bluuebunny/crossref_metadata_2025_split huggingface dataset:
Riparian vegetation: degradation, alien plant invasions, and restoration prospects
Authors: Richardson David M. , Holmes Patricia M. , Esler Karen J. , Galatowitsch Susan M. , Stromberg Juliet C. , Kirkman Steven P. , Pyšek Petr , Hobbs Richard J. 
Published: August 2010

ABSTRACTRivers are conduits for materials and energy; this, the frequent and intense disturbances that these systems experience, and their narrow, linear nature, create problems for conservation of biodiversity and ecosystem functioning in the face of increasing human influence. In most parts of the world, riparian zones are highly modified. Changes caused by alien plants — or environmental changes that facilitate shifts in dominance creating novel ecosystems — are often important agents of perturbation in these systems. Many restoration projects are underway. Objective frameworks based on an understanding of biogeographical processes at different spatial scales (reach, segment, catchment), the specific relationships between invasive plants and resilience and ecosystem functioning, and realistic endpoints are needed to guide sustainable restoration initiatives. This paper examines the biogeography and the determinants of composition and structure of riparian vegetation in temperate and subtropical regions and conceptualizes the components of resilience in these systems. We consider changes to structure and functioning caused by, or associated with, alien plant invasions, in particular those that lead to breached abiotic‐ or biotic thresholds. These pose challenges when formulating restoration programmes. Pervasive and escalating human‐mediated changes to multiple factors and at a range of scales in riparian environments demand innovative and pragmatic approaches to restoration. The application of a new framework accommodating such complexity is demonstrated with reference to a hypothetical riparian ecosystem under three scenarios: (1) system unaffected by invasive plants; (2) system initially uninvaded, but with flood‐generated incursion of alien plants and escalating invasion‐driven alteration; and (3) system affected by both invasions and engineering interventions. The scheme has been used to derive a decision‐making framework for restoring riparian zones in South Africa and could guide similar initiatives in other parts of the world.
Outcomes of pancreas transplants for patients with type 2 diabetes mellitus
Authors: Nath Dilip S , Gruessner Angelika C , Kandaswamy Raja , Gruessner Rainer W , Sutherland David ER , Humar Abhinav 
Published: August 2010

Abstract:  Background:  The objective of this study was to examine how effectively pancreas transplants provide long‐term glucose control in patients with type 2 diabetes mellitus (DM). We used guidelines from the American Diabetes Association (ADA) and the World Health Organization (WHO) to appropriately classify recipients with type 2 DM (vs. type 1 DM).Results:  From 1994 through 2002, a total of 17 patients with type 2 DM underwent a pancreas transplant at our center. Mean recipient age was 52.5 yr. The mean age at diabetes onset was 35.7 yr; mean duration, 16.8 yr. Most recipients had one or more secondary complications related to their diabetes: retinopathy (94%), neuropathy (76%), or nephropathy (65%). At the time of their transplant, three (18%) were on oral hypoglycemic agents alone and 14 (82%) were on insulin therapy. Of the 17 transplants, seven (41%) were a simultaneous pancreas‐kidney transplant (SPK); four (24%), pancreas after kidney transplant (PAK); and six (35%), pancreas transplant alone (PTA). One recipient died during the perioperative period because of aspiration. The other 16 recipients became euglycemic post‐transplant and had a functional graft at 1 yr post‐transplant (patient and graft survival rates, 94%). Now, with a mean follow‐up of 4.3 yr post‐transplant, the patient survival rate is 71%. The four additional deaths were because of sepsis (n = 2), suicide (n = 1), and unknown cause (n = 1). All four of these recipients were insulin‐independent at the time of death, although one was on an oral hypoglycemic agent. Of the 12 recipients currently alive, 11 remain euglycemic without requiring insulin therapy or oral hypoglycemic agents; one began insulin therapy 1.2 yr post‐transplant (current daily dose, 60 units).Conclusion:  These findings suggest that pancreas transplants can provide excellent glucose control in recipients with type 2 DM. All 16 (94%) of our recipients whose transplant was technically successful were rendered euglycemic. Long‐term results were comparable with those seen in transplant recipients with type 1 DM.
Radiofrequency ablation prior to liver transplantation: focus on complications and on a rare but severe case
Authors: Eisele Robert M. , Schumacher Guido , Jonas Sven , Neuhaus Peter 
Published: August 2010

