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Acute cellular rejection

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https://www.readbyqxmd.com/read/28326855/impact-of-postoperative-pulmonary-hypertension-on-outcome-after-heart-transplantation
#1
Jakob Lundgren, Carl Söderlund, Göran Rådegran
OBJECTIVES: We wanted to investigate the effects of postoperative pulmonary hypertension (PHpostop: mean pulmonary artery pressure [MPAP] ≥ 25 mmHg), diastolic pressure gradient (DPG), pulmonary vascular resistance (PVR), and repeated hemodynamic measurements on long-term survival after heart transplantation (HT). DESIGN: Eighty-nine patients who underwent HT at Skåne University Hospital in Lund in the period 1988-2010 and who were evaluated with right-heart-catheterization at rest, prior to HT and repeatedly during the first postoperative year, were grouped based on their MPAP, DPG, and PVR...
March 22, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28316844/aspergillus-pericarditis-with-tamponade-in-a-renal-transplant-patient
#2
Sylvia Biso, Rapeepat Lekkham, Antoinette Climaco
Aspergillus pericarditis is a rare and life-threatening infection in immunosuppressed patients. It has nonspecific clinical manifestations that often mimic other disease entities especially in patients who have extensive comorbidities. Diagnosis is oftentimes delayed and rarely done antemortem. A high degree of suspicion in immunocompromised patients is necessary for evaluation and timely diagnosis. This is a case of Aspergillus pericarditis with cardiac tamponade in a renal transplant patient with liver cirrhosis...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28314071/epidemiology-risk-factors-and-outcome-of-clostridium-difficile-infection-in-heart-and-heart-lung-transplant-recipients
#3
Jackrapong Bruminhent, Kelly A Cawcutt, Charat Thongprayoon, Tanya M Petterson, Walter K Kremers, Raymund R Razonable
BACKGROUND: Clostridium difficile is a major cause of diarrhea in thoracic organ transplant recipients. We investigated the epidemiology, risk factors and outcome of Clostridium difficile infection (CDI) in heart and heart-lung transplant (HT) recipients. METHODS: This is a retrospective study from 2004-2013. CDI was defined by diarrhea and a positive toxigenic Clostridium difficile in stool measured by toxin enzyme immunoassay (2004-2006) or polymerase chain reaction (2007-2013)...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28314052/incidence-of-acute-cellular-rejection-following-granulocyte-colony-stimulating-factor-administration-in-lung-transplantation-a-retrospective-case-cohort-analysis
#4
Nicole Casciello, Amanda Hulbert, Laurie Snyder, Jennifer Byrns
Granulocyte colony-stimulating factor (GCSF) is an option to treat leukopenia in lung transplant recipients. Conflicting evidence exists regarding its effects on acute cellular rejection (ACR). A retrospective, case-cohort study was conducted to assess whether the use of GCSF in lung transplant recipients is associated with an increased incidence of ACR. Patients had to have received at least one dose of GCSF but were excluded if they received GCSF within 30 days prior to transplant or received a lymphocyte-depleting agent within 14 days of GCSF administration...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28306671/noninvasive-monitoring-of-acute-and-chronic-rejection-in-heart-transplantation
#5
Maria G Crespo-Leiro, Gonzalo Barge-Caballero, David Couto-Mallon
PURPOSE OF REVIEW: Recent years have seen advances in the early detection of cardiac graft rejection. RECENT FINDINGS: We review the possibilities offered by tissue Doppler imaging and speckle tracking echocardiography, cardiac magnetic resonance, cardiac computed tomography, single positron emission tomography, gene expression profiling, and quantitation of donor-derived cell-free DNA, and microRNAs. SUMMARY: Noninvasive monitoring of acute and chronic rejection after cardiac transplantation is an unmet need and remains a challenge...
