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Highly sensitized kidney recipients

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https://www.readbyqxmd.com/read/30076973/bk-polyomavirus-in-the-urine-for-follow-up-of-kidney-transplant-recipients
#1
Etienne Brochot, Véronique Descamps, Lynda Handala, Justine Faucher, Gabriel Choukroun, François Helle, Sandrine Castelain, Catherine François, Gilles Duverlie, Antoine Touzé
OBJECTIVES: After kidney transplantation, human BK polyomavirus (BKPyV) can induce a progressive disease, in three stages: viruria, viremia, and then nephropathy after a few months of viral replication. Therapeutic intervention is recommended when BKPyV is detected in the plasma. The objective of our study was to assess urinary BKPyV nucleic acid test as a predictor for developing viremia. METHODS: We first defined a viruria threshold based on 393 time-matched urine and plasma samples collected after kidney transplantation and then to validate this threshold, we followed-up a cohort of 236 kidney transplant patients...
August 1, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/30056929/issues-of-immunological-and-hemodynamic-monitoring-before-and-during-kidney-transplantation-in-sensitized-heart-transplant-recipient
#2
D Kamińska, M Łukaszewski, N Kozera, K Kościelska-Kasprzak, D Bartoszek, O Mazanowska, W Goździk, P Chudoba, P Zaleska, A Lepiesza, M Klinger
Previously transplanted highly sensitized patients experience problems with subsequent transplantation. It is also difficult to provide optimal hemodynamic conditions during successive kidney transplantation in heart transplant recipients. PATIENT AND METHODS: We present a case of a 56-year old patient with end-stage renal failure after heart transplantation performed 21 years ago and hemodialyzed using arteriovenous fistula. The patient had 69% panel-reactive antibