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Acute cellular rejection

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https://www.readbyqxmd.com/read/29146891/heart-transplantation-and-risk-of-cardiac-vasculopathy-development-what-factors-are-important
#1
Małgorzata Sobieszczańska-Małek, Jerzy Korewicki, Krzysztof Komuda, Małgorzata Karczmarz, Sylwia Szymańska, Alicja Cicha-Mikołajczyk, Paweł Bekta, Adam Parulski, Maciej Pronicki, Wiesława Grajkowska, Grzegorz Małek, Przemysław Leszek, Maria Kaczorowska, Mariusz Kuśmierczyk, Tomasz Zieliński
BACKGROUND The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL AND METHODS There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest)...
November 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29140405/the-apoptotic-crypt-abscess-an-underappreciated-histologic-finding-in-gastrointestinal-pathology
#2
Geoffrey Talmon, Tristan Manasek, Ross Miller, David Muirhead, Audrey Lazenby
Objectives: To differentiate apoptotic crypt abscesses (ACAs) from neutrophilic crypt abscesses (NCAs). Methods: Cases with crypt abscesses were classified as containing ACAs, NCAs, or mixed crypt abscesses (MCAs) by H&E staining. Sections were stained with cleaved caspase 3 and myeloperoxidase and recategorized. Results: Fifty-nine cases were reviewed: inflammatory bowel disease (IBD; n = 33), acute cellular rejection (n = 5), graft vs host disease (GVHD; n = 14), cytomegalovirus (n = 5), and drug reaction (n = 2)...
November 11, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29139621/paneth-and-intestinal-stem-cells-preserve-their-functional-integrity-during-worsening-of-acute-cellular-rejection-in-small-bowel-transplantation
#3
M Pucci Molineris, V Gonzalez Polo, Federico Perez, D Ramisch, M Rumbo, G E Gondolesi, D Meier
Graft survival after small bowel transplantation remains impaired due to acute cellular rejection (ACR), the leading cause of graft loss. Although it was shown that the number of enteroendocrine progenitor cells in intestinal crypts was reduced during mild ACR, no results of Paneth and intestinal stem cells localized at the crypt bottom have been shown so far. Therefore, we wanted to elucidate integrity and functionality of the Paneth and stem cells during different degrees of ACR, and to assess whether these cells are the primary targets of the rejection process...
November 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29130775/results-of-native-and-transplant-kidney-biopsies-of-children-in-a-single-center-over-a-15-years-period
#4
Emel Isiyel, Kibriya Fidan, Bahar Buyukkaragoz, Meltem Akcaboy, Yasar Kandur, Ipek Isik Gonul, Necla Buyan, Sevcan Bakkaloglu, Oguz Soylemezoglu
Renal biopsy is an important diagnostic procedure in pediatric nephrology. This study retrospectively investigates the indications, results and complications in a single tertiary children's hospital in Turkey. We evaluated the native and transplant kidney biopsies in Gazi University Pediatric Nephrology Department between 2001 and 2015. A total of 196 biopsies (144 natives and 52 transplants) were included into the study. The mean age of the patients was respectively 10.8 ± 3.5, 13.9 ± 1.5 years...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/29128017/acute-rejection-and-antibody-mediated-rejection-in-lung-transplantation
#5
REVIEW
Ramsey R Hachem
Despite advances in immunosuppression over the past 25 years, acute cellular rejection remains a common complication early after lung transplantation. Although acute cellular rejection has often not resulted in clinical signs or symptoms of allograft dysfunction, it has been widely recognized as a strong independent risk factor for the development of chronic rejection, emphasizing its clinical significance. In recent years, the role of humoral immunity in lung rejection has been increasingly appreciated, and antibody-mediated rejection is now recognized as a form of rejection that may result in allograft failure...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29122645/interleukin-33-levels-are-elevated-in-chronic-allograft-dysfunction-of-kidney-transplant-recipients-and-promotes-epithelial-to-mesenchymal-transition-of-human-kidney-hk-2-cells
#6
Zhen Xu, Chunchun Zhao, Zijie Wang, Jun Tao, Zhijian Han, Wei Zhang, Ruoyun Tan, Min Gu
This study is aimed to investigate the potential role of interleukin (IL)-33 in transplanted kidney interstitial fibrosis and the associated mechanism. Serum IL-33 levels were detected using an enzyme-linked immunosorbent assay (ELISA) in healthy volunteers, stable kidney transplantation recipients (KTRs) (stable), KTRs with acute rejection (AR), and KTRs with chronic allograft dysfunction (CAD) (CAD). Immunohistochemical (IHC) staining, Western blotting, and quantitative real-time PCR (qRT-PCR) were used to detect the expression of IL-33 in human kidney tissues obtained from control and CAD patients...
