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chronic allograft dysfunction

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https://www.readbyqxmd.com/read/29327719/the-histomorphological-spectrum-of-restrictive-chronic-lung-allograft-dysfunction-and-implications-for-prognosis
#1
Jan H von der Thüsen, Elly Vandermeulen, Robin Vos, Birgit Weynand, Erik K Verbeken, Stijn E Verleden
Chronic lung allograft dysfunction continues to be the main contributor to poor long-term allograft survival after lung transplantation. The restrictive phenotype of chronic lung allograft dysfunction carries a particularly poor prognosis. Little is known about the pathogenetic mechanisms involved in restrictive chronic lung allograft dysfunction. In this study, we performed histomorphological and immunohistochemical analysis of restrictive chronic lung allograft dysfunction lungs. Explant lung tissue from 21 restrictive chronic lung allograft dysfunction patients was collected and histopathologic patterns of rejection, fibrosis and vascular changes were scored after routine histochemical stains and additional immunohistochemistry for endothelial markers and C4d...
January 12, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/29325996/direct-acting-antiviral-therapy-for-hepatitis-c-virus-infection-in-the-kidney-transplant-recipient
#2
REVIEW
Donald F Chute, Raymond T Chung, Meghan E Sise
Hepatitis C virus infection (HCV) is a common comorbidity in patients who have undergone kidney transplantation and is associated with increased morbidity and mortality compared with recipients who do not have chronic HCV infection. Because interferon-α-based therapies can precipitate acute rejection, they are relatively contraindicated after kidney transplantation. Thus, the majority of kidney transplant recipients with HCV remain untreated. There are now all-oral, interferon-free direct-acting antiviral therapies for HCV infection that are extremely effective and well tolerated in the general population...
January 9, 2018: Kidney International
https://www.readbyqxmd.com/read/29325696/urinary-mrna-analysis-of-biomarkers-to-epithelial-mesenchymal-transition-of-renal-allograft
#3
Imen Mezni, Pierre Galichon, Mohammed Mongi Bacha, Yi-Chun Xu-Dubois, Imen Sfar, David Buob, Sabrina Benbouzid, Rim Goucha, Yousr Gorgi, Ezzedine Abderrahim, Mondher Ounissi, Karine Dahan, Nacera Ouali, Alexandre Hertig, Isabelle Brocheriou, Aly Raies, Taieb Ben Abdallah, Éric Rondeau
Renal allograft loss is most often a chronic process, irrespective of the mechanism at stake. In this prospective study, we studied the expression of epithelial to mesenchymal transition (EMT) markers vimentin and β-catenin by immunohistochemistry in the surveillance biopsy and measured the mRNA encoding vimentin (VIM), CD45, GAPDH and uroplakin 1a (UPK) by quantitative PCR in urinary cells in 75 renal transplant patients. The aim is to establish a simple screening test for chronic renal allograft dysfunction...
January 8, 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29322685/feasibility-safety-and-tolerance-of-mesenchymal-stem-cell-therapy-for-obstructive-chronic-lung-allograft-dysfunction
#4
Cesar Ariel Keller, Thomas Arthur Gonwa, David Orel Hodge, Derek Joseph Hei, John Michael Centanni, Abba Chedi Zubair
Feasibility, tolerance, and safety of intravenous infusions of allogeneic mesenchymal stem cell (MSC) therapy in lung transplant recipients with bronchiolitis obliterans syndrome (BOS) are not well established. MSCs were manufactured, cryopreserved, transported to our facility, thawed, and infused into nine recipients with moderate BOS (average drop in forced expiratory volume in 1 second was 56.8% ± 3.2% from post-transplant peak) who were refractory to standard therapy and not candidates for retransplant...
January 11, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29312756/history-of-lung-transplantation
#5
REVIEW
Federico Venuta, Dirk Van Raemdonck
Lung transplantation nowadays is a well-accepted and routine treatment for well selected patients with terminal respiratory disease. However, it took several decades of experimental studies and clinical attempts to reach this success. In this paper, we describe the early experimental activity from the mid-forties until the early sixties. The first clinical attempt in humans was reported by Hardy and Webb in 1963 followed by others with short survival only except for one case by Derom et al. who lived for 10 months...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29312755/acute-rejection
#6
REVIEW
Mark Benzimra, Greg L Calligaro, Allan R Glanville
Despite induction immunosuppression and the use of aggressive maintenance immunosuppressive regimens, acute allograft rejection following lung transplantation is still a problem with important diagnostic and therapeutic challenges. As well as causing early graft loss and mortality, acute rejection also initiates the chronic alloimmune responses and airway-centred inflammation that predispose to bronchiolitis obliterans syndrome (BOS), also known as chronic lung allograft dysfunction (CLAD), which is a major source of morbidity and mortality after lung transplantation...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29300898/impact-of-human-leukocyte-antigen-mismatch-on-lung-transplant-outcome
#7
Yoshito Yamada, Tim Langner, Ilhan Inci, Christian Benden, Macé Schuurmans, Walter Weder, Wolfgang Jungraithmayr
OBJECTIVES: Human leucocyte antigen (HLA) mismatch between donor and recipient has a differential impact on the outcome after transplant (Tx) among transplantable solid organs. Although the lung is considered a highly antigenic organ, the impact of HLA matching between the donor and the recipient has been shown to be heterogeneous on lung Tx outcome. To provide further evidence that HLA matching should be considered in the decision process prior to lung Tx, we evaluated the impact of donor/recipient HLA mismatch on the outcome after lung Tx at our institution...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29262341/feeling-exhausted-tuning-irf4-energizes-dysfunctional-t-cells
#8
Vijaykumar Chennupati, Werner Held
The regulatory mechanisms governing T cell exhaustion remain incompletely understood. Man et al. (2017) and Wu et al. (2017) report that the T cell receptor responsive transcription factor Irf4 promotes T cell exhaustion in chronic viral infection but dampens exhaustion in response to tissue allografts.
