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chronic renal allograft dysfunction

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https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#1
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/29198660/utility-of-oxford-classification-in-post-transplant-immunoglobulin-a-nephropathy
#2
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
#3
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/29174387/role-of-tumor-necrosis-factor-%C3%AE-in-epithelial-to-mesenchymal-transition-in-transplanted-kidney-cells-in-recipients-with-chronic-allograft-dysfunction
#4
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
#5
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/29110796/long-term-outcomes-and-management-of-the-heart-transplant-recipient
#6
REVIEW
Sharon L McCartney, Chetan Patel, J Mauricio Del Rio
Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart transplantation is currently 10.7 years. While early graft failure and multiorgan system dysfunction are the most important causes of early mortality, malignancy, rejection, infection, and cardiac allograft vasculopathy contribute to late mortality. Chronic renal dysfunction is common after heart transplantation and occurs in up to 68% of patients by year 10, with 6...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28982622/retroperitoneal-compartment-syndrome-in-renal-transplantation-how-to-salvage-the-graft
#7
Karen Pineda-Solís, Wen Yan Xie, Vivian McAlister, Alp Sener, Patrick P Luke
OBJECTIVE: Early allograft dysfunction may be caused by several technical factors including vascular complications such as thrombosis, kinking, or extrinsic compression. Renal allograft compartment syndrome (RACS) is an unrecognized cause of early allograft dysfunction. This complication is characterized by increased pressure of the iliac fossa that reduces the blood supply to the graft with a potentially devastating consequence. The main objective when recognizing this condition is to create a tension-free muscle closure...
September 2017: Urology
https://www.readbyqxmd.com/read/28969763/peri-and-postsurgical-evaluations-of-renal-transplant
#8
REVIEW
Belkis Erbas
Renal transplantation is the best treatment of choice for patient with chronic renal insufficiency because it provides better quality of life and longer survival. Survival rates for grafts and patients have improved over the recent decades because of significant evolution of surgical techniques and immunosuppressive treatment. However, renal transplantation is still associated with several complications, which may result in poor outcome. Cause of allograft dysfunction, which occurs in the early or late post-transplantation period, should be recognized immediately, so that it can be managed correctly...
November 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28932575/pediatric-lung-transplantation
#9
REVIEW
Christian Benden
Pediatric lung transplantation has been undertaken since the 1980s, and it is today considered an accepted therapy option in carefully selected children with end-stage pulmonary diseases, providing carefully selected children a net survival benefit and improved health-related quality of life. Nowadays, >100 pediatric lung transplants are done worldwide every year. Here, specific pediatric aspects of lung transplantation are reviewed such as the surgical challenge, effects of immunosuppression on the developing pediatric immune system, and typical infections of childhood, as it is vital to comprehend that children undergoing lung transplants present a real challenge as children are not 'just small adults'...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28904437/cryptococcal-infection-in-transplant-kidney-manifesting-as-chronic-allograft-dysfunction
#10
C Agrawal, V Sood, A Kumar, V Raghavan
Invasive fungal infections (IFIs) are a significant cause of morbidity in solid organ transplant (SOT) recipients. Common causes among them are Aspergillus, Candida, and Cryptococcus. Antifungal prophylaxis has led to decrease in overall incidence of IFI; however, there is very little decline in the incidence of Cryptococcal infections of SOT recipients because effective prophylaxis is not available against this infectious agent. Spectrum of manifestation of Cryptococcal infection varies in immunocompetent and immunocompromised host with subclinical and self-limiting with lungs being the primary site in immunocompetent and central nervous system as the most common site in an immunocompromised host...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28904428/collapsing-glomerulopathy-a-troublemaker-for-the-renal-allograft-lessons-learnt
#11
K V Kanodia, A V Vanikar, L K Nigam, R D Patel, K S Suthar, H V Patel, H L Trivedi
Collapsing glomerulopathy (CG) is a well-recognized distinct morphological pattern of proliferative parenchymal injury leading to rapid graft failure. We conducted a single-center retrospective study to evaluate the prevalence, clinicopathological features, and prognosis of CG in renal transplant recepient. We analyzed 2518 renal allograft biopsies performed from 2007 to 2015 and correlated their clinicopathological features. The prevalence of CG was 0.83% (21 out of 2518) of allograft biopsies with a higher prevalence of 1...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28794296/recurrent-aa-amyloidosis-combined-with-chronic-active-antibody-mediated-rejection-after-kidney-transplantation
#12
Min-Kyung Yeo, Young Rok Ham, Song-Yi Choi, Yong-Moon Lee, Moon Hyang Park, Kwang-Sun Suh
Kidney transplantation for amyloidosis remains a contentious issue. Recurrence of amyloidosis is one of the risks of transplantation. Chronic active antibody-mediated rejection is an important cause of chronic allograft dysfunction. A 47-year-old woman underwent kidney transplantation due to renal AA amyloidosis with unknown etiology. Six years posttransplantation, a kidney biopsy showed AA amyloidosis with chronic active antibody-mediated rejection. Donor-specific antibody class II was positive. The patient underwent intravenous plasmapheresis and treatment with rituximab and colchicine...
