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Protocol transplant biopsy

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https://www.readbyqxmd.com/read/29749699/histological-findings-in-protocol-biopsies-following-pediatric-liver-transplant-low-incidence-of-abnormalities-at-5-years
#1
Amin Sheikh, Kai Y Chau, Helen M Evans
Histological abnormalities, including chronic hepatitis, fibrosis, and steatosis, are increasingly reported in liver biopsies of children after LT. These changes may be progressive and represent a form of rejection. Liver biochemistry is often initially normal. Our LT program began in 2002, utilizing tacrolimus and low-dose steroids for the first year post-LT. Patients undergo a protocol biopsy at 1 year post-LT prior to stopping steroids, then at 5 years and every 5 years thereafter. Target tacrolimus levels are 5-8 μg/L and 3-5 μg/L after 3 and 12 months, respectively...
May 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29731924/the-spectrum-of-histopathological-changes-in-the-renal-allograft-a-12-months-protocol-biopsy-study
#2
Galina Severova-Andreevska, Ladislava Grcevska, Gordana Petrushevska, Koco Cakalaroski, Aleksandar Sikole, Olivera Stojceva-Taneva, Ilina Danilovska, Ninoslav Ivanovski
INTRODUCTION: Renal transplantation became a routine and successful medical treatment for Chronic Kidney Disease in the last 30 years all over the world. Introduction of Luminex based Single Antigen Beads (SAB) and recent BANFF consensus of histopathological phenotypes of different forms of rejection enables more precise diagnosis and changes the therapeutic approach. The graft biopsies, protocol or cause, indicated, remain a golden diagnostic tool for clinical follow up of kidney transplant recipients (KTR)...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29725772/benefits-and-risks-of-protocol-biopsies-in-pediatric-renal-transplantation
#3
Roberto Gordillo, Raj Munshi, Eric J Monroe, Giridhar M Shivaram, Jodi M Smith
Protocol biopsies are defined as sampling of allograft tissue at predetermined times regardless of function. This procedure can be justified due to the lack of non-invasive methods to reliably diagnose rejection (acute or subclinical). Changes in creatinine are not seen with subclinical rejection or early acute rejection and do not always correlate with efficacy of treatment. Parents and providers are still hesitant to pursue protocol biopsy due to the potential complications and lack of definitive evidence of a benefit from doing this procedure...
May 3, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29725635/vascular-endothelial-growth-factor-gene-polymorphism-is-associated-with-long-term-kidney-allograft-outcomes
#4
Swayam Prakash, Manas Ranjan Patel, Suraksha Agrawal, Rahul M Jindal, Narayan Prasad
Introduction: Vascular endothelial growth factor (VEGF) regulates vasculogenesis in physiological and pathological states. We evaluated the role of VEGF single-nucleotide polymorphisms (SNPs) -1154 G/A, -2578 C/A, +936 C/T, and -2549 Ins/Del in chronic allograft nephropathy. Methods: Blood samples were collected before renal transplantation, and DNA was extracted. Genotyping of VEGF SNPs -1154 G/A (rs1570360), -2578 C/A (rs699947), +936 C/T (rs112005313), and -2549 Ins/Del (18bpindel) polymorphisms were carried out...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29719115/preemptive-treatment-of-early-donor-specific-antibodies-with-iga-and-igm-enriched-intravenous-human-immunoglobulins-in-lung-transplantation
#5
Fabio Ius, Murielle Verboom, Wiebke Sommer, Reza Poyanmehr, Ann-Kathrin Knoefel, Jawad Salman, Christian Kuehn, Murat Avsar, Thierry Siemeni, Caroline Erdfelder, Michael Hallensleben, Dietmar Boethig, Nicolaus Schwerk, Carsten Mueller, Tobias Welte, Christine Falk, Axel Haverich, Igor Tudorache, Gregor Warnecke
This retrospective study presents our 4-year experience of preemptive treatment of early anti-HLA donor specific antibodies with IgA- and IgM-enriched immunoglobulins. We compared outcomes between patients with antibodies and treatment (case patients) and patients without antibodies (control patients). Records of patients transplanted at our institution between 03/2013 and 11/2017 were reviewed. The treatment protocol included one single 2g/kg immunoglobulin infusion followed by successive 0.5g/kg infusions for a maximum of 6 months, usually combined with a single dose of anti-CD20 antibody and, in case of clinical rejection or positive crossmatch, with plasmapheresis or immunoabsorption...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29716794/proliferative-glomerulonephritis-with-monoclonal-immunoglobulin-g-deposits-is-associated-with-high-rate-of-early-recurrence-in-the-allograft
#6
Samar M Said, Fernando G Cosio, Anthony M Valeri, Nelson Leung, Sanjeev Sethi, Hassan Salameh, Lynn D Cornell, Mary E Fidler, Mariam P Alexander, Fernando C Fervenza, Maria Eleni Drosou, Da Zhang, Vivette D D'Agati, Samih H Nasr
The characteristics of allograft proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID) are not well defined. To better characterize this disease we retrospectively identified 26 patients with allograft PGNMID, including 16 followed with early protocol biopsies. PGNMID was found to be a recurrent disease in most (89%) patients. A diagnostic biopsy was done for proteinuria and/or increased creatinine in most patients. Median time from transplant to diagnostic biopsy was 5.5 months, with detection within three to four months post-transplant in 86% of patients...
