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https://www.readbyqxmd.com/read/28544435/solid-renal-masses-in-transplanted-allograft-kidneys-a-closer-look-at-the-epidemiology-and-management
#1
John J Griffith, Katherine A Amin, Nikhil Waingankar, Susan M Lerner, Veronica Delaney, Scott A Ames, Ketan Badani, Michael A Palese, Reza Mehrazin
The objective of this review is to explore the available literature on solid renal masses (SRM) in transplant allograft kidneys to better understand the epidemiology and management of these tumors. A literature review using PubMed was performed according to the PRISMA methodology. Fifty-six relevant studies were identified from 1988-2015. A total of 174 SRMs in 163 patients, were identified with a mean tumor size of 2.75 cm (0.5-9.0cm). Tumor histology was available in 164 (94.3%) tumors: clear cell renal cell carcinoma (RCC) (45...
May 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28542109/application-and-interpretation-of-histocompatibility-data-in-pediatric-kidney-transplantation
#2
Hilda E Fernandez
PURPOSE OF REVIEW: Advances in technology to assess immunologic risk in solid organ transplant offer an opportunity to optimize the approach to pediatric deceased donor kidney transplant in the setting of a new allocation system in the United States. RECENT FINDINGS: Degree of human leukocyte antigen (HLA) mismatch, class II HLA mismatch, unacceptable antigens and donor-specific antibody (DSA) detected by solid-phase assays, and epitope matching pretransplant affect pediatric kidney transplant outcomes...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28540902/primary-focal-segmental-glomerulosclerosis-recurring-rapidly-as-collapsing-glomerulopathy-in-a-renal-allograft-recipient
#3
Vinita Agrawal, Narayan Prasad, Pritpal Singh
Recurrent focal segmental glomerulosclerosis (FSGS) develops in about 30%-40% of patients of FSGS undergoing renal transplantation. We report a patient who received a live- related renal transplant for end-stage renal disease due to a primary FSGS (not otherwise specified) in the native kidney and presented with graft dysfunction in the immediate posttransplant period. The first and the second biopsy showed no evidence of rejection or glomerular lesion. A repeat biopsy done on the 30th day revealed recurrent FSGS morphologically presenting as collapsing variant...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540837/enterovesical-fistula-after-enteric-conversion-of-a-bladder-drained-pancreatic-allograft-a-case-report
#4
Clifford Akateh, Amer Rajab, Mitchell Henry, Ashraf El-Hinnawi
Since the inception of pancreas transplant as a treatment for type 1 diabetes mellitus, there has been considerable debate about the best way to manage exocrine secretions and monitor patients for graft rejection. For patients who undergo bladder exocrine drainage of a pancreatic allograft, a bladder-to-enteric drainage conversion can serve as a rescue procedure in case of anastomotic leaks or other complications. However, this procedure is associated with its own complications, including a rarely described enterovesical fistula...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28538243/bk-virus-as-a-mediator-of-graft-dysfunction-following-kidney-transplantation
#5
Stephanie G Yi, Richard J Knight, Keri E Lunsford
PURPOSE OF REVIEW: BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients. RECENT FINDINGS: Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy...
May 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28536887/ficolin-2-gene-rs7851696-polymorphism-is-associated-with-delayed-graft-function-and-acute-rejection-in-kidney-allograft-recipients
#6
Ewa Dabrowska-Zamojcin, Michal Czerewaty, Damian Malinowski, Maciej Tarnowski, Sylwia Słuczanowska-Głabowska, Leszek Domanski, Krzysztof Safranow, Andrzej Pawlik
Ficolin-2 is an activator of the complement system that acts via the lectin pathway. Complement activation plays a substantial role in the renal injury inherent to kidney transplantation. In this study, we examined the associations between ficolin-2 gene polymorphisms in exon 8 and kidney allograft function. This study comprised 270 Caucasian deceased-donor renal transplant recipients. The following parameters were recorded in each case: delayed graft function (DGF), acute rejection (AR), and chronic allograft dysfunction...
May 23, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/28536123/randomized-controlled-trial-of-mineralocorticoid-receptor-blockade-in-children-with-chronic-kidney-allograft-nephropathy
#7
Mara Medeiros, Luis Velásquez-Jones, Ana M Hernández, Guillermo Ramón-García, Saúl Valverde, Yolanda Fuentes, Arindal Vargas, Mauricio Patiño, Rosalba Pérez-Villalva, Juan Antonio Ortega-Trejo, Jonatan Barrera-Chimal, Norma A Bobadilla
BACKGROUND AND OBJECTIVES: We showed that mineralocorticoid receptor blockade (MRB) prevented acute and chronic cyclosporine nephropathy (CsA-Nx) in the rat. The aim of this translational study was to investigate the effect of long-term eplerenone administration on renal allograft function in children with biopsy-proven chronic allograft nephropathy (CAN). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Renal transplant children <18 years, biopsy-proven CAN, and a GFR>40 ml/min per 1...
