish. The concept of justice demands that every person have an equal right to life, and to protect this right, society has an obligation to ensure that every person has equal access to medical care. Regrettably, the Egyptian system does not legally recognize brain death and continues to allow the buying and selling of organs. For more than 30 years in Egypt, the ability to pay has determined who receives an organ and economic need has determined who will be the donor. As transplant professionals, it is important that we advocate on behalf of all patients, potential recipients, and donors and for those who are left out and not likely to receive a donor organ in an economically based system. Current issues associated with this debate are reviewed and recommendations about how to address them in Egypt are discussed.

  6. Challenges in Organ Transplantation

    Directory of Open Access Journals (Sweden)

    Rafael Beyar

    2011-04-01

    Full Text Available Organ transplantation has progressed tremendously with improvements in surgical methods, organ preservation, and pharmaco-immunologic therapies and has become a critical pathway in the management of severe organ failure worldwide. The major sources of organs are deceased donors after brain death; however, a substantial number of organs come from live donations, and a significant number can also be obtained from non-heart-beating donors. Yet, despite progress in medical, pharmacologic, and surgical techniques, the shortage of organs is a worldwide problem that needs to be addressed internationally at the highest possible levels. This particular field involves medical ethics, religion, and society behavior and beliefs. Some of the critical ethical issues that require aggressive interference are organ trafficking, payments for organs, and the delicate balance in live donations between the benefit to the recipient and the possible harm to the donor and others. A major issue in organ transplantation is the definition of death and particularly brain death. Another major critical factor is the internal tendency of a specific society to donate organs. In the review below, we will discuss the various challenges that face organ donation worldwide, and particularly in Israel, and some proposed mechanisms to overcome this difficulty.

  7. Challenges in organ transplantation.

    Science.gov (United States)

    Beyar, Rafael

    2011-04-01

    Organ transplantation has progressed tremendously with improvements in surgical methods, organ preservation, and pharmaco-immunologic therapies and has become a critical pathway in the management of severe organ failure worldwide. The major sources of organs are deceased donors after brain death; however, a substantial number of organs come from live donations, and a significant number can also be obtained from non-heart-beating donors. Yet, despite progress in medical, pharmacologic, and surgical techniques, the shortage of organs is a worldwide problem that needs to be addressed internationally at the highest possible levels. This particular field involves medical ethics, religion, and society behavior and beliefs. Some of the critical ethical issues that require aggressive interference are organ trafficking, payments for organs, and the delicate balance in live donations between the benefit to the recipient and the possible harm to the donor and others. A major issue in organ transplantation is the definition of death and particularly brain death. Another major critical factor is the internal tendency of a specific society to donate organs. In the review below, we will discuss the various challenges that face organ donation worldwide, and particularly in Israel, and some proposed mechanisms to overcome this difficulty.

  8. Challenges in Organ Transplantation

    Science.gov (United States)

    Beyar, Rafael

    2011-01-01

    Organ transplantation has progressed tremendously with improvements in surgical methods, organ preservation, and pharmaco-immunologic therapies and has become a critical pathway in the management of severe organ failure worldwide. The major sources of organs are deceased donors after brain death; however, a substantial number of organs come from live donations, and a significant number can also be obtained from non-heart-beating donors. Yet, despite progress in medical, pharmacologic, and surgical techniques, the shortage of organs is a worldwide problem that needs to be addressed internationally at the highest possible levels. This particular field involves medical ethics, religion, and society behavior and beliefs. Some of the critical ethical issues that require aggressive interference are organ trafficking, payments for organs, and the delicate balance in live donations between the benefit to the recipient and the possible harm to the donor and others. A major issue in organ transplantation is the definition of death and particularly brain death. Another major critical factor is the internal tendency of a specific society to donate organs. In the review below, we will discuss the various challenges that face organ donation worldwide, and particularly in Israel, and some proposed mechanisms to overcome this difficulty. PMID:23908807

  9. Facial transplantation surgery introduction.

    Science.gov (United States)

    Eun, Seok-Chan

    2015-06-01

    Severely disfiguring facial injuries can have a devastating impact on the patient's quality of life. During the past decade, vascularized facial allotransplantation has progressed from an experimental possibility to a clinical reality in the fields of disease, trauma, and congenital malformations. This technique may now be considered a viable option for repairing complex craniofacial defects for which the results of autologous reconstruction remain suboptimal. Vascularized facial allotransplantation permits optimal anatomical reconstruction and provides desired functional, esthetic, and psychosocial benefits that are far superior to those achieved with conventional methods. Along with dramatic improvements in their functional statuses, patients regain the ability to make facial expressions such as smiling and to perform various functions such as smelling, eating, drinking, and speaking. The ideas in the 1997 movie "Face/Off" have now been realized in the clinical field. The objective of this article is to introduce this new surgical field, provide a basis for examining the status of the field of face transplantation, and stimulate and enhance facial transplantation studies in Korea.

  10. 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.

  11. [Metabolic syndrome after kidney transplantation].

    Science.gov (United States)

    Nedbálková, Marta; Svojanovský, Jan; Trnavský, Karel; Kuman, Milan; Jarkovský, Jiří; Karpíšek, Michal; Souček, Miroslav

    2014-03-01

    Metabolic syndrome is a risk factor for cardiovascular diseases. Higher risk of the metabolic syndrome and its components in patients after kidney transplantation is caused by immunosuppressive therapy. THE AIM OF OUR STUDY was to evaluate the prevalence of the metabolic syndrome and its components in kidney transplant recipients and to analyse their influence on allograft function and albuminuria. In the study we monitored 69 patients after cadaveric kidney transplantation. The prevalence of the meta-bolic syndrome was 61.3 % 3 years after kidney transplantation. The prevalence of new onset diabetes mellitus after transplantation was 27 % and that of abdominal obesity 59.7 % of patients. The age of kidney transplant recipients with the metabolic syndrome was higher than of these without it, but not statistically significant. The age of kidney transplant recipients with new onset diabetes mellitus after transplantation was significantly higher, 54.0 (35.0; 69.0) years, than in patients without it, 45.5 (27.0; 60.0) years, OR (95% IS) 1.116 (1.031; 1.207), p = 0.006.The number of components of the metabolic syndrome was negatively correlated with the graft function (rs -0,275, p = 0,031). In patients with impaired renal function with estimated glomerular filtration (using MDRD equation) metabolic syndrome and hypertriglyceridaemia was significantly higher. Chronic allograft dysfunction was predicted by donor age, delayed allograft function, rejection, low level of HDL-cholesterol, hypertriglyceridaemia and hyperuricaemia. Hyperuricaemia was the only significant predictor of allograft dysfunction independently of the presence of delayed allograft function, rejection episodes and donor age. The metabolic syndrome, elevation of apolipoprotein B and nonHDL-cholesterol and increased systolic blood pressure were associated with albuminuria. Higher levels of apolipoprotein B and total cholesterol were independent predictors of increased albumin-creatinine ratio. Obesity

  12. 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 ...

  13. Les droits relatifs à l'eau en Bolivie : après la guerre de l'eau | IDRC ...

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

    Après vingt ans de difficultés économiques (en 1985, le taux d'inflation en Bolivie a atteint 24 000 %, un sommet), l'adoption de réformes axées sur le marché a enrichi l'élite bolivienne mais n'a pas apporté aux démunis .... Assessing the Impact of State-Community Collaboration to Address Urban Violence in South Africa.

  14. 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 ... L'Initiative des conseils subventionnaires de la recherche scientifique en Afrique subsaharienne remporte le prix de la diplomatie scientifique.

  15. 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.

  16. 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.

  17. 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.

  18. Thermodynamic analysis for the three-layered melt pool during the severe accidents in the APR1400

    International Nuclear Information System (INIS)

    Kang, Kyoungho; Park, Raejoon; Hong, Seongwan

    2009-01-01

    For precise evaluations of the coolability through the External Reactor Vessel Cooling (ERVC) during a severe accident, the melt pool configuration should be accurately defined. The melt pool configurations inside the lower head of the reactor vessel affect the initial thermal load to the vessel and play a key role in determining the integrity of the reactor vessel. In this study, thermodynamic analyses were performed to examine the final melt pool configuration during the severe accidents in the APR1400. As the representative accident scenarios, Large Break Loss of Coolant Accident (LBLOCA), Medium Break Loss of Coolant Accident (MBLOCA), Small Break Loss of Coolant Accident (SBLOCA), Station Black Out (SBO), and Total Loss of Feed Water (TLFW) were selected. The initial melt pool conditions, such as melt mass and melt pool temperature etc., were calculated using the SCDAP/RELAP5/MOD3.3 code. The thermodynamic analyses were performed using the GEMINI code. Combined with the GEMINI code calculations and a peer review of the RASPLAV/MASCA experimental results, the final melt pool configurations were determined for the major accident scenarios of the APR1400. Density evaluation graph was developed for the precise examination of the melt pool layer inversion. The thermodynamic analyses results address the possibility of a melt pool layer inversion in the APR1400 accident sequences. (author)

  19. 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.

  20. 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.

  1. Analysis of a molten pool natural convection in the APR1400 RPV at a severe accident

    International Nuclear Information System (INIS)

    Kim, Jong Tae; Park, Rae Joon; Kim, Sang Baik

    2005-01-01

    During a hypothetical severe accident, reactor fuel rods and structures supporting them are melted and relocated in the lower head of the reactor vessel. These relocated molten materials could be separated by their density difference and construct metal/oxide stratified pools in the lower head. A decay heat generated from the fuel material is transferred to the vessel wall and upper structures remaining in the reactor vessel by natural convection. As shown in Fig. 1 two-layered stratified molten pool is developed in the reactor lower vessel. The oxidic pool usually constructed by the mixture of uranium oxide and zirconium oxide. The melting temperature of the oxidic material is very high compared to the steel vessel and metallic layer. And highly turbulent natural convection generated by the decay heat enhances heat transfer to the boundary of the oxidic pool. By this thermal mechanism, oxide curst is developed around the oxidic layer as shown in Fig. 1. The oxidic pool is bounded thermally and fluid-dynamically by the developed crust. By this boundedness, the heat transfer structure in the stratified oxidic/metallic pool can be solved separately. The thermal boundary condition of the oxidic pool is isothermal with constant melting temperature of the oxidic material. The decay heat is transfer to side wall and upper interface between oxidic and metallic layer. Turbulent natural convection is dominant heat transfer mechanism in the oxidic pool. The heat transferred from the bottom oxidic layer is imposed to the upper metallic layer. This transferred heat in the metallic pool is removed through side and upper surface, which is augmented also by natural convection developed in the pool. In this study, a molten pool natural convection in the APR1400 RPV during a severe accident is simulated using the Lilac code and the calculated heat flux distribution on the reactor vessel wall is compared with a lumped-parameter (LP) prediction

  2. Onset of liquid droplet entrainment on a direct vessel injection system for APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han-sol; Lee, Jae-Young [Handong Global University, Pohang (Korea, Republic of); Kim, Jong-Rok; Euh, Dong-Jin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    In this research, a series of visualization works was conducted to understand droplet entrainment of the flow pattern generated in direct vessel injection system(DVI) of Korea nuclear power plant, APR 1400. In the emergency situation of a nuclear power plant, reliability of DVI cooling can be an important issue. It is known that, the amount and the rate of entrainment during the DVI cooling process can significantly affect the total heat removal. To visualize the film Reynolds number closely related with onset of droplet entrainment induced by falling film flow and lateral air flow in a small gap, confocal chromatic sensing method for measuring accurately film thickness and depth averaging particle image velocimetry for film velocity were used. The results have been post processed 4G Insight software. By measuring two dimensional film Reynolds number, we can predict the onset of droplet entrainment and obtain visible breakup region intuitively. To visualize the droplet entrainment induced by falling film flow and lateral air flow in a small gap, shadowgraph method with CCD camera (2200fps, 1280 pixel X 800 pixel, ) on coated plate with super water-repellent agent was used. The results have been post processed using 4G Insight software. By measuring two dimensional film Reynolds number, we can predict the onset of droplet entrainment and obtain visible breakup region intuitively. By adopting both super hydrophobic coating method and shadowgraph method, entrainment in a narrow gap was successfully visualized that has rarely performed before and meaningful results for DVI system research fields have been made.

  3. Steady state flow evaluations for passive auxiliary feedwater system of APR

    International Nuclear Information System (INIS)

    Park, Jongha; Kim, Jaeyul; Seong, Hoje; Kang, Kyoungho

    2012-01-01

    This paper briefly introduces a methodology to evaluate steady state flow of APR+ Passive Auxiliary Feedwater System (PAFS). The PAFS is being developed as a safety grade passive system to completely replace the existing active Auxiliary Feedwater System (AFWS). Natural circulation cooling can be generally classified into the single-phase, two-phase, and boiling-condensation modes. The PAF is designed to be operated in a boiling-condensation natural circulation mode. The steady-state flow rate should be equal to the steady-state boiling/condensation rate determined by the steady-state energy and momentum balances in the PAFS. The determined steady-state flow rate can be used in the design optimization for the natural circulation loop of the PAFS through the steady-state momentum balance. Since the retarding force, which is to be balanced by the driving force in the natural circulation system design depends on the reliable evaluation of the success of a natural circulation system design depends on the reliable evaluation of the pressure loss coefficients. In PAFS, the core decay heat is released by natural circulation flow between the S G secondary side and the Passive Condensation Heat Exchanger (PCHX) that is immersed in the Passive Condensation Cooling Tank (PCCT). The PCCT is located on the top of Auxiliary building The driving force is determined by the difference between the S/G (heat Source) secondary water level and condensation liquid (heat sink) level. It will overcome retarding force at flowrate in the system, which is determined by vaporization and condensation of the steam which is generated at the S/G by the latent heat in system. In this study, the theoretical method to estimate the steady state flow rate in boiling-condensation natural circulation system is developed and compared with test results

  4. Pediatric organ donation and transplantation.

    Science.gov (United States)

    Workman, Jennifer K; Myrick, Craig W; Meyers, Rebecka L; Bratton, Susan L; Nakagawa, Thomas A

    2013-06-01

    There is increasing unmet need for solid organ donation. Alternative donor sources, such as donation after circulatory determination of death (DCDD), are needed. The objective of this study was to examine the impact of DCDD on trends in pediatric organ donation and transplantation. Data were obtained from the Organ Procurement and Transplantation Network for US organ recipients and donors from 2001 to 2010 stratified according to age, organ, and deceased donor type (DCDD or donation after neurologic determination of death). Additional data included transplant wait-list removals due to death. From 2001 to 2010, pediatric organ transplant recipients increased from 1170 to 1475. Organs from DCDD donors were transplanted into children infrequently but increased from 1 to 31. Pediatric donation after neurologic determination of death decreased by 13% whereas DCDD increased by 174% (50 to 137). Recipients of pediatric grafts decreased from 3042 to 2751. Adults receiving grafts from pediatric donors decreased from 2243 to 1780; children receiving pediatric grafts increased from 799 to 971. Transplant recipients receiving pediatric DCDD grafts were few but increased annually from 50 to 128 adults and 0 to 9 children. Pediatric candidates dying waiting for an organ decreased from 262 to 110. From 2001 to 2010, children received more solid organ transplants and fewer children died waiting. Organ recovery from pediatric and adult DCDD donors increased. The number of pediatric recipients of DCDD grafts remains small. Adults primarily receive the direct benefit from pediatric DCDD but other changes in organ allocation have directly benefited children.

  5. 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

  6. Hepatitis C and liver transplantation

    Science.gov (United States)

    Brown, Robert S.

    2005-08-01

    Liver transplantation is a life-saving therapy to correct liver failure, portal hypertension and hepatocellular carcinoma arising from hepatitis C infection. But despite the successful use of living donors and improvements in immunosuppression and antiviral therapy, organ demand continues to outstrip supply and recurrent hepatitis C with accelerated progression to cirrhosis of the graft is a frequent cause of graft loss and the need for retransplantation. Appropriate selection of candidates and timing of transplantation, coupled with better pre- and post-transplant antiviral therapy, are needed to improve outcomes.

  7. Airway Complications After Lung Transplantation.

    Science.gov (United States)

    Frye, Laura; Machuzak, Michael

    2017-12-01

    Airway complications remain a significant source of morbidity and mortality after lung transplantation. The incidence of complications is wide-ranging depending on the definition of the event, and there is still no universally accepted grading system for airway findings after transplantation. Additionally, although surgical technique and organ preservation have improved, other modifiable risk factors remain unclear. The management is as wide-ranging as the definitions. A multimodality approach is often needed with airway stenting reserved for refractory cases and stent management by a transplant team with expertise in placement and management of long-term complications." Copyright © 2017. Published by Elsevier Inc.

  8. 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 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....

  9. Pre- and post- transplantation lung cancer in heart transplant recipients.

    Science.gov (United States)

    Pricopi, Ciprian; Rivera, Caroline; Varnous, Shaida; Arame, Alex; Le Pimpec Barthes, Françoise; Riquet, Marc

    2015-05-01

    Heart transplantation after lung cancer surgery can be questionable because of the high risk of cancer recurrence. We report the results of two patients. The first underwent right lobectomy in 2008 for pT1N0 adenocarcinoma, heart-transplantation in 2010, and surgery for synchronous adenocarcinoma and squamous-cell carcinoma in 2012. The second underwent left segmentectomy for pT1aN0 adenosquamous carcinoma and transplantation in 1995 and then surgery for pT1aN1 adenocarcinoma in 2013. Posttransplantation lung cancer histologic analysis results were different in both cases, demonstrating the absence of metastatic recurrence. Thus, early stage lung cancer might not be a contraindication to heart transplantation, nor are long delays be necessary before registering on a waiting list. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. 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

  11. 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

  12. Historical Overview of Transplantation

    Science.gov (United States)

    Markmann, James F.

    2013-01-01

    Except for legends and claims of miracles, most histories of transplantation cover only the last 60 years because there were no earlier successes. However, the story of even this era has been documented in such rich detail that a full account would fill several volumes. Thus, this brief summary must be limited to highly selected “landmarks.” Some landmarks had an immediate impact, but the importance of others went unrecognized for decades. Some findings that deserved landmark status were overlooked or forgotten, whereas others of no biological significance had major impact. Placing these events in perspective is challenging. Several of transplantation’s pioneers are still alive, and most of the others are within living memory. Virtually all of them have produced their own accounts. For the most part, they agree on what the “landmarks” are, but their differences in emphasis and perspective make an interesting story. PMID:23545575

  13. What Is a Heart Transplant?

    Science.gov (United States)

    ... for death and transplantation in children with dilated car... Building 31 31 Center Drive Bethesda, MD 20892 Learn more about getting to NIH Get Email Alerts Receive automatic alerts about NHLBI related news and highlights from ...

  14. Organ Transplantation: Frequently Asked Questions

    Science.gov (United States)

    ... some cases, but not always. There is no advantage to listing at more than one transplant center ... Subscribe to enews Follow Facebook Twitter LinkedIn YouTube Instagram Google+ Contact 700 N. 4th Street Richmond, VA ...

  15. The history of liver transplantation in Turkey.

    Science.gov (United States)

    Moray, Gökhan; Arslan, Gülnaz; Haberal, Mehmet

    2014-03-01

    Liver transplantation is the definitive treatment for end-stage liver diseases. The first successful liver transplant was performed in the United States by Thomas Starzl in 1967. The first successful solid organ transplant in Turkey was a living-related kidney transplant performed by Dr. Haberal in 1975. After much effort by Dr. Haberal, the Turkish parliament enacted a law about organ transplantation in 1979. After clinical and experimental studies, the first liver transplant in Turkey was performed by Dr. Haberal in 1988. The first successful partial living-donor liver transplant in children in Turkey was performed by the same team on March 15, 1990. On April 24, 1990, the first living-donor liver transplant was performed on a child in Turkey using a left lateral segment by Dr. Haberal and coworkers. On May 16, 1992, Dr. Haberal performed a simultaneous living-donor liver and kidney transplantation to an adult from the same donor. There currently are 30 liver transplantation centers in Turkey. According to data from the Ministry of Health, there presently are 2065 patients in Turkey who are waiting for a liver transplantation. From January 2002 to June 2013, there were 6091 liver transplants performed in Turkey (4020 living-donor [66% ] and 2071 deceased donor liver transplants [34% ]). From January 2011 to June 2013, there were 2514 patients who had liver transplants in Turkey, and 437 patients (17%) died. The number of liver transplants per year in Turkey reached 1000 transplants in 2012 and more than 1150 transplants in 2013 (15.1/million/y). Therefore, Turkey has one of the highest volumes of liver transplantation per population worldwide, with 90% survival within 1 year after transplantation.

  16. [BK virus and renal transplantation].

    Science.gov (United States)

    Liu, Hang; Shi, Yi; Li, Chao-yang; Wang, Jian-li

    2009-06-01

    BK virus (BKV) is a subtype of papovaviridae. The latent and asymptomatic infection of BKV is common among healthy people. The incidence of BKV re-activation in renal transplant recipients ranges 10%-68%. About 1%-7% of renal transplant recipients will suffer from BKV-associated nephropathy (BKVAN), and half of them will experience graft failure. This paper summarizes the re-activation mechanism of BKV as well as the risk factors, pathology, diagnosis, and treatment of BKVAN.

