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https://www.readbyqxmd.com/read/27898462/recent-advances-in-allograft-vasculopathy
#1
Jonathan Merola, Daniel D Jane-Wit, Jordan S Pober
PURPOSE OF REVIEW: Despite considerable advances in controlling acute rejection, the longevity of cardiac and renal allografts remains significantly limited by chronic rejection in the form of allograft vasculopathy. This review discusses recently reported mechanistic insights of allograft vasculopathy pathogenesis as well as recent clinical evaluations of new therapeutic approaches. RECENT FINDINGS: Although adaptive immunity is the major driver of allograft vasculopathy, natural killer cells mediate vasculopathic changes in a transplanted mouse heart following treatment with donor-specific antibody (DSA)...
November 24, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27893617/differential-role-of-b-cells-and-il-17-versus-ifn-%C3%AE-during-early-and-late-rejection-of-pig-islet-xenografts-in-mice
#2
Hee Kap Kang, Shusen Wang, Anil Dangi, Xiaomin Zhang, Amar Singh, Lei Zhang, James M Rosati, Wilma Suarez-Pinzon, Xuelian Deng, Xiaoyan Chen, Edward B Thorp, Bernhard J Hering, Stephen D Miller, Xunrong Luo
BACKGROUND: Xenogeneic islet transplantation is an emerging therapeutic option for diabetic patients. However, immunological tolerance to xenogeneic islets remains a challenge. METHODS: The current study used a pig-to-mouse discordant xenogeneic islet transplant model to examine anti-donor xenogeneic immune responses during early and late rejection, and to determine experimental therapeutic interventions that promote durable pig islet xenograft survival. RESULTS: We found that during early acute rejection of pig islet xenografts, the rejecting hosts exhibited a heavy graft infiltration with B220 B cells and a robust anti-pig antibody production...
November 23, 2016: Transplantation
https://www.readbyqxmd.com/read/27889299/safety-and-efficacy-outcomes-3-years-after-switching-to-belatacept-from-a-calcineurin-inhibitor-in-kidney-transplant-recipients-results-from-a-phase-2-randomized-trial
#3
Josep M Grinyó, Maria Del Carmen Rial, Josefina Alberu, Steven M Steinberg, Roberto C Manfro, Georgy Nainan, Flavio Vincenti, Charlotte Jones-Burton, Nassim Kamar
BACKGROUND: In a phase 2 study, kidney transplant recipients of low immunologic risk who switched from a calcineurin inhibitor (CNI) to belatacept had improved kidney function at 12 months postconversion versus those continuing CNI therapy, with a low rate of acute rejection and no transplant loss. STUDY DESIGN: 36-month follow-up of the intention-to-treat population. SETTING & PARTICIPANTS: CNI-treated adult kidney transplant recipients with stable transplant function (estimated glomerular filtration rate [eGFR], 35-75mL/min/1...
November 23, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27885144/treatment-of-multiple-myeloma-in-a-heart-transplant-recipient-focus-on-the-immunomodulatory-effects-of-lenalidomide
#4
Lola Xie, Bartosz Jozwik, Phillip Weeks, L Maximilian Buja, Robert Brown, Sriram Nathan, Keshava Rajagopal, Christina Paruthi, Biswajit Kar, Pranav Loyalka, Indranee Rajapreyar
Malignancy following solid organ transplant remains a significant threat to the survival of cardiac transplant recipients. Plasma cell dyscrasias including multiple myeloma have been encountered in this population, and medication treatments traditionally used to treat these disorders demonstrate immunomodulatory effects that may have implications on the transplanted allograft. Lenalidomide is an immunomodulatory agent that has been used to treat plasma cell disorders, including light-chain amyloidosis (AL) and multiple myeloma, and represents such a class of medications in which the risks and benefits in the solid organ transplant population remain to be fully elucidated...
November 24, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27871759/rabbit-atg-or-basiliximab-induction-for-rapid-steroid-withdrawal-after-renal-transplantation-harmony-an-open-label-multicentre-randomised-controlled-trial
#5
Oliver Thomusch, Michael Wiesener, Mirian Opgenoorth, Andreas Pascher, Rainer Peter Woitas, Oliver Witzke, Bernd Jaenigen, Markus Rentsch, Heiner Wolters, Thomas Rath, Tülay Cingöz, Urs Benck, Bernhard Banas, Christian Hugo
BACKGROUND: Standard practice for immunosuppressive therapy after renal transplantation is quadruple therapy using antibody induction, low-dose tacrolimus, mycophenolate mofetil, and corticosteroids. Long-term steroid intake significantly increases cardiovascular risk factors with negative effects on the outcome, especially post-transplantation diabetes associated with morbidity and mortality. In this trial, we examined the efficacy and safety parameters of rapid steroid withdrawal after induction therapy with either rabbit antithymocyte globulin (rabbit ATG) or basiliximab in immunologically low-risk patients during the first year after kidney transplantation...
