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Protocol transplant biopsy

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https://www.readbyqxmd.com/read/28805293/utility-of-protocol-kidney-biopsies-for-de-novo-donor-specific-antibodies
#1
Sandesh Parajuli, Patrick K Reville, Thomas M Ellis, Arjang Djamali, Didier A Mandelbrot
There is limited information about the role of protocol kidney biopsies for de novo donor specific antibodies (dnDSA) in kidney transplant recipients, especially in those with stable graft function. We initiated a routine post-transplant DSA monitoring and surveillance biopsy program for dnDSA since 2014. We identified 45 kidney transplant recipients with dnDSA detected between January 2014 and February 2017 that underwent kidney biopsy within 60 days of detection of dnDSA. 29 (64%) had stable graft function and 16 (36%) had impaired graft function at the time of dnDSA detection...
August 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28757451/six-years-experience-of-tolerance-induction-in-renal-transplantation-using-stem-cell-therapy
#2
Aruna V Vanikar, Hargovind L Trivedi, Umang G Thakkar
Tolerance induction (TI) has been attempted with chimerism/clonal deletion. We report results of TI protocol (TIP) using stem cell therapy (SCT) included adipose derived mesenchymal stem cells (AD-MSC) and hematopoietic stem cells (HSC) in 10 living-donor related renal transplantation (LDRT) patients under non-myeloablative conditioning with Bortezomib, Methylprednisone, rabbit-anti-thymoglobulin and Rituximab, without using conventional immunosuppression. Transplantation was performed following acceptable lymphocyte cross-match, flow cross-match, single antigen assay and negative mixed lymphocyte reaction (MLR)...
July 27, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28735354/transplantation-sites-for-human-and-murine-islets
#3
Rebecca A Stokes, Kim Cheng, Amit Lalwani, Michael M Swarbrick, Helen E Thomas, Thomas Loudovaris, Tom W Kay, Wayne J Hawthorne, Philip J O'Connell, Jenny E Gunton
AIMS/HYPOTHESIS: Beta cell replacement is a potential cure for type 1 diabetes. In humans, islet transplants are currently infused into the liver via the portal vein, although this site has disadvantages. Here, we investigated alternative transplantation sites for human and murine islets in recipient mice, comparing the portal vein with quadriceps muscle and kidney, liver and spleen capsules. METHODS: Murine islets were isolated from C57BL6/J mice and transplanted into syngeneic recipients...
July 22, 2017: Diabetologia
https://www.readbyqxmd.com/read/28731375/no-incidence-of-nephrogenic-systemic-fibrosis-after-gadobenate-dimeglumine-administration-in-patients-undergoing-dialysis-or-those-with-severe-chronic-kidney-disease
#4
Diego R Martin, Bobby Kalb, Ankush Mittal, Khalil Salman, Srinivasan Vedantham, Pardeep K Mittal
Purpose To determine the incidence of nephrogenic systemic fibrosis (NSF) in patients with severe chronic kidney disease (CKD) who underwent a uniform protocol for contrast material-enhanced magnetic resonance (MR) imaging with a gadolinium-based contrast agent (GBCA). Materials and Methods This retrospective, single-center, institutional review board-approved, HIPAA-compliant study included 3819 patients with severe (stage 4 or 5) CKD who underwent gadobenate dimeglumine-enhanced MR imaging as part of a preoperative evaluation for potential renal transplantation from January 2008 to February 2014...
July 21, 2017: Radiology
https://www.readbyqxmd.com/read/28718984/effect-of-pnpla3-i148m-polymorphism-on-histologically-proven-nonalcoholic-fatty-liver-disease-in-liver-transplant-recipients
#5
Hyeyoung Kim, Kwang-Woong Lee, Kyoungbun Lee, Sooin Seo, Min-Young Park, Sung Woo Ahn, Suk Kyun Hong, Kyung Chul Yoon, Hyo-Sin Kim, YoungRok Choi, Hae Won Lee, Nam-Joon Yi, Kyung-Suk Suh
AIM: PNPLA3 I148M polymorphism (rs738409 C>G) is the most important and the best known polymorphism for nonalcoholic fatty liver disease (NAFLD). However, little is known about the effect of this polymorphism on NAFLD after liver transplantation (LT). We aimed to evaluate the association between this polymorphism and post-LT NAFLD. METHODS: We designed a prospective case-control study. Among adult recipients who underwent LT between April 2014 and October 2015, those whose whole blood were preoperatively collected for genotyping in both recipients and coupled donors and those who have undergone protocol biopsy at post-LT 1 year were enrolled...