  17. Nutritional status and liver transplantation.

    Science.gov (United States)

    Merli, Manuela; Giusto, Michela; Giannelli, Valerio; Lucidi, Cristina; Riggio, Oliviero

    2011-12-01

    Chronic liver disease has a profound effect on nutritional status and undernourishment is almost universally present in patients with end-stage liver disease undergoing liver transplantation. In the last decades, due to epidemiological changes, a trend showing an increase in patients with end-stage liver disease and associated obesity has also been reported in developed countries. Nutrition abnormalities may influence the outcome after transplantation therefore, the importance to carefully assess the nutritional status in the work-up of patients candidates for liver transplantation is widely accepted. More attention has been given to malnourished patients as they represent the greater number. The subjective global nutritional assessment and anthropometric measurements are recognized in current guidelines to be adequate in identifying those patients at risk of malnutrition. Cirrhotic patients with a depletion in lean body mass and fat deposits have an increased surgical risk and malnutrition may impact on morbidity, mortality and costs in the post-transplantation setting. For this reason an adequate calorie and protein intake should always be ensured to malnourished cirrhotic patient either through the diet, or using oral nutritional supplements or by enteral or parenteral nutrition although studies supporting the efficacy of nutritional supplementation in improving the clinical outcomes after transplantation are still scarce. When liver function is restored, an amelioration in the nutritional status is expected. After liver transplantation in fact dietary intake rapidly normalizes and fat mass is progressively regained while the recovery of muscle mass can be slower. In some patients unregulated weight gain may lead to over-nutrition and may favor metabolic disorders (hypertension, hyperglycemia, hyperlipidemia). This condition, defined as 'metabolic syndrome', may play a negative role on the overall survival of liver transplant patients. In this report we review

  18. Computed tomography after liver transplantation

    International Nuclear Information System (INIS)

    Dupuy, D.E.; Costello, P.

    1992-01-01

    Orthotopic liver transplantation is commonly performed at many institutions around the world. The care of these critically ill patients has heavily relied upon cross-sectional imaging, specifically CT. CT is of enormous benefit in the postoperative management of the various complications which is common in this group of patients. This article reviews the role of CT and its respective strengths and weaknesses, in the adult liver transplant recipient. (orig.) [de

  19. ABO-incompatible heart transplants.

    Science.gov (United States)

    Hageman, M; Michaud, N; Chinnappan, I; Klein, T; Mettler, B

    2015-04-01

    A month-old baby girl with blood type O positive received a donor heart organ from a donor with blood type B. This was the first institutional ABO-incompatible heart transplant. Infants listed for transplantation may be considered for an ABO-incompatible heart transplant based on their antibody levels and age. The United Network of Organ Sharing (UNOS) protocol is infants under 24 months with titers less than or equal to 1:4.(1) This recipient's anti-A and anti-B antibodies were monitored with titer assays to determine their levels; antibody levels less than 1:4 are acceptable pre-transplant in order to proceed with donor and transplant arrangements.1 Immediately prior to initiating cardiopulmonary bypass (CPB), a complete whole body exchange transfusion of at least two-times the patient's circulating blood volume was performed with packed red blood cells (pRBC), fresh frozen plasma (FFP) and 25% albumin. Titer assays were sent two minutes after initiation of full CPB and then hourly until the cross-clamp was removed. Institutionally, reperfusion of the donor heart is not restored until the antibody level from the titer assay is known and reported as less than 1:4; failing to achieve an immulogically tolerant recipient will provide conditions for hyperacute rejection. The blood collected during the transfusion exchange was immediately processed through a cell saver so the pRBC's could be re-infused to the patient during CPB, as necessary. The remainder of the transplant was performed in the same fashion as an ABO-compatible heart transplant. The patient has shown no signs of rejection following transplantation. © The Author(s) 2014.

  20. Getting More Organs for Transplantation

    OpenAIRE

    Judd B. Kessler; Alvin E. Roth

    2014-01-01

    Organs for transplantation are a scarce resource. Paying to increase the supply of organs is illegal in much of the world. We review efforts to increase transplantation by increasing the supply of available organs from living and deceased donors. Progress has been made in increasing the availability of living donor kidneys through kidney exchange. Recent legislation in Israel aims at encouraging deceased donation by awarding priority for receiving organs to registered donors. We also explore ...

  1. Development of an amphibious robot for visual inspection of APR1400 Npp IRWST strainer

    Energy Technology Data Exchange (ETDEWEB)

    Jang, You Hyun; Kim, Jong Seog [Korea Hydro Nuclear Power Central Research Institute, Daejeon (Korea, Republic of)

    2014-06-15

    An amphibious inspection robot system (hereafter AIROS) is being developed to visually inspect the in-containment refueling storage water tank (hereafter IRWST) strainer in APR1400 instead of a human diver. Four IRWST strainers are located in the IRWST, which is filled with boric acid water. Each strainer has 108 sub-assembly strainer fin modules that should be inspected with the VT-3 method according to Reg. guide 1.82 and the operation manual. AIROS has 6 thrusters for submarine voyage and 4 legs for walking on the top of the strainer. An inverse kinematic algorithm was implemented in the robot controller for exact walking on the top of the IRWST strainer. The IRWST strainer has several top cross braces that are extruded on the top of the strainer, which can be obstacles of walking on the strainer, to maintain the frame of the strainer. Therefore, a robot leg should arrive at the position beside the top cross brace. For this reason, we used an image processing technique to find the top cross brace in the sole camera image. The sole camera image is processed to find the existence of the top cross brace using the cross edge detection algorithm in real time. A 5-DOF robot arm that has multiple camera modules for simultaneous inspection of both sides can penetrate narrow gaps. For intuitive presentation of inspection results and for management of inspection data, inspection images are stored in the control PC with camera angles and positions to synthesize and merge the images. The synthesized images are then mapped in a 3D CAD model of the IRWST strainer with the location information. An IRWST strainer mock-up was fabricated to teach the robot arm scanning and gaiting. It is important to arrive at the designated position for inserting the robot arm into all of the gaps. Exact position control without anchor under the water is not easy. Therefore, we designed the multi leg robot for the role of anchoring and positioning. Quadruped robot design of installing sole

  2. DEVELOPMENT OF AN AMPHIBIOUS ROBOT FOR VISUAL INSPECTION OF APR1400 NPP IRWST STRAINER ASSEMBLY

    Directory of Open Access Journals (Sweden)

    YOU HYUN JANG

    2014-06-01

    Full Text Available An amphibious inspection robot system (hereafter AIROS is being developed to visually inspect the in-containment refueling storage water tank (hereafter IRWST strainer in APR1400 instead of a human diver. Four IRWST strainers are located in the IRWST, which is filled with boric acid water. Each strainer has 108 sub-assembly strainer fin modules that should be inspected with the VT-3 method according to Reg. guide 1.82 and the operation manual. AIROS has 6 thrusters for submarine voyage and 4 legs for walking on the top of the strainer. An inverse kinematic algorithm was implemented in the robot controller for exact walking on the top of the IRWST strainer. The IRWST strainer has several top cross braces that are extruded on the top of the strainer, which can be obstacles of walking on the strainer, to maintain the frame of the strainer. Therefore, a robot leg should arrive at the position beside the top cross brace. For this reason, we used an image processing technique to find the top cross brace in the sole camera image. The sole camera image is processed to find the existence of the top cross brace using the cross edge detection algorithm in real time. A 5-DOF robot arm that has multiple camera modules for simultaneous inspection of both sides can penetrate narrow gaps. For intuitive presentation of inspection results and for management of inspection data, inspection images are stored in the control PC with camera angles and positions to synthesize and merge the images. The synthesized images are then mapped in a 3D CAD model of the IRWST strainer with the location information. An IRWST strainer mock-up was fabricated to teach the robot arm scanning and gaiting. It is important to arrive at the designated position for inserting the robot arm into all of the gaps. Exact position control without anchor under the water is not easy. Therefore, we designed the multi leg robot for the role of anchoring and positioning. Quadruped robot design of

  3. Development of an amphibious robot for visual inspection of APR1400 Npp IRWST strainer

    International Nuclear Information System (INIS)

    Jang, You Hyun; Kim, Jong Seog

    2014-01-01

    An amphibious inspection robot system (hereafter AIROS) is being developed to visually inspect the in-containment refueling storage water tank (hereafter IRWST) strainer in APR1400 instead of a human diver. Four IRWST strainers are located in the IRWST, which is filled with boric acid water. Each strainer has 108 sub-assembly strainer fin modules that should be inspected with the VT-3 method according to Reg. guide 1.82 and the operation manual. AIROS has 6 thrusters for submarine voyage and 4 legs for walking on the top of the strainer. An inverse kinematic algorithm was implemented in the robot controller for exact walking on the top of the IRWST strainer. The IRWST strainer has several top cross braces that are extruded on the top of the strainer, which can be obstacles of walking on the strainer, to maintain the frame of the strainer. Therefore, a robot leg should arrive at the position beside the top cross brace. For this reason, we used an image processing technique to find the top cross brace in the sole camera image. The sole camera image is processed to find the existence of the top cross brace using the cross edge detection algorithm in real time. A 5-DOF robot arm that has multiple camera modules for simultaneous inspection of both sides can penetrate narrow gaps. For intuitive presentation of inspection results and for management of inspection data, inspection images are stored in the control PC with camera angles and positions to synthesize and merge the images. The synthesized images are then mapped in a 3D CAD model of the IRWST strainer with the location information. An IRWST strainer mock-up was fabricated to teach the robot arm scanning and gaiting. It is important to arrive at the designated position for inserting the robot arm into all of the gaps. Exact position control without anchor under the water is not easy. Therefore, we designed the multi leg robot for the role of anchoring and positioning. Quadruped robot design of installing sole

  4. Predictors of exclusive breastfeeding: observations from the Alberta pregnancy outcomes and nutrition (APrON) study

    Science.gov (United States)

    2013-01-01

    Background Despite growing evidence that supports the importance of 6-month exclusive breastfeeding, few Canadian mothers adhere to this, and early weaning onto solids is a common practice. This study assessed infant feeding transitions during the first 6 months postpartum and factors that predicted exclusive breastfeeding to 3 and 6 months. Methods This prospective cohort study was part of the Alberta Pregnancy Outcomes and Nutrition study (APrON). From an initial sample of 600 pregnant women recruited from Edmonton and Calgary, 402 mothers provided complete details at 3 months postpartum; 300 stayed on to provide information at 6 months postpartum. During pregnancy and at 3 and 6 months postpartum, data on maternal and infant socio-demographic, behavior, and feeding were collected. Results Even though there was a high rate of “ever having breastfed” (98.6%), exclusive breastfeeding rates for 3 and 6 months were 54.0% and 15.3%, respectively. After controlling for potential confounders, the study showed that mothers who held post-graduate university degrees were 3.76 times more likely to breastfeed exclusively for 6 months than those without a university degree (95% CI: 1.30-10.92; p = 0.015). In addition, mother of previous children were more likely to breastfeed exclusively for 6 months (OR: 2.21, 95% CI: 1.08-4.52; p = 0.031). Mothers who were in the highest quartile of the Iowa Infant Feeding Attitude Score were 4.29 and 5.40 times more likely to breastfeed exclusively for 3 months (95% CI: 1.31-14.08; p-trend breastfeeding rate in Alberta is considerably below national and international breastfeeding recommendations. Professional advice that focuses on prenatal maternal knowledge, attitudes, and misperceptions may promote adherence to World Health Organization breastfeeding guidelines. Knowing that exclusive breastfeeding is less likely to take place among lower-educated, primiparous women may help health practitioners focus their

  5. Physical Activity and Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Vincenzo Bellizzi

    2014-07-01

    Full Text Available Renal transplantation is burdened by high cardiovascular risk because of increased prevalence of traditional and disease-specific cardiovascular risk factors and, consequently, patients are affected by greater morbidity and mortality. In renal transplanted patients, healthy lifestyle and physical activity are recommended to improve overall morbidity and cardiovascular outcomes. According to METs (Metabolic Equivalent Task; i.e. the amount of energy consumed while sitting at rest, physical activities are classified as sedentary (<3.0 METs, of moderate-(3.0 to 5.9 METs or vigorous-intensity (≥6.0 METs. Guidelines suggest for patients with chronic kidney disease an amount of physical activity of at least 30 minutes of moderate-intensity activity five times per week (min 450 MET-minutes/week. Data on physical activity in renal transplanted patients, however, are limited and have been mainly obtained by mean of non-objective methods. Available data suggest that physical activity is low either at the start or during renal transplantation and this may be associated with poor patient and graft outcomes. Therefore, in renal transplanted patients more data on physical activity obtained with objective, accelerometer-based methods are needed. In the meanwhile, physical activity have to be considered as an essential part of the medical care for renal transplanted recipients.

  6. Ethics of facial transplantation revisited.

    Science.gov (United States)

    Coffman, Kathy L; Siemionow, Maria Z

    2014-04-01

    There have been 26 cases of facial transplantation reported, and three deaths, 11.5%. Mortality raises the issue of risk versus benefit for face transplantation, a procedure intended to improve quality of life, rather than saving life. Thus, one of the most innovative surgical procedures has opened the debate on the ethical, legal, and philosophical aspects of face transplantation. Morbidity in face transplant recipients includes infections and metabolic consequences. No graft loss caused by technical failure, hyperacute, or chronic graft rejection or graft-versus-host disease has been reported. One case of posttransplant lymphoproliferative disorder, 3.45% and one case of lymphoma in an HIV-positive recipient were reported. Psychological issues in candidates can include chronic pain, mood disorders, preexisting psychotic disorders, post-traumatic stress disorder (PTSD), and substance abuse. Early publications on ethical aspects of face transplantation focused mainly on informed consent. Many other ethical issues have been identified, including lack of coercion, donor family consent and confidentiality, respect for the integrity of the donor's body, and financial promotion of the recipient and transplant team, as well as the cost to society for such a highly technical procedure, requiring lifelong immunosuppression.

  7. 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 ......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...

  8. 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

  9. Geriatric issues in renal transplantation.

    Science.gov (United States)

    Bia, M J

    1999-01-01

    There are an increasing amount of data which are compelling us to consider the issue of age in dealing with decisions regarding both renal transplant recipients and donors. These geriatric issues in transplantation can be summarized as follows: (1) The explosion of a geriatric population of patients with ESRD, in association with data showing a survival advantage of transplantation over wait-listed dialysis patients, demands an increase in expertise in transplantating patients over 60 years old. (2) The critical shortage in cadaveric organ supply is creating a variety of solutions including expanding the donor pool with older kidneys in which long term survival may be shorter than in kidneys from younger donors. (3) The donor shortage, in association with data demonstrating improved survival of living related and unrelated donor transplants, is generating an increased number of older (> 60 years old) individuals who want to donate to a relative, spouse or friend. Future efforts should be directed toward continued research designed to evaluate the efficacy and safety of these trends. We also need to provide improved training in geriatrics for nephrologists so that we and transplant surgeons can deliver better medical care to an aging population of patients with ESRD.

  10. 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.

  11. Immunization practices among pediatric transplant hepatologists.

    Science.gov (United States)

    Feldman, Amy G; Kempe, Allison; Beaty, Brenda L; Sundaram, Shikha S

    2016-12-01

    Vaccination of pediatric liver transplant candidates and recipients represents an opportunity to decrease infectious complications following transplant. Although vaccine recommendations exist, studies have shown that many transplant candidates and recipients are under-immunized. The goals of this study were to assess among pediatric transplant hepatologists: (i) current immunization practices before and after transplantation, (ii) involvement of an ID physician in the transplant evaluation, and (iii) perceptions about vaccine safety and barriers to immunization. An 80-item e-mail survey of pediatric transplant hepatologists at centers in the United States and Canada participating in the SPLIT consortium was conducted from December 2014 to March 2015. The overall response rate was 80% (73/91), representing 97% (32/33) of SPLIT centers. Fifty percent of programs routinely involved an ID physician in the transplant evaluation. Administration of palivizumab was routinely considered by 48% of hepatologists pre-transplant and by 41% post-transplant. Live vaccines were recommended by 26% of hepatologists after transplant. About 10% of hepatologists reported concern that live vaccines after transplant could induce rejection. There is wide variation in immunization practices among transplant hepatologists. Specific evidence-based protocols are needed to guide immunization practices in transplant candidates and recipients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. How is organ transplantation depicted in internal medicine and transplantation journals.

    Science.gov (United States)

    Durand, Céline; Duplantie, Andrée; Chabot, Yves; Doucet, Hubert; Fortin, Marie-Chantal

    2013-10-02

    In their book Spare Parts, published in 1992, Fox and Swazey criticized various aspects of organ transplantation, including the routinization of the procedure, ignorance regarding its inherent uncertainties, and the ethos of transplant professionals. Using this work as a frame of reference, we analyzed articles on organ transplantation published in internal medicine and transplantation journals between 1995 and 2008 to see whether Fox and Swazey's critiques of organ transplantation were still relevant. Using the PubMed database, we retrieved 1,120 articles from the top ten internal medicine journals and 4,644 articles from the two main transplantation journals (Transplantation and American Journal of Transplantation). Out of the internal medicine journal articles, we analyzed those in which organ transplantation was the main topic (349 articles). A total of 349 articles were randomly selected from the transplantation journals for content analysis. In our sample, organ transplantation was described in positive terms and was presented as a routine treatment. Few articles addressed ethical issues, patients' experiences and uncertainties related to organ transplantation. The internal medicine journals reported on more ethical issues than the transplantation journals. The most important ethical issues discussed were related to the justice principle: organ allocation, differential access to transplantation, and the organ shortage. Our study provides insight into representations of organ transplantation in the transplant and general medical communities, as reflected in medical journals. The various portrayals of organ transplantation in our sample of articles suggest that Fox and Swazey's critiques of the procedure are still relevant.

  13. Detailed evaluation of melt pool configuration in the lower plenum of the APR1400 reactor vessel during severe accidents

    International Nuclear Information System (INIS)

    Park, Rae-Joon; Kang, Kyoung-Ho; Hong, Seong-Wan; Kim, Hwan-Yeol

    2015-01-01

    Highlights: • Melt pool condition in the lower plenum was determined using SCDAP/RELAP5. • GEMINI analyses were performed to examine the final melt pool composition. • A density evaluation graph was developed for the melt pool layer inversion. • The final melt pool configurations were determined for five accident scenarios. • The thermodynamic results address the possibility of the layer inversion. - Abstract: For a detailed evaluation of the IVR (In-Vessel corium Retention) through the ERVC (External Reactor Vessel Cooling) during a severe accident, the melt pool configuration should be accurately determined in the lower plenum of the reactor vessel. It affects the thermal load to the vessel wall and plays a key role in determining the integrity of the reactor vessel under the IVR-ERVC. SCDAP/RELAP5 and GEMINI analyses have been performed to determine the final corium condition and examine the final melt pool composition at a reactor vessel failure during a severe accident in an APR (Advanced Power Reactor) 1400, respectively. As the representative accident scenarios, five dominant sequences of the TLFW (Total Loss of Feed Water), the SBO (Station BlackOut), the SBLOCA (Small Break Loss of Coolant Accident) without SI (Safety Injection), the MBLOCA without SI, and the LBLOCA without SI were selected from the level I PSA (Probabilistic Safe Assessment) results. A density evaluation graph was developed for the precise examination of the melt pool layer inversion. The final melt pool configurations at the reactor vessel failure have been determined for five dominant accident scenarios of the APR1400 using the GEMINI results and the density evaluation graph. The thermodynamic analysis results in three sequences of the APR1400 accident address the possibility of a melt pool layer inversion in the lower plenum of the reactor vessel. The layer inversion led to corium pool stratification with a heavy metallic layer below the oxidic pool, which leads to a three

  14. Processing of High Resolution, Multiparametric Radar Data for the Airborne Dual-Frequency Precipitation Radar APR-2

    Science.gov (United States)

    Tanelli, Simone; Meagher, Jonathan P.; Durden, Stephen L.; Im, Eastwood

    2004-01-01

    Following the successful Precipitation Radar (PR) of the Tropical Rainfall Measuring Mission, a new airborne, 14/35 GHz rain profiling radar, known as Airborne Precipitation Radar - 2 (APR-2), has been developed as a prototype for an advanced, dual-frequency spaceborne radar for a future spaceborne precipitation measurement mission. . This airborne instrument is capable of making simultaneous measurements of rainfall parameters, including co-pol and cross-pol rain reflectivities and vertical Doppler velocities, at 14 and 35 GHz. furthermore, it also features several advanced technologies for performance improvement, including real-time data processing, low-sidelobe dual-frequency pulse compression, and dual-frequency scanning antenna. Since August 2001, APR-2 has been deployed on the NASA P3 and DC8 aircrafts in four experiments including CAMEX-4 and the Wakasa Bay Experiment. Raw radar data are first processed to obtain reflectivity, LDR (linear depolarization ratio), and Doppler velocity measurements. The dataset is then processed iteratively to accurately estimate the true aircraft navigation parameters and to classify the surface return. These intermediate products are then used to refine reflectivity and LDR calibrations (by analyzing clear air ocean surface returns), and to correct Doppler measurements for the aircraft motion. Finally, the the melting layer of precipitation is detected and its boundaries and characteristics are identifIed at the APR-2 range resolution of 30m. The resulting 3D dataset will be used for validation of other airborne and spaceborne instruments, development of multiparametric rain/snow retrieval algorithms and melting layer characterization and statistics.

  15. Pharmacological bridge to cardiac transplantation.

    Science.gov (United States)

    Loisance, D; Dubois Rande, J L; Deleuze, P H; Hillion, M L; Duval, A M; Tavolaro, O; Romano, P; Castaigne, A; Tarral, A; Cachera, J P

    1989-01-01

    From September 1985 to August 1988, 32 patients were referred from various intensive care units throughout Paris for urgent cardiac transplantation or for a mechanical bridge to transplantation. At time of admission, under maximal sympathomimetic therapy, the cardiac index (CI) was 1.81 +/- 0.26 l/min per m2, the pulmonary capillary wedge pressure (PCWP 31 +/- 7 mmHg), systemic vascular resistances (SVR) 2053 +/- 469 dynes s cm-5. In 25, diuresis was less than 25 ml/h. Five were anuric. Prior to any final decision, a new inotropic agent, enoximone, was infused in addition to previous treatment as a 10 min bolus iv 1.5-2 mg/kg every 8 h. In 3, the situation further deteriorated, leading to a Jarvik 7-70 implantation within 12 h. In 29 however, within 3 h, the Cl increased to 2.69 +/- 0.56 as SVR dropped to 1410 +/- 453 and PCWP to 18 +/- 7. Diuresis increased to more than 100 ml/h in all. This permitted an indepth evaluation of the transplant candidates leading to contraindications to transplantation in 16. Nine patients could be weaned off iv enoximone. Four of these are still living (NYHA class III) with a follow up of 6-17 months. In 11, transplantation was performed within 2 days. Four died within a month, 2 with multiple organ failure. One patient died after 5 months. Six are back to normal life, NYHA class I (follow up 10 months-2.5 years). This protocol suggests that in patients with extreme heart failure, immediate survival may be increased by iv enoximone therapy, permitting a better selection of the recipients, more efficient pre-transplantation intensive care and consequently a decrease in the indications for a temporary mechanical bridge to a staged transplantation.

