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Article ; Online: Transplantation of kidneys after normothermic perfusion: A single center experience.

Pearson, Robert / Geddes, Colin / Mark, Patrick / Clancy, Marc / Asher, John

2021 Volume 35, Issue 10, Page(s) e14431

Abstract: Background: In order to expand the pool of usable donors from circulatory death (DCD) there is increasing interest in normothermic regional perfusion (NRP) to assess and improve liver viability.: Methods: Data was obtained from a prospectively ... ...

Abstract	Background: In order to expand the pool of usable donors from circulatory death (DCD) there is increasing interest in normothermic regional perfusion (NRP) to assess and improve liver viability. Methods: Data was obtained from a prospectively maintained database between December 2012 and September 2018. Primary endpoints were incidence of delayed graft function (DGF) and estimated glomerular filtration rate (eGFR). Results: Six-hundred and thirty-two decease donor kidneys were transplanted, 229 from DCD donors, 29 of which had NRP. The DGF rate was lower for NRP versus DCD (six of 29, 20.7% vs. 70 of 200, 35.0%) with reduced duration of DGF. Multivariate analysis demonstrated transplant type to be a statistically significant independent predictor of eGFR at 7 and 14 days. Early transplant function in NRP kidneys was comparable to DBD. There were no graft losses within 30 days in the NRP group. One-year graft loss rate was 3.4% for NRP and 6.0% for standard DCD. Conclusion: This data suggests NRP is safe, and reduces rates of DGF and improves early renal transplant function.
MeSH term(s)	Delayed Graft Function/etiology ; Graft Survival ; Humans ; Kidney ; Organ Preservation ; Perfusion ; Tissue Donors
Language	English
Publishing date	2021-08-03
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.14431
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Article ; Online: The New UK National Kidney Allocation Scheme With Maximized "R4-D4" Kidney Transplants: Better Patient-to-Graft Longevity Matching May Be at the Cost of More Resources.

Pearson, Robert / Murray, Eleanor / Thomson, Peter C / Mark, Patrick B / Clancy, Marc J / Asher, John

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

2021 Volume 19, Issue 11, Page(s) 1133–1141

Abstract: Objectives: A new kidney matching scheme for allocation of deceased donor kidneys for transplantation was introduced in the United Kingdom in September 2019. Donors and recipients are stratified into quartiles derived from demographic and retrieval ... ...

Abstract	Objectives: A new kidney matching scheme for allocation of deceased donor kidneys for transplantation was introduced in the United Kingdom in September 2019. Donors and recipients are stratified into quartiles derived from demographic and retrieval indices associated with risk of adverse outcome. We present data on 2 years of transplants, with the aim of understanding the potential impacts ofthe scheme on patient/transplant outcomes, hospitalization, and resource utilization. Materials and methods: All deceased donortransplants from 2015 and 2016 were reclassified using the risk quartiles (D1-D4 for donor and R1-R4 for recipient, where 4 is highestrisk). Inpatientlength of stay, kidney function defined by estimated glomerular rate at 1 year, and patient survival data were collected. Results: Of the 195 deceased donor transplants analyzed, 144 recipients (73.4%) were in the highest risk R4 category, including 55 with R4-D4 combination (28.1%). Recipients in the R4 category had longer index admissions (mean of 12.4 vs 8.1 days for R1-R3; P = .002) and higher subsequent admission rates 90 days posttransplant(185.7 vs 122.7/1000 patient days for R1-R3; P < .001). Kidney transplant function at 1 year was lower for grafts categorized as D4 (mean estimated glomerular filtration rate of 35.7 vs 54.8 mL/min/1.73 m2 for D1-D3; P < .001). However, survival for R4 recipients with D4 kidneys was not significantly differentfrom R4 recipients with D1 to D3 kidneys (4-year patient survival rate with R4-D4 combination was 90.9%). Conclusions: The principles ofthe allocation scheme in matching graft and patient survival were already largely being observed (matching higher risk deceased donor kidneys to higher risk recipients). However, an increase in D4 proportions in the R4 group may be associated with longer hospitalization posttransplant. Consideration should be given to mitigation strategies to address this. Despite poorer graft function, patient survival appears satisfactory.
MeSH term(s)	Female ; Graft Survival ; Humans ; Kidney/surgery ; Kidney Transplantation/adverse effects ; Registries ; Tissue Donors ; Treatment Outcome ; United Kingdom
Language	English
Publishing date	2021-11-23
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2396778-X
ISSN	2146-8427 ; 1304-0855
ISSN (online)	2146-8427
ISSN	1304-0855
DOI	10.6002/ect.2021.0129
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Article: Memory Impairment Allied to Temporal Lobe Epilepsy and its Deterioration by Phenytoin: A Highlight on Ameliorative Effects of Levetiracetam in Mouse Model

