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https://www.readbyqxmd.com/read/29757900/detection-of-complement-binding-donor-specific-antibodies-not-igg-antibody-strength-nor-c4d-status-at-antibody-mediated-rejection-diagnosis-is-an-independent-predictor-of-kidney-graft-failure
#1
Jorge Malheiro, Sofia Santos, Sandra Tafulo, Leonídio Dias, La Salete Martins, Isabel Fonseca, Manuela Almeida, Sofia Pedroso, Idalina Beirão, António Castro-Henriques, António Cabrita
BACKGROUND: Antibody-mediated rejection (ABMR) remains associated with reduced kidney graft survival and no clear prognostic marker is available. METHODS: We investigated whether donor-specific antibodies (DSA) ability to bind C1q in comparison with ABMR C4d status, both indirect signs of complement activation, improve risk stratification at time of ABMR. Hence, among 467 patients in whom ≥1 graft biopsy was performed between 2008 and 2015, we included 56 with ABMR according to Banff'15 criteria...
May 3, 2018: 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/29731056/clinical-significance-of-macrophage-polarization-in-antibody-mediated-rejection-of-renal-allograft
#3
J Kim, S-E Choi, B J Lim, Y S Kim, K H Huh, J Lee, S I Kim, M S Kim, H J Jeong
BACKGROUND: The significance of proinflammatory M1 (classically activated) and profibrotic M2 (alternatively activated) macrophages in antibody-mediated rejection (ABMR) after kidney transplantation has not been investigated. METHODS: Fifty-five biopsy-confirmed ABMR samples were stained with MRP 8/14 (a marker of M1 macrophages) and CD163 (a marker of M2 macrophages), and positive cells were counted in glomeruli and the tubulointerstitium, respectively. Patients were classified into M1 and M2 polarization groups according to the glomerular and tubulointerstitial M1:M2 ratio, and the results were compared with Banff scores, serum creatinine level, estimated glomerular filtration rate (eGFR), and graft survival...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#4
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29676812/impact-of-pretransplant-donor-specific-antibodies-on-kidney-allograft-recipients-with-negative-flow-cytometry-crossmatches
#5
Hyunwook Kwon, Young Hoon Kim, Ji Yoon Choi, Sung Shin, Joo Hee Jung, Su-Kil Park, Duck Jong Han
The Luminex test can detect low levels of donor-specific antibody (DSA) that cannot be detected by flow-cytometric crossmatching (FCXM) in kidney transplantation (KT). This study evaluated the impact of DSA on clinical outcomes in KT recipients negative on FCXM. Of 575 consecutive patients who underwent living donor KT between January 2013 and July 2016, 494 (85.9%) were DSA-negative and 81 (14.1%) were DSA-positive. Although rates of acute cellular rejection (ACR) at 1 year were similar in the two groups (P = 0...
April 20, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29676803/outcome-of-the-risk-stratified-desensitization-protocol-in-donor-specific-antibody-positive-living-kidney-transplant-recipients-a-retrospective-study
#6
Daigo Okada, Masayoshi Okumi, Yoichi Kakuta, Kohei Unagami, Junpei Iizuka, Toshio Takagi, Hideki Ishida, Kazunari Tanabe
Acceptable outcomes of donor-specific antibody (DSA)-positive living kidney transplantation (LKT) have recently been reported. However, LKT in crossmatch (XM)-positive patients remains at high-risk and requires an optimal desensitization protocol. We report our intermediate-term outcomes of XM-positive LKT versus XM-negative LKT in patients who underwent LKT between January 2012 and June 2015 in our institution. The rate of acute antibody-mediated rejection (ABMR) within 90 days post-operation, graft function, and patient and graft survival rates at 4 years were investigated...
April 20, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29672702/the-disappointing-contribution-of-anti-human-leukocyte-antigen-donor-specific-antibodies-characteristics-for-predicting-allograft-loss
#7
Maxime Courant, Jonathan Visentin, Gabriel Linares, Valérie Dubois, Sébastien Lepreux, Gwendaline Guidicelli, Olivier Thaunat, Pierre Merville, Lionel Couzi, Jean-Luc Taupin
Background: Pathogenicity of donor-specific antibodies (DSAs) can be assessed using the single-antigen flow beads (SAFB) assays through mean fluorescence intensity (MFI) with or without serum ethylenediaminetetraacetic acid (EDTA) treatment, measurement of C1q or C3d binding and/or their intragraft detection [graft-bound donor-specific antibody (gDSA)]. We aimed to investigate which of these markers best associates with antibody-mediated rejection (ABMR) and kidney allograft loss at the time of a for-cause biopsy...