March 16, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28299025/interleukin-28b-rs12979860-c-t-polymorphism-and-acute-cellular-rejection-after-liver-transplantation
#6
H Fereidooni, N Azarpira, R Yaghobi, A Vahdati, S A Malek-Hoseini
BACKGROUND: Interleukin-28 (IL-28B) rs12979860 C/T polymorphism is a known predictor of sustained virological response after antiviral treatment in hepatitis C. IL-28B affects the innate immune system as well as intrahepatic expression level of interferon-stimulated genes. OBJECTIVE: To investigate the effect of recipient IL-28B polymorphism on occurrence of acute rejection after liver transplantation. METHODS: 140 liver allograft recipients were selected...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#7
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T-cells were measured using an interferon-γ Elispot-assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28295657/severe-acute-cellular-rejection-after-intestinal-transplantation-is-associated-with-poor-patient-and-graft-survival
#8
Genevieve Huard, Thomas D Schiano, Jang Moon, Kishore Iyer
BACKGROUND: Severe acute cellular rejection (ACR) occurs frequently after intestinal transplantation (ITx). AIM: To evaluate the outcomes and the risk factors for graft failure and mortality in patients with severe ACR after ITx. METHODS: Retrospective study evaluating all ITx recipients who developed severe ACR between 01/2000 and 07/2014. Demographic and histologic data were reviewed. RESULTS: 20/126 (15.9%) ITx recipients developed severe ACR...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28280702/mycophenolate-mofetil-toxicity-mimicking-acute-cellular-rejection-in-a-small-intestinal-transplant
#9
Ross Apostolov, Khashayar Asadi, Julie Lokan, Ning Kam, Adam Testro
Mycophenolate mofetil (MMF) is an important medication used for maintenance immunosuppression in solid organ transplants. A common gastrointestinal (GI) side effect of MMF is enterocolitis, which has been associated with multiple histological features. There is little data in the literature describing the histological effects of MMF in small intestinal transplant (SIT) recipients. We present a case of MMF toxicity in a SIT recipient, with histological changes in the donor ileum mimicking persistent acute cellular rejection (ACR)...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28273390/purpureocillium-lilacinum-tattoo-related-skin-infection-in-a-kidney-transplant-recipient
#10
Sonya A Trinh, Michael P Angarone
Purpureocillium lilacinum is an emerging pathogenic mold among immunocompromised hosts that causes cutaneous infections related to skin breakdown. We present the first reported case of P. lilacinum tattoo-related skin infection, to our knowledge. A kidney transplant recipient recently treated for acute cellular rejection presented with skin papules overlying a tattoo. Diagnosis was confirmed on culture, histology, and 18s ribosomal RNA polymerase chain reaction. The morphological features on culture characteristic of P...
March 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28273385/effect-of-aerosolized-antipseudomonals-on-pseudomonas-positivity-and-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#11
Cody A Moore, Joseph M Pilewski, Raman Venkataraman, Keven M Robinson, Matthew R Morrell, Stephen R Wisniewski, Adriana Zeevi, John F McDyer, Christopher R Ensor
PURPOSE: To describe the effects of aerosolized antipseudomonals (AAP) on Pseudomonas (PS) culture positivity, bronchiolitis obliterans syndrome (BOS), and acute cellular rejection (ACR) in lung transplant recipients (LTRs). METHODS: Single-center, retrospective cohort study of adult LTRs treated with either AAP for ≥28 days vs no AAP therapy or AAP therapy <28 days, indexed to a matched median date post lung transplantation (LT). Primary outcome was freedom from PS positivity by positive bronchoalveolar lavage (BAL) or bronchial wash at 1 year...
March 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28262440/telomere-length-in-patients-with-pulmonary-fibrosis-associated-with-chronic-lung-allograft-dysfunction-and-post-lung-transplantation-survival
#12
Chad A Newton, Julia Kozlitina, Jefferson R Lines, Vaidehi Kaza, Fernando Torres, Christine Kim Garcia
BACKGROUND: Prior studies have shown that patients with pulmonary fibrosis with mutations in the telomerase genes have a high rate of certain complications after lung transplantation. However, few studies have investigated clinical outcomes based on leukocyte telomere length. METHODS: We conducted an observational cohort study of all patients with pulmonary fibrosis who underwent lung transplantation at a single center between January 1, 2007, and December 31, 2014...
February 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28260447/preliminary-results-of-a-newly-established-organ-transplantation-program-in-a-teaching-hospital
#13
Hammam Momani, Samer Algeizawi, Badia Shamoun, Atef Abu Taha, Hamed Alshakhatreh, Abdel-Hadi Breizat
OBJECTIVES: End-stage renal disease is the complete failure of kidney function; kidney transplant offers the best survival advantage. We analyzed data from Al-Basheer Hospital's newly established transplant program and present our kidney transplant results from the first year of operation. MATERIALS AND METHODS: Between April 2015 and June 2016, 20 kidney transplants were performed (19 living-related donors and 1 deceased donor). We assessed the demographic data, surgical techniques employed, complications, immunosuppressive drugs used, and graft and patient survival rates...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260426/borderline-changes-on-dysfunctional-renal-allograft-biopsies-clinical-relevance-in-a-living-related-renal-transplant-setting
#14
Muhammed Mubarak, Shaheera Shakeel, Khawar Abbas, Tahir Aziz, Mirza Naqi Zafar, Syed Anwer Naqvi, Syed Adibul Hasan Rizvi
OBJECTIVES: Our aim was to determine the clinical significance of borderline lymphocytic infiltrates on indicated renal allograft biopsies in a living related renal transplant setting. MATERIALS AND METHODS: The study was conducted at the histopathology department of Sindh Institute of Urology and Transplantation. A retrospective review of 421 renal transplant patients was conducted from October 2007 to September 2008 to identify patients in whom a histologic diagnosis of borderline changes was made on dysfunctional renal allograft biopsies...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28256042/the-allomap%C3%A2-genomic-biomarker-story-10-years-after
#15
Mario C Deng
Over the last >20 years, we have co-developed the rationale for the first diagnostic and prognostic leukocyte gene expression profiling (GEP) biomarker test in transplantation medicine that gained US-FDA-regulatory clearance and international evidence-based medicine guideline acceptance to rule out moderate/severe acute cellular cardiac allograft rejection without invasive endomyocardial biopsies (EMB). Based on this test, a non-invasive clinical algorithm was implemented since 2005. After clinical implementation, this GEP-based monitoring in direct comparison with an EMB-based strategy was non-inferior with respect to detection of clinical rejection, defined as new onset allograft dysfunction with/without histology of ACR, re-transplantation or death, and at the same time improved patient satisfaction...