May 23, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28535529/looking-into-the-graft-without-a-biopsy-biomarkers-of-acute-rejection-in-renal-transplantation
#8
Andrea Angeletti, Paolo Cravedi
Immunosuppression in kidney transplantation is still largely driven by center-specific protocols and adjusted according to the presence of graft dysfunction, drug toxicity or infection. Due to the current inability to titrate immunosuppression to the needs of every single patient, this approach is burdened by an increased risk of under or over-immunosuppression. To extend allograft survival, immunosuppression should be decided based on reliable biomarkers capable of quantifying the alloimmune response and/or noninvasively diagnosing acute rejection...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535527/treatment-of-acute-antibody-mediated-rejection
#9
Giorgia Comai, Matteo Ravaioli, Olga Baraldi, Vania Cuna, Lorenzo Gasperoni, Giovanni Liviano D''Arcangelo, Maria Cappuccilli, Antonio D Pinna, Claudio Ronco, Gaetano La Manna
Acute antibody-mediated rejection (AMR) remains an important challenge in the field of kidney transplantation despite the advances in immunosuppressive strategies, and has been recognized as an important cause of allograft dysfunction and graft loss. The treatments of acute AMR are not standardized and poor evidence is currently available on the effectiveness of therapy regimens with combinations of drugs. Standard treatment for acute AMR is based on 3 cornerstones: removal of donor-specific antibodies (DSAs) from the bloodstream, reduction of DSAs synthesis, and inhibition of the interaction between DSAs and human leukocyte antigen antigens on donor's cells...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28520146/association-of-tenofovir-disoproxil-fumarate-with-primary-allograft-survival-in-hiv-positive-kidney-transplant-recipients
#10
Suzanne M Boyle, Gregory Malat, Meera N Harhay, Dong H Lee, Lisa Pang, Sindhura Talluri, Akshay Sharma, Tiffany E Bias, Karthik Ranganna, Alden M Doyle
BACKGROUND: Tenofovir disoproxil fumarate (TDF) is an anti-retroviral agent frequently used to treat human immunodeficiency virus (HIV). There are concerns regarding its potential to cause acute kidney injury, chronic kidney disease, and proximal tubulopathy. Although TDF can effectively suppress HIV after kidney transplantation, it is unknown whether use of TDF-based anti-retroviral therapy (ART) after kidney transplant (KT) adversely affects allograft survival. METHODS: We examined 104 HIV+ KT recipients at our center between 2001 and 2014...
May 18, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28518414/systematic-review-of-surgical-and-medical-treatment-for-tertiary-hyperparathyroidism
#11
REVIEW
R R Dulfer, G J H Franssen, D A Hesselink, E J Hoorn, C H J van Eijck, T M van Ginhoven
BACKGROUND: A significant proportion of patients with chronic kidney disease and secondary hyperparathyroidism (HPT) remain hyperparathyroid after kidney transplantation, a state known as tertiary HPT. Without treatment, tertiary HPT can lead to diminished kidney allograft and patient survival. Parathyroidectomy was commonly performed to treat tertiary HPT until the introduction of the calcimimetic drug, cinacalcet. It is not known whether surgery or medical treatment is superior for tertiary HPT...
June 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28518062/retrograde-flushing-of-living-donor-renal-allografts-via-the-renal-vein-a-simple-effective-technique
#12
Mark J Hobeika, Wasim A Dar, David R Hall, John S Bynon
BACKGROUND: Prograde flushing (PF) of living donor renal allografts with preservation solution via the renal artery or arteries is standard practice. PF may be difficult and potentially injurious to the donor kidney, especially in grafts with small or multiple arteries. In this report we present our experience with retrograde flushing (RF) of 7 living donor kidneys via the renal vein. METHODS: Retrospective review of 7 consecutive living donor renal transplants (LDRT) performed using the RF technique was performed...
October 11, 2016: Transplantation
https://www.readbyqxmd.com/read/28510327/pre-existing-diabetes-is-a-risk-factor-for-increased-rates-of-cellular-rejection-after-kidney-transplantation-an-observational-cohort-study
#13
S Johal, F Jackson-Spence, H Gillott, S Tahir, J Mytton, F Evison, B Stephenson, J Nath, A Sharif
AIM: To investigate whether people with diabetes have an elevated risk of kidney allograft rejection in a well characterized clinical cohort in the setting of contemporary immunosuppression. METHODS: We conducted a retrospective cohort study including all kidney allograft recipients at a single centre between 2007 and 2015, linking clinical, biochemical and histopathological data from electronic patient records. RESULTS: Data were analysed for 1140 kidney transplant recipients...
