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American Journal of Transplantation

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https://www.readbyqxmd.com/read/27888576/total-recall-can-we-reshape-t-cell-memory-by-lymphoablation
#1
Michael Nicosia, Anna Valujskikh
Despite recent advances in immunosuppression, donor-reactive memory T cells remain a serious threat to successful organ transplantation. To alleviate damaging effects of preexisting immunologic memory, lymphoablative induction therapies are used as a part of standard care in sensitized recipients. However, there is accumulating evidence that memory T cells have advantages over their naïve counterparts in surviving depletion and expanding under lymphopenic conditions. This may at least partially explain the inability of existing lymphoablative strategies to improve long term allograft outcome in sensitized recipients, despite well-documented decrease in the frequency of early acute rejection episodes...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888569/providing-coverage-for-the-unique-life-long-health-care-needs-of-living-kidney-donors-within-the-framework-of-financial-neutrality
#2
John S Gill, Francis Delmonico, Scott Klarenbach, Alexander Morgan Capron
Organ donation should neither enrich nor impose financial burdens on donors. We describe the scope of health care required for all living kidney donors that reflects contemporary understanding of long-term donor health outcomes, propose an approach to identify donor health conditions which should be covered within the framework of financial neutrality, and propose strategies to pay for this care. Despite the Affordable Care Act in the United States, donors continue to have inadequate coverage for important health conditions that are either donation related or may compromise post-donation kidney function...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888565/applying-mass-cytometry-to-the-analysis-of-lymphoid-populations-in-transplantation
#3
Sheri M Krams, Steven Schaffert, Audrey H Lau, Olivia M Martinez
Single-cell flow cytometric techniques have been indispensable to improving our understanding of the phenotype and function of immune cell subsets that are important in both rejection and tolerance post-transplant. Mass cytometry, or Cytometry by Time-of-Flight (CyTOF), is a single cell-based platform that utilizes antibodies conjugated to rare heavy metal ions for analysis of cellular proteins by a time-of-flight mass spectrometer. This new technology allows for the evaluation of over 40 simultaneous cellular parameters in a single sample because the limitation of spectral overlap, seen in conventional flow cytometry, is eliminated...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888562/parainfluenza-3-infections-early-after-kidney-or-simultaneous-pancreas-kidney-transplantation
#4
Ilkka Helanterä, Veli-Jukka Anttila, Raisa Loginov, Marko Lempinen
Parainfluenza (PIV) can cause serious infections after hematopoietic stem cell or lung transplantation. Limited data exist about PIV infections after kidney transplantation. We describe an outbreak of PIV-3 in a transplant unit. During the outbreak 45 patients were treated on the ward for postoperative care after kidney or simultaneous pancreas-kidney (SPK) transplantation. Altogether 29 patients were tested for respiratory viruses (12 patients with respiratory symptoms, 17 asymptomatic exposed patients) from nasopharyngeal swabs with PCR...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888555/renal-operational-tolerance-is-associated-with-a-defect-of-blood-tfh-cells-that-exhibit-impaired-b-cell-help
#5
Alexis Chenouard, Mélanie Chesneau, Linh Bui Nguyen, Sabine Le Bot, Marion Cadoux, Emilie Dugast, Chloé Paul, Stéphanie Malard-Castagnet, Simon Ville, Pierrick Guérif, Jean-Paul Soulillou, Nicolas Degauque, Richard Danger, Magali Giral, Sophie Brouard
Renal operationally tolerant patients (TOL) display a defect in B cell differentiation, with a deficiency in plasma cells. Recently described, T follicular helper cells (Tfh) play a critical role in B cell differentiation. We analyzed blood Tfh subsets in TOL and transplanted patients with stable graft function under immunosuppression (STA). We observed a reduced proportion of blood activated and highly functional Tfh subsets in TOL, without affecting Tfh absolute numbers. Functionally, Tfh from TOL displayed a modified gene expression profile, failed to produce IL-21 and were unable to induce IgG production by naive B cells...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888553/left-lobe-auxiliary-liver-transplantation-for-end-stage-hepatitis-b-liver-cirrhosis
