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https://www.readbyqxmd.com/read/29738100/steroid-free-three-drug-maintenance-regimen-for-pancreas-transplant-alone-comparison-of-induction-with-rabbit-antithymocyte-globulin-rituximab
#1
Jonathan Fridell, Richard Mangus, Jeanne Chen, Tim Taber, Arianna E Cabrales, Asif Sharfuddin, Muhammad Yaqub, John Powelson
Graft survival following pancreas transplant alone (PTA) is inferior to other pancreas transplants. Steroid elimination is appealing, but a two drug maintenance strategy may be inadequate. Additionally, recipients tend to have diabetic nephropathy and do not tolerate nephrotoxic medications. A three-drug maintenance strategy permits immunosuppression through different mechanisms as well as an opportunity to use lower doses of the individual medications. Induction consisted of five doses of rabbit antithymocyte globulin (1 mg/kg/dose)...
May 8, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29731924/the-spectrum-of-histopathological-changes-in-the-renal-allograft-a-12-months-protocol-biopsy-study
#2
Galina Severova-Andreevska, Ladislava Grcevska, Gordana Petrushevska, Koco Cakalaroski, Aleksandar Sikole, Olivera Stojceva-Taneva, Ilina Danilovska, Ninoslav Ivanovski
INTRODUCTION: Renal transplantation became a routine and successful medical treatment for Chronic Kidney Disease in the last 30 years all over the world. Introduction of Luminex based Single Antigen Beads (SAB) and recent BANFF consensus of histopathological phenotypes of different forms of rejection enables more precise diagnosis and changes the therapeutic approach. The graft biopsies, protocol or cause, indicated, remain a golden diagnostic tool for clinical follow up of kidney transplant recipients (KTR)...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29701351/heart-transplantation-early-results-of-two-different-regimes-of-immnunosuppression
#3
Carlos Branco, David Prieto, André Antunes, Manuel Batista, Manuel J Antunes
INTRODUCTION: The management of induction and maintenance immunosuppression therapy after heart transplantation (HT) remains a controversial issue. The dosage and the timing has been a changing target. We aimed at evaluate the incidence of acute cellular rejection (ACR) [≥1R grade], major infection and survival in first year after HT in patients receiving two different induction immunosuppression regimes and with a reduction in intensity of triple maintenance immunosuppression dose...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29688072/steroid-free-immunosuppression-with-low-dose-tacrolimus-is-safe-and-significantly-reduces-the-incidence-of-new-onset-diabetes-mellitus-following-liver-transplantation
#4
M Castedal, C Skoglund, C Axelson, W Bennet
OBJECTIVES: Corticosteroids (CS) are traditionally used as part of the basal immunosuppression (IS) following liver transplantation (LT) but are known to be associated with an increased risk of new-onset diabetes mellitus (NODM), cardiovascular morbidity and mortality. The aim of this study was to retrospectively compare the incidence of transient as well as persistent NODM, rejection rate and patient- and graft survival between patients receiving steroid-based and steroid-free maintenance IS...
April 24, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29661440/renopancreatic-transplantation-evaluation-of-15-years-in-131-patients
#5
C G Marmanillo, C Langaro, J E Nicoluzzi, R T Belila, M Macri, R Zamprogna, M Luvizotto, M Takahashi
BACKGROUND: The most common multiple-organ transplant is the simultaneous pancreas-kidney transplantation (SPK). It is usually offered to patients who have insulin-dependent diabetes mellitus and those with diabetic nephropathy and renal failure that has already been established. In this study we present the results of 15 years of SPK in a transplant hospital center in Paraná, Brazil, and evaluated survival, immunosuppression, and transplant-related problems. METHODS: This study was a retrospective analysis of 131 SPK transplants performed at the Angelina Caron Hospital between January 2001 and December 2015...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29602266/cmv-infection-in-heart-transplantation-a-single-center-experience
#6
Ignacio A Echenique, Michael P Angarone, Jonathan Rich, Allen S Anderson, Valentina Stosor
BACKGROUND: CMV infection remains a major complication after heart transplantation with varying prophylaxis strategies employed. We sought to determine the impact of valganciclovir (VGC) duration on the epidemiology of CMV infections after heart transplantation. METHODS: We performed a prospective cohort study of CMV donor (D) or recipient (R) seropositive heart transplant recipients from 2005-2012 who completed VGC prophylaxis, ranging from 3-12 months according to serostatus and induction immunosuppression...
