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liver transplantation immunology

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https://www.readbyqxmd.com/read/28060025/antibody-mediated-rejection-what-is-the-clinical-relevance
#1
Rachel Hogen, Joseph DiNorcia, Kiran Dhanireddy
PURPOSE OF REVIEW: The review outlines the diagnosis, clinical implications, and treatment strategies for acute and chronic antibody-mediated rejection (AMR) after orthotopic liver transplantation (OLT). RECENT FINDINGS: A combination of clinical work-up, histopathology, C4d staining, and donor-specific antibody (DSA) should be used to diagnose AMR. The differential diagnosis for idiopathic fibrosis now includes chronic AMR. Characterization of pathogenic DSA continues to progress...
January 3, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28006867/differential-profile-of-activated-regulatory-t-cell-subsets-and-micrornas-in-tolerant-liver-transplant-recipients
#2
B Revilla-Nuin, A de Bejar, L Martínez-Alarcón, J I Herrero, C M Martínez-Cáceres, P Ramírez, A Baroja-Mazo, J A Pons
: Regulatory T cells (Tregs) play a potential role in operational tolerance in liver transplant patients, and microRNAs (miRNAs) are known to be involved in immunological responses and tolerance. Thus, we analyzed the implication of different peripheral blood Treg subsets and miRNAs on liver transplantation tolerance in 24 tolerant (Tol) and 23 non-tolerant (non-Tol) liver transplant recipients by cellular, genetic and epigenetic approximation. Non-Tol patients had a lower demethylation rate of the FOXP3 Treg-specific demethylated region (TSDR) than Tol patients that correlated with the frequency of circulating Tregs...
December 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27965672/hereditary-angioedema-as-a-metabolic-liver-disorder-novel-therapeutic-options-and-prospects-for-cure
#3
Rohan Ameratunga, Adam Bartlett, John McCall, Richard Steele, See-Tarn Woon, Constance H Katelaris
Hereditary angioedema (HAE) is a rare autosomal dominant disorder caused by mutations of the SERPING1 or the Factor 12 genes. It is potentially fatal, particularly if not identified at an early stage. Apart from androgens, which are contraindicated in children and in pregnant women, a range of effective, albeit very expensive treatments have recently become available for HAE patients. The cost of these new treatments is beyond the reach of most developing countries. At this time, there is no cure for the disorder...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27942590/early-cytokine-signatures-of-ischemia-reperfusion-injury-in-human-orthotopic-liver-transplantation
#4
Rebecca A Sosa, Ali Zarrinpar, Maura Rossetti, Charles R Lassman, Bita V Naini, Nakul Datta, Ping Rao, Nicholas Harre, Ying Zheng, Roberto Spreafico, Alexander Hoffmann, Ronald W Busuttil, David W Gjertson, Yuan Zhai, Jerzy W Kupiec-Weglinski, Elaine F Reed
BACKGROUND. Orthotopic liver transplant (OLT) is the primary therapy for end-stage liver disease and acute liver failure. However, ischemia/reperfusion injury (IRI) can severely compromise allograft survival. To understand the evolution of immune responses underlying OLT-IRI, we evaluated longitudinal cytokine expression profiles from adult OLT recipients before transplant through 1 month after transplant. METHODS. We measured the expression of 38 cytokines, chemokines, and growth factors in preoperative and postoperative recipient circulating systemic blood (before transplant and 1 day, 1 week, and 1 month after transplant) and intraoperative portal blood (before and after reperfusion) of 53 OLT patients and analyzed this expression in relation to biopsy-proven IRI (n = 26 IRI+; 27 IRI-), clinical liver function tests early (days 1-7) after transplant, and expression of genes encoding cytokine receptors in biopsies of donor allograft taken before and after reperfusion...
December 8, 2016: JCI Insight
https://www.readbyqxmd.com/read/27924436/resolution-of-multifocal-epstein-barr-virus-related-smooth-muscle-tumor-in-a-patient-with-gata2-deficiency-following-hematopoietic-stem-cell-transplantation
#5
Mark Parta, Jennifer Cuellar-Rodriguez, Alexandra F Freeman, Juan Gea-Banacloche, Steven M Holland, Dennis D Hickstein
We performed allogeneic hematopoietic stem cell transplantation in a patient with GATA2 deficiency and an Epstein-Barr virus (EBV)-related spindle cell tumor involving the liver and possibly bone. He received a matched-related donor transplant with donor peripheral blood stem cells following a myeloablative conditioning regimen. He achieved rapid and high levels of donor engraftment and had complete reversal of the clinical and immunologic phenotype of MonoMAC/GATA2 deficiency and eradication of the EBV tumors after 3 years of follow-up...
December 6, 2016: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/27911488/hepatocellular-carcinoma-as-an-emerging-morbidity-in-the-thalassemia-syndromes-a-comprehensive-review
#6
REVIEW
Hassan M Moukhadder, Racha Halawi, Maria Domenica Cappellini, Ali T Taher
The incidence of hepatocellular carcinoma (HCC) in patients with thalassemia is on the rise. The 2 well recognized HCC risk factors in thalassemia are iron overload and chronic viral infection with hepatitis C. The carcinogenicity of iron is related to its induction of oxidative damage, which results in genotoxicity, and to immunologic dysregulation, which attenuates cancer immune surveillance. Chronic hepatitis B and C infections lead to necroinflammation, which can prompt progression to HCC, but an independent role of hepatitis B virus in hepatic carcinogenesis among patients with thalassemia has not been demonstrated...
December 1, 2016: Cancer
https://www.readbyqxmd.com/read/27869439/immunology-update-long-term-care-of-solid-organ-transplant-recipients
#7
S Paul Starr
Nearly 31,000 US patients received solid organ transplants in 2015 and the number is increasing. Care of transplant recipients includes management of a variety of common posttransplantation issues. Skin cancers are common because of immunosuppression and require skin examinations at intervals. Patients should be educated about the need to report new skin lesions. The rates of other cancers also are increased, including cancers of the head and neck, lung, esophagus, cervix, and urinary tract. Osteoporosis is common in transplant recipients; monitoring and early therapy are important...
November 2016: FP Essentials
https://www.readbyqxmd.com/read/27862900/long-term-renal-allograft-survival-after-sequential-liver-kidney-transplantation-from-a-single-living-donor
#8
Kumiko Kitajima, Yuichi Ogawa, Katsuyuki Miki, Kotaro Kai, Akihito Sannomiya, Kazuhiro Iwadoh, Toru Murakami, Ichiro Koyama, Ichiro Nakajima, Shohei Fuchinoue
Background Combined liver-kidney transplantation (CLKT) is well-established as a definitive therapy with the potential to provide complete recovery for certain liver-kidney diseases, although the results might be contingent on the cause of transplantation. The purposes of the present study were to review the long-term outcome of renal allografts in CLKT patients from single living donors and to investigate the beneficial factors, compared with solitary renal transplantation. Materials and Methods Thirteen patients underwent sequential liver (LTx) and kidney (KTx) transplantations from single living donors...
November 10, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27860293/thrombocytopenia-in-chronic-liver-disease
#9
REVIEW
Markus Peck-Radosavljevic
Thrombocytopenia is a common haematological disorder in patients with chronic liver disease. It is multifactorial and severity of liver disease is the most influential factor. As a result of the increased risk of bleeding, thrombocytopenia may impact upon medical procedures, such as surgery or liver biopsy. The pathophysiology of thrombocytopenia in chronic liver disease has long been associated with the hypothesis of hypersplenism, where portal hypertension causes pooling and sequestration of all corpuscular elements of the blood, predominantly thrombocytes, in the enlarged and congested spleen...