July 18, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28714646/-biopsy-transcriptome-in-kidney-transplantation-ready-for-primetime
#6
Yassine Bouatou, Karine Hadaya
Kidney graft biopsy is the main diagnostic tool used in kidney transplantation to classify disease processes. Graft biopsies are performed at a predetermined time (protocol) or by indication. However, they bear limitations including the interobserver variability. Intragraft transcriptomics has taken the center stage in the field of biomarkers research in kidney transplantation as it might improve disease stratification. Although already included in the international Banff classification, clinical transition has yet to be confirmed in external validation studies...
February 22, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28706981/outcomes-of-liver-transplant-recipients-with-autoimmune-liver-disease-using-long-term-dual-immunosuppression-regimen-without-corticosteroid
#7
Sanjaya K Satapathy, Ollie D Jones, Jason M Vanatta, Faisal Kamal, Satish K Kedia, Yu Jiang, Satheesh P Nair, James D Eason
BACKGROUND: Liver transplant (LT) recipients with autoimmune liver disease (primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis) are at increased risk of developing acute cellular rejection (ACR), and in many cases graft failure due to recurrent disease. We describe our experience with dual immunosuppression without steroid maintenance and analyze its effect on disease recurrence; ACR; patient and graft survivals; and complications, such as sepsis and de novo malignancy...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28665475/autologous-cultivated-limbal-stem-cell-transplantation-after-failed-previous-limbal-graft
#8
Karl A Knutsson, Stanislav Matuska, Paolo Rama
PURPOSE: To describe a case of unilateral limbal stem cell deficiency (LSCD) with previously failed autologous graft, resolved by ocular surface reconstruction using cultured autologous limbal stem cells from the contralateral eye. CASE REPORT: A 35-year-old patient presented to our clinic with LSCD due to a unilateral alkali burn. The patient had received a previous limbal graft from the contralateral eye that had failed to impede corneal conjunctivalization. We decided to repeat limbal stem cell transplantation using an ex vivo cultivation procedure to reduce the risk of tissue harvesting on the healthy fellow eye...
June 20, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28664821/de-novo-iga-nephropathy-in-a-renal-allograft
#9
Amir Shabaka, Isabel Pérez-Flores, José Antonio Cortés, Ana Isabel Sánchez-Fructuoso
Posttransplant glomerulonephritis is a complication of kidney transplant that can impair graft function and long-term graft survival. De novo immunoglobulin A disease in kidney allografts appears to be much less common than the recurrent disease, and in most cases it is diagnosed in protocol biopsies with no clinical evidence of disease or in association with other renal transplant pathologies such as chronic rejection. We present a case of de novo immunoglobulin A nephropathy presenting with overt proteinuria, microscopic hematuria, and progressive deterioration of renal function 30 months after renal transplant...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28662985/building-a-tissue-based-molecular-diagnostic-system-in-heart-transplant-rejection-the-heart-molecular-microscope-diagnostic-mmdx-system
#10
Philip F Halloran, Luciano Potena, Jean-Paul Duong Van Huyen, Patrick Bruneval, Ornella Leone, Daniel H Kim, Xavier Jouven, Jeff Reeve, Alexandre Loupy
BACKGROUND: The emergence of molecular systems offers opportunities for improving the assessment of rejection in heart transplant biopsy specimens. The present study developed a microarray-based system for assessing heart transplant endomyocardial biopsy (EMB) specimens. METHODS: We analyzed 331 protocol or for-cause EMB specimens from 221 subjects in 3 centers (Edmonton, Bologna, and Paris). Unsupervised principal component analysis (PCA) and archetype analysis used rejection-associated transcripts (RATs) shown in kidney transplants to be associated with antibody-mediated rejection (ABMR) or T cell-mediated rejection (TCMR), or both...
