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https://www.readbyqxmd.com/read/28535528/chronic-allograft-injury-an-overview-of-pathogenesis-and-treatment-strategies
#1
Hector M Madariaga, Leonardo V Riella
Chronic allograft injury (CAI) remains one of the biggest challenges in transplantation as it directly affects the long-term allograft survival, an area in which the scientific and transplantation communities have struggled to improve outcomes. Therefore, understanding the mechanisms of CAI is paramount to implement preventive measures and novel therapeutic options. In this review, we will address the latest evidence on CAI, potential etiologies and risk factors including non-adherence, antibody-mediated rejection, recurrence of glomerular disease, BK nephropathy, and calcineurin nephrotoxicity...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28460645/statin-use-and-hip-fractures-in-u-s-kidney-transplant-recipients
#2
Chandan Vangala, Colin R Lenihan, Maria E Montez-Rath, Sumi Sukumaran Nair, Sankar D Navaneethan, Venkat Ramanathan, Wolfgang C Winkelmayer
BACKGROUND: Basic and translational research supports beneficial effects of statins on bone metabolism. Clinical studies suggest that statin use may reduce the risk of hip fractures in the general population. Whether statin use is associated with hip fracture risk in kidney transplant recipients, a particularly high-risk group for this outcome, is unknown. METHODS: From the U.S. Renal Data System (2007-2011), we identified all hip fracture events recorded in Medicare billing claims of first-time kidney transplant recipients...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28457016/patterns-of-primary-care-utilization-before-and-after-living-kidney-donation
#3
Jennifer L Alejo, Xun Luo, Allan B Massie, Macey L Henderson, Sandra R DiBrito, Jayme E Locke, Tanjala Purnell, Brian J Boyarsky, Saad Anjum, Samantha E Halpern, Dorry L Segev
BACKGROUND: Annual visits with a primary care provider (PCP) are recommended for living kidney donors to monitor long-term health post-donation, yet adherence to this recommendation is unknown. METHODS: We surveyed 1170 living donors from our center from 1970-2012 to ascertain frequency of PCP visits pre- and post-donation. Interviews occurred median (IQR) 6.6 (3.8 - 11.0) years post-transplant. We used multivariate logistic regression to examine associations between donor characteristics and PCP visit frequency...
April 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28428716/transition-after-pediatric-liver-transplantation-perceptions-of-adults-adolescents-and-parents
#4
Norman Junge, Katarina Migal, Imeke Goldschmidt, Ulrich Baumann
AIM: To develop a locally adapted, patient-focused transition-program, we evaluated the perceptions of adult and adolescent patients and parents regarding transition-programs and transfer. METHODS: We evaluated these perceptions by analyzing the responses of pre-transfer adolescents (n = 57), their parents (n = 57) and post-transfer adults (n = 138) from a cohort of pediatric-liver-transplant-patients using a self-designed questionnaire. Furthermore, we compared a responder group with a non-responder group as well as the provided answers with baseline characteristics and clinical outcomes to exclude selection bias, characterize high-risk patients for non-adherence and test for gender differences...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28374343/factors-relevant-to-medication-non-adherence-in-kidney-transplant-a-systematic-review
#5
Stephanie Belaiche, Bertrand Décaudin, Sébastien Dharancy, Christian Noel, Pascal Odou, Marc Hazzan
Background Medication non-adherence is a major issue after transplant that can lead to misdiagnosis, rejection, poor health affecting quality of life, graft loss or death. Several estimations of adherence and related factors have previously been described but conclusions leave doubt as to the most accurate assessment method. Aim of the review To identify the factors most relevant to medication non-adherence in kidney transplant in current clinical practice. Method This systematic review is registered in the PROSPERO data base and follows the Prisma checklist...
April 3, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28356080/patient-reported-non-adherence-and-immunosuppressant-trough-levels-are-associated-with-rejection-after-renal-transplantation
#6
Jennifer Scheel, Sandra Reber, Lisa Stoessel, Elisabeth Waldmann, Sabine Jank, Kai-Uwe Eckardt, Franziska Grundmann, Frank Vitinius, Martina de Zwaan, Anna Bertram, Yesim Erim
BACKGROUND: Different measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels). METHODS: Patient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were ≥12 months post-transplantation...