Mohan, Asher John / Krishna, Kamsagara Linganna

International Journal of Epilepsy

2018 Volume 05, Issue 01, Page(s) 19–27

Abstract: Background/Objectives: Memory impairment (MI) and epilepsy go hand in hand, mainly in conditions of temporal lobe epilepsy (TLE). This disease comorbidity has been reported to worsen upon treatment. Hence this study aims to evaluate the extent of ... ...

Abstract	Background/Objectives: Memory impairment (MI) and epilepsy go hand in hand, mainly in conditions of temporal lobe epilepsy (TLE). This disease comorbidity has been reported to worsen upon treatment. Hence this study aims to evaluate the extent of aggravating effect of phenytoin (PHT) at normal and reduced doses on MI associated with TLE and additionally assesses the protective effect of levetiracetam (LEV) on these adverse effects. Methods: Swiss albino mice of either sex ( n = 36) were used for this study in which seizures were induced by intraperitoneal administration of pilocarpine (300 mg/kg i.p.) followed by evaluation of antiepileptic activity by technique of Racine's scale for convulsive scores. Errors (a factor denoting MI) were assessed using radial arm maze. Finally brain biochemical measures of acetylcholinesterase and glutamate along with cresyl violet staining and estimation of total neuronal number of the hippocampus were performed. Results: Exacerbation of MI by PHT was observed, where the extent of MI was found to be lesser in the reduced dose approach (PHTR: 28.50 ± 1.03; p ≤ 0.05). However, this tactic in dose reduction was interfered with the antiepileptic potential of the drug. Attenuation of MI upon combining with LEV, without an interference in the principal treatment, was observed equally in the behavioral and brain aspects of the study (PHTN + LEV: 1.33 ± 0.33 and PHTR + LEV: 1.00 ± 0.17; p ≤ 0.05). Conclusions: The promising effects of LEV could thus aid in proposing a new management remedy for TLE to minimize the adverse effect associated with it.
Keywords	pilocarpine ; phenytoin ; levetiracetam ; antiepileptic drugs
Language	English
Publishing date	2018-04-01
Publisher	Thieme Medical and Scientific Publishers Private Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2772834-1
ISSN	2213-6339 ; 2213-6320 ; 2213-6339
ISSN (online)	2213-6339
ISSN	2213-6320 ; 2213-6339
DOI	10.1055/s-0038-1656714
Database	Thieme publisher's database

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Article ; Online: Viability assessment and utilization of declined donor kidneys with rhabdomyolysis using ex vivo normothermic perfusion without preimplantation biopsy.

Pearson, Robert / Asher, John / Jackson, Andrew / Mark, Patrick B / Shumeyko, Vlad / Clancy, Marc J

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2020 Volume 21, Issue 3, Page(s) 1317–1321

Abstract: The role of ex vivo normothermic perfusion (EVNP) in both organ viability assessment and reconditioning is increasingly being demonstrated. We report the use of this emerging technology to facilitate the transplantation of a pair of donor kidneys with ... ...

