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infection and kidney allograft

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https://www.readbyqxmd.com/read/29409743/tolerance-induction-in-hla-disparate-living-donor-kidney-transplantation-by-facilitating-cell-enriched-donor-stem-cell-infusion-the-importance-of-durable-chimerism
#1
REVIEW
Joseph R Leventhal, Suzanne T Ildstad
Successful solid organ transplantation currently requires the life-long use of medications to suppress the immune system in order to prevent transplant rejection. Drug-based immunosuppression significantly increases the risk of infection and cancer, as well as being very costly. Development of new therapies to minimize or eliminate entirely the need for anti-rejection drugs is of great interest to the transplant community. Therapeutic cell transfer for the control of the human immune system represents a compelling approach to reduce or eliminate the need for anti-rejection drugs...
February 2, 2018: Human Immunology
https://www.readbyqxmd.com/read/29407295/bk-virus-associated-nephropathy-current-situation-in-a-resource-limited-country
#2
P Yooprasert, P Rotjanapan
BACKGROUND: Data on BK virus-associated nephropathy (BKVAN) and treatment strategy in a resource-limited country are scarce. This study aimed to evaluate epidemiology of BKVAN and its situation in Thailand. METHODS: A retrospective analysis was conducted among adult kidney transplant recipients at Ramathibodi Hospital from October 2011 to September 2016. Patients' demographic data, information on kidney transplantation, immunosuppressive therapy, cytomegalovirus and BK virus infections, and allograft outcomes were retrieved and analyzed...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29389394/plasmacytoid-dendritic-cells-important-players-in-human-kidney-allograft-rejection
#3
Barbara Reich, Susanne F Viehmann, Christian Kurts
Plasmacytoid dendritic cells are a unique dendritic cell subset that bridges innate and adaptive immune responses. They release high amounts of type I interferons in response to viral and bacterial infection. Plasmacytoid dendritic cells are thought to act as key players in renal allograft rejection, but the underlying mechanisms are unclear. Ruben et al. now demonstrate that granulocyte/macrophage colony-stimulating factor produced by renal epithelial cells is important to induce plasmacytoid dendritic cell maturation and indirect antigen presentation triggering allogeneic immune responses...
February 2018: Kidney International
https://www.readbyqxmd.com/read/29377474/a-prospective-randomized-controlled-trial-of-eculizumab-to-prevent-ischemia-reperfusion-injury-in-pediatric-kidney-transplantation
#4
Michael Kaabak, Nadeen Babenko, Ron Shapiro, Allan Zokoyev, Olga Dymova, Edward Kim
Ischemia-reperfusion injury has multiple effects on a transplanted allograft, including delayed or impaired graft function, compromised long-term survival, and an association with an increased incidence of rejection. Eculizumab, a monoclonal antibody blocking terminal complement activation, has been postulated to be an effective agent in the prevention or amelioration of IRI. We performed a single-center prospective, randomized controlled trial involving 57 pediatric kidney transplant recipients between 2012 and 2016...
January 29, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29359836/factors-and-outcomes-in-association-with-sepsis-differ-between-simultaneous-pancreas-kidney-and-single-kidney-transplant-recipients
#5
Thomas Schachtner, Marina Zaks, Natalie M Otto, Andreas Kahl, Petra Reinke
As immunosuppressive therapy has improved in simultaneous pancreas/kidney transplant recipients (SPKTRs), infection has become the major limitation of disease-free survival. We studied all SPKTRs and deceased-donor kidney transplant recipients (KTRs) between 2003 and 2015. 36/134 SPKTRs (26.9%) were diagnosed with sepsis among which 13/36 SPKTRs (36.1%) developed severe sepsis/septic shock. A control group of 98 SPKTRs without sepsis and 61/538 KTRs (11.3%) with sepsis were used for comparison. Among SPKTRs, female sex, low BMI, CMV-seronegativity, CMV-disease, and acute cellular rejection increased the risk for sepsis (p<0...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29346260/race-risk-and-willingness-of-end-stage-renal-disease-patients-without-hepatitis-c-hcv-to-accept-an-hcv-infected-kidney-transplant
#6
Maureen McCauley, Adam Mussell, David Goldberg, Deirdre Sawinski, Rodolfo N Molina, Ricarda Tomlin, Sahil D Doshi, Peter Abt, Roy Bloom, Emily Blumberg, Sanjay Kulkarni, Gabriela Esnaola, Justine Shults, Carrie Thiessen, Peter P Reese
BACKGROUND: Despite effective antiviral treatment, hundreds of kidneys from deceased donors with hepatitis C virus (HCV) are discarded annually. Little is known about the determinants of willingness to accept HCV-infected kidneys among HCV-negative patients. METHODS: At 2 centers, 189 patients undergoing initial or reevaluation for transplant made 12 hypothetical decisions about accepting HCV-infected kidneys in which we systematically varied expected HCV cure rate, allograft quality and wait-time for an uninfected kidney...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29325996/direct-acting-antiviral-therapy-for-hepatitis-c-virus-infection-in-the-kidney-transplant-recipient
#7
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/29233098/intractable-ascites-associated-with-mycophenolate-in-a-simultaneous-kidney-pancreas-transplant-patient-a-case-report
#8
Nina T Weber, Ali Sigaroudi, Alexander Ritter, Andreas Boss, Kuno Lehmann, David Goodman, Stefan Farese, Stefan Weiler, Thomas F Mueller
BACKGROUND: Mycophenolic acid (MPA), either given as an ester pro-drug or as an enteric-coated sodium salt, is the most commonly prescribed anti-proliferative immunosuppressive agent used following organ transplantation and widely applied in immune-mediated diseases. Clinicians are well aware of common adverse reactions related to MPA treatment, in particular diarrhea, leukopenia and infections. Here we report a case of severe, persistent ascites associated with MPA treatment. The otherwise unexplained and intractable ascites, requiring repeated paracenteses for more than 8 months, rapidly ceased with stopping the MPA treatment...
