Chapter category: Transplant
Islet Transplantation
Chronic Allograft Failure:
Natural History, Pathogenesis,
Diagnosis and Management
Edited by: Nasimul AhsanISBN: 978-1-58706-153-0
» Get more information about this book at landesbioscience.com «
Chapter authors:
Breay W. Paty and A.M. James Shapiro
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Breay W. Paty
Department of Medicine, Clinical Islet Transplant Program, University of Alberta
A.M. James Shapiro
Department of Surgery, University of Alberta
Additional chapters from this book:
Pancreas and Islet Allograft Failure
Patrick G. Dean, Yogish Kudva and Mark D. Stegall
The treatment of diabetes mellitus is aimed at improving glycemic control. Establishing relatively tight control using exogenous insulin has been shown to reduce the ophthal‑mologic, neurologic ...
Cytomegalovirus and Allograft Failure after Solid Organ Transplantation
Hugo Bonatti, Walter C. Hellinger and Raymund R. Razonable
Allograft rejection and infections are the two major complications of solid organ transplantation. These clinical entities are intimately interrelated, with one predisposing to the other, in a bidirec...
Polyomavirus Type BK‑Associated Nephropathy and Renal Allograft Graft Loss: Natural History, Patho‑Physiology, Diagnosis and Management
Nasimul Ahsan
In recent years, polyomavirus type BK‑associated nephropathy (PVAN) has emerged as an important cause of renal allograft dysfunction and graft loss. It is estimated to affect up to 10% of renal ...
Experimental Gene Therapy of Heart Transplantation
Giuseppe Vassalli, Charles Seydoux, Pierre Vogt, Manuel Pascual and Ludwig K. von Segesser
Maintenance of a functional graft requires life‑long immuno-suppression to prevent rejection by the immune system. Unfortunately, current immunosuppressive agents do not effectively prevent chro...
Renal Allograft Survival: Epidemiologic Considerations
Titte R. Srinivas and Herwig-Ulf Meier-Kriesche
Kidney transplantation is the treatment of choice for patients with end‑stage renal disease. From initial pioneering experiences 50 years ago, kidney transplantation has become a clinical realit...
Islet of Langerhans: Cellular Structure and Physiology
Amanda Jabin Gustafsson and Md. Shahidul Islam
Islets of Langerhans, named after their discoverer Paul Langerhans, constitute a unique endocrine organ of critical importance in the metabolism of nutrients and energy homeostasis. Individual islets ...
The Immunology of Chronic Allograft Injury
Raphael Thuillier and Roslyn B. Mannon
The causes of chronic graft injury are diverse and are dependant on the recipient, donor organ and immunosuppressive strategy. In this chapter, we explore the contribution of the immune system to this...
Diagnosis of Chronic Graft Failure after Lung Transplantation
David B. Erasmus, Andras Khoor and Cesar A. Keller
Since 1984, when bronchiolitis obliterans (BO) was recognized as the main factor influencing long‑term survival after lung and heart‑lung transplantation, this condition has remained the m...
The Role for Cytokine Responses in the Pathogenesis of Lung Allograft Dysfunction
John A. Belperio, Brigette Gomperts, Samuel Weigt and Michael P. Keane
Lung transplantation is now considered to be a therapeutic option for patients with end‑stage pulmonary disorders. However, due to problems of allograft dysfunction, 5 year survival rates are on...
Dendritic Cell‑Based Approaches to Organ Transplantation
Andrea Meinhardt and Giuseppe Vassalli
Dendritic cells (DCs) take up antigens at peripheral sites and migrate to T‑cell areas of lymph nodes and spleen, where they present antigenic peptides to T‑cells. As such, DCs initiate in...
Late Allograft Failure: Liver
Jeffrey S. Crippin
Dysfunction and subsequent loss of a liver allograft can have dire consequences for the recipient. Acute and chronic rejection, an ongoing risk for the lifetime of the allograft in the vast majority o...