November 6, 2017: Gene
https://www.readbyqxmd.com/read/29121125/presumed-serum-sickness-following-thymoglobulin-treatment-of-acute-cellular-rejection-of-a-cardiac-allograft
#7
Vladimir Ratushny, Brian C Capell, Misha Rosenbach
Serum sickness is a hypersensitivity reaction to proteins in antiserum derived from nonhuman animal sources and can be seen in patients being treated with antiserum to prevent transplant rejection. Serum sickness may display variable clinical presentations. Because cutaneous findings may be the initial symptom in some cases, it is important for dermatologists to be able to recognize this condition given its potentially life-threatening symptoms. We present a case of a 35-year-old man with presumed serum sickness after receiving thymoglobulin for the treatment of acute cellular rejection of a heart transplant...
September 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29119293/asparaginase-erwinia-chrysanthemi-effectively-depletes-plasma-glutamine-in-adult-patients-with-relapsed-refractory-acute-myeloid-leukemia
#8
Ashkan Emadi, Jennie Y Law, Erin T Strovel, Rena G Lapidus, Linda J B Jeng, Myounghee Lee, Miriam G Blitzer, Brandon A Carter-Cooper, Danielle Sewell, Isabella Van Der Merwe, Sunita Philip, Mohammad Imran, Stephen L Yu, Hongxia Li, Philip C Amrein, Vu H Duong, Edward A Sausville, Maria R Baer, Amir T Fathi, Zeba Singh, Søren M Bentzen
Depletion of glutamine (Gln) has emerged as a potential therapeutic approach in the treatment of acute myeloid leukemia (AML), as neoplastic cells require Gln for synthesis of cellular components essential for survival. Asparaginases deplete Gln, and asparaginase derived from Erwinia chrysanthemi (Erwinaze) appears to have the greatest glutaminase activity of the available asparaginases. In this Phase I study, we sought to determine the dose of Erwinaze that safely and effectively depletes plasma Gln levels to ≤ 120 μmol/L in patients with relapsed or refractory (R/R) AML...
November 8, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#9
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29116389/development-of-cd3-cell-quantitation-algorithms-for-renal-allograft-biopsy-rejection-assessment-utilizing-open-source-image-analysis-software
#10
Andres Moon, Geoffrey H Smith, Jun Kong, Thomas E Rogers, Carla L Ellis, Alton B Brad Farris
Renal allograft rejection diagnosis depends on assessment of parameters such as interstitial inflammation; however, studies have shown interobserver variability regarding interstitial inflammation assessment. Since automated image analysis quantitation can be reproducible, we devised customized analysis methods for CD3+ T-cell staining density as a measure of rejection severity and compared them with established commercial methods along with visual assessment. Renal biopsy CD3 immunohistochemistry slides (n = 45), including renal allografts with various degrees of acute cellular rejection (ACR) were scanned for whole slide images (WSIs)...