December 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29226570/campath-calcineurin-inhibitor-reduction-and-chronic-allograft-nephropathy-the-3c-study-results-of-a-randomized-controlled-clinical-trial
#9
Richard Haynes, Lisa Blackwell, Natalie Staplin, William G Herrington, Jonathan Emberson, Parminder K Judge, Benjamin C Storey, Martin J Landray, Paul N Harden, Colin Baigent, Peter Friend
Calcineurin inhibitors (CNI e.g. tacrolimus) reduce short-term kidney transplant failure, but chronic nephrotoxicity may contribute to late transplant loss. Elective conversion to inhibitors of the mammalian target of rapamycin pathway (mTOR e.g. sirolimus) might avoid long-term CNI renal damage and improve outcomes. The 3C Study was a pragmatic randomized controlled trial comprising sequential randomizations between alemtuzumab and basiliximab induction therapy (at the time of surgery) and between tacrolimus and sirolimus maintenance therapy at 6-months post-transplant...
December 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29217890/nontubercular-mycobacterial-infection-in-a-renal-allograft-recipient
#10
U Anandh, K Jayanna
A 71-year-old male, a renal allograft recipient, presented to us with a history of fever and right palm swelling. He had a history of fever 7 years back when he was treated with antitubercular treatment (ATT). Three years back, he was diagnosed to have gout and he was started on allopurinol. He developed severe bone marrow toxicity and allopurinol was changed to febuxostat. On admission, routine investigations did not reveal any focus of infection. The fluid aspirate from the palm revealed acid-fast bacilli (AFB)...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29215813/kidney-transplantation-in-patients-with-atypical-hemolytic-uremic-syndrome-due-to-complement-factor-h-deficiency-impact-of-liver-transplantation
#11
Sejin Kim, Eujin Park, Sang Il Min, Nam Joon Yi, Jongwon Ha, Il Soo Ha, Hae Il Cheong, Hee Gyung Kang
BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is a rare disease that is often associated with genetic defects. Mutations of complement factor H (CFH) are the most common genetic defects that cause aHUS and often result in end-stage renal disease. Since CFH is mainly produced in the liver, liver transplantation (LT) has been performed in patients with defective CFH. METHODS: The clinical courses of four kidney allograft recipients who lost their native kidney functions due to aHUS associated with a CFH mutation were reviewed...
January 1, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#12
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/29208248/kidney-diseases-associated-with-alternative-complement-pathway-dysregulation-and-potential-treatment-options
#13
REVIEW
Prateek Sanghera, Mythili Ghanta, Fatih Ozay, Venkatesh K Ariyamuthu, Bekir Tanriover
Atypical hemolytic uremic syndrome and C3 glomerulopathy (dense deposit disease and C3 glomerulonephritis) are characterized as inappropriate activation of the alternative complement pathway. Genetic mutations affecting the alternative complement pathway regulating proteins (complement factor H, I, membrane cofactor protein and complement factor H-related proteins) and triggers (such as infection, surgery, pregnancy and autoimmune disease flares) result in the clinical manifestation of these diseases. A decade ago, prognosis of these disease states was quite poor, with most patients developing end-stage renal disease...
