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Dialysis, renal transplantation, rejection,

Nicole A Pilch, Vinayak Rohan, Vinaya Rao, Patrick D Mauldin, Zemin Su, Derek A Dubay, Thomas A Morinelli, David J Taber
BACKGROUND: Several studies have been performed to evaluate surrogate markers of long-term allograft function in renal transplant recipients. These include serum creatinine, estimated glomerular filtration rate (eGFR), slope of eGFR, and more recently eGFR variability. The aim of this study was to measure eGFR slope while assessing the variability of this slope and if high variability occurring at any time post-transplant was predictive of poorer long-term outcomes in a large cohort of kidney transplant recipients...
March 14, 2018: American Journal of Nephrology
Shokoufeh Savaj, Seyedeh Ghazal Hosseini, Ahad J Ghods
INTRODUCTION: Non-human leukocyte antigen antibodies are an independent risk factor for acute rejection in kidney transplant recipients. Among them, angiotensin II receptor type 1 (ART1) antibodies can induce various effects, but their clinical importance in kidney transplant recipients has not been properly explained. This study aimed to evaluate the effect of ART1 antibodies on allograft function and hypertension in stable kidney transplant recipients. MATERIALS AND METHODS: Eighty-one kidney recipients from non- human leukocyte antigen antibodies-matched donors with stable allograft function were examined for estimated glomerular filtration rate (Chronic Kidney Disease-Epidemiology Collaboration formula) and ART1 antibodies (measured using an enzyme-linked immunosorbent assay method)...
March 2018: Iranian Journal of Kidney Diseases
Alexander J Gallan, W James Chon, Michelle A Josephson, Patrick N Cunningham, Kammi J Henriksen, Anthony Chang
Acute T cell-mediated rejection (TCMR) is an important cause of renal allograft loss. The Banff classification for tubulointerstitial (type I) rejection is based on the extent of both interstitial inflammation and tubulitis. Lymphocytes may also be present between parietal epithelial cells and Bowman capsules in this setting, which we have termed "capsulitis." We conducted this study to determine the clinical significance of capsulitis. We identified 42 patients from the pathology archives at the University of Chicago with isolated Banff type I TCMR from 2010-2015...
February 28, 2018: Human Pathology
Mohamed S Al Riyami, Sulaiman Al Saidi, Badria Al Ghaithi, Anisa Al Maskari, Sadiq Lala, Nabil Mohsin, Lekha Hirshikesan, Naifain Al Kalbani
Objectives: This study sought to report 22 years experience in pediatric kidney transplantation in Oman. Methods: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection) graft and patient survival, and duration of follow-up...
January 2018: Oman Medical Journal
Abdol-Mohammad Kajbafzadeh, Reza Khorramirouz, Seyede Maryam Kameli, Behnam Nabavizadeh
End-stage renal disease is becoming a contemporary global concern with increasing prevalence. The available treatment strategies are limited to dialysis and renal transplantation. However, limited organ supply and autoimmune rejection are the shortcomings that limit widespread application of transplantation. Favorably, regenerative medicine is able to provide acellular natural scaffolds for renal transplantation. Experimental surgeries in animal models are a fundamental step in transplantation research. This video presents a practical method for transplantation of bilateral acellular kidneys in a rat model, which could serve as a key step for further research...
February 3, 2018: Journal of Pediatric Urology
Hamidreza Omrani, Alireza Rai, Zahra Daraei, Masoud Sadeghi
Background: Cardiovascular complications are the leading cause of mortality in end-stage renal disease (ESRD) patients. This study aimed to evaluate the efficacy of kidney transplantation on the cardiovascular status in ESRD patients. Methods: During 2012 to 2014 and in a cross-sectional study, 181 patients were randomly selected for this study. All patients were followed for periods of 6 and 12 months after kidney transplantation. The patients with ESRD and kidney transplant recipients; the patients with left ventricle ejection fraction<50%, left ventricular hypertrophy, mitral valve regurgitation and tricuspid valve regurgitation were included to study and the patients with kidney transplant rejection, myocardial infarction, high blood pressure with treatment-resistant, high blood pressure and addicted patients were censored...