Abstract:  Background:  Radiofrequency ablation (RFA) is an established treatment for hepatocellular carcinoma (HCC) in patients awaiting liver transplantation, due to its comparably low rate of complication and high effectiveness. Complications are thought to be rare and mostly self‐limiting. By contrast, we report on a life‐threatening complication and discuss it in the context of other complications.Patients and methods:  Out of a total of 149 RFA procedures, the incidence of major complications was 4% on a per‐procedure basis. Mortality was 0.67%. Major complications included intractable pain, intrahepatic hematoma, skinburn at the site of patch electrode, and sectorial bile duct stricture. All complications occurred after percutaneous RFA. Highlighted is a young patient listed for liver transplantation because of HCC recurrence following hepatic resection, who was treated by percutaneous RFA as a bridging therapy until a suitable graft became available. Post‐operatively, gastric perforation occurred due to heat injury of the gastric wall.Conclusions:  The percutaneous RFA approach can occasionally lead to detrimental complications, particularly in patients with intra‐abdominal adhesions, due to previous surgery if new intrahepatic malignant lesions accrue near the resection margin. Even widespread HCC disease can be treated effectively with orthotopic liver transplantation if the tumor growth is limited to the liver.
Peritubular capillary C4d staining in late acute renal allograft rejection – is it relevant?
Authors: Satoskar Anjali A , Lehman Amy M , Nadasdy Gyongyi M , Sedmak Daniel D , Pesavento Todd E , Henry Mitchell L , Pelletier Ronald P , Ferguson Ronald M , Nadasdy Tibor 
Published: August 2010

Abstract:  Background:  In the early post‐transplant period, renal allograft rejection with diffuse peritubular capillary (PTC) C4d deposition predicts poor graft survival. In the late post‐transplant setting, that is, one or more yr after transplantation, the implication of diffuse PTC C4d deposition is still a topic of debate. The purpose of our study was to see if diffuse PTC C4d deposition, in late acute rejection (LAR), occurring more than one yr post‐transplant, has any impact on graft survival and function.Methods:  We selected cases, both cadaveric as well as living donor renal transplant recipients, in whom acute rejection with PTC C4d deposition was first detected after the first year post‐transplant. Recipients with multiple acute rejection episodes during the first year post‐transplant were excluded from the study. The first biopsy diagnosed with LAR was considered the index biopsy (n = 40). We formed two groups: group 1, C4d‐positive LAR (n = 20), and group 2, C4d‐negative LAR (n = 20). Groups were matched for maintenance and post‐rejection immunosuppressive therapy, baseline serum creatinine levels before the time of the index biopsy, time from transplant to index biopsy, as well as chronic allograft damage index (CADI) score in the index biopsies. We compared the rate of graft loss, and the graft function of the surviving grafts at the end of the study period, as well as histologic parameters in the index biopsy specimens between the two groups. The mean follow‐up period was 20 months.Results:  No significant differences in the rate of graft loss or graft function were found between groups 1 and 2 at the end of the follow‐up period. Histologically, PTC margination and transplant glomerulopathy were more common in the C4d‐positive group, and this difference was statistically significant. There was no statistically significant difference in the degree of plasma cell infiltrates.Conclusions:  Unlike in the acute setting, the presence or absence of PTC C4d staining in renal allografts with LAR may not have a predictive value regarding graft outcome.
Liver transplantation in a subject with familial hypercholesterolemia carrying the homozygous p.W577R LDL‐receptor gene mutation
Authors: Schmidt Hartmut H‐J. , Tietge Uwe J.F. , Buettner Janine , Barg‐Hock Hannelore , Offner Gisela , Schweitzer Susanne , Dedoussis Giorgos V. , Rodeck Burkhard , Kallfelz Hans C. , Schlitt Hans‐Jürgen , Oldhafer Karl , Klempnauer Jürgen 
Published: August 2010