April 28, 2018: Kidney International
https://www.readbyqxmd.com/read/29709679/molecular-profiling-of-subclinical-inflammatory-lesions-in-long-term-surviving-adult-liver-transplant-recipients
#7
María-Carlota Londoño, Lara Neves Souza, Juan-José Lozano, Rosa Miquel, Juan G Abraldes, Laura-Patricia LLovet, Alberto Quaglia, Antoni Rimola, Miquel Navasa, Alberto Sánchez-Fueyo
BACKGROUND AND AIMS: Sub-clinical inflammatory changes are commonly described in long-term transplant recipients undergoing protocol liver biopsies. The pathogenesis of these lesions remains unclear. The aim of the study was to identify the key molecular pathways driving progressive sub-clinical inflammatory liver allograft damage. PATIENTS AND METHODS: All liver recipients followed at Hospital Clínic Barcelona who were >10 years post-transplant were screened to participate in the study...
April 27, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29706414/-current-insights-about-recurrence-of-glomerular-diseases-after-renal-transplantation
#8
Tomek Kofman, Julie Oniszczuk, Philippe Lang, Philippe Grimbert, Vincent Audard
Recurrence of glomerular disease after renal transplantation is a frequent cause of graft loss. Incidence, risk factors and outcome of recurrence are widely due to the underlying glomerular disease. Graft biopsy analysis is required to confirm the definitive diagnosis of recurrence and to start an appropriate therapy that, in some cases, remains challenging to prevent graft failure. Increased use of protocol biopsy and recent advances in our understanding of the pathogenesis of some glomerular diseases with the identification of some relevant biomarkers provide a unique opportunity to initiate kidney-protective therapy at early stages of recurrence on the graft...
April 26, 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29705974/extreme-hypercalcemia-in-a-kidney-transplant-recipient
#9
Erol Demir, Cagla Karaoglan, Gulcin Yegen, Betul Sair, Halil Yazici, Aydin Turkmen, Mehmet Sukru Sever
Post-transplant hypercalcemia is a major problem in renal transplant recipients, which may negatively affect both graft and patient survival. In this paper, we present a 66-year-old male kidney transplant recipient, who was admitted to our clinic with symptoms of fever, nausea, vomiting and lethargy. Laboratory data showed good renal function; however, a serum calcium level of 22.1 mg/dL. The patient was treated by isotonic saline together with furosemide and methylprednisolone. Because of treatment resistance, subcutaneous calcitonin and ibandronate were added to the treatment protocol as well...
April 28, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29704327/morphological-characterization-of-chronic-antibody-mediated-rejection-in-abo-identical-or-compatible-pediatric-liver-graft-recipients
#10
Myriam Dao, Dalila Habès, Jean-Luc Taupin, Charlotte Mussini, Marie-José Redon, Caroline Suberbielle, Emmanuel Jacquemin, Emmanuel Gonzales, Catherine Guettier
ASBTRACT This study aims to define the morphological profile associated with the presence of donor-specific antibodies (DSA) and/or C4d immunostaining in ABO-identical or compatible pediatric liver grafts. Ten-year protocol liver graft biopsies performed at 131.3 ± 15.3 months post-transplantation in 53 pediatric liver graft recipients were reviewed. Immunostaining for C4d was systematically performed and semi-quantitatively analyzed. DSA were concurrently quantified and results were available for 44 patients...