#6
S Wang, X Chen, Z Chen, L Wei, S Dong, H Guo, J Jiang, W Teng, Z Huang, W Zhang
Auxiliary liver transplantation (ALT) for Hepatitis B virus (HBV) related liver cirrhosis previously showed poor results, because the native liver was a significant source of HBV recurrence and the graft could be rapidly destroyed by HBV infection in an immunosuppressive condition. Four patients suffering from HBV-related liver cirrhosis were unable to undergo orthotopic liver transplantation because the only available grafts of left lobe were too small. Under entecavir based anti-HBV treatment, they underwent ALT in which the recipient left liver was removed and the small left lobe graft was implanted in the corresponding space...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888551/selective-targeting-of-high-affinity-lfa-1-does-not-augment-costimulation-blockade-in-a-nonhuman-primate-renal-transplantation-model
#7
K P Samy, D A Anderson, D J Lo, M S Mulvihill, M Song, A B Farris, B S Parker, A L MacDonald, C Lu, T A Springer, S C Kachlany, K A Reimann, T How, F V Leopardi, K S Franke, K D Williams, B H Collins, A D Kirk
Costimulation blockade (CoB) via belatacept is a lower morbidity alternative to calcineurin inhibitor (CNI)-based immunosuppression. However, it has higher rates of early acute rejection. These early rejections are mediated in part by memory T cells, which have reduced dependence on the pathway targeted by belatacept, and increased adhesion molecule expression. One such molecule is Leukocyte Function Associated Antigen (LFA)-1. LFA-1 exists in two forms, a commonly expressed, low-affinity form, and a transient, high-affinity form, expressed only during activation...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27873483/successful-lung-transplantation-from-hepatitis-c-positive-donor-to-seronegative-recipient
#8
Basha Khan, Lianne G Singer, Cecilia Chaparro, Tereza Martinu, Stephen Juvet, Mauricio Pipkin, Thomas K Waddell, Shaf Keshavjee, Atul Humar, Marcelo Cypel
Lung Transplantation using RNA+ hepatitis C (HCV+) donors to seronegative recipients is not currently performed due to the very high risk of transmission. Previous reports have shown poor survival when this practice was applied. The emergence of new direct-acting antiviral drugs (DAA) suggests a high chance of sustained virologic response (SVR) in immunocompetent patients. We report here successful transplantation of lungs from HCV+ donor to HCV- recipient. The recipient was an HCV- patient with chronic lung allograft dysfunction (CLAD)...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27873477/telemedically-supported-case-management-of-living-donor-renal-transplant-recipients-to-optimize-routine-evidence-based-aftercare-a-single-center-randomized-controlled-trial
#9
A Schmid, S Hils, A Kramer-Zucker, L Bogatyreva, D Hauschke, S De Geest, P Pisarski
Improving mid-term and long-term outcomes after solid organ transplantation is imperative, and requires both state-of-the-art transplant surgery and optimization of routine, evidence-based aftercare. This randomized, controlled trial assessed the effectiveness of standard aftercare versus telemedically-supported case management, an innovative aftercare model, in 46 living-donor renal transplant recipients during the first post-transplant year. The model includes three components: (a) chronic care case management initiated after discharge, (b) case management initiated in emerging acute care situations, and (c) a telemedically-equipped team comprising a transplant nurse case manager and two senior transplant physicians (nephrologist, surgeon)...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27873464/hyalinosis-lesions-in-renal-transplant-biopsies-time-dependent-complexity-of-interpretation
#10
Gunilla Einecke, Jeff Reeve, Philip F Halloran
Because calcineurin inhibitor immunosuppressive drugs (CNIs) induce arteriolar hyalinosis (ah) in kidney transplants, ah lesions can potentially provide information about drug exposure. We studied the relationship of ah lesions to findings and outcomes in 562 indication biopsies taken 3 days to 35 years post-transplant. Prevalence of ah lesions increased with time post-transplant (TxBx). Ah-scores correlated with arterial intimal thickening and atrophy-fibrosis but, unlike atrophy-fibrosis, did not increase until after 500 days because of a background of ah1 lesions in early biopsies reflecting donor aging...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27873446/the-first-two-years-of-activity-of-a-specialized-organ-procurement-centre-report-of-an-innovative-approach-to-improve-organ-donation