  16. Development of a Human Performance Evaluation Support System for Human Factors Validation of MCR MMI Design in APR-1400

    International Nuclear Information System (INIS)

    Ha, Jun Su; Seong, Poong Hyun

    2005-01-01

    As CRT-based display and advanced information technology were applied to advanced reactors such as APR-1400 (Advanced Power Reactor-1400), human operators' tasks became more cognitive works. As a results, Human Factors Engineering (HFE) became more important in designing the MCR (Main Control Room) MMI (Man-Machine Interface) of an advanced reactor. According to the Human Factors Engineering Program Review Model, human factors validation of MCR MMI design should be performed through performance-based tests to determine whether it acceptably supports safe operation of the plant. In order to support the evaluation of the performance, a HUman Performance Evaluation Support System (HUPESS) is in development

  17. Contrôle hormonal des caractéristiques des fibres musculaires après la naissance

    OpenAIRE

    Cassar-Malek, Isabelle; Listrat, Anne; Picard, Brigitte

    1998-01-01

    Après la naissance, la croissance et les propriétés contractiles et métaboliques des fibres musculaires sont soumises à une régulation endocrinienne complexe. A l’exception des glucocorticoïdes, la plupart des hormones présente une action anabolique sur le tissu musculaire. Leur influence sur les caractéristiques des fibres est cependant très différente. Ainsi, les hormones somatotropes affectent peu la composition en fibres des muscles. La GH, comme l’IGF-1, régulerait cependant l’expression...

  18. Multi-analytical characterisation of D’Aprés Cormon by José Veloso Salgado

    Energy Technology Data Exchange (ETDEWEB)

    Cardeira, A.M. [Faculdade de Belas-Artes da Universidade de Lisboa, Largo da Academia Nacional de Belas-Artes, 1249-058 Lisboa (Portugal); Centro de Física Atómica da Universidade de Lisboa, Av. Professor Gama Pinto 2, 1649-003 Lisboa (Portugal); Longelin, S. [Centro de Física Atómica da Universidade de Lisboa, Av. Professor Gama Pinto 2, 1649-003 Lisboa (Portugal); Costa, S.; Candeias, A. [Laboratório José de Figueiredo, Direcção Geral do Património Cultural, Rua das Janelas Verdes 37, 1249-018 Lisboa (Portugal); Laboratório HERCULES e Centro de Química de Évora, Universidade de Évora, Largo Marquês de Marialva 8, 7000 Évora (Portugal); Carvalho, M.L. [Centro de Física Atómica da Universidade de Lisboa, Av. Professor Gama Pinto 2, 1649-003 Lisboa (Portugal); Manso, M., E-mail: marta974@cii.fc.ul.pt [Centro de Física Atómica da Universidade de Lisboa, Av. Professor Gama Pinto 2, 1649-003 Lisboa (Portugal)

    2014-07-15

    This case study reveals the analytical characterisation carried out on ‘D’Aprés Cormon’ (1891) by Veloso Salgado, a copy of ‘Caïn’ (1880) by Fernando Cormon, belonging nowadays to Musée d’Orsay. Infrared Reflectography made in situ revealed underdrawing grid that was used to transpose the original painting to a smaller scale, pictorial style, execution method and retouched/restored areas. In situ EDXRF analysis together with Raman microscopy allowed the identification of gypsum, lead white, titanium white, yellow ochre, vermilion, ultramarine and lamp black. These results provide valuable information about the Salgado’s palette and his production technique.

  19. Urinary stones following renal transplantation.

    Science.gov (United States)

    Kim, H; Cheigh, J S; Ham, H W

    2001-06-01

    The formation of urinary tract stones following renal transplantation is a rare complication. The clinical features of stones after transplantation differ from those of non-transplant patients. Renal colic or pain is usually absent and rarely resembles acute rejection. We retrospectively studied 849 consecutive kidney transplant patients in The Rogosin Institute/The Weill-Cornell Medical Center, New York who were transplanted between 1980 and 1997 and had functioning grafts for more than 3 months, to determine the incidence of stone formation, composition, risk factors and patient outcome. At our center, urinary stones were diagnosed in 15 patients (1.8%) of 849 functioning renal grafts for 3 or more months. Of the 15 patients, 10 were males and 5 were females in their third and fourth decade. Eight patients received their transplant from living donors and 7 from cadaveric donors. The stones were first diagnosed between 3 and 109 months after transplantation (mean 17.8 months) and 5 patients had recurrent episodes. The stones were located in the bladder in 11 cases (73.3%), transplanted kidney in 3 cases and in multiple sites in one case. The size of stones varied from 3.4 mm to 40 mm (mean 12 mm). The composition of stones was a mixed form of calcium oxalate and calcium phosphate in 5 cases and 4 patients had infected stones consisting of struvite or mixed form of struvite and calcium phosphate. Factors predisposing to stone formation included tertiary hyperparathyroidism (n = 8), hypercalciuria (n = 5), recurrent urinary tract infection (n = 5), hypocitraturia (n = 4), and obstructive uropathy (n = 2). Many cases had more than one risk factor. Clinically, painless hematuria was observed in 6 patients and dysuria without bacteriuria in 5 patients. None had renal colic or severe pain at any time. There were no changes in graft function at diagnosis and after removal of stones. Five patients passed stones spontaneously and 8 patients underwent cystoscopy for stone

  20. 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.

  1. Robotic renal transplantation: Current status

    Directory of Open Access Journals (Sweden)

    Akshay Sood

    2015-01-01

    Full Text Available Introduction: Kidney transplantation (KT has traditionally been performed by open renal transplantation, but recently, a few groups including our own have described a minimally invasive approach to KT. We aim to discuss the current status of robotic kidney transplantation (RKT and describe our technique of RKT with regional hypothermia. Material and Methods: We used the search terms "minimally invasive" OR "robotic" OR "robot assisted" AND "kidney transplantation." Papers written in English and concerning technical and/or clinical outcomes following minimally invasive kidney transplantation were selected. Three hundred and eighteen unique articles were retrieved and nine were relevant. Comparative outcomes data following RKT with regional hypothermia versus open KT (OKT from our own group were also included. Findings: Nine papers, so far, have evaluated the role of robotic approach in KT and have conclusively established the feasibility, safety, and reproducibility of RKT, although these studies have been performed by experienced robotic surgeons/teams. The contemporary published series note that rejection rates were similar in RKT and OKT patients. Mean serum creatinine at 6 months in RKT and OKT patients was equivalent, across the three series. Most of the studies also note a dramatic reduction in the wound-related complication rates. Conclusion: RKT appears to be a safe surgical alternative to the standard open approach of KT. RKT is associated with reduced postoperative pain, analgesic requirement, and better cosmesis. RKT, although in its infancy, appears to be associated with lower complication rates.

  2. 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.

  3. Immunization after renal transplantation: current clinical practice

    NARCIS (Netherlands)

    Struijk, G. H.; Lammers, A. J. J.; Brinkman, R. J.; Lombarts, M. J. M. H.; van Vugt, M.; van der Pant, K. A. M. I.; ten Berge, I. J. M.; Bemelman, F. J.

    2015-01-01

    The use of potent immunosuppressive drugs and increased travel by renal transplant recipients (RTR) has augmented the risk for infectious complications. Immunizations and changes in lifestyle are protective. The Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group has developed

  4. Organ Transplant Patients and Fungal Infections

    Science.gov (United States)

    ... Waterborne, and Environmental Diseases Mycotic Diseases Branch Organ Transplant Patients and Fungal Infections Recommend on Facebook Tweet ... Top of Page Preventing fungal infections in organ transplant patients Fungi are difficult to avoid because they ...

  5. Current development of liver transplantation in China

    Directory of Open Access Journals (Sweden)

    ZHENG Shusen

    2014-01-01

    Full Text Available As the only effective way for the treatment of end-stage liver disease, liver transplantation has been developed rapidly in China over recent years. The latest developments of liver transplantation in China are reviewed, including establishment of selection criteria for the liver cancer recipients of liver transplantation——Hangzhou Criteria; latest application of salvage liver transplantation and downstaging therapy in liver transplantation for liver cancer; progress in liver transplantation combined with artificial liver support system for treatment of severe acute liver failure; breakthrough in technology innovation of living donor liver transplantation and organ donation and transplantation after cardiac death in China. Facing the problem of organ shortage, a scientific and standardized organ donation system should be established in line with the national conditions of China, so as to benefit the people and further improve the reputation of China in the international organ transplant community.

  6. Archives: Arab Journal of Nephrology and Transplantation

    African Journals Online (AJOL)

    Items 1 - 17 of 17 ... Archives: Arab Journal of Nephrology and Transplantation. Journal Home > Archives: Arab Journal of Nephrology and Transplantation. Log in or Register to get access to full text downloads.

  7. Primary sclerosing cholangitis and liver transplantation

    NARCIS (Netherlands)

    Klompmaker, IJ; Haagsma, EB; Jansen, PLM; Slooff, MJH

    1996-01-01

    Primary sclerosing cholangitis is a chronic disease, strongly associated with ulcerative colitis and cholangiocarcinoma. Ulcerative colitis itself does not influence the liver transplant results. However; intensified screening after liver transplantation for carcinoma of the colon may be necessary.

  8. What Is a Bone Marrow Transplant?

    Science.gov (United States)

    ... however you can Daughter's dying wish became mother's motivation Be The Match Blog Stories Anna, transplant recipient ... Jobs Job application FAQs E-Verify Career events Employee benefits About us Bea, transplant recipient Be The ...

  9. Urological complications in pediatric renal transplantation.

    NARCIS (Netherlands)

    Nuininga, J.E.; Feitz, W.F.J.; Dael, K.C. van; Gier, R.P.E. de; Cornelissen, E.A.M.

    2001-01-01

    OBJECTIVE: In this study, we evaluated the urological complications and their consequences after renal transplantation in children. MATERIALS AND METHODS: A retrospective study was performed concerning urological complications after kidney transplantation in children at the University Medical Center

  10. Urological complications in pediatric renal transplantation

    NARCIS (Netherlands)

    Nuininga, JE; Feitz, WFJ; van Dael, KCML; de Gier, RPE

    Objective: In this study, we evaluated the urological complications and their consequences after renal transplantation in children. Materials and Methods: A retrospective study was performed concerning urological complications after kidney transplantation in children at the University Medical Center

  11. Liver transplantation: history, outcomes and perspectives

    Science.gov (United States)

    Meirelles, Roberto Ferreira; Salvalaggio, Paolo; de Rezende, Marcelo Bruno; Evangelista, Andréia Silva; Guardia, Bianca Della; Matielo, Celso Eduardo Lourenço; Neves, Douglas Bastos; Pandullo, Fernando Luis; Felga, Guilherme Eduardo Gonçalves; Alves, Jefferson André da Silva; Curvelo, Lilian Amorim; Diaz, Luiz Gustavo Guedes; Rusi, Marcela Balbo; Viveiros, Marcelo de Melo; de Almeida, Marcio Dias; Pedroso, Pamella Tung; Rocco, Rodrigo Andrey; Meira, Sérgio Paiva

    2015-01-01

    In 1958 Francis Moore described the orthotopic liver transplantation technique in dogs. In 1963, Starzl et al. performed the first liver transplantation. In the first five liver transplantations no patient survived more than 23 days. In 1967, stimulated by Calne who used antilymphocytic serum, Starzl began a successful series of liver transplantation. Until 1977, 200 liver transplantations were performed in the world. In that period, technical problems were overcome. Roy Calne, in 1979, used the first time cyclosporine in two patients who had undergone liver transplantation. In 1989, Starzl et al. reported a series of 1,179 consecutives patients who underwent liver transplantation and reported a survival rate between one and five years of 73% and 64%, respectively. Finally, in 1990, Starzl et al. reported successful use of tacrolimus in patents undergoing liver transplantation and who had rejection despite receiving conventional immunosuppressive treatment. Liver Transplantation Program was initiated at Hospital Israelita Albert Einstein in 1990 and so far over 1,400 transplants have been done. In 2013, 102 deceased donors liver transplantations were performed. The main indications for transplantation were hepatocellular carcinoma (38%), hepatitis C virus (33.3%) and alcohol liver cirrhosis (19.6%). Of these, 36% of patients who underwent transplantation showed biological MELD score > 30. Patient and graft survival in the first year was, 82.4% and 74.8%, respectively. A major challenge in liver transplantation field is the insufficient number of donors compared with the growing demand of transplant candidates. Thus, we emphasize that appropriated donor/receptor selection, allocation and organ preservation topics should contribute to improve the number and outcomes in liver transplantation. PMID:25993082

  12. 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.

  13. Performance Assessment of Turbulence Models for the Prediction of the Reactor Internal Flow in the Scale-down APR+

    International Nuclear Information System (INIS)

    Lee, Gonghee; Bang, Youngseok; Woo, Swengwoong; Kim, Dohyeong; Kang, Minku

    2013-01-01

    The types of errors in CFD simulation can be divided into the two main categories: numerical errors and model errors. Turbulence model is one of the important sources for model errors. In this study, in order to assess the prediction performance of Reynolds-averaged Navier-Stokes (RANS)-based two equations turbulence models for the analysis of flow distribution inside a 1/5 scale-down APR+, the simulation was conducted with the commercial CFD software, ANSYS CFX V. 14. In this study, in order to assess the prediction performance of turbulence models for the analysis of flow distribution inside a 1/5 scale-down APR+, the simulation was conducted with the commercial CFD software, ANSYS CFX V. 14. Both standard k-ε model and SST model predicted the similar flow pattern inside reactor. Therefore it was concluded that the prediction performance of both turbulence models was nearly same. Complex thermal-hydraulic characteristics exist inside reactor because the reactor internals consist of fuel assembly, control rod assembly, and the internal structures. Either flow distribution test for the scale-down reactor model or computational fluid dynamics (CFD) simulation have been conducted to understand these complex thermal-hydraulic features inside reactor

  14. 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

  15. Bone marrow transplantation after irradiation

    International Nuclear Information System (INIS)

    Koch, M.; Blaha, M.; Merka, V.

    1990-01-01

    Bone marrow transplantation after irradiation is successful in only a part of the affected patients. The Chernobyl accident added to our knowledge: BMT can save life after whole-body irradiation with a dose exceeding 7-8 Gy. A timely decision on transplantation after a nuclear accident is difficult to make (rapid determination of homogeneity and type of radiation and the total dose. HL-A typing in lymphopenia, precise identification of radiation damage to other target organs, etc.). Further attention is to be paid to the treatment. Transplantations in case of malignities (especially hematologic ones) and other diseases will add to our knowledge and will lead to more simple procedures. (author). 3 figs., 1 tab., 12 refs

  16. Heart transplantation for Chagas cardiomyopathy.

    Science.gov (United States)

    Ramalho, Ana Rita; Prieto, David; Antunes, Pedro; Franco, Fátima; Antunes, Manuel J

    2017-11-01

    Chagas disease is an endemic disease in Latin America that is increasingly found in non-endemic areas all over the world due to the flow of migrants from Central and South America. We present the case of a Brazilian immigrant in Portugal who underwent orthotopic heart transplantation for end-stage Chagas cardiomyopathy. Immunosuppressive therapy included prednisone, mycophenolate mofetil and tacrolimus. Twelve months after the procedure she is asymptomatic, with good graft function, and with no evidence of complications such as graft rejection, opportunistic infections, neoplasms or reactivation of Trypanosoma cruzi infection. By reporting the first case in Portugal of heart transplantation for Chagas cardiomyopathy, we aim to increase awareness of Chagas disease as an emerging global problem and of Chagas cardiomyopathy as a serious complication for which heart transplantation is a valuable therapeutic option. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Value of radionuclide studies in cardiac transplantation

    International Nuclear Information System (INIS)

    Flotats, A.; Carrio, I.

    2006-01-01

    Effective noninvasive evaluation of acute and chronic allograft rejection remains an important challenge in patients with cardiac transplantation. Radionuclide studies have demonstrated utility because of their ease of use, giving relevant information about the pathophysiology of the transplanted heart, along with valuable diagnostic and prognostic indicators. This article focuses on reviewing the pathophysiological changes of the transplanted heart and implications for radionuclide studies. (author)

  18. 42 CFR 441.35 - Organ transplants.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Organ transplants. 441.35 Section 441.35 Public... Provisions § 441.35 Organ transplants. (a) FFP is available in expenditures for services furnished in connection with organ transplant procedures only if the State plan includes written standards for the...

  19. When Your Child Needs a Heart Transplant

    Science.gov (United States)

    ... be sure to ask them questions if you don't understand something. What Happens Before Heart Transplant Surgery? If the transplant team decides that a heart transplant is the right treatment, your child will be placed on an organ waiting list . This list has the names of ...

  20. Improved cardiac function after renal transplantation.

    OpenAIRE

    Fleming, S. J.; Caplin, J. L.; Banim, S. O.; Baker, L. R.

    1985-01-01

    There are few reports of the outcome of renal transplantation in patients with severe left ventricular (LV) impairment. We describe three men with chronic disabling heart failure associated with LV dysfunction in whom a remarkable improvement in cardiac function followed renal transplantation. Transplantation may offer the prospect of successful rehabilitation in these circumstances. Undue pessimism as to the prognosis in such patients is unwarranted.

  1. 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)

  2. Pancreatic islet transplantation. Experimental and clinical aspects

    DEFF Research Database (Denmark)

    Yderstræde, Knud Bonnet

    1987-01-01

    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...

  3. 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

  4. 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

  5. How is organ transplantation depicted in internal medicine and transplantation journals

    OpenAIRE

    Durand, C?line; Duplantie, Andr?e; Chabot, Yves; Doucet, Hubert; Fortin, Marie-Chantal

    2013-01-01

    Background In their book Spare Parts, published in 1992, Fox and Swazey criticized various aspects of organ transplantation, including the routinization of the procedure, ignorance regarding its inherent uncertainties, and the ethos of transplant professionals. Using this work as a frame of reference, we analyzed articles on organ transplantation published in internal medicine and transplantation journals between 1995 and 2008 to see whether Fox and Swazey?s critiques of organ transplantation...

  6. VASCULAR COMPLICATIONS AFTER KIDNEY TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    M. Sh. Khubutia

    2013-01-01

    Full Text Available Aim: evaluation of the incidence and the pattern of vessel complications, efficacy of the prophylactic anticoagulation therapy after kidney transplantation. Materials and methods. From March 2007 till January 2013 421 patients: 230 men (54,6% and 191 women (45,4%; mean age 43,07 ± 11,62 undergone 429 kidney transplantations in the department of pancreas and kidney transplantation of the Scientific-Research Institute of Emergency Care named after N.V. Sklifosovsky. In order to evaluate the condition and the function of the kidney transplant ultrasound investigation (daily andacquisition(weekly wereused. In cases of kidney dysfunction and assumption of vessel complications we used computerized tomography. Besides, we used daily analysis of biochemical and clinical parameters of blood and urine. Results. The most common vessel complication was the thrombosis of the microvasculature of the kidney transplant due to acute humoral and combined rejection resistant to antirejection therapy (n = 9; 2,1%; in 4 cases there was a breakage of the transplant due to the acute rejection and the urgent transplantatectomy in an effort to save the patient; thrombosis of the transplantat artery occurred in 1 case (0,23%; we observed 2 cases (0,46% of the artery stenosis and 2 cases (0,46% of venous thrombosis. Conclusion. Summary frequency of vessel complications in our clinic, including thrombosis due to rejection, was 3,49%. It fully corresponds with data obtained from the global medical community. The incidence of great vessel thrombosis was less than 1% which indicates the adequate prophylactic anticoagulation therapy. For the benefit of early diacrisis of complications Doppler sonography is needed. In case of assumption of vessel complications urgent acquisition, computerized tomography and/ or angiography are to be held. 

  7. 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.

  8. 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

  9. Ischemic Conditioning in Kidney Transplantation.

    Science.gov (United States)

    Veighey, Kristin; MacAllister, Raymond

    2017-07-01

    Ischemia-reperfusion injury is a composite of the injury sustained during a period of reduced or absent blood flow to a tissue or organ and the additional insult sustained on reperfusion, which limits the amount of tissue that can be salvaged. Ischemia-reperfusion injury is the predominant insult during kidney transplantation, contributing to graft dysfunction, increased rates of acute rejection, and reduced rejection-free graft survival. In this review, we discuss the potential therapeutic benefits of a cost-effective and low-risk intervention, ischemic preconditioning, and its potential for improving kidney function following transplantation.

  10. Ventilatory strategy during liver transplantation

    DEFF Research Database (Denmark)

    Sørensen, Henrik; Grocott, Hilary P; Niemann, Mads

    2014-01-01

    BACKGROUND: As measured by near infrared spectroscopy (NIRS), cerebral oxygenation (ScO2) may be reduced by hyperventilation in the anhepatic phase of liver transplantation surgery (LTx). Conversely, the brain may be subjected to hyperperfusion during reperfusion of the grafted liver. We investig......BACKGROUND: As measured by near infrared spectroscopy (NIRS), cerebral oxygenation (ScO2) may be reduced by hyperventilation in the anhepatic phase of liver transplantation surgery (LTx). Conversely, the brain may be subjected to hyperperfusion during reperfusion of the grafted liver. We...

  11. Pacemaker Use Following Heart Transplantation

    Science.gov (United States)

    Mallidi, Hari R.; Bates, Michael

    2017-01-01

    Background: The incidence of permanent pacemaker implantation after orthotopic heart transplantation has been reported to be 2%-24%. Transplanted hearts usually exhibit sinus rhythm in the operating room following reperfusion, and most patients do not exhibit significant arrhythmias during the postoperative period. However, among the patients who do exhibit abnormalities, pacemakers may be implanted for early sinus node dysfunction but are rarely used after 6 months. Permanent pacing is often required for atrioventricular block. A different cohort of transplant patients presents later with bradycardia requiring pacemaker implantation, reported to occur in approximately 1.5% of patients. The objectives of this study were to investigate the indications for pacemaker implantation, compare the need for pacemakers following bicaval vs biatrial anastomosis, and examine the long-term outcomes of heart transplant patients who received pacemakers. Methods: For this retrospective, case-cohort, single-institution study, patients were identified from clinical research and administrative transplant databases. Information was supplemented with review of the medical records. Standard statistical techniques were used, with chi-square testing for categorical variables and the 2-tailed t test for continuous variables. Survival was compared with the use of log-rank methods. Results: Between January 1968 and February 2008, 1,450 heart transplants were performed at Stanford University. Eighty-four patients (5.8%) were identified as having had a pacemaker implanted. Of these patients, 65.5% (55) had the device implanted within 30 days of transplantation, and 34.5% (29) had late implantation. The mean survival of patients who had an early pacemaker implant was 6.4 years compared to 7.7 years for those with a late pacemaker implant (Ppacemaker implantation. Starting in 1997, a bicaval technique was used for implantation. The incidence of pacemaker implantation by technique was 2.0% for

  12. Measuring family management of transplant tasks: the transplant responsibility questionnaire.

    Science.gov (United States)

    Kullgren, Kristin A; Hmiel, S Paul; Gevers, Anik

    2013-05-01

    Little is known about how parents and youth perceive their roles in post-transplant management and how this relates to post-transplant adherence. The goals of this study are to (1) describe a new measure, the TRQ, (2) to describe parent and child performance on the TRQ, and to (3) determine the relationship between the TRQ and adherence. We hypothesized that older youth would describe higher post-transplant self-care behaviors, parents would underestimate youth self-care, and greater parent involvement would be associated with better adherence. Participants included 59 parent-child dyads. Inclusion criteria included: (i) youth aged 7-18 yr and (ii) at least three months post-kidney or post-liver transplant. Parents and youth completed the TRQ, and adherence was measured by s.d. of sequential immunosuppressant blood levels. Youth perceived greater levels of self-care than their parents perceived. Older youth reportedly engaged in more self-care than younger youth. Less than 25% of the sample was non-adherent, and non-adherence was unrelated to performance on the TRQ. The TRQ may have utility as a clinical tool to address areas for improvement in youth self-care. The high degree of parental involvement likely explains the high degree of adherence in this sample. © 2013 John Wiley & Sons A/S.

  13. ABO-incompatibility in solid organ transplantation.

    Science.gov (United States)

    Rydberg, L

    2001-08-01

    The most important transplantation antigen system in solid organ transplantation is the ABO histo-blood group system. Crossing the ABO barrier in solid organ transplantation is usually not done except for emergency liver transplantations. Early experiences of crossing the ABO barrier in renal transplantation were very disappointing. In the 1970s, clinical trials were started transplanting kidneys of subgroup A2 into blood group O recipients. The tissues of the A2 subgroup expresses reduced amount of A antigens compared to subgroup A1 and the recipients had no special pretreatment and standard immunosuppression. A number of early graft losses were experienced but the trial also resulted in several long time surviving grafts. A few centres have adapted the concept of A2 to non A kidney transplantations with successful results, when the recipient anti-A titres are low or reduced prior to transplantation. In the early 1980s one group successfully transplanted A1 and B kidneys from living related donors across the ABO-barrier using an immunosuppressive protocol consisting of quadruple drugs and splenectomy and this protocol was adapted by a few other groups. In Japan, where cadaver donors are available in very limited number, the largest number of ABO-incompatible transplantations have been performed. Altogether more than 300 ABO-incompatible kidney transplantations have been performed in more than 40 centres since 1989. ABO-incompatible liver transplantations have been performed mainly in emergency cases and the results have generally been inferior to ABO-compatible grafts. In children below the age of three years, liver transplantations across the ABO-barrier have been quite successful especially with living related donors. Very few ABO-incompatible heart/heart-lung/lung-transplantations have been reported with a few successful cases, but the majority have been failures. Recently a series of ABO-incompatible heart transplants performed in small children have been

  14. Transplant tourism outcome: a single center experience.

    Science.gov (United States)

    Alghamdi, Saad A; Nabi, Zahid G; Alkhafaji, Dania M; Askandrani, Sumaya A; Abdelsalam, Mohamed S; Shukri, Mohamed M; Eldali, Abdelmoneim M; Adra, Chaker N; Alkurbi, Lutfi A; Albaqumi, Mamdouh N

    2010-07-27

    Transplant tourism is the term used for patients who travel abroad for transplantation. Transplant tourism has always been surrounded with controversy regarding how these organs were obtained, the donor's care after transplantation, and the recipient outcome. Many authors have found that the outcome of the recipients in transplant tourism is inferior to those transplanted in their own countries. However, most these studies were small, with the latest one including only 33 patients. Here, we describe the outcome of 93 patients who were transplanted abroad compared with local transplantation. All transplant patients who were followed up at our Nephrology Clinic from 1998 until 2008 were identified using our data base system. We selected patients transplanted from 2003 and forward because the computerized system for laboratory and electronic records began operation that year. A total of 165 patients were identified (93 in the tourist group and 72 in the local one). Transplant tourists had a higher rate of acute rejection in the first year compared with local transplantation (27.9% vs. 9.9, P=0.005), higher mean creatinine at 6 months and 1 year (120 vs. 101 micromol/L, P=0.0007, 113 vs. 98 micromol/L, P=0.008). There was no statistical difference in graft or patient survival in 1 or 2 years after transplantation. However, transplant tourist had a higher rate of cytomegalovirus infection (15.1% vs. 5.6%, P=0.05) and hepatitis C seroconversion (7.5% vs. 0%, P=0.02). Transplant tourists had a more complex posttransplantation course with higher incidence of acute rejection and infectious complications.

  15. Microsurgical Composite Tissue Transplantation

    Science.gov (United States)

    Serafin, Donald; Georgiade, Nicholas G.

    1978-01-01

    Since 1974, 69 patients with extensive defects have undergone reconstruction by microsurgical composite tissue transplantation. Using this method, donor composite tissue is isolated on its blood supply, removed to a distant recipient site, and the continuity of blood flow re-established by microvascular anastomoses. In this series, 56 patients (81%) were completely successful. There have been eight (12%) failures, primarily in the extremities. There have been five (7%) partial successes, (i.e., a microvascular flap in which a portion was lost requiring a secondary procedure such as a split thickness graft). In those patients with a severely injured lower extremity, the failure rate was the greatest. Most of these were arterial (six of seven). These failures occurred early in the series and were thought to be related to a severely damaged recipient vasculature. This problem has been circumvented by an autogenous interpositional vein graft, permitting more mobility of flap placement. In the upper extremity, all but one case were successful. Early motion was permitted, preventing joint capsular contractures and loss of function. Twenty-three cases in the head and neck region were successful (one partial success). This included two composite rib grafts to the mandible. Prolonged delays in reconstruction following extirpation of a malignancy were avoided. A rapid return to society following complete reconstruction was ensured. Nine patients presented for reconstruction of the breast and thorax following radical mastectomy. All were successfully reconstructed with this new technique except one patient. Its many advantages include immediate reconstruction without delayed procedures and no secondary deformity of the donor site. Healthy, well vascularized tissue can now be transferred to a previously irradiated area with no tissue loss. This new method offers many advantages to older methods of reconstruction. Length of hospital stay and immobilization are reduced. The

  16. Anesthesia for Kidney and Pancreas Transplantation.

    Science.gov (United States)

    Mittel, Aaron M; Wagener, Gebhard

    2017-09-01

    Kidney transplants are the most common solid organ abdominal transplant and are occasionally performed simultaneously with pancreas transplants in diabetic patients. Preoperative evaluation of potential transplant recipients should focus on the potential for occult cardiovascular disease while also screening for other signs of end-organ dysfunction. Intraoperatively, it is of utmost importance to ensure adequate graft perfusion to limit the risk of postoperative graft dysfunction or rejection. Postoperative care of the kidney or pancreas transplant patient should focus on ensuring normalization of volume status, electrolyte concentrations, and glycemic control. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Brūču aprūpes dokumentācijas izveidošana ambulatorajā praksē

    OpenAIRE

    Sokola, Baiba

    2016-01-01

    Bakalaura darba tēma- “ Brūču aprūpes dokumentācijas izveidošana ambulatorajā praksē. Tēma ir aktuāla, jo pašlaik, 2016.gadā, Latvijas medicīnisko dokumentu lietvedībā nav pieejamas brūču aprūpes protokols, kas ir paredzēts ambulatoriem pacientiem. Darba mērķis ir izveidot brūču aprūpes dokumentāciju ambulatorai praksei. Pētījuma uzdevumi tika izvirzīti, lai sasniegtu pētījuma mērķi. Bakalaura darbā tika izmantoti 36 literatūras avoti, no tiem 17 latviešu valodā, 18 angļu valodā, 1 krievu val...

  18. AUTOGENOUS TOOTH TRANSPLANTATION IN ADULT ...

    African Journals Online (AJOL)

    drclement

    ABSTRACT. A case of autotransplantation of a tooth in a 26 year old female African cleft palate patient is reported. This case report emphasizes the possibility and success of autotransplantation in our centre, it also emphasizes that transplantation is only technique sensitive but less equipment sensitive. It further stresses.

  19. KIDNEY TRANSPLANT URODYNAMICS: NEUROPHYSIOLOGIC CONSIDERATIONS

    Directory of Open Access Journals (Sweden)

    V. B. Berdichevskiy

    2014-01-01

    Full Text Available By analyzing data from the literature and the results of own clinical the authors suggest the presence of its own physiological rhythmogenesis motility of the urinary system to ensure its functional viability after denervation in the process of donor kidney recоvery and its transplantation to the recipient. 

  20. Hepatitis A Virus in Transplants

    Centers for Disease Control (CDC) Podcasts

    2017-05-17

    Dr. Monique Foster, a CDC epidemiologist, discusses an unusual case of hepatitis A virus in a transplant patient.  Created: 5/17/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/17/2017.

  1. Cancer rates after kidney transplantation

    DEFF Research Database (Denmark)

    Sodemann, Ulrik; Bistrup, Claus; Marckmann, Peter

    2011-01-01

    Previous studies demonstrated a 3-5-fold increased cancer risk in kidney allograft recipients compared with the general population. Our aim was to estimate cancer frequencies among kidney allograft recipients who were transplanted in 1997-2000 and who were immunosuppressed according to a more...

  2. Anesthesia care for liver transplantation.

    Science.gov (United States)

    Hannaman, Michael J; Hevesi, Zoltan G

    2011-01-01

    Intraoperative transfusion practices for liver transplantation have evolved dramatically since the first transplants of the 1960s. It is important for today's clinicians to be current in their understanding of how transplant patients should be managed with regard to their coagulation profile, volume status, and general hemodynamic state. The anesthesia team is presented with the unique task of manipulating this tenuous balance in a rapid and precise manner when managing patients undergoing liver transplantation. Although significant progress has been made in reducing blood product administration, it is still common to encounter large volume blood loss in these cases. Increasingly, clinicians are challenged to justify transfusion practices with a stronger evidentiary base. The current state of the literature for transfusion guidelines and blood product management in this particular patient subset will be discussed, as well as a variety of means (both pharmacologic and otherwise) used to reduce the need for transfusion. The aim was to review the latest evidence on these topics, as well as to highlight areas that need further clarification regarding their role in the optimal care of these patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Cancer rates after kidney transplantation

    DEFF Research Database (Denmark)

    Sodemann, Ulrik; Bistrup, Claus; Marckmann, Peter

    2011-01-01

    Previous studies demonstrated a 3-5-fold increased cancer risk in kidney allograft recipients compared with the general population. Our aim was to estimate cancer frequencies among kidney allograft recipients who were transplanted in 1997-2000 and who were immunosuppressed according to a more mod...

  4. Renal outcomes in pediatric liver transplantation.

    Science.gov (United States)

    Bartosh, S M; Alonso, E M; Whitington, P F

    1997-10-01

    The outcomes of 294 orthotopic liver transplants performed in 221 children at The University of Chicago Children's Hospital between October 1984 and October 1992 have been retrospectively reviewed. Medical information for 281 transplant in 210 children was sufficient for inclusion in this analysis. The mean age at transplant was 4.1 +/- 5.0 yr. Forty-four percent of the children were male, and 16% of the transplants were living-related. Four children received combined liver-kidney transplants. Seventy-six percent of the children are currently alive. The incidence of acute renal failure occurring following transplantation and requiring dialysis was 6.2% with a mortality rate of 85%. Early postoperative hypertension was seen in 65% of the children and persistent hypertension of greater than 12 months duration was seen in 28%. Sixteen percent of children developed metabolic acidosis requiring sustained sodium bicarbonate supplementation. Aggregate and longitudinal analysis of serial calculated glomerular filtration rates revealed abnormal renal function in approximately one third of children at any given time period following transplantation. The renal dysfunction was unrelated to age at transplant, type of transplant, gender, previous transplants, rejection episodes, courses of nephrotoxic drugs, presence of hypertension, or cyclosporin dose. This review supports prior studies which document abnormal renal function following orthotopic liver transplantation in a significant proportion of children.

  5. 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.

  6. Haematopoietic Cell Transplants in Latin America

    Science.gov (United States)

    Gale, Robert Peter; Seber, Adriana; Bonfim, Carmem; Pasquini, Marcello

    2016-01-01

    Haematopoietic cell transplants are done by more than 1500 transplant centres in 75 countries, mostly for life-threatening haematological disorders. However, transplant technology and access are not uniformly-distributed worldwide. Most transplants are done in predominately Europe, North America and some Asian countries. We review transplants activity in Latin America, a geographic region with a population of more than 600 million persons living in countries with diverse economic and social development levels. The data indicate a 20-40-fold lower frequency of transplants in Latin America compared with Europe and North America. We show that although economics, infrastructure and expertise are important limitations, other variables also operate. Changes in several of these variables may substantially increase transplant activity in Latin America. PMID:26999468

  7. 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.

  8. Pregnancy In Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    H. Shahbazian

    2006-07-01

    Full Text Available Background:Correction of the uremic state by a functioning allograft often restores fertility in women of reproductive age. The rate of fertility significantly differs between industrial countries, developing and middle east countries.On the other hand the results of pregnancy in Kidney Transplantation (KTP patients are significantly better than hemodialysis patients,and pregnancy most often has no side effects on the function of the transplanted kidney.Objectives: The purpose of this study is to investigate the rate of fertility and results of pregnancy among KTP women, and the assessment of the function of transplanted kidneys during pregnancy among those who have received kidneys in Golestan Hospital from 1996 to 2003. Methods: All the transplanted women in child bearing age who were interested in accepting pregnancy were involved in this study. After pregnancy, all the patients were visited twice a month until the 32nd week of pregnancy and their histories were taken and regular clinical examination and necessary paraclinical assessments were carried out. After the 32nd week, they were visited weekly and other necessary assessments were done in addition to previous measures. Taking immunosuppressive drugs was continued with a minor dose reduction and consumption of harmful drugs like some antihypertensives was prohibited. Results: 16 out of 48 women who were at child bearing age and were interested in pregnancy got pregnant and totally 22 cases of pregnancy occurred. Four cases resulted in spontaneous or therapeutic abortion and 3 out of 18 remaining cases had intrauterine fetal death and the others had successful pregnancy. The most common complication was LBW and following that premature labor. Maternal complications were no more than the general population and the function of the transplanted kidney had no decline in most of the cases. Conclusion:Based on what was mentioned,it is concluded that successful KTP can increase the chance of

  9. 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

  10. [Deceased donation in renal transplantation].

    Science.gov (United States)

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

    2016-11-01

    To review epidemiologic data's and medical results of deceased donation in renal transplantation. Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) database using the following keywords, alone or in association, "brain death; cardiac arrest; deceased donation; organ procurement; transplantation". Articles were selected according to methods, language of publication and relevance. The reference lists were used to identify additional historical studies of interest. Both prospective and retrospective series, in French and English, as well as review articles and recommendations were selected. In addition, French national transplant and health agencies (http://www.agence-biomedecine.fr and http://www.has-sante.fr) databases were screened using identical keywords. A total of 2498 articles, 8 official reports and 17 newspaper articles were identified; after careful selection 157 publications were eligible for our review. Deceased donation may involve either brain death or non-heartbeating donors (NHBD). Organ shortage led to the procurement of organs from expanded-criteria donors, with an increased age at donation and extended vascular disease, leading to inferior results after transplantation and underlining the need for careful donor management during brain death or cardiac arrest. Evolution of French legislation covering bioethics allowed procurement from Maastricht categories II and recently III non-heartbeating donors. The increase of organ shortage emphasizes the need for a rigorous surgical technique during procurement to avoid loss of transplants. A history or current neoplasm in deceased-donors, requires attention to increase the pool of organs without putting the recipients at risk for cancer transmission. French NHBD program, especially from Maastricht category III, may stand for a potential source of valuable organs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Electroretinographic findings in transplant chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Brian T Chan-Kai

    2010-07-01

    Full Text Available Brian T Chan-Kai1, Steven Yeh2, Richard G Weleber2, Peter J Francis2, Grazyna Adamus2, S Robert Witherspoon3, Andreas K Lauer11Cullen Eye Institute, Baylor College of Medicine, Houston, Texas; 2Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; 3Retina Institute of Texas, Dallas, Texas, USAAim: Transplant chorioretinopathy is a rare complication following solid organ or bone ­marrow transplantation and can result in severe vision loss. This series presents electroretinogram (ERG results in patients with this condition.Methods: Patients who presented with bilateral vision loss following bone marrow or solid organ transplantation were identified. A complete ophthalmologic examination, fundus ­photography, and fluorescein angiography (FA were performed. Full-field ERG was obtained in all patients and a multifocal ERG (mfERG was obtained in two patients.Results: Four patients were identified. All patients had bilateral vision loss and displayed a characteristic pattern of mottled hyperfluorescence on FA. Three patients developed ­progressive vision loss ranging from 20/60 to hand motions whereas one retained 20/40 vision. All patients exhibited moderate to severe cone dysfunction, while the degree of rod abnormalities was varied. Two patients with severe cone dysfunction showed mild clinical changes initially, but later developed progressive vision loss and chorioretinal atrophy.Conclusion: Transplant chorioretinopathy patients undergoing ERG testing show cone ­dysfunction with a variable degree of rod dysfunction. ERG abnormalities preceded the visual acuity and clinical changes in two patients, suggesting that ERG may be a helpful predictor of the clinical course in this rare disease.Keywords: transplant, chorioretinopathy, electroretinogram, ERG, mfERG

  12. 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.

  13. Beatriz Colomina, Cernés par les images. L’Architecture de l’après Spoutnik

    OpenAIRE

    Clément, Jean-François

    2015-01-01

    Ce livre est consacré à un événement qui a eu lieu en 1959, deux ans après la mise en orbite du premier satellite russe qui survola trois fois les États-Unis. Designers américains, Charles et Ray Eames furent chargés de présenter leur pays à Moscou dans le cadre d’une exposition qui répondait à une autre que les Soviétiques avaient organisée aux États-Unis l’année précédente. Plutôt que d’établir un parcours linéaire et de ne montrer que quelques réalisations techniques proprement américaines...

  14. Fatou, Julia, Montel le grand prix des sciences mathématiques de 1918, et après

    CERN Document Server

    Audin, Michèle

    2009-01-01

    Comment Fatou et Julia ont inventA(c) ce que la (TM)on appelle aujourda (TM)hui les ensembles de Julia, avant, pendant et aprA]s la premiA]re guerre mondiale? La (TM)histoire est racontA(c)e, avec ses mathA(c)matiques, ses conflits, ses personnalitA(c)s. Elle est traitA(c)e A partir de sources nouvelles, et avec rigueur. On pourra sa (TM)y initier A la (TM)itA(c)ration des fractions rationnelles et A la dynamique complexe (ensembles de Julia, de Mandelbrot, ensembles-limites). Qui A(c)taient Pierre Fatou, Gaston Julia, Paul Montel? On y trouvera en particulier des informations sur un mathA(c)m

  15. La diffraction des rayons X par les poudres cent ans après Röntgen

    OpenAIRE

    Louër , D.

    1996-01-01

    Les progrès survenus dans le domaine de la diffraction par les poudres au cours des vingt dernières années sont présentés. Après une analyse des facteurs à l'origine du problème majeur du recouvrement des raies de diffraction, les moyens pour y remédier sont passés en revue. Ils comprennent les méthodes de modélisation, de reconstruction géométrique du réseau réciproque et les améliorations dans le domaine de la résolution instrumentale obtenues avec des sources de rayons X monochromatiques e...

  16. Perfect timing, no remorse, and kidney transplantation.

    Science.gov (United States)

    Brand, D A

    1998-01-01

    Kidney transplantation is usually delayed until a patient has reached end-stage renal failure. When a living donor is used, earlier transplantation may be feasible. By averting the final stages of renal failure, early transplantation spares the patient the more pronounced effects of uremia. Unfortunately, lack of precision in predicting the future course of a patient's disease creates a dilemma: the kidneys could remain viable longer than anticipated. In that case, an early transplantation that leads to serious complications or graft failure will have caused harm by truncating the period of time the patient could have been sustained by his or her native kidneys. The present article introduces a theorem that helps solve the dilemma of early kidney transplantation. The theorem states that the timing decision depends only on the current burden of a disease relative to the risks of transplantation-that the future rate of progression of the disease is immaterial. The generality of the theorem makes it applicable, in principle, to any degenerative disease that can be treated by engraftment. The article also introduces a formula for the optimal timing of transplantation that depends on only four factors--a patient's perceived quality of life before transplantation as a function of time, the mortality associated with a transplant operation, the graft survival curve, and the quality of life in the event of a graft failure. The theorem and related formula should be helpful to patients and physicians in selecting the best time for transplantation.