March 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28349215/adherence-in-pediatric-kidney-transplant-recipients-solutions-for-the-system
#7
REVIEW
Elizabeth A Steinberg, Mary Moss, Cindy L Buchanan, Jens Goebel
Non-adherence remains a significant problem among pediatric (and adult) renal transplant recipients. Non-adherence among solid organ transplant recipients results in US$15-100 million annual costs. Estimates of non-adherence range from 30 to 70% among pediatric patients. Research demonstrates that a 10% decrement in adherence is associated with 8% higher hazard of graft failure and mortality. Focus has begun to shift from patient factors that impact adherence to the contributing healthcare and systems factors...
March 27, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28320631/outcomes-of-adolescent-recipients-after-lung-transplantation-an-analysis-of-the-international-society-for-heart-and-lung-transplantation-registry
#8
Miranda A Paraskeva, Leah B Edwards, Bronwyn Levvey, Josef Stehlik, Samuel Goldfarb, Roger D Yusen, Glen P Westall, Greg I Snell
BACKGROUND: Recipient adolescent age for non-lung solid-organ transplantation is associated with higher rates of rejection, graft loss and mortality. Although there have been no studies specifically examining adolescent outcomes after lung transplantation (LTx), limited data from the International Society of Heart and Lung Transplantation (ISHLT) Registry suggest that a similar association may exist. Recently, adolescence has been defined as 10 to 24 years of age, taking into account the biologic and sociologic transitions that occur during this age interval...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28271997/a-retrospective-study-of-clinical-profile-and-long-term-outcome-to-imatinib-mesylate-alone-in-childhood-chronic-myeloid-leukemia-in-chronic-phase
#9
(no author information available yet)
OBJECTIVE: Chronic myeloid leukemia (CML) is relatively rare malignancy in childhood. There are limited studies of use of Imatinib Mesylate (IM) alone in management of CML in this age group. METHOD: We retrospectively analyzed the outcome of 30 consecutive children with CML chronic phase treated with IM alone. RESULTS: The median age at the time of diagnosis was 11 years with male preponderance. Asthenia and abdominal discomfort due to splenomegaly were the most common presenting features and splenomegaly a dominant sign...
January 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28256241/exploring-the-usage-of-a-mobile-phone-application-in-transplanted-patients-to-encourage-medication-compliance-and-education
#10
Alana Zanetti-Yabur, Amanda Rizzo, Nicole Hayde, Anthony C Watkins, Juan P Rocca, Jay A Graham
BACKGROUND: Medication non-adherence in transplant patients is a grave problem that results in increased rejection episodes, graft loss and significant morbidity. METHODS: The efficacy of users and non-users of a mobile phone application (mobile app) in promoting medication adherence was investigated. The Beliefs about Medicine Questionnaire (BMQ) and Morisky Medication Adherence Scale (MMAS-8) were used in these cohorts to assess the predilection for poor adherence...
February 17, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28223731/risk-of-alcohol-use-relapse-after-liver-transplantation-for-alcoholic-liver-disease
#11
Yasuharu Onishi, Hiroyuki Kimura, Tomohide Hori, Shinichi Kishi, Hideya Kamei, Nobuhiko Kurata, Chisato Tsuboi, Naoko Yamaguchi, Mayu Takahashi, Saki Sunada, Mitsuaki Hirano, Hiroshige Fujishiro, Takashi Okada, Masatoshi Ishigami, Hidemi Goto, Norio Ozaki, Yasuhiro Ogura
AIM: To investigate factors, including psychosocial factors, associated with alcoholic use relapse after liver transplantation (LT) for alcoholic liver disease (ALD). METHODS: The clinical records of 102 patients with ALD who were referred to Nagoya University Hospital for LT between May 2003 and March 2015 were retrospectively evaluated. History of alcohol intake was obtained from their clinical records and scored according to the High-Risk Alcoholism Relapse scale, which includes duration of heavy drinking, types and amount of alcohol usually consumed, and previous inpatient treatment history for alcoholism...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28211192/racial-differences-in-incident-de-novo-donor-specific-anti-hla-antibody-among-primary-renal-allograft-recipients-results-from-a-single-center-cohort-study
#12
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 leucocyte 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/28211034/infectious-complications-as-the-leading-cause-of-death-after-kidney-transplantation-analysis-of-more-than-10-000-transplants-from-a-single-center
#13
Flávio de Castro Rodrigues Ferreira, Marina Pontello Cristelli, Mayara Ivani Paula, Henrique Proença, Claudia Rosso Felipe, Helio Tedesco-Silva, José Osmar Medina-Pestana
AIM: To identify specific causes of graft failure in a large sample of kidney transplant patients from a middle-income, developing country. METHODS: Retrospective cohort study analyzing all consecutive single kidney transplants (KTs) performed at a single center in Brazil between January 1st 1998 and December 31st 2013. The database closing date was December 31st 2014. RESULTS: Out of 10,400 KTs, there were 1191 (11.45%) deaths with a functioning graft, 40 cases (0...