December 19, 2017: Immunity
https://www.readbyqxmd.com/read/29249167/comparison-of-ultrasound-shear-wave-elastography-with-magnetic-resonance-elastography-and-renal-microvascular-flow-in-the-assessment-of-chronic-renal-allograft-dysfunction
#9
Stephan R Marticorena Garcia, Jing Guo, Michael Dürr, Timm Denecke, Bernd Hamm, Ingolf Sack, Thomas Fischer
Background Monitoring of renal allograft function is essential for early identification of dysfunction and improvement of kidney transplant (KTX) outcome. Purpose To non-invasively assess renal stiffness in KTX recipients using ultrasound shear wave elastography (USE) in correlation with multifrequency magnetic resonance elastography (MRE), renal allograft function, and renal microvascular flow determined using a novel ultrasound microvascular imaging technique. Material and Methods This prospective study investigated 25 KTXs (functional KTX [FCT], n = 14; chronic KTX insufficiency [DYS], n = 11) in 20 KTX recipients (mean age = 43 ± 14 years)...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#10
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29198928/lung-autoantibodies-ready-for-prime-time
#11
EDITORIAL
Luke Milross, Ramsey Hachem, Deborah Levine, Allan R Glanville
Despite advances in our understanding of the immunology of lung allograft tolerance and a reduction in the rate of acute allograft rejection using contemporary immunosuppressive protocols, the rate of chronic lung allograft dysfunction (CLAD), both obstructive and restrictive, remains unacceptably high. CLAD, particularly the restrictive phenotype, is a harbinger of a foreshortened survival. The development of a consensus approach to the diagnosis of antibody-mediated rejection by the International Society for Heart and Lung Transplantation has highlighted the need for a uniform approach toward the investigation, diagnosis, implications and management of both human leukocyte antigen (HLA) and non-HLA-related antibody formation...
November 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29198660/utility-of-oxford-classification-in-post-transplant-immunoglobulin-a-nephropathy
#12
V Agrawal, A Singh, A Kaul, R Verma, M Jain, R Pandey
BACKGROUND: With increasing graft survival, post-transplant immunoglobulin A nephropathy (IgAN) has emerged as an important cause of chronic graft dysfunction in renal allograft recipients. We studied the clinico-pathological features of post-transplant IgAN regardless of the primary disease. The aim was to study the usefulness of the Oxford classification in predicting survival. METHODS: Indication graft biopsy specimens (n = 915) were received during a 10-year period; 27 biopsy specimens from 22 patients were diagnosed as IgAN...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29187134/correlation-between-renal-cortical-stiffness-and-histological-determinants-by-point-shear-wave-elastography-in-patients-with-kidney-transplantation
#13
A L Croci Chiocchini, C Sportoletti, G Comai, S Brocchi, I Capelli, O Baraldi, P Bruno, F Conti, C Serra, M Meola, M Zompatori, G La Manna
INTRODUCTION: Renal allograft biopsy is the gold standard for the detection of histological lesions of chronic allograft dysfunction. The identification of a noninvasive routine test would be desirable. Elastosonography is used to assess tissue stiffness according to viscosity, and no data are available on the use of point quantification shear-wave elastography (ElastPQ) for the evaluation of renal chronic lesions. RESEARCH QUESTION: To evaluate the feasibility of ElastPQ to assess cortical allograft stiffness and to determine the correlation of clinical, biological, and pathological factors with the diagnostic accuracy of kidney stiffness values in patients with histological lesions...
