Transplantation Reviews RSS feed: Current Issue. Transplantation Reviews contains state-of-the-art review articles on both clinical and experimental transplantation. The journal features invited articles by authorities in immunology, transplantation medicine and surgery.http://www.journals.elsevierhealth.com/periodicals/ytrre/?rss=yesElsevier Inc.en © 2009 Published by Elsevier Inc. All rights reserved. Transplantation Reviews0955-470X234October 2009 © 2009 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000718/abstract?rss=yesSubscription Prices10.1016/S0955-470X(09)00071-8Transplantation Reviews 23, 4 (2009)2009-10-01Transplantation Reviews2009-10-01234S0955-470X(09)X0004-2IFCIFChttp://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000640/abstract?rss=yesAbstract: For the past 40 years, T cells have been considered the primary threat to the survival of allografts. However, antibodies can induce severe vascular disease of organ transplants, and this disease, particularly “antibody-mediated” rejection, has become a major clinical challenge. Not only do antibodies cause rejection, the rejection caused by antibodies resists treatment by conventional drug regimens. On the other hand, antibodies can induce a condition in which grafts seemingly resist antibody-mediated injury, which is accommodation. In this communication, we discuss the role of antibodies in the diagnosis and pathogenesis of rejection and accommodation, and suggest what we considerd the major gaps in knowledge and directions research into this subject might productively take.The role of antibodies in transplantationAlexander T. Chang, Jeffrey L. Platt10.1016/j.trre.2009.06.002Transplantation Reviews 23, 4 (2009)2009-07-23Transplantation Reviews2009-07-23234S0955-470X(09)X0004-2191198http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000676/abstract?rss=yesAbstract: Monocytes/macrophages (MO) have long been recognized to be involved in renal allograft rejection. Monocytes/macrophages have been detected in the glomerular, vascular, and tubulointerstitial compartments during rejection. The recent demonstration that peritubular capillary deposition of complement split factor C4d, a marker for antibody-mediated rejection, is associated with relatively marked MO infiltration of the allograft during acute rejection is a significant development in our understanding of the role of the MO in rejection. High levels of MO in rejecting allografts have been associated with severe rejection, and glomerular MO infiltration in particular has been shown to be an indicator of poor graft outcome.Monocytes/macrophages in renal allograft rejectionAlex B. Magil10.1016/j.trre.2009.06.005Transplantation Reviews 23, 4 (2009)2009-07-29Transplantation Reviews2009-07-29234S0955-470X(09)X0004-2199208http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000652/abstract?rss=yesAbstract: Renal transplant is performed on patients with end-stage renal disease. Gray-scale renal sonography combined with color Doppler has become the main noninvasive imaging method for evaluating a kidney transplant, as it provides information about the kidney anatomy and its vascular flow.In this article, we discuss the utility of sonography in renal transplants and describe the ultrasound findings in early and chronic graft pathology. Also, we explain new developments in ultrasound imaging with contrast media and its utility in renal transplantation, proposing that contrast-enhanced sonography be incorporated as a method to evaluate graft status because of its capability to evaluate cortical capillary blood flow.Ultrasonography in kidney transplantation: values and new developmentsCarlos Jimenez, María Ovidea Lopez, Elena Gonzalez, Rafael Selgas10.1016/j.trre.2009.06.003Transplantation Reviews 23, 4 (2009)2009-08-05Transplantation Reviews2009-08-05234S0955-470X(09)X0004-2209213http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000639/abstract?rss=yesAbstract: People who receive a kidney transplant experience overall better quality of life (QOL) than those on dialysis. However, one area of QOL that does not seem to improve after transplant is sexuality. The purposes of this review were to evaluate the literature specific to sexuality after kidney and kidney/pancreas transplant, identify gaps in the literature, and suggest directions for future research. Sources for this review included studies published in nursing and medical journals as well as studies from the related fields of social work and psychology. This literature review revealed several factors that may affect posttransplant sexuality and sexual functioning including chronic illnesses, pretransplant dialysis, and medication side effects. In addition, numerous studies have shown that problems with sexual functioning are prevalent in the transplant population affecting up to 50% of kidney transplant recipients. These