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Renal, kidney, renal transplant

Hongfeng Huang, Xi Yao, Jianyong Wu, Wenhan Peng, Jianghua Chen
AIMS: To investigate the area under the curve (AUC) of mycophenolic acid (MPA) in adult Chinese renal allograft recipients receiving concomitant enteric-coated mycophenolate sodium (EC-MPS) and cyclosporine (CsA) during the early post-transplant phase and to develop optimal model equations for estimation of the MPA area under the plasma concentration-time curve from 0 to 12 hours (AUC0-12h) using a limited-sampling strategy (LSS). METHODS: The present study enrolled 24 Chinese renal recipients treated with EC-MPS, CsA, and corticosteroid, from whom 24 serial blood samples were collected over 12 hours...
October 26, 2016: International Journal of Clinical Pharmacology and Therapeutics
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Lin Yan, Yi Li, Jiang-Tao Tang, Yun-Fei An, Li-Mei Luo, Bo Dai, Yun-Ying Shi, Lan-Lan Wang
OBJECTIVE: A genome-wide association study has identified several gene polymorphisms associated with loss of renal function. The effect of these variants on renal function in kidney transplant recipients receiving immunosuppressive treatment is unknown. MATERIALS AND METHODS: A cohort of 189 kidney transplant recipients and their living donors were recruited from West China Hospital of Sichuan University, on whom we assessed the association of five single nucleotide polymorphisms with renal function after kidney transplantation...
October 24, 2016: Pharmacogenetics and Genomics
Jia Loon Chong
Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation...
October 2016: Singapore Medical Journal
Eva Schrezenmeier, Kayin Wu, Fabian Halleck, Lutz Liefeldt, Susanne Brakemeier, Friederike Bachmann, Susanne Kron, Klemens Budde, Michael Duerr
Recurrence of hepatitis C virus (HCV)-associated membranoproliferative glomerulonephritis (MPGN) in the kidney transplant may lead to continuous graft deterioration and the need for further renal replacement therapy. The novel direct acting antiviral agents (DAAs) allow a highly effective and interferon-free treatment option for chronic HCV infected patients. Data on the therapeutic safety and efficacy in HCV infected renal transplant patients are sparse, especially for patients with severe renal impairment...
October 25, 2016: American Journal of Transplantation
Bulent Ergin, Michal Heger, Asli Kandil, Cihan Demirci-Tansel, Can Ince
Ischemia/reperfusion (I/R) is one of the main causes of acute kidney injury (AKI), which is characterized by sterile inflammation and oxidative stress. Immune cell activation can provoke overproduction of inflammatory mediators and reactive oxygen species (ROS), leading to perturbation of the microcirculation and tissue oxygenation associated with local and remote tissue injury. This study investigated whether the clinically employed immunosuppressant mycophenolate mofetil (MMF) was able to reduce I/R-induced renal oxygenation defects and oxidative stress by preventing sterile inflammation...
October 25, 2016: Clinical and Experimental Pharmacology & Physiology
Rosa M Michel Ortega, Daynna J Wolff, Cynthia A Schandl, Harry A Drabkin
BACKGROUND: Malignancy after transplantation is an uncommon multifactorial occurrence. Immunosuppression to prevent graft rejection is described as a major risk factor in malignancy development in the post-transplant state. Donor-derived malignancy is a rare reported complication. Herein, we review our patient history and discuss diagnostic strategies and the implications of immunosuppression for donor-derived malignancy. CASE PRESENTATION: This is a 69-year-old man with post-renal-transplant urothelial carcinoma determined to be of donor origin...
2016: Journal for Immunotherapy of Cancer
Deirdre Sawinski
HIV+ patients are at increased risk for end-stage renal disease, but HIV infection was once considered a contraindication to renal transplantation. However, contemporary studies from the United States and Europe have now demonstrated that renal transplantation is a safe and effective treatment for end-stage renal disease in HIV patients, with equivalent patient and allograft survival to those uninfected. Broader experience in transplantation in HIV+ patients has identified unique challenges including high rates of acute rejection, delayed graft function, and significant drug-drug interactions...
