Biomedical subjects

Martin Zand

Publications and source records attributed to Martin Zand.

4 recordsLinked to original sources

PubMed2006

Modification of a biventricular assist device to facilitate preservative infusion and organ recovery in a nonheart-beating donor.

A 46-year-old patient supported by a biventricular assist device (BiVAD) was transferred to our institution for evaluation for heart transplant. The patient was found to have a large intracranial hemorrhage with profound deterioration of neurologic status. The poor prognosis prompted the decision to withdraw care and pursue organ donation. Because the patient did not meet brain death criteria, nonheart-beating donor organ donation was pursued. After the termination of care, the BiVAD was modified: the left side to provide organ preservative solution and the right side to allow drainage. Eight liters of cold University of Wisconsin solution were pumped systemically over 10 minutes, the donor was drained, and the liver was harvested. This technique expedited donor perfusion by eliminating the need to cannulate, minimizing ischemic time for the liver. Although the recipient outcome was poor, and retransplantation was eventually necessary, we believe it was most likely not attributable to the quality of organ preservation. This report discusses the technical aspects of this potentially beneficial procedure.

Cadaver↗

PubMed2005

Mini-BEAM and autologous hematopoietic stem-cell transplant for treatment of post-transplant lymphoproliferative disorders.

Post-transplant lymphoproliferative disorder (PTLD) represents a spectrum of lymphoid proliferative diseases seen as result of immunosuppression in recipients of solid organ or hematopoietic stem-cell transplantation. Options of treatment include reduction or discontinuation of immunosuppressive agents, antiviral drugs, rituximab, chemotherapy, and radiation. We report two unique cases of PTLD (CNS and plasmacytoma-like) treated successfully with salvage chemotherapy, mini-BEAM chemotherapy, and autologous stem-cell transplant. In both cases, patients were also treated with sirolimus and prednisone as immunosuppression, and neither patient rejected their solid organ transplants. With over 30 months of follow-up, both patients remain in complete remission with excellent allograft function.

Adult↗

PubMed2004

Impact of hepatitis C viral infection in primary cadaveric liver allograft versus primary living-donor allograft in 100 consecutive liver transplant recipients receiving tacrolimus.

BACKGROUND: There has been concern that adult living-donor liver transplantation (LLTx) for hepatitis C virus (HCV) infection may lead to recurrent disease that is more severe compared with the results of cadaveric LTx (CLTx), because the smaller sized graft in LLTx regenerates and may increase viral replication. This study examines the survival outcome and HCV recurrence in CLTx versus LLTx performed at a single institution. METHOD: A total of 100 consecutive adult recipients (75 men and 25 women; mean age 49.9+/-8.4 years) of LTx (65 CLTxs and 35 LLTxs performed July 2000-July 2002) who tested positive for HCV by polymerase chain reaction were examined retrospectively until October 2003. All patients received tacrolimus-based immunosuppression with mycophenolate mofetil and steroids. RESULTS: The overall actual patient survival was 85% (83.1% for CLTx vs. 88.6% for LLTx). The 39-month Kaplan-Meier actuarial patient survivals were 75.1% for CLTx and 88.6% for LLTx. Of 15 deaths, 6 were the result of recurrent HCV (five CLTxs and one LLTx), and of 10 retransplants, 2 were related to recurrent HCV (one CLTx and one LLTx). The rates of recurrence were 72.3% and 77.1%, the hepatitis activity indices were 5.4 + 2.4 and 6.2 + 2.8, the fibrosis scores were 1.4+/-1.4 and 1.5+/-1.3, and the times to recurrence were 318+/-269 days and 394+/-250 days for CLTx and LLTx, respectively. None of the differences between the two groups were significant. CONCLUSION: No detrimental effect of HCV infection was found in LLTx recipients when compared with contemporaneous CLTx recipients. Patient survival, graft survival, rate of HCV recurrence, severity of HCV recurrence, graft loss from HCV, and interval for recurrence in CLTx and LLTx were similar.

Adult↗

PubMedDate not supplied

Towards a consensus on datasets and evaluation metrics for developing B-cell epitope prediction tools.

A B-cell epitope is the three-dimensional structure within an antigen that can be bound to the variable region of an antibody. The prediction of B-cell epitopes is highly desirable for various immunological applications, but has presented a set of unique challenges to the bioinformatics and immunology communities. Improving the accuracy of B-cell epitope prediction methods depends on a community consensus on the data and metrics utilized to develop and evaluate such tools. A workshop, sponsored by the National Institute of Allergy and Infectious Disease (NIAID), was recently held in Washington, DC to discuss the current state of the B-cell epitope prediction field. Many of the currently available tools were surveyed and a set of recommendations was devised to facilitate improvements in the currently existing tools and to expedite future tool development. An underlying theme of the recommendations put forth by the panel is increased collaboration among research groups. By developing common datasets, standardized data formats, and the means with which to consolidate information, we hope to greatly enhance the development of B-cell epitope prediction tools.

Animals↗