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Transplant International: Official Journal of the European Society for Organ Transplantation

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https://www.readbyqxmd.com/read/28211192/racial-differences-in-incident-de-novo-donor-specific-anti-hla-antibody-among-primary-renal-allograft-recipients
#1
Matthew J Everly, Kimberly P Briley, Carl E Haisch, Georg Dieplinger, Paul Bolin, Scott A Kendrick, Claire Morgan, Angela Q Maldonado, Lorita M Rebellato
Controversy exists as to whether African American (AA) transplant recipients are at risk for developing de novo donor-specific anti-human leukocyte antigen (HLA) antibody (dnDSA). We studied 341 HLA-mismatched, primary renal allograft recipients who were consecutively transplanted between 3/1999 and 12/2010. Sera were collected sequentially pre- and post-transplant and tested for anti-HLA immunoglobulin G (IgG) via single antigen bead assay. Of the 341 transplant patients (225 AA and 116 non-AA), 107 developed dnDSA at a median of 9...
February 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28207978/glomerular-c4d-deposits-can-mark-structural-capillary-wall-remodeling-in-thrombotic-microangiopathy-and-transplant-glomerulopathy-c4d-beyond-active-antibody-mediated-injury
#2
Adil H Gasim, Jamie S Chua, Ron Wolterbeek, John Schmitz, Eric Weimer, Harsharan K Singh, Volker Nickeleit
Peritubular capillary C4d (ptc-C4d) usually marks active antibody mediated rejection, while pseudolinear glomerular capillary C4d (GBM-C4d) is of undetermined diagnostic significance, especially when seen in isolation without concurrent ptc-C4d. We correlated GBM-C4d with structural GBM abnormalities and active antibody mediated rejection in 319 renal transplant and 35 control native kidney biopsies. In kidney transplants ptc-C4d was associated with GBM-C4d in 97% by immunofluorescence microscopy (IF) and 61% by immunohistochemistry (IHC; p<0...
February 16, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28186648/the-recipient-s-heme-oxygenase-1-promoter-region-polymorphism-is-associated-with-cardiac-allograft-vasculopathy
#3
Kathrin Freystaetter, Martin Andreas, Martin Bilban, Thomas Perkmann, Alexandra Kaider, Marco Masetti, Alfred Kocher, Michael Wolzt, Andreas Zuckermann
BACKGROUND: Heme oxygenase-1 (HO-1) catalyses the degradation of heme to biliverdin, free iron and carbon monoxide. The promoter region contains a highly polymorphic (GT)n repeat, where shorter (GT)n repeat sequences are linked to higher transcriptional activity, which was shown to correlate with a cytoprotective effect. Higher HO-1 levels may protect from cardiac allograft vasculopathy. METHODS: Cardiac allograft recipients transplanted between 1988 and 2012 were analysed for the HO-1 (GT)n repeat polymorphism using PCR and DNA fragment analysis with capillary electrophoresis...
February 10, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28186642/higher-calcineurin-inhibitor-levels-predict-better-kidney-graft-survival-in-patients-with-de-novo-donor-specific-anti-hla-antibodies-a-cohort-study
#4
Marc-Antoine Béland, Isabelle Lapointe, Réal Noël, Isabelle Côté, Eric Wagner, Julie Riopel, Eva Latulippe, Olivier Désy, Stéphanie Béland, Ciara N Magee, Isabelle Houde, Sacha A De Serres
The development of de novo anti-HLA donor specific antibodies (dnDSA) is associated with poorer outcomes in kidney transplant recipients. Despite this, antibody screening post-transplant is not widespread, largely because the optimal management of patients with dnDSA remains undetermined. We hypothesized that in this population, calcineurin inhibitor blood levels would be an independent predictor of graft loss. We analyzed a cohort of unsensitized patients for whom anti-HLA antibody screening was performed prospectively post-transplant...
February 10, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28166398/belatacept-after-kidney-transplantation-in-adolescents-a-retrospective-study
#5
Christian Lerch, Nele K Kanzelmeyer, Thurid Ahlenstiel-Grunow, Kerstin Froede, Martin Kreuzer, Jens Drube, Murielle Verboom, Lars Pape
Regardless of recipient age at kidney transplantation (KTx), patients are at greatest risk for graft loss in adolescence, partly due to non-adherence to an oral immunosuppressive regimen. Belatacept, a non-nephrotoxic, first-in-class immunosuppressant that inhibits co-stimulation of T-cells, requires intravenous application only every 4 weeks, potentially leading to better adherence. However, it is only approved for use in adults. We report here the findings of the first study of belatacept in adolescents, comprising all patients in our department switched to belatacept post-KTx...
