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Protocol transplant biopsy

Wael M Hamza, Hanan H Ali, Samia M Gabal, Sawsan A Fadda
The chronic dysfunction stands as the most common cause of renal allograft loss. During the nineties of the past century, this condition was referred to as chronic allograft nephropathy (CAN). Since 2005, CAN has been assigned by the eighth Banff schema to four main categories via histopathological and immunohistochemical findings including chronic antibodymediated rejection (CAMR), chronic T-cell-mediated rejection (CTMR), chronic cyclosporine toxicity (CNITOX), and "interstitial fibrosis (IF)/tubular atrophy; not otherwise specified (NOS)" to eliminate the term CAN...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Yihung Huang, Evan Farkash
As both T cell and antibody-mediated rejection can have a subclinical phase, protocol biopsies provide an early opportunity to intervene before the onset of clinical allograft dysfunction. Protocol biopsies are usually done after reperfusion to establish baseline, between 3 and 6 months to identify subclinical rejection, and at 6-12 months to assess chronicity and persistent inflammation that have prognostic implication. Treatment of both subclinical T cell and antibody-mediated rejection prevents progression of rejection and development of interstitial fibrosis/tubular atrophy or transplant glomerulopathy...
September 2016: Advances in Chronic Kidney Disease
Avnish Kumar Seth, Pawan Rawal, Ruchika Bagga, Priti Jain
Forty-four-year-old male with ulcerative colitis (UC) for 11 years reported frequent relapse despite daily sulfasalazine 4 g, azathioprine 125 mg, and rectal 5-aminosalicylic acid. Repeated use of corticosteroids led to cataract. At enrollment, he was passing eight stools a day with blood with a Mayo score of 9 (3+1+3+2). Stool was negative for ova/cysts/acid fast bacilli and Clostridium difficile toxin assay. Rectal biopsy showed cryptitis, crypt abscess, and crypt distortion with no inclusion bodies, and cytomegalovirus DNA was negative...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Meeta Pathak, O K Olstad, Liv Drolsum, Morten C Moe, Natalia Smorodinova, Sarka Kalasova, Katerina Jirsova, Bjørn Nicolaissen, Agate Noer
Patients with limbal stem cell deficiency (LSCD) often experience pain and photophobia due to recurrent epithelial defects and chronic inflammation of the cornea. Successfully restoring a healthy corneal surface in these patients by transplantation of ex vivo expanded human limbal epithelial cells (LECs) may alleviate these symptoms and significantly improve their quality of life. The clinical outcome of transplantation is known to be influenced by the quality of transplanted cells. Presently, several different protocols for cultivation and transplantation of LECs are in use...
October 1, 2016: Experimental Eye Research
Sharifeh Khosravi, Mansour Salehi, Mahboobeh Ramezanzadeh, Hamed Mirzaei, Rasoul Salehi
BACKGROUND AND AIMS: Thalassemia is curable by bone marrow transplantation; however, finding suitable donors with defined HLA combination remains a major challenge. Cord blood stem cells with preselected HLA system through preimplantation genetic diagnosis (PGD) proved very useful for resolving scarce HLA-matched bone marrow donors. METHODS: A thalassemia trait couple with an affected child was included in this study. We used informative STR markers at the HLA and beta globin loci to develop a single cell multiplex fluorescent PCR protocol...
May 2016: Archives of Medical Research
Vincent Vuiblet, Michael Fere, Ezechiel Bankole, Alain Wynckel, Cyril Gobinet, Philippe Birembaut, Olivier Piot, Philippe Rieu
In brain-dead donor resuscitation, hydroxyethyl starch (HES) use has been associated with presence of osmotic-nephrosis-like lesions in kidney transplant recipients. Our aim was to determine whether the presence of HES in protocol renal graft biopsies at three months (M3) after transplantation is associated with renal graft quality. According to the HES administered to the donor during the procurement procedure, two groups of patients were defined according graft exposition to HES: HES group, (N = 20) and control group (N = 6)...
2016: Scientific Reports
Mirjana Trukalj, Marija Perica, Željko Ferenčić, Damir Erceg, Marta Navratil, Gzim Redžepi, Boro Nogalo
BACKGROUND Pulmonary alveolar proteinosis (PAP) is a rare condition characterized by the intra-alveolar accumulation of surfactant-derived material, which impairs gas exchange and results in respiratory insufficiency. Two major subtypes of PAP are autoimmune and non-autoimmune PAP. The diagnosis relies on clinical presentation, ground glass opacities on CT scan, bronchoscopy with PAS stain of BAL fluid (BALF), lung biopsy with PAS-positive material in the alveoli, and the presence of anti GM-CSF antibodies in serum or BALF for an autoimmune subtype...