February 17, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28198130/psychosocial-predictors-of-medication-adherence-in-pediatric-heart-and-lung-organ-transplantation
#14
Michael O Killian
Few studies have identified the psychosocial characteristics of those children and their families associated with future non-adherence to immunosuppressive medications following a heart or lung transplant. UNOS data and medical records information were used to test the association between patient and family psychosocial characteristics and medication adherence. Medication adherence outcomes were obtained using the physician assessments in the UNOS data and measured through patient-level standard deviation scores of immunosuppressive medication blood levels...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28191531/urine-biomarkers-in-renal-allograft
#15
Hongting Wang, Zuan-Tao Lin, Yulin Yuan, Tianfu Wu
There is a high risk for the survival of patients with an end-stage renal disease for kidney transplantation. To avoid rejection by strict medication adherence is of utmost importance to avoid the failure of a kidney transplant. It is imperative to develop non-invasive biomarkers to assess immunity risk, and to ultimately provide guidance for therapeutic decision-making following kidney transplantation. Urine biomarkers may represent the promising non-invasive tools that will help in predicting risk or success rates of kidney transplantations...
September 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28166398/belatacept-after-kidney-transplantation-in-adolescents-a-retrospective-study
#16
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 nonadherence to an oral immunosuppressive regimen. Belatacept, a non-nephrotoxic, first-in-class immunosuppressant that inhibits costimulation 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...
May 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28152180/magnetic-nanoparticle-mediated-gene-delivery-to-two-and-three-dimensional-neural-stem-cell-cultures-magnet-assisted-transfection-and-multifection-approaches-to-enhance-outcomes
#17
Mark R Pickard, Christopher F Adams, Divya M Chari
Neural stem cells (NSCs) have high translational potential in transplantation therapies for neural repair. Enhancement of their therapeutic capacity by genetic engineering is an important goal for regenerative neurology. Magnetic nanoparticles (MNPs) are major non-viral vectors for safe bioengineering of NSCs, offering critical translational benefits over viral vectors, including safety, scalability, and ease of use. This unit describes protocols for the production of suspension (neurosphere) and adherent (monolayer) murine NSC cultures...
February 2, 2017: Current Protocols in Stem Cell Biology
https://www.readbyqxmd.com/read/28145625/pediatric-renal-transplant-practices-in-india
#18
Sidharth Kumar Sethi, Rajiv Sinha, Smriti Rohatgi, Vijay Kher, Arpana Iyengar, Arvind Bagga
Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India...
May 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28058225/psychological-perspective-of-medication-adherence-in-transplantation
#19
Concetta De Pasquale, Massimiliano Veroux, Michele Fornaro, Nunzia Sinagra, Giusi Basile, Cecilia Gozzo, Roberta Santini, Alessandra Costa, Maria Luisa Pistorio
AIM: To identify the risk factors and the post-transplant psychological symptoms that affect adherence to therapy in a population of kidney transplant recipients. METHODS: The study examined the psychological variables likely responsible for the non-adherent behavior using a psychological-psychiatric assessment, evaluation of the perception of patients' health status, and an interview regarding the anti-rejection drug therapy assumption. The study included 74 kidney transplant recipients...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28042353/immunosuppressive-therapy-after-solid-organ-transplantation-does-the-intermed-identify-patients-at-risk-of-poor-adherence
#20
Laurent Michaud, Gundula Ludwig, Sylvie Berney, Stéphanie Rodrigues, Anne Niquille, Valérie Santschi, Anne-Sophie Favre, Anne-Catherine Lange, Annemieke A Michels, Bernard Vrijens, Olivier Bugnon, Nathalie Pilon, Manuel Pascual, Jean-Pierre Venetz, Friedrich Stiefel, Marie-Paule Schneider
BACKGROUND: Lack of adherence to medication is a trigger of graft rejection in solid-organ transplant (SOT) recipients. OBJECTIVE: This exploratory study aimed to assess whether a biopsychosocial evaluation using the INTERMED instrument before transplantation could identify SOT recipients at risk of suboptimal post-transplantation adherence to immunosuppressant drugs. We hypothesized that complex patients (INTERMED>20) might have lower medication adherence than noncomplex patients (INTERMED≤20)...
October 2016: Pharmacy Practice
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