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American Journal of Transplantation

Cover image for Vol. 8 Issue 12

December 2008

Volume 8, Issue 12

Pages 2481–2694

  1. The AJT Report

    1. Top of page
    2. The AJT Report
    3. Editorials
    4. Special Articles
    5. Meeting Report
    6. Personal Viewpoint
    7. Original Articles
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      News and issues that affect organ and tissue transplantation (pages 2481–2482)

      SUE PONDROM

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02496_1.x

      This month The AJT Report looks at how CMS regulations on transplantation outcome measures could affect which patients are selected to receive transplants, as well as new research that is re-igniting the debate over timing of death.

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      Debate Renews over Timing of Death (page 2482)

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02496_2.x

      This month The AJT Report looks at how CMS regulations on transplantation outcome measures could affect which patients are selected to receive transplants, as well as new research that is re-igniting the debate over timing of death.

  2. Editorials

    1. Top of page
    2. The AJT Report
    3. Editorials
    4. Special Articles
    5. Meeting Report
    6. Personal Viewpoint
    7. Original Articles
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      SOFT Endpoints in Liver Transplantation (pages 2483–2484)

      R. B. Freeman, Jr

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02452.x

      Accurately predicting liver transplant outcomes is complicated by numerous variables with only some being captured by the UNOS/OPTN database limiting the usefulness of predictive statistical models. See also article by Rana et al in this issue on page 2537.

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      Downstaging of Hepatocellular Carcinoma Before Transplantation: An Advance in Therapy or Just Another Selection Criterion (pages 2485–2486)

      ChungMau Lo

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02466.x

      Down-staging before liver transplant may not change the behavior of hepatocellular carcinoma beyond Milan criteria but it may select those with a more favorable biology. See also article by Ravaioli et al in this issue on page 2547.

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      Pediatric Kidney Transplantation in the United States: The Current Realities (pages 2487–2488)

      Francis L. Delmonico and William E. Harmon

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02453.x

      It is unclear why such a large percentage of the pediatric list remains inactive for an extended period of time when deceased donors are available and the mortality on the list is high. See also article by Gillen et al in this issue on page 2600.

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      Rituximab in Pediatric Renal Transplantation: A Treatment for Allograft Rejection with B-Cell Infiltrates? (pages 2489–2490)

      M. S. Zand

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02454.x

      A recent pediatric pilot of rituximab for treatment of renal allograft rejections with B cell infiltrates is intriguing, but much more data and adequately powered clinical trials are needed to determine whether therapy is efficacious. See also article by Zarkhin et al in this issue on page 2607.

  3. Special Articles

    1. Top of page
    2. The AJT Report
    3. Editorials
    4. Special Articles
    5. Meeting Report
    6. Personal Viewpoint
    7. Original Articles
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      Preventable Death: Children on the Transplant Waiting List (pages 2491–2495)

      S. V. McDiarmid, W. S. Cherikh and S. C. Sweet

      Version of Record online: 27 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02443.x

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      For children on the transplant waiting list, the highest risk group for death is young children. Means for prevention of these deaths may include broader allocation of small donor organs to small recipients and improvements in pediatric donor supply.

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      Transplant Center Regulations—A Mixed Blessing? An ASTS Council Viewpoint (pages 2496–2502)

      M. M. Abecassis, R. Burke, A. B. Cosimi, A. J. Matas, R. M. Merion, D. Millman, J. P. Roberts, G. B. Klintmalm and on behalf of the American Society of Transplant Surgeons

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02434.x

      The Transplant Center Conditions of Participation regulations published by the Centers for Medicare and Medicaid (CMS) raise important issues relevant to the regulations.

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      Improving Organ Transplantation in the United States—A Regulatory Perspective (pages 2503–2505)

      T. E. Hamilton

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02446.x

      The CMS provides their perspective and responds to some of the issues raised by the ASTS viewpoint.

