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https://www.readbyqxmd.com/read/28449350/scandiatransplant-acceptable-mismatch-program-stamp-a-bridge-to-transplanting-highly-immunized-patients
#1
P Koefoed-Nielsen, I Weinreich, M Bengtsson, J Lauronen, C Naper, M Gäbel, S S Sørensen, L Wennberg, A V Reisaeter, B K Møller
BACKGROUND: Highly immunized patients are a challenge for organ transplantation programs. One way of increasing the likelihood of transplantation in this group of patients is to expand the possible donations by defining acceptable HLA mismatches. In the Scandiatransplant Acceptable Mismatch Program (STAMP), a de-centralized approach has been implemented in 2009. AIMS: The program has been improved during the years from utilizing HLA-A, -B, -DR matching only to include typing of all deceased donors for HLA-A, -B, -C, -DRB1 and -DQB1...
April 27, 2017: HLA
https://www.readbyqxmd.com/read/28449211/operational-tolerance-in-kidney-transplantation-and-associated-biomarkers
#2
REVIEW
Annick Massart, Lidia Ghisdal, Marc Abramowicz, Daniel Abramowicz
In the 1960s, our predecessors won a historical battle against acute rejection and ensured that transplantation became a common life-saving treatment. In parallel to this success, or perhaps because of it, we lost the battle for long-lived transplants, being overwhelmed with chronic immune insults and the toxicities of immunosuppression. It is likely that current powerful treatments block acute rejection, but at the same time condemn the few circulating donor cells that would have been able to elicit immunoregulatory host responses towards the allograft...
April 27, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28445794/post-transplant-malignancy-after-pediatric-kidney-transplantation-retrospective-analysis-of-incidence-and-risk-factors-in-884-patients-transplanted-between-1963-and-2015-at-the-university-of-minnesota
#3
Oscar K Serrano, Ananta S Bangdiwala, David M Vock, Srinath Chinnakotla, Ty B Dunn, Erik B Finger, Raja Kandaswamy, Timothy L Pruett, John S Najarian, Arthur J Matas, Blanche M Chavers
BACKGROUND: Post-transplant malignancy (PTM) remains a concern among pediatric kidney transplant (PKT) recipients. STUDY DESIGN: Between 1963 and 2015, 884 pediatric (age: 0-17 years old) recipients received 1055 PKTs at our institution. Cox proportional hazards models were constructed to identify risk factors for PTM after PKT with time-to-first-PTM as a primary outcome. Secondly, the hazard of death or graft loss was calculated in patients who developed PTM. RESULTS: Median patient survival was 33 years (interquartile range [IQR]: 18...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28438856/tailoring-the-perfect-fit-for-renal-transplant-recipients-with-end-stage-polycystic-kidney-disease-indications-and-timing-of-native-nephrectomy
#4
REVIEW
Chrysoula Argyrou, Demetrios Moris, Spyridon Vernadakis
BACKGROUND: The ideal timing of native nephrectomy in relation to kidney transplantation in patients with autosomal-dominant polycystic kidney disease (ADPKD) can be a very puzzling decision for transplant surgeons and remains a matter of debate. This review article aims to present current literature regarding this highly controversial issue. MATERIALS AND METHODS: The MEDLINE/PubMed database was searched using "polycystic kidney disease", "renal/kidney transplantation" and "native nephrectomy" as key words...
May 2017: In Vivo
https://www.readbyqxmd.com/read/28438668/non-neuronal-neuropeptide-y-and-its-receptors-during-acute-rejection-of-rat-pulmonary-allografts
#5
Jessica Schmitz, Anna Zakrzewicz, Sigrid Wilker, Jitka Kuncová, Andreas Hecker, Veronika Grau, Winfried Padberg, Julia P N Holler
This study tested the hypothesis that neuropeptide Y (NPY) and NPY receptors 1 (Y1) and 2 (Y2) participate in lung allograft rejection. Inflammation in grafts may include interaction between blood leukocytes and graft endothelial cells and marked accumulation of intravascular blood leukocytes. Fewer leukocytes accumulate in lung than in kidney allografts. Lung transplantion was performed in the Dark Agouti to Lewis rat strain combination. Intravascular and intraalveolar leukocytes were isolated from the grafts, and we evaluated the mRNA expression of NPY, Y1, and Y2 by real-time RT-PCR as well as the peptide expression of NPY by radioimmunoassay and immunohistochemistry...
