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https://www.readbyqxmd.com/read/28714558/everolimus-and-reduced-calcineurin-inhibitor-therapy-in-pediatric-liver-transplant-recipients-results-from-a-multicenter-prospective-study
#1
Rainer Ganschow, Bo-Goran Ericzon, Anil Dhawan, Khalid Sharif, El-Djouher Martzloff, Barbara Rauer, Jennifer Ng, Patricia Lopez
In a 24-month, multicenter, single-arm, prospective study, 56 pediatric liver transplant patients with or without basiliximab induction were converted at 1-6 months post-transplant from standard calcineurin inhibitor (CN) therapy (± mycophenolic acid), to everolimus with reduced exposure to CNI (tacrolimus n=50, cyclosporine n=6). Steroid therapy was optional. Recruitment was stopped prematurely due to high rates of PTLD, treatment-related serious infections leading to hospitalization and premature study drug discontinuation...
July 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28714235/tuberculosis-after-kidney-transplantation-is-associated-with-significantly-impaired-allograft-function
#2
Silvana Daher Costa, Tainá Veras de Sandes-Freitas, Camilla Neves Jacinto, Lorena Vasconcelos Mesquita Martiniano, Yago Sucupira Amaral, Fernando José Villar Nogueira Paes, Maria Luiza de Mattos Brito Oliveira Sales, Ronaldo de Matos Esmeraldo, Elizabeth de Francesco Daher
BACKGROUND: This study aimed to evaluate renal function before, during and after the course of tuberculosis (TB) disease in kidney transplant recipients; and assess the risk factors for non-recovery of baseline renal function. METHODS: We performed a retrospective, single-center cohort study, including all patients with confirmed or presumed TB diagnosis after kidney transplant (n=34, 2.1%). Renal function was assessed by serum creatinine (Cr) and glomerular filtration rate (GFR) adjusted for deaths and graft losses...
July 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28709641/glucocest-magnetic-resonance-imaging-in%C3%A2-vivo-may-be-diagnostic-of-acute-renal-allograft-rejection
#3
Dominik Kentrup, Philipp Bovenkamp, Annika Busch, Katharina Schuette-Nuetgen, Helga Pawelski, Hermann Pavenstädt, Eberhard Schlatter, Karl-Heinz Herrmann, Jürgen R Reichenbach, Bettina Löffler, Barbara Heitplatz, Veerle Van Marck, Nirbhay N Yadav, Guanshu Liu, Peter C M van Zijl, Stefan Reuter, Verena Hoerr
Acute cellular renal allograft rejection (AR) frequently occurs after kidney transplantations. It is a sterile T-cell mediated inflammation leading to increased local glucose metabolism. Here we demonstrate in an allogeneic model of Brown Norway rat kidneys transplanted into uninephrectomized Lewis rats the successful implementation of the recently developed glucose chemical exchange saturation transfer (glucoCEST) magnetic resonance imaging. This technique is a novel method to assess and differentiate AR...