  17. Kidney transplantation at Tokyo Women's Medical University.

    Science.gov (United States)

    Inui, Masashi; Ishida, Hideki; Omoto, Kazuya; Tanabe, Tatsu; Hattori, Motoshi; Hirano, Hajime; Tanabe, Kazunari

    2011-01-01

    The first case of kidney transplantation at our institution was carried out in 1971, and this first renal transplant recipient is still living with a functioning kidney. From 1971 through the end of 2011, more than 3000 cases of kidney transplantation have been carried out at our institution. Since 1983, cyclosporine-based immunosuppression has been employed at our center. During this period, most of the patients were treated with cyclosporine- or tacrolimus-based immunosuppression. The latest outcomes of kidney transplantation seem to have significantly improved compared to earlier periods. Since 2000, 10 year-graft survival is more than 90% in living donor kidney transplantation and 82% in deceased donor kidney transplantation. To resolve the serious problem of donor organ shortage, expansion of the donor pool by various options such as transplantation using extended criteria donation, donation after cardiac death, ABO-incompatible (ABO-ILKT) donors, or crossmatch-positive donors, has been carried out at our institution over the last decade. We performed the first case of ABO-ILKT in 1989, and have performed more than 400 cases at our institution as of 2011. We will describe our experience of kidney transplantation, including ABO-ILKT, sensitized recipients, pathological analysis, pediatric renal transplantation, laparoscopic donor nephrectomy, and recurrent glomerulonephritis. The data shows good outcomes, however, we still have many issues to resolve to improve long-term renal transplant outcome and to reduce complications.

  18. Acute rejection episodes after kidney transplantation

    International Nuclear Information System (INIS)

    Hamida, Fethi Ben; Barbouch, Samia; Helal, Imed; Kaaroud, Hayet; Fatma, Lilia Ben; Hedri, Hafedh; Abderrahim, Ezzeddine; Kheder, Adel; Bardi, Rafika; Abdallah, Taieb Ben; Ayed, Khaled; Maiz, Hedi Ben

    2009-01-01

    Obesity in nontransplant patients has been associated with hypertension, hyperlipidemia, diabetes, and proteinuria. To determine whether renal transplant recipients with an elevated BMI have worse long term graft survival, we prospectively studied 92 patients transplanted between April 1999 and July 2000. Weight (Wt) and height of the patients were recorded prior to transplantation and two weeks, one, two and three years post transplantation. Blood urea nitrogen (BUN), creatinine (Cr) and blood pressure were checked monthly, while triglyceride, cholesterol, high density lipoprotein (HDL), and low density lipoprotein (LDL) were obtained 3 monthly for 3 years post transplantation. Graft dysfunction was defined as serum Cr> 1.8 mg/dL. While BMI and Wt of the patients before transplantation did not show any significant correlation with chronic renal allograft dysfunction (CRAD), patients with higher Wt and BMI two weeks after transplantation showed an increased risk of developing CRAD during the three year post transplant independent of other risk factors (P< 0.05). Patients with greater Wt loss in the first two weeks post transplantation showed a decreased risk of developing CRAD in the following 3 years (P< 0.001). Our study suggests that high Wt and BMI are significantly associated with worse graft survival 3 years post renal transplantation. (author)

  19. 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.

  20. How is organ transplantation depicted in internal medicine and transplantation journals

    Science.gov (United States)

    2013-01-01

    Background In their book Spare Parts, published in 1992, Fox and Swazey criticized various aspects of organ transplantation, including the routinization of the procedure, ignorance regarding its inherent uncertainties, and the ethos of transplant professionals. Using this work as a frame of reference, we analyzed articles on organ transplantation published in internal medicine and transplantation journals between 1995 and 2008 to see whether Fox and Swazey’s critiques of organ transplantation were still relevant. Methods Using the PubMed database, we retrieved 1,120 articles from the top ten internal medicine journals and 4,644 articles from the two main transplantation journals (Transplantation and American Journal of Transplantation). Out of the internal medicine journal articles, we analyzed those in which organ transplantation was the main topic (349 articles). A total of 349 articles were randomly selected from the transplantation journals for content analysis. Results In our sample, organ transplantation was described in positive terms and was presented as a routine treatment. Few articles addressed ethical issues, patients’ experiences and uncertainties related to organ transplantation. The internal medicine journals reported on more ethical issues than the transplantation journals. The most important ethical issues discussed were related to the justice principle: organ allocation, differential access to transplantation, and the organ shortage. Conclusion Our study provides insight into representations of organ transplantation in the transplant and general medical communities, as reflected in medical journals. The various portrayals of organ transplantation in our sample of articles suggest that Fox and Swazey’s critiques of the procedure are still relevant. PMID:24219177

  1. Clinical experience in organ transplant from the Shiraz Transplant Center: 2011.

    Science.gov (United States)

    Nikeghbalian, Saman; Aliakbarian, Mohsen; Kazemi, Kourosh; Shamsaee far, Alireza; Salehipour, Mahdi; Bahreini, Amin; Mehdi, Syed Heider; Salahi, Heshmatollah; Bahador, Ali; Malekhossein, Seyed Ali

    2012-08-01

    The Shiraz Organ Transplant Center, the largest transplant center in Iran, has expanded its program of organ transplant during recent years. This article seeks to summarize organ transplantation over the last 2 decades and evaluate its status as of 2011. We retrospectively analyzed the clinical records of all organ transplants performed in our center in 2011. We reviewed the patients' demographics, underlying disease, operation details as well as postoperative complications. During this period, 655 organ transplants including 345 liver, 297 kidney, 29 pancreas, and 11 intestine and multivisceral transplants were done. Among 345 liver transplants, 291 patients received a deceased-donor graft including 18 cases of split liver transplants while 54 patients received living-donor liver transplants. The 1-year graft and patient survival rates were 90.1% and 91%. In recent years, our program in organ transplants has expanded in number and variety of organs transplanted. This improvement is related to our multidisciplinary strategies to expand the donor pool and the experiences obtained during our transplant activities.

  2. Efficacy of highland production of strawberry transplants

    African Journals Online (AJOL)

    STORAGESEVER

    2009-04-20

    Apr 20, 2009 ... However, relatively little research has been conducted to assess the differences in plant physiology between HE and LE-propagated plant material. MATERIALS AND METHODS. Propagation of runner plants was conducted at both LE and HE sites in Kangwon-do Province in the Republic of South Korea.

  3. Haemodialysis and Transplantation Facilities in South Africa

    African Journals Online (AJOL)

    1974-04-13

    Apr 13, 1974 ... The provIsion of services in South Africa for patients suffering from chronic renal failure is inadequate in terms· of nationai requirements. A survey of the available facili- ties made in July 1973 showed that 14 maintenance haemodialysis centres had a total of 39 dialysing stations capable of treating 143 ...

  4. [Transplant coordinator: organ donation process].

    Science.gov (United States)

    Gironés-Guillem, Purificación; Camaño-Puig, Ramón; Lillo-Crespo, Manuel

    2014-01-01

    Spain is a leader in organ donations although it seems that this number does not increase in the same proportion that the waiting list and it is necessary to decrease the refusal situations, which are ~16%. Analytic study. We review the reports prepared by the coordinators of transplants archived at the hospital La Fe during the period between May 1, 2004 and December 31, 2007, resulting in conceptualization and categorization. Sixty-nine topics were obtained from the point of view of the family and 11 from the point of view of the interviewer. After its conceptualization, codification and classification, we proceeded to create an appropriate text. Certain guidelines may be offered that allow us to standardize the action of transplant coordinators during the interview and to be more effective.

  5. [Indications for micrograft hair transplantation].

    Science.gov (United States)

    Bouhanna, P

    2002-05-01

    Advances in treatment of androgenetic alopecia have led to the development of novel medical or surgical therapies adapted to the severity of hair loss and balding. Follicular units or tiny micro-graft hair transplants are a fundamental technical progress. This technique leads to the simple and painless permanent restoration of hair in male and female baldness. It provides the patient with a group of 1 to 3 hairs, emerging from a single orifice. The difference between androgenic receptors of occipital areas and those of other areas explains the permanent nature of the implanted hair growth. The degree of male or female androgenetic alopecia can be determined according to Hamilton's static classification or Ludwig's Classification, or it can be measured and monitored more accurately with Bouhanna's Dynamic Multifactorial Classification. The current indications for micro-graft transplantation are

  6. [Living-donor kidney transplantation].

    Science.gov (United States)

    Mehrabi, A; Fonouni, H; Golriz, M; Schmied, B; Tahmasbirad, M; Weitz, J; Büchler, M W; Zeier, M; Schmidt, J

    2010-09-01

    Due to the existing organ shortage the option of a kidney transplantation (KTx) in patients with end-stage renal disease is not always possible despite the offer of this therapy. So far the required number of KTx could not be adequately achieved by organ donations from deceased persons. To solve this problem living donation KTx programs have already become established in many transplantation centers. In published reports it has been shown that with the living donation program better results could be achieved in terms of graft function and patient survival compared to cadaver donation KTx. Therefore, living donation KTx allows an optimal alternative to expand the organ pool. The aim of our study is to present the long-term results of our living donation KTx program regarding graft function and patient survival. Finally, the risks of living donation KTx will be discussed based on the reported experiences of other centers.

  7. Ethical issues in organ transplantation.

    Science.gov (United States)

    Freeman, Richard B; Bernat, James L

    2012-01-01

    We discuss ethical issues of organ transplantation including the stewardship tension between physicians' duty to do everything possible for their patients and their duty to serve society by encouraging organ donation. We emphasize consideration of the role of the principles of justice, utility and equity in the just distribution of transplantable organ as scarce resources. We then consider ethical issues of determining death of the organ donor including the remaining controversies in brain death determination and the new controversies raised by circulatory death determination. We need uniformity in standards of death determination, agreement on the duration of asystole before death is declared, and consensus on the allowable circulatory interventions on the newly declared organ donor that are intended to improve organ function. We discuss the importance of maintaining the dead donor rule, despite the argument of some scholars to abandon it. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. [Calcification in nonfunctioning transplanted kidneys].

    Science.gov (United States)

    Peces, R; Sánchez, R J; Fernández, E J; Peces, C

    2007-01-01

    Failed renal allografts often are left in situ in patients who revert to chronic dialysis therapy or who undergo retransplantation. These organs may be the site of massive calcification despite their lack of physiological function. Calcification of an endstage renal allograft is sometimes found incidentally. We report here two patients who developed extensive calcification of the renal graft, one was on chronic hemodialysis and the other had a second renal transplantation with normal renal function. The precise pathogenesis of calcification and the factors which determine its tissue localization are unclear. Factors postulated to promote the development of metastatic calcification include an elevated calcium phosphate product, severe secondary hyperparathyroidism, aluminium toxicity and duration of dialytic therapy. In some cases local factors related with the chronic inflammatory rejection process are probably involved as well. However, the exact relative contribution of these factors remains unresolved. Unless specific clinical indications are present, transplant nephrectomy is not necessary for calcified end-stage renal allografts.

  9. Parathyroid transplantation in thyroid surgery

    Science.gov (United States)

    Gołkowski, Filip; Nawrot, Ireneusz

    2017-01-01

    Permanent hypoparathyroidism following thyroid surgery is rare. Its prevalence is reported to be below 1–2% if surgery is performed by experienced thyroid surgeons. Parathyroid identification and preservation in situ with good vascular supply is the mainstay of safe thyroid surgery. However, if the parathyroid glands are damaged, autotransplantation should be undertaken to preserve their function. Parathyroid transplantation can be considered in three distinct modes of application: (I) fresh parathyroid tissue autotransplantation during thyroidectomy in order to reduce the risk of permanent hypoparathyroidism; (II) cryopreserved parathyroid tissue autotransplantation in patients with permanent hypoparathyroidism; (III) parathyroid allotransplantation in patients with permanent hypoparathyroidism when cryopreserved parathyroid tissue is not available for grafting. Nowadays, allotransplantation of cultured parathyroid cells without immunosuppression should be taken into consideration in selected patients as an alternative to calcium and vitamin D3 supplementation in management of permanent hypoparathyroidism. This paper is aimed to provide a review of current status of various parathyroid transplantation techniques in thyroid surgery. PMID:29142845

  10. Hair transplantation in alopecia androgenetica

    Directory of Open Access Journals (Sweden)

    Singh Gurinderjit

    1992-01-01

    Full Text Available One hundred patients suffering from male pattern baldness were given 3 to 4 sittings of hair transplantation at an interval of about 4 to 6 weeks each. They included 46 patients of type III baldness, 23 patients of type III (vertex baldness, and 31 patients of type IV baldness. It needed 3 sittings in type III as well as type III (vertex patients, whereas type IV patients needed 4 sittings for cosmetically acceptable results. Sixty percent patients of type III (including type III vertex showed excellent results; whereas 24 percent patients showed good response. Thirty-four percent patients of type IV got excellent cosmetic appearance; whereas, good results could be obtained in 17 percent patients. The reasons for poor results in certain patients were poor density of hair at donor sites and poor growth of hair in some of the transplanted plugs.

  11. APR-246 (PRIMA-1(MET)) strongly synergizes with AZD2281 (olaparib) induced PARP inhibition to induce apoptosis in non-small cell lung cancer cell lines.

    Science.gov (United States)

    Deben, Christophe; Lardon, Filip; Wouters, An; Op de Beeck, Ken; Van den Bossche, Jolien; Jacobs, Julie; Van Der Steen, Nele; Peeters, Marc; Rolfo, Christian; Deschoolmeester, Vanessa; Pauwels, Patrick

    2016-06-01

    APR-246 (PRIMA-1(Met)) is able to bind mutant p53 and restore its normal conformation and function. The compound has also been shown to increase intracellular ROS levels. Importantly, the poly-[ADP-ribose] polymerase-1 (PARP-1) enzyme plays an important role in the repair of ROS-induced DNA damage. We hypothesize that by blocking this repair with the PARP-inhibitor AZD2281 (olaparib), DNA damage would accumulate in the cell leading to massive apoptosis. We observed that APR-246 synergistically enhanced the cytotoxic response of olaparib in TP53 mutant non-small cell lung cancer cell lines, resulting in a strong apoptotic response. In the presence of wild type p53 a G2/M cell cycle block was predominantly observed. NOXA expression levels were significantly increased in a TP53 mutant background, and remained unchanged in the wild type cell line. The combined treatment of APR-246 and olaparib induced cell death that was associated with increased ROS production, accumulation of DNA damage and translocation of p53 to the mitochondria. Out data suggest a promising targeted combination strategy in which the response to olaparib is synergistically enhanced by the addition of APR-246, especially in a TP53 mutant background. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. 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.

  13. 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...

  14. 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.

  15. The start of the transplant journey: Referral for pediatric solid organ transplantation

    Science.gov (United States)

    Shellmer, Diana; Brosig, Cheryl; Wray, Jo

    2014-01-01

    The focus of the majority of the psychosocial transplant literature is on post-transplant outcomes but the transplant journey starts much earlier than this, at the point when transplantation is first considered and a referral for transplant evaluation is made. In this review we cover information regarding the meaning of the referral process for solid organ transplantation. We discuss various factors of the referral for transplantation including the impact of referral on the pediatric patient and the family, potential expectations and misconceptions held by pediatric patients and parents, the role of health literacy, decision making factors, and the informational needs of pediatric patients and parents. We elucidate steps that providers can take to enhance transplant referral and provide suggestions for much needed research within this area. PMID:24438194

  16. Hepatic Hemangiosarcoma : An Absolute Contraindication to Liver Transplantation-The European Liver Transplant Registry Experience

    NARCIS (Netherlands)

    Orlando, Giuseppe; Adam, Rene; Mirza, Darius; Soderdahl, Goran; Porte, Robert J.; Paul, Andreas; Burroughs, Andrew K.; Seiler, Christian A.; Colledan, Michele; Graziadei, Ivo; Garcia Valdecasas, Juan-Carlos; Pruvot, Francois-Rene; Karam, Vincent; Lerut, Jan

    2013-01-01

    Background. Liver transplantation (LT) is performed for hemangiosarcoma (HAS) despite disappointing results. Methods. Retrospective study of 14 males and 8 females reported to the European Liver Transplant Registry. In view of the difficult differential diagnosis between HAS and hemangioendothelioma

  17. Renal transplantation in Mapuche people.

    Science.gov (United States)

    Ardiles, R; Beltrán, R; Jerez, V; Droguett, M A; Mezzano, S; Ardiles, L

    2008-04-01

    Previous studies have demonstrated higher concentrations of some histocompatibility antigens in Mapuche people compared with non-Mapuche Chileans in the renal transplantation program. With the aim of evaluating whether those antigenic differences might induce differences in the outcomes of renal transplantation among patients belonging to that ethnic group, we reviewed HLA studies and at least 6 months follow-up of all patients with a first kidney transplant between 1980 and 2006. The 248 patients had a mean age of 37.6 years, 40% were females, and 48% had living related donors. The mean kidney follow-up was 90 months and patient follow-up was 106 months. Thirty-nine patients (16%) were classified as Mapuche, according to their surnames, including 16 women with overall mean age of 34.5 years, and 14 had been transplanted from a living related donor. Mapuche patients received organs with better HLA matching expressed as number of identities (3.4 +/- 0.1 versus 2.8 +/- 0.1 among non-Mapuche; P or = 3 compatibilities was significantly higher (Mapuche 38% versus non-Mapuche 22%; P Mapuche; and 83% and 65%, respectively, for non-Mapuche. Patient survival rates were 97% at 5 years and 86% at 10 years in the Mapuche group versus 91% and 79%, respectively, in the non-Mapuche group; both results were not significantly different. Our results showed similar outcomes of kidney and patient survivals among Mapuche people even when they received organs with better HLA matches.

  18. Parathyroid transplantation in thyroid surgery

    OpenAIRE

    Barczyński, Marcin; Gołkowski, Filip; Nawrot, Ireneusz

    2017-01-01

    Permanent hypoparathyroidism following thyroid surgery is rare. Its prevalence is reported to be below 1–2% if surgery is performed by experienced thyroid surgeons. Parathyroid identification and preservation in situ with good vascular supply is the mainstay of safe thyroid surgery. However, if the parathyroid glands are damaged, autotransplantation should be undertaken to preserve their function. Parathyroid transplantation can be considered in three distinct modes of application: (I) fresh ...

  19. [Impact of HLA mismatch on transplant outcomes].

    Science.gov (United States)

    Kanda, Junya

    Human leukocyte antigen (HLA) mismatch increases the risk of severe graft-versus-host disease (GVHD) and transplant-related mortality. However, the variety of stem cell sources such as cord blood units or the improvements in GVHD prophylaxis makes the interpretation of HLA mismatch more complex. In unrelated transplantation, the locus of HLA mismatch has a great impact on the donor candidate selection, whereas in related transplantation, it has an impact on the intensity of GVHD prophylaxis because donor availability is limited. Anti-thymocyte globulin and post-transplant cyclophosphamide are attractive GVHD prophylactic agents to reduce the risk of immune-associated complications in HLA-mismatched transplantations. HLA mismatch has a reduced impact in adult cord blood transplantation. In this review article, the impact of HLA mismatch based on graft sources is discussed.

  20. An abridged photographic history of organ transplantation.

    Science.gov (United States)

    Marino, Ignazio R; Cirillo, Claudia

    2014-03-01

    Organ transplantation is one of the most remarkable therapeutic advances in modern medicine; it started as an experiment and has become a life-saving practice. We briefly describe the major milestones of this multidisciplinary clinical science, the challenges that it still faces, and we consider the crucial contribution that its example could set for other medical fields. A review of the literature was conducted and a selection of images was made to complete a brief history of organ transplantation, with a particular focus on liver transplantation. The largest problem affecting organ transplantation today is the shortage of organs. Attention should be given to preserving the peculiar high ethical value that characterizes the very nature of organ transplantation. Methods successfully adopted by organ transplantation during the past 60 years can inspire promising fields, such as stem cell research, and provide useful tools to face the ethical challenges posed by scientific discoveries.

  1. Quality measurement and improvement in liver transplantation.

    Science.gov (United States)

    Mathur, Amit K; Talwalkar, Jayant

    2018-03-17

    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 centers. 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, outline the status quo including 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 programs holds significant promise but multiple challenges to successful implementation must be addressed in order to optimize value. Copyright © 2018. Published by Elsevier B.V.

  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 heart allocation and transplantation in Eurotransplant.

    Science.gov (United States)

    Smits, Jacqueline M; Thul, Josef; De Pauw, Michel; Delmo Walter, Eva; Strelniece, Agita; Green, Dave; de Vries, Erwin; Rahmel, Axel; Bauer, Juergen; Laufer, Guenther; Hetzer, Roland; Reichenspurner, Hermann; Meiser, Bruno

    2014-09-01

    Pediatric heart allocation in Eurotransplant (ET) has evolved over the past decades to better serve patients and improve utilization. Pediatric heart transplants (HT) account for 6% of the annual transplant volume in ET. Death rates on the pediatric heart transplant waiting list have decreased over the years, from 25% in 1997 to 18% in 2011. Within the first year after listing, 32% of all infants (heart transplant. Survival after transplantation improved over the years, and in almost a decade, the 1-year survival went from 83% to 89%, and the 3-year rates increased from 81% to 85%. Improved medical management of heart failure patients and the availability of mechanical support for children have significantly improved the prospects for children on the heart transplant waiting list. © 2014 Steunstichting ESOT.

  4. 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.

  5. Law, religion and organ transplants

    Directory of Open Access Journals (Sweden)

    M. Slabbert

    2011-06-01

    Full Text Available Currently any organ donation in South Africa, whether from a living or a dead donor, is donated altruistically, which means that it is the free choice of the donor or the family of the deceased to donate organs. There is no financial compensation for the donor. Nearly all religions support altruistic organ donations as it serves or promotes life. But, despite the positive attitude of the followers of different faiths towards organ transplantations, there is a worldwide shortage of transplantable organs,especially kidneys. Many patients die while waiting for a transplant organ from an altruistic donor. The question may therefore be asked whether the different religions should not also support the clamouring for the financial rewarding of an organ donor. In this article the emphasis is on the Christian and Muslim faiths to try and fathom their position in this regard. In conclusion, however,we argue that financial compensation to donors, as a general practice, should be allowed irrespective of religious arguments, as the decision to donate altruistically or to receive compensation is an expression of personal autonomy.