problems have a strong negative association with QOL and life satisfaction. Future research should focus on identifying the specific sexual concerns of kidney transplant recipients and on the development and testing of interventions to help alleviate these concerns.Sexuality, an important component of the quality of life of the kidney transplant recipientRebecca J. Muehrer10.1016/j.trre.2009.06.001Transplantation Reviews 23, 4 (2009)2009-08-03Transplantation Reviews2009-08-03234S0955-470X(09)X0004-2214223http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000184/abstract?rss=yesAbstract: 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, diabe tic 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 transplantation is needed by physicians taking care of these patients from predialysis stages of chronic renal failure.Renal transplantation in high cardiovascular risk patientsJulio Bittar, Paula Arenas, Carlos Chiurchiu, Jorge de la Fuente, Javier de Arteaga, Walter Douthat, Pablo U. Massari10.1016/j.trre.2009.02.001Transplantation Reviews 23, 4 (2009)2009-06-12Transplantation Reviews2009-06-12234S0955-470X(09)X0004-2224234http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000688/abstract?rss=yesAbstract: Cardiac transplantation remains the best treatment in patients with advanced heart failure with a high risk of death. However, an inadequate supply of donor hearts decreases the likelihood of transplantation for many patients. Ventricular assist devices (VADs) are being increasingly used as a bridge to transplantation in patients who may not survive long enough to receive a heart. This expansion in VAD use has been associated with increasing rates of allosensitization in cardiac transplant candidates. Anti-HLA antibodies can be detected before transplantation using different techniques. Complement-dependent lymphocytotoxicity assays are widely used for measurement of panel-reactive antibody (PRA) and for crossmatch purposes. Newer assays using solid-phase flow techniques feature improved specificity and offer detailed information concerning antibody specificities, which may lead to improvements in donor-recipient matching. Allosensitization prolongs the wait time for transplantation and increases the risk of post-transplantation complications and death; therefore, decreasing anti-HLA antibodies in sensitized transplant candidates is of vital importance. Plasmapheresis, intravenous immunoglobulin, and rituximab have been used to decrease the PRA before transplantation, with varying degrees of success. The most significant post-transplantation complications seen in allosensitized recipients are antibody-mediated rejection (AMR) and cardiac allograft vasculopathy (CAV). Often, AMR manifests with severe allograft dysfunction and hemodynamic compromise. The underlying pathophysiology is not fully understood but appears to involve complement-mediated activation of endothelial cells resulting in ischemic injury. The treatment of AMR in cardiac recipients is largely empirical and includes high-dose corticosteroids, plasmapheresis, intravenous immunoglobulin, and rituximab. Diffuse concentric stenosis of allograft coronary arteries due to intimal expansion is a characteristic of CAV. Its pathophysiology is unclear but may involve chronic complement-mediated endothelial injury. Sirolimus and everolimus can delay the progression of CAV. In some nonsensitized cardiac transplant recipients, the de novo formation of anti-HLA antibodies after transplantation may increase the likelihood of adverse clinical outcomes. Serial post-transplantation PRAs may be advisable in patients at high risk of de novo allosensitization.Management of allosensitized cardiac transplant candidatesMauricio Velez, Maryl R. Johnson10.1016/j.trre.2009.07.001Transplantation Reviews 23, 4 (2009)2009-10-01Transplantation Reviews2009-10-01234S0955-470X(09)X0004-2235247http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X0900072X/abstract?rss=yesEditorial Board10.1016/S0955-470X(09)00072-XTransplantation Reviews 23, 4 (2009)2009-10-01Transplantation Reviews2009-10-01234S0955-470X(09)X0004-2FrontmatterA1A1http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000731/abstract?rss=yesContents10.1016/S0955-470X(09)00073-1Transplantation Reviews 23, 4 (2009)2009-10-01Transplantation Reviews2009-10-01234S0955-470X(09)X0004-2FrontmatterA2A2http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000743/abstract?rss=yesInstructions for Authors10.1016/S0955-470X(09)00074-3Transplantation Reviews 23, 4 (2009)2009-10-01Transplantation Reviews2009-10-01234S0955-470X(09)X0004-2FrontmatterA3A5http://www.journals.elsevierhealth.com/periodicals/ytrre/article/PIIS0955470X09000755/abstract?rss=yesPrevious Issue10.1016/S0955-470X(09)00075-5Transplantation Reviews 23, 4 (2009)2009-10-01Transplantation Reviews2009-10-01234S0955-470X(09)X0004-2FrontmatterA6A6