Cover Gallery

 

 

 Other Issues


 Volume 14 Issue 5 (May 2014)

 

Hepatitis C virus (HCV) remains one of the most common indications for liver transplantation and a significant problem for much of the chronic dialysis population. Importantly, although liver transplantation is an effective remedy for HCV-related liver failure, posttransplant HCV recurrence remains a near certainty. However, many new antiviral agents are emerging with legitimate promise to not only control HCV, but eliminate it. Gane and Agarwal (page 994) provide an update on the drugs that may potentially dethrone HCV as a top indication for transplantation. Also in this issue, Stock et al (page 1136) make novel observations regarding an association between sirolimus exposure and a lower frequency of CD4 lymphocytes containing HIV DNA, suggesting that immunosuppression required for kidney transplantation in the HIV-infected recipient may impact the level of HIV persistence.
Cover design by Ken North, North Design Group.

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 Volume 14 Issue 4 (April 2014)

 

Allograft biopsies have served as the standard for diagnosis in organ transplantation, but their utility has been limited by sampling error. Increasingly, practitioners have looked toward sampling techniques that are less invasive than tissue biopsy and at the same time reflect the entire organ’s condition. In this issue we highlight two articles (pages 831 and 841) examining the utility of bronchoalveolar lavage in assessing lung transplant rejection. Both of these studies find that there is substantial untapped information to be gleaned from this secretory product—information that has both diagnostic and mechanistic value. We also present a case report (page 960) of a rare metabolic disorder, lathosterolosis, that was successfully treated by liver transplantation, and surprisingly mollified an autism phenotype associated with this disease.
Cover design by Ken North, North Design Group.

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 Volume 14 Issue 3 (March 2014)

 

Allotransplantation in all its forms begins with organ donors. This month’s cover features a unique approach to organ procurement that utilizes a centralized organ donor facility rather than having organs procured at the donor hospital. Doyle et al (page 615) review a decade of liver donation performed in this facility. We also have articles on live donor risks and benefi ts, and novel approaches to deceased donor trial conduct.
Cover design by Ken North, North Design Group.

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 Volume 14 Issue 2 (February 2014)

 

 Antibody-mediated rejection (ABMR) is a signifi cant issue in kidney transplantation that presents in highly variable ways. Its variability has confounded both its diagnosis and mechanistic defi nition. In this issue of AJT, we highlight current concepts surrounding ABMR with several relevant laboratory science papers, a comprehensive review, and the meeting report from the most recent Banff meeting.
Cover design by Ken North, North Design Group.

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 Volume 14 Issue 1 (January 2014)

Islet transplantation is performed by injecting islets into the recipient portal vein. This month, Esposito et al (page 202) use sophisticated magnetic resonance imaging (MRI) techniques to evaluate the impact of islet embolization into the portal system on hepatic blood fl ow, showing that fl ow is dynamic after transplantation, and suggesting that a reduction in fl ow associates with early islet graft loss. Liver AUC60 (top panels) and Ktrans (bottom panels) maps derived from dynamic-contrast enhancement MRI studies before (left) and after (right) islet transplantation in a patient with early graft failure show a strong reduction in liver perfusion 7 days after transplantation.
Cover design by Ken North, North Design Group.

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 Volume 13 Issue 12 (December 2013)

 

The use of rabbit antithymocyte globulin (RATG) has gained increasing popularity in North America as an induction immunosuppression strategy, particularly in kidney transplantation, with over 50% of centers using this preparation on a routine basis. However, despite its heavy usage and longstanding presence in the transplant armamentarium, its derivation from immunized rabbits and polyclonal makeup make its true content and mechanism of action somewhat of a black box. This month, Popow et al (page 3103) lift the lid to this box a bit, providing the most up-todate analysis of RATG’s content and providing additional insight into its therapeutic mechanism.
Cover design by Ken North, North Design Group.

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 Volume 13 Issue 11 (November 2013)

 

 Immunobiology is a study of homeostatic mechanisms fostering survival. However, it is increasingly evident that regulated cell death is an important component of survival. Numerous mechanisms of cell death have been characterized, and this month, AJT highlights the mechanisms and infl uence of necroptosis. Lau et al provide insights into the role of necroptosis in ischemia-reperfusion injury (page 2805) and Linkermann et al provide a useful overview of necroptosis in general (page 2797), highlighting its potential role in allograft survival. Also see a thoughtful editorial by Mannon providing additional perspective on this dynamic topic (page 2785).
Cover design by Ken North, North Design Group.

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 Volume 13 Issue 10 (October 2013)

Antibodies specific for HLA molecules have long been known to negatively influence allograft function and survival. This month, three manuscripts report on antibodies with atypical specificities, including two focusing on angiotensin II type 1 receptor-specific antibodies (see articles by Giral et al and Taniguchi et al on pages 2567–2589) and one addressing polyreactive antibodies (see article by Porcheray et al on pages 2590–2600), indicating that the breadth of an antibody response towards a transplanted graft may significantly influence the organ’s ultimate fate.