November 17, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27819130/current-status-and-future-prospects-of-mesenchymal-stem-cell-therapy-for-liver-fibrosis
#10
Yang Guo, Bo Chen, Li-Jun Chen, Chun-Feng Zhang, Charlie Xiang
Liver fibrosis is the end-stage of many chronic liver diseases and is a significant health threat. The only effective therapy is liver transplantation, which still has many problems, including the lack of donor sources, immunological rejection, and high surgery costs, among others. However, the use of cell therapy is becoming more prevalent, and mesenchymal stem cells (MSCs) seem to be a promising cell type for the treatment of liver fibrosis. MSCs have multiple differentiation abilities, allowing them to migrate directly into injured tissue and differentiate into hepatocyte-like cells...
2016: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/27758159/comparison-of-human-hematopoietic-reconstitution-in-different-strains-of-immunodeficient-mice
#11
Ashley I Beyer, Marcus O Muench
Immunodeficient mice play a critical role in hematology research as in vivo models of hematopoiesis and immunology. Multiple strains have been developed, but hematopoietic stem cell engraftment and immune reconstitution have not been methodically compared among them. Four mouse strains were transplanted with human fetal bone marrow or adult peripheral blood CD34(+) cells: NSG, NSG-3GS, hSCF-Tg-NSG, and hSIRPα-DKO. Hematopoietic engraftment in the bone marrow, blood, spleen, and liver was evaluated by flow cytometry 12 weeks after transplant...
January 15, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/27729094/identification-of-donor-origin-and-condition-of-transplanted-islets-in-situ-in-the-liver-of-a-type-1-diabetic-recipient
#12
Cornelis R van der Torren, Jessica S Suwandi, DaHae Lee, Ernst-Jan T van 't Wout, Gaby Duinkerken, Godelieve Swings, Arend Mulder, Frans H J Claas, Zhidong Ling, Pieter Gillard, Bart Keymeulen, Peter In 't Veld, Bart O Roep
Transplantation of islet allografts into type 1 diabetic recipients usually requires multiple pancreas donors to achieve insulin independence. This adds to the challenges of immunological monitoring of islet transplantation currently relying on surrogate immune markers in peripheral blood. We investigated donor origin and infiltration of islets transplanted in the liver of a T1D patient who died of hemorrhagic stroke four months after successful transplantation with two intraportal islet grafts combining six donors...
October 10, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27722166/gender-mainstreaming-and-transplant-surgery
#13
REVIEW
Eva Maria Teegen, Isabell Krebs, Corinna Langelotz, Johann Pratschke, Beate Rau
BACKGROUND: Gender differences in medicine are gaining in importance. In transplant surgery, not only the patient's gender but also that of the donor play an important role in the outcome of transplantation due to sociocultural and genetic factors. METHODS: This review article gives an overview of the latest investigations into gender-related influences in the field of visceral transplantation. For this purpose, a systematic review of the literature was performed...
August 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27678350/tolerance-in-liver-transplantation-biomarkers-and-clinical-relevance
#14
REVIEW
Alberto Baroja-Mazo, Beatriz Revilla-Nuin, Pascual Parrilla, Laura Martínez-Alarcón, Pablo Ramírez, José Antonio Pons
Transplantation is the optimal treatment for end-stage organ failure, and modern immunosuppression has allowed important progress in short-term outcomes. However, immunosuppression poorly influences chronic rejection and elicits chronic toxicity in current clinical practice. Thus, a major goal in transplantation is to understand and induce tolerance. It is well established that human regulatory T cells expressing the transcription factor FoxP3 play important roles in the maintenance of immunological self-tolerance and immune homeostasis...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27640806/combining-exosomes-derived-from-immature-dcs-with-donor-antigen-specific-treg-cells-induces-tolerance-in-a-rat-liver-allograft-model
#15
Ben Ma, Jing-Yue Yang, Wen-Jie Song, Rui Ding, Zhuo-Chao Zhang, Hong-Chen Ji, Xuan Zhang, Jian-Lin Wang, Xi-Sheng Yang, Kai-Shan Tao, Ke-Feng Dou, Xiao Li
Allograft tolerance is the ultimate goal in the field of transplantation immunology. Immature dendritic cells (imDCs) play an important role in establishing tolerance but have limitations, including potential for maturation, short lifespan in vivo and short storage times in vitro. However, exosomes (generally 30-100 nm) from imDCs (imDex) retain many source cell properties and may overcome these limitations. In previous reports, imDex prolonged the survival time of heart or intestine allografts. However, tolerance or long-term survival was not achieved unless immune suppressants were used...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27605884/polyethylene-glycols-an-effective-strategy-for-limiting-liver-ischemia-reperfusion-injury
#16
REVIEW
Gianfranco Pasut, Arnau Panisello, Emma Folch-Puy, Alexandre Lopez, Carlos Castro-Benítez, Maria Calvo, Teresa Carbonell, Agustín García-Gil, René Adam, Joan Roselló-Catafau
Liver ischemia-reperfusion injury (IRI) is an inherent feature of liver surgery and liver transplantation in which damage to a hypoxic organ (ischemia) is exacerbated following the return of oxygen delivery (reperfusion). IRI is a major cause of primary non-function after transplantation and may lead to graft rejection, regardless of immunological considerations. The immediate response involves the disruption of cellular mitochondrial oxidative phosphorylation and the accumulation of metabolic intermediates during the ischemic period, and oxidative stress during blood flow restoration...