March 30, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29423200/idiopathic-membranous-nephropathy-in-patients-with-diabetes-mellitus-a-diagnostic-and-therapeutic-quandary
#7
Dharmendra Bhadauria, Anand Chellappan, Anupma Kaul, Praveen Etta, Vinay Badri, Raj Kumar Sharma, Narayan Prasad, Amit Gupta, Manoj Jain
Background: Proteinuria and renal dysfunction is common in diabetic patients and may occur due to variety of causes. Nondiabetic renal diseases (NDRD) account for 30% of the renal biopsies, and idiopathic membranous nephropathy (iMN) is a common non diabetic glomerular disease that can exist alone or in combination with diabetic nephropathy (DN). Immunosuppressants used in iMN may be associated with complications of worsening glycemic control and recurrent infections. There is a paucity of literature on the clinical course, outcomes and treatment adverse effects of patients with iMN and diabetes...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29259387/simultaneous-liver-pancreas-duodenum-and-kidney-transplantation-in-a-patient-with-hepatitis-b-cirrhosis-uremia-and-insulin-dependent-diabetes-mellitus
#8
Jiang Li, Qing-Jun Guo, Jin-Zhen Cai, Cheng Pan, Zhong-Yang Shen, Wen-Tao Jiang
Simultaneous liver, pancreas-duodenum, and kidney transplantation has been rarely reported in the literature. Here we present a new and more efficient en bloc technique that combines classic orthotopic liver and pancreas-duodenum transplantation and heterotopic kidney transplantation for a male patient aged 44 years who had hepatitis B related cirrhosis, renal failure, and insulin dependent diabetes mellitus (IDDM). A quadruple immunosuppressive regimen including induction with basiliximab and maintenance therapy with tacrolimus, mycophenolate mofetil, and steroids was used in the early stage post-transplant...
December 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28943556/central-diabetes-insipidus-in-refractory-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#9
Keiji Ohashi, Michiko Morishita, Haruki Watanabe, Ken-Ei Sada, Takayuki Katsuyama, Yoshia Miyawaki, Eri Katsuyama, Mariko Narazaki, Noriko Tatebe, Katsue Watanabe, Tomoko Kawabata, Jun Wada
We herein describe two cases of refractory antineutrophil cytoplasmic antibody-associated vasculitis (AAV) complicated with diabetes insipidus (DI) possibly related to hypertrophic pachymeningitis (HP). One patient had microscopic polyangiitis and HP, which were refractory to cyclophosphamide, azathioprine, rituximab, mycophenolate mofetil (MMF), and mizoribine. Remission was finally achieved with the use of etanercept, but DI occurred 5 years later. The other patient had granulomatosis with polyangiitis, which that was refractory to cyclophosphamide, methotrexate, MMF, and rituximab...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28873970/immunosuppressive-agents-in-adult-kidney-transplantation-in-the-national-health-service-a-model-based-economic-evaluation
#10
Tristan M Snowsill, Jason Moore, Ruben E Mujica Mota, Jaime L Peters, Tracey L Jones-Hughes, Nicola J Huxley, Helen F Coelho, Marcela Haasova, Chris Cooper, Jenny A Lowe, Jo L Varley-Campbell, Louise Crathorne, Matt J Allwood, Rob Anderson
Background: Immunosuppression is required in kidney transplantation to prevent rejection and prolong graft survival. We conducted an economic evaluation to support England's National Institute for Health and Care Excellence in developing updated guidance on the use of immunosuppression, incorporating new immunosuppressive agents, and addressing changes in pricing and the evidence base. Methods: A discrete-time state transition model was developed to simulate adult kidney transplant patients over their lifetime...