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 Volume 13 Issue 9 (September 2013)

 

 In the continued quest for refined methods of live donor liver donation and optimized means of minimizing donor morbidity, three groups present case reports on their techniques for laparoscopic live donor liver donation. See articles by Samstein et al (page 2462), Soubrane et al (page 2467) and Troisi et al (page 2472). As this technically challenging procedure performed on healthy donors is not without substantial risks and ethical concerns, Mohamed Akoad and Elizabeth Pomfret provide editorial perspective on page 2243.

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 Volume 13 Issue 8 (August 2013)

 

Gentry et al (page 2052) present a provocative analysis of means to eliminate regional disparities in liver allocation in which they show that regional sharing of donor organs best addresses the issue of disparity when combined with an aligned reorganization of the existing regions. A thoughtful commentary on this work by Yeh and Hunsicker is found on page 1949. Also, this month’s issue contains a Special Article on the new Public Health Service Guideline for Reducing HIV, HBV and HCV Transmission Through Organ Transplantation (page 1953).

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 Volume 13 Issue 7 (July 2013)

 

Transplantation has been closely linked to basic science from its beginnings. However, as the questions being asked in modern clinical trials become increasingly nuanced and dependent on multicenter clinical trials, the ability to derive mechanistic information from patients at multiple sites has been diffi cult to orchestrate. This month, AJT features fi ve Brief Communications from collaborative research groups in North America and Europe demonstrating that advanced mechanistic study can be coordinated in support of multicenter clinical trials. See reports in the Clinical Trials in Organ Transplantation series, beginning on page 1859.

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 Volume 13 Issue 6 (June 2013)

 “Keeping an eye” on the mechanisms of allograft rejection, Tan et al (page 1461) present an elegant model for studying chemokines produced locally within corneal allografts and use it to demonstrate the dynamic behavior of infi ltrating effector T cells. In addition to the static images in the print version, be sure to view the in vivo movies at http://goo.gl/cAEhl

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 Volume 13 Issue 5 (May 2013)

 

This month, Salehi et al (page 1282) take advantage of a unique clinical opportunity, auxiliary liver transplantation, to study the basic biology of liver regeneration. The study not only provides new information on the molecular processes associated with hepatic regeneration, but also highlights the creative use of a clinical transplant scenario to directly investigate human biology in vivo. Opportunities like this are often part of transplantation and will increasingly need to be exploited to provide the most relevant scientific information in an increasingly competitive research funding environment.

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 Volume 13 Supplement 5 (April 2013)

 

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 Volume 13 Issue 4 (April 2013)

Garonzik-Wang et al (page 936) present the results of a national study examining center-level utilization of various categories of livers that suggests that high waitlist disease severity, organ availability, and transplant volume are the main drivers of aggressive utilization of higher-risk livers. The study leads to questions as to what defi nes appropriately aggressive organ utilization, and how centers should respond to metrics quantifying aggressive use of marginal livers, or any other ruler of aggressiveness, to examine and alter their liver acceptance practice. Also see related editorial by Lai and Feng on page 837.

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 Volume 13 Supplement 4 (March 2013)

 

Upper left: GMS stain of a lung biopsy in a liver transplant patient with disseminated coccidioidomycosis. Provided by Dr. Rachel Miller, University of Iowa.
Upper right: Dermatomal grouped vesicles consistent with herpes zoster virus reactivation in a transplant recipient. Provided by Dr. Misha Rosenbach, Perelman School of Medicine of the University of Pennsylvania.
Lower left: Skin biopsy of a pancreas transplant recipient with cutaneous strongyloidiasis. Provided by Drs. Steven D. Mawhorter and Melissa Piliang, Cleveland Clinic, and Dr. Wendy Armstrong, Emory University School of Medicine.
Lower right: Pneumocystis and nocardial pneumonia with pneumothorax in a liver transplant recipient. Provided by Dr. Sang-Oh Lee, University of Ulsan College of Medicine.

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 Volume 13 Issue 3 (March 2013)

A provocative article from Fadi Lakkis’s lab in this month’s issue (page 580) demonstrates a broad spectrum of rejection seen when outbred, wild-type mice are used rather than the standard laboratory inbred strains. The article helps refine the tools used for mechanistic study, and will improve the field’s ability to study the complexities of outbred (e.g. human) allograft rejection in a tractable mouse model system.

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 Volume 13 Supplement 3 (February 2013)

Figure adapted from Smith and Khanna (see page 9).

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 Volume 13, Issue 2 (February 2013)

One of the most critical factors dictating the success of free tissue transplantation is the development of sufficient vascular supply through posttransplant angiogenesis. This month, Kuehl et al (page 286) demonstrate that neonatal liver stimulates much more robust angiogenesis, seen as a blush of vascularity in their novel model of in vivo hepatic free tissue transfer, and use this model to describe some of the features potentially contributing to this phenomenon.

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 Volume 13 Supplement 2 (January 2013)

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 Volume 13 Supplement 1 (January 2013)

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 Volume 13, Issue 1 (January 2013)

This month's AJT pays tribute to Joseph E. Murray, the father of clinical organ transplantation, who passed away in November 2012. Dr. Murray revolutionized transplantation, medicine in general and indeed the way the public perceived the promise of modern medicine. A memorial tribute is provided by Stefan Tullius, Chief of Transplant Surgery at Brigham and Women's Hospital, where Dr. Murray performed the first successful kidney transplant in 1954 (see article on page 5).