  6. Pulmonary complications in renal transplantation

    International Nuclear Information System (INIS)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin

    2003-01-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation

  7. Troubling dimensions of heart transplantation.

    Science.gov (United States)

    Shildrick, M; McKeever, P; Abbey, S; Poole, J; Ross, H

    2009-06-01

    Heart transplantation is now the accepted therapy for end-stage heart failure that is resistant to medical treatment. Families of deceased donors routinely are urged to view the heart as a "gift of life" that will enable the donor to live on by extending and sustaining the life of a stranger. In contrast, heart recipients are encouraged to view the organ mechanistically-as a new pump that was rendered a spare, reusable part when a generous stranger died. Psychosocial and psychoanalytic research, anecdotal evidence and first-person accounts indicate that after transplant, many recipients experience unexpected changes or distress that cannot be understood adequately using biomedical explanatory models alone. In this paper it is argued that phenomenological philosophy offers a promising way to frame an ongoing empirical study that asks recipients to reflect on what it is like to incorporate the heart of another person. Merleau-Ponty and others have posited that any change to the body inevitably transforms the self. Hence, it is argued in this paper that replacing failing hearts with functioning hearts from deceased persons must be considered much more than a complex technical procedure. Acknowledging the disturbances to embodiment and personal identity associated with transplantation may explain adverse outcomes that heretofore have been inexplicable. Ultimately, a phenomenological understanding could lead to improvements in the consent process, preoperative teaching and follow-up care.

  8. Liver transplantation for Wilson disease

    Science.gov (United States)

    Catana, Andreea M; Medici, Valentina

    2012-01-01

    The aim of this paper is to review the current status of liver transplantation (LT) for Wilson disease (WD), focusing on indications and controversies, especially in patients with neuropsychiatric disease, and on identification of acute liver failure (ALF) cases related to WD. LT remains the treatment of choice for patients with ALF, as initial presentation of WD or when anti-copper agents are stopped, and for patients with chronic liver disease progressed to cirrhosis, unresponsive to chelating medications or not timely treated with copper chelating agents. The indication for LT in WD remains highly debated in patients with progressive neurological deterioration and failure to improve with appropriate medical treatment. In case of Wilsonian ALF, early identification is key as mortality is 100% without emergency LT. As many of the copper metabolism parameters are believed to be less reliable in ALF, simple biochemical tests have been proposed for diagnosis of acute WD with good sensitivity and specificity. LT corrects copper metabolism and complications resulting from WD with excellent 1 and 5 year survival. Living related liver transplantation represents an alternative to deceased donor LT with excellent long-term survival, without disease recurrence. Future options may include hepatocyte transplantation and gene therapy. Although both of these have shown promising results in animal models of WD, prospective human studies are much needed to demonstrate their long-term beneficial effects and their potential to replace the need for medical therapy and LT in patients with WD. PMID:22312450

  9. Nutritional consequences of renal transplantation.

    Science.gov (United States)

    Teplan, Vladimir; Valkovsky, Ivo; Teplan, Vladimir; Stollova, Milena; Vyhnanek, Frantisek; Andel, Michal

    2009-01-01

    Successful kidney transplantation leads to restoration of renal function. Some metabolic disorders from chronic renal failure may persist and new metabolic abnormalities can develop (obesity, diabetes, hypertension, bone disease, and anemia). Additionally, influence of immunosuppressive drugs (corticosteroids, cyclosporine A, tacrolimus, and rapamycin) may aggravate the course of diabetes, hypertension, and dyslipidemia. Nutritional management of renal transplantation is divided into the pretransplant period, transplant surgery, and early and late posttransplant period. Patients in the pretransplant period in dialysis treatment may develop protein-energy malnutrition and negative nitrogen balance, with loss of lean body mass and fat deposits. Nutritional management in the early posttransplant period with a functioning kidney graft necessitates fluid and electrolyte balance control with protein intake of 1,2/kg BW/day and 30-35 kcal/kg BW/day. In a nonfunctioning kidney graft, dialysis treatment continues and the therapeutic dose of immunosuppressive drugs must be reduced. The principal objective in the late posttransplant period is the maintenance of optimal nutritional status. Nutrition is important in managing obesity, insulin resistance, diabetes, hyperlipidemia, and hypertension. Other posttransplant conditions for which diet and/or nutritional supplements may be beneficial include hypomagnesemia, hypophosphatemia, hyperuricemia, hyperkalemia, hyperhomocysteinemia, chronic renal allograft failure, renal anemia, and renal bone disease.

  10. Pulmonary complications in renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-04-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.

  11. 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.

  12. The history of organ donation and transplantation in Iran.

    Science.gov (United States)

    Ghods, Ahad J

    2014-03-01

    The first kidney transplant in Iran was performed in 1967, and this was the first organ transplant in countries that are current members of the Middle East Society for Organ Transplantation. In 1988, in response to the long waiting list at the Iranian Ministry of Health for kidney transplant, a state-regulated living-unrelated donor kidney transplant program was adopted. By 1999, the kidney transplant waiting list in Iran was eliminated. In 1989, a fatwa (religious approval) from the Supreme Religious Leader was obtained that recognized brain death and allowed deceased-donor organ transplant. Subsequently, transplant centers began performing deceased-donor kidney, liver, and heart transplants. In 2000, the Brain Death and Organ Transplantation Act was passed by the Iranian parliament, legalizing deceased-donor organ transplant. The transplant team at Shiraz began performing more deceased-donor kidney and liver transplants and became a successful deceased-donor organ transplant model in the country. By the end of 2012, there were 34166 kidney (including 4436 deceased-donor) and 2021 liver (including 1788 deceased-donor), 482 heart, 147 pancreas, 63 lung, and several intestine and multiorgan transplants performed in Iran. In 2011, there were 2771 solid-organ transplants performed in Iran (37 transplants per million population), and Iran ranked as number 33 among the 50 most active countries worldwide. In 2011 and 2012, Iran was ahead of all country members of the Middle East Society for Organ Transplantation in performing deceased-donor kidney and liver transplants.

  13. [Therapeutic education in the transplant patient's pathway].

    Science.gov (United States)

    Esposito, Laure; Dalmon, Pauline; Mosnier, Magali; Marceillac, Anne; Kamar, Nassim

    2016-12-01

    The success of a transplant in the long term depends to a large extent on the taking of immunosuppressant treatments and its follow-up. Therapeutic education plays an important role in the follow-up of transplant patients and in nurses' daily practice. It is integrated into the patient's pre-transplant care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Overview of adult congenital heart transplants

    Science.gov (United States)

    Morales, David

    2018-01-01

    Transplantation for adult patients with congenital heart disease (ACHD) is a growing clinical endeavor in the transplant community. Understanding the results and defining potential high-risk patient subsets will allow optimization of patient outcomes. This review summarizes the scope of ACHD transplantation, the mechanisms of late ventricular dysfunction, the ACHD population at risk of developing heart failure, the indications and potential contraindications for transplant, surgical considerations, and post-transplant outcomes. The findings reveal that 3.3% of adult heart transplants occur in ACHD patients. The potential mechanisms for the development of late ventricular dysfunction include a morphologic systemic right ventricle, altered coronary perfusion, and ventricular noncompaction. The indications for transplant in ACHD patients include systemic ventricular failure refractory medical therapy, Fontan patients failing from chronic passive pulmonary circulation, and progressive cyanosis leading to functional decline. Transplantation in ACHD patients can be quite complex and may require extensive reconstruction of the branch pulmonary arteries, systemic veins, or the aorta. Vasoplegia, bleeding, and graft right ventricular dysfunction can complicate the immediate post-transplant period. The post-transplant operative mortality ranges between 14% and 39%. The majority of early mortality occurs in ACHD patients with univentricular congenital heart disease. However, there has been improvement in operative survival in more contemporary studies. In conclusion, the experience with cardiac transplantation for ACHD patients with end-stage heart failure is growing, and high-risk patient subsets have been defined. Significant strides have been made in developing evidence-based guidelines of indications for transplant, and the intraoperative management of complex reconstruction has evolved. With proper patient selection, more aggressive use of mechanical circulatory support

  15. Cancer Risk After Pediatric Solid Organ Transplantation.

    Science.gov (United States)

    Yanik, Elizabeth L; Smith, Jodi M; Shiels, Meredith S; Clarke, Christina A; Lynch, Charles F; Kahn, Amy R; Koch, Lori; Pawlish, Karen S; Engels, Eric A

    2017-05-01

    The effects of pediatric solid organ transplantation on cancer risk may differ from those observed in adult recipients. We described cancers in pediatric recipients and compared incidence to the general population. The US transplant registry was linked to 16 cancer registries to identify cancer diagnoses among recipients <18 years old at transplant. Standardized incidence ratios (SIRs) were estimated by dividing observed cancer counts among recipients by expected counts based on the general population rates. Cox regression was used to estimate the associations between recipient characteristics and non-Hodgkin's lymphoma (NHL) risk. Among 17 958 pediatric recipients, 392 cancers were diagnosed, of which 279 (71%) were NHL. Compared with the general population, incidence was significantly increased for NHL (SIR = 212, 95% confidence interval [CI] = 188-238), Hodgkin's lymphoma (SIR = 19, 95% CI = 13-26), leukemia (SIR = 4, 95% CI = 2-7), myeloma (SIR = 229, 95% CI = 47-671), and cancers of the liver, soft tissue, ovary, vulva, testis, bladder, kidney, and thyroid. NHL risk was highest during the first year after transplantation among recipients <5 years old at transplant (SIR = 313), among recipients seronegative for Epstein-Barr virus (EBV) at transplant (SIR = 446), and among intestine transplant recipients (SIR = 1280). In multivariable analyses, seronegative EBV status, the first year after transplantation, intestine transplantation, and induction immunosuppression were independently associated with higher NHL incidence. Pediatric recipients have a markedly increased risk for many cancers. NHL constitutes the majority of diagnosed cancers, with the highest risk occurring in the first year after transplantation. NHL risk was high in recipients susceptible to primary EBV infection after transplant and in intestine transplant recipients, perhaps due to EBV transmission in the donor organ. Copyright © 2017 by the American Academy of Pediatrics.

  16. Kidney transplant outcomes from older deceased donors

    DEFF Research Database (Denmark)

    Pippias, Maria; Jager, Kitty J; Caskey, Fergus

    2018-01-01

    As the median age of deceased kidney donors rises, updated knowledge of transplant outcomes from older deceased donors in differing donor-recipient age groups is required. Using ERA-EDTA Registry data we determined survival outcomes of kidney allografts donated from the same older deceased donor ...... transplanted into differing donor-recipient age groups are better than previously reported. These allografts remain a valuable transplant resource, particularly for similar-aged recipients....

  17. 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.

  18. Inguinal Herniation of a Transplant Kidney Ureter: A Case Report

    OpenAIRE

    Pourafkari, Marina; Ghofrani, Mishka; Riahi, Majid

    2012-01-01

    Ureteral obstruction is relatively common after renal transplantation. A rare cause is the inguinal herniation of the transplant ureter. We report a case of late allograft renal transplant failure due to ureteral herniation as well as ureterovesical junction stenosis.

  19. Overcoming the shortage of transplantable organs: ethical and psychological aspects.

    Science.gov (United States)

    Quante, Michael; Wiedebusch, Silvia

    2007-03-02

    The main ethical problem of organ transplantation is the shortage of transplantable organs. The substitute strategies currently under discussion endanger frust in transplantion medicine and thereby increase the problem. Thus ethically preferable alternatives to overcome the shortage are suggested.

  20. Design and Methods of the Korean Organ Transplantation Registry

    Directory of Open Access Journals (Sweden)

    Jaeseok Yang, MD, PhD

    2017-08-01

    Conclusions. KOTRY, as a systematic Korean transplant cohort, is expected to provide important information on Asian organ transplantation. The processes used to establish KOTRY provide a good model for launching new nationwide transplant cohort studies.

  1. Central nervous system infections in heart transplant recipients

    NARCIS (Netherlands)

    van de Beek, Diederik; Patel, Robin; Daly, Richard C.; McGregor, Christopher G. A.; Wijdicks, Eelco F. M.

    2007-01-01

    OBJECTIVE: To study central nervous system infections after heart transplantations. DESIGN: Retrospective cohort study. SETTING: Cardiac Transplant Program at Mayo Clinic, Rochester, Minnesota. Patients Three hundred fifteen consecutive patients who underwent heart transplantation from January 1988

  2. Lung Transplantation for Ventilator-Dependent Respiratory Failure

    NARCIS (Netherlands)

    Vermeijden, J. Wytze; Zijlstra, Jan G.; Erasmus, Michiel E.; van der Bij, Wim; Verschuuren, Erik A.

    Introduction: Lung transplantation of patients on mechanical ventilation is controversial, but successful transplantation of these patients has been reported. This report describes our institutional experience with lung transplantation of mechanically Ventilated patients since 2003. Methods: A

  3. The impact of neurologic complications on outcome after heart transplantation

    NARCIS (Netherlands)

    van de Beek, Diederik; Kremers, Walter; Daly, Richard C.; Edwards, Brooks S.; Clavell, Alfredo L.; McGregor, Christopher G. A.; Wijdicks, Eelco F. M.

    2008-01-01

    OBJECTIVE: To study neurologic complications after heart transplant. DESIGN: Retrospective cohort study. SETTING: Cardiac transplant program at Mayo Clinic, Rochester, Minnesota. PATIENTS: We retrospectively studied 313 patients who underwent heart transplant at Mayo Clinic Rochester from January 1,

  4. Pulmonary thromboembolism as a complication of lung transplantation

    DEFF Research Database (Denmark)

    Kristensen, Anna Warncke; Mortensen, Jann; Berg, Ronan M G

    2017-01-01

    Post-transplantation mortality after lung transplantation (LTX) is higher than for other solid organ transplantations. Thoracic surgery is associated with increased risk of thromboembolic complications, and as LTX recipients lack the collateral bronchial circulation, pulmonary thromboembolism (PTE...

  5. The role of diet and physical activity in post-transplant weight gain after renal transplantation

    NARCIS (Netherlands)

    Zelle, Dorien M.; Kok, Trijntje; Dontje, Manon L.; Danchell, Eva I.; Navis, Gerjan; van Son, Willem J.; Bakker, Stephan J. L.; Corpeleijn, Eva

    Background Long-term survival of renal transplant recipients (RTR) has not improved over the past 20yr. The question rises to what extent lifestyle factors play a role in post-transplant weight gain and its associated risks after transplantation. Methods Twenty-six RTR were measured for body weight,

  6. Primary Liver Transplantation for Autoimmune Hepatitis : A Comparative Analysis of the European Liver Transplant Registry

    NARCIS (Netherlands)

    Schramm, Christoph; Bubenheim, Michael; Adam, Rene; Karam, Vincent; Buckels, John; O'Grady, John G.; Jamieson, Neville; Pollard, Stephen; Neuhaus, Peter; Manns, Michael M.; Porte, Robert; Castaing, Denis; Paul, Andreas; Traynor, Oscar; Garden, James; Friman, Styrbjorn; Ericzon, Bo-Goran; Fischer, Lutz; Vitko, Stefan; Krawczyk, Marek; Metselaar, Herold J.; Foss, Aksel; Kilic, Murat; Rolles, Keith; Burra, Patrizia; Rogiers, Xavier; Lohse, Ansgar W.

    The principal aim of this study was to compare the probability of and potential risk factors for death and graft loss after primary adult and pediatric liver transplantation in patients undergoing transplantation for autoimmune hepatitis (AIH) to those in patients undergoing transplantation for

  7. 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

  8. 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

  9. 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.

  10. Alcoholic hepatitis: appropriate indication for liver transplantation?

    Science.gov (United States)

    Schneekloth, Terry D; Niazi, Shehzad K; Simonetto, Douglas A

    2017-12-01

    The majority of liver transplantation centers have required patients with alcohol-induced liver disease to demonstrate a period of abstinence (generally 6 months' duration) to qualify for transplant listing. This requirement has excluded patients with alcoholic hepatitis from transplant consideration. Since 2011, several studies have examined the outcomes of patients undergoing liver transplantation with brief abstinence as a lifesaving intervention for alcoholic hepatitis. This review includes each of the recent studies and discusses their implications for general transplant practice. A Medical Literature Analysis and Retrieval System search revealed five published studies - three prospective and two retrospective - pertaining to liver transplantation for alcoholic hepatitis. Among patients with medication-nonresponsive alcoholic hepatitis, those who underwent transplantation had superior survival. Liver recipients with alcoholic hepatitis had comparable survival to those with 6 or more months of abstinence. Their relapse rates were not statistically different in the short term over those transplanted with longer abstinence, although some patients in each prospective cohort relapsed to drinking despite narrow inclusion criteria and extensive pretransplant staff reviews and posttransplant surveillance. Liver transplantation is a reasonable treatment consideration for highly selective cases of alcoholic hepatitis. Further research is needed to refine inclusion criteria, address posttransplant relapse prevention interventions, and monitor long-term outcomes.

  11. Bone marrow transplant – children - discharge

    Science.gov (United States)

    American Academy of Pediatric Dentistry. Guideline on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation. Pediatr Dent . 2013 Sep- ...

  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. Neurologic complications after solid organ transplantation.

    Science.gov (United States)

    Senzolo, Marco; Marco, Senzolo; Ferronato, Cecilia; Cecilia, Ferronato; Burra, Patrizia; Patrizia, Burra

    2009-03-01

    Neurologic complications are common after solid organ transplantation and are associated with significant morbidity. Approximately one-third of transplant recipients experiences neurologic alterations with incidence ranging from 10% to 59%. The complications can be divided into such of those common to all types of transplant and others of those specific to transplanted organ. The most common complication seen with all types of transplanted organ is neurotoxicity attributable to immunosuppressive drugs, followed by seizures, opportunistic central nervous system (CNS) infections, cardiovascular events, encephalopathy and de novo CNS neoplasms. Amongst immunosuppressants, calcineurin inhibitors are the main drugs involved in neurotoxicity, leading to complications which ranges from mild symptoms, such as tremors and paresthesia to severe symptoms, such as disabling pain syndrome and leukoencephalopathy. Neurologic complications of liver transplantation are more common than that of other solid organ transplants (13-47%); encephalopathy is the most common CNS complication, followed by seizures; however, central pontine myelinolysis can appear in 1-8% of the patients leading to permanent disabilities or death. In kidney transplanted patients, stroke is the most common neurologic complication, whereas cerebral infarction and bleeding are more typical after heart transplantation. Metabolic, electrolyte and infectious anomalies represent common risk factors; however, identification of specific causes and early diagnosis are still difficult, because of patient's poor clinical status and concomitant systemic and metabolic disorders, which may obscure symptoms.

  14. 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.

  15. False iliac artery aneurysm following renal transplantation

    DEFF Research Database (Denmark)

    Levi, N; Sønksen, Jens Otto Reimers; Schroeder, T V

    1999-01-01

    We report a very rare case of a false iliac artery aneurysm following renal transplantation. The patient was a 51-year-old women who presented with a painful 10 x 10 cm pulsating mass in her left iliac fossa. The patient had received a second cadaveric renal transplantation 5 years previously....... The graft never functioned and transplant nephrectomy was performed 2 weeks later. A CT-scanning showed a 10 x 10 cm large aneurysm arising from the left external iliac artery. At operation a large false aneurysm was identified arising from the original transplant anastomotic site. Due to the extent...

  16. Pancreas transplant imaging: how I do it.

    Science.gov (United States)

    Tolat, Parag P; Foley, W Dennis; Johnson, Christopher; Hohenwalter, Mark D; Quiroz, Francisco A

    2015-04-01

    Pancreas transplantation aims to restore physiologic normoglycemia in diabetic patients with glomerulopathy and avoid or delay the onset of diabetic retinopathy and arteriopathy. Simultaneous pancreas-kidney transplant is the most common approach, using a cadaveric pancreas donation in conjunction with either cadaveric or live donor renal transplant. Alternative techniques include pancreas after kidney transplant, in which the pancreas transplant is performed some years after renal transplant. Pancreas transplant alone is utilized rarely in diabetic patients with compensated renal function. Pancreas grafts have vascular and enteric connections that vary in their anatomic approach, and understanding of this is critical for imaging with ultrasonography, computed tomography, or magnetic resonance imaging. Imaging techniques are directed to display the pancreatic transplant arterial and venous vasculature, parenchyma, and intestinal drainage pathway. Critical vascular information includes venous thrombosis (partial or complete), arterial occlusion, or aneurysm. Parenchymal abnormalities are nonspecific and occur in pancreatitis, graft rejection, and subsequent graft ischemia. Peripancreatic fluid collections include hematoma/seroma, pseudocyst, and abscess. The latter two are related to pancreatitis, duct disruption, or leak from the duodenojejunostomy. An understanding of transplant anatomy and complications will lead to appropriate use of imaging techniques to diagnose or exclude important complications.

  17. 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.

  18. Evaluation of a Heart Transplant Candidate.

    Science.gov (United States)

    Lee, Sook Jin; Kim, Kyung Hee; Hong, Suk Keun; Hankins, Shelley

    2017-11-04

    Heart transplantation is the best option for irreversible and critically advanced heart failure. However, limited donor pool, the risk of rejection, infection, and right ventricular dysfunction in short-term post-transplant period, as well as, the development of coronary allograft vasculopathy and malignancy in the long-term post-transplant period limits the utility of heart transplantation for all comers with advanced heart failure. Therefore, selection of appropriate candidates is very important for the best short and long-term prognosis. In this article, we discuss the principles of selection of candidates and compare to the recently updated International Society for Heart and Lung Transplantation (ISHLT) listing criteria with the goal of updating current clinical practice. We found that while most of the recommendations in the new listing criteria are continuous with the previous criteria, updated recommendations are made on the risk stratification models in choosing transplantation candidates. Recommendation on hepatic dysfunction is not directly included in the updated ISHLT listing criteria; however, adoption of the Model for End-stage Liver Disease (MELD) score and modified MELD scores in the evaluation of risk are suggested in recent studies. In conclusion, evaluation of patient selection for heart transplantation should be comprehensive and individualized with respect to indications and the risk of comorbidities of candidates. With the advancement of mechanical circulatory support (MCS), the selection of heart transplantation candidate is continuously evolving and widened. MCS as bridge to candidacy should be considered when the candidate has potentially reversible risk factors for transplantation.