  4. Meeting Report

    1. Top of page
    2. The AJT Report
    3. Editorials
    4. Special Articles
    5. Meeting Report
    6. Personal Viewpoint
    7. Original Articles
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      Improving Long-Term Outcomes After Liver Transplantation in Children (pages 2506–2513)

      J. C. Bucuvalas, E. Alonso, J. C. Magee, J. Talwalkar, D. Hanto and E. Doo

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02432.x

      The current knowledge and gaps in knowledge were discussed at a one-day conference sponsored by NIDDK concerning long-term outcome after liver transplantation in children.

  5. Personal Viewpoint

    1. Top of page
    2. The AJT Report
    3. Editorials
    4. Special Articles
    5. Meeting Report
    6. Personal Viewpoint
    7. Original Articles
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      You Can Be a Kidney Transplant Donor but You Can't Be a Kidney Recipient (pages 2514–2515)

      J. J. Curtis

      Version of Record online: 27 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02445.x

      The author believes that the transplant community has drifted too far from equity.

  6. Original Articles

    1. Top of page
    2. The AJT Report
    3. Editorials
    4. Special Articles
    5. Meeting Report
    6. Personal Viewpoint
    7. Original Articles
    1. Basic Science

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      Rejection of Cardiac Xenografts Transplanted from α1,3-Galactosyltransferase Gene-Knockout (GalT-KO) Pigs to Baboons (pages 2516–2526)

      Y. Hisashi, K. Yamada, K. Kuwaki, Y.-L. Tseng, F. J. M. F. Dor, S. L. Houser, S. C. Robson, H.-J. Schuurman, D. K. C. Cooper, D. H. Sachs, R. B. Colvin and A. Shimizu

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02444.x

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      In α 1,3-galactosyltransferase gene-knockout swine cardiac xenografts transplanted into baboons, this study showed prevention of hyperacute rejection and prolonged graft survival up to almost 6 months. However, rejection was not controlled by chronic immunosuppressive protocols, and acute and chronic antibody- and cellular-mediated rejection developed in the cardiac xenografts.

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      CD8+ T-Cell Depletion and Rapamycin Synergize with Combined Coreceptor/Stimulation Blockade to Induce Robust Limb Allograft Tolerance in Mice (pages 2527–2536)

      Z. Li, F. S. Benghiat, L. Marie Charbonnier, C. Kubjak, M. N. Rivas, S. P. Cobbold, H. Waldmann, V. De Wilde, M. Petein, F. Schuind, M. Goldman and A. Le Moine

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02419.x

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      Mixed donor-recipient chimerism and robust tolerance to composite tissue allografts is achieved in the most stringent allogeneic strain combination after a short course of monoclonal antibodies, rapamycin and vascularized bone marrow transplantation.

    3. Clinical Science

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      Survival Outcomes Following Liver Transplantation (SOFT) Score: A Novel Method to Predict Patient Survival Following Liver Transplantation (pages 2537–2546)

      A. Rana, M. A. Hardy, K. J. Halazun, D. C. Woodland, L. E. Ratner, B. Samstein, J. V. Guarrera, R. S. Brown Jr and J. C. Emond

      Version of Record online: 25 SEP 2008 | DOI: 10.1111/j.1600-6143.2008.02400.x

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      Unlike MELD, the SOFT score predicts 3-month survival following liver transplantation, with the most significant factors being previous transplantation and life-support pre-transplant. See also editorial by Freeeman in this issue on page 2483.

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      Liver Transplantation for Hepatocellular Carcinoma: Results of Down-Staging in Patients Initially Outside the Milan Selection Criteria (pages 2547–2557)

      M. Ravaioli, G. L. Grazi, F. Piscaglia, F. Trevisani, M. Cescon, G. Ercolani, M. Vivarelli, R. Golfieri, A. D'Errico Grigioni, I. Panzini, C. Morelli, M. Bernardi, L. Bolondi and A. D. Pinna

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02409.x

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      This study of a new down-staging protocol for patients with HCC moderately beyond the Milan criteria on waiting list for liver transplantation shows that both the intention-to-treat analysis and the post-operative outcome were comparable between down-staging and conventional criteria group. See also editorial by Lo in this issue on page 2485.