July 11, 2017: Kidney International
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#4
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995-2015. Nineteen patients were switched from tacrolimus(n=15) or cyclosporin(n=4) to everolimus(n=4) or sirolimus(n=15) due to nephrotoxicity(n=5), malignancy(n=8), EBV viremia/reactive plasmacytic changes(n=5) and immune hemolytic anemia(n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28702185/potential-cost-savings-by-minimisation-of-blood-sample-delays-on-care-decision-making-in-urgent-care-services
#5
David M S Bodansky, Sophie E Lumley, Rudrajoy Chakraborty, Dhanasekaran Mani, James Hodson, Mike T Hallissey, Olga N Tucker
BACKGROUND: Timely availability of blood sample results for interpretation affects planning and delivery of patient care from initial assessment in Accident and Emergency (A&E) departments. MATERIALS AND METHODS: Rates of, and reasons for, rejected blood samples submitted from all clinical areas over one month were evaluated. Haemoglobin (Hb) represented haematology and potassium (K(+)), biochemistry. A prospective observational study evaluated the methodology of sample collection and impact on utility...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28700465/alemtuzumab-versus-antithymocyte-globulin-induction-therapies-in-kidney-transplantation-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
Jianming Zheng, Wenli Song
Alemtuzumab (ALEM) is widely used as an induction therapy for organ transplantation, and numerous randomized controlled trials (RCTs) have been published to evaluate its efficacy and safety in kidney transplantation as compared with antithymocyte globulin (ATG). The purpose of this study was to compare the benefits and safety of ALEM with those of ATG for induction therapy.A systematic literature search in three electronic databases, including PubMed, EmBase, and Cochrane Library, since inception through October 2016, was conducted to identify potential RCTs for inclusion...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#7
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/28682561/-immunosuppression-in-kidney-transplantation-a-way-between-efficacy-and-toxicity
#8
Costanza Casati, Alberto Menegotto, Maria Luisa Querques, Federica Ravera, Giacomo Colussi
Renal transplantation is the best treatment for patients with end-stage renal disease. Over the last decades, the introduction of new immunosuppressive agents resulted into the reduction of the incidence of acute rejection and early graft loss. Despite this progress, there has been little improvement in the average life of the transplant. The main reasons of late failure are patient's death due to several complications (e.g. cancer, infectious or metabolic), and progressive deterioration of renal function caused by immunological and non-immunological factors...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28676864/innate-immune-response-in-kidney-ischemia-reperfusion-injury-potential-target-for-therapy
#9
REVIEW
Aleksandra Kezić, Natasa Stajic, Friedrich Thaiss
Acute kidney injury caused by ischemia and subsequent reperfusion is associated with a high rate of mortality and morbidity. Ischemia/reperfusion injury in kidney transplantation causes delayed graft function and is associated with more frequent episodes of acute rejection and progression to chronic allograft nephropathy. Alloantigen-independent inflammation is an important process, participating in pathogenesis of injurious response, caused by ischemia and reperfusion. This innate immune response is characterized by the activity of classical cells belonging to the immune system, such as neutrophils, macrophages, dendritic cells, lymphocytes, and also tubular epithelial cells and endothelial cells...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28669130/review-of-the-clinical-pharmacokinetics-and-pharmacodynamics-of-alemtuzumab-and-its-use-in-kidney-transplantation
#10
REVIEW
Marieke van der Zwan, Carla C Baan, Teun van Gelder, Dennis A Hesselink
Alemtuzumab is a humanized monoclonal antibody against CD52 and causes depletion of T and B lymphocytes, monocytes, and NK cells. Alemtuzumab is registered for the treatment of multiple sclerosis (MS) and is also used in chronic lymphocytic leukemia (CLL). Alemtuzumab is used off-label in kidney transplantation as induction and anti-rejection therapy. The objective of this review is to present a review of the pharmacokinetics, pharmacodynamics, and use of alemtuzumab in kidney transplantation. A systematic literature search was conducted using Ovid Medline, Embase, and Cochrane Central Register of controlled trials...
July 1, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28665496/limitations-of-the-interpretation-and-extrapolation-of-clinical-trial-data-in-kidney-transplant-recipients
#11
N I Oliveira, M I Paula, C R Felipe, H Tedesco-Silva, J O Medina-Pestana
OBJECTIVE: The risks and benefits of the participation of kidney transplant recipients in Randomized Clinical Trials (RCT) investigating new immunosuppressive therapies is unknown. DESIGN AND SETTING: We included patients from 12 prospective phase II/III RCT randomized to the experimental (G1, n=319) or standard of care internal control group (G2, n=118). We constructed two additional external control groups with (G3, n=319) or without (G4, n=319) matching inclusion/exclusion criteria based on transplant date...