April 17, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29536028/rituximab-and-monitoring-strategies-for-late-antibody-mediated-rejection-after-kidney-transplantation
#8
Sandesh Parajuli, Didier A Mandelbrot, Brenda Muth, Maha Mohamed, Neetika Garg, Fahad Aziz, Robert R Redfield, Weixiong Zhong, Brad C Astor, Arjang Djamali
Background: There is limited information on treatment strategies and monitoring strategies for late antibody-mediated rejection (ABMR) after kidney transplantation. Methods: In this observational and nonrandomized study, we compared 78 patients diagnosed with late ABMR (>3 months after transplant) who were treated with standard of care steroids/IVIG (n = 38) ± rituximab (n = 40) at our center between March 1, 2013 and December 31, 2016. All patients had follow-up biopsy and donor-specific antibodies (DSA) monitoring within 3 to 12 weeks...
December 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29524568/impact-of-persistent-and-cleared-preformed-hla-dsa-on-kidney-transplant-outcomes
#9
Dolores Redondo-Pachón, María José Pérez-Sáez, Marisa Mir, Javier Gimeno, Laura Llinás, Carmen García, Juan José Hernández, Jose Yélamos, Julio Pascual, Marta Crespo
Preformed HLA donor-specific antibodies (DSA) only detected with Luminex have been associated with increased risk of antibody-mediated rejection (ABMR) and graft failure after kidney transplantation (KT). Their evolution after KT may modify this risk. We analyzed postransplant evolution of preformed DSA identified retrospectively and their impact on outcomes of 370 KT performed 2006-2014. Antibodies were monitored prospectively at 1-3-5 years after KT and if any dysfunction. Early acute ABMR was more frequent among patients with preformed DSA class-I or I + II than isolated class-II (29...
June 2018: Human Immunology
https://www.readbyqxmd.com/read/29478298/functional-fc-gamma-receptor-gene-polymorphisms-and-donor-specific-antibody-triggered-microcirculation-inflammation
#10
M L Arnold, A Kainz, L G Hidalgo, F Eskandary, N Kozakowski, M Wahrmann, H Haslacher, R Oberbauer, A Heilos, B M Spriewald, P F Halloran, G A Böhmig
Fc-dependent effector mechanisms may contribute to antibody-mediated rejection (ABMR), and distinct gene polymorphisms modifying the function of Fc gamma receptors (FcγRs) may influence the capability of donor-specific antibodies (DSAs) to trigger inflammation. To evaluate the relevance of functional FcγR variants in late ABMR, 85 DSA-positive kidney allograft recipients, who were recruited upon antibody screening of 741 prevalent patients, were genotyped for polymorphisms in FcγRIIA (FCGR2A-H/R131 ; rs1801274), FcγRIIIA (FCGR3A-V/F158 ; rs396991), and FcγRIIIB (FCGR3B-neutrophil antigen 1 ([NA1]/NA2; rs35139848)...
February 25, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29456206/c4d-negative-antibody-mediated-rejection-a-pathologist-s-perspective-and-clinical-outcome
#11
Lovelesh Kumar Nigam, Aruna V Vanikar, Kamal V Kanodia, Rashmi D Patel, Kamlesh S Suthar, Himanshu V Patel
Banff'13 update included C4d-antibody-mediated rejection (ABMR) as a separate entity responsible for graft dysfunction with limited clinical/prognostic implications. We present a retrospective study to determine the incidence and outcome of C4d-negative ABMR. A total of 987 renal allograft (RA) biopsies obtained from 987 RA recipients were studied from January 2013 to January 2016. All samples were subjected to light microscopy using standard stains and C4d immunohistochemistry on paraffin sections and reported according to modified Banff's criteria...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29444269/association-of-angiotensin-ii-type-1-receptor-antibodies-with-graft-histology-function-and-survival-in-paediatric-renal-transplant-recipients
#12
Alexander Fichtner, Caner Süsal, Claudia Schröder, Britta Höcker, Susanne Rieger, Rüdiger Waldherr, Jens H Westhoff, Anja Sander, Duska Dragun, Burkhard Tönshoff
Background: We analysed in a carefully phenotyped cohort of paediatric patients the association of serum angiotensin II type 1 receptor antibodies (AT1R-Ab) with specific histological lesions and with graft function and survival in conjunction with overall and complement-binding donor-specific human leucocyte antigen donor-specific antibodies (HLA-DSA). Methods: Sera of 62 patients at the time of renal graft biopsy for clinical indication >1 year post-transplant were assessed for AT1R-Ab by enzyme-linked immunosorbent assay (ELISA) and for DSA and C1q-fixing DSA by single-antigen bead technology...