November 18, 2016: Lancet
https://www.readbyqxmd.com/read/27866541/-influencing-factors-for-postoperative-survival-of-patients-with-stage-iii-silicosis-treated-by-lung-transplantation
#6
W J Mao, X W Nie, W Xia, M F Zheng, R Chen, Y J He, F Liu, S G Ye, R G Lu, J Y Chen
Objective: To investigate the clinical effect, postoperative complications, and causes of death in the treatment of stage III silicosis with lung transplantation and the influencing factors for survival. Methods: A retrospective analysis was performed for the clinical data of 32 patients with stage III silicosis who underwent lung transplantation in our hospital from September 2002 to September 2015. The survival, causes of death, and postoperative complications were analyzed. The Kaplan-Meier method was used to plot survival curves, the log-rank test was used to compare the influence of each factor on survival rates, and the multivariate Cox proportional hazards regression model was used to evaluate the influence of each factor on survival...
September 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/27865034/prevention-of-hepatitis-c-recurrence-by-bridging-sofosbuvir-ribavirin-from-pre-to-post-liver-transplant-a-real-life-strategy
#7
Maria Francesca Donato, Cristina Morelli, Renato Romagnoli, Federica Invernizzi, Chiara Mazzarelli, Rosa Maria Iemmolo, Marzia Montalbano, Ilaria Lenci, Sherrie Bhoori, Giulia Pieri, Sonia Berardi, Paolo Caraceni, Silvia Martini
BACKGROUND AND AIMS: Hepatitis C virus (HCV) reinfection following liver transplant (LT) is associated with reduced graft and patients survival. Before transplant, Sofosbuvir/Ribavirin (SOF/R) treatment prevents recurrent HCV in 96% of those patients achieving viral suppression for at least 4 weeks before transplant. We evaluated whether a bridging SOF-regimen from pre to post-transplant is safe and effective to prevent HCV recurrence in those patients with less than 4 week HCV-RNA undetectability at the time of transplant...
November 19, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27861809/immune-monitoring-in-renal-transplantation-the-search-for-biomarkers
#8
Richard Danger, Birgit Sawitzki, Sophie Brouard
It is now widely accepted that in order to improve long-term graft function and survival, a more personalized immunosuppressive treatment of transplant patients according to the individual anti-donor immune response status is needed. This applies to the identification of potentially "high-risk" patients likely to develop acute rejection episodes or display an accelerated decline of graft function, patients who might need immunosuppression intensification, and operationally tolerant patients suitable for immunosuppression minimization or weaning off...
November 10, 2016: European Journal of Immunology
https://www.readbyqxmd.com/read/27859595/recipient-bone-marrow-derived-stromal-cells-prolong-graft-survival-in-a-rat-hind-limb-allotransplantation-model
#9
Ryosuke Ikeguchi, Ryosuke Kakinoki, Souichi Ohta, Hiroki Oda, Hirofumi Yurie, Yukitoshi Kaizawa, Hiroto Mitsui, Tomoki Aoyama, Junya Toguchida, Shuichi Matsuda
BACKGROUND: Recent studies have indicated that bone marrow-derived stromal cells (BMSCs) have immunomodulatory properties that suppress the T cell responses that cause graft rejection. The purpose of this study is to evaluate the effect of recipient BMSCs intravenous infusion for immunomodulation in a rat vascularized composite allotransplantation model. METHODS: A total of nine Wistar (WIS) rats and thirty Lewis (LEW) rats were used. BMSCs were harvested from three LEW rats...