December 2017: Medical Archives
L Zhu, H Feng, J D Jia, S Peng, Y Q Li, J F Shao, X F He, Y Guan, H Guo, Z B Lin, G Chen
Objective: To investigate the therapeutic efficacy of tonsillectomy for patients with recurrence of IgA nephropathy (IgAN) after kidney transplantation. Methods: From May 2014, tonsillectomy was performed in 11 renal transplant patients with biopsy-proved recurrent IgAN. In a median follow-up of 14 (4-38) months, data of proteinuria, hematuria, estimated glomerular filtration rate (eGFR), and serum levels of IgA in these patients were compared before and after tonsillectomy.Patient's survival and renal graft survival were also summarized...
January 16, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Rupesh Raina, Joseph Wang, Vinod Krishnappa, Maria Ferris
The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care...
January 16, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Maria Júlia Correia Lima Nepomuceno Araujo, Janaina Almeida Mota Ramalho, Rosilene Motta Elias, Vanda Jorgetti, William Nahas, Melani Custodio, Rosa M A Moysés, Elias David-Neto
BACKGROUND: Although a successful kidney transplant (KTx) improves most of the mineral and bone disorders (MBD) produced by chronic kidney disease (CKD), hyperparathyroidism may persist (pHPT). Current guidelines recommend parathyroidectomy if serum parathormone is persistently elevated 1 year after KTx, because pHPT has been recently associated with poor graft outcomes. However, whether patients with pHPT and adequate renal function are at risk for long-term graft failure is unknown...
January 10, 2018: Surgery
Sailaja Kesiraju, Praneeth Srikanti, S Sahariah
Prevalence of hepatitis C infection, which is associated with mortality and morbidity, is higher in chronic kidney disease patients on hemodialysis and transplant recipients when compared to non HCV infected patients. In addition to the conventional risk factors, HCV infection maybe an additional risk factor in the development of chronic kidney disease. HCV causes adverse effects leading to the poor long term outcome in renal transplant recipients; hepatitis C infection can cause both hepatic as well as extra hepatic complications...
September 2017: Virusdisease
J Martinelli, D Habes, L Majed, C Guettier, E Gonzalès, A Linglart, C Larue, V Furlan, D Pariente, C Baujard, S Branchereau, F Gauthier, E Jacquemin, O Bernard
We report the results of a study of survival, liver and kidney functions, and growth with a median follow-up of 24 years following liver transplantation in childhood. From 1988 to 1993, 128 children underwent deceased donor liver transplantation (median age: 2.5 years). Twenty-year patient and graft survival rates were 79% and 64%, respectively. Raised serum aminotransferase and/or γ-glutamyl transferase activities were present in 42% of survivors after a single transplantation. Graft histology (35 patients) showed signs of chronic rejection in 11 and biliary obstruction in 5...
December 15, 2017: American Journal of Transplantation
Sean A Hebert, Rita D Swinford, David R Hall, Jason K Au, John S Bynon
Universally accepted as the treatment of choice for children needing renal replacement therapy, kidney transplantation affords children the opportunity for an improved quality of life over dialysis therapy. Immunologic and surgical advances over the last 15 years have improved the pediatric patient and kidney graft survival. Unique to pediatrics, congenital genitourinary anomalies are the most common primary diseases leading to kidney failure, many with urological issues. Early urological evaluation for post-transplant bladder dysfunction and emphasis on immunization adherence are the mainstays of pediatric pretransplant and post-transplant evaluations...
November 2017: Advances in Chronic Kidney Disease
Yanli Ding, Jean Francis, Amitabh Gautam, Linda Pelletier, Vaishali Sanchorawala, Karen Quillen
Late occurrence of antibody-mediated rejection (AMR), defined as occurring 6 months after transplantation, is associated with poor renal allograft survival, compared to early acute AMR and acute cellular rejection. The proteasome inhibitor bortezomib has multiple immunomodulatory effects on plasma cells, the source of donor-specific HLA antibodies which mediate AMR. MATERIALS AND METHODS: Consecutive patients who presented with biopsy-proven AMR and donor-specific anti-HLA antibodies (DSA) at a single institution between July 2011 and February 2015 were included...
December 6, 2017: Clinical Nephrology
Mathilde Lemoine, Dominique Guerrot, Dominique Bertrand
Due to the increase in life expectancy and the ageing of end-stage renal disease patients, the number of patients older than 65 years receiving a kidney transplant has been continuously growing over the last fifteen years. The benefits of renal transplantation compared to dialysis in terms of survival and quality of life have been shown in selected recipients over 65, or 70 years. However, the age remains the main limiting factor for the access to the waiting list, and the reluctance of the clinicians can be explained by the multiple comorbidities of these candidates, their limited life expectancy or the shortage of grafts...