December 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29178607/detection-and-clinical-impact-of-human-leukocyte-antigen-antibodies-in-lung-transplantation-a-systematic-review-and-meta-analysis
#14
A Courtwright, J M Diamond, I Wood, I Guleria, E Milford, S El-Chemaly, H J Goldberg
There is significant variability in lung transplant centers' approach to HLA (human leukocyte antigen) antibodies, creating heterogeneity regarding their clinical significance. Some institutions use beads coated with multiple HLA to screen candidate sera and then use single antigen beads (SAB) to determine antibody identity if the pre-screen is positive. Other centers do not pre-screen, using SAB alone, which may detect low-level antibodies of unknown significance. The primary objective of this study was to review the current literature to identify sources of heterogeneity in the identification of pre- and post-lung transplant HLA antibodies, particularly regarding antibody detection methods...
November 25, 2017: HLA
https://www.readbyqxmd.com/read/29174387/role-of-tumor-necrosis-factor-%C3%AE-in-epithelial-to-mesenchymal-transition-in-transplanted-kidney-cells-in-recipients-with-chronic-allograft-dysfunction
#15
Chunchun Zhao, Zhen Xu, Zijie Wang, Chuanjian Suo, Jun Tao, Zhijian Han, Min Gu, Ruoyun Tan
BACKGROUND: Chronic allograft dysfunction (CAD) is characterized by allograft kidney interstitial fibrosis, the underlying mechanism of which is unclear. Our aim was to elucidate the role and mechanism of TNF-α-induced epithelial-to-mesenchymal transition (EMT) in transplant kidney tubular interstitial fibrosis. METHODS: Human kidney tissues from normal volunteers and CAD patients were assessed using periodic acid-Schiff, Masson trichrome and immunohistochemical staining...
November 23, 2017: Gene
https://www.readbyqxmd.com/read/29164120/expression-of-mitochondrial-encoded-genes-in-blood-differentiate-acute-renal-allograft-rejection
#16
Silke Roedder, Tara Sigdel, Szu-Chuan Hsieh, Jennifer Cheeseman, Diana Metes, Camila Macedo, Elaine F Reed, H A Gritsch, Adriana Zeevi, Ron Shapiro, Allan D Kirk, Minnie M Sarwal
Despite potent immunosuppression, clinical and biopsy confirmed acute renal allograft rejection (AR) still occurs in 10-15% of recipients, ~30% of patients demonstrate subclinical rejection on biopsy, and ~50% of them can show molecular inflammation, all which increase the risk of chronic dysfunction and worsened allograft outcomes. Mitochondria represent intracellular endogenous triggers of inflammation, which can regulate immune cell differentiation, and expansion and cause antigen-independent graft injury, potentially enhancing the development of acute rejection...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29151274/effect-of-hmg-coa-reductase-inhibitors-on-the-development-of-chronic-lung-allograft-dysfunction
#17
Amanda Szczepanik, Amanda Hulbert, Hui-Jie Lee, Clark Benedetti, Laurie Snyder, Jennifer Byrns
Lung transplant recipients (LR) have a reduced median five-year survival of approximately 55% primarily due to chronic lung allograft dysfunction (CLAD). Statins have anti-inflammatory and immunomodulatory effects that may facilitate CLAD prevention. This study sought to evaluate statin effect on CLAD development. Adult bilateral LR from January 2004-October 2013 were included. Statin group included recipients with early statin use and continued for minimum 6 months. Propensity score matching was performed for age, gender and native lung disease to select matched non-statin group...
November 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29149977/donor-smoking-and-older-age-increases-morbidity-and-mortality-after-lung-transplantation
#18
H H Schultz, C H Møller, M Zemtsovski, J Ravn, M Perch, T Martinussen, J Carlsen, M Iversen
BACKGROUND: The lack of lung transplant donors has necessitated the use of donors with a smoking history and donors of older age. We have evaluated the effects of donor smoking history and age on recipient morbidity and mortality with baseline values of pulmonary function and survival free of chronic lung allograft dysfunction (CLAD) as morbidity variables. METHODS: This is a retrospective analysis of 588 consecutive lung transplant recipients and their corresponding 454 donors...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29146602/donor-specific-and-nonspecific-hla-antibodies-and-outcome-post-lung-transplantation
#19
Stijn E Verleden, Bart M Vanaudenaerde, Marie-Paul Emonds, Dirk E Van Raemdonck, Arne P Neyrinck, Geert M Verleden, Robin Vos
Donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) are associated with chronic lung allograft dysfunction (CLAD) and mortality post lung transplantation, but data concerning prevalence, time of onset, persistence and effects on long-term outcome remain scarce.We assessed the association between HLA antibodies and CLAD-free and graft survival in a cohort of 362 patients. We stratified our analysis according to DSA status, persistence of antibodies and timing of antibodies (pre-transplant, early or late post-transplant)...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29128018/update-in-chronic-lung-allograft-dysfunction
#20
REVIEW
Rupal J Shah, Joshua M Diamond
Chronic lung allograft dysfunction (CLAD) is the major limitation to posttransplant survival. This review highlights the evolving definition of CLAD, risk factors, treatment, and expected outcomes after the development of CLAD.
December 2017: Clinics in Chest Medicine
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