Abstract	The role of ex vivo normothermic perfusion (EVNP) in both organ viability assessment and reconditioning is increasingly being demonstrated. We report the use of this emerging technology to facilitate the transplantation of a pair of donor kidneys with severe acute kidney injury (AKI) secondary to rhabdomyolysis. Donor creatinine was 10.18 mg/dl with protein (30 mg/dl) present in urinalysis. Both kidneys were declined by all other transplantation units and subsequently accepted by our unit. The first kidney was perfused with red cell-based perfusate at 37°C for 75 min, mean renal blood flow was 110 ml/min/100 g and produced 85 ml of urine. Having demonstrated favorable macroscopic appearance and urine output, the kidney was transplanted into a 61-year-old peritoneal dialysis dependent without complication. Given the reassuring information from the first kidney provided by EVNP, the second kidney was not perfused with EVNP and was directly implanted to a 64-year-old patient. The first kidney achieved primary function and the second functioned well after delayed graft function. Recipient eGFR have stabilized at 88.5 and 55.3, respectively (ml/min/1.73 m
MeSH term(s)	Biopsy ; Delayed Graft Function/etiology ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation/adverse effects ; Middle Aged ; Organ Preservation ; Perfusion ; Rhabdomyolysis/etiology ; Tissue Donors
Language	English
Publishing date	2020-10-19
Publishing country	United States
Document type	Case Reports
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/ajt.16329
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Article: The eradication of ungulates (sheep and goats) from Dirk Hartog Island, Shark Bay World Heritage Area, Australia

Heriot, Shane / Asher, John / Williams, Matthew R / Moro, Dorian

Biological invasions. 2019 May, v. 21, no. 5

2019

Abstract: The eradication of ungulates from offshore islands has now become achievable for island managers, with the size and complexity of an island no longer a major impediment to the desired outcome. Here, we report on a whole-of-island eradication campaign of ... ...

Abstract	The eradication of ungulates from offshore islands has now become achievable for island managers, with the size and complexity of an island no longer a major impediment to the desired outcome. Here, we report on a whole-of-island eradication campaign of ungulates (sheep Ovis aries and goats Capra hircus) from the semi-arid Dirk Hartog Island (63,300 ha) off the western Australian coast. The motive behind this campaign was to contribute towards the ecological restoration of this former grazing lease. From 2005, a concerted effort to remove ungulates began with regular destocking, and from 2010 a methodical aerial and ground shooting campaign was undertaken. Long-term commitments of funding and departmental support, staff with diverse skills, and an advisory network of professional people, have been critical components to this large-scale exercise. From 2005 to 2017 a total of 16,318 ungulates (5185 sheep and 11,133 goats) were removed from Dirk Hartog Island: 6839 by mustering, 2422 by ground shooting, 7040 by aerial shooting, and finally 17 by follow-up aerial monitoring and ground shooting. The island was declared free of ungulates in November 2017. To determine the success of the whole-of-island eradication campaign, multiple methods were adopted to locate remaining animals: use of ‘Judas’ goats, monitoring by motion-sensor cameras at water sources and across the island, and recording of tracks and fresh scats to locate any remaining animals. We estimated the likelihood that sheep and goats have been successfully eradicated from the island is 99.9% and 96.9%, respectively. The total cost (AUS$) of the aerial component of the eradication was $1,055,184, an average of $150/goat or $16/ha. The monitoring phase of the campaign (aerial detection and ground shoot) cost the least in terms of actual expenses (approximately $187,000) but the most is terms of cost per remaining goat (approximately $14,400). Ecosystem recovery following the eradication is already apparent with increased vegetation cover and reduced erosion. We conclude with some shared lessons that may assist similar large-scale eradication campaigns of islands. To date, Dirk Hartog Island is the largest island in the world where whole-of-island goat (and sheep) eradication has been achieved.
Keywords	Capra hircus ; cameras ; coasts ; ecological invasion ; ecological restoration ; ecosystems ; feces ; funding ; goats ; grazing ; islands ; leasing ; monitoring ; sheep ; vegetation cover ; Australia
Language	English
Dates of publication	2019-05
Size	p. 1789-1805.
Publishing place	Springer International Publishing
Document type	Article
ZDB-ID	1438729-3
ISSN	1573-1464 ; 1387-3547
ISSN (online)	1573-1464
ISSN	1387-3547
DOI	10.1007/s10530-019-01937-7
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Successful endovascular salvage of a pancreatic graft after a venous thrombosis: case report and literature review.