2016: American Journal of Case Reports
Jenni Miettinen, Juuso Tainio, Timo Jahnukainen, Mikko Pakarinen, Jouni Lauronen, Hannu Jalanko
BACKGROUND: Anemia and low-grade inflammation are reported to be associated with impaired long-term graft outcome in renal transplant (RTx) recipients. In this study, hemoglobin (Hb) and inflammation marker levels were correlated with measured glomerular filtration rate (GFR) in 128 pediatric RTx recipients over a median follow-up period of 10 years. METHODS: Serum levels of erythropoietin (EPO), hepcidin-25, high-sensitivity C-reactive protein (CRP) (hsCRP) and interleukin-6 (IL-6) were analyzed by enzyme-linked immunosorbent assays, and GFR was analyzed by (51)Cr-EDTA clearance...
August 30, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Masaaki Yanishi, Hiroyasu Tsukaguchi, Nguyen Thanh Huan, Yuya Koito, Hisanori Taniguchi, Kenji Yoshida, Takao Mishima, Motohiko Sugi, Hidefumi Kinoshita, Tadashi Matsuda
AIM: Optimizing nephron supply to recipient demand is a non-immunologic determinant of renal allograft outcome. Nephron reduction is usually caused by physical donor-recipient mismatch, but its pathologic relevance remains to be determined. METHODS: Thirty-one recipients of living donor renal transplants were divided into three subgroups: those who received transplants from the same gender (n = 6, Group 1) and those who underwent male-to-female (n = 8, Group 2) and female-to-male (n = 17, Group 3) transplants...
August 30, 2016: Nephrology
Abraham Shaked, Bao-Li Chang, Michael R Barnes, Peter Sayre, Yun R Li, Smita Asare, Michele DesMarais, Michael V Holmes, Toumy Guettouche, Brendan J Keating
: The ability to noninvasively diagnose acute cellular rejection (ACR) with high specificity and sensitivity would significantly advance personalized liver transplant recipient care and management of immunosuppression. We performed microRNA (miRNA) profiling in 318 serum samples from 69 liver transplant recipients enrolled in the Immune Tolerance Network immunosuppression withdrawal (ITN030ST) and Clinical Trials in Organ Transplantation (CTOT-03) studies. We quantified serum miRNA at clinically indicated and/or protocol biopsy events (n = 130)...
August 17, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Fernanda Ortiz, Rosana Gelpi, Ilkka Helanterä, Edoardo Melilli, Eero Honkanen, Oriol Bestard, Josep M Grinyo, Josep M Cruzado
INTRODUCTION: The pros and cons for implementing protocol biopsies (PB) after kidney transplantation are still a matter of debate. We aimed to address the frequency of pathological findings in PB, to analyze their impact on long-term graft survival (GS) and to analyze the risk factors predicting an abnormal histology. METHODS: We analyzed 946 kidney PB obtained at a median time of 6.5 (±2.9) months after transplantation. Statistics included comparison between groups, Kaplan-Meier and multinomial logistic regression analysis...
2016: PloS One
Martin Schiemann, Elisabeth Puchhammer-Stöckl, Farsad Eskandary, Philip Kohlbeck, Susanne Rasoul-Rockenschaub, Andreas Heilos, Nicolas Kozakowski, Irene Görzer, Željko Kikić, Harald Herkner, Georg A Böhmig, Gregor Bond
BACKGROUND: Antibody-mediated rejection (ABMR) represents 1 of the cardinal causes of late allograft loss after kidney transplantation and there is great need for noninvasive tools improving early diagnosis of this rejection type. One promising strategy might be the quantification of peripheral blood DNA levels of the highly prevalent and apathogenic Torque Teno virus (TTV), which might mirror the overall level of immunosuppression and thus help determine the risk of alloimmune response...
August 12, 2016: Transplantation
Aygül Çeltik, Sait Şen, Mümtaz Yılmaz, Meltem Seziş Demirci, Gülay Aşçı, Abdülkerim Furkan Tamer, Banu Sarsık, Cüneyt Hoşcoşkun, Hüseyin Töz, Ercan Ok
PURPOSE: Persistent hypercalcemia after kidney transplantation (KTx) may cause nephrocalcinosis and graft dysfunction. The aim of this study was to evaluate patients with hypercalcemia and assess its effect on tubulointerstitial calcification. METHODS: A total of 247 recipients were enrolled. Transient and persistent hypercalcemia was defined as hypercalcemia (corrected serum calcium >10.2 mg/dL) persisting for 6 and 12 months after KTx, respectively. The severity of calcification in the 0-h, 6- and 12-month protocol biopsies of patients with transient (n = 8) and persistent hypercalcemia (n = 20) was compared with a matched control group (n = 28)...