Abstract:Mutations within the low density lipoprotein (LDL)‐receptor gene result in familial hypercholesterolemia, an autosomal dominant inherited disease. Clinical homozygous affected subjects die of premature coronary artery disease as early as in early childhood. We identified a girl at the age of five yr with clinical homozygous familial hypercholesterolemia presenting with achilles tendon xanthomas and arcus lipoides. Her total cholesterol reached up to 1050 mg/dL. Molecular characterization of the LDL‐receptor gene revealed a homozygous p.W577R mutation. Despite intensive treatment interventions with the combination of diet, statins, colestipol, and LDL‐apheresis, the patient developed symptomatic coronary artery disease at the age of 16 yr. Subsequently, orthotopic liver transplantation was performed to cure the defective LDL‐receptor gene. Clinical follow‐up for almost nine yr post‐transplantation revealed excellent liver function, normal liver enzymes, normal LDL‐cholesterol, and regression of both tendon xanthomas and symptomatic coronary artery disease. In conclusion, liver transplantation can effectively reduce LDL‐cholesterol in a familial hypercholesterolemia recipient with subsequent regression of xanthomas and atherosclerosis. Timing is extremely important in these exceptional cases to exclude the demand for heart transplantation due to severe coronary artery disease. In addition, the identification of the LDL‐receptor as etiology of clinical homozygous hypercholesterolemia is a prerequisite once liver transplantation is considered as therapeutic option.
A randomized trial of thymoglobulin vs. alemtuzumab (with lower dose maintenance immunosuppression) vs. daclizumab in renal transplantation at 24 months of follow‐up
Authors: Ciancio Gaetano , Burke George W. , Gaynor Jeffrey J. , Roth David , Kupin Warren , Rosen Anne , Cordovilla Tatiana , Tueros Lissett , Herrada Eva , Miller Joshua 
Published: August 2010

Abstract: Introduction: A long‐term prospective randomized trial evaluating alemtuzumab, a humanized anti‐CD52 monoclonal antibody, in a predominantly non‐Caucasian population has yet to be reported.Methods: Ninety deceased donor (DD) first renal transplant recipients were randomized into three different antibody induction groups: group A, thymoglobulin (Thymo); group B, alemtuzumab; group C, daclizumab (Dac). In groups A and C, the target trough levels of tacrolimus were 8–10 ng/mL, mycophenolate mofetil (MMF) 1 g administered twice daily, and maintenance methylprednisolone. In group B, target tacrolimus trough levels were 4–7 ng/mL, 500 mg MMF administered twice‐daily, without methylprednisolone. African‐Americans and Hispanics comprised more than 50% in each group.Results: A minimum follow‐up of 27 months showed no overall group differences in patient or graft survival (p = 0.89 and 0.66), but a trend towards worse death‐censored graft survival in group B (p = 0.05). Acute rejection rates were not significantly different: six (20%), seven (23%), and seven (23%) in groups A, B, and C, respectively. The incidence of chronic allograft nephropathy was higher in group B than in A and C (p = 0.008). The mean calculated creatinine clearance at 24 months was 81.1 ± 5.5, 64.4 ± 4.5, and 80.7 ± 5.7 in groups A, B, and C, respectively (p = 0.01 for B vs. average of A and C).Conclusion: In this randomized 27‐month minimum follow‐up trial of predominantly non‐Caucasian DD renal transplant recipients with alemtuzumab induction, lower maintenance tacrolimus, MMF, and steroid avoidance appear less effective than either Thymo or Dac with higher maintenance immunosuppression.
Nondirected living kidney donation: experiences in a Swedish Transplant Centre
Authors: Lennerling Annette , Fehrman‐Ekholm Ingela , Nordén Gunnela 
Published: August 2010

Abstract:  The lack of kidneys for transplantation is a worldwide problem. Different efforts to expand the donor pool have been made. One of them has been the acceptance of altruistic nondirected living kidney donors. This concept was first published by Matas et al. in 2000. Since then, several centres in the United States have started programmes with altruistic nondirected donors (NDD) for kidney transplantation. The use of NDD is still very controversial and rare in Europe. In Sweden, an NDD programme was initiated by the Swedish Transplantation Society in 2004. This article addresses central issues involved with NDD and describes our experiences with the programme so far at Sahlgrenska University Hospital in Göteborg, Sweden.
The improvement in survival of expanded criteria donor kidneys with transplantation era
Authors: Carroll Robert P. , MacGregor Lachlan , Walker Rowan G. 
Published: August 2010