Asher, John F / Wilson, Colin H / Talbot, David / Manas, Derek M / Williams, Rob / White, Steve A

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

2013 Volume 11, Issue 4, Page(s) 375–378

Abstract: Simultaneous kidney and pancreatic transplant is the criterion standard for treatment of end-stage renal failure because of diabetic nephropathy. Venous thrombosis occurs in approximately 5% of pancreatic transplants, and it is notoriously difficult to ... ...

Abstract	Simultaneous kidney and pancreatic transplant is the criterion standard for treatment of end-stage renal failure because of diabetic nephropathy. Venous thrombosis occurs in approximately 5% of pancreatic transplants, and it is notoriously difficult to treat, forming the most common nonimmunologic cause of graft loss. We report a case of early detection of pancreatic graft venous thrombosis by measuring urinary amylase, resulting in the successful endovascular salvage of the pancreatic graft.
MeSH term(s)	Amylases/urine ; Biomarkers/urine ; Diabetes Mellitus, Type 1/complications ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/surgery ; Early Diagnosis ; Endovascular Procedures ; Female ; Humans ; Kidney Failure, Chronic/diagnosis ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Middle Aged ; Pancreas Transplantation/adverse effects ; Phlebography ; Predictive Value of Tests ; Radiography, Interventional ; Thrombectomy/methods ; Time Factors ; Treatment Outcome ; Venous Thrombosis/diagnosis ; Venous Thrombosis/etiology ; Venous Thrombosis/therapy ; Venous Thrombosis/urine
Chemical Substances	Biomarkers ; Amylases (EC 3.2.1.-)
Language	English
Publishing date	2013-08
Publishing country	Turkey
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2396778-X
ISSN	2146-8427 ; 1304-0855
ISSN (online)	2146-8427
ISSN	1304-0855
DOI	10.6002/ect.2012.0234
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Article ; Online: SARS-CoV-2 infection and early mortality of waitlisted and solid organ transplant recipients in England: A national cohort study.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2020 Volume 20, Issue 11, Page(s) 3008–3018

Abstract: Patients waitlisted for and recipients of solid organ transplants (SOT) are perceived to have a higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and death; however, definitive epidemiological evidence is lacking. In ...

Abstract	Patients waitlisted for and recipients of solid organ transplants (SOT) are perceived to have a higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and death; however, definitive epidemiological evidence is lacking. In a comprehensive national cohort study enabled by linkage of the UK transplant registry and Public Health England and NHS Digital Tracing services, we examined the incidence of laboratory-confirmed SARS-CoV-2 infection and subsequent mortality in patients on the active waiting list for a deceased donor SOT and recipients with a functioning SOT as of February 1, 2020 with follow-up to May 20, 2020. Univariate and multivariable techniques were used to compare differences between groups and to control for case-mix. One hundred ninety-seven (3.8%) of the 5184 waitlisted patients and 597 (1.3%) of the 46 789 SOT recipients tested positive for SARS-CoV-2. Mortality after testing positive for SARS-CoV-2 was 10.2% (20/197) for waitlisted patients and 25.8% (154/597) for SOT recipients. Increasing recipient age was the only variable independently associated with death after positive SARS-CoV-2 test. Of the 1004 transplants performed in 2020, 41 (4.1%) recipients have tested positive for SARS-CoV-2 with 8 (0.8%) deaths reported by May 20. These data provide evidence to support decisions on the risks and benefits of SOT during the coronavirus disease 2019 pandemic.
MeSH term(s)	Adolescent ; Adult ; COVID-19/epidemiology ; Child ; Child, Preschool ; England/epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Organ Transplantation ; Pandemics ; Registries ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Survival Rate/trends ; Tissue Donors ; Transplant Recipients ; Waiting Lists/mortality ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-09-16
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/ajt.16247
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Book: Der guote Gêrhart

Rudolf / Asher, John A

(Altdeutsche Textbibliothek ; 56)

1989

Title translation	Der gute Gerhard
Author's details	von Rudolf von Ems. Hrsg. von John A. Asher
Series title	Altdeutsche Textbibliothek ; 56
Language	German ; German, Middle High
Size	XXVII, 232 S, 19 cm
Edition	3., durchges. Aufl
Document type	Book
Note	Literaturverz. S. XXII - XXV
ISBN	3484200537 ; 3484200553 ; 9783484200531 ; 9783484200555
Database	Former special subject collection: coastal and deep sea fishing

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Article: A Prospective Randomised Paired Trial of Sirolimus versus Tacrolimus as Primary Immunosuppression following Non-Heart Beating Donor Kidney Transplantation.