June 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28664838/treatment-of-antibody-mediated-rejection-of-kidney-grafts-with-bortezomib-and-or-rituximab-compared-to-standard-regimen-experience-of-slovene-national-center
#12
Teja Oblak, Jelka Lindič, Jakob Gubenšek, Radoslav Kveder, Andreja Aleš Rigler, Andrej Škoberne, Željka Večerić Haler, Špela Borštnar, Nuša Avguštin, Rafael Ponikvar, Gregor Mlinšek, Dušan Ferluga, Nika Kojc, Uroš Godnov, Damjan Kovač
BACKGROUND: The aim of our study was to determine outcomes of standard treatment of antibody-mediated rejection (ABMR) of kidney grafts as compared to the addition of bortezomib or rituximab. METHODS: The cohort of this retrospective study included patients treated for ABMR of kidney grafts at our national center in the period of 2005 - 2017, divided into two groups: standard (ST) group treated standardly with plasmapheresis or immunoadsorption, intravenous immunoglobulins, and corticosteroids, and BR group treated with the addition of bortezomib and/or rituximab...
2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28662279/impact-of-early-conversion-from-cyclosporin-to-everolimus-on-left-ventricular-mass-index-a-randomized-controlled-trial
#13
Anoushka Krishnan, Armando Teixeira-Pinto, Doris Chan, Aron Chakera, Gursharan Dogra, Neil Boudville, Ashley Irish, Kelly Morgan, Jessica Phillips, Germaine Wong, Wai H Lim
This is an 18-month prospective, randomized controlled trial (RCT) designed to compare the effect of early conversion from cyclosporin to everolimus/ mycophenolic acid (E-MPA) between 3-4 months post-transplant to cyclosporin/mycophenolic acid (CsA-MPA) on left ventricular mass index (LVMI) at 3 and 18 months post-transplant (primary outcome). Secondary outcomes included estimated glomerular filtration rate (eGFR), viral infection and adverse events. Twenty-four patients were randomized in a 1:1 ratio to E-MPA or CsA-MPA groups...
June 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28658202/pharmacokinetics-and-clinical-outcomes-of-generic-tacrolimus-hexal-versus-branded-tacrolimus-in-de-novo-kidney-transplant-patients-a-multicenter-randomized-trial
#14
Wolfgang Arns, Andrea Huppertz, Thomas Rath, Stephan Ziefle, Lars C Rump, Anita Hansen, Klemens Budde, Lukas J Lehner, Maria Shipkova, Daniel Baeumer, Irena Kroeger, Christian Sieder, Thomas Klein, Peter Schenker
BACKGROUND: Scrupulous comparison of the pharmacokinetic and clinical characteristics of generic tacrolimus formulations versus the reference drug (Prograf) is essential. Pharmacokinetics of the TacHexal formulation are similar to Prograf in stable renal transplant patients but data in de novo patients is lacking. METHODS: De novo kidney transplant patients were randomized to generic tacrolimus (Tacrolimus Hexal [TacHexal]) or Prograf in a 6-month open-label study...