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      The MAP Kinase Phosphatase-1 MKP-1/DUSP1 Is a Regulator of Human Liver Response to Transplantation (pages 2558–2568)

      T. Boutros, A. Nantel, A. Emadali, G. Tzimas, S. Conzen, E. Chevet and P. P Metrakos

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02420.x

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      Microarray results in human livers and studies in the human hepatoma cell line HepG2 indicate a potential role of MKP-1 in the human liver response to injury.

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      Recipient Morbidity After Living and Deceased Donor Liver Transplantation: Findings from the A2ALL Retrospective Cohort Study (pages 2569–2579)

      C. E. Freise, B. W. Gillespie, A. J. Koffron, A. S. F. Lok, T. L. Pruett, J. C. Emond, J. H. Fair, R. A. Fisher, K. M. Olthoff, J. F. Trotter, R. M. Ghobrial, J. E. Everhart and and the A2ALL Study Group

      Version of Record online: 27 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02440.x

      This retrospective study conducted by the A2ALL consortium compares the complication rates in recipients of living donor and deceased donor liver transplants.

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      Erectile Dysfunction in Liver Transplant Patients (pages 2580–2589)

      E. Huyghe, N. Kamar, F. Wagner, S. J. Yeung, A. H. Capietto, L. El-Kahwaji, F. Muscari, P. Plante and L. Rostaing

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02424.x

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      Candidates for liver transplantation have a high prevalence of sexual inactivity and erectile dysfunction. Liver transplantation improves sexual activity, but erectile dysfunction remains in the majority of patients.

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      Polyfunctional Cytomegalovirus-Specific CD4+ and pp65 CD8+ T Cells Protect Against High-Level Replication After Liver Transplantation (pages 2590–2599)

      G. Nebbia, F. M. Mattes, C. Smith, E. Hainsworth, J. Kopycinski, A. Burroughs, P. D. Griffiths, P. Klenerman and V. C. Emery

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02425.x

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      In a prospective analysis of liver transplant recipients, CMV-specific T cells were associated with a lower frequency of CMV DNAemia.

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      Survival Advantage of Pediatric Recipients of a First Kidney Transplant Among Children Awaiting Kidney Transplantation (pages 2600–2606)

      D. L. Gillen, C. O. Stehman-Breen, J. M. Smith, R. A. McDonald, B. A. Warady, J. R. Brandt and C. S. Wong

      Version of Record online: 19 SEP 2008 | DOI: 10.1111/j.1600-6143.2008.02410.x

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      This study used epidemiologic data from the USRDS to determine the associated risk factors for death and mortality rates among children waiting for their first kidney transplant. See also editorial by Delmonico in this issue on page 2487.

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      A Randomized, Prospective Trial of Rituximab for Acute Rejection in Pediatric Renal Transplantation (pages 2607–2617)

      V. Zarkhin, L. Li, N. Kambham, T. Sigdel, O. Salvatierra and M. M. Sarwal

      Version of Record online: 19 SEP 2008 | DOI: 10.1111/j.1600-6143.2008.02411.x

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      This prospective, open-label, randomized study of twenty consecutive pediatric transplanted patients with biopsy proven rejection and intragraft CD20+ clusters reports safety and potential efficacy of rituximab for treatment of B-cell dense renal allograft rejection. See also editorial by Zand in this issue on page 2489.

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      Kidney Allocation to Liver Transplant Candidates with Renal Failure of Undetermined Etiology: Role of Percutaneous Renal Biopsy (pages 2618–2626)

      H. M. Wadei, X. J. Geiger, C. Cortese, M. L. Mai, D. J. Kramer, B. G. Rosser, A. P. Keaveny, D. L. Willingham, N. Ahsan and T. A. Gonwa

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02426.x

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      This study demonstrates the lack of correlation between clinical presentation and pathological findings in 44 liver transplant candidates with renal failure of unknown etiology, and suggests that kidney biopsy may be useful in kidney allocation to these patients.

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      Caveolin-1 Expression Is a Distinct Feature of Chronic Rejection-Induced Transplant Capillaropathy (pages 2627–2635)

      I. Yamamoto, S. Horita, T. Takahashi, A. Kobayashi, D. Toki, K. Tanabe, M. Hattori, S. Teraoka, K. Aita, M. Nagata and Y. Yamaguchi

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02421.x

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      In patients with chronic renal allograft disease, caveolin-1 is over-expressed in the endothelial cells of peritubular capillary, correlated with the grade of peritubular capillary basement membrane multilayering and the reduced peritubular capillary number.