Predictive Parameters of Graft Failure
Paola Romagnani
The incidence of end stage renal disease (ESRD) is increasing at a faster rate than the availability of kidney donors, but unfortunately the improvement in short‑term graft survival rates has no...
Analyzing Graft Failure in the Scientific Registry of Transplant Recipients: The Sources and Nature of the Data Available
David M. Dickinson, Gregory N. Levine, Douglas E. Schaubel and Robert A. Wolfe
This chapter uses information from a series of articles published in previous editions of the SRTR Report on the State of Transplantation and the OPTN/SRTR Annual Report to assemble a practical backgr...
Pathology of Kidney Allograft Dysfunction
Bela Ivanyi
The pathologic features, clinical correlations and differential diagnoses of the major causes of kidney allograft dysfunction are reviewed. Rejection is an inflammatory process of the recipient during...
Liver Allograft Failure Due to Recurrent Disease: Pathology
Urmila Khettry and Atoussa Goldar-Najafi
Liver transplantation (LT) is an acceptable mode of therapy for end‑stage liver diseases of varying etiology. With the exception of certain disorders of genetic and toxic etiology, most other di...
The Basic Science of Lung Allograft Failure
Trudie Goers, Ryan Fields and Thalachallour Mohanakumar
Although great strides have been made in the field of lung transplantation with respect to surgical technique, treatment of acute rejection and post‑operative management, the long term success o...
Treatment of Chronic Graft Failure after Lung Transplantation
Francisco G. Alvarez and Cesar A. Keller
Since lung transplantation became a reality 25 years ago, improvements in lung preservation, surgical techniques and post‑operative management have improved the 1‑year patient survival to ...
Ischemia‑Reperfusion Injury: Pathophysiology and Clinical Approach
Maria Teresa Gandolfo and Hamid Rabb
Significant ischemia‑reperfusion injury (IRI) occurs in every deceased donor organ transplant and in some live donor ones. In renal transplants, it remains the leading contributor to delayed gra...
Chronic Allograft Dysfunction—Liver
Susan Lerner, Pauline Chen and Paul Martin
In the United States, more than six thousand patients undergo liver transplantation (LT) annually with generally excellent outcomes reflected in patient survival of 88% at one year and 80% at three ye...
Graft Loss due to Vascular Complications
Barbara Stange, Matthias Glanemann and Natascha C. Nüssler
Vascular complications occur in about 10% of patients undergoing orthotopic liver transplantation. Depending on the involved vessels and the time point after liver transplantation, the clinical course...
Pharmacotherapeutic Options in Solid Organ Transplantation
Jennifer Trofe, Anikphe Imoagene-Oyedeji and Roy D. Bloom
Over the past decade, advances in immunosuppressive therapies have resulted in lower rates of acute rejection and consequently, significant improvements in patient and graft survival after solid organ...
Heat Shock Protein 47 in Chronic Allograft Nephropathy
Takashi Taguchi and Mohammed Shawkat Razzaque
Chronic allograft nephropathy (CAN), associated with late allograft dysfunction is caused by alloantigen‑dependent and ‑independent mechanisms that eventually progresses to irreversible in...
Cardiac Allograft Vasculopathy
Jignesh K. Patel and Jon A. Kobashigawa
Over the last four decades, cardiac transplantation has been the preferred therapy for select patients with end‑stage heart disease. Improvements in immunosuppression, donor procurement, surgica...
Pathological Aspects of Pancreas Allograft Failure
Cinthia B. Drachenberg and John C. Papadimitriou
Pancreas allograft failure results from a variety of causes, highly dependent on the time posttransplantation. In the early posttransplantation period pancreas allograft failure is usually related to ...
Metabolic Indicators of Islet Graft Dysfunction
Raquel N. Faradji, Kathy Monroy, Misha Denham, Camillo Ricordi and Rodolfo Alejandro
Assessing b‑cell mass and function is of great importance in the islet transplant setting but it has been challenging. Although achieving insulin independence has been one of the most important ...