Asher, John / Vasdev, Nikhil / Wyrley-Birch, Hugh / Wilson, Colin / Soomro, Naeem / Rix, David / Jaques, Bryon / Manas, Derek / Torpey, Nicholas / Talbot, David

Current urology

2014 Volume 7, Issue 4, Page(s) 174–180

Abstract: Introduction: With calcineurin inhibitors potentiating damage from ischaemia-reperfusion injury in kidneys from donors after cardiac death we wanted to investigate the role of substituting sirolimus for tacrolimus in the delayed introduction of ... ...

Abstract	Introduction: With calcineurin inhibitors potentiating damage from ischaemia-reperfusion injury in kidneys from donors after cardiac death we wanted to investigate the role of substituting sirolimus for tacrolimus in the delayed introduction of calcineurin inhibitor regime used in our centre. Method: A prospective randomised paired open-label study was performed taking pairs of kidneys from each donor and randomising one to a tacrolimus-based regime and the other to a similar regime based on sirolimus. Graft function at one year was the primary endpoint. Results: Total 31 pairs of kidneys were randomised to each group, with 19 pairs of recipients available for analysis after post-randomisation study exclusions. Despite a higher incidence of biopsy proven acute rejection in the sirolimus group, renal allograft function was similar in both groups at three-monthly intervals up to one year post-transplant. All episodes of acute rejection in the sirolimus group occurred in the first three months. Graft and patient survival at one year was 100% in the tacrolimus group, with one death with functioning graft in the sirolimus group (95% survival). Unfortunately, 10 of the 19 patients in the sirolimus arm required switch of medication to tacrolimus due to acute rejection or intolerable drug side effects. Conclusions: Graft survival and function were very similar in the two groups despite the higher rate of acute rejection in the sirolimus arm, raising the possibility that the damage done by acute rejection was adequately offset by the nephron-sparing effect of sirolimus compared to tacrolimus. Sirolimus may have a role as a longer-term maintenance immunosuppressant after initial treatment with a different agent such as tacrolimus or belatacept.
Language	English
Publishing date	2014-08-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2253664-4
ISSN	1661-7657 ; 1661-7649
ISSN (online)	1661-7657
ISSN	1661-7649
DOI	10.1159/000365671
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Article: SARS-CoV-2 infection and early mortality of wait-listed and solid organ transplant recipients in England: a national cohort study

Am. j. transplant

Abstract: Patients wait-listed for and recipients of solid organ transplants (SOT) are perceived to have a higher risk of contracting SARS-CoV-2 and death; however, definitive epidemiological evidence is lacking. In a comprehensive national cohort study enabled by ...

Abstract	Patients wait-listed for and recipients of solid organ transplants (SOT) are perceived to have a higher risk of contracting SARS-CoV-2 and death; however, definitive epidemiological evidence is lacking. In a comprehensive national cohort study enabled by linkage of the UK transplant registry and Public Health England and NHS Digital Tracing services we examined the incidence of laboratory confirmed SARS-CoV-2 infection and subsequent mortality in patients on the active waiting list for a deceased donor SOT and recipients with a functioning SOT as of 1st February 2020 with follow up to 20th May 20202. Univariate and multivariable techniques were used to compare differences between groups and to control for case-mix. 197 (3·8%) of the 5,184 wait-listed patients and 597 (1·3%) of the 46,789 SOT recipients tested positive for SARS-CoV-2. Mortality after testing positive for SARS-CoV-2 was 10·2% (20/197) for wait-listed patients and 25·8% (154/597) for SOT recipients. Increasing recipient age was the only variable independently associated with death after positive SARS-CoV-2 test. Of the 1004 transplants performed in 2020, 41 (4·1%) recipients have tested positive for SARS-CoV-2 with 8 (0·8%) deaths reported by 20th May. These data provide evidence to support decisions on the risks and benefits of SOT during the COVID-19 pandemic.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #780678
Database	COVID19

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