July 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28860788/impact-of-immunosuppressant-therapy-on-new-onset-diabetes-in-liver-transplant-recipients
#11
Fu-Chao Liu, Huan-Tang Lin, Jr-Rung Lin, Huang-Ping Yu
This nationwide, population-based study aimed to clarify the effects of immunosuppressive regimens on new-onset diabetes after liver transplantation (NODALT). The National Health Insurance database of Taiwan was explored for patients who received liver transplantation without pre-transplant diabetes from 1998 to 2012. Information regarding clinical conditions and immunosuppressant utilization among these patients was analyzed statistically. Of the 2,140 patients included in our study, 189 (8.8%) developed NODALT...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28757006/-pulmonary-mucormycosis-in-a-patient-with-kidney-transplant-and-uncontrolled-haemoptysis
#12
Dulce Iliana Navarro Vergara, Gloria Barragán Pola, Alexandro Bonifaz, Carlos Núñez Pérez-Redondo, Omar Choreño García, Raúl Cicero Sabido
BACKGROUND: Pulmonary mucormycosis is a rare opportunistic infection with high mortality that is caused by species of Mucorales. The most common species involved are Rhizopus, Mucor, Lichtheimia, and Rhizomucor. CASE REPORT: A 56 year-old woman presented with a clinical history of diabetes mellitus type 2 and chronic renal disease. She underwent a cadaveric kidney transplantation two years before her admission, for which immunomodulating therapy with thymoglobulin, tacrolimus, mofetil-microphenolate and prednisone was established...
July 27, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28683654/efficacy-and-safety-of-multitarget-therapy-with-cyclophosphamide-and-tacrolimus-for-lupus-nephritis-a-prospective-single-arm-single-centre-open-label-pilot-study-in-japan
#13
R Sakai, T Kurasawa, E Nishi, T Kondo, Y Okada, A Shibata, K Nishimura, K Chino, A Okuyama, H Takei, H Nagasawa, K Amano
Background Pulsed cyclophosphamide or mycophenolate mofetil for lupus nephritis has limited efficacy. We previously reported a case of mixed-class IV + V lupus nephritis successfully treated with cyclophosphamide and tacrolimus. This study assessed the efficacy and safety of multitarget therapy with cyclophosphamide and tacrolimus for the treatment of lupus nephritis. Methods In a prospective, single-arm, open label pilot study, we recruited 15 patients aged 18-64 years with active lupus nephritis who met the American College of Rheumatology criteria for a diagnosis of systemic lupus erythematosus (1997)...
February 2018: Lupus
https://www.readbyqxmd.com/read/28662293/retrospective-evaluation-of-the-efficacy-and-safety-of-belatacept-with-thymoglobulin-induction-and-maintenance-everolimus-a-single-center-clinical-experience
#14
David Wojciechowski, Sindhu Chandran, Joshua Y C Yang, Minnie M Sarwal, Flavio Vincenti
Belatacept use has been constrained by higher rates of acute rejection. We hypothesized that belatacept with low-dose rATG and initial mycophenolate maintenance with conversion to everolimus at 1 month post-transplant ± corticosteroids would improve efficacy and maintain safety. Retrospective single-center analysis of the first 44 low immunologic risk kidney transplant recipients treated with this regimen. The cohort was 59% male, mean age at transplant of 57 years. Diabetes was the most common cause of ESRD (39%)...
September 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28609764/hemodialysis-and-kidney-transplantation-as-predisposing-conditions-to-onychomycosis
#15
Antonio M S Filho, Carlucci G Ventura, Paulo R Criado, Gilda B Del Negro, Roseli S Freitas, Olinda C Luiz, Mauro C Giudice, Elias D Neto, Gil Benard
BACKGROUND/AIM: Onychomycosis (OM) is one of the commonest superficial fungal infections. Patients undergoing hemodialysis (HD) treatment and kidney transplant recipients (KTR) are considered at risk of contracting fungal infections, but the few published data do not reach the conclusion of whether they are predisposed to OM. This study aimed to determine the prevalence and etiology of OM in these patients and to determine the antifungal susceptibility profile of the isolated fungal species...