April 27, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29696778/evolution-of-renal-function-and-urinary-biomarker-indicators-of-inflammation-on-serial-kidney-biopsies-in-pediatric-kidney-transplant-recipients-with-and-without-rejection
#11
Christine M Mincham, Ian W Gibson, Atul Sharma, Chris Wiebe, Rupasri Mandal, David Rush, Peter Nickerson, Julie Ho, David S Wishart, Tom D Blydt-Hansen
Urinary CXCL10 and metabolites are biomarkers independently associated with TCMR. We sought to test whether these biomarkers fluctuate in association with histological severity of TCMR over short time frames. Forty-nine pairs of renal biopsies obtained 1-3 months apart from 40 pediatric renal transplant recipients were each scored for TCMR acuity score (i + t; Banff criteria). Urinary CXCL10:Cr and TCMR MDS were obtained at each biopsy and were tested for association with changes between biopsies in acuity, estimated GFR (ΔeGFR), and 12-month ΔeGFR...
April 25, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29688072/steroid-free-immunosuppression-with-low-dose-tacrolimus-is-safe-and-significantly-reduces-the-incidence-of-new-onset-diabetes-mellitus-following-liver-transplantation
#12
M Castedal, C Skoglund, C Axelson, W Bennet
OBJECTIVES: Corticosteroids (CS) are traditionally used as part of the basal immunosuppression (IS) following liver transplantation (LT) but are known to be associated with an increased risk of new-onset diabetes mellitus (NODM), cardiovascular morbidity and mortality. The aim of this study was to retrospectively compare the incidence of transient as well as persistent NODM, rejection rate and patient- and graft survival between patients receiving steroid-based and steroid-free maintenance IS...
April 24, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29680337/t1-mapping-by-cardiac-magnetic-resonance-and-multidimensional-speckle-tracking-strain-by-echocardiography-for-the-detection-of-acute-cellular-rejection-in-cardiac-allograft-recipients
#13
Leyla Elif Sade, Tuncay Hazirolan, Hatice Kozan, Handan Ozdemir, Mutlu Hayran, Serpil Eroglu, Bahar Pirat, Atilla Sezgin, Haldun Muderrisoglu
OBJECTIVES: The aim of this study was to test the hypothesis that echocardiographic strain imaging, by tracking subtle alterations in myocardial function, and cardiac magnetic resonance T1 mapping, by quantifying tissue properties, are useful and complement each other to detect acute cellular rejection in heart transplant recipients. BACKGROUND: Noninvasive alternatives to endomyocardial biopsy are highly desirable to monitor acute cellular rejection. METHODS: Surveillance endomyocardial biopsies, catheterizations, and echocardiograms performed serially according to institutional protocol since transplantation were retrospectively reviewed...
April 14, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29664507/echocardiographic-evaluation-after-pediatric-heart-transplant-in-chile-initial-application-of-a-functional-protocol-with-global-longitudinal-strain
#14
Claudia Trincado, Víctor Molina, Gonzalo Urcelay, Paulina Dellepiane
INTRODUCTION: The echocardiographic evaluation of patients after heart transplantation is a useful tool. However, it is still necessary to define an optimal follow-up protocol. OBJECTIVE: To describe the results of the application of a functional echocardiographic protocol in patients being followed after pediatric heart transplantation. PATIENTS AND METHOD: Alls patients being followed at our institution after pediatric heart transplantation underwent an echocardiographic examination with a functional protocol that included global longitudinal strain...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29661451/ischemia-with-preconditioning-in-wistar-rats-maintains-mitochondrial-respiration-even-with-mild-hepatocellular-disturbance
#15
R R Tártaro, G L Jorge, A H Dianin, C A F Escanhoela, I F S F Boin
INTRODUCTION: In hepatectomy or liver transplantation, preconditioning is a procedure indicated to protect the organ from ischemia-reperfusion injury (I-R). OBJECTIVE: Evaluate the effect of preconditioning after hepatic I-R in Wistar rats, through mitochondrial respiration, liver histology, and profile. METHOD: Twenty male Wistar rats, weighing on average 307.1 g, were anesthetized with sodium thiopental (25 mg/kg) intravenously and xylazine hydrochloride (30 mg/kg) intramuscularly...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29656112/influence-of-immunosuppressive-drugs-on-the-cd30-molecule-in-kidney-transplanted-patients
#16
Patricia Cristina Grenzi, Érika Fernandes Campos, Hélio Tedesco-Silva, Claudia Rosso Felipe, Maria Fernanda Soares, José Medina-Pestana, Hinrich Peter Hansen, Maria Gerbase-DeLima
BACKGROUND: Soluble CD30 (sCD30) is a suggested marker for kidney transplantation outcomes. We investigated whether sCD30 serum levels are influenced by immunosuppression and whether they correlate with findings in protocol biopsies and with CD30 gene expression in peripheral blood mononuclear cells (PBMC). METHODS: We studied 118 kidney transplant recipients that initially received tacrolimus (TAC) and, at month-3, were converted or not to sirolimus (SRL). RESULTS: sCD30 serum levels gradually declined after transplantation, being the decline more pronounced in the SRL group...