#11
Pierre Marsolais, Philippe Durand, Emmanuel Charbonney, Karim Serri, Anne-Marie Lagacé, Francis Bernard, Martin Albert
The number of patients requiring organ transplants continues to outgrow the number of organs donated each year. In an attempt to improve the organ donation process and increase the number of organs available, we created a specialized multidisciplinary team within a specialized Organ Procurement Centre (OPC) with dedicated intensive care unit beds and operating rooms. The OPC was staffed with ICU nurses, operating room nurses, organ donor management ICU physicians and multidisciplinary staff. All organ donors within a designated geographic area were transferred and managed within the OPC...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27868389/monitoring-of-human-uterus-transplantation-with-cervical-biopsies-a-provisional-scoring-system-for-rejection
#12
J Mölne, V Broecker, J Ekberg, O Nilsson, P Dahm-Kähler, M Brännström
Until now, absolute uterine factor infertility has been the major untreatable form of female infertility. Recently, uterus transplantation has proven to be the first successful treatment for absolute uterine factor infertility, with demonstration of live births. Here, live donation uterus transplantation was performed in nine women. 163 cervical biopsies (149 protocol, 14 follow-up) were taken to detect histopathological signs of rejection. Based on experience from animal experiments, we used a three-grade scoring system to evaluate biopsies systematically...
November 21, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27865040/psychological-outcomes-of-living-liver-donors-from-a-multi-center-prospective-study-results-from-the-adult-to-adult-living-donor-liver-transplantation-cohort-study-a2all
#13
Z Butt, M A Dew, Q Liu, M A Simpson, A R Smith, J Zee, B W Gillespie, S E Abbey, D P Ladner, R Weinrieb, R A Fisher, S Hafliger, N Terrault, J Burton, A H Sherker, A Di Martini
While single-center and cross-sectional studies have suggested modest impact of liver donation on donor psychological well-being, few studies have assessed these outcomes prospectively among a large cohort. We conducted one of the largest, prospective, multi-center studies of psychological outcomes in living liver donors within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL-2) Consortium. 271 (91%) of 297 eligible donors were interviewed at least once at pre-donation, 3-, 6-, 12- and 24-months post-donation using validated measures...
November 19, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862995/reply-to-predictive-modeling-of-tacrolimus-dose-requirements-all-that-is-gold-does-not-glitter
#14
LETTER
C Damon, N Pallet
We actually built predictive models of inter-individual tacrolimus (Tac) concentration/dose ratio variability at each time point (PLS1 model) and for all time points (PLS2 model) (2). We learned the models on a training set corresponding to 80% of the whole dataset, and we assessed them on an independent test set corresponding to the 20% remaining subjects. The statistical significance of the predictive power of our models has been estimated with a permutation test. This article is protected by copyright. All rights reserved...
November 15, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862942/a-novel-xenogeneic-graft-versus-host-disease-model-for-investigating-the-pathological-role-of-human-cd4-or-cd8-t-cells-using-immunodeficient-nog-mice
#15
Ryoji Ito, Ikumi Katano, Kenji Kawai, Mika Yagoto, Takeshi Takahashi, Yuyo Ka, Tomoyuki Ogura, Riichi Takahashi, Mamoru Ito
Graft-versus-host disease (GVHD) is a major complication of allogenic bone marrow transplantation and involves the infiltration of donor CD4+ and/or CD8+ T cells into various organs of the recipient. The pathological role of human CD4+ and CD8+ T cells in GVHD remains controversial. In this study, we established two novel xenogeneic (xeno)-GVHD models. Human CD4+ or CD8+ T cells were purified from peripheral blood and were transplanted into immunodeficient NOD/Shi-scid IL2rg(null) (NOG) mice. Human CD8+ T cells did not induce major GVHD symptoms in conventional NOG mice...