  19. Transplantation of Hearts Donated after Circulatory Death

    Science.gov (United States)

    White, Christopher W.; Messer, Simon J.; Large, Stephen R.; Conway, Jennifer; Kim, Daniel H.; Kutsogiannis, Demetrios J.; Nagendran, Jayan; Freed, Darren H.

    2018-01-01

    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. PMID:29487855

  20. 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.

  1. Impact of pre-transplant pulmonary hypertension on survival after heart transplantation: a UNOS registry analysis.

    Science.gov (United States)

    Vakil, Kairav; Duval, Sue; Sharma, Alok; Adabag, Selcuk; Abidi, Kashan Syed; Taimeh, Ziad; Colvin-Adams, Monica

    2014-10-20

    Severe pre-transplant pulmonary hypertension (PH) has been associated with adverse short-term clinical outcomes after heart transplantation in relatively small single-center studies. The impact of pre-transplant PH on long-term survival after heart transplantation has not been examined in a large, multi-center cohort. Adults (≥18 years) who underwent first time heart transplantation in the United States between 1987 and 2012 were retrospectively identified from the United Network for Organ Sharing registry. Pre-transplant PH was classified as mild, moderate, or severe based on pulmonary vascular resistance (PVR), trans-pulmonary gradient (TPG), and pulmonary artery (PA) mean pressure. Primary outcome was all-cause mortality. Data from 26,649 heart transplant recipients (mean age 52±12 years; 76% male; 76% Caucasian) were analyzed. During a mean follow-up of 5.7±4.8 years, there were 10,334 (39%) deaths. Pre-transplant PH (PVR≥2.5 WU) was a significant predictor of mortality (hazard ratio 1.10, 95% confidence interval 1.05-1.14, ptransplant PH (mild/moderate vs. severe) did not affect short or long-term survival. Similarly, even in patients who were supported with either a left ventricular assist device or a total artificial heart prior to transplant, severe pre-transplant PH was not associated with worse survival when compared to patients with mild/moderate pre-transplant PH. Pre-transplant PH (PVR≥2.5 WU) is associated with a modest increase in mortality when compared to patients without pre-transplant PH. However, the severity of pre-transplant PH, assessed by PVR, TPG, or mean PA pressure, is not a discriminating factor for poor survival in patients listed for heart transplantation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. 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.

  3. TCC in Transplant Ureter--When and When Not to Preserve the Transplant Kidney.

    Science.gov (United States)

    Olsburgh, J; Zakri, R H; Horsfield, C; Collins, R; Fairweather, J; O'Donnell, P; Koffman, G

    2016-02-01

    We present four cases of transitional cell carcinoma of the transplant ureter (TCCtu). In three cases, localized tumor resection and a variety of reconstructive techniques were possible. Transplant nephrectomy with cystectomy was performed as a secondary treatment in one locally excised case. Transplant nephroureterectomy was performed as primary treatment in one case. The role of oncogenic viruses and genetic fingerprinting to determine the origin of TCCtu are described. Our cases and a systematic literature review illustrate the surgical, nephrological, and oncological challenges of this uncommon but important condition. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  4. 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.

  5. Sex inequality in kidney transplantation rates.

    Science.gov (United States)

    Schaubel, D E; Stewart, D E; Morrison, H I; Zimmerman, D L; Cameron, J I; Jeffery, J J; Fenton, S S

    Men in the United States undergoing renal replacement therapy are more likely than women to receive a kidney transplant. However, the ability to pay may, in part, be responsible for this finding. To compare adult male and female transplantation rates in a setting in which equal access to medical treatment is assumed. Using data from the Canadian Organ Replacement Register, the rate of first transplantations was computed for the 20, 131 men and the 13,458 women aged 20 years or older who initiated renal replacement therapy between January 1, 1981, and December 31, 1996. Poisson regression analysis was used to estimate the male-female transplantation rate ratio, adjusting for age, race, province, calendar period, underlying disease leading to renal failure, and dialytic modality. Actuarial survival methods were used to compare transplantation probability for covariable-matched cohorts of men and women. Men experienced 20% greater covariable-adjusted kidney transplantation rates relative to women (rate ratio, 1.20; 95% confidence interval, 1.13-1.27). The sex disparity was stronger for cadaveric transplants (rate ratio, 1.23) compared with those from living donors (rate ratio, 1.10). The 5-year probability of receiving a transplant was 47% for men and 39% for women within covariable-matched cohorts (P<.001). The sex disparity in transplantation rates increased with increasing age. The sex effect was weaker among whites and Oriental persons (Chinese, Japanese, Vietnamese, Cambodian, Laotian, Filipino, Malaysian, Indonesian, and Korean) and stronger among blacks, Asian Indians (Indian, Pakistani, and Sri Lankan), and North American Indians (aboriginal). Since survival probability and quality of life are superior for patients who undergo transplantation relative to those who undergo dialysis, an increased effort should be made to distribute kidneys available for transplantation more equitably by sex among patients undergoing renal replacement therapy.

  6. A commercial transplant network's perspective of value in solid organ transplantation: Strategizing for value in transplant care.

    Science.gov (United States)

    Irwin, Frank D; Wu, Charlotte; Bannister, Wade M; Bonagura, Anthony F; Laihinen, Bart; Axelrod, David A; Schnitzler, Mark A

    2016-04-01

    Solid organ transplantation has been an area of great interest to commercial payers ever since it moved into mainstream medical care beginning in the 1980s. Over the years a system of evaluating transplant program performance based on volume and one year graft and patient survival has developed. While this system has served its purpose, there is an increasing realization from payers that a need exists for a more sophisticated way to evaluate quality and cost-effectiveness of these complex procedures. We report on the perspective of a large transplant network and its efforts to better understand the drivers of value over the entire continuum of care from referral through one year post-transplant. We evaluated members of a large commercial health plan who were referred for solid organ transplantation between January 1, 2010 and April 30, 2014. A total of 18,453 cases were evaluated for both clinical and economic outcomes. We report on two areas that can impact value over the entire continuum of care. Large variation in clinical practice and cost was noted. The observed variation was independent of inclusion in the transplant network's preferred network. The average pre-transplant and post-transplant costs for kidney, liver and heart transplantation cases at center level showed a variation of between 18 and 250% of the network's average. Clinical outcomes of median days on the waitlist, waitlist mortality and readmission within thirty days after transplant also showed wide variation. There was similar wide variation in cardiac evaluation of transplant candidates despite the existence of published recommendations. We demonstrated that pre-emptive renal transplantation is a high value strategy for this membership independent of donor source. In the studied population the data show wide variation in both clinical and economic parameters related to the transplant process in programs with statistically similar one year patient and graft survival. These results require

  7. A study on the hydrogen behavior and its mitigation in the APR1400 containment during a severe accident

    International Nuclear Information System (INIS)

    Kim, Jong Tae; Hong, Seong Wan; Park, Rae Joon; Kim, Sang Baik

    2005-02-01

    During a hypothetical severe accident in a nuclear power plant (NPP), hydrogen is generated by the active reaction of fuel-cladding and steam in the reactor pressure vessel and released with steam into the containment. In this study, the analysis of the hydrogen and steam behavior during selected severe accidents in the APR1400 containment has been conducted by using the GASFLOW code. For the SBLOCA, hydrogen was accumulated in the containment dome region quickly when only PARSs were used. When the igniters were turned on, a standing flame was formed around a coolant pump and burnt most of the hydrogen blown-out. For the TLOFW accident, the flap-type pressure damper installed at the IRWST vents strongly affected the flow structure of the hydrogen. And by the steam-rich and oxygen starvation conditions in the IRWST, DDT is not likely to occur. For the SBO accident, dry hydrogen was release in the IRWST by the assumption of full condensation of the released steam in the IRWST water. In this case, the possibility of flame acceleration is high in the IRWST and annular compartment. In this study two design modifications were proposed in view of the hydrogen mitigation strategy and their effectiveness was evaluated by the GASFLOW analysis

  8. The fifteenth period report on the cooperative utilization of the AVF cyclotron at Osaka University RCNP (Dec 1982 - Apr 1983)

    International Nuclear Information System (INIS)

    1984-01-01

    The AVF cyclotron at the RCNP (Research Center for Nuclear Physics) of Osaka University has been cooperatively used by various researchers of Japanese universities or colleges. This collective report covers papers concerning various studies performed at the AVF during Dec 1982 to Apr 1983. Some of the titles of these papers are as follows : Elastic scattering of 56 MeV polarized deuterons from 12 C and 40 Ca ; Pionic three-nucleon capture reactions ; Measurement on branching ratios of short-lived beta emitter 23 Mg and its hyperfine interactions ; Half-life and branching ratios of short-lived beta emitter 13 O ; 7 Li excitation of the giant resonances in 208 Pb ; Measurements of spin polarization of residual nuclei after light particle emission in heavy ion reactions ; Target dependence of the sequential alpha decay through the narrow resonances of 20 Ne ; Analyzing power of neutron continuum spectra for the 93 Nb (p,nx) reaction and a simple one step OWBA analysis ; Energy dependence of the reaction mechanism for the 3 He and alpha induced reactions ; Medium energy gamma rays following radiative capture of polarized protons on light nuclei. (Aoki, K.)

  9. Living related donor liver transplantation.

    Science.gov (United States)

    Chen, C L; Chen, Y S; Liu, P P; Chiang, Y C; Cheng, Y F; Huang, T L; Eng, H L

    1997-10-01

    Living related liver transplantation (LRLT) has been developed in response to the paediatric organ donor shortage. According to the International Living Donor Registry, 521 transplants had been performed in 515 patients between December 8 1988 and January 19 1996 in 30 centres worldwide. The overall actuarial patient and graft survival rates were 82.7 and 80%, respectively. Between June 17 1994 and November 30 1996, the authors performed 11 LRLT at the Chung Gung Memorial Hospital. The living donors consisted of 10 mothers and one father. The mean graft weight was 303 g and the mean graft recipient weight ratio was 2.2%. Donor hepatectomy was performed without vascular inflow occlusion. The intra-operative blood loss ranged from 30 mL to 120 mL with an average of 61 mL, and blood transfusion was not required in all donors both intra-operatively and during the postoperative period. Underlying diseases of the recipients were biliary atresia (n = 10) and glycogen storage disease (n = 1). The mean graft cold ischaemia time was 106 min, the mean second warm ischaemia time was 51 min and the mean interval between portal and arterial reperfusion was 81 min. The initial LRLT results were promising with all donors having been discharged without complication. The recipients experienced a few complications, all of which were manageable with early intervention. All 11 recipients are alive and well. These are encouraging results and the authors hope to expand the use of live donors for liver transplantation to cope with demand.

  10. 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

  11. Exploring pharmacodynamics of immunosuppresive agents in transplantation

    NARCIS (Netherlands)

    R. Vafadari (Ramin)

    2013-01-01

    textabstractSupported by advancements in technology, surgical techniques and immunosuppressive drugs, solid organ transplantation has become the preferred solution to end stage organ failure. The first solid organ transplantation was performed in 1954 under supervision of Joseph Murray in the Peter

  12. Diabetes Mellitus in the Transplanted Kidney

    Directory of Open Access Journals (Sweden)

    Vasil ePeev

    2014-08-01

    Full Text Available Diabetes mellitus (DM is the most common cause of chronic kidney disease (CKD and end stage renal disease (ESRD. New onset diabetes mellitus after transplant (NODAT has been described in approximately 30 percent of non-diabetic kidney transplant recipients many years post transplantation. DM in patients with kidney transplantation constitutes a major comorbidity, and has significant impact on the patients and allografts’ outcome. In addition to the major comorbidity and mortality that result from cardiovascular and other DM complications, long standing DM after kidney transplant has significant pathological injury to the allograft, which results in lowering the allografts and the patients’ survivals. In spite of the cumulative body of data on diabetic nephropathy (DN in the native kidney, there has been very limited data on the DN in the transplanted kidney. In this review, we will shed the light on the risk factors that lead to the development of NODAT. We will also describe the impact of DM on the transplanted kidney, and the outcome of kidney transplant recipients with NODAT. Additionally, we will present the most acceptable data on management of NODAT.

  13. Issues in organ procurement, allocation, and transplantation.

    Science.gov (United States)

    Nierste, Deborah

    2013-01-01

    Organ transplantation extends lives and improves health but presents complex ethical dilemmas for nurses caring for donors, recipients, and their families. This article overviews organ procurement and allocation, discusses ethical dilemmas in transplantation, and offers strategies from professional and biblical perspectives for coping with moral distress and maintaining compassionate care.

  14. Liver Transplantation in the Obese Cirrhotic Patient.

    Science.gov (United States)

    Spengler, Erin K; O'Leary, Jacqueline G; Te, Helen S; Rogal, Shari; Pillai, Anjana A; Al-Osaimi, Abdullah; Desai, Archita; Fleming, James N; Ganger, Daniel; Seetharam, Anil; Tsoulfas, Georgios; Montenovo, Martin; Lai, Jennifer C

    2017-10-01

    Despite the rapidly increasing prevalence of obesity in the transplant population, the optimal management of obese liver transplant candidates remains undefined. Setting strict body mass index cutoffs for transplant candidacy remains controversial, with limited data to guide this practice. Body mass index is an imperfect measure of surgical risk in this population, partly due to volume overload and variable visceral adiposity. Weight loss before transplantation may be beneficial, but it remains important to avoid protein calorie malnutrition and sarcopenia. Intensive lifestyle modifications appear to be successful in achieving weight loss, though the durability of these interventions is not known. Pretransplant and intraoperative bariatric surgeries have been performed, but large randomized controlled trials are lacking. Traditional cardiovascular comorbidities are more prevalent in obese individuals and remain the basis for pretransplant cardiovascular evaluation and risk stratification. The recent US liver transplant experience demonstrates comparable patient and graft survival between obese and nonobese liver transplant recipients, but obesity presents important medical and surgical challenges during and after transplant. Specifically, obesity is associated with an increased incidence of wound infections, wound dehiscence, biliary complications and overall infection, and confers a higher risk of posttransplant obesity and metabolic syndrome-related complications. In this review, we examine current practices in the obese liver transplant population, offer recommendations based on the currently available data, and highlight areas where additional research is needed.

  15. Social participation after successful kidney transplantation

    NARCIS (Netherlands)

    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.

    2007-01-01

    Purpose. To explore and describe the degree of social participation after kidney transplantation and to examine associated factors. Method. 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

  16. 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.

  17. Stem Cell Transplants in Cancer Treatment

    Science.gov (United States)

    Stem cell transplants are procedures that restore blood-forming stem cells in cancer patients who have had theirs destroyed by very high doses of chemotherapy or radiation therapy. Learn about the types of transplants and side effects that may occur.

  18. Commercial kidney transplantation: Trends, outcomes and ...

    African Journals Online (AJOL)

    Background/Objective: Many experts believe that commercial organ transplants continue unabated despite international efforts to curb them. The aim was to determine the trends, outcomes and challenges of commercial living unrelated renal transplants (LURT) as seen in our institution. Materials and Methods: A ...

  19. Hematopoietic stem cell transplantation for infantile osteopetrosis

    NARCIS (Netherlands)

    Orchard, Paul J.; Fasth, Anders L.; Le Rademacher, Jennifer L.; He, Wensheng; Boelens, Jaap Jan; Horwitz, Edwin M.; Al-Seraihy, Amal; Ayas, Mouhab; Bonfim, Carmem M.; Boulad, Farid; Lund, Troy; Buchbinder, David K.; Kapoor, Neena; OBrien, Tracey A.; Perez, Miguel A Diaz; Veys, Paul A.; Eapen, Mary

    2015-01-01

    We report the international experience in outcomes after related and unrelated hematopoietic transplantation for infantile osteopetrosis in 193 patients. Thirty-four percent of transplants used grafts from HLA-matched siblings, 13% from HLA-mismatched relatives, 12% from HLA-matched, and 41% from

  20. [Reproduction following kidney transplantation (author's transl)].

    Science.gov (United States)

    Hengst, P; Fischer, W; Scholz, D; May, G; Göbel, U

    1979-01-01

    Reported in this paper are the first two pregnancies and childbirths in the GDR following kidney transplantations. The point is made that pregnancy following kidney transplantation should remain to be a rare exception, though the courses were favourable in both cases described. Reference is made to most suitable forms of anticonception.

  1. Blood-Forming Stem Cell Transplants

    Science.gov (United States)

    ... and suppresses the patient’s immune system to prevent rejection of the transplant. Unlike traditional BMT or PBSCT, ... be given an injection of the donor’s white blood cells. This procedure is called a “ donor ... “tandem transplant” is a type of autologous transplant. This method is being studied ...

  2. Interprofessional communication in organ transplantation in ...

    African Journals Online (AJOL)

    Conclusion. Transplantation in Gauteng is characterised by aspects of good teamwork, and the importance of effective communication is acknowledged. Transplantation also faces some challenges in terms of interprofessional communication. Recommendations for mitigating some of the gaps include integrating a health ...

  3. Urinary tract infection in renal transplant recipients

    African Journals Online (AJOL)

    Abstract. Introduction: Urinary tract infection (UTI) is the commonest bacterial infection occurring in renal transplant recipients, and it is associated with significant morbidity. This study aimed to assess the characteristics of all UTI episodes diagnosed in renal transplant patients who attended regularly for follow up in the ...

  4. Revisional bariatric surgery in a transplant patient

    Directory of Open Access Journals (Sweden)

    Salman Al Sabah

    2017-01-01

    Conclusion: Bariatric surgery is a safe and effective procedure to assist renal transplant patients in losing weight. In addition, it has proven to be effective in the management of the co-morbidities that are associated with renal failure. Our study was also able to prove that converting form an SG to a bypass in a transplant patient is a safe and feasible option.

  5. Graft loss after pediatric liver transplantation

    NARCIS (Netherlands)

    Sieders, E; Peeters, PMJG; TenVergert, EM; de Jong, KP; Porte, RJ; Zwaveling, JH; Bijleveld, CMA; Gouw, ASH; Slooff, MJH

    Objective To describe the epidemiology and causes of graft loss after pediatric liver transplantation and to identify risk factors. Summary Background Data Graft failure after transplantation remains an important problem. It results in patient death or retransplantation, resulting in lower survival

  6. Arab Journal of Nephrology and Transplantation

    African Journals Online (AJOL)

    The Arab Journal of Nephrology and Transplantation is the official publication of the Arab Society of Nephrology and Renal Transplantation. It publishes original articles pertaining to various aspects of renal medicine, as well as editorials, reviews, case reports, short communications, guidelines and statistical data pertaining ...

  7. Hyperthyroidism in a renal transplant recipient.

    Science.gov (United States)

    Peces, R; Navascués, R A; Baltar, J; Laurés, A S; Ortega, F; Alvarez-Grande, J

    1998-01-01

    We report a case of toxic multinodular goiter with severe symptomatic hyperthyroidism in a female diagnosed 5 months after successful renal transplantation. To our knowledge, this is the first well-documented case of hyperthyroidism in a renal transplant recipient that responded well to methimazole. Special attention should be made to the use of methimazole and the possible interaction with immunosuppressive drugs.

  8. Transplantation of the sensitized patient: histocompatibility testing.

    Science.gov (United States)

    Montgomery, Robert A; Leffell, Mary S; Zachary, Andrea A

    2013-01-01

    A component necessary for successful transplantation of the sensitized patient is timely and high quality support from the histocompatibility laboratory that helps guide selection of the best route to transplantation and the clinical care of the patient. Responsibilities of the laboratory include risk assessment, HLA typing, and accurate antibody characterization.

  9. Commercial kidney transplantation: Trends, outcomes and ...

    African Journals Online (AJOL)

    The aim was to determine the trends, outcomes and challenges of commercial living unrelated renal transplants (LURT) as .... Commercial kidney transplants: Trends and outcomes. (22,2%), diabète post-greffe dans sept (15 .... (42.2%) with UTI as the commonest infection, which is in keeping with the known fact that UTI.

  10. Bile acids for liver-transplanted patients

    DEFF Research Database (Denmark)

    Poropat, Goran; Giljaca, Vanja; Stimac, Davor

    2010-01-01

    Liver transplantation has become a widely accepted form of treatment for numerous end-stage liver diseases. Bile acids may decrease allograft rejection after liver transplantation by changing the expression of major histocompatibility complex class molecules in bile duct epithelium and central vein...

  11. Microwave treatment of xenogeneic cartilage transplants

    NARCIS (Netherlands)

    Visser, C. E.; Boon, M. E.; Visser, P. E.; Kok, L. P.

    1989-01-01

    Human rib cartilage was irradiated with microwaves according to six different methods and transplanted into rabbits. Untreated rib cartilage preserved in Cialit served as a control. After 12 and 40 wk of implantation, the microscopic appearance of these xenogeneic cartilage transplants was given a

  12. Solid organ transplants following hematopoietic stem cell transplant in children.

    Science.gov (United States)

    Bunin, Nancy; Guzikowski, Virginia; Rand, Elizabeth R; Goldfarb, Samuel; Baluarte, Jorge; Meyers, Kevin; Olthoff, Kim M

    2010-12-01

    SOT may be indicated for a select group of pediatric patients who experience permanent organ failure following HSCT. However, there is limited information available about outcomes. We identified eight children at our center who received an SOT following an HSCT. Patients were six months to 18 yr at HSCT. Diseases for which children underwent HSCT included thalassemia, Wiskott-Aldrich syndrome, Shwachman-Diamond/bone marrow failure, sickle cell disease (SCD), erythropoietic porphyria (EP), ALL, chronic granulomatous disease, and neuroblastoma. Time from HSCT to SOT was 13 days to seven yr (median, 27 months. Lung SOT was performed for two patients with BO, kidney transplants for three patients, and liver transplants for three patients (VOD, chronic GVHD). Seven patients are alive with functioning allografts 6-180 months from SOT. Advances in organ procurement, operative technique, immunosuppressant therapy, and infection control may allow SOT for a select group of patients post-HSCT. However, scarcity of donor organs available in a timely fashion continues to be a limiting factor. Children who have undergone HSCT and develop single organ failure should be considered for an SOT if there is a high likelihood of cure of the primary disease. © 2010 John Wiley & Sons A/S.