Abstract:  Background:  To compensate for the shortage of donor kidneys, use of expanded donor criteria (ECD) has been adopted by many transplant centres. Multiple criteria on which to score such kidneys have been proposed but the evidence base for the definitions is derived from retrospective and registry data only. We aimed to see if analysis of ECD in our population would indicate the need to change our donor selection process.Methods:  Data on primary kidney transplants (minimum follow‐up two yr) from 1989 to 2004 were reviewed (n = 635). The primary study endpoint was overall graft survival. Published ECD, including the United Network for Organ Sharing (UNOS) ECD criteria were assessed as potential prognostic variables, in a multivariable Cox proportional hazards model.Results:  Patients transplanted after 1996 had improved graft survival compared to those transplanted pre‐1996 HR = 0.51 (0.35–0.76), p = 0.0001. Pre‐1996 UNOS defined ECD kidneys had a markedly increased risk of graft failure compared to live donor kidneys HR = 3.52 (1.9–6.35), p < 0.001. Post‐1996 ECD kidneys had similar prognosis compared to live donor kidneys HR 0.38 (0.1–1.59), p = 0.184. The observed improvement in graft survival was not explained by changes in donor source, cause of end stage renal failure (ESRF), human leukocyte antigen mismatch, recipient age or any histological parameter on implantation biopsy.Conclusions: The explanation for improved overall graft survival and marked improved survival of ECD kidneys is unclear, but introduction of mycophenolate and subsequent falls in calcineurin inhibitor doses over the study period could be potential factors. These results provide some justification for our current selection and management of ECD kidneys.
Comparative effects of renal transplantation and maintenance dialysis on arterial stiffness and left ventricular mass index
Authors: Keven Kenan , Calayoglu Reyhan , Sengul Sule , Dincer Irem , Kutlay Sim , Erturk Sehsuvar , Erbay Bulent , Nergizoglu Gokhan 
Published: August 2010

Abstract:  Background:  Arterial stiffness and left ventricular hypertrophy (LVH) are major independent risk factors for cardiovascular disease in healthy and renal population. In this study, we aimed to investigate comparative long‐term effects of renal transplantation (RTx) and of hemodialysis (HD) on both arterial stiffness and LVH.Methods:  Twenty‐eight RTx patients, 23 HD patients, and 20 healthy subjects were included in this prospective study. In addition to demographical and laboratory parameters, arterial stiffness [pulse wave velocity (PWV)] and left ventricular mass index (LVMi) were assessed before and one‐yr after RTx, and at the baseline and one‐yr later in HD patients.Results:  There were no differences in the parameters between HD and RTx patients at baseline. PWV was significantly higher than that of healthy controls. After one yr, PWV had significantly decreased in RTx patients, but was unchanged in HD patients. Changes in PWV were significant when both groups were compared (p < 0.0001). Although LVMi significantly decreased after RTx (p = 0.02), changes were not significant between the groups.Conclusions:  Renal transplantation markedly improved arterial stiffness, while it remained elevated in HD patients at the one‐yr follow‐up. There was no difference between maintenance HD and RTx groups with respect to impact on LVMi in the one‐yr follow‐up.
Predictors of employment after successful kidney transplantation – a population‐based study
Authors: Bohlke Maristela , Marini Stela Scaglioni , Gomes Rafael Hissé , Terhorst Lisoneide , Rocha Marcos , Poli de Figueiredo Carlos Eduardo , Sesso Ricardo , Irigoyen Maria Claudia 
Published: August 2010