April 21, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28437790/utility-in-treating-kidney-failure-in-end-stage-liver-disease-with-simultaneous-liver-kidney-transplantation
#6
Xingxing S Cheng, Margaret R Stedman, Glenn M Chertow, W Ray Kim, Jane C Tan
BACKGROUND: Simultaneous liver-kidney (SLK) transplantation plays an important role in treating kidney failure in patients with end-stage liver disease. It used 5% of deceased donor kidney transplanted in 2015. We evaluated the utility, defined as posttransplant kidney allograft lifespan, of this practice. METHODS: Using data from the Scientific Registry of Transplant Recipients, we compared outcomes for all SLK transplants between January 1, 1995, and December 3, 2014, to their donor-matched kidney used in kidney-alone (Ki) or simultaneous pancreas kidney (SPK) transplants...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28436117/early-introduction-of-oral-paricalcitol-in-renal-transplant-recipients-an-open-label-randomized-study
#7
Hege Kampen Pihlstrøm, Franscesca Gatti, Clara Hammarström, Ivar Anders Eide, Monika Kasprzycka, Junbai Wang, Guttorm Haraldsen, My Hanna Sofia Svensson, Karsten Midtvedt, Geir Mjøen, Dag Olav Dahle, Anders Hartmann, Hallvard Holdaas
In stable renal transplant recipients with hyperparathyroidism, previous studies have indicated that vitamin D agonist treatment might have anti-proteinuric effects. Animal studies indicate possible anti-fibrotic and anti-inflammatory effects. Early introduction of paricalcitol in de-novo renal transplant recipients might reduce proteinuria and prevent progressive allograft fibrosis. We performed a single-centre, prospective, randomized, open-label trial investigating effects of paricalcitol 2μg/day added to standard care...
April 24, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28435278/genetic-factors-in-pathogenesis-of-diabetes-mellitus-after-kidney-transplantation
#8
REVIEW
Maciej Tarnowski, Sylwia Słuczanowska-Głabowska, Andrzej Pawlik, Małgorzata Mazurek-Mochol, Elżbieta Dembowska
Posttransplant diabetes mellitus (PTDM) is one of the major metabolic complications after transplantation of solid organs including the kidney. This type of diabetes mellitus affects allograft survival, cardiovascular complications and overall patient survival. The modifiable risk factors that contribute to PTDM include obesity, some viral infections (eg, hepatitis C virus, cytomegalovirus) and especially immunosuppressive drugs including corticosteroids, tacrolimus, cyclosporine and sirolimus. Currently, predisposing genetic factors have been considered important in PTDM development...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28433384/cold-ischemia-time-up-to-16-hours-has-little-impact-on-living-donor-kidney-transplant-outcomes-in-the-era-of-kidney-paired-donation
#9
Jagbir Gill, Caren Rose, Yayuk Joffres, Matthew Kadatz, John Gill
In living donor transplantation, cold ischemia time is a concern in transplants involving kidney paired donation. The impact of cold ischemia time over eight hours is unknown. Here we examined the association of cold ischemia time with delayed graft function and allograft loss among 48,498 living recipients in the Scientific Registry of Transplant Recipients registry. The incidence of delayed graft function was low but significantly higher among patients with longer cold ischemia times (0-2.0 hours: 3.3%; 2...