October 11, 2016: Transplantation Reviews
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
Sunil K George, Mehran Abolbashari, John D Jackson, Tamer Aboushwareb, Anthony Atala, James J Yoo
Chronic kidney disease (CKD) occurs when certain conditions cause the kidneys to gradually lose function. For patients with CKD, renal transplantation is the only treatment option that restores kidney function. In this study, we evaluated primary renal cells obtained from diseased kidneys to determine whether their normal phenotypic and functional characteristics are retained, and could be used for cell therapy. Primary renal cells isolated from both normal kidneys (NK) and diseased kidneys (CKD) showed similar phenotypic characteristics and growth kinetics...
2016: PloS One
Annabelle Pourbaix, Nacera Ouali, Patrick Soussan, Anne Marie Roque Afonso, Marie-Noelle Péraldi, Eric Rondeau, Julie Peltier
Hepatitis E virus (HEV) can cause chronic infection among immunocompromised patients, especially solid organ transplant (SOT) recipients, and can evolve to cirrhosis. Several modes of transmission are known. Here we describe the first 2 cases, to our knowledge, of HEV infection transmitted by a kidney graft from the same infected donor that led to chronic hepatitis. Consequently, systematic screening of donors by HEV serology and HEV RNA detection by polymerase chain reaction, particularly in endemic regions, should be considered...
October 24, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
A S Vidane, A O Pinheiro, J B Casals, D Passarelli, McFns Hage, R S Bueno, D S Martins, C E Ambrósio
Chronic kidney disease (CKD) is a common clinical condition in domestic cats, characterized by tubulointerstitial, vascular and glomerular inflammation and severe fibrosis. Studies in rodent model of induced CKD have shown a decrease and stabilization of the clinical condition. In this study was evaluated the safety and effect of intrarenal and intravenous infusion of allogeneic mesenchymal stem cells (AMSCs) derived from feline amniotic membrane in cats with naturally occurring CKD. Cat AMSCs were harvested after mechanical and enzymatic digestion of amnion...
October 23, 2016: Reproduction in Domestic Animals, Zuchthygiene
Kathleen O Degnan, Emily A Blumberg
Patients infected with human immunodeficiency virus (HIV) are living longer, healthier lives on highly active antiretroviral therapy and, as a result, interest in kidney transplantation for HIV-infected patients with end-stage renal disease has increased. HIV is no longer considered a contraindication to solid-organ transplantation and the number of kidney transplants performed in HIV-infected patients each year is increasing steadily. HIV-infected kidney transplant recipients have had excellent outcomes overall, but there are still significant challenges, including high rates of acute rejection, drug-drug interactions, and poor outcomes in patients co-infected with hepatitis C virus...
September 2016: Seminars in Nephrology
Kiran Gajurel, Jack T Stapleton
Hepatitis viruses are named for their primary clinical illness, inflammation of the liver. Currently, six types of viruses are designated hepatitis viruses (A, B, C, D, E, and G), although only five of these cause hepatitis. Hepatitis viruses are composed of RNA and DNA viruses from different families and with different virologic properties, some of which typically cause acute hepatitis while others cause acute and chronic hepatitis. In addition to their role in liver disease, members of this group of viruses may cause a variety of pathologic changes in the kidney and other organs, and chronic infection may lead to cirrhosis in addition to raising a variety of important issues in the management of kidney transplant recipients...
September 2016: Seminars in Nephrology
Jennifer Trofe-Clark, Deirdre Sawinski
For more than 40 years, polyomaviruses (BK virus and JC virus) have been known to cause disease in human beings. Recently, 11 new polyomaviruses were discovered. However, the majority of these viruses are rare in renal transplant recipients and BK and JC viruses remain the most important polyomaviruses to impact this population. BK virus presents as BK virus nephropathy and has, in rare instances, been associated with hemorrhagic cystitis or ureteral strictures. JC virus can cause progressive multifocal leukoencephalopathy or nephropathy in this population as well, but is uncommon...