March 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28246556/switching-stable-kidney-transplant-recipients-to-a-generic-tacrolimus-is-feasible-and-safe-but-it-must-be-monitored
#16
Fernando González, René López, Elizabeth Arriagada, René Carrasco, Natalia Gallardo, Eduardo Lorca
Background. Tacrolimus is the primary immunosuppressive drug used in kidney transplant patients. Replacing brand name products with generics is a controversial issue that we studied after a Chilean Ministry of Health mandate to implement such a switch. Methods. Forty-one stable Prograf (Astellas) receiving kidney transplant patients were switched to a generic tacrolimus (Sandoz) in a 1 : 1 dose ratio and were followed up for up to 8 months. All other drugs were maintained as per normal practice. Results...
2017: Journal of Transplantation
https://www.readbyqxmd.com/read/28242482/single-center-experience-of-subclinical-rejections-and-bk-nephropathies-by-kidney-allografts-surveillance-biopsies
#17
Beata Naumnik, Jolanta Kowalewska, Tomasz Hryszko, Jerzy Glowiński, Magdalena Durlik, Michal C Myśliwiec
PURPOSE: Acute rejection of the kidney allograft remains the most important factor affecting the long-term graft outcome and is a major predictor of development of chronic damage and graft loss. Several studies have shown that early detection and treatment of subclinical rejection episodes may be beneficial for the graft outcome. The role of protocol (surveillance) biopsies and the value of donor specific antibodies (DSA) monitoring are still debatable. METHODS: This is a prospective observational study involving seventeen kidney recipients transplanted in north-eastern part of Poland who underwent "zero", 3-month and 12-month allograft biopsies as well as DSA assessment...
February 24, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28223723/sinusoidal-endotheliitis-as-a-histological-parameter-for-diagnosing-acute-liver-allograft-rejection
#18
Yu Shi, Kun Dong, Yu-Guo Zhang, René P Michel, Victoria Marcus, Yu-Yue Wang, Yu Chen, Zu-Hua Gao
AIM: To investigated the feasibility of using sinusoidal endotheliitis (SE) as a histological marker for liver allograft rejection. METHODS: We compared the histological features of 88 liver allograft biopsies with acute cellular rejection (ACR) and 59 cases with no evidence of ACR. SE was scored as: (1) focal linear lifting up of the endothelial cells by lymphocytes with no obvious damage to adjacent hepatocytes; (2) focal disruption of the endothelial lining by a cluster of subendothelial lymphocytes (a group of > 3 lymphocytes); and (3) severe confluent endotheliitis with hemorrhage and adjacent hepatocyte loss...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28220684/living-donor-liver-transplantation-during-the-first-three-months-of-life
#19
Mureo Kasahara, Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Toshihiro Kitajima, Takanobu Shigeta, Soichi Narumoto, Yoshihiro Hirata, Akinari Fukuda
BACKGROUND: Living donor liver transplantation is now an established technique for treating children with end-stage liver disease. Few data exist about liver transplantation for exclusively young infants, especially infants of <3 months of age. We report our single-center experience with 12 cases in which living donor liver transplantation (LT) was performed during the first 3 months of life and compare the results with those of older infants who underwent LT. All of the patients were treated at the National Center of Child Health and Development, Tokyo, Japan...
February 21, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28210263/a-paradigm-shift-on-the-question-of-b-cells-in-transplantation-recent-insights-on-regulating-the-alloresponse
#20
REVIEW
Daniel J Firl, Gilles Benichou, James I Kim, Heidi Yeh
B lymphocytes contribute to acute and chronic allograft rejection through their production of donor-specific antibodies (DSAs). In addition, B cells present allopeptides bound to self-MHC class II molecules and provide costimulation signals to T cells, which are essential to their activation and differentiation into memory T cells. On the other hand, both in laboratory rodents and patients, the concept of effector T cell regulation by B cells is gaining traction in the field of transplantation. Specifically, clinical trials using anti-CD20 monoclonal antibodies to deplete B cells and reverse DSA had a deleterious effect on rates of acute cellular rejection; a peculiar finding that calls into question a central paradigm in transplantation...
2017: Frontiers in Immunology
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