Abstract Background Post-transplantation tumors (PTTs) are the greatest limiting factor for patient survival following organ transplantation. Aim To describe the incidence and main characteristics of ...malignancies developed in patients who underwent kidney transplantation in Budapest between 1973 and 2014. Methods During this period, the essential data for PTTs were repeatedly evaluated. In this study, the results from 1990, 1995, 2000, 2006, and 2013 were evaluated. Results Incidence of PTTs increased from 2.3% to 11.1%. Male/female ratio was 2:1. Skin, native kidney, and lung cancers were the most common tumors during the entire observation period. Lymphoma was seen rarely at the beginning and became common in 2013. The same was observed in the most frequent general population tumors (colorectal, breast, hepatic, prostate, gastric cancer, and malignant melanoma) where the occurrence increased in the last 10 years. Mean age of patients increased from 35.7 to 56.5 years. During the last 20 years, age of recipients increased: above 50 years from 22.9% to 40.5%, and above 60 years from 8.2% to 23.1%. Patient survival was different according to tumor stage at discovering, i.e. renal cell carcinoma was usually discovered in stage I. resulting in a 66.1% 5-year survival rate, whereas 43.5% of colorectal cancers were diagnosed in stage IV, with a 13.9% 5-year survival rate. Conclusion The frequency of PTTs and proportion of elderly persons undergoing transplants are continuously increasing. Tumor stage is a determining factor for patient survival. Recognition of precancerous conditions, diagnosis of tumors in early stage, and oncological screening can improve survival time.
: Infective endocarditis is a rare complication affecting solid organ transplant recipients. Staphylococcus aureus is a common cause of infective endocarditis accounting for about 30% of cases. We ...present a case of nosocomial methicillin‐resistant S. aureus endocarditis with persistent bacteremia, in a patient following orthotopic liver transplantation. We were unable to eradicate this infection with primary linezolid therapy or with secondary treatment with combined vancomycin and rifampicin, but successfully treated it with daptomycin, in addition to tricuspid and aortic valve replacement.
Abstract Introduction There is a greater risk of malignant tumors developing in kidney transplant patients. Due to this, early detection is of outmost importance, in which screening tests play an ...important role. Methods We have conducted a survey among renal transplant recipients to assess individual risk factors. Results Of 530 respondents, 55 developed post-transplantation tumors. Cutaneous tumors (36%) and kidney cancer (16%) were the most frequent. In total, 59% of recipients were over the age of 50, 61.7% were over the normal body-mass index range, 40.3% smoked or used to smoke, and 21.8% had diabetes. Five patients had hepatitis B virus and 11 were hepatitis C virus–positive. Malignancies developed significantly more frequent in men than in women ( P = .04). The progressing of age ( P = .0001) and the time elapsed after transplantation ( P < .01) also were associated with a significant increase in the occurrence of post-transplantation tumors. Conclusion We have created a database to facilitate a more personalized and efficient screening program for immunocompromised patients.
Abstract Background Liver transplantation (OLT) represents the treatment of choice for small hepatocellular carcinomas (HCC) in patients with end-stage liver disease. However, because of organ ...scarcity, alternative options must be explored, such as the use of extended criteria donor (ECD) grafts. Patients and Methods We reviewed data of transplanted HCC patients using ECD grafts. Statistical analysis included uni- and multivariate Cox proportional hazards regression and survival analysis using the Kaplan–Meier method with the log-rank test. Results Over a 6-year period, we transplanted 53 HCC patients with ECD grafts. The 38 men and 15 women showed a mean age of 56.3 ± 8.26 years. Thirty-four patients underwent a bridging treatment before OLT. Thirty-eight patients (72%) were outside the Milan criteria. The median value for alpha fetoprotein (AFP) level was 30.7 ng/dL. Pathologic tumor grade was G1 ( n = 4), G2 ( n = 32), G3 ( n = 6), or Gx ( n = 11). Median follow-up time was 23 months (range, 9–75). Overall 3- and 5- year patient survivals were 79% and 74%, respectively. The 5-year survivals for patients within or outside the Milan criteria were 87% versus 69%, respectively ( P = .3728). Donor transaminases and post-OLT hemodialysis were prognostic factors for patient survival upon mutivariate regression analysis ( P = .0043 and P = .0003, respectively). Conclusion OLT with ECD grafts constitutes an additional option for patients with HCC and cirrhosis, particularly subjects outside the Milan criteria. The risk– benefit ratio in these instances should be evaluated on a case-by-case basis.
The objective of this article is to report a single-center experience with islet autotransplantation after extensive pancreatic resection for benign tumors of the pancreas.
Seven patients underwent ...extensive left pancreatectomy for benign lesions located at the neck of the pancreas. Once an unequivocal diagnosis of a benign nature was ascertained, the rest of the specimen was processed and the unpurified pancreatic digest was infused into the portal vein. The results were compared with those of 8 autotransplantations performed for chronic pancreatites over the same period.