September 2016: Seminars in Nephrology
Salvatore Citarda, Roula Galland, Jean-Michel Poux, Abdallah Guerraoui, Patrick Hallonet, Marie Lino-Daniel, Pascale Thivend, Agnès Caillette-Beaudoin
Early information about the kidney transplant is recommended to begin quickly the process of registration on the kidney transplantation waiting list, even for the patients not dialyzed at stage V of the renal insufficiency. It is a strategic choice for the patient care. From the arrival of all the patients in our center of dialysis, a systematic evaluation of the access to the kidney transplant waiting list is organized thanks to a clinical pathway. The impact of this new organization was estimated at 18 months with regard to the information about the kidney transplant transmitted to the patient, of the time required for the assessment of pre-kidney transplant evaluation, and of putting in contraindication...
October 19, 2016: Néphrologie & Thérapeutique
Clark Kensinger, Aihua Bian, Meagan Fairchild, Guanhua Chen, Loren Lipworth, T Alp Ikizler, Kelly A Birdwell
BACKGROUND: Endothelial dysfunction is an important precursor to the development of atherosclerosis, and has been suggested to play a role in the increased cardiovascular risk in patients with end stage renal disease. Endothelial function improves rapidly following post kidney transplantation, but the long term change remains unclear. Hypothesizing that endothelial function would remain improved long term post kidney transplantation, we evaluated the longitudinal change of endothelial function, measured by flow-mediated dilation (FMD) of the brachial artery, from months 1 to 24 post transplantation...
October 22, 2016: BMC Nephrology
Kristy S Yap, Murray B Urowitz, Quenby Mahood, Jorge Medina-Rosas, Arthy Sabapathy, Daeria Lawson, Jiandong Su, Dafna D Gladman, Zahi Touma
OBJECTIVES: To study the utility of lupus serology as a predictor for kidney graft outcome in (a) a systematic literature review (SLR) and (b) the Toronto lupus cohort (TLC). METHODS: For the SLR, a comprehensive literature search was performed to identify the articles reporting on the serology at renal transplantation (RT) and on the outcome of RT. Studies were critically appraised using the Newcastle Ottawa Scale (NOS). Patients who underwent RT in the TLC were identified and grouped into graft failure and graft survival...
September 21, 2016: Seminars in Arthritis and Rheumatism
Stefan Reuter, Stefanie Reiermann, Viola Malyar, Katharina Schütte-Nütgen, Renè Schmidt, Hermann Pavenstädt, Holger Reinecke, Barbara Suwelack
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death after renal transplantation with a high prevalence in dialysis patients. It is still a matter of debate how to assess the cardiovascular risk in kidney transplant candidates. Several approaches and scores exist and found their way into the guidelines. METHODS AND RESULTS: We herein assessed PROCAM, Framingham, ESC-SCORE and our own dedicated algorithm in patients applying for renal transplantation at our transplantation center between July 2006 and August 2009...
2016: PloS One
Jayme E Locke, Sally Gustafson, Shikha Mehta, Rhiannon D Reed, Brittany Shelton, Paul A MacLennan, Christine Durand, Jon Snyder, Nicholas Salkowski, Allan Massie, Deirdre Sawinski, Dorry L Segev
OBJECTIVE: To determine the survival benefit of kidney transplantation in human immunodeficiency virus (HIV)-infected patients with end-stage renal disease (ESRD). SUMMARY BACKGROUND DATA: Although kidney transplantation (KT) has emerged as a viable option for select HIV-infected patients, concerns have been raised that risks of KT in HIV-infected patients are higher than those in their HIV-negative counterparts. Despite these increased risks, KT may provide survival benefit for the HIV-infected patient with ESRD, yet this important clinical question remains unanswered...
April 26, 2016: Annals of Surgery
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