July 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27515042/multiorgan-transplantation
#17
REVIEW
Erik Stites, Alexander C Wiseman
Kidney transplantation has proven to be the gold standard therapy for severe chronic kidney disease (CKD) due to multiple etiologies in individuals deemed eligible from a surgical standpoint. While kidney transplantation is traditionally considered in conditions of native kidney disease such as diabetes and immunological or inherited causes of kidney disease, an increasing indication for kidney transplantation is kidney dysfunction in the setting of other severe organ dysfunction that requires transplant, such as severe liver or heart disease...
October 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/27500258/lowered-immune-cell-function-in-liver-recipients-recovered-from-posttransplant-lymphoproliferative-disease-who-developed-graft-tolerance
#18
Patrick Ho Yu Chung, See Ching Chan, Kwong Leung Chan, Yuk Sing Chan, Janette Siu Yin Kwok, Chung Mau Lo
UNLABELLED: Tolerance after treatment and recovery from posttransplant lymphoproliferative disease (PTLD) have been described but little is known about the immunology. The objective of this study is to evaluate the immunity of pediatric recipients who recovered from PTLD. MATERIALS AND METHODS: Pediatric recipients who recovered from PTLD after liver transplant and twice the number of recipients who never had PTLD were recruited. Their immune statuses were measured by ImmuKnow (measurement of adenosine 5-triphospate level produced CD4+ T helper cells), and the results were divided into 3 groups, "low" (≤225 ng/mL), "moderate" (226 to 524 ng/mL), and "high" (≥525 ng/mL)...
March 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27468206/role-of-nk-nkt-cells-and-macrophages-in-liver-transplantation
#19
REVIEW
René Fahrner, Felix Dondorf, Michael Ardelt, Utz Settmacher, Falk Rauchfuss
Liver transplantation has become the treatment of choice for acute or chronic liver disease. Because the liver acts as an innate immunity-dominant organ, there are immunological differences between the liver and other organs. The specific features of hepatic natural killer (NK), NKT and Kupffer cells and their role in the mechanism of liver transplant rejection, tolerance and hepatic ischemia-reperfusion injury are discussed in this review.
July 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27423762/profiling-immunologic-risk-for-acute-rejection-in-liver-transplantation-recipient-age-is-an-important-risk-factor
#20
Michael L Kueht, Ronald T Cotton, N Thao N Galvan, Christine A O'Mahony, John A Goss, Abbas Rana
BACKGROUND: Careful management of induction and maintenance of immunosuppression is paramount to prevent acute rejection in liver transplantation. A methodical analysis of risk factors for acute cellular rejection may provide a more comprehensive method to profile the immunologic risk of candidates. METHODS: Using registry data from the Organ Procurement and Transplantation Network (OPTN), we identified 42,508 adult recipients who underwent orthotopic liver transplant (OLT) between 2002 and 2013...
September 2016: Transplant Immunology
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