May 29, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28638610/looking-for-the-needle-in-the-kidney-transplantation-haystack
#11
Josep M Cruzado, Edoardo Melilli
The diagnosis of acute rejection still relies on renal allograft biopsy. In fact, histological features including C4d staining can be useful to differentiate cellular and antibody-mediated acute rejection. However, the pathogenic mechanism to define the type of rejection is usually assessed by anti-HLA donor specific antibodies (DSA) monitoring. Suspicion of acute rejection is usually based on renal function deterioration. This method has low sensitivity. Moreover, creatinine increase follows graft injury and therefore the diagnosis is performed when there is an ongoing acute rejection...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28627016/unique-clinical-conditions-associated-with-different-acinar-regions-of-fibrosis-in-long-term-surviving-pediatric-liver-grafts
#12
Marjolein Baas, Annette S H Gouw, Marius C van den Heuvel, Bouke G Hepkema, Paul M G J Peeters, HenkJan Verkade, René Scheenstra
In the majority of long-term survivors after PLTx, graft fibrosis has been identified. Recently, subtypes of graft fibrosis have been described based on their predominant acinar localization. We aimed to evaluate whether the development of portal, perisinusoidal, and centrilobular distribution of graft fibrosis is related to patient or transplantation-related parameters. We reviewed the histological features in protocol liver biopsies taken at 1 and 5 years after PLTx of 47 children on a tacrolimus-based immunosuppressive regimen...
June 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28613436/the-incremental-cost-of-incompatible-living-donor-kidney-transplant-a-national-cohort-analysis
#13
David Axelrod, Krista L Lentine, Mark A Schnitzler, Xun Luo, Huiling Xiao, Babak J Orandi, Allan Massie, Jacqueline Garonzik-Wang, Mark D Stegall, Stanley C Jordan, Jose Oberholzer, Ty B Dunn, Lloyd E Ratner, Sandip Kapur, Ronald P Pelletier, John P Roberts, Marc L Melcher, Pooja Singh, Debra L Sudan, Marc P Posner, Jose M El-Amm, Ron Shapiro, Matthew Cooper, George S Lipkowitz, Michael A Rees, Christopher L Marsh, Bashir R Sankari, David A Gerber, Paul W Nelson, Jason Wellen, Adel Bozorgzadeh, A Osama Gaber, Robert A Montgomery, Dorry L Segev
Incompatible living donor kidney transplant (ILDKT) has been established as an effective option for end stage renal disease (ESRD) patients with willing but HLA incompatible live donors, reducing mortality and improving quality of life. Depending upon antibody titer, ILDKT can require highly resource intensive procedure including intravenous immunoglobulin, plasma exchange and/or cell depleting antibody treatment as well as protocol biopsies and DSA testing. This study sought to compare the cost and Medicare reimbursement, exclusive of organ acquisition payment, for ILDKT recipients (N=926) with varying antibody titers to matched compatible transplants (N=2762) performed between 2002-2011...
June 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28610776/two-stage-late-reconstruction-with-a-fresh-large-osteochondral-shell-allograft-transplantation-flocsat-for-a-large-ostechondral-defect-in-a-non-union-after-a-lateral-tibia-plateau-fracture-2-year-follow-up
#14
C Krettek, J Clausen, M Omar, S Noack, C Neunaber
This is the description of a 58-year-old female patient presenting 8 months after a horse riding accident with significant pain and inability to walk independently. Imaging revealed a large osseous defect of the lateral tibia plateau which was not united posteriorly. The patient refused knee replacement and we developed a patient specific two-step procedure for her. Step 1: Filling of the defect with a large cortico-cancellous autograft from the posterior iliac crest; step 2: Transplantation of a fresh large osteochondral shell allograft (FLOCSAT)...
July 2017: Injury
https://www.readbyqxmd.com/read/28600850/eight-year-follow-up-in-pediatric-living-donor-kidney-recipients-receiving-alemtuzumab-induction
#15
Michael M Kaabak, Nadeen N Babenko, Ron Shapiro, Alexey A Maschan, Allan K Zokoev, Stanislav V Schekaturov, Julia N Vyunkova, Olga V Dymova
Recipient lymphocytes are crucial for direct and indirect pathways of allorecognition. We proposed that the administration of alemtuzumab several weeks pretransplantation could eradicate peripheral lymphatic cells and promote donor-specific acceptance. This was a single-center, retrospective review of 101 consecutive living donor kidney transplantations in pediatric patients (age 7 months-18 years), performed between September 2006 and April 2010. IS protocol included two 30 mg doses of alemtuzumab: The first was given 12-29 days prior to transplantation, and the second at the time of transplantation...