  13. Clinical Significance of Pre- and Post-Transplant BAFF Levels in Kidney Transplant Recipients.

    Directory of Open Access Journals (Sweden)

    Ji Won Min

    Full Text Available It is well known that pre-transplant B cell activating factor (BAFF levels are associated with the development of de novo anti-HLA antibodies and antibody mediated rejection post-transplant. However, the clinical significance of BAFF values at allograft rejection has not been determined. In this study, we investigated the clinical significance of pre-transplant BAFF level as well as post-transplant BAFF levels measured when indication biopsy was done. We checked for anti-HLA antibodies in 115 kidney transplant recipients who required allograft biopsy due to an increase in serum creatinine. With the same serum specimen, we measured BAFF levels, and in 78 of these patients, pre-transplant BAFF and anti-HLA antibody levels were detected as well. Patients in each group were divided into tertiles according to BAFF levels. We investigated the relationship between BAFF levels and the occurrence of anti-HLA antibodies. Pre-transplant BAFF levels showed significant association with pre-transplant sensitization, and also with early rejection (Tertile 3, 26.9% vs. Tertile 1, 11.5%; P<0.05. Post-transplant BAFF levels showed significant association with pre-transplant sensitization, but did not show association with anti-HLA antibodies and positive donor-specific antibodies at the time of biopsy. We did not find any association between post-transplant BAFF levels and allograft biopsy results, Banff scores and microvascular inflammation scores. In conclusion, pre-transplant BAFF levels are associated with pre-transplant sensitization and are useful in predicting allograft rejection. But post-transplant BAFF levels measured at the time of indication biopsy are not associated with the appearance of de novo HLA-DSA, allograft rejection, biopsy findings and other allograft outcomes.

  14. 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.

  15. A transplant of real life.

    Science.gov (United States)

    Diaz, V

    1993-10-01

    A case of steroid-resistant nephrotic syndrome with focal segmental glomerulosclerosis leading to renal failure in a 4-year-old girl is described by her mother, with special emphasis on the problems resulting from recurrence of this disease, with graft loss in three successive kidney transplants. This report chronicles the gradual evolution from a family's initial heavy dependence upon medical solutions to their ultimate primary emphasis upon spiritual values, with medicine seen as the support toward achieving the child's psychological well-being and spiritual growth. The physician's role in balancing medical decision making, non-medical alternatives, and demands on limited and precious resources in such difficult cases is discussed.

  16. Pneumonia in renal transplant patients.

    OpenAIRE

    Bowie, D. M.; Marrie, T. J.; Janigan, D. T.; MacKeen, A. D.; Belitsky, P.; MacDonald, A. S.; Lannon, S. G.; Cohen, A. D.

    1983-01-01

    Between January 1976 and March 1982, 28 episodes of pneumonia occurred in 26 renal transplant patients. The overall mortality rate was 46%. Of the 16 patients with nosocomial pneumonia 9 (56%) died, whereas of the 12 patients with community-acquired pneumonia 4 (33%) died. In all 9 cases of unknown cause the response to empiric treatment was prompt, whereas in 4 of the 10 cases of monomicrobial pneumonia and 8 of the 9 cases of polymicrobial pneumonia the patient died. Cytomegalovirus was the...

  17. [Peritoneal dialysis and renal transplantation].

    Science.gov (United States)

    Marangon, N; Hadaya, K

    2013-01-16

    Individualized prescription of bicarbonate solutions allows one to control metabolic acidosis. Low sodium solutions improve sodium removal and may become available in the future. Varying dwell time and fill volume when intermittent APD is prescribed improves the efficiency of dialysis. Continuous flow peritoneal dialysis can dramatically improves the efficiency of dialysis. Normalized haemoglobin values by epoietin-beta in renal transplant recipients are associated with a better graft survival at 2 years. Switch from calcineurins inhibitors to sirolimus after the first squamous-cell carcinoma lead to significantly longer survival free of cutaneous carcinoma at 2 years. Eculizumab allowed successful prevention and treatment of atypical haemolytic and uremic syndrome episodes.

  18. Sirolimus experience in heart transplantation.

    Science.gov (United States)

    Aranda-Dios, A; Lage, E; Sobrino, J M; Mogollón, M V; Guisado, A; Cabezón, S; Hinojosa, R; Hernández, A; Ordóñez, A

    2006-10-01

    Sirolimus is a potent, nonnephrotoxic immunosuppressant with antiproliferative activity in nonimmune cells. Recent data support the conversion in late renal failure secondary to calcineurin inhibitors (CNIs), with limited experience in de novo regimens in patients with predictive factors of postoperative renal impairment. We evaluated our experience of sirolimus-based immunosuppression administered to 25 heart transplant recipients. A retrospective analysis of 25 heart transplant recipients who received sirolimus included 17 conversions due to late CNI-related chronic renal dysfunction, six patients with a de novo regimen, and two patients who developed posttransplant pulmonary neoplasms. The conversion from CNI to sirolimus was started with 2 mg, with an average time after transplantation of 78 +/- 43 months and a mean baseline serum creatinine level of 2.1 +/- 0.45 mg/dL. The mean clinical follow-up was 17 +/- 9 months postconversion, and included echocardiography and laboratory studies. In the de novo group successive endomyocardial biopsies were performed during the first semester. Serum creatinine fell from 2.1 +/- 0.45 mg/dL to 1.8 +/- 0.51 mg/dL (P = .012). Mean sirolimus levels were 15 +/- 9 ng/mL (doses 2.2 +/- 0.4 mg). This improvement continued until 3 months (creatinine 1.5 +/- 0.35 P < .01)/sirolimus levels 11.7 +/- 5 ng/mL [1.9 +/- 0.7 mg]), with maintenance at 6 months (1.58 +/- 0.3 mg/dL/14 +/- 4 ng/mL [1.85 +/- 0.7 mg]) and 1-year postconversion (1.53 +/- 0.39 mg/dL; P = .019/10.7 +/- 2.5 ng/mL [1.5 +/- 0.7 mg]). De novo, after a mean follow-up of 13 months (range 3 to 35), sirolimus appeared to increase the incidence of a moderate histological grade of rejection without hemodynamic compromise. Side effects were common (63%), including peripheral edema, skin eruptions, and pericardial effusion. Only one patient discontinued treatment, due to intestinal intolerance. Four patients died during follow-up: two because of lung neoplasms and two because

  19. Life after a lung transplant

    DEFF Research Database (Denmark)

    Graarup, Jytte; Mogensen, Elin Lindberg; Missel, Malene

    2017-01-01

    and psychological challenges. The interviewees were happy to get another chance to live, although some of them suffered from medical side effects, postoperative complications and psychological problems. When asked about the future, interviewees stated that life could be described as (3) a balance of joy...... and challenges. They had received a new chance in life and were eager to fulfil their life hopes and dreams. At the same time, they were worried about the future. Having a lung transplant implies rules that have to be followed. What are the healthy choices they are supposed to make? And will there be a tomorrow...

  20. Hematopoietic stem cell transplantation in Algeria.

    Science.gov (United States)

    Bekadja, Mohamed Amine; Brahimi, Mohamed; Osmani, Soufi; Yafour, Nabil; Krim, Amina; Serradj, Faiza; Talhi, Souad; Amani, Kamila; Bouhass, Rachid Amar

    2017-12-01

    Algeria is a country of 40.4 million inhabitants and half of which is under 30years. In Algeria, Health-care insurance covered, 90% of the population. Health care is free and it is supported by the Ministry of Health. 16 university hospitals exist in Algeria and only two (Algiers and Oran) practicing bone marrow transplant. Adult hematologic malignancies account for 10% (about 4000 new cases/year) of the malignancy affecting in most cases young patients under 65years of age. In 2016, 270 transplants were performed in total (Algiers+Oran), including 149 allografts (related donor transplants: 99%) and 121 autografts. 98% of transplants are done in adults and only 2% in children with cord blood transplants. In summary for the two transplant centers, the predominant types of transplantation performed are allogeneic transplant in 55% and autologous transplant in 45%. The particularity of EHU1st November in Oran, is the use of non-cryopreserved stem cells. Stem cell was mobilized using G-CSF alone and the grafts were kept in a conventional blood bank refrigerator at +4°C until reinfusion on day 0. The outcome with non-cryopreserved stem cells are the same as those with cryopreserved stem cells and we conclude that autologous transplant with non cryopreserved hematopoietic stem cells (HSC) is a simple, effective and safe method and the cryopreservation is not necessary in our work conditions in developing countries. The projects are achieving the autograft in all University Hospitals with non cryopreserved HSC, achieving a center allograft in the east of the country and the development of bone marrow transplantation in children. Currently in Algeria, the number of transplantation is insufficient and the development of new transplant centers is essential. In the future, we hope to implement the National Society of Bone Marrow transplant and also the National recipient registry and Donor registry in Algeria. Copyright © 2017 King Faisal Specialist Hospital & Research

  1. Neurological complications of solid organ transplantation

    Directory of Open Access Journals (Sweden)

    José Luiz Pedroso

    Full Text Available ABSTRACT Solid organ transplantation is a significant development in the treatment of chronic kidney, liver, heart and lung diseases. This therapeutic approach has increased patient survival and improved quality of life. New surgical techniques and immunosuppressive drugs have been developed to achieve better outcomes. However, the variety of neurological complications following solid organ transplantation is broad and carries prognostic significance. Patients may have involvement of the central or peripheral nervous system due to multiple causes that can vary depending on time of onset after the surgical procedure, the transplanted organ, and the intensity and type of immunosuppressive therapy. Neurological manifestations following solid organ transplantation pose a diagnostic challenge to medical specialists despite extensive investigation. This review aimed to provide a practical approach to help neurologists and clinicians assess and manage solid organ transplant patients presenting with acute or chronic neurological manifestations.

  2. 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)

  3. Antiradiation effect of thymus transplantation in mice

    International Nuclear Information System (INIS)

    Shen Shiren; Liu Shouli; Su Yuanfu

    1985-01-01

    Thymus is an important organ of the immune system and is involved in the regulation of blood cell formation. Thymus transplantation can reconstitute the immune system to a certain extent in immunodeficiencies. The results of our primary experiment showed that thymus transplantation could increase the survival rate of lethally irradiated mice. The survival rate in the group with thymus transplanted in abdominal wall was higher than that in the group with the organ transplanted in peritoneum. In the recovery period, the labelling index of bone marrow cells in the former group was significantly higher than that in the controls. After 3 months of transplantation, no significant immunologic rejection was observed histologically either in the mice with syngenetic thymic graft or in the mice with homograft

  4. Cancer risk and mortality after kidney transplantation

    DEFF Research Database (Denmark)

    Engberg, Henriette; Wehberg, Sonja; Bistrup, Claus

    2016-01-01

    BACKGROUND: Kidney recipients receive immunosuppression to prevent graft rejection, and long-term outcomes such as post-transplant cancer and mortality may vary according to the different protocols of immunosuppression. METHODS: A national register-based historical cohort study was conducted......, the Danish National Cancer Registry and the Danish National Patient Register were used. A historical cohort of 1450 kidney recipients transplanted in 1995-2005 was followed up with respect to post-transplant cancer and death until 31 December 2011. RESULTS: Compared with Center 1 the adjusted post...... to examine whether post-transplant cancer and all-cause mortality differed between Danish renal transplantation centres using standard immunosuppressive protocols including steroids (Centres 2, 3, 4) or a steroid-free protocol (Centre 1). The Danish Nephrology Registry, the Danish Civil Registration System...

  5. Histoplasmosis hepatitis after orthotopic liver transplantation.

    Science.gov (United States)

    Washburn, Laura; Galván, N Thao; Dhingra, Sadhna; Rana, Abbas; Goss, John A

    2017-12-01

    Histoplasmosis is an endemic mycosis in the Ohio and Mississippi River valleys and can cause disseminated infection in immunocompromised hosts. Disseminated histoplasmosis is often respiratory in nature and most cases in transplant patients occur within 2 years post-transplantation. A 32-year-old male on mycophenolate and tacrolimus who underwent an orthotopic liver transplantation 10 years prior presented with generalized body aches, fevers, mild congestion, dysuria and elevated transaminases. Liver biopsy revealed epithelioid granulomas with narrow-based budding yeast, suggesting histoplasma. Liver involvement in disseminated histoplasmosis is well characterized however the disease is usually pulmonary in origin. Only three other case reports describe isolated granulomatous hepatitis, and this is the first to our knowledge to occur in a liver transplant allograft. A high index of suspicion is essential for diagnosis and prompt treatment of histoplasmosis in transplant patients considering their immunocompromised state.

  6. 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.)

  7. THE ISLAMIC ETHICS OF MITOCHONDRIA TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

  9. 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

  10. 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)

  11. 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.

  12. [Eye banks and available transplants].

    Science.gov (United States)

    Slettedal, Jon Klokk; Drolsum, Liv; Ramstad, Hanne; Nicolaissen, Bjørn

    2008-04-17

    Eye banks have procured, processed and stored donor corneas for decades. In parallel, new techniques have emerged employing allogeneic transplantation of various cells and tissues from the eye banks. This progress is a consequence of increased knowledge of stem cells, cell kinetics and immunological aspects and improved techniques for cell culturing, tissue storage and microsurgery. Review article on available transplants for treating eye diseases, based on experience with eye banking, clinical ophthalmological practice, own research and literature retrieved from PubMed, Medline and www.google.com. Treatment techniques for eye diseases, which require biological material for grafting, need efficient eye banks for continuous supply of donor material of high quality. New Norwegian legislation, based on implementation of EU Directive 2004/23/EC, demands authorization of all eye banks. The EU Directive sets high and rigorous standards for quality and safety for donation, procurement, testing, processing, storage and distribution of tissues and cells. Well-run eye banks are of great importance for modern treatment of patients suffering from eye diseases and for progress and research in ophthalmology.

  13. [Biliary complications after liver transplant].

    Science.gov (United States)

    Lladó, Laura; Fabregat, Joan; Ramos, Emilio; Baliellas, Carme; Torras, Jaume; Rafecas, Antoni

    2012-01-01

    There have been biliary complications since the beginning of liver transplants, and is a topic of great interest due to its high incidence, as well as their influence on morbidity and mortality. The biliary fistula is currently uncommon and its management is straightforward. Anastomotic stenosis continues to have an incidence of 10-15%. Although the current treatment of choice is endoscopic retrograde cholangiopancreatography (ERCP), surgical treatment (hepatico-jejunostomy) continues to have an important role. Non-anastomotic stenosis has an incidence of 5-10%, and is associated with ischaemic or immunological factors, and usually involves a re-transplant. Choledocholithiasis has an incidence of 5-10%, with the treatment of choice being ERCP. However the treatment of biliary complications should be individualised. We must take into account, liver function, the general health status of the patient, and the availability and experience of the team in the different therapeutic options. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

  14. 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 organ trafficking. National effort to achieve self-sufficiency by increasing activities for organ donations is one of the fundamental solutions to transplant tourism.

  15. Outcomes of Pediatric Kidney Transplantation in Recipients of a Previous Non-Renal Solid Organ Transplant.

    Science.gov (United States)

    Hamdani, G; Zhang, B; Liu, C; Goebel, J; Zhang, Y; Nehus, E

    2017-07-01

    Children who receive a non-renal solid organ transplant may develop secondary renal failure requiring kidney transplantation. We investigated outcomes of 165 pediatric kidney transplant recipients who previously received a heart, lung, or liver transplant using data from 1988 to 2012 reported to the United Network for Organ Sharing. Patient and allograft survival were compared with 330 matched primary kidney transplant (PKT) recipients. Kidney transplantation after solid organ transplant (KASOT) recipients experienced similar allograft survival: 5- and 10-year graft survival was 78% and 60% in KASOT recipients, compared to 80% and 61% in PKT recipients (p = 0.69). However, KASOT recipients demonstrated worse 10-year patient survival (75% KASOT vs. 97% PKT, p transplants performed from 2006 to 2012 were separately investigated. Since 2006, KASOT and PKT recipients had similar 5-year graft survival (82% KASOT vs. 83% PKT, p = 0.48), although 5-year patient survival of KASOT recipients remained inferior (90% KASOT vs. 98% PKT, p Transplantation and the American Society of Transplant Surgeons.

  16. Clinical Significance of Pre- and Post-Transplant BAFF Levels in Kidney Transplant Recipients.

    Science.gov (United States)

    Min, Ji Won; Kim, Kyoung Woon; Kim, Bo-Mi; Doh, Kyoung Chan; Choi, Min Seok; Choi, Bum Soon; Park, Cheol Whee; Yang, Chul Woo; Kim, Yong-Soo; Oh, Eun-Jee; Chung, Byung Ha

    2016-01-01

    It is well known that pre-transplant B cell activating factor (BAFF) levels are associated with the development of de novo anti-HLA antibodies and antibody mediated rejection post-transplant. However, the clinical significance of BAFF values at allograft rejection has not been determined. In this study, we investigated the clinical significance of pre-transplant BAFF level as well as post-transplant BAFF levels measured when indication biopsy was done. We checked for anti-HLA antibodies in 115 kidney transplant recipients who required allograft biopsy due to an increase in serum creatinine. With the same serum specimen, we measured BAFF levels, and in 78 of these patients, pre-transplant BAFF and anti-HLA antibody levels were detected as well. Patients in each group were divided into tertiles according to BAFF levels. We investigated the relationship between BAFF levels and the occurrence of anti-HLA antibodies. Pre-transplant BAFF levels showed significant association with pre-transplant sensitization, and also with early rejection (Tertile 3, 26.9% vs. Tertile 1, 11.5%; PBAFF levels showed significant association with pre-transplant sensitization, but did not show association with anti-HLA antibodies and positive donor-specific antibodies at the time of biopsy. We did not find any association between post-transplant BAFF levels and allograft biopsy results, Banff scores and microvascular inflammation scores. In conclusion, pre-transplant BAFF levels are associated with pre-transplant sensitization and are useful in predicting allograft rejection. But post-transplant BAFF levels measured at the time of indication biopsy are not associated with the appearance of de novo HLA-DSA, allograft rejection, biopsy findings and other allograft outcomes.

  17. Impact of transplant nephrectomy on peak PRA levels and outcome after kidney re-transplantation.

    Science.gov (United States)

    Tittelbach-Helmrich, Dietlind; Pisarski, Przemyslaw; Offermann, Gerd; Geyer, Marcel; Thomusch, Oliver; Hopt, Ulrich Theodor; Drognitz, Oliver

    2014-06-24

    To determine the impact of transplant nephrectomy on peak panel reactive antibody (PRA) levels, patient and graft survival in kidney re-transplants. From 1969 to 2006, a total of 609 kidney re-transplantations were performed at the University of Freiburg and the Campus Benjamin Franklin of the University of Berlin. Patients with PRA levels above (5%) before first kidney transplantation were excluded from further analysis (n = 304). Patients with graft nephrectomy (n = 245, NE+) were retrospectively compared to 60 kidney re-transplants without prior graft nephrectomy (NE-). Peak PRA levels between the first and the second transplantation were higher in patients undergoing graft nephrectomy (P = 0.098), whereas the last PRA levels before the second kidney transplantation did not differ between the groups. Age adjusted survival for the second kidney graft, censored for death with functioning graft, were comparable in both groups. Waiting time between first and second transplantation did not influence the graft survival significantly in the group that underwent nephrectomy. In contrast, patients without nephrectomy experienced better graft survival rates when re-transplantation was performed within one year after graft loss (P = 0.033). Age adjusted patient survival rates at 1 and 5 years were 94.1% and 86.3% vs 83.1% and 75.4% group NE+ and NE-, respectively (P PRA levels that normalize before kidney re-transplantation. In patients without nephrectomy of a non-viable kidney graft timing of re-transplantation significantly influences graft survival after a second transplantation. Most importantly, transplant nephrectomy is associated with a significantly longer patient survival.

  18. Combinaison de la chaîne de valeur du poisson après récolte et des ...

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

    Combinaison de la chaîne de valeur du poisson après récolte et des interventions favorisant le changement social en Zambie et au Malawi (CultivAf). Bien que les ressources halieutiques soient un moyen de subsistance essentiel pour 700 millions de personnes dans le monde, elles ne sont pas exploitées à leur plein ...

  19. L'endométriose pariétale cicatricielle après césarienne: une entité rare

    African Journals Online (AJOL)

    L'endométriose de la paroi est une entité clinique rare, dont la physiopathologie demeure imprécise. Elle survient le plus souvent après une intervention chirurgicale gynécologique ou obstétricale. Nous rapportons le cas d'une patiente présentant une douleur cyclique, au niveau de la cicatrice de césarienne, Avec à ...

  20. Pesquisa dos genes lipA e aprX em linhagens de Corynebacterium bovis, e seu crescimento sob refrigeração

    OpenAIRE

    Victória, Cassiano [UNESP; Silva, Rodrigo Costa da [UNESP; Romão, Felipe Gazza [UNESP; Langoni, Helio [UNESP

    2011-01-01

    Some microorganisms frequently found in the raw milk of mastitics animals have the hability of multiplying in low temperatures, being called of psychotropic, and in this group, some have still the capacity to produce term steady enzymes that degrade proteins and fats, promoting relevant alterations in long periods stored milk. The present study aimed to determine if Corynebacterium bovis has the capacity to multiply in low temperature and if it had aprX and lipA genes, producing enzymes that ...