Review
Biochemistry & Molecular Biology
Ioanna Lazana
Summary: Transplant-associated thrombotic microangiopathy (TA-TMA) is a significant contributor to morbidity and mortality after allogenic hematopoietic stem cell transplantation (allo-HSCT). The diagnosis of TA-TMA is challenging due to lack of consensus diagnostic criteria and common clinical features mimicking other diseases. Therapeutic plasma exchange (TPE) has been traditionally used, but the efficacy is doubtful. Complement inhibitors, such as eculizumab, have shown promising results in clinical trials. Future goals include identifying specific risk factors and developing better treatment options.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Immunology
Vojtech Petr, Dorottya Csuka, Petra Hruba, Agnes Szilagyi, Marek Kollar, Antonij Slavcev, Zoltan Prohaszka, Ondrej Viklicky
Summary: De novo thrombotic microangiopathy (TMA) is associated with poor kidney graft survival, and there is a recipient-driven process with suspected genetic background. Carriers of the MCPggaac haplotype have a higher risk of graft loss, and longer cold ischemia time is associated with worse graft survival.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Immunology
Hiroshi Okamura, Hirohisa Nakamae, Takero Shindo, Katsuki Ohtani, Yoshihiko Hidaka, Yasufumi Ohtsuka, Yosuke Makuuchi, Masatomo Kuno, Teruhito Takakuwa, Naonori Harada, Mitsutaka Nishimoto, Yasuhiro Nakashima, Hideo Koh, Asao Hirose, Mika Nakamae, Nobutaka Wakamiya, Masayuki Hino, Norimitsu Inoue
Summary: The study found that plasma levels of Ba protein play a sensitive and predictive role as a biomarker in transplant-associated thrombotic microangiopathy, while complement-related genetic variants do not predict the development of TA-TMA.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Critical Care Medicine
Nicholas A. Kolaitis
Summary: Lung transplantation is a unique and effective treatment option for patients with end-stage pulmonary arterial hypertension. However, these patients face various challenges and inequities in the organ allocation process, resulting in less favorable long-term outcomes.
Review
Chemistry, Medicinal
Gianluigi Ardissino, Valentina Capone, Silvana Tedeschi, Luigi Porcaro, Massimo Cugno
Summary: Thrombotic microangiopathy (TMA) is a complication that may occur after hematopoietic stem cell transplantation (HSCT), and the pathogenesis and diagnosis of transplant-associated thrombotic microangiopathy (TA-TMA) are still challenging. The involvement of complement dysregulation in the development of TA-TMA has been supported by evidence, but more data is needed to support the systematic use of complement inhibition therapy in all patients.
Article
Respiratory System
Robert F. Tamburro, Kenneth R. Cooke, Stella M. Davies, Samuel Goldfarb, James S. Hagood, Ashok Srinivasan, Marie E. Steiner, Dennis Stokes, Nancy DiFronzo, Nahed El-Kassar, Nonniekaye Shelburne, Aruna Natarajan
Summary: Approximately 2,500 pediatric hematopoietic cell transplants, mostly allogeneic, are performed annually in the United States for life-threatening malignant and nonmalignant conditions. Post-HCT complications, with pulmonary dysfunction as the leading cause of nonrelapse mortality, limit successful outcomes. A multidisciplinary group of 33 experts convened to address knowledge gaps and research strategies to improve outcomes.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2021)
Article
Cardiac & Cardiovascular Systems
Michal Schafer, D. Dunbar Ivy, Kathleen Nguyen, Katie Boncella, Benjamin S. Frank, Gareth J. Morgan, Kathleen Miller-Reed, Uyen Truong, Kelley Colvin, Michael E. Yeager
Summary: The disturbed balance between matrix metalloproteinases (MMPs) and tissue inhibitors (TIMPs) is recognized as a pathophysiological component of pulmonary arterial hypertension (PAH). This study found that levels of MMPs and TIMPs in children with PAH were associated with standard cardiac MRI hemodynamic indices and markers of pulmonary arterial stiffness, suggesting their potential as prognostic indicators in PAH.