February 12, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29407335/late-steroid-withdrawal-following-ab0-incompatible-renal-transplantation
#13
F Bachmann, N Lachmann, K Budde, L Liefeldt, F Halleck, M Naik, F Friedersdorff, B Rudolph, K Wu, O Meyer, T Slowinski, J Waiser
BACKGROUND: Current evidence on steroid withdrawal following AB0-incompatible (AB0i) renal transplantation is low. We compared clinical outcomes of patients who agreed to late steroid withdrawal and patients who remained on steroid treatment. METHODS: Steroid withdrawal was carried out in 11 patients at ≥12 months after transplantation (group W). For comparison, we analyzed 19 patients who remained on triple immunosuppression including steroids (group M). Minimum follow-up was 24 months following transplantation and 12 months after steroid withdrawal...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29397036/antibody-mediated-rejection-in-pediatric-small-bowel-transplantation-capillaritis-is-a-major-determinant-of-c4d-positivity-in-intestinal-transplant-biopsies
#14
Marion Rabant, Maud Racapé, Laetitia-Marie Petit, Jean Luc Taupin, Olivier Aubert, Julie Bruneau, Patrick Barbet, Olivier Goulet, Christophe Chardot, Caroline Suberbielle, Florence Lacaille, Danielle Canioni, Jean-Paul Duong Van Huyen
The diagnostic criteria for antibody-mediated rejection (ABMR) after small bowel transplantation (SBT) are not clearly defined, although the presence of donor-specific antibodies (DSAs) has been reported to be deleterious for graft survival. We aimed to determine the incidence and prognostic value of DSAs and C4d in pediatric SBT and to identify the histopathologic features associated with C4d positivity. We studied all intestinal biopsies (IBx) obtained in the first year posttransplantation (N = 345) in a prospective cohort of 23 children...
February 3, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29319615/clinical-and-pathological-features-of-plasma-cell-rich-acute-rejection-after-kidney-transplantation
#15
Jumpei Hasegawa, Kazuho Honda, Kazuya Omoto, Sachiko Wakai, Hiroki Shirakawa, Masayoshi Okumi, Hideki Ishida, Shohei Fuchinoue, Motoshi Hattori, Kazunari Tanabe
BACKGROUND: Plasma cell-rich acute rejection (PCAR) is a rare type of allograft rejection characterized by the presence of mature plasma cells. In general the prognosis of PCAR is poor, and its clinical and pathological features remain unclear. METHODS: We performed a retrospective observational study and compared allograft survival between kidney transplant recipients who developed PCAR and those who did not develop PCAR. We further analyzed clinical and pathological risk factors for allograft failure in PCAR patients...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29300203/evolving-criteria-for-the-diagnosis-of-antibody-mediated-rejection-in-renal-allografts
#16
Mark Haas
PURPOSE OF REVIEW: To review changes in the Banff schema for antibody-mediated renal allograft rejection over the past decade, including key revisions agreed upon during and immediately subsequent to the 2017 Banff Conference on Allograft Pathology. RECENT FINDINGS: The original Banff schema for diagnosis of acute and chronic active antibody-mediated rejection (ABMR) in renal allografts was formulated at the 2001 and 2007 Banff Conferences, and required histologic (primarily microvascular inflammation and transplant glomerulopathy), immunohistologic (C4d in peritubular capillaries), and serologic [circulating donor-specific antibodies (DSA)] evidence for a definitive diagnosis of ABMR...