July 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28757398/high-expression-of-tim-3-and-kim-1-in-blood-and-urine-of-renal-allograft-rejection-patients
#13
Sanaz Keshavarz Shahbaz, Fatemeh Pourrezagholi, Mehri Barabadi, Farshad Foroughi, Morteza Hosseinzadeh, Pedram Ahmadpoor, Mohesn Nafar, Mir Saeed Yekaninejad, Aliakbar Amirzargar
BACKGROUND: T cell immunoglobulin and mucin domain 3 (TIM-3) is involved in alloimmune and autoimmune responses, as well as tolerance induction in kidney transplantation. Kidney injury molecule-1 (KIM-1) is highly expressed in epithelial cells of the injured proximal tubule. In this study, we have investigated both urinary and blood TIM-3 mRNA expressions, urinary KIM-1 mRNA expression, and urinary and serum KIM-1 proteins in renal allograft recipients diagnosed with acute allograft rejection (AR) and chronic allograft dysfunction (CAD), as well as those with well-functioning transplants (WFG)...
July 27, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28709599/recurrence-of-glomerulonephritis-an-underestimated-and-unmet-medical-need
#14
Johan W de Fijter
Recurrent glomerulonephritis is increasingly recognized as an important contributor to premature renal allograft failure. The incidence of recurrent glomerulonephritis varies widely depending on original disease, renal biopsy policy, and time of observation. Biopsy-documented clinical recurrence rates underestimate the true prevalence. The impact of recurrent glomerulonephritis on graft survival parameters also widely varies and requires large collaborative efforts with more detailed and balanced evaluations, such as other major causes for chronic renal allograft dysfunction...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#15
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Genomics, proteomics and molecular biology lead to tremendous advances in all fields of medical sciences. Among these the finding of biomarkers as non invasive indicators of biologic processes represents a useful tool in the field of transplantation. In addition to define the principal characteristics of the biomarkers, this review will examine the biomarker usefulness in the different clinical phases following renal transplantation. Biomarkers of ischemia-reperfusion injury and of delayed graft function are extremely important for an early diagnosis of these complications and for optimizing the treatment...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28691954/maintenance-belatacept-based-immunosuppression-in-lung-transplantation-recipients-who-failed-calcineurin-inhibitors
#16
Carlo J Iasella, Ryan J Winstead, Cody A Moore, Bruce A Johnson, Ayelet T Feinberg, Matthew R Morrell, J W Awori Hayanga, Elizabeth A Lendermon, Adriana Zeevi, John F McDyer, Christopher R Ensor
BACKGROUND: Traditional immunosuppressive regimens (ISR) used in lung transplantation rely on calcineurin inhibitors (CNI) that occasionally cause severe adverse reactions necessitating discontinuation. Belatacept is a novel costimulation antagonist approved for use in renal transplantation which lacks data in lung transplantation. This series aims to describe the response to belatacept ISR in 11 lung transplantation recipients after CNI failure. METHODS: Single center, retrospective medical record review of adult lung transplant recipients (LTR) before and after conversion to belatacept-based ISR...