August 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28586044/noninvasive-detection-of-acute-renal-allograft-rejection-by-measurement-of-soluble-tim-3-in-urine
#16
Dajin Chen, Wenhan Peng, Hong Jiang, Hao Yang, Jianyong Wu, Huiping Wang, Jianghua Chen
The purpose of the present study was to assess whether urinary soluble T-cell immunoglobulin and mucin domain-containing protein 3 (sTim-3) could be adopted as a novel non‑invasive biomarker for acute rejection (AR) following renal transplantation. A total of 156 patients were enrolled between January 2006 and December 2009, comprising 49 patients with biopsy‑proven AR, 58 patients with stable grafts and no abnormal histological findings (NO‑AR), 10 patients with subclinical rejection (SCR) in protocol biopsies, 10 patients with acute tubular necrosis (ATN) and 29 patients with chronic allograft nephropathy (CAN)...
July 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28583566/influences-of-pre-formed-donor-specific-anti-human-leukocyte-antigen-antibodies-in-living-donor-renal-transplantation-results-with-graft-immunocomplex-capture-fluorescence-analysis
#17
T Nakamura, H Ushigome, K Watabe, Y Imanishi, K Masuda, T Matsuyama, S Harada, K Koshino, T Iida, S Nobori, N Yoshimura
BACKGROUND: Advances in immunosuppressants enable organ transplantation for sensitized patients. However, influences of pre-formed donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA) have not been fully understood in renal transplantation (RT). On the other hand, immunocomplex capture fluorescence analysis (ICFA) is a reliable method to detect donor-specific anti-HLA antibodies and HLA antigen complexes. Graft ICFA can detect DSA in an allograft (g-DSA). METHODS: To elucidate the consequences of pre-formed DSA, 198 patients who underwent living-donor RT were enrolled for this study (observation period: 57...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28556519/lessons-learned-early-termination-of-a-randomized-trial-of-calcineurin-inhibitor-and-corticosteroid-avoidance-using-belatacept
#18
K A Newell, A K Mehta, C P Larsen, P G Stock, A B Farris, S G Mehta, D Ikle, B Armstrong, Y Morrison, N Bridges, M Robien, R B Mannon
The intent of this National Institutes of Health-sponsored study was to compare a belatacept-based immunosuppressive regimen with a maintenance regimen of tacrolimus and mycophenolate. Nineteen primary, Epstein-Barr virus-immune renal transplant recipients with a negative cross-match were randomized to one of three groups. All patient groups received perioperative steroids and maintenance mycophenolate mofetil. Patients in groups 1 and 2 were induced with alemtuzumab and maintained on tacrolimus or belatacept, respectively...
May 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28553041/a-single-center-experience-of-kidney-transplantation-from-donation-after-circulatory-death-challenges-and-scope-in-india
#19
S Singh, S Kumar, S Dasgupta, D B Kenwar, M Rathi, A Sharma, H S Kohli, V Jha, K L Gupta, M Minz
Donation after circulatory death (DCD) has never been attempted in India because of legal constraints and lack of guidelines for the withdrawal of life support in end-of-life situations. The present report describes the initial experience of transplantation of organs from DCD donors in a tertiary care center in India. Between 2011 and 2015, five donors had kidneys retrieved after cardiac arrest. These patients were declared dead after waiting for 5 min with no electrocardiographic signal on monitor following cardiopulmonary resuscitation (CPR), which was restarted in three patients till organ retrieval...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28546531/supplementary-administration-of-everolimus-reduces-cardiac-systolic-function-in-kidney-transplant-recipients
#20
Kazuma Tsujimura, Morihito Ota, Kiyoshi Chinen, Kiyomitsu Nagayama, Masato Oroku, Morikuni Nishihira, Yoshiki Shiohira, Masami Abe, Kunitoshi Iseki, Hideki Ishida, Kazunari Tanabe
BACKGROUND The effect of everolimus, one of the mammalian targets of rapamycin inhibitors, on cardiac function was evaluated in kidney transplant recipients. MATERIAL AND METHODS Seventy-six participants who underwent kidney transplant between March 2009 and May 2016 were retrospectively reviewed. To standardize everolimus administration, the following criteria were used: (1) the recipient did not have a donor-specific antigen before kidney transplantation; (2) the recipient did not have proteinuria and uncontrollable hyperlipidemia after kidney transplantation; and (3) acute rejection was not observed on protocol biopsy 3 months after kidney transplantation...
May 26, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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