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Recipient's Body Weight (recipient + body_weight)

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Selected Abstracts

Mobilization effects of G-CSF, GM-CSF, and darbepoetin-, for allogeneic peripheral blood stem cell transplantation

JOURNAL OF CLINICAL APHERESIS, Issue 5 2009
Shi Nae Kim
Abstract The effects of GM-/G-CSF and darbepoetin-, on stem cell mobilization were investigated. From February 2005 to March 2007, 30 allogeneic sibling donors were randomly assigned to a G-CSF group (5 ,g/kg/day for 5,7 days) or triple group (GM-CSF 10 ,g/kg/day on 1st and 2nd day, G-CSF 5 ,g/kg/day for 5,7 days, and darbepoetin-, 40 mg on 1st day). The MNCs and CD34+ cells were not different between the two groups, although the doses (×108/kg of recipient body weight) of CD3+ cells (3.64 ± 1.75 vs. 2.63 ± 1.36, P = 0.089) and CD8+ cells (1.07 ± 0.53 vs. 0.60 ± 0.30, P = 0.006) were lower in the triple group. The engraftments, frequency of RBC transfusions, and hemoglobin recovery were not different between the two groups. The cumulative incidence of overall and Grades II,IV aGVHD was 64.3% vs. 61.1% and 25.9% vs. 27.1% in the G-CSF and triple regimen group, respectively, whereas the cumulative incidence of cGVHD was 20.8 ± 1.3% and 24.4 ± 1.7%, respectively. In conclusion, the triple regimen did not seem to be superior to G-CSF alone in terms of the CD34+ cell dose, hemoglobin recovery, and GVHD. However, the CD8+ cell count was significantly lower in the triple regimen group. The role of a lower CD8+ cell count in the graft may need to be elucidated in the future. J. Clin. Apheresis, 2009. © 2009 Wiley-Liss, Inc. [source]

Probabilities of heart donors arising within specified times for child recipients

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2007
John C Galati
Aim: To determine the availability of donor hearts for children of different blood group and weight needing urgent heart transplantation. Methods: Data maintained by the Australia and New Zealand Organ Donor Registry 1989,2004 were analysed to determine the frequency of donation. Probabilities of suitable donor availability within 10, 20, 30, 40, 60, 90 and 180 days were estimated using a Poisson model with the assumptions that traditional ABO blood compatibilities applied, suitable donors were 0.8,4.0 times the recipient's body weight (BW) and suitable adult donors were aged <40 years. Results: Probabilities of suitable donor availability increase with passage of time from 10 to 180 days and decrease with competition from other needful recipients. Maximum suitable donor availability occurs for children of all blood groups at body weight 20 kg. The probabilities of a donor heart arising within 40 days (maximum safe duration of extracorporeal membrane oxygenation support locally available for young children) for this recipient body weight according to blood group is 0.89, 0.85, 0.73, 0.67 (AB, A, B, O). Probabilities for recipients of BW 3 kg and 60 kg respectively are 0.16, 0.14, 0.10, 0.09 (AB, A, B, O) and 0.66, 0.61, 0.47, 0.42 (AB, A, B, O). Conclusion: Expectation of suitable heart donation arising within 40 days for needful recipients in Australia is low for infants (probability <0.3), moderate for small children (probability 0.5,0.9) and modest for large children (probability 0.4,0.7), with variation at all body weights according to blood group and waiting time. [source]

Liver Graft Regeneration in Right Lobe Adult Living Donor Liver Transplantation

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2009
Y.-F. Cheng
Optimal portal flow is one of the essentials in adequate liver function, graft regeneration and outcome of the graft after right lobe adult living donor liver transplantation (ALDLT). The relations among factors that cause sufficient liver graft regeneration are still unclear. The aim of this study is to evaluate the potential predisposing factors that encourage liver graft regeneration after ALDLT. The study population consisted of right lobe ALDLT recipients from Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan. The records, preoperative images, postoperative Doppler ultrasound evaluation and computed tomography studies performed 6 months after transplant were reviewed. The volume of the graft 6 months after transplant divided by the standard liver volume was calculated as the regeneration ratio. The predisposing risk factors were compiled from statistical analyses and included age, recipient body weight, native liver disease, spleen size before transplant, patency of the hepatic venous graft, graft weight-to-recipient weight ratio (GRWR), posttransplant portal flow, vascular and biliary complications and rejection. One hundred forty-five recipients were enrolled in this study. The liver graft regeneration ratio was 91.2 ± 12.6% (range, 58,151). The size of the spleen (p = 0.00015), total portal flow and GRWR (p = 0.005) were linearly correlated with the regeneration rate. Patency of the hepatic venous tributary reconstructed was positively correlated to graft regeneration and was statistically significant (p = 0.017). Splenic artery ligation was advantageous to promote liver regeneration in specific cases but splenectomy did not show any positive advantage. Spleen size is a major factor contributing to portal flow and may directly trigger regeneration after transplant. Control of sufficient portal flow and adequate hepatic outflow are important factors in graft regeneration. [source]