February 6, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28166393/donor-specific-antibodies-c1q-binding-improvement-in-kidney-graft-management
#6
Sylvie Ferrari-Lacraz
The diagnosis of acute antibody mediated rejection (ABMR) after kidney transplantation is based on three parameters: 1) decreased renal function, 2) histopathological signs of rejection, 3) presence of Donor Specific Antibody (DSA) [1]. Patient survival, as well as graft survival have improved since 5 to 10 years [2], thanks to several factors, including better management of patients, better immunosuppressive regimens, detection and avoidance of DSA. Although anti-HLA antibodies follow-up have improved ABMR management, its treatment remains challenging, and outcome may be worsened because of a delay in the diagnosis...
February 6, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28152216/what-is-the-significance-of-esrd-risk-estimation-in-living-kidney-donors
#7
François Gaillard, Stéphanie Baron, Marc-Olivier Timsit, Dominique Eladari, Catherine Fournier, Caroline Prot-Bertoye, Jean-Philippe Bertocchio, Lionel Lamhaut, Gérard Friedlander, Arnaud Méjean, Christophe Legendre, Marie Courbebaisse
BACKGROUND: Two end stage renal disease (ESRD) risk calculators were recently developed by Grams et al, and Ibrahim et al to calculate ESRD risk before donation among living kidney donors. However those calculators have never been studied among potential donors for whom donation was refused due to medical contraindications and compared to a group of donors. METHODS: We compared 15-year and lifetime ESRD risk of donors and non-donors due to medical cause as estimated by those two calculators...
February 2, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28130928/renal-graft-intolerance-syndrome-in-late-graft-failure-patients-efficacy-and-safety-of-embolization-as-first-line-treatment-compared-to-surgical-removal
#8
Ghalib Al Badaai, Vincent Pernin, Valérie Garrigue, Valérie Monnin, Thibaut Murez, Saad Ed Dine Fadli, Nicolas Molinari, Rodolphe Thuret, François Iborra, Georges Mourad
BACKGROUND: Although renal graft percutaneous embolization was introduced to avoid the risk associated with graft nephrectomy, there is no universal consensus about its indications and results. OBJECTIVE: Evaluate the efficacy of graft embolization in the treatment of graft intolerance syndrome as well as its safety compared to surgical removal with respect to complications and other morbidity measures. MATERIALS AND METHODS: A retrospective observational study comparing 2 groups of patients treated for graft intolerance syndrome: Group 1: patients who had embolization as first line treatment and Group 2: patients directly treated by surgical removal...
January 28, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28130926/penile-transplantation-an-emerging-option-for-genitourinary-reconstruction
#9
Sami H Tuffaha, Damon S Cooney, Nikolai A Sopko, Trinity J Bivalacqua, Denver M Lough, Carisa M Cooney, Gerald Brandacher, W P Andrew Lee, Arthur L Burnett, Richard J Redett
Penile transplantation is an emerging option for patients with severe genital defects not amenable to traditional reconstructive options. In this article, we discuss the burgeoning problem of severe male genitourinary trauma in the military, the limitations of traditional reconstructive options in addressing these problems, and the potential for penile transplantation to provide improved outcomes. We also review the preclinical research and limited worldwide experience with penile transplantation to date, including lessons learned, and discuss the many important technical, logistical and ethical considerations pertaining to penile transplantation that must be addressed to maximize the likelihood of successful implementation...
January 28, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28120476/mineral-adaptations-following-kidney-transplantation
#10
Sven-Jean Tan, Amy Crosthwaite, David Langsford, Varuni Obeysekere, Frank L Ierino, Matthew A Roberts, Peter D Hughes, Tim D Hewitson, Karen M Dwyer, Nigel D Toussaint
BACKGROUND: Klotho is predominantly expressed in the kidney and reported to have anti-oxidant and anti-fibrotic properties. Soluble-Klotho (sKl), the circulating protein cleaved from membrane-bound Klotho, is reduced significantly with kidney disease and inversely associated with mortality. sKl has not been thoroughly evaluated prospectively after kidney transplantation. METHODS: Incident kidney transplant recipients (KTRs) were prospectively evaluated pre-transplantation, 1-week, 12-weeks and 52-weeks post-transplantation...