July 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28665959/increased-migration-of-antigen-presenting-cells-to-newly-formed-lymphatic-vessels-in-transplanted-kidneys-by-glycol-split-heparin
#17
Ditmer T Talsma, Kirankumar Katta, Miriam Boersema, Saritha Adepu, Annamaria Naggi, Giangiacomo Torri, Coen Stegeman, Gerjan Navis, Harry van Goor, Jan-Luuk Hillebrands, Saleh Yazdani, Jacob van den Born
BACKGROUND: Chronic renal transplant dysfunction is characterized by loss of renal function and tissue remodeling, including chronic inflammation and lymph vessel formation. Proteoglycans are known for their chemokine presenting capacity. We hypothesize that interruption of the lymphatic chemokine-proteoglycan interaction interferes with the lymphatic outflow of leukocytes from the renal graft and might decrease the anti-graft allo-immune response. METHODS: In a rat renal chronic transplant dysfunction model (female Dark-Agouti to male Wistar Furth), chemokines were profiled by qRT-PCR in microdissected tubulo-interstitial tissue...
2017: PloS One
https://www.readbyqxmd.com/read/28577875/circulating-mir-150-mir-192-mir-200b-and-mir-423-3p-as-non-invasive-biomarkers-of-chronic-allograft-dysfunction
#18
Sepideh Zununi Vahed, Ahmad Poursadegh Zonouzi, Fariba Mahmoodpoor, Nasser Samadi, Mohammadreza Ardalan, Yadollah Omidi
BACKGROUND AND AIMS: Chronic allograft dysfunction (CAD) is the major cause of renal allograft loss and can only be diagnosed by invasive histological examinations. The current study aimed to determine whether or not the circulating miR-125a, miR-150, miR-192, miR-200b, miR-423-3p and miR-433 could serve as predictors of graft outcome in the renal transplant recipients with CAD. METHODS: To evaluate the expression levels of miRNAs, we used quantitative real-time PCR (qPCR) and analyzed the plasma samples of 53 renal transplant recipients, including: 27 recipients with stable graft function (SGF), 26 recipients with biopsy-proven interstitial fibrosis and tubular atrophy (IFTA) and 15 healthy controls...
January 2017: Archives of Medical Research
https://www.readbyqxmd.com/read/28573901/a-case-report-of-parvovirus-b19-infection-in-a-renal-allograft
#19
Diana M Oramas, Suman Setty, Vijay Yeldandi, Julio Cabrera, Tushar Patel
Parvovirus B19 infection is undiagnosed in recipients undergoing solid organ transplantation. It is usually responsible for unexplained acute and chronic red blood cell aplasia that does not respond to erythropoietin therapy. Cases of parvovirus B19 infection associated with pancytopenia, solid organ dysfunction, and allograft rejection have been described in the literature. The deterioration of the immune system as a result of severe immunotherapy favors the reactivation of a previous infection or the acquisition of a new one...
October 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28571148/de-novo-focal-segmental-glomerulosclerosis-in-renal-allograft-histological-presentation-and-clinical-correlation-single-centre-experience
#20
Rashmi D Patel, Aruna V Vanikar, Lovelesh A Nigam, Kamal V Kanodia, Kamlesh S Suthar, Himanshu V Patel
INTRODUCTION: Recurrent or de novo glomerulonephritis are one of the well-known causes for renal allograft dysfunction in early and late period after renal transplantation. Focal Segmental Glomerulosclerosis (FSGS) is a devastating lesion of the renal allograft. De novo FSGS is uncommon compared to recurrent FSGS. AIM: To find out the incidence of de novo FSGS. MATERIALS AND METHODS: A retrospective evaluation of renal allograft biopsies was performed from 2007 to 2015, by light microscopy and immunohistochemistry including patient-donor demographics...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
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