December 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29198677/single-donor-derived-pseudomonas-aeruginosa-pseudoaneurysms-in-two-kidney-transplant-recipients-a-case-report-of-dichotomous-allograft-outcomes
#14
M F Berger, I R Badell
Infectious pseudoaneurysm (IPA) is a rare but devastating complication following renal transplantation that typically leads to graft loss and occasionally patient death. IPAs following kidney transplantation are most often mycotic in etiology, but have been sporadically reported to result from Pseudomonas aeruginosa infection. These IPAs occur at various anatomic sites, most commonly at the vascular anastomosis or iliac artery, and very rarely in the transplanted renal artery or hilum. Here we report the occurrence of single donor-derived P aeruginosa IPAs in two kidney transplant recipients with divergent allograft outcomes...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198659/incidence-of-infectious-disease-and-malignancies-after-rituximab-therapy-in-kidney-transplant-recipients-results-from-a-cohort-in-germany
#15
E Schrezenmeier, K Budde, O Staeck, L Lehner, M Duerr, D Khadzhynov, T Dörner, F Halleck
BACKGROUND: Rituximab is frequently used in solid organ transplantation off-label, especially in patients with renal allografts. Few data are available on the safety aspects of solid organ transplant recipients receiving rituximab. There is a knowledge gap on long-term follow-up data, in particular on infectious complications. PATIENTS AND METHODS: A retrospective observational registry study (German Registry on Autoimmune Diseases) comprising a total of 681 patients was conducted...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29159992/clinical-and-histopathologic-features-of-antibody-mediated-rejection-among-pediatric-renal-transplant-recipients-with-preformed-vs-de-novo-donor-specific-antibodies
#16
Justin A Steggerda, Irene K Kim, Mark Haas, Xiaohai Zhang, Alexis Kang, Helen Pizzo, Elaine Kamil, Stanley Jordan, Dechu Puliyanda
Preformed and de novo donor specific antibodies (pDSA and dnDSA) are risk factors for ABMR. This study compares the effects of pDSA vs dnDSA in pediatric kidney transplant recipients. Sixteen pediatric patients with biopsy-proven ABMR were evaluated. Strong DSA (MFI >10 000) was recorded at transplant, rejection, and follow-up. DSAs with the highest MFI were termed iDSAs. Allograft biopsies were scored according to Banff 2013 criteria. Seven of 16 (44%) patients had pDSA at transplant; 9 (56%) developed dnDSA...
December 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29159528/death-with-graft-function-after-kidney-transplantation-a-single-center-experience
#17
Mi-Yeon Yu, Yong Chul Kim, Jung Pyo Lee, Hajeong Lee, Yon Su Kim
BACKGROUND: Death with graft function (DWGF) is an important cause of long-term loss of grafts and patients. In this study, we investigated clinical characteristics and causes of DWGF in kidney transplant recipients. METHODS: We recruited kidney allograft recipients who underwent surgery during 1973-2016 at Seoul National University Hospital in Korea (n = 2137). We divided recipients into four groups: alive with graft function (AWGF), alive with graft loss (AWGL), DWGF, and death with graft loss (DWGL)...
November 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29152583/inhibition-of-retrograde-transport-limits-polyomavirus-infection-in-vivo
#18
Saumya Maru, Ge Jin, Dhimant Desai, Shantu Amin, Shwetank, Matthew D Lauver, Aron E Lukacher
Polyomaviruses (PyVs) silently infect most humans, but they can cause life-threatening diseases in immunocompromised individuals. The JC polyomavirus (JCPyV) induces progressive multifocal leukoencephalopathy, a severe demyelinating disease in multiple sclerosis patients receiving immunomodulatory therapy, and BK polyomavirus (BKPyV)-associated nephropathy is a major cause of kidney allograft failure. No effective anti-PyV agents are available. Several compounds have been reported to possess anti-PyV activity in vitro, but none have shown efficacy in clinical trials...
November 2017: MSphere
https://www.readbyqxmd.com/read/29145879/allogeneic-mesenchymal-stem-cell-as-induction-therapy-to-prevent-both-delayed-graft-function-and-acute-rejection-in-deceased-donor-renal-transplantation-study-protocol-for-a-randomized-controlled-trial
#19
Qipeng Sun, Liangqing Hong, Zhengyu Huang, Ning Na, Xuefeng Hua, Yanwen Peng, Ming Zhao, Ronghua Cao, Qiquan Sun
BACKGROUND: Using kidneys from deceased donors is an available strategy to meet the growing need of grafts. However, higher incidences of delayed graft function (DGF) and acute rejection exert adverse effects on graft outcomes. Since ischemia-reperfusion injury (IRI) and ongoing process of immune response to grafts are the major causes of DGF and acute rejection, the optimal induction intervention should possess capacities of both repairing renal structure injury and suppressing immune response simultaneously...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29145515/male-kidney-allograft-recipients-at-risk-for-urinary-tract-infection
#20
Gerold Thölking, Katharina Schuette-Nuetgen, Thomas Vogl, Ulrich Dobrindt, Barbara C Kahl, Marcus Brand, Hermann Pavenstädt, Barbara Suwelack, Raphael Koch, Stefan Reuter
BACKGROUND: Urinary tract infection (UTI) is the most common infection after renal transplantation (RTx). Although female sex is a well-known risk factor for the development of UTI after RTx, the role of the donor sex in this context remains unclear. METHODS: In this case control study 6,763 RTx cases were screened for UTI when presenting at our transplant outpatient clinics. 102 different RTx patients fulfilled the inclusion criteria and were compared to 102 controls...
2017: PloS One
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