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      Income-Related Disparities in Kidney Transplant Graft Failures Are Eliminated by Medicare's Immunosuppression Coverage (pages 2636–2646)

      R. S. Woodward, T. F. Page, R. Soares, M. A. Schnitzler, K. L. Lentine and D. C. Brennan

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02422.x

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      Medicare's 2000 extension of immunosuppression medication coverage from three years to a lifetime benefit for aged and disabled beneficiaries eliminated income-related disparities in kidney graft survival.

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      Can DXA Predict Fractures in Renal Transplant Patients? (pages 2647–2651)

      S. Akaberi, O. Simonsen, B. Lindergård and G. Nyberg

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02423.x

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      DXA predicts fracture in renal transplant patients: osteopenia/osteoporosis and absolute BMD value below 0.9 g/cm2 in the hip region were independent risk factors for fracture.

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      Posttransplant HLA Alloreactivity in Stable Kidney Transplant Recipients—Incidences and Impact on Long-Term Allograft Outcomes (pages 2652–2660)

      G. Bartel, H. Regele, M. Wahrmann, N. Huttary, M. Exner, W. H. Hörl and G. A. Böhmig

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02428.x

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      This study demonstrates that, in kidney transplant recipients with excellent 1-year graft performance, the occurrence of complement- and noncomplement-fixing anti-HLA alloreactivity may not be associated with adverse long-term graft function, suggesting cautious interpretation of post-transplant antibody monitoring in the absence of graft dysfunction.

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      The Instability of Organ Donation Decisions by Next-of-Kin and Factors That Predict It (pages 2661–2667)

      J. R. Rodrigue, D. L. Cornell and R. J. Howard

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02429.x

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      Regret among non-donor next-of-kin is common and is predicted by transplant attitudes, discussion with a non-OPO professional, not being told their loved one was dead before discussion, sensing lack of time to make decision, not discussing donation with family members, and not having heard a public service announcement about organ donation.

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      The Effect of Sirolimus on Prostate-Specific Antigen (PSA) Levels in Male Renal Transplant Recipients Without Prostate Cancer (pages 2668–2673)

      K. Chamie, P. M. Ghosh, T. M. Koppie, V. Romero, C. Troppmann and R. W. DeVere White

      Version of Record online: 6 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02430.x

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      In male renal transplant recipients without known prostate cancer, the use of sirolimus was associated with a significant decrease in PSA, while in a similar cohort tacrolimus use had no significant effect on PSA.

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      Natural Killer Cell Receptor Repertoire and Their Ligands, and the Risk of CMV Infection After Kidney Transplantation (pages 2674–2683)

      K. Hadaya, C. De Rham, C. Bandelier, C. Bandelier, S. Ferrari-Lacraz, S. Jendly, T. Berney, L. Buhler, L. Kaiser, J. D. Seebach, J. M. Tiercy, P. Y. Martin and J. Villard

      Version of Record online: 11 NOV 2008 | DOI: 10.1111/j.1600-6143.2008.02431.x

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      Natural killer cells may play an important role in controlling CMV infection after kidney transplantation, with regards to the genotyping of the KIR receptors and its HLA ligands but also at the functional level.

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      Alloantibody Levels and Acute Humoral Rejection Early After Positive Crossmatch Kidney Transplantation (pages 2684–2694)

      J. M. Burns, L. D. Cornell, D. K. Perry, H. S. Pollinger, J. M. Gloor, W. K. Kremers, M. J. Gandhi, P. G. Dean and M. D. Stegall

      Version of Record online: 27 OCT 2008 | DOI: 10.1111/j.1600-6143.2008.02441.x

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      Donor specific antibody (DSA) levels after positive crossmatch kidney transplant determine the incidence of acute humoral rejection (AHR), with the level of DSA necessary to cause AHR surprisingly consistent from patient to patient.

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