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 Volume 12 Supplement 4 (December 2012)

 

Small intestinal grafts after procurement (top row) and following reperfusion (bottom row) from various sized donors (left to right, pediatric to adult) used to quantify the length of the small bowel, an important factor in determining bowel sufficiency. See article by Gondolesi et al on page S49. This is one study highlighted in this supplement presenting outstanding articles from the XII International Small Bowel Transplant Symposium of the Intestinal Transplant Association.

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 Volume 12, Issue 12 (December 2012)

 

Hospital readmission rates are likely to become increasingly cited as a key metric in healthcare reform, particularly under pay-for-performance funding formats. This month, McAdams-DeMarco et al (page 3283) provide an interesting look at hospital readmission rates post–kidney transplantation, showing that nearly a third of transplanted patients are readmitted in the first 30 days posttransplant. A thoughtful editorial by Kaplan and Sweeney (page 3171) points out the importance of understanding this metric as it clearly relates to the quality of patient care and may well be used to influence reimbursement in the future.
Cover design by Ken North, North Design Group.

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 Volume 12, Issue 11 (November 2012)

This issue highlights the current state of Simultaneous Liver–Kidney Transplantation (SLKT). Shown are data from a recent SLKT summit report by Nadim et al (see page 2901) indicating the increased use of this combined transplant strategy, in tandem with its wide regional variation and poorly defined reported indication. See numerous additional articles on this topic including an editorial by Feng and Trotter (page 2869); articles by Levitsky et al (page 2949), Ruebner et al (page 2958) and Hibi et al (page 2966); and a brief communication by Nadim et al (page 3119).

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 Volume 12, Issue 10 (October 2012)

 

Transplantation has typically been organized around organ preservation, slowing the demise of a procured organ until it can be transplanted, ideally as soon as possible. This month highlights the application of organ repair, improving the graft ex vivo to facilitate the use of an otherwise suboptimal organ, at a remote location. This is the first report of such a repair process occurring using an organ shipped to a collaborative site for resuscitation and returned for transplantation; this raises the potential for organ repair centers to aid in the optimal use of the available organs. See case report by Wigfield et al on page 2838.

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Volume 12, Issue 9 (September 2012)

Diagrammatic representation of a national paired kidney donor exchange program that facilitated the transplantation of over 270 patients with excellent clinical outcomes. The study highlights the growing use of paired exchange to facilitate the transplantation of highly sensitized individuals and individuals with incompatible donors, and represents a watershed experience in the national acceptance of this approach. See article by Melcher et al on page 2429.

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Volume 12 Issue 8 (August 2012)

An educated chef can find many good uses for the typically eschewed overripe banana; so too can the prepared transplanter find uses for organs that are past their prime. See related editorials (Tedesco on page 1969, Friedewald on page 1971, and Gill on page 1973) and articles (Mohan et al on page 2098 and Woodside et al on page 2106) as well as other donor-relevant articles by Ross et al (on page 2115), Bingaman et al (on page 2125) and Venkataramani et al (on page 2133).
Cover design by Ken North, North Design Group.

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 Volume 12 Issue 7 (July 2012)

A schematic depicting the potential actions of CD28-specific biologic agents. See minireview by Poirier et al (page 1682) for an overview of the opportunities and challenges associated with selective costimulation blockade.

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Volume 12 Issue 6 (June 2012)

 

There is marked variation in the stroke- and trauma-related death rate across the United States, and this relates to the number of deaths eligible for donation. See brief communication by Sheehy et al on page 1598.

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  Volume 12 Supplement 3 (May 2012)

 

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  Volume 12 Issue 5 (May 2012)

 

The striking impact of de novo donor-specific antibody (but not non-donor-specific alloantibody) on graft survival is made apparent by an article by Wiebe et al (see page 1157). Through the use of protocol biopsies, they show that histological evidence of graft injury is evident well prior to clinically apparent graft dysfunction.

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 Volume 12 Issue 4 (April 2012)

 

An intestinal allograft biopsy from a NOD2 wild-type recipient showing normal architecture with respect to cellular organization and the presence of lamina propria myeloid cells expressing CX3CR1 (green) with well-developed transepithelial dendrites (F-actin, red). These properties are proposed as critical for an intestinal allograft to resist microbe-induced inflammation that can be mistaken for alloantigen-directed rejection. See article by Lough et al on page 992.

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Volume 12 Issue 3 (March 2012)

 


 

The relative influence of risk factors for fracture after kidney transplantation. See article by Nikkel et al on page 649. Image courtesy of the Department of Radiology and Imaging Sciences, Emory Healthcare.

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Volume 12 Issue 2 (February 2012)

 


Despite exceptional improvement in essentially all aspects of its biology, organ transplantation remains challenged by social barriers to its equitable delivery. See AJT Report (page 269), editorial by Abbott and Gaston (page 273), and articles by Kucirka et al (page 351) and Patzer et al (pages 358 and 369) for related content.

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Volume 12 Supplement 2 (January 2012)

 


  

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Volume 12 Supplement 1 (January 2012)

 


  

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Volume 12 Issue 1 (January 2012) 

 


  

Preservation of renal tubular cilia in a transplanted kidney is demonstrated by immunofluorescence and immunohistochemical staining (inset) following retinoic acid therapy. This therapy, designed to target the Wnt and Hedgehog pathways, provides proof-of-concept that changes resulting from chronic allograft injury can be mollified pharmacologically. See article by von Toerne et al on page 55 and associated editorial by Fabian and Humphreys on page 5.