April 12, 2018: Human Immunology
https://www.readbyqxmd.com/read/29606262/-identifying-the-specific-causes-of-kidney-allograft-loss-a-population-based-study
#17
Charlotte Lohéac, Olivier Aubert, Alexandre Loupy, Christophe Legendre
INTRODUCTION: Results of kidney transplantation have been improving but long-term allograft survival remains disappointing. The objective of the present study was to identify the specific causes of renal allograft loss, to assess their incidence and long-term outcomes. METHODS: A total of 4783 patients from four French centres, transplanted between January 2004 and January 2014 were prospectively included. A total of 9959 kidney biopsies (protocol and for cause) performed between January 2004 and March 2015 were included...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29578937/determination-of-tacrolimus-concentration-and-protein-expression-of-p-glycoprotein-in-single-human-renal-core-biopsies
#18
Veronica Krogstad, Nils Tore Vethe, Ida Robertsen, Grete Hasvold, Anne-Marthe Due Ose, Monica Hermann, Anders Mikal Andersen, Joe Chan, Morten Skauby, My Hanna Sofia Svensson, Anders Åsberg, Hege Christensen
BACKGROUND: Tacrolimus is currently the cornerstone of immunosuppressive protocols for renal transplant recipients. Despite therapeutic whole blood monitoring, tacrolimus is associated with nephrotoxicity and it has been hypothesized that intrarenal accumulation of tacrolimus and/or its metabolites are involved. As tacrolimus is a substrate of P-glycoprotein (P-gp), the expression and activity of this efflux transporter could influence the levels of tacrolimus in renal tissue. The primary aim of this study was to develop and validate a method for quantification of tacrolimus in tissue homogenates from single human renal core biopsies...
March 23, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29536032/a-successful-approach-to-kidney-transplantation-in-patients-with-enteric-secondary-hyperoxaluria
#19
Joke I Roodnat, Anneke M E de Mik-van Egmond, Wesley J Visser, Stefan P Berger, Wilbert A G van der Meijden, Felix Knauf, Madelon van Agteren, Michiel G H Betjes, Ewout J Hoorn
Background: Enteric hyperoxaluria due to malabsorption may cause chronic oxalate nephropathy and lead to end-stage renal disease. Kidney transplantation is challenging given the risk of recurrent calcium-oxalate deposition and nephrolithiasis. Methods: We established a protocol to reduce plasma oxalic acid levels peritransplantation based on reduced intake and increased removal of oxalate. The outcomes of 10 kidney transplantation patients using this protocol are reported...
December 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29535503/risk-factors-for-calcineurin-inhibitor-nephrotoxicity-after-renal-transplantation-a-systematic-review-and-meta-analysis
#20
REVIEW
Tianyi Xia, Sang Zhu, Yan Wen, Shouhong Gao, Mingming Li, Xia Tao, Feng Zhang, Wansheng Chen
Background: Nephrotoxicity of calcineurin inhibitors (CNIs) is the major concern for long-term allograft survival despite its predominant role in current immunosuppressive regime after renal transplantation. CNI nephrotoxicity is multifactorial with demographic, environmental, and pharmacogenetic flexibility, whereas studies indicating risk factors for CNI nephrotoxicity obtained incomplete or conflicting results. Methods: A systematic review and meta-analysis of risk factors for CNI nephrotoxicity was performed on all retrieved studies through a comprehensive research of network database...
2018: Drug Design, Development and Therapy
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