June 28, 2017: Transplantation
https://www.readbyqxmd.com/read/28658148/graft-versus-host-disease-after-kidney-transplantation-a-case-report-and-literature-review
#15
REVIEW
Yanhua Guo, Shouyang Ding, Hui Guo, Shenqiu Li, Xia Lu, Zhishui Chen, Zhonghua Klaus Chen, Changsheng Ming, Nianqiao Gong
INTRODUCTION: Acute graft-versus-host-disease (GVHD) in kidney recipients is extremely rare. Knowledge about its clinical manifestations, diagnosis, treatment, and prognosis is limited and needs to be increased. CLINICAL FINDINGS: One male kidney transplant recipient developed diarrhea and suffered kidney function damage. Primarily diagnosed with acute rejection, he was given methylprednisolone (MP) bolus treatment. Meanwhile, intravenous immunoglobulin (IVIG) and decreased immunosuppressive agents were applied for the corresponding infection...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28655390/acute-granulomatous-interstitial-nephritis-and-acute-rejection-in-a-kidney-transplant-recipient-after-zoledronic-acid-therapy-a-case-report-and-review-of-the-literature
#16
Nuša Avguštin, Damjan Kovač, Nika Kojc, Gregor Mlinšek, Jelka Lindič
BACKGROUND: Acute granulomatous interstitial nephritis (AGIN) in native kidneys is most commonly linked to drugs. In allografts, it is a rare complication, and it occurs mostly with infections. CASE PRESENTATION: Our case report presents AGIN with simultaneous acute cellular rejections and acute tubular necrosis in a kidney transplant patient 2 weeks after intravenous application of zoledronic acid. A kidney biopsy showed signs of destructive AGIN with acute cellular rejection...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28654684/intravenous-immunoglobulin-therapy-in-kidney-transplant-recipients-with-de-novo-dsa-results-of-an-observational-study
#17
Marie Matignon, Caroline Pilon, Morgane Commereuc, Cynthia Grondin, Claire Leibler, Tomek Kofman, Vincent Audard, José Cohen, Florence Canoui-Poitrine, Philippe Grimbert
BACKGROUND: Approximately 25% of kidney transplant recipients develop de novo anti-HLA donor-specific antibodies (dnDSA) leading to acute antibody-mediated rejection (ABMR) in 30% of patients. Preemptive therapeutic strategies are not available. METHODS: We conducted a prospective observational study including 11 kidney transplant recipients. Inclusion criteria were dnDSA occurring within the first year after transplant and normal allograft biopsy. All patients were treated with high-dose IVIG (2 g/kg 0, 1 and 2 months post-dnDSA)...
2017: PloS One
https://www.readbyqxmd.com/read/28653398/lung-transplant-recipients-on-long-term-extracorporeal-photopheresis
#18
Bruno Isenring, Cécile Robinson, Urs Buergi, Macé M Schuurmans, Malcolm Kohler, Lars C Huber, Christian Benden
Extracorporeal photophoresis (ECP) is an increasingly used therapy to address chronic lung allograft dysfunction (CLAD) following lung transplantation. In 2008, we reported the first single-center experience showing that ECP not only reduces lung function decline in patients with bronchiolitis obliterans syndrome (BOS) but results in stabilization of patients with recurrent acute cellular rejection (ACR). In the current study, the original cohort was followed up further 5 years. In addition, patients with CLAD were retrospectively classified according to recently published phenotypes...
June 27, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28643821/non-invasive-approaches-in-the-diagnosis-of-acute-rejection-in-kidney-transplant-recipients-part-i-in-vivo-imaging-methods
#19
REVIEW
Oriane Hanssen, Pauline Erpicum, Pierre Lovinfosse, Paul Meunier, Laurent Weekers, Luaba Tshibanda, Jean-Marie Krzesinski, Roland Hustinx, François Jouret
Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ultimately relies on transplant needle biopsy. However, such an invasive procedure is associated with a significant risk of complications and is limited by sampling error and interobserver variability. In the present review, we summarize the current literature about non-invasive approaches for the diagnosis of AR in kidney transplant recipients (KTRs), including in vivo imaging, gene expression profiling and omics analyses of blood and urine samples...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28643819/non-invasive-approaches-in-the-diagnosis-of-acute-rejection-in-kidney-transplant-recipients-part-ii-omics-analyses-of-urine-and-blood-samples
#20
REVIEW
Pauline Erpicum, Oriane Hanssen, Laurent Weekers, Pierre Lovinfosse, Paul Meunier, Luaba Tshibanda, Jean-Marie Krzesinski, Roland Hustinx, François Jouret
Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, the full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ultimately relies on transplant needle biopsy. However, such an invasive procedure is associated with a significant risk of complications and is limited by sampling error and interobserver variability. In the present review, we summarize the current literature about non-invasive approaches for the diagnosis of AR in kidney transplant recipients (KTRs), including in vivo imaging, gene-expression profiling and omics analyses of blood and urine samples...
February 2017: Clinical Kidney Journal
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