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Early hepatic artery thrombosis is a serious complication that may follow living donor liver transplant. Acute graft loss and patient morbidity and mortality are possible consequences. The therapeutic algorithm includes surgical or interventional revascularization, conservative approaches, or retransplantation.

Among 155 patients who underwent living donor liver transplant at our transplant center from 2004 to 2020, there were 5 who developed hepatic artery thrombosis. From our 13- year experience, we herein present their demographic and clinical characteristics, radiological imaging findings, perioperative courses, and the postoperative follow-up.

All patients displayed advanced liver disease with a Child-Pugh score of C and a mean Model for End-Stage Liver Disease score of 32. Underlying causes for end-stage liver disease included hepatitis B and C infection and cryptogenic liver cirrhosis. The mean patient age was 49 years; 2 patients were female. Living donor liver transplant was performed with dono the thrombosis, may be beneficial to both graft and patient survival.

Favorable long-term outcomes are achievable in patients with persistent hepatic artery thrombosis. When retransplant is not feasible and interventional approaches fail, conservative treatment with careful observation of liver function should be implemented. Attentive observation of collateral circulation toward the liver, distal of the thrombosis, may be beneficial to both graft and patient survival.

Early posttransplant, the administration of oral or enteral medications in pancreas transplant is challenging because of the management of postoperative ileus and gastroparesis. The use of sublingual tacrolimus may offer a promising alternative. The objective of this study was to compare the pharmacokinetics and perioperative outcomes between oral and sublingual tacrolimus in pancreas transplant.

This was a single-center, retrospective study of pancreas transplants between January 1, 2011, and July 1, 2018. BX471 supplier We transitioned our tacrolimus protocol from oral to sublingual dosing in pancreas transplant patients beginning January 1, 2017.

This analysis included 54 pancreas transplant recipients, with 17 patients on sublingual tacrolimus matched to 37 patients on oral tacrolimus. Within the sublingual group, it took a mean of 3.2 days to achieve a therapeutic tacrolimus trough level (≥8 ng/mL) compared with a mean of 3.8 days in the oral group (P = .175). There was no difference in the incidence of hyperkalemia and supratherapeutic tacrolimus levels between groups. The conversion factor from sublingual to oral in this patient population was 0.67, which was different than what has been reported in other populations. Clinical outcomes were similar between groups.

Sublingual tacrolimus use in pancreas transplant patients appears to be a safe and effective strategy to avoid oral or intravenous therapy in the perioperative period and may reduce the time to achieve therapeutic levels.

Sublingual tacrolimus use in pancreas transplant patients appears to be a safe and effective strategy to avoid oral or intravenous therapy in the perioperative period and may reduce the time to achieve therapeutic levels.Sinusoidal obstructive syndrome, also known as venoocclusive disease, is a potentially life-threatening complication of hematopoietic stem cell transplant. The conditioning regimens given before hematopoietic stem cell transplant result in the production of toxic metabolites that trigger the activation, damage, and inflammation of the endothelial cells that line the sinusoids. Although liver transplant has been performed for treatment of sinusoidal obstructive syndrome, reports by various liver transplant centers worldwide have been limited and disappointing. We report our experience of successfully treating a patient with sinusoidal obstructive syndrome with deceased donor liver transplant. A 34-year-old male patient was referred to our department due to refractory ascites and jaundice within 1 month after receiving peripheral blood stem cell transplant for acute lymphocytic leukemia. He was diagnosed with biopsy-proven sinusoidal obstructive syndrome. Despite therapy with defibrotide, his condition continueients with life-threatening liver dysfunction after hematopoietic stem cell transplant.

Renal transplant with ABO-incompatible donors expands the donor pool. Earlier studies have focused the use of protocol biopsies in ABO-incompatible transplant patients. Our study described outcomes of indication (for cause) renal biopsies and clinical outcomes in patients with ABO-incompatible renal transplant.

This retrospective study included 164 patients from January 2012 to June 2019. Biochemical parameters, serial immunoglobulin G anti-ABO titers, and class I and II donor-specific antibody findings were obtained from hospital records, and renal graft biopsies were reviewed according to the Banff 2017 update.

We analyzed the results of 65 biopsies from 54 patients. Biopsy-proven acute antibody-mediated rejection (12.8%) was found to be more prevalent than acute cellular rejection (1.8%). Patients with antibodymediated rejection all had microvascular inflammation (g+ptc score of 2 or more, where g+ptc is the sum of the glomerulitis and peritubular capillaritis scores) and were positive for C4d. Acuteantibody-mediated rejection.

The microvascular inflammation score (g+ptc score of 2 or higher) is more reliable than diffuse C4d positivity to determine antibody-mediated rejection in ABO-incompatible transplants because diffuse C4d positivity may also be seen in etiologies unrelated to antibody-mediated rejection. Acute tubular injury with C4d positivity without microvascular injury does not confirm antibody-mediated rejection. We suggest that Banff classification be updated in ABO-incompatible transplants to include diagnostic criteria for the diagnosis of antibody-mediated rejection.