November 21, 2017: Néphrologie & Thérapeutique
Burç Dedeoglu, Nicolle H R Litjens, Annelies E de Weerd, Frank Jmf Dor, Mariska Klepper, Derek Reijerkerk, Carla C Baan, Michiel G H Betjes
Background: The T-cell composition within the lymph node (LN) of end-stage renal disease (ESRD) patients differs from the composition within the circulation. Activation of the alloreactive T-cell response within secondary lymphoid organs is important after organ transplantation. However, to date no data are present on LN T-cell subsets and the risk for acute rejection after kidney transplantation. Methods: T cells from LNs of ESRD patients were analyzed for frequency of recent thymic emigrants, relative telomere length, expression of differentiation markers, and were related to the development of early acute rejection (EAR), occurring within 3 months after renal transplantation (RT)...
2017: Frontiers in Immunology
Ismaheel Lawal, Alfred Ankrah, Kehinde Ololade, Moshe Modiselle, Mike Sathekge
RATIONALE: F-18 Fluoro Deoxyglucose positron emission tomography and computed tomography (F-18 FDG PET/CT) is a useful modality in the evaluation of patients with malignancies. Increased incidence of lympho-proliferative disorders has been reported in individuals with long-standing end-stage renal disorders treated with renal replacement therapy. PATIENT CONCERNS: A 30-year-old male on peritoneal dialysis on account of end-stage renal disease. He had acute rejection of an earlier transplanted renal allograft...
November 2017: Medicine (Baltimore)
Sharon L McCartney, Chetan Patel, J Mauricio Del Rio
Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart transplantation is currently 10.7 years. While early graft failure and multiorgan system dysfunction are the most important causes of early mortality, malignancy, rejection, infection, and cardiac allograft vasculopathy contribute to late mortality. Chronic renal dysfunction is common after heart transplantation and occurs in up to 68% of patients by year 10, with 6...
June 2017: Best Practice & Research. Clinical Anaesthesiology
Macaulay Amechi Onuigbo, Nneoma Agbasi
INTRODUCTION: We first described the syndrome of rapid onset end stage renal disease (SORO-ESRD), acute yet irreversible renal failure, in 2010. OBJECTIVE: The impact of SORO-ESRD renal allograft survival remains speculative and we plan to study this question. METHODS: A retrospective analysis of individual adult patient-level serum creatinine trajectories of ESRD patients on maintenance hemodialysis for >90 days at Mayo Clinic, Rochester, 2001-2013...
October 2017: Hemodialysis International
Suraj Mishra, Gaurav Gupta, I Moinuddin, Brian Strife, Uma Prasad, D Massey, Anne King, Dhiren Kumar, Chandra S Bhati
The case of a 39-year-old highly sensitized woman who underwent second renal transplantation after being on warfarin because of a history of frequent thromboses of her left femoral arteriovenous graft (AVG) is reported here. The patient received a flow cytometric positive crossmatch kidney transplant from a deceased donor. Her posttransplant course was complicated by prolonged delayed graft function (DGF) lasting for 9 months. Antibody-mediated rejection occurred in the immediate postoperative period. This resolved after treatment, and resolution was confirmed by repeat biopsy...
October 2017: Transplantation Direct
Mümtaz Yılmaz, Deniz Gökengin, Osman Bozbıyık, Cüneyt Hoşcoşkun, Ayşe Uyan, Hüseyin Töz
End-stage renal disease in the human immunodeficiency virus-positive population is increasing. Kidney transplant is the optimal therapy for this population rather than dialysis modalities if some criteria are met. These include undetectable plasma human immunodeficiency virus RNA, CD4 cell count over 200 cells/μL, and the absence of any AIDS-defining illness. Here, we describe the first living-donor kidney transplant in a human immunodeficiency virus-positive recipient in Turkey. The patient, a 52-year-old male diagnosed as human immunodeficiency virus positive, was on antiretroviral therapy, which consisted of 400 mg twice daily darunavir, 100 mg/day ritonavir, and 50 mg/day dolutegravir...
September 30, 2017: Experimental and Clinical Transplantation
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