November 17, 2016: Microsurgery
https://www.readbyqxmd.com/read/27858871/case-report-brincidofovir-induced-reversible-severe-acute-kidney-injury-in-2-solid-organ-transplant-for-treatment-of-cytomegalovirus-infection
#10
Emmanuel Faure, Tatiana Galperine, Olivier Cannesson, Sophie Alain, Viviane Gnemmi, Celine Goeminne, Annie Dewilde, Johana Béné, Mohamed Lasri, Célia Lessore de Sainte Foy, Arnaud Lionet
RATIONALE: Resistant cytomegalovirus-mediated infections are increasing in solid organ recipient with few available alternative treatments. Brincidofovir is an oral broad-spectrum antiviral in development for prevention and treatment of viral infection, particularly cytomegalovirus. PATIENTS CONCERNS: Although brincidofovir is an analogue of cidofovir, previous studies reported no renal toxicity. DIAGNOSES: Here, we report 2 cases of severe tubular necrosis in solid organ recipients, 1 heart and 1 kidney transplant...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27855589/twice-daily-telaprevir-for-posttransplant-genotype-1-hepatitis-c-virus-a-prospective-safety-efficacy-and-pharmacokinetics-study
#11
Raymond A Rubin, Mark W Russo, Kimberly A Brown, Robert J Fontana, Josh Levitsky, Hugo Vargas, Eric M Yoshida, Robert S Brown
OBJECTIVES: Our objective was to determine the safety, efficacy, and pharmacokinetics of telaprevir plus pegylated interferon alfa 2a and ribavirin for chronic, posttransplant genotype 1 hepatitis C virus infection. MATERIALS AND METHODS: A prospective, single-arm, multicenter, open-label, phase 2b study was conducted at 22 North American sites to assess the safety, efficacy, and pharmacokinetics of pegylated interferon alfa 2a, ribavirin, and twice daily telaprevir in liver transplant recipients with recurrent, chronic hepatitis C without cirrhosis...
November 18, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27846156/plasma-c4d-endothelial-microvesicles-increase-in-acute-antibody-mediated-rejection
#12
Cindy M Tower, Morayma Reyes, Karen Nelson, Nicolae Leca, Niamh Kieran, Kimberly Muczynski, Jonathan A Jefferson, Christopher Blosser, Aleksandra Kukla, David Maurer, Wayne Chandler, Behzad Najafian
BACKGROUND: Antibody mediated rejection (AMR) is a major cause of kidney allograft loss. Currently, AMR diagnosis relies on biopsy which is an invasive procedure. A noninvasive biomarker of acute AMR could lead to early diagnosis and treatment of this condition and improve allograft outcome. Microvesicles are membrane bound vesicles released from the cell surface following injury. We hypothesized that since AMR is associated with allograft endothelial injury and C4d deposition, plasma microvesicles positive for endothelial (CD144) marker and C4d are increased in this condition...
November 15, 2016: Transplantation
https://www.readbyqxmd.com/read/27813419/anti-interleukin-2-receptor-antibodies-for-the-prevention-of-rejection-in-liver-transplant-recipients-a-systematic-review-and-meta-analysis
#13
Yi Zhang, Weidong Jin, Xun Cai
BACKGROUND: Antibody induction therapy aims to prevent acute cellular rejection by reducing T-cell proliferation and activation. We evaluated the efficacy and side effects of two anti-interleukin-2 receptor antibodies (IL2RA), basiliximab and daclizumab, for prevention of liver transplant rejection in adult patients. METHODS: Randomized controlled trials on basiliximab or daclizumab were identified by searching multiple databases and reference lists published up to July, 2015...
November 4, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27805521/smoking-is-related-to-postoperative-pulmonary-complications-and-graft-outcomes-in-renal-transplant-patients
#14
Balam Er Dedekargınoğlu, Gaye Ulubay, Elif Küpeli, Mahir Kırnap, Füsun Öner Eyüboğlu, Mehmet Haberal
OBJECTIVES: Renal transplant is an important treatment option for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk compared with maintenance dialysis in patients with end-stage renal disease. Several immunologic and nonimmunologic factors are responsible for graft outcomes in renal transplant patients. Our study was performed to evaluate the role of smoking on postoperative pulmonary complications and graft outcomes in renal transplant patients...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27798373/prolongation-of-cardiac-allograft-survival-by-endometrial-regenerative-cells-focusing-on-b-cell-responses
#15
Xiaoxi Xu, Xiaochun Li, Xiangying Gu, Bai Zhang, Weijun Tian, Hongqiu Han, Peng Sun, Caigan Du, Hao Wang
: : Endometrial regenerative cells (ERCs) have been recently evaluated as an attractive candidate source for emerging stem cell therapies in immunosuppression, but their role in immunoregulation is not fully understood. The present study was designed to investigate their effects, especially on B-cell responses in heart transplantation. In this study, ERCs were noninvasively obtained from menstrual blood. Heart transplantation was performed between C57BL/6 (H-2(b)) donor mice and BALB/c (H-2(d)) recipients...
