Current Issue : July - September Volume : 2020 Issue Number : 3 Articles : 5 Articles
Neurological complications are common after liver transplantation, as they affect up to one-third of the transplanted patients and\nare associated with significant morbidity. The introduction of calcineurin inhibitors, cyclosporine A and tacrolimus, in immunosuppressive\nregimens significantly improved the outcome of solid-organ transplantation even though immunosuppressionassociated\nneurotoxicity remains a significant complication, particularly occurring in about 25% of cases after liver transplantation.\nThe immunosuppressant cyclosporine A and tacrolimus have been associated with the occurrence of major neurological\ncomplications, diffuse encephalopathy being the most common. The biochemical and pathogenetic basis of calcineurin\ninhibitors-induced neurotoxicity are still unclear although several mechanisms have been suggested. Early recognition of\nsymptoms could help reduce neurotoxic event. The aim of the study was to evaluate cerebral changes through MRI, in particular\nwith diffusion-weighted images (DWI) and apparent diffusion coefficient (ADC) maps, in two patients undergoing liver\ntransplantation after immunosuppressive therapy. We describe two patients in which clinical pictures, presenting as a severe\nneurological condition, early after orthotopic liver transplantation during immunosuppression therapy, showed a different\nevolution in keeping with evidence of focal-multifocal lesions at DWI and ADC maps. At clinical onset, DWI showed\nhyperintensity of the temporo-parieto-occipital cortex with normal ADC values in the patient with following good clinical\nrecovery and decreased values in the other one; in the latter case, MRI abnormalities were still present after ten days, until the\npatientâ??s exitus. The changes in DWI with normal ADC may be linked to brain edema with a predominant vasogenic component\nand therefore reversible, while the reduction in ADC is due to cytotoxic edema and linked to more severe, nonreversible, clinical\npicture. Brain MRI and particularly DWI and ADC maps provide not only a good and early representation of neurological\ncomplications during immunosuppressant therapy but can also provide a useful prognostic tool on clinical outcome of the patient....
Epstein-Barr virus (EBV) is a ubiquitous virus belonging to the human....................
Cell therapy for central nervous system (CNS) disorders is beginning to prove its safety and efficiency. Intraparenchymal\ntransplantation can be an option for cell delivery; however, one concern regarding this method is that the transplantation\ncannula may cause additional brain injuries. These include vessel damage, which results in brain hemorrhage, and clogging of\nthe cannula by brain debris and/or cell clusters, which requires replacement of the cannula or forced injection causing jet flow\nof the cell suspension. We compared cannulas for cell delivery used in clinical trials, the Pittsburg and Mizuho cannulas, to a\nnewly designed one, MK01, to assess their usability. MK01 has a spherical-shaped tip with a fan-like open orifice on the side of\nthe cannula, which prevents vessel damage, clogging of brain debris, and jet flow phenomenon. We compared the extent of rat\ncervical and abdominal arterial damage with the cannula, the amount of debris in the cannula, the force needed to cause jet\nflow, and cell viability. While the viability of cells passed through the cannulas was almost the same among cannulas\n(approximately 95%), the Pittsburg cannula caused cervical arterial injury and subsequent hemorrhage, as it required a\nsignificantly smaller force to penetrate the arterial wall. Moreover, the Pittsburg cannula, but not the Mizuho and MK01\ncannulas, showed high frequency of brain debris in the needle tip (approximately 80%) after brain puncture. While jet flow of\nthe injection liquid was observed even when using smaller forces in the Pittsburg and Mizuho cannulas, MK01 constantly\nshowed low jet flow occurrence. Thus, MK01 seems to be safer than the previously reported cannulas, although further\ninvestigation is necessary to validate its safety for clinical use....
Growth differentiation factor 15 (GDF-15) is strongly associated with cardiovascular disease (CVD). The aim of our study was to\nevaluate plasma and urinary levels of GDF-15 after pediatric renal transplantation (Rtx) and in children with chronic kidney\ndisease (CKD) and its associations to cardiovascular risk factors. In this cross-sectional study, GDF-15 was measured in plasma\nand urine from 53 children with a renal transplant and 83 children with CKD and related to cardiovascular risk factors\n(hypertension, obesity, and cholesterol) and kidney function. Forty healthy children served as a control group. Plasma levels of\nGDF-15 (median and range) for a Tx (transplantation) cohort, CKD cohort, and healthy controls were, respectively, 865 ng/L\n(463-3039 ng/L), 508 ng/L (183-3279 ng/L), and 390 ng/L (306-657 ng/L). The CKD and Tx cohorts both had significantly\nhigher GDF-15 levels than the control group........................
Background: Respiratory infections are a major threat for lung recipients. We aimed to compare with a\nmonocentric study the impact of late viral and bacterial respiratory infections on the graft function.\nMethods: Patients, who survived 6 months or more following lung transplantation that took place between 2009\nand 2014, were classified into three groups: a viral infection group (VIG) (without any respiratory bacteria), a\nbacterial infection group (BIG) (with or without any respiratory viruses), and a control group (CG) (no documented\ninfection). Chronic lung allograft dysfunction (CLAD) and acute rejection were analysed 6 months after the inclusion\nin the study.\nResults: Among 99 included lung recipients, 57 (58%) had at least one positive virological respiratory sample\nduring the study period. Patients were classified as follows: 38 in the VIG, 25 in the BIG (among which 19 coinfections\nwith a virus) and 36 in the CG. The BIG presented a higher initial deterioration in lung function...................................
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