Abstract:  Introduction:  Kidney transplantation is currently the treatment of choice for end‐stage renal disease. As the successful transplantation improves the physical and mental quality of life, it is expected that the transplant recipient should play a productive role in the society. The present study evaluates the occurrence and predictors of employment after kidney transplantation.Methods:  Population‐based cross‐sectional study in which 272 adult kidney recipients assisted in a Brazilian Southern state were evaluated.Results:  At the moment of the interview, 29% of the patients were employed. After analysis with logistic regression, the predictors of employment were male sex (OR 4.04; 95% CI 1.99–8.23), pre‐transplant employment for non‐diabetic (OR 4.35; 95% CI 3.79–4.99), diabetes for individuals who worked while on dialysis (OR 0.06; 95% CI 0.008–0.5), high educational level for individuals with mental quality of life scores above the 25th percentile (OR 3.06; 95% CI 2.98–3.14 for 50th percentile of mental quality of life). The Hosmer–Lemeshow test was of 3.33 (p = 0.91).Conclusion:  The participation of the kidney transplant recipients with functioning graft into the work force in the Brazilian state of Rio Grande do Sul is low, being predicted mainly by sociodemographic factors. It was not detected any influence of patient perception of his/her physical conditions or other clinical variables, except for the presence of diabetes.
Effect of procurement‐related organ lesions on renal transplant outcome
Authors: Bentas Wassilios , Jones Jon , Urbschat Anja , Tilp Ursula , Probst Michael , Scheuermann Ernst , Hauser Ingeborg A. , Blaheta Roman A. , Jonas Dietger , Gossmann Jan 
Published: August 2010

Abstract: Background:  The purpose of our study was to examine the nature and incidence of renal injuries during organ procurement, to identify risk factors and to analyse the effects of organ lesions on the following transplantation.Methods:  All cadaveric kidney transplantations performed at our centre from 1996 to 2006 with an organ donated within the Eurotransplant (ET) region were retrospectively analysed.Results:  Five hundred and sixty‐three renal grafts procured in 62 centres throughout the ET region were transplanted in the analysed period. One hundred and twenty (21.3%) kidneys were inadequately procured with 143 errors in total. The frequency of procurement errors did not differ significantly between kidneys procured by urologists and general surgeons (19.2% vs. 24.6%) nor when kidneys were procured alone or together with pancreas and/or liver (19.3% vs. 22.0%). Inadequate procurement lead to a discard rate of 0.2% and ultimately resulted in a surgical complication rate of 3.4%. Primary graft function (75.8% vs. 78.6%), three‐yr graft survival (76.6% vs. 82.4%) and cumulated long‐term graft survival were not significantly influenced by procurement errors.Conclusion:  Additional measures to improve procurement quality are necessary. Nevertheless, adequate repair of organ lesions is possible and most organs can be successfully transplanted with very good short‐ and long‐term results.
Malignancy after kidney transplantation: results of 400 patients from a single center
Authors: Stratta Piero , Morellini Veronica , Musetti Claudio , Turello Ernesto , Palmieri Daniela , Lazzarich Elisa , Cena Tiziana , Magnani Corrado 
Published: August 2010

Abstract: Background:  Post‐transplant malignancies (PTM) occur in a percentage as high as 50% in patients followed 20 yr and have become a main cause of mortality and are expected to be the first cause of death within the next 20 yr in kidney transplant recipients.Patients and methods:  We analyzed the PTM incidence in our kidney transplant recipients, and its main risk factors. The records of 400 patients (min follow up = one yr) have been retrospectively reviewed and categorized into three groups: patients without any tumor, with a non‐melanoma skin cancer and with a solid or hematologic cancer. A cancer‐free multivariate survival study was performed stratified by age, sex, immunosuppressive therapy, time on dialysis, body mass index (BMI), smoke, diabetes and nephropathy.Results:  Thirty patients developed PTM: 12 non‐melanoma skin cancer, three lymphomas and 15 solid malignancies (seven genitourinary, three lung, two breast, two gastrointestinal and one sarcoma). The mean age at diagnosis was 55 yr, with a mean time from transplant of 27 months. We observed six deaths and two graft losses. Non‐melanoma skin cancer‐free survival and the solid/hematologic cancer‐free survival was 99.5% and 98.5% at one yr, and 95.2% and 94.6% at five yr, respectively. At univariate analysis, age and induction therapy were significant risk factors for both types of PTM, while only recipient age significantly increased the risk of all PTM, and anti CD25 significantly reduced the risk of non‐melanoma skin cancer at the multivariate study.Conclusions:  These data confirm the role of age and induction strategies in modulating the risk of neoplasia. To look for which strategies might reduce the PTM risk, including a personalized therapy to minimize the effects of chronic immunosuppressant, will be a crucial goal.