November 8, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/29071779/risk-factors-and-clinical-outcomes-of-pediatric-liver-transplant-recipients-with-post-transplant-lymphoproliferative-disease-in-a-multi-ethnic-asian-cohort
#11
James Guoxian Huang, Mervin Ye Qing Tan, Seng-Hock Quak, Marion Margaret Aw
BACKGROUND: We aimed to evaluate clinical characteristics, risk factors, and disease outcomes for liver transplant recipients (LTR) with post-transplant lymphoproliferative disease (PTLD) at our center. METHODS: Retrospective review of data of all pediatric LTR (1991-2015) was conducted. RESULTS: The overall incidence of PTLD was 16.4% (18/110), the majority (13/18) were early lesions, while 3/18 were polymorphic/monomorphic PTLD. The risk factors significant on univariate analysis were as follows: mean age (years) at transplant (1...
October 26, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29053910/a-simplified-protocol-using-rituximab-and-immunoglobulin-for-abo-incompatible-low-titre-living-donor-liver-transplantation
#12
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
BACKGROUND & AIMS: No consensus has been reached regarding optimal treatment strategies for ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). We introduce a simplified protocol using rituximab and intravenous immunoglobulin (IVIG). METHODS: Data were analysed on adult patients who underwent ABO-I LDLT of which protocol added rituximab (300 mg/m(2) ) before surgery and IVIG (0.8 g/kg) on post-operative days 1 and 4 to the conventional immunosuppressive regimen used in ABO-compatible (ABO-C) LDLT, without plasmapheresis, splenectomy or graft local infusion...
October 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29030994/transplant-tourism-following-the-declaration-of-istanbul-poor-outcomes-and-nephrologist-dilemma
#13
Meteb M AlBugami, Fahad E AlOtaibe, Abdulnaser M AlAbadi, Khaled Hamawi, Khalid Bel'eed-Akkari
BACKGROUND: Transplant tourism (TT) violates many international laws and documents. Despite all efforts, TT seems to be increasing. The aim of this study is to review outcomes of recipients of commercially transplanted kidneys since the Declaration of Istanbul. METHODS: All recipients of kidney transplantation done abroad and then returned to our center, from September 2008 to December 2015, were included (tourists). Demographics and outcomes were collected from patients' charts...
October 14, 2017: Nephrology
https://www.readbyqxmd.com/read/29030720/molecular-diagnostic-testing-in-cardiac-transplantation
#14
REVIEW
Kiran Khush, Shirin Zarafshar
PURPOSE OF REVIEW: Acute rejection is one of the most feared complications of cardiac transplantation. Developing non-invasive methods for detection and surveillance of acute rejection have long been a goal for post-transplant care. RECENT FINDINGS: Here, we will review molecular diagnostic tests that are currently in use or under development to diagnose acute cellular rejection after cardiac transplantation. Gene expression, microRNA, molecular microscope, and cell-free DNA assays offer non-invasive alternatives to the endomyocardial biopsy for acute rejection surveillance...
October 13, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/29023354/effects-of-hypercapnia-on-acute-cellular-rejection-after-lung-transplantation-in-rats
#15
Jing Tan, Yanhong Liu, Tao Jiang, Ling Wang, Can Zhao, Dongfang Shen, Xiaoguang Cui
BACKGROUND: Hypercapnia alleviates pulmonary ischemia-reperfusion injury, regulates T lymphocytes, and inhibits immune reaction. This study aimed to evaluate the effect of hypercapnia on acute cellular rejection in a rat lung transplantation model. METHODS: Recipient rats in sham-operated (Wistar), isograft (Wistar to Wistar), and allograft (Sprague-Dawley to Wistar) groups were ventilated with 50% oxygen, whereas rats in the hypercapnia (Sprague-Dawley to Wistar) group were administered 50% oxygen and 8% carbon dioxide for 90 min during reperfusion (n = 8)...