November 2016: International Urology and Nephrology
Moana Rossella Nespoli, Marco Rispoli, Dario Maria Mattiacci, Marianna Esposito, Antonio Corcione, Carlo Curcio, Salvatore Buono
INTRODUCTION: We present the case of a patient with dilatative cardiomyopathy waiting for heart transplantation with pleural effusion to be subjected to pleural biopsy, treated with preoperative infusion of levosimendan to improve heart performances. PRESENTATION OF CASE: A 56-year-old man (BMI 22,49) with dilatative cardiomyopathy (EF 18%) presented right pleural effusion. The levosimendan treatment protocol consisted of 24h continuous infusion (0,1ug/kg/min), without bolus...
2016: International Journal of Surgery Case Reports
Dawn K Coletta, Latoya E Campbell, Jennifer Weil, Bruce Kaplan, Marie Clarkson, Jean Finlayson, Lawrence J Mandarino, Harini A Chakkera
INTRODUCTION: Decreased insulin sensitivity blunts the normal increase in gene expression from skeletal muscle after exercise. In addition, chronic inflammation decreases insulin sensitivity. Chronic kidney disease (CKD) is an inflammatory state. How CKD and, subsequently, kidney transplantation affects skeletal muscle gene expression after exercise are unknown. METHODS: Study cohort: non-diabetic male/female 4/1, age 52±2 years, with end-stage CKD who underwent successful kidney transplantation...
2016: PloS One
Antoine Sicard, Jean Kanitakis, Valérie Dubois, Palmina Petruzzo, Lionel Badet, Olivier Thaunat, Emmanuel Morelon
PURPOSE OF REVIEW: Vascularized composite allotransplantation (VCA) has several immunological peculiarities that imply a specific immune monitoring. Here, we provide an integrated view of current procedures of immune monitoring in VCA and potential complementary approaches learned from organ transplantation. RECENT FINDINGS: Because the skin is highly immunogenic and is the main target of the alloimmune response, immune monitoring in VCA essentially relies on visual inspection and pathological examination of for-causes and protocol skin biopsies...
October 2016: Current Opinion in Organ Transplantation
A Furmańczyk-Zawiska, A Urbanowicz, A Perkowska-Ptasińska, T Bączkowska, A Sadowska, S Nazarewski, A Chmura, M Durlik
BACKGROUND: Antibody-mediated rejection (ABMR) has emerged as the leading cause of renal graft loss. The optimal treatment protocol in ABMR remains unknown. This study aimed to assess the efficacy of intravenous immunoglobulin (IVIG) for treatment of ABMR in renal recipients. METHODS: Thirty-nine ABO-compatible cross-match-negative renal recipients with biopsy-proven ABMR composed the study group. Pulses of methylprednisolone (MP) and appropriate enhancement of net state of immunosuppression were applied in all individuals; 17/39 recipients were administered IVIG (IVIG group); the remaining 22/39 patients, identified to be nonadherent or unsatisfactorily immunosuppressed, were kept on the initial treatment (MP group)...
June 2016: Transplantation Proceedings
Kevin V Chow, Shaun M Flint, Angeline Shen, Anthony Landgren, Moira Finlay, Anand Murugasu, Rosemary Masterson, Peter Hughes, Solomon J Cohney
BACKGROUND: Excellent short-term results have been reported in ABO-incompatible renal transplant recipients (ABOi) managed solely with antibody removal and conventional immunosuppression. However, long-term clinical outcomes with this regimen and predictive information from protocol biopsies is lacking. METHODS: We compared outcome data in ABOi and ABO compatible (ABOc) recipients receiving this regimen approximately 4 years posttransplant, and histology from biopsies approximately 12 month posttransplant...
August 5, 2016: Transplantation
Arun Jesudian, Sameer Desale, Jonathan Julia, Elizabeth Landry, Christopher Maxwell, Bhaskar Kallakury, Jacqueline Laurin, Kirti Shetty
BACKGROUND: The utilization of liver transplantation (LT) is limited by the availability of suitable organs. This study aimed to assess the impact of the donor risk index (DRI) and other donor characteristics on fibrosis progression, graft, and patient survival in hepatitis C virus (HCV)-infected LT recipients. METHODS: HCV-infected LT recipients who had at least 2 post-LT protocol liver biopsy specimens available were included. Hazard ratio for bivariate analysis was computed using Cox proportional hazard regression analysis...
June 2016: Journal of Clinical and Experimental Hepatology
Luke A Wiley, Erin R Burnight, Adam P DeLuca, Kristin R Anfinson, Cathryn M Cranston, Emily E Kaalberg, Jessica A Penticoff, Louisa M Affatigato, Robert F Mullins, Edwin M Stone, Budd A Tucker
Immunologically-matched, induced pluripotent stem cell (iPSC)-derived photoreceptor precursor cells have the potential to restore vision to patients with retinal degenerative diseases like retinitis pigmentosa. The purpose of this study was to develop clinically-compatible methods for manufacturing photoreceptor precursor cells from adult skin in a non-profit cGMP environment. Biopsies were obtained from 35 adult patients with inherited retinal degeneration and fibroblast lines were established under ISO class 5 cGMP conditions...
2016: Scientific Reports
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