2017: Nephron
https://www.readbyqxmd.com/read/28457383/kidney-transplantation-in-alstr%C3%A3-m-syndrome-case-report
#16
L Poli, G Arroyo, M Garofalo, E Choppin de Janvry, G Intini, A Saracino, R Pretagostini, F Della Pietra, P B Berloco
The Alström syndrome is a rare genetic disorder, inherited in an autosomal recessive manner. It has recently been classified as a ciliopathic disorder. Alström syndrome is a multiorgan pathology characterized by cone-rod dystrophy, hearing loss, childhood truncal obesity, insulin resistance and hyperinsulinemia, type 2 diabetes mellitus, dyslipidemia, short stature in adulthood, hypothyroidism, hypogonadism, dilated or restrictive cardiomyopathy, and progressive pulmonary, hepatic, and renal dysfunction. End-stage renal disease can occur as early as the late teens and is the leading cause of death...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28261211/targeting-the-monocyte-macrophage-lineage-in-solid-organ-transplantation
#17
REVIEW
Thierry P P van den Bosch, Nynke M Kannegieter, Dennis A Hesselink, Carla C Baan, Ajda T Rowshani
There is an unmet clinical need for immunotherapeutic strategies that specifically target the active immune cells participating in the process of rejection after solid organ transplantation. The monocyte-macrophage cell lineage is increasingly recognized as a major player in acute and chronic allograft immunopathology. The dominant presence of cells of this lineage in rejecting allograft tissue is associated with worse graft function and survival. Monocytes and macrophages contribute to alloimmunity via diverse pathways: antigen processing and presentation, costimulation, pro-inflammatory cytokine production, and tissue repair...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28240590/a-meta-analysis-of-avascular-necrosis-in-systemic-lupus-erythematosus-prevalence-and-risk-factors
#18
REVIEW
Tatiana Nevskaya, Maeve P Gamble, Janet E Pope
OBJECTIVES: To determine the prevalence of and risk factors for avascular necrosis (AVN) in systemic lupus erythematosus (SLE). METHODS: MEDLINE, CINAHL, Web of Science, EMBASE and Cochrane Library were searched from inception to July, 2015 and a random effects model was used to combine frequencies; study quality was assessed using STROBE. RESULTS: 2,041 citations identified 62 articles. Many results had high heterogeneity. The prevalence of symptomatic AVN was 9% (range 0...
July 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28215945/mycophenolate-mofetil-combined-with-prednisone-versus-full-dose-prednisone-in-iga-nephropathy-with-active-proliferative-lesions-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Jin-Hua Hou, Wei-Bo Le, Nan Chen, Wei-Ming Wang, Zhang-Suo Liu, Dong Liu, Jiang-Hua Chen, Jiong Tian, Ping Fu, Zhang-Xue Hu, Cai-Hong Zeng, Shao-Shan Liang, Min-Lin Zhou, Hai-Tao Zhang, Zhi-Hong Liu
BACKGROUND: Observational studies suggest that patients with immunoglobulin A nephropathy (IgAN) with active proliferative lesions show a good response to immunosuppressive treatment. STUDY DESIGN: Multicenter, prospective, randomized, controlled trial. SETTING & PARTICIPANTS: 176 patients with IgAN with active proliferative lesions (cellular and fibrocellular crescents, endocapillary hypercellularity, or necrosis), proteinuria with protein excretion ≥ 1...
June 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28160394/cardiovascular-morbidity-and-mortality-after-liver-transplantation-the-protective-role-of-mycophenolate-mofetil
#20
MULTICENTER STUDY
Delia D'Avola, Valentín Cuervas-Mons, Josep Martí, Jorge Ortiz de Urbina, Laura Lladó, Carlos Jimenez, Esteban Otero, Francisco Suarez, Juan M Rodrigo, Miguel-Angel Gómez, Enrique Fraga, Pedro Lopez, M Trinidad Serrano, Antonio Rios, Emilio Fábrega, José Ignacio Herrero
Cardiovascular (CV) diseases are recognized longterm causes of death after liver transplantation (LT). The objective of this multicenter study was to analyze the prevalence and the evolution of CV risk factors and CV morbidity and mortality in 1819 LT recipients along 5 years after LT. The influence of baseline variables on survival, morbidity, and mortality was studied. There was a continuous and significant increase of the prevalence of all the CV risk factors (except smoking) after LT. CV diseases were the fourth cause of mortality in the 5 years after LT, causing 12% of deaths during the follow-up...
April 2017: Liver Transplantation
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