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 Volume 11 Issue 12 (December 2011)
 


Arteriolar hyalinization is frequently cited as evidence of calcineurin inhibitor (CNI) toxicity. In this issue, Snanoudj and colleagues provide clear evidence that although these changes are more frequent in patients on CNIs, they are not specific to CNI-associated injury. See article on page 2635 and accompanying editorial by Mengel et al on page 2549.

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 Volume 11 Issue 11 (November 2011)
 


 

A pediatric patient with acute hepatic failure provides the diagnostic dilemma for the first installment of “Images in Transplantation.” This new feature provides an opportunity for readers to test and add to their knowledge, and receive Continuing Medical Education credit. See page 2533 for details.

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Volume 11 Issue 10 (October 2011)
 


 

The influenza virus. This month, AJT presents several articles detailing the recommended influenza vaccine strategies for transplant patients and the population at large, and unique aspects of influenza vaccine performance in transplant recipients.
See special article by Kumar et al on page 2020, a brief communication by Cordero et al on page 2205 and Reports from the CDC: MMWR on page 2250.
Cover figure by Russell Kightley Media.

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Volume 11 Issue 9 (September 2011)
 



 

The estimated cumulative proportion of patients with surgical site infections after liver transplantation by surgeon, showing the marked variability attributable to surgeon-specific variations in practice. The figure suggests a need for reduced practice variation, a common theme in modern healthcare reform.
See article by Hellinger et al on page 1877.

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Volume 11 Issue 8 (August 2011)
 


Number of deceased donor kidney transplants by race before and after the elimination of allocation points for HLA-B matches. See article by Ashby et al on page 1712.

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  Volume 11 Issue 7 (July 2011)


 

B cells, plasma cells and the effects of allospecific antibodies and complement continue to present barriers to long-term allograft survival. See minireview by Clatworthy (page 1359) and related articles by Raedler et al (page 1397) and Loupy et al (page 1478).

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Volume 11 Issue 6 (June 2011)


 

Donor-derived malignancy and other donor-derived risks are featured in this issue of AJT. Shown on the cover is fluorescence in situ hybridization of the Y chromosome illuminating male tumor cells (yellow spots in red cells) in the renal allograft of a female recipient.
See the article by Olagne et al on page 1260 and other articles addressing risks of donor-transmitted diseases.

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Volume 11 Issue 5 (May 2011)


A graphic depiction of the variation in liver Donor Risk Index by organ procurement region in the United States suggests that the quality of the deceased donor livers that patients receive is variable and dependent in part on a center effect. See article by Volk et al on page 958.

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Volume 11 Supplement 2 (April 2011)


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Volume 11 Issue 4 (April 2011)


The impact of transplantation to the surgical literature is graphically demonstrated through a “word cloud” composed of words from the 100 most cited articles from the 10 surgical journals with the highest impact factor over the last decade.
See letter to the editor by McGee and McGee on page 871.

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Volume 11 Issue 3 (March 2011)


 The entire transplant community pauses to remember the historic and selfless contributions of Ronald Herrick, the first kidney donor. See “The AJT Report” on page 415 and the special feature on page 419.

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Volume 11 Issue 2 (February 2011)


A facial CT scan image demonstrating the bony integration of one of many face allografts reported in this edition of the American Journal of Transplantation.
See case reports by Lantieri et al (page 367), Siemionow et al (page 379) and Pomahac et al (page 386).

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Volume 11 Supplement 1 (January 2011)


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Volume 11 Issue 1 (January 2011)


A conceptual triangulation of the fundamental diagnostic components of Antibody Mediated Rejection. See article by Loupy et al on page 56.

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Volume 10 Issue 12 (December 2010)


The blood supply to the human biliary system (A) in health, and (B) following a Donation after Cardiac Death (DCD) liver transplant with micro-thombosis. Hashimoto et al propose this as a predominant mechanism of ischemic-type biliary strictures.
See article on page 2665.

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Volume 10 Issue 11 (November 2010)


The Atlanta Skyline. With this issue the Editorial Office moves to Emory University in Atlanta, Georgia. See editorial by Kirk on page 2385.
Photo Credit: Eric Kirk Photography, www.erickirk.com

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Volume 10 Issue 10 (October 2010)

Loss of nephrin expression in glomeruli of kidney transplanted patients under m-TOR inhibitor therapy.  Shown is the immunofluorescence staining for nephrin in glomeruli of a pretransplant donor kidney biopsy (left figure) and of a posttransplant kidney biopsy before (centre figure) and after introduction of m-TOR inhibitor therapy (right figure) in a representative patient.  See article by Biancone et al on page 2270.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 9  (September 2010)


Schematic illustration of domino paired donation chain. See article by Lonze et al on page 2154.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 8 (August 2010)


Post transplant lymphoproliferative disorder in a liver transplant patient. See article by Collett et al on page 1889.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 7 (July 2010)


Thrombotic microangiopathy after kidney transplantation. See minireview by Noris and Remuzzi on page 1517.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 6 (June 2010)


Improvement 12 months after switching to Sirolimus in a 67 year-old male having been on immunosuppression for 278 months at baseline. See article by Salgo et al on page 1385–1393.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 5 (May 2010)


May of 2010 marks the 10th year of publication of AJT and represents an occasion to think about the project and its future directions.
Cover design by Ken North of North Design Group.