January 25, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28120465/postoperative-surgical-site-hemorrhage-after-kidney-transplantation-incidence-risk-factors-and-outcomes
#11
Laureen D Hachem, Anand Ghanekar, Markus Selzner, Olusegun Famure, Yanhong Li, S Joseph Kim
Studies investigating the incidence, risk factors, and outcomes of surgical-site hemorrhage after kidney transplantation are limited. Patients who underwent a kidney transplant from 1 Jan 2000 to 30 Sep 2012 (followed until 31 Dec 2012) at Toronto General Hospital were included in this study. Postoperative surgical-site hemorrhage was defined as a drop in hemoglobin ≥ 20 g/L over a 24-hour period within 3 days of transplantation, followed by an ultrasound indicating a significant hematoma/collection. A total of 59 of 1,203 (4...
January 25, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28120462/research-priority-setting-in-organ-transplantation-a-systematic-review
#12
Allison Tong, Benedicte Sautenet, Jeremy R Chapman, Claudia Harper, Peter MacDonald, Nicholas Shackel, Sally Crowe, Camilla Hanson, Sophie Hill, Anneliese Synnot, Jonathan C Craig
BACKGROUND: Barriers to access and long-term complications remain a challenge in transplantation. Further advancements may be achieved through research priority setting with patient engagement to strengthen its relevance. We evaluated research priority setting in solid organ transplantation and described stakeholder priorities. METHODS: Databases were searched to October 2016. We synthesized the findings descriptively. RESULTS: The 28 studies (n=2071 participants) addressed kidney (9 [32%]), heart (7 [25%]), liver (3 [11%]), lung (1 [4%]), pancreas (1 [4%]), and non-specified organ transplantation (7 [25%]) using consensus conferences, expert panel meetings, workshops, surveys, focus groups, interviews, and the Delphi technique...
January 25, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28120425/kidney-transplantation-in-patients-with-systemic-sclerosis-a-nationwide-multicenter-study
#13
Dominique Bertrand, Julien Dehay, Julien Ott, Rebecca Sberro, Charlotte Brunelle, Nassim Kamar, Charlotte Colosio, Valérie Chatelet, Laetitia Albano, Sophie Girerd, Vincent Audard, Christelle Barbet, Jacques Dantal, Didier Ducloux, Antoine Durrbach, Valérie Garrigue, Marc Hazzan, Anne-Elisabeth Heng, Christophe Mariat, Pierre Merville, Jean-Philippe Rerolle, Bruno Moulin, Dominique Guerrot
Kidney transplantation is one of the therapeutic options for end-stage renal disease (ESRD) in systemic sclerosis (SS). Current evidence demonstrates poorer patient and graft survival after transplantation in SS than in other primary kidney diseases. All the patients presenting ESRD associated with SS who had received a kidney allograft between 1987 and 2013 were systematically included from 20 French kidney transplantation centres. Thirty-four patients received 36 kidney transplants during the study period...