This study aimed to assess awareness toward eye donation and the effects of COVID-19 on perceptions about eye donation in an urban community of West Bengal, India.

Eligible adults residing in the area under study were chosen by simple random sampling and interviewed using a predesigned and pretested data collection schedule to assess awareness and perception. Based on their total awareness score, the participants were classified as having good awareness or poor awareness toward eye donation.

Among 423 participants, 52.0% were male, 34.0% were 18 to 30 years old, 38.3% were educated up to secondary level, and 85.6% had eye disease in their family. Of total participants, 70.2% had heard about eye donation, with 59.9% of this group having knowledge of eye donation only after death and 57.9% having knowledge that donation must occur within 6 hours of death. In addition, 52.9% were aware about donation from home, 30.6% said only the cornea is transplantable, and 52.2% knew it can be preserved. Participants with higher education, higher socioeconomic status, and outside of the house occupational engagement had significantly higher chance of good eye donation awareness. Of total participants, 32.0% said that COVID-19 could be transmitted through eye donation, with 58.2% of participants opining that the pandemic was not a suitable time to consider donation of eyes.

COVID-19 has had a negative impact on eye donation perceptions. Although most of our participants had heard about eye donation, their awareness regarding important aspects about eye donation were still lacking, thus calling for a more focused action plan and implementation of the same.

COVID-19 has had a negative impact on eye donation perceptions. Although most of our participants had heard about eye donation, their awareness regarding important aspects about eye donation were still lacking, thus calling for a more focused action plan and implementation of the same.Guillain-Barre syndrome is an acute immune-mediated demyelinating, polyneuropathy, which is usually provoked by a preceding infection. Guillain-Barre syndrome lies within the spectrum of disimmune neuropathies and usually occurs in immunocompromised patients because it is theoretically contradictory. Guillain-Barre syndrome in liver transplant recipients has been rarely reported. Here, we present a case of a patient who had undergone a deceased donor liver transplant and who developed symptoms of Guillain-Barre syndrome in the posttransplant period. We postulated that reactivation of varicella-zoster virus in our patient triggered the autoimmune-related peripheral neuropathy leading to Guillain-Barre syndrome; another etiology for this complication may be autoimmune hepatitis, as also shown in our patient.

In children who undergo renal transplant, vesicoureteral reflux on the transplanted kidney is a serious complication that may result in organ loss. In this study, we aimed to evaluate the results of endoscopic and open surgical techniques in the treatment of patients with recurrent urinary tract infections and vesicoureteral reflux after renal transplant.

The files of pediatric patients who underwent renal transplant in our hospital between January 2016 and January 2019 were evaluated retrospectively. In this single-center analysis, we investigated the incidence of vesicoureteral reflux in the kidney transplant recipients and the results of various approaches to treat it.

Eighty pediatric patients underwent renal transplant between January 2016 and January 2019. Fourteen of those patients (17.5%, 7 female and 7 male) were diagnosed with vesicoureteral reflux in the postoperative period. Twelve of 14 patients received endoscopic injections as the first treatment. Clinical or radiological success was achin most cases.The Learning Ratio (LR) is a novel learning score examining the proportion of information learned over successive learning trials relative to information available to be learned. Validation is warranted to understand LR's sensitivity to Alzheimer's disease (AD) pathology. One-hundred twenty-three participants across the AD continuum underwent memory assessment, quantitative brain imaging, and genetic analysis. LR scores were calculated from the HVLT-R, BVMT-R, RBANS List Learning, and RBANS Story Memory, and compared to total hippocampal volumes,18F-Flutemetamol composite SUVR uptake, and APOE ε4 status. Lower LR scores were consistently associated with smaller total hippocampal volumes, greater cerebral β-amyloid deposition, and APOE ε4 positivity. This LR score outperformed a traditional learning slope calculation in all analyses. LR is sensitive to AD pathology along the AD continuum - more so than a traditional raw learning score - and reducing the competition between the first trial and subsequent trials can better depict learning capacity.The present study examined the effect of Acetaminophen on the painful experience of social rejection by examining brain, cardiac and behavioral measures reflecting different aspects of social feedback processing. Healthy students (N = 72), after ingesting either Acetaminophen or a placebo, performed a social judgment paradigm (SJP), in which they could be expectedly or unexpectedly rejected or accepted. During the task, cardiac and brain responses to different types of feedback were measured, as well as expectancies relating to the given feedback. Enhanced cardiac deceleration was found after unexpected social rejection as compared to all other conditions. Larger mean P3 amplitude was found after expected positive and negative feedback stimuli as compared to unexpected stimuli. While cardiac deceleration and P3 were not affected by Acetaminophen, behavioral responses were. While in the control group the percentage of acceptance predictions decreased over the experiment (learning from negative feedback), the Acetaminophen group did not adjust their positive prediction bias over time.