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Volume 10 Supplement 4 (April 2010)


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Volume 10 Supplement 3 (April 2010)



Encouraging trends in intestine transplantation: Intestine transplantation results have improved dramatically over the past decade. Waiting list mortality has significantly decreased, and one year patient and graft survival approach 80%. Increased numbers of waiting list registrations and transplants have also been noted, but significant clinical challenges remain.
See the article by Mazariegos et al on page 1020–1034.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 4 (April 2010)


 

MicroRNAs are transcribed and processed within the cell and constitute an important mechanism of post-transcriptional regulation of gene expression.
See article by Martinez et al on page 713–719.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 3 (March 2010)

Molecular model of belatacept consisting of two CTLA-4 domains (represented in two separate colors cyan and blue) containing active site mutations (rendered in green) and the IgG1 Fc domain (colored red & orange). The disulfide bond linking the two CTLA-4 domains is colored yellow. The CTLA4 domains are shown bound to CD86 (magenta) and CD80 (pink). The molecular surface of the CD86 binding site is colored white. (Courtesy of Dr. Stanley R. Krystek, Jr.)
See articles by Vincenti et al on page 535 and Durrbach et al on page 547.
Cover design by Ken North of North Design Group.

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Volume 10 Issue 2 (February 2010)

In this issue, Guarrera et al report on a clinical trial of machine liver preservation. The system utilizes centrifugal flow via the portal vein and hepatic artery at 3-7 _C.
See article by Guarrera et al on page 372–381.
Cover designed by Ken North of North Design Group.

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Volume 10 Supplement 2 (January 2010)


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Volume 10 Supplement 1 (January 2010)


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Volume 10 Issue 1 (January 2010)



 

Recipients of MHC-mismatched cardiac allografts were treated with a single dose of 500 _g anti-TNF_ mAb or rat IgG at
the time of transplant. A. The A/J allografts were retrieved from C57BL/6 recipients 9 and 12 hours post-transplant and
prepared frozen sections were stained to detect graft infiltrating neutrophils. B. Grafts were retrieved from groups of
4 recipients at the indicated times post-transplant and flow cytometry analyses of anti-CD45 and anti-Gr1 mAb stained
cells from digested grafts were performed to determine numbers of neutrophils infiltrating the allografts.
See article by Fairchild et al on page 59–68.
Cover designed by Ken North of North Design Group.

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Volume 9 Supplement 4 (December 2009)


1. Top left: MRI brain in a patient with post-transplant lymphoproliferative disease.
Provided by Dr. Marian Michaels, University of Pittsburgh.
2. Top right: Stain showing intracellular Legionella species bacteria. Provided
by Dr. Sang-Oh Lee, University of Ulsan College of Medicine.
3. Bottom left: Absidia corymbifera gastro-intestinal tract infection in a heart-kidney
transplant recipient. Provided by Dr. Philippe Hauser and Dr. Oriol Manuel,
University Hospital of Lausanne.
4. Bottom right: Maculopapular rash in a lung transplant patient with disseminated
human herpesvirus-6 infection.

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Volume 9 Issue 12 (December 2009)


See randomized clinical trial results by Servais, et al on page 2552.

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Volume 9 Supplement 3 (November2009)


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Volume 9 Issue 11 (November 2009)


See randomized clinical trial results by Servais, et al on page 2552.
Cover Design by Ken North of North Design Group.
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Volume 9 Issue 10 (October 2009)   


 

See obituary by Terasaki on page 2441.
Photo Credit: Keystone/Stringer, Hulton Archive, Getty Images
Cover Design by Ken North of North Design Group
 

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 Volume 9 Issue 9 (September 2009)


Flow-cytometric analysis of peripheral blood mononuclear cells from healthy volunteers reveals that the CD4+ and CD8+ populations mount similar proliferative responses and contain comparable frequencies of alloreactive precursors.
See article by Macedo et al on page X.
 

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Volume 9 Issue 8 (August 2009)


Rat lung tissue post transplantation.
See article by Shilling and Wilkes on page1714.
 

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Volume 9 Issue 7 (July 2009)


Cover design by Ken North of the North Design Group.

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Volume 9 Issue 6 (June 2009)


Relationship between the total portal flow and graft regeneration.
See article by Cheng et al on page 1382.
Cover design by Ken North of the North Design Group.
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Volume 9 Supplement 2 (May 2009)

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Volume 9 Issue 5 (May 2009)


Migration patterns of B2 lymphocytes. B2 lymphocytes begin life in the bone marrow, then migrate to either the gut, lymph nodes or spleen where they remain quiescent until they encounter antigen in the presence of antigen-presenting cells and T-helper cells. Following a series of steps, B cells may become terminally differentiated PCs. Some PCs may migrate back to the bone marrow where they may persist for years in specialized antiapoptotic ’survival niches‘.
Please see minireview by Stegall et al on page 998.
Cover design by Ken North of the North Design Group.
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Volume 9 Supplement 1 (April 2009)