January 25, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28109030/prolonged-circulatory-support-with-short-term-continuous-flow-pump-in-an-infant-with-end-stage-heart-failure
#14
LETTER
Ivan Knezevic, Bojan Vrtovec, Jus Ksela
We report a case of an infant who was successfully supported with Levitronix PediVAS (Levitronix LLC, Waltham, MA) short-term continuous-flow (STCF) pump in both, left ventricular assist device (LVAD) and extracorporeal membrane oxygenation (ECMO) settings for 130 consecutive days before he successfully underwent heart transplantation. Mechanical circulatory support (MCS) therapy in infants and small children with end-stage heart failure remains an ongoing clinical challenge due to limited number of suitable devices and lack of quality data from randomized controlled trials...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28109026/refinement-of-the-criteria-for-ultrastructural-peritubular-capillary-basement-membrane-multilayering-in-the-diagnosis-of-chronic-active-acute-antibody-mediated-rejection
#15
Heounjeong Go, Sung Shin, Young Hoon Kim, Duck Jong Han, Yong Mee Cho
Chronic active/acute antibody-mediated rejection (cABMR) is the main cause of late renal allograft loss. Severe peritubular capillary basement membrane multilayering (PTCML) assessed on electron microscopy is one diagnostic feature of cABMR according to the Banff2013 classification. We aimed to refine the PTCML criteria for an earlier diagnosis of cABMR. We retrospectively investigated ultrastructural features of 159 consecutive renal allografts and 44 non-allografts. The presence of serum donor-specific antibodies at the time of biopsy of allografts was also examined...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28109023/intraportal-islet-transplantation-the-impact-of-the-liver-micro-environment
#16
REVIEW
Vaihere Delaune, Thierry Berney, Stéphanie Lacotte, Christian Toso
The portal vein remains the preferred site for pancreatic islet transplantation due to its easy access and low morbidity. However, despite great progress in isolation and transplantation protocols over the past few years, it is still associated with the early loss of some 50-70% of transplanted islets. The complex liver micro-environment itself presumably plays an important role in this loss. The present review focuses on the specifics of the liver micro-environment, notably the localized hepatic ischemia/reperfusion injury following transplantation, the low oxygenation of the portal vein, the instant blood mediated inflammatory reaction (IBMIR), the endogenous liver immune system, and the gut-liver axis, and how they can each have an impact on the transplanted islets...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28109015/a-single-centre-experience-of-roux-en-y-enteric-drainage-for-pancreas-transplantation
#17
Irum Amin, Andrew J Butler, Gail Defries, Neil K Russell, Simon J F Harper, Asif Jah, Kourosh Saeb-Parsy, Gavin J Pettigrew, Christopher J E Watson
Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodeno-jejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001- 2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD)...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28102906/filling-the-gap-between-clinical-trials-and-real-life-in-the-treatment-of-severe-hcv-recurrence-after-liver-transplantation
#18
Patrizia Burra, Alberto Zanetto
In this issue of Transplant International, Herzer et al. report the results obtained in a real-world European cohort of 87 patients with severe recurrent hepatitis C (HCV) after liver transplantation (LT), who were treated with a compassionate use of daclatasvir (DCV) plus registered sofosbuvir (SOF), with or without ribavirin (RBV). The vast majority of patients were HCV genotype 1, though the sample included a few with genotypes 3 and 4. It is noteworthy that 37/87 patients (42.5%) had cirrhosis (and 16/37 patients [43%] had Child-Pugh B/C decompensated cirrhosis)...
January 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28095640/irradiation-before-and-donor-splenocyte-infusion-immediately-after-transplantation-induce-tolerance-to-lung-but-not-heart-allografts-in-miniature-swine
#19
Wiebke Sommer, Gwen Buechler, Katharina Jansson, Murat Avsar, Ann-Kathrin Knöfel, Jawad Salman, Klaus Hoeffler, Thierry Siemeni, Jens Gottlieb, Johann H Karstens, Danny Jonigk, Ansgar Reising, Axel Haverich, Martin Strüber, Gregor Warnecke
Solid organs may differ in their potential to induce and maintain a state of donor-specific tolerance. Previously, we induced stable immunological tolerance in a lung transplantation model in miniature swine. Here, we wished to transfer this established protocol into a heart transplantation model in miniature swine. Heterotopic heart transplantation (HTX) was performed in four, and left-sided lung transplantation (LTX) in seven minipigs from gender and SLA mismatched donors. All recipients received non-myeloablative irradiation, donor splenocyte infusion and intravenous pharmacologic immunosuppression for 28 postoperative days...
January 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28078769/interleukin-1%C3%AE-induced-release-of-interleukin-8-by-human-bronchial-epithelial-cells-in-vitro-assessing-mechanisms-and-possible-treatment-options
#20
REVIEW
Hannelore Bellon, Elly Vandermeulen, Carolien Mathyssen, Annelore Sacreas, Stijn E Verleden, Tobias Heigl, Hanne Vriens, Elise Lammertyn, Charles Pilette, Peter Hoet, Robin Vos, Bart M Vanaudenaerde, Geert M Verleden
BACKGROUND: Survival after lung transplantation is hampered by chronic lung allograft dysfunction (CLAD). Persistently elevated BAL-neutrophilia is observed in some patients despite treatment with azithromycin, which may be induced by IL-1α. Our aim is to establish an in vitro model, assess mechanistic pathways and test different therapeutic strategies of IL-1α induced release of IL-8 by human bronchial epithelial cells. METHODS: Bronchial epithelial cells (16HBE) were stimulated with IL-1α with or without azithromycin or dexamethasone...
January 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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