April 19, 2017: Kidney International
https://www.readbyqxmd.com/read/28431981/ventricular-assist-device-elicits-serum-natural-igg-that-correlates-with-the-development-of-primary-graft-dysfunction-following-heart-transplantation
#10
Sarah B See, Kevin J Clerkin, Peter J Kennel, Feifan Zhang, Matthew P Weber, Kortney J Rogers, Debanjana Chatterjee, Elena R Vasilescu, George Vlad, Yoshifumi Naka, Susan W Restaino, Maryjane A Farr, Veli K Topkara, Paolo C Colombo, Donna M Mancini, P Christian Schulze, Bruce Levin, Emmanuel Zorn
BACKGROUND: Pre-transplant sensitization is a limiting factor in solid-organ transplantation. In heart transplants, ventricular assist device (VAD) implantation has been associated with sensitization to human leukocyte antigens (HLA). The effect of VAD on non-HLA antibodies is unclear. We have previously shown that polyreactive natural antibodies (Nabs) contribute to pre-sensitization in kidney allograft recipients. Here we assessed generation of Nabs after VAD implantation in pre-transplant sera and examined their contribution to cardiac allograft outcome...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28430784/non-invasive-quantification-of-collagen-turnover-in-renal-transplant-recipients
#11
Elisabeth G D Stribos, Signe Holm Nielsen, Susanne Brix, Morten Asser Karsdal, Marc A Seelen, Harry van Goor, Stephan J L Bakker, Peter Olinga, Henricus A M Mutsaers, Federica Genovese
Kidney allograft failure due to chronic injury/rejection remains the main cause of graft loss in renal transplant recipients (RTR). Here, we investigated whether specific biomarkers of extracellular matrix (ECM) turnover are associated with allograft function and chronic kidney disease (CKD) stage in RTR. Seventy-eight patients who attended the University Medical Center Groningen for a routine check-up after kidney transplantation were enrolled in the study. Plasma and/or 24h-urine samples were collected and specific matrix-metalloproteinase-generated neo-epitope fragments of collagens were measured by enzyme-linked immunosorbent assay...
2017: PloS One
https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#12
Matthew J Damasiewicz, Peter R Ebeling
The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. All patients active on transplant waiting lists should be screened for bone disease...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28428030/complement-inhibition-with-eculizumab-for-thrombotic-microangiopathy-rescues-a-living-donor-kidney-transplant-in-a-patient-with-antiphospholipid-antibody-syndrome
#13
Praveen Ramakrishnan Geethakumari, Patrick Mille, Rakesh Gulati, Srikanth Nagalla
Antiphospholipid antibody syndrome (APS) is an enigmatic heterogeneous disorder despite several revelations in its pathobiology. Renal transplantation in patients with APS has been notoriously difficult due to the high risk of development of thrombotic microangiopathy (TMA), which is often refractory to conventional treatment modalities such as aggressive anticoagulation and plasmapheresis. We describe a case of a 58-year-old male with secondary APS undergoing living unrelated renal transplantation for end-stage renal disease from lupus nephritis...
March 10, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28423464/high-clinical-suspicion-of-donor-derived-disease-leads-to-timely-recognition-and-early-intervention-to-treat-solid-organ-transplant-transmitted-lymphocytic-choriomeningitis-virus
#14
Gagan Mathur, Kunal Yadav, Bradley Ford, Ilana J Schafer, Shridhar V Basavaraju, Barbara Knust, Wun-Ju Shieh, Sam Hill, Garret D Locke, Patricia Quinlisk, Shelley Brown, Ardith Gibbons, Deborah Cannon, Matthew Kuehnert, Stuart T Nichol, Pierre E Rollin, Ute Ströher, Rachel Miller
Despite careful donor screening, unexpected donor-derived infections continue to occur in organ transplant recipients (OTRs). Lymphocytic choriomeningitis virus (LCMV) is one such transplant-transmitted infection that in previous reports has resulted in a high mortality among the affected OTRs. We report a LCMV case cluster that occurred 3 weeks post-transplant in three OTRs who received allografts from a common organ donor in March 2013. Following confirmation of LCMV infection at Centers for Disease Control and Prevention, immunosuppression was promptly reduced and ribavirin and/or intravenous immunoglobulin therapy were initiated in OTRs...