Mean five-year future lifetime by MELD
Average survival benefit from liver transplantation increases steadily as MELD increases. Benefit is defined as the difference between predicted years lived with a transplant versus without. See article by Schaubel et al on page 970.
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Volume 9 Issue 4 (April 2009)


Longitudinal analysis of EMT markers in bronchial brushing-derived epithelial cells. Epithelial cell expression of the EMT markers (_-sma and S100A4) and BAL cytokines (TGF_1 and HGF) were measured in a highly sensitized (pretransplant panel reactive antibody 90%) 57-year-female recipient of a single lung transplant for usual interstitial pneumonia (UIP). The patient developed treatment refractory BOS following a late episode of acute rejection (A2B0) at 6-month posttransplant and an episode of CMV pneumonitis at 10-month posttransplant. Note increased expression of EMT markers, TGF_1 and HGF concurrent with the diagnosis of BOS at 17 months after transplantation. No bronchial brushing samples were obtained at the last bronchoscopy at 20 months. _SMA = _-smooth muscle actin; S100A4; TGF_1 = transforming growth factor _; HGF = hepatocyte growth factor; FEV1 = forced expiratory volume in 1 second; BAL = bronchoalveolar lavage; CMV = cytomegalovirus.
Please see article by Hodge et al on pages 727–733.
Cover designed by Ken North of North Design Group.

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Volume 9 Issue 3 (March 2009)


 

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Volume 9 Issue 2 (February 2009)


Some potential regulatory and effector roles of NKG2D. Figure provided by Suárez-Álvarez et al (see article on pages 251–257) and designed by Ken North of north design group (Edmonton, Canada).
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Volume 9 Issue 1 (January 2009)


Figure provided by Djamali et al (see article on pages 74–82) and designed by Ken North of north design group (Edmonton, Canada).
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Volume 8 Supplement 2


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Volume 8 Issue 12 (December 2008)


Sarah, aged 1 year, died awaiting liver transplantation a few days after this photograph was taken by her mother. Her parents have since become vigorous activists for donation awareness in their community (reproduced with permission of K. Schonhoff).
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Volume 8 Issue 11 (November 2008)


Flow diagram of the process of UV-induced skin carcinoma, and the interference from the immunosuppressive drugs, azathioprine (Aza), cyclosporine (CS) and Rapamycin (Rapa).
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Volume 8 Issue 10 (October 2008)


Novel biologics and small molecules targeting cell surface receptors and intracellular pathways of the T cell. PKC = Protein Kinase C, CN = Calcineurin Inhibitor.
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Volume 8 Issue 9 (September 2008)


Left figure:
Shown is the cumulative survival of all heart transplant recipients at Stanford University over the 40-year period between 1968 and 2007, broken down into 5-year intervals. The cumulative survival continuously improved with every successive 5-year period. Sixty out of 479 patients transplanted before 1988 survived at least 20 years (grey box). The conditional half-life in this patient population was 28.1 years. See article by Deuse et al on pages 1769–1774.
Right figure:
Cytochrome c immunostaining was performed after transplantation of wildtype (JNK2 +/+) and JNK2 deficient (JNK2 -/-) mouse livers after 30 h of cold storage. In JNK2 +/+ grafts, brown immunostaining for cytochrome c was diffuse, indicating cytochrome c release from mitochondria to the cytosol due to the mitochondrial permeability transition. In JNK2 -/- grafts, cytochrome c immunostaining was punctate, indicating mitochondrial retention of cytochrome c. Bar is 20 μm.
See article by Theruvath et al on pages 1819–1828.
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 Volume 8 Issue 8 (August 2009)


Figure on the left-hand side:
Digital images from the electron microscopy of transplant glomerulopathy and peritubular capillary laminations.
A: Glomerular loop with new basement membrane (arrow), i.e., duplication, activated endothelium (arrow) and lumen with a red blood cell (RBC, arrow). Original magnification 7100x.
B: Glomerular loop with thickened basement membrane laminations (arrow), and activated endothelium (arrow). Podocytes for reference (arrow). Original magnification, 15000x.
C: Peritubular capillary with laminations (arrow) and activated endothelium (arrow). Peritubular capillary lumen for reference (PTC Lumen). Original magnification, 9100x. See article by Smith et al on pages 1662–1672.
Figure on the right-hand side:
ECD in Canada defined as donors ≥60 years of age. In the United States, Expanded criteria donors (ECD) are donors age ≥60 years or donors aged 50–59 years with at least two of the following conditions: cerebrovascualar accident as cause of death, serum creatinine > 1.5 mg/dl or a history of hypertension. * 2007 Canadian data are preliminary and have not been verified. The number of SCD, ECD and DCD in the United States were obtained from reference 10 within the article by Gill et al on pages 1580–1587.
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Volume 8 Issue 7 (July 2008)