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY
(2021)
Article
Virology
Sebastien Barral, Aline Mamin, Carole Dantin, Stavroula Masouridi-Levrat, Yves Chalandon, Laurent Kaiser, Diem-Lan Vu
Summary: This retrospective observational study found that rhinovirus infections are the most common in allo-HSCT patients, including pre-transplant infections. However, the mortality rate due to pre-transplant RVIs is low.
Article
Hematology
Will Thomas, Theodora Foukaneli, Joyce Cosgrove, Dunecan Massey, Jeremy Woodward, Stephen Middleton, Martin Besser, Neil Russell, Irum Amin, Andrew Butler, Lisa Sharkey
Summary: Descriptions of passenger lymphocyte syndrome (PLS), immune cytopenias, and transplant-associated thrombotic microangiopathy (TA-TMA) after intestine-containing transplants are rare. In this study of 96 patients who received 103 transplants, PLS, immune cytopenias, and TA-TMA were observed as common complications that required comprehensive treatment. Further research in this patient group is needed.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Editorial Material
Hematology
Anthony Sabulski, Sonata Jodele
Summary: Transplant-associated thrombotic microangiopathy is a life-threatening complication of haematopoietic stem cell transplant, and some patients do not respond to current treatment methods. Qi et al. show that HIF-1α may be a previously unrecognized driver of this endothelial injury syndrome.
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Tatsuaki Watanabe, Satoshi Matsuo, Yui Watanabe, Takashi Hirama, Yasushi Matsuda, Masafumi Noda, Hiromichi Niikawa, Hisashi Oishi, Yamato Suzuki, Yutaka Ejima, Hiroaki Toyama, Yoshikatsu Saiki, Yoshinori Okada
Summary: This study examined the outcomes of bilateral lung transplantation (BLT) with pulmonary artery reconstruction (PAR) using donor aorta for pulmonary arterial hypertension (PAH) patients with a giant pulmonary arterial aneurysm (PAA). The study found that the operation time was longer in the PAR group, but the 90-day mortality and 5-year survival rates were comparable to the non-PAR group. This suggests that lung transplantation with PAR using donor aorta is a valid surgical option for PAH patients with a giant PAA.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Hematology
Nozomu Kawashima, Yoshie Fukasawa, Eri Nishikawa, Keiko Ohta-Ogo, Hatsue Ishibashi-Ueda, Motoharu Hamada, Daisuke Ichikawa, Atsushi Narita, Yusuke Okuno, Hideki Muramatsu, Nobuhiro Nishio, Seiji Kojima, Taichi Kato, Yoshiyuki Takahashi
Summary: This study found that routine echocardiography after HSCT in children can detect patients with PH earlier, and treatment with tadalafil can lead to a durable response. Close monitoring is necessary to ensure safe and effective administration.
TRANSPLANTATION AND CELLULAR THERAPY
(2021)
Article
Oncology
Shivanthan Shanthikumar, William A. Gower, Matthew Abts, Deborah R. Liptzin, Elizabeth K. Fiorino, Anne Stone, Saumini Srinivasan, Timothy J. Vece, Nour Akil, Theresa Cole, Kenneth R. Cooke, Samuel B. Goldfarb
Summary: Hematopoietic Stem Cell Transplant (HSCT) is a common treatment for various conditions, with pulmonary disease being a significant cause of morbidity and mortality. A survey was conducted to assess current practices in monitoring pulmonary complications post-pediatric HSCT, showing variation in surveillance methods.
Article
Medicine, General & Internal
Minjoo Kim, Hee Yoon, Min Yeong Kim, Ik Joon Jo, Soo Yeon Kang, Guntak Lee, Jong Eun Park, Taerim Kim, Se Uk Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin
Summary: Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal disease that obstructs pulmonary vessels, causing pulmonary hypertension and right-sided heart failure. A retrospective chart review found that all patients in the case series presented with severe and rapidly progressive dyspnea, as well as signs of RV dilatation and pulmonary hypertension.
Review
Urology & Nephrology
Lilian Monteiro Pereira Palma, Meera Sridharan, Sanjeev Sethi
Summary: Thrombotic microangiopathy (TMA) is a condition characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA) with involvement of complement. TMA can be classified into primary and secondary forms, each with distinct etiology and treatment approaches.
KIDNEY INTERNATIONAL REPORTS
(2021)