Tumors were 4 cystadenomas, 2 insulinomas and 1 neuroendocrine tumor. Mean islet yields were 275,000 islet equivalents (IEQ) versus 129,000 in chronic pancreatitis (
P = .04) or 6700 IEQ/g of tissue versus 1900 (
P = .002), resulting in transplantation of 4200 IEQ/kg body weight vs 2150 in chronic pancreatitis (
P = .03), respectively at 4-month to 7.5-year follow-up, all patients are alive and 6 of 7 are off insulin. All patients off insulin after at least 1 year currently have a normal IVGTT, with K values ranging between −1.19 and −2.36 (normal < −1.00). All patients, including 1 on insulin, display positive basal and glucagon-stimulated C-peptide levels.
Compared with chronic pancreatitis tissue resected for benign tumors is more likely to achieve good islet yields, and thus insulin independence after autotransplantation. Islet autotransplantation should be considered when extensive pancreatectomy is required for resection of a benign tumor, and only if the benign nature of the lesion is demonstrated unequivocally.
The optimal neutral protease to collagenase activity ratio has not been determined for islet isolation. We evaluated a new highly purified collagenase that can be blended with predetermined amounts ...of neutral protease (NP).
Islets were isolated from 7 groups of Sprague-Dawley rats. In group I, collagenase type XI (Sigma) at 2 mg/mL, and, in group II, Liberase at 0.6 mg/mL (2.4 PZ- U/mL; Roche) were used as controls. In groups III to VII, collagenase NB1 0.6 mg/mL (2.4 PZ-U/mL; Serva Electrophoresis) was used with increasing amounts of added NP. The NP to collagenase activity ratio (DMC-U/PZ-U) increased from 0.5% in group III to 2.0% in group VII.
Mean islet equivalent (IE) yields per rat were 1367, 1755, 597, 895, 1712, 1043, and 905 in groups I to VII. IE yields were maximal at DMC-U/PZ-U = 1.2%. Islet morphology was influenced by NP concentration with decreasing numbers of trapped islets and increasing numbers of fragmented islets as NP contents increased. Cytokine release, islet cell apoptosis, and in vitro function were significantly better in groups III to VII as compared with groups I and II.
NP is a crucial additive to collagenase for islet isolation. Optimization of the NP to collagenase activity ratio (1.2% in this model) improves yields and morphology after islet isolation.
The current of batch flotation froth modelling is critically reviewed in order to identify its significance and usefulness, particularly in the scale-up of batch data to a continuous flotation ...process. This review suggests that the concept of the froth recovery factor,
R
f, may provide the most useful way of establishing the performance of the froth phase in a batch flotation process. The froth recovery factor refers to the fraction of material reporting to the pulp-froth interface which is ultimately recovered in the concentrate. It is also proposed that a froth recovery model based on froth retention time can be used for relating batch froth performance to continuous flotation systems. However, a quantitative model which relates the froth recovery factor and froth sub-processes has yet to be developed.
Complications associated with intraportal islet infusion have been reported. In this study, we analyzed the relationship between occurrence of complications and islet preparation ...characteristics/infusion technique.
We reviewed all intraportal islet infusions from 1992 to 2003.
Sixteen islet autotransplantations were performed without infusion-related complications. The tissue volume injected was 13 ± 11 mL with basal and peak portal pressures of 13 ± 6 and 21 ± 6 mm Hg. Seventy-seven intraportal islet allotransplantations were performed in 51 patients. Fifteen islet infusions were done by laparotomy during simultaneous islet/kidney transplantation without complication. Among 62 percutaneous transhepatic injections, nine complications (two portal branch thrombosis and seven intra-abdominal hemorrhages) were recorded. Rise in portal pressure was related to tissue volume injected (
P < .05). Basal and peak portal pressures were 14 ± 5 and 18 ± 6 mm Hg in uncomplicated infusions, 14 ± 9 and 18 ± 9 mm Hg in the thrombosis group, and 13 ± 7 and 18 ± 5 mm Hg in the hemorrhage group (
P > .05). Complications occurred only after percutaneous islet infusion (
P < .03).
Procedure-related morbidity of intraportal islet infusion is low. Changes in portal pressure are related to volume of tissue injected but do not seem to be associated with the occurrence of complications. Percutaneous infusion is a minimally invasive procedure, but this advantage must be balanced by the higher rate of complications.
The LHCb Data Management System Baud, J P; Charpentier, Ph; Ciba, K ...
Journal of physics. Conference series,
01/2012, Letnik:
396, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The LHCb Data Management System is based on the DIRAC Grid Community Solution. LHCbDirac provides extensions to the basic DMS such as a Bookkeeping System. Datasets are defined as sets of files ...corresponding to a given query in the Bookkeeping system. Datasets can be manipulated by CLI tools as well as by automatic transformations (removal, replication, processing). A dynamic handling of dataset replication is performed, based on disk space usage at the sites and dataset popularity. For custodial storage, an on-demand recall of files from tape is performed, driven by the requests of the jobs, including disk cache handling. We shall describe the tools that are available for Data Management, from handling of large datasets to basic tools for users as well as for monitoring the dynamic behavior of LHCb Storage capacity.
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