Figure 1. Immunohistochemistry for CCR1, CCR2 and CCR5 on lung allograft biopsy tissue with CMV disease, showing (A) type II pneumocytes (red arrows) and (B) alveolar macrophages (AM). Pulmonary CMVD biopsy specimen showing CCR1 expression predominantly by C) AM (green arrows), other mononuclear cells (blue arrows) and D) interstitial mast cells (orange arrows). Pulmonary CMVD biopsy specimen showing CCR5 localization to E) AM (green arrows), interstitial mast cells (orange arrows) and F) other mononuclear cells (blue arrows). All images were photographed at 400 x original magnication.
Figure 2a. Acute Rejection. Erythematous macules on the sentinel skin graft at day 20 post partial face transplantation. Clinical involvement of >50% of the composite tissue graft.
Figure 2b. Regression of signs of skin rejection of the sentinel skin graft after increasing the immunossuppressive treatment.
Figure 2c. Banff 2007 Classification of Skin-Containing Composite Tissue Allograft Pathology Grade I rejection of the sentinel skin graft.
Figure 2d. Pathological appearance of the sentinel skin graft after increasing the immunosuppressive regimen.
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Volume 8 Issue 6 (June 2008)


Figure 1. Acute T-cell mediated pancreas allograft rejection 5 years post transplantation, triggered by decreased immunosuppression due to refractory viral infections. Two representative fields of the needle core biopsy demonstrate lymphocytic inflammatory infiltrates involving the glandular tissue, interstitium and vessels. CD8 stain highlights endothelial inflammation in an artery and a vein (center lower picture) and amidst the acinar cells (lower right). Asterisk in top left
image marks active transplant arteriopathy (arterial intimal fibrosis with mononuclear inflammation), also indicative of ongoing T-cell mediated rejection. Please see article by Drachenberg et al on page 1237.
Figure 2. (A) Overall survival after primary liver transplantation (n=147) vs. liver resection in patients potentially eligible for LT (n=80); (B) Disease-free survival after primary LT (n=147) vs. LR in patients potentially eligible for LT (n=80). Please see article by Del Gaudio et al on page 1177.
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Volume 8 Issue 5 (May 2008)


Figure 1. Double-immunofluorescent immunohistochemistry of infiltrating CD3+ T-cells in CAV vessels. For a full description see Figure 4 in Hagemeijer et al in this issue on page 1040.
Figure 2. In this figure, Shimazono (2007) illustrates four modes of transplant tourism. Mode 1 entails a recipient traveling from Country B to Country A where the donor and transplant center are located, Mode 2 entails a donor from Country A traveling to Country B where the recipient and transplant center are located, Mode 3 entails a donor and recipient from Country A traveling to Country B where the transplant center is located, and Mode 4 entails a donor from Country A and a recipient from Country B traveling to Country C where the transplant center is located. Reproduced with permission from Yosuke Shimazono, University of Oxford Institute of Social and Cultural Anthropology.
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Volume 8 Supplement 1 (April 2008)


 

Front cover: These six graphs provide a quick view of transplant and waiting list activity in the United States over the past decade. (Multi-organ transplants are excluded.) Additional detail is given in the organ-specific articles of this report, as well as in the overview article by Port et al.

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Volume 8 Issue 4 (April 2008)


The collage depicting the watchful eye symbolizes the vigilance that, on many different levels, monitors organ transplantation in the United States.
Cover Illustration by Andrew Swartz.
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Volume 8 Issue 3 (March 2008)


Figure 1: Graft survival of MHC-mismatched A/J renal allografts in wild type C57BL/6 vs. B6.CCR5-/- recipients. Groups of wild type C57BL/6 (- -, n=8) and B6.CCR5-/- (-♦-, n=7) received renal allografts from A/J donors and graft survival was followed by daily examination of overall animal health and weekly serum creatinine checks. Allograft rejection was confirmed by histopathology.
Figure 2: Left: Characteristic glomerular features of TG, note extensive duplication of GBM (arrows); Right: TG is often a focal lesion affecting only some glomeruli (top but not the bottom glomerulus in this slide). By Banff criteria (17), the diagnosis of TG is based on the identification of duplicated GBM in more than 10% of glomerular capillary loops in the most affected non-sclerotic glomerulus.
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Volume 8 Issue 2 (February 2008)


Top panel: Cumulative incidence of biopsy-proven acute rejection (BPAR) in patients randomized to steroid-free therapy, steroid withdrawal at Day 7, or standard steroids (Kaplan-Meier, ITT population). P=0.003 for the steroid-free group and p=0.03 for the steroid-withdrawal group, both versus the standard-steroids group (log rank test).
Bottom panel: A group of children who received heart transplants as infants at a picnic in June 2007 in Toronto, Ontario, Canada. Picture taken by Dr. Anne Dipchand and used with her permission and consent of the families involved.
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Volume 8 Issue 1 (January 2008)


This figure illustrates the overall process from bone marrow aspiration to the performance of the allo-ASC functional assays. The pie chart demonstrates the percentages of each cell type in the CD 138* fraction of cells. Please see article by D.K. Perry et al in this issue on page 133. (The top panel of this figure was reproduced with permission from the Mayo Foundation for Medical Education and Research.)
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Volume 7 Issue 12 (December 2007)


Relationship between PBT scores, histopathologic lesions, histopathologic and clinical diagnosis, and classifier predictions. A) Biopsies for cause (n = 143) were sorted based on the CAT1 score (from lowest to highest). According to this order, scores for all PBTs (CAT1, CAT2, GRIT1, GRIT2, KT1, KT2) are illustrated for each individual biopsy for cause. The panel above the graph illustrates the relationship of the PBT scores to the presence of Acute Tubular Necrosis (ATN), the degree of interstitial infiltrate (i score), tubulitis (t score), intimal arteritis (v score), histopathology diagnosis, retrospective clinical-pathologic diagnosis, and the probability of rejection (%), predicted from the classifiers. Please see article by Mueller & Einecke et al on page 2712 of this issue.
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 Volume 7 Issue 11 (November 2007)


 

Platelets in action: Totally granular, dude!