November 15, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862962/effect-of-replacing-race-with-apolipoprotein-l1-genotype-in-calculation-of-kidney-donor-risk-index
#16
B A Julian, R S Gaston, W M Brown, A M Reeves-Daniel, A K Israni, D P Schladt, S O Pastan, S Mohan, B I Freedman, J Divers
Renal allografts from deceased African Americans with two apolipoprotein L1 gene (APOL1) renal-risk variants fail sooner than kidneys from donors with fewer variants. Kidney Donor Risk Index (KDRI) was developed to evaluate organ offers by predicting allograft longevity and includes African American race as a risk factor. Substituting APOL1 genotype for race may refine the KDRI. For 622 deceased African American kidney donors, we applied 10-fold cross-validation approach to estimate contribution of APOL1 variants to a revised KDRI...
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862938/combined-percutaneous-trans-renal-and-trans-femoral-endovascular-recanalization-and-angioplastic-reconstruction-of-a-disrupted-transplant-renal-artery-stent-a-novel-salvage-technique
#17
Dustin J Carpenter, Sumit Mohan, Lloyd E Ratner, Peter Schlossberg
Renal artery stenosis (RAS) is the most common vascular complication following renal transplantation. Percutaneous endovascular transluminal angioplasty with stenting is the treatment of choice for clinically significant RAS. We present a case describing a novel combined trans-renal parenchyma and trans-femoral approach to repairing a disrupted transplant renal artery stent. Our patient's allograft RAS was initially managed by standard percutaneous approach, but during follow-up the stent became disrupted and crushed causing partial occlusion of the renal artery...
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27860213/discontinuing-mycophenolate-with-respect-to-pregnancy-and-the-interpretation-of-voluntary-registry-results
#18
LETTER
B Kaplan, R King
As the authors of the article entitled Pregnancy Outcomes Related to Mycophenolate Exposure in Female Kidney Transplant Recipients (1), we are responding to Moritz et al's Letter to the Editor (2) in this issue of the American Journal of Transplantation. We thank Moritz et al for identifying an error in our discussion, but would also like to address what we feel to be misrepresentations of our data. This article is protected by copyright. All rights reserved.
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862968/the-xiii-th-banff-conference-on-allograft-pathology-the-banff-2015-heart-meeting-report-improving-antibody-mediated-rejection-diagnostics-strengths-unmet-needs-and-future-directions
#19
P Bruneval, A Angelini, D Miller, L Potena, A Loupy, A Zeevi, E F Reed, D Dragun, N Reinsmoen, R N Smith, L West, S Tebutt, T Thum, M Haas, M Mengel, P Revelo, M Fedrigo, J P Duong Van Huyen, G J Berry
The 13(th) Banff Conference on Allograft Pathology was held in Vancouver, British Columbia, Canada from October 5-10, 2015. The cardiac session was devoted to current diagnostic issues in heart transplantation with a focus on antibody-mediated rejection (AMR) and small vessel arteriopathy. Specific topics included the strengths and limitations of the current rejection grading system, the central role of microvascular injury in AMR and approaches to semi-quantitative assessment of histopathologic and immunophenotypic indicators, the role of AMR in the development of cardiac allograft vasculopathy, the important role of serologic antibody detection in the management of transplant recipients and the potential application of new molecular approaches to the elucidation of the pathophysiology of AMR and potential for improving the current diagnostic system...
November 12, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862972/long-term-medical-and-psychosocial-outcomes-in-living-liver-donors
#20
Mary Amanda Dew, Zeeshan Butt, Abhinav Humar, Andrea F DiMartini
Due to the enduring organ shortage, living donor liver transplantation has been a valuable treatment strategy for advanced liver disease patients for over 20 years. A variety of reviews have summarized the extensive data now available on medical and psychosocial risks to living donors in the aftermath of donation. However, evidence on donor medical and psychosocial outcomes beyond the first year postdonation has not been synthesized in any previous review. The evidence base on such "long-term" outcomes has been growing in recent years...
November 10, 2016: American Journal of Transplantation
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