Probabilities of heart donors arising within specified times for child recipients

Hematopoietic and immune recovery after allogeneic peripheral blood stem cell transplantation and bone marrow transplantation in a pediatric population

PEDIATRIC TRANSPLANTATION, Issue 4 2002
Yoshihisa Nagatoshi
Abstract: To compare the hematopoietic and immune recoveries after allogeneic transplantation with different cell sources, we analyzed the recovery patterns of blood components after allogeneic peripheral blood stem cell transplantation (PBSCT) in comparison with that after allogeneic bone marrow transplantation (BMT) in a pediatric population. Sixteen patients received PBSCT, and 24 received BMT between January, 1995 and March, 2000. The patients had acute lymphoblastic leukemia (ALL; n = 22), acute myelogenous leukemia (AML; n = 8), myelodysplastic syndrome (MDS; n = 3), or other diseases (n = 7). The median ages of patients in the PBSCT and BMT groups were 9 yr and 6 yr, respectively. Cyclosporin A (CsA) plus methotrexate or methylprednisolone was used as a graft-vs.-host disease (GvHD) prophylaxis regimen in the PBSCT group, whereas CsA alone or methotrexate alone was used in the BMT group. Circulating lymphocyte numbers and subpopulations determined by flow cytometric analysis were used as markers of immune recovery. In the PBSCT group, the median number of harvested CD34+ cells was 7.25 (range: 1.3,27.6) × 106/kg of the recipient's body weight, while the median number of harvested nucleated cells was 4.7 (range: 3.7,10.5) × 108/kg. All of the patients were engrafted. Myeloid engraftment occurred sooner after PBSCT than after BMT (median number of days to achieve absolute neutrophil counts (ANC) > 0.5 × 109/L; 11 and 15, respectively; p < 0.0001) and similar results were found for platelet engraftment (median number of days to achieve a platelet count of > 20 × 109/L; 12 and 21, respectively; p = 0.004). On the other hand, after PBSCT the absolute numbers of total circulating lymphocytes and lymphocyte subpopulations were not significantly different from those after BMT. The incidence of acute GvHD after PBSCT was the same as that after BMT, while chronic GvHD developed more frequently after PBSCT than after BMT (p = 0.005). In a pediatric population, the indications for PBSCT and BMT should be based on these findings in addition to regard for the donor's safety. [source]

Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weight

CLINICAL TRANSPLANTATION, Issue 4 2010
Yasumasa Shirouzu
Shirouzu Y, Ohya Y, Suda H, Asonuma K, Inomata Y. Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weight. Clin Transplant 2010: 24: 520,527. © 2009 John Wiley & Sons A/S. Abstract:, Background:, There are only limited data on post-transplant ascites unrelated to small-sized grafts in living donor liver transplantation (LDLT). Methods:, The subjects were 59 adult patients who had received right lobe LDLT with a graft weight-to-recipient weight ratio (GRWR) > 0.8%. Patients were divided into either Group 1 (n = 14, massive ascites, defined as the production of ascitic fluid > 1000 mL/d that lasted longer than 14 d after LDLT) or Group 2 (n = 45, no development of massive ascites). Patients were followed for a median period of 3.0 yr (range, 0.5,7.5 yr). Results:, Group 1 had both higher Model for End-Stage Liver Disease score and Child-Pugh score than Group 2. Portal venous flow volume just after reperfusion was significantly greater in Group 1 than Group 2 (307.8 ± 268.8 vs. 176.2 ± 75.0 mL/min/100 g graft weight, respectively; p < 0.05). Post-transplant infectious complications including ascites infection developed more frequently within the first post-transplant month in Group 1. Massive ascites was significantly associated with early graft loss (p < 0.05). Conclusion:, Post-transplant massive ascites associated with portal over-perfusion into the graft liver can develop in patients with a GRWR over 0.8%. Recipients with post-transplant massive ascites require careful management to prevent infection. [source]