October 12, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28990220/low-dose-basiliximab-induction-therapy-in-heart-transplantation
#16
Veraprapas Kittipibul, Pakpoom Tantrachoti, Pat Ongcharit, Aekarach Ariyachaipanich, Sarawut Siwamogsatham, Supaporn Sritangsirikul, Kanokwan Thammanatsakul, Sarinya Puwanant
We prospectively studied efficacy and safety outcomes of two 10-mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2-week assessment post-transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT grade ≥ 2R. By the 1-year assessment post-transplant, there were 1 (6%) infectious death, no graft failure, 2 (12%) grade 2R ACRs, 6 (35%) asymptomatic CMV infections, and 4 (25%) treated infections...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28985848/transforming-growth-factor-%C3%AE-1-and-fas-ligand-synergistically-enhance-immune-tolerance-in-dendritic-cells-in-liver-transplantation
#17
Minglian Qiu, Yujuan Chen, Lihong Chen, Jinhua Zeng, Jingfeng Liu
BACKGROUND: Long-term survival of patients following liver transplantation can be achieved by application of genetically modified, immune tolerogenic immature dendritic cells (imDCs) to overcome allograft-induced acute cellular rejection, a major cause of death. In this study, using a rat model of liver transplantation, we determined whether cotransfection of transforming growth factor β1 (TGF-β1) and Fas ligand (FasL) in imDCs synergistically enhances immune tolerance. MATERIALS AND METHODS: We first determined the immune tolerogenic effects of TGF-β1 and FasL independently or together in imDCs by measuring the levels of CD86 and CD80 and by assessing T-cell proliferation using mixed lymphocyte reaction tests...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28974434/graft-immunologic-events-in-deceased-donor-kidney-transplant-recipients-with-preformed-hla-donor-specific-antibodies
#18
Xicohténcatl Ixtlapale-Carmona, Adriana Arvizu, Adrian De-Santiago, Norma González-Tableros, Mayra López, Natalia Castelán, Lluvia A Marino, Norma O Uribe-Uribe, Alan G Contreras, Mario Vilatobá, Luis E Morales-Buenrostro, Josefina Alberú
INTRODUCTION: Pretransplant donor-specific HLA alloantibodies detected with the Single Antigen Bead (SAB) assay reflect an increased risk for acute antibody-mediated rejection (AMR). We herein report the incidence of both acute AMR and acute cellular rejection (ACR) during the first year posttransplantation, in a cohort of kidney transplant recipients (KTR) of deceased donor (DD) grafts, according to their DSA status. Pretransplant DSA do not preclude DD-KT in negative CDC-XM recipients at our center...
September 30, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28969528/intrapatient-variability-in-tacrolimus-exposure-does-not-predict-the-development-of-cardiac-allograft-vasculopathy-after-heart-transplant
#19
Nauras Shuker, Rachida Bouamar, Dennis A Hesselink, Teun van Gelder, Kadir Caliskan, Olivier C Manintveld, Aggie H Balk, Alina A Constantinescu
OBJECTIVE: A high intrapatient variability in tacrolimus exposure is associated with poor long-term outcomes after kidney transplant. We hypothesized that a high intrapatient variability of tacrolimus exposure after heart transplant may be associated with cardiac allograft vasculopathy as a determinant of long-term survival of heart transplant recipients. MATERIALS AND METHODS: Eighty-six heart transplant recipients were included. Patients underwent coronary angiography at years 1 and 4 after transplant and were divided according to low and high intrapatient variability of tacrolimus exposure, with the median variability as cut-off...
September 30, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28945480/myriad-applications-of-circulating-cell-free-dna-in-precision-organ-transplant-monitoring
#20
Philip Burnham, Kiran Khush, Iwijn De Vlaminck
Solid organ transplantation remains the preferred treatment for many end-stage organ diseases, but complications due to acute rejection and infection occur frequently and undermine its long-term benefits. Monitoring of the health of the allograft is therefore a critically important component of post-transplant therapy. Here, we review several emerging applications of circulating cell-free DNA (cfDNA) in the post-transplant monitoring of rejection, infection, and immunosuppression. We further discuss the cellular origins and salient biophysical properties of cfDNA...
September 2017: Annals of the American Thoracic Society
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