The Graft: Emerging Viruses in Transplantation
Deepali Kumar and Atul Humar
Emerging infections have become increasingly recognized as causes of morbidity, mortality, graft dysfunction, graft failure and donor‑transmitted infections. Specifically, a number of emerging v...
Hepatitis C Virus Infection as a Risk Factor for Graft Loss after Renal Transplantation
José M. Morales and B. Dominguez-Gil
Liver disease is an important complication after renal transplantation and Hepatitis C virus (HCV) infection is the most frequent cause of liver disease. Clinical course is irrelevant in the shortR...
Hepatic Allograft Loss: Pathogenesis, Diagnosis and Management
Mohammad Ali
Liver transplantation is the established therapeutic modality for the treatment of both acute and chronic end stage liver disease. After successful transplantation 85% recipients usually survive one y...
Solid Organ Transplantation—An Overview
Roy D. Bloom, Lee R. Goldberg, Andrew Y. Wang, Thomas W. Faust and Robert M. Kotloff
Human solid organ transplantation became a reality in 1954 with the performance of the first successful kidney transplant by Dr. Joseph Murray and colleagues. The ensuing 15‑20 years witnessed a...
Recurrent Glomerular Disease in the Allograft: Risk Factors and Management
Hani M. Wadei, Xochiquetzal J. Geiger and Martin L. Mai
In contrast to the major improvement in immunologically mediated allograft loss, little advances have been made in the area of recurrent glomerular disease which currently stands as the third leading ...
Chronic Allograft Failure: Past, Present and Future
Basit Javaid and John D. Scandling
Transplantation is the treatment of choice for irreversible organ damage. According to United Network for Organ Sharing (UNOS) data, by the end of June 2007, 400,291 solid organ transplants had been p...
Chronic Allograft Enteropathy
Gonzalo P. Rodriguez-Laiz and Kishore R. Iyer
Current immunosuppression has made small bowel transplantation the standard of care for patients with short bowel syndrome who face complications of total parenteral nutrition (TPN). With standardizat...
The Pathology of Heart Allograft Rejection
Jon Carthy, Heather Heine, Alice Mui and Bruce McManus
In 1905, the innovative French surgeon Alexis Carrel performed the first heterotopic canine heart transplant with Charles Guthrie. Twenty years later, the concept of cardiac allograft rejection was pr...
Liver Transplantation—An Overview
Tiffany E. Kaiser, E. Steve Woodle and Guy W. Neff
Liver transplantation has offered thousands of patients a new lease on life. The improvements in survivals are attributed to the various treatment modalities before and after liver transplantation. Ce...
Polyomavirus Allograft Nephropathy: Clinico‑Pathological Correlations
Volker Nickeleit and Harsharan K. Singh
Polyomavirus nephropathy (PVN) is primarily caused by a productive intra‑renal BK virus infection. It is often an iatrogenic complication due to long term over immunosuppression and frequently l...
Islet Transplantation
Breay W. Paty and A.M. James Shapiro
Islet transplantation restores endogenous insulin secretion in individuals with type 1 diabetes by infusing insulin‑secreting islet cells, isolated from cadaveric pancreata, into the liver. The ...
Clinico-Pathological Correlations of Chronic Allograft Nephropathy
Jeremy R. Chapman
Despite, or perhaps because of, common usage “CAN” is a poorly defined term. At Westmead we combine both pathology and physiology to arrive at the following definition: “Progressive graft dysfunction ...
Chronic Pancreas Allograft Failure
Elizabeth K. Gross and Rainer W.G. Gruessner
Apancreas transplant is the only treatment of diabetes mellitus that establishes long‑term insulin independence. As of December 31, 2006, about 20,000 pancreas transplants had been performed in ...
Introducing Chronic Graft Failure
Harold C. Yang
Over the past 50 years the short‑term improvement in one year graft survival in solid organ transplantation has improved dramatically. The latest statistics from the Scientific Registry of Trans...