April 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#15
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies didn't identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. 50 (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28420070/lower-kidney-allograft-survival-in-african-americans-compared-to-hispanic-americans-with-lupus
#16
M L Gonzalez-Suarez, G Contreras
Background and objective African-Americans and Hispanic-Americans with lupus are the two most common minority groups who receive kidney transplants in the USA. It is unknown if African-Americans and Hispanic-Americans with lupus have similar outcomes after kidney transplantation. In this study, we assessed whether African-Americans compared to Hispanic-Americans have worse kidney allograft survival after risk factors of rejection and other prognostic factors were matched between both groups. Methods Out of 1816 African-Americans and 901 Hispanic-Americans with lupus, who received kidney transplants between 1987 and 2006 and had complete records in the UNOS program, 478 pairs were matched in 16 baseline predictors and follow-up time employing a predicted probability of group membership...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28419176/mica-diversity-and-linkage-disequilibrium-with-hla-b-alleles-in-renal-transplant-candidates-in-southern-brazil
#17
Roger Haruki Yamakawa, Patrícia Keiko Saito, Geórgia Fernanda Gelmini, José Samuel da Silva, Maria da Graça Bicalho, Sueli Donizete Borelli
The major histocompatibility complex (MHC) class I chain-related gene A (MICA) is located centromerically to the human leukocyte antigen (HLA)-B. The short distance between these loci in the MHC indicates the presence of linkage disequilibrium (LD). Similarly to the HLA, the MICA is highly polymorphic, and this polymorphism has not been well documented in different populations. In this study, we estimated the allelic frequencies of MICA and the linkage disequilibrium with HLA-B alleles in 346 renal-transplant candidates in southern Brazil...
2017: PloS One
https://www.readbyqxmd.com/read/28418995/kidney-biopsy-yield-an-examination-of-influencing-factors
#18
Miroslav Sekulic, Gretchen S Crary
Kidney biopsies are conducted under varying scenarios, presenting variables that could potentially influence yield and adequacy of tissue collected. We retrospectively reviewed 636 native and allograft kidney biopsies, and compared tissue collected between differing practitioners performing the biopsy (nephrologists or radiologists), imaging modalities for guidance (ultrasound or computed tomography), gauge needle used (18 or 16 G), and between on-site evaluators of biopsy adequacy conducted at the time of biopsy (general pathologists, renal pathologists, nephrologists)...
April 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28415888/bioengineered-gold-nanoparticles-targeted-to-mesenchymal-cells-from-patients-with-bronchiolitis-obliterans-syndrome-does-not-rise-the-inflammatory-response-and-can-be-safely-inhaled-by-rodents
#19
Emanuela Cova, Simona Inghilleri, Laura Pandolfi, Monica Morosini, Sara Magni, Miriam Colombo, Davide Piloni, Chiara Finetti, Gabriele Ceccarelli, Laura Benedetti, Maria Gabriella Cusella, Manuela Agozzino, Fabio Corsi, Raffaele Allevi, Simona Mrakic-Sposta, Sarah Moretti, Simona De Gregori, Davide Prosperi, Federica Meloni
The use of gold nanoparticles as drug delivery system represents a promising issue for diseases without effective pharmacological treatment due to insufficient local drug accumulation and excessive systemic toxicity. Bronchiolitis obliterans syndrome (BOS) represents about 70% of cases of chronic lung allograft dysfunction, the main challenge to long term lung transplantation. It is believed that due to repeated insults to epithelial bronchiolar cells local inflammatory response creates a milieu that favours epithelial mesenchymal transition and activation of local mesenchymal cells leading to airway fibro-obliteration...
April 18, 2017: Nanotoxicology
https://www.readbyqxmd.com/read/28415773/effects-of-cd20-b-cell-infiltration-into-allografts-on-kidney-transplantation-outcomes-a-systematic-review-and-meta-analysis
#20
REVIEW
Yingying Lu, Bingjue Li, Qixia Shen, Rending Wang, Zhimin Chen, Hong Jiang, Jianghua Chen
The effects of CD20+ B-cell infiltration during acute rejection on graft outcomes are controversial. The objective of this systematic review and meta-analysis was to clarify this issue. We performed a systematic literature search for studies published up to January 14, 2016. A total of 5 studies, with 200 patients, were included. The presence of CD20+ B cells in renal biopsies during allograft rejection was associated with graft loss and steroid resistance. No association of CD20+ B-cell infiltration with C4d-positive staining of the peritubular capillaries in renal biopsies was found in the analysis of patients who experienced kidney graft rejection...
March 15, 2017: Oncotarget
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