May 16, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#14
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction of immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a five year period following the initiation of a serum BKV screening protocol...
May 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28508971/short-term-outcome-and-quality-of-life-in-kidney-transplant-recipient-with-monoclonal-gammopathy
#15
Masaaki Yanishi, Hiroyasu Tsukaguchi, Takashi Yoshida, Hisanori Taniguchi, Kenji Yoshida, Takao Mishima, Yoshihiro Komai, Kaneki Yasuda, Masato Watanabe, Motohiko Sugi, Hidefumi Kinoshita, Tadashi Matsuda
Monoclonal gammopathy of undetermined significance (MGUS) is the common pre-malignant B cell disorders with a general prevalence of 3-5 % at age over 50. Because of the potential malignant transformation and immune insufficiency, pre-transplant MGUS recipient should be carefully followed after allograft transplantation. The post-transplant prognosis and quality of life (QOL) in patient with MGUS have not yet been fully determined. The aim of this study is to evaluate function and pathology of the renal allograft and self-assessment QOL changes during 2 years after transplantation in our case of MGUS-bearing recipient...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28507915/smoking-in-renal-transplantation-facts-beyond-myth
#16
REVIEW
Ahmed Aref, Ajay Sharma, Ahmed Halawa
Smoking is one of the preventable leading causes of death worldwide. Most of the studies focused on the association between smoking and cardiovascular disease, pulmonary diseases, malignancy and death. However, the direct effect of smoking on the renal system was undermind. There are emerging evidence correlating tobacco use with pathological changes in the normal kidneys. The effect is more obvious on the renal allograft most probably due to the chronic immune suppression status and the metabolic effect of the drugs...
April 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28506366/antibody-mediated-rejection-after-liver-transplant
#17
REVIEW
Michael Lee
Antibody-mediated rejection (AMR) in liver transplants is a field in its infancy compared with its allograft cohorts of the kidney and lung. Acute AMR is diagnosed based on specific clinical and histopathologic criteria: serum donor specific antibodies, C4d staining, histopathologic findings on liver biopsy, and exclusion of other entities. In contrast, the histologic features of chronic AMR are not as specific and it is a more challenging diagnosis to make. Treatments of acute and chronic AMR include some combination of steroids, immune-modulating agents, intravenous immunoglobulin, plasmapheresis, and proteasome inhibitors...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28503746/application-of-ultrasound-elastography-for-chronic-allograft-dysfunction-in-kidney-transplantation
#18
REVIEW
Zijie Wang, Haiwei Yang, Chuanjian Suo, Jifu Wei, Ruoyun Tan, Min Gu
Interstitial fibrosis is the main characteristic of chronic allograft dysfunction, which remains the key factor affecting long-term allograft survival after kidney transplantation. Ultrasound elastography (UE), including real-time elastography, transient elastography, and acoustic radiation force impulse, has been applied widely in breast, thyroid, and liver diseases, especially in the assessment of liver fibrosis. Recently, numerous studies have reported the efficacy of UE methods in evaluating renal allograft fibrosis...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28503733/long-term-safety-from-transmission-of-porcine-endogenous-retrovirus-after-pig-to-non-human-primate-corneal-transplantation
#19
Hyuk Jin Choi, Jiyeon Kim, Jae Young Kim, Hyun Ju Lee, Won Ryang Wee, Mee Kum Kim, Eung Soo Hwang
BACKGROUND: The risk of xenozoonosis mainly by porcine endogenous retrovirus (PERV) has been considered as one of the main hurdles in xenotransplantation and therefore should be elucidated prior to the clinical use of porcine corneal grafts. Accordingly, an investigation was performed to analyze the infectivity of PERVs from porcine keratocytes to human cells, and the long-term risk of transmission of PERVs was determined using pig-to-non-human primate (NHP) corneal transplantation models...
May 14, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28502128/belatacept-resistant-rejection-is-associated-with-cd28-memory-cd8-t-cells
#20
D V Mathews, W C Wakwe, S C Kim, M C Lowe, C Breeden, M E Roberts, A B Farris, E A Strobert, J B Jenkins, C P Larsen, M L Ford, R Townsend, A B Adams
Recently newer therapies have been designed to more specifically target rejection in an effort to improve efficacy and limit unwanted toxicity. Belatacept, a CD28-CD80/86 specific reagent is associated with superior patient survival and graft function than traditional therapy but its adoption as a mainstay immunosuppressive therapy has been tempered by increased rejection rates. It is essential that the underlying mechanisms associated with this rejection be elucidated before belatacept is more widely employed...
May 14, 2017: American Journal of Transplantation
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