October 26, 2016: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/27796825/complete-response-to-post-transplant-lymphoproliferative-disorder-by-surgical-resection-and-rituximab-after-living-donor-liver-re-transplantation-for-recurrent-primary-sclerosing-cholangitis
#16
Koichiro Haruki, Hiroaki Shiba, Junichi Shimada, Norimitsu Okui, Tomonori Iida, Katsuhiko Yanaga
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation. We herein report a case of PTLD after living-donor liver re-transplantation (reLDLT) for recurrent primary sclerosing cholangitis (PSC), for which complete response was achieved by surgical resection and rituximab. A 47-year-old man, who had undergone living-donor liver transplantation (LDLT) twice at age of 43 and 45 years for end-stage liver disease firstly for PSC and secondary for recurrent PSC, suffered liver dysfunction due to an acute cellular rejection (ACR) 17 months after reLDLT...
October 31, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27795990/early-kidney-allograft-dysfunction-threatened-allograft-comparative-effectiveness-of-continuing-versus-discontinuation-of-tacrolimus-and-use-of-sirolimus-to-prevent-graft-failure-a-retrospective-patient-centered-outcome-study
#17
Ravinder K Wali, Heather A Prentice, Venkata Reddivari, Geroge Baffoe-Bonnie, Cinthia I Drachenberg, John C Pappadimitriou, Emilio Ramos, Matthew Cooper, Johann Jonsson, Stephen Bartlett, Matthew R Weir
BACKGROUND: Due to lack of treatment options for early acute allograft dysfunction in the presence of tubular-interstitial injury without histological features of rejection, kidney transplant recipients are often treated with sirolimus-based therapy to prevent cumulative calcineurin inhibitor exposure and to prevent premature graft failure. METHODS: We analyzed transplant recipients treated with sirolimus-based (n = 220) compared with continued tacrolimus-based (n = 276) immunosuppression in recipients of early-onset graft dysfunction (threatened allograft) with the use of propensity score-based inverse probability treatment weighted models to balance for potential confounding by indication between 2 nonrandomized groups...
September 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27795623/rituximab-in-the-treatment-of-refractory-late-acute-antibody-mediated-rejection-our-initial-experience
#18
M Surendra, S B Raju, N Raju, S Chandragiri, K K Mukku, M S Uppin
Antibody-mediated rejection (AMR) is not uncommon after renal transplantation and is harder to handle compared to cell-mediated rejection. When refractory to conventional therapies, rituximab is an attractive option. This study aims to examine the effectiveness of rituximab in refractory late acute AMR. This is a retrospective study involving nine renal transplant recipients. Four doses of rituximab were administered at weekly interval for 4 weeks, at a dose of 375 mg/m(2). The mean age of patients was 35.3 ± 7...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27793122/acute-pancreatitis-associated-with-everolimus-after-kidney-transplantation-a-case-report
#19
Francesco Fontana, Gianni Cappelli
BACKGROUND: Acute pancreatitis (AP) following KT is a rare and often fatal complication of the early post-transplant period. Common causative factors for AP are rare after KT; anti-rejection drugs as CyA, prednisone and MMF have been implicated, although evidence is not strong and we found no reports on possible causative role for mTOR inhibitors. CASE PRESENTATION: A 55-year-old Caucasian man with end-stage renal disease due to idiopathic membrano-prolipherative glomerulonephritis underwent single kidney transplantation (KT) from cadaveric donor...
October 28, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27788794/impact-of-trough-levels-of-tacrolimus-on-kidney-function-and-graft-survival-in-short-and-longer-periods-after-renal-transplantation
#20
Z Žilinská, I Dedinská, J Breza, L Laca
BACKGROUND: Optimizing immunosuppressive treatment in the early posttransplant period is important for achieving long-term graft function and survival. MATERIAL AND METHODS: There were 205 renal transplant recipients involved in this study. Patients were divided into groups according to the induction therapy (no induction vs basiliximab/daclizumab vs rabbit antithymocyte globulin), maintenance therapy at the time of transplantation (tacrolimus [TAC] vs cyclosporine), the average trough TAC levels in months 4 to 6 after TO and serum creatinine 5 years after renal transplantation...
October 2016: Transplantation Proceedings
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