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Volume 7 Issue 10 (October 2007)


 

Left image: Time to (A) acute humoral and (B) cellular rejection in living donor renal transplant recipients
Right image: Incidence of de novo antibodies after islet transplantation
 

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Volume 7 Issue 9 (September 2007)


 

Left image: C4D staining of capillaries (top) and capillary endothelial swelling and leukocyte margination (bottom) in antibody-mediated heart transplant rejection
Right image: Reduction in CMV viral load with time in patients treated with oral valganciclovir and intravenous valganciclovir
 

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Volume 7 Issue 8 (August 2007)


 

Left image: Dr. Olga Jonasson the first woman transplant surgeon 1934-2006
Right image: Global expression of PV1 in the glomerulus of transplant glomerulopathy
 

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Volume 7 Issue 7 (July 2007)


 

‘The first successful organ transplant’ Joel Babb

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Volume 7 Issue 6 (June 2007)


 

 Left panel:
Organs procured and transplanted from deceased donors per million population in 2005 (Council of Europe data).
See the editorial by Roels et al. on page 1439 for more information.
Right panel:
Age-specific donation rates for Spain and the United States in 2004. For more information, see Cuende et al.
on page 1526 of this issue.

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Volume 7 Issue 5 (May 2007)


Left image: New additions to the deceased donor renal transplant waiting list 2000-2005
Right image: Mouse cardiac allograft survival in wild-type and B3 integrin-deficient recipients
 

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 Volume 7 Issue 4 (April 2007)

 


Left image: Conditional gene expression: a new tool for the transplantologist
Right image: Estimated glomerular filtration rates underestimate graph functional loss in kidney transplants
 

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Volume 7 Issue 3 (March 2007)


 Left panel:
This figure from the article by Ekberg et al on the results from the CAESAR Study on pages 560 shows first
biopsy-proven acute rejection in renal transplant patients at 6 and 12 months as defined according
to the Banff criteria.
Right panel:
In this issue of AJT we highlight the Banff '05 meeting report on pages 518. This figure shows a 32-year-old man
who had been originally diagnosed as membranoproliferative glomerulonephritis and received a kidney transplant.
Nine years after transplantation, he developed severe tubular atrophy and interstitial fibrosis and graft failure
with no evidence of any specific etiology (Masson trichrome, original magnification, x200).

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Volume 7 Issue 2 (February 2007)


Persistent inflammation in renal allografts detected by protocol biopsies

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Volume 7 Issue 1 (January 2007)


Left image: Paying tribute to Dr. Robert Zhong 1946-2006
Right image: Loss in renal function after clinical islet transplantation
 

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Volume 6 Issue 12 (December 2006)


 

Current Issues in Lung Transplantation

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Volume 6 Issue 11 (November 2006)


Left image: CATHETER SUBTRACTION ANGIOGRAPHY OF A HEPATOCELLULAR CARCINOMA
Right image: RECURRENT IgA NEPHROPATHY AFTER RENAL TRANSPLANT
 

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Volume 6 Issue 10 (October 2006)


Emory Algorithm for evaluating the sensitized patient

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Volume 6 Issue 9 (September 2009)


Left image: BK virus DNA in several tubular epithelial cells
Right image: Decline in glomerular filtration rate after kidney transplant
 

 

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Volume 6 Issue 8 (August 2006)


 

Emerging issues and insights in antibody-mediated rejection

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Volume 6 Issue 7 (July 2006)


 

PANDEMIC INFLUENZA AND ITS IMPLICATIONS FOR TRANSPLANTATION
 

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Volume 6 Issue 6 (June 2006)


 

CARDIAC ALLOGRAFT VASCULOPATHY INITIATED AND PROPAGATED BY IMMUNOLOGIC AND NON-IMMUNOLOGIC FACTORS
 

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Volume 6 Issue 5 (May 2006)



 

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Volume 6 Issue 4 (April 2006)


 

Left Image: Bilateral hand transplantation: five years later
Right Image: Late kidney deterioration in two of ten patients with “operational tolerance”

 

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Volume 6 Issue 3 (March 2006)


 

Intravenous immunoglobulin (ivig) blocks cytotoxic anti-HLA antibodies in the panel reactive antibody system
 

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Volume 6 Issue 2 (February 2006)


 

Left Image: C4d staining of interacinar capillaries in a pancreas transplant with antibody-mediated rejection (top) versus control (bottom)
Right Image: Risk adjusted cumulative sum chart depicts renal transplant center with a cluster of graft failures

 

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Volume 6 Issue 1 (January 2006)


 

Top image: Liver ischemia after intraportal islet transplantation: necrosis on liver surface (left) intraportal islet cluster with necrotic hepatic tissue (right)
Bottom image: Laryngeal replantation technique in a human

 

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Volume 1 Issue 2 (July 2001)


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Volume 1 Issue 1 (May 2001)


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