May 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29245962/associations-between-hvem-light-btla-cd160-polymorphisms-and-the-occurrence-of-antibody-mediate-rejection-in-renal-transplant-recipients
#17
Zijie Wang, Ke Wang, Haiwei Yang, Zhijian Han, Jun Tao, Hao Chen, Yuqiu Ge, Miao Guo, Chuanjian Suo, Ji-Fu Wei, Ruoyun Tan, Min Gu
Antibody-mediated rejection (ABMR) is a serious complications that can occur following renal transplantation. The production of donor-specific antibodies by the humoral immune response can trigger costimulatory signals, which are crucial in activating immune cells, and therefore, playing a potential role in ABMR. To investigate the role of HVEM/LIGHT/BTLA/CD160 polymorphisms in ABMR, we retrospectively analyzed 200 renal transplant recipients. We adopted next-generation sequencing (NGS) to identify HVEM/LIGHT/BTLA/CD160 single-nucleotide polymorphisms (SNPs) in the genotypes of these patients...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29243394/the-banff-2017-kidney-meeting-report-revised-diagnostic-criteria-for-chronic-active-t-cell-mediated-rejection-antibody-mediated-rejection-and-prospects-for-integrative-endpoints-for-next-generation-clinical-trials
#18
M Haas, A Loupy, C Lefaucheur, C Roufosse, D Glotz, D Seron, B J Nankivell, P F Halloran, R B Colvin, Enver Akalin, N Alachkar, S Bagnasco, Y Bouatou, J U Becker, L D Cornell, J P Duong van Huyen, I W Gibson, Edward S Kraus, R B Mannon, M Naesens, V Nickeleit, P Nickerson, D L Segev, H K Singh, M Stegall, P Randhawa, L Racusen, K Solez, M Mengel
The kidney sessions of the 2017 Banff Conference focused on 2 areas: clinical implications of inflammation in areas of interstitial fibrosis and tubular atrophy (i-IFTA) and its relationship to T cell-mediated rejection (TCMR), and the continued evolution of molecular diagnostics, particularly in the diagnosis of antibody-mediated rejection (ABMR). In confirmation of previous studies, it was independently demonstrated by 2 groups that i-IFTA is associated with reduced graft survival. Furthermore, these groups presented that i-IFTA, particularly when involving >25% of sclerotic cortex in association with tubulitis, is often a sequela of acute TCMR in association with underimmunosuppression...
February 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29242250/a-randomized-trial-of-bortezomib-in-late-antibody-mediated-kidney-transplant-rejection
#19
Farsad Eskandary, Heinz Regele, Lukas Baumann, Gregor Bond, Nicolas Kozakowski, Markus Wahrmann, Luis G Hidalgo, Helmuth Haslacher, Christopher C Kaltenecker, Marie-Bernadette Aretin, Rainer Oberbauer, Martin Posch, Anton Staudenherz, Ammon Handisurya, Jeff Reeve, Philip F Halloran, Georg A Böhmig
Late antibody-mediated rejection (ABMR) is a leading cause of kidney allograft failure. Uncontrolled studies have suggested efficacy of the proteasome inhibitor bortezomib, but no systematic trial has been undertaken to support its use in ABMR. In this randomized, placebo-controlled trial (the Bortezomib in Late Antibody-Mediated Kidney Transplant Rejection [BORTEJECT] Trial), we investigated whether two cycles of bortezomib (each cycle: 1.3 mg/m2 intravenously on days 1, 4, 8, and 11) prevent GFR decline by halting the progression of late donor-specific antibody (DSA)-positive ABMR...
February 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29212248/impact-of-complement-component-3-4-5-single-nucleotide-polymorphisms-on-renal-transplant-recipients-with-antibody-mediated-rejection
#20
Zijie Wang, Haiwei Yang, Miao Guo, Zhijian Han, Jun Tao, Hao Chen, Yuqiu Ge, Ke Wang, Ruoyun Tan, Ji-Fu Wei, Min Gu
Antibody-mediated rejection (ABMR) is an important risk of allograft dysfunction in kidney transplantation. The complement system is considered to be associated with the generation of alloreative antibodies and donor-specific antibodies. However, the association of complement single nucleotide polymorphisms (SNPs) with ABMR still remained unclear. Blood samples of 199 renal transplant recipients containing 68 with ABMR and 131 with stable graft function were collected, and analyzed by next-generation sequencing with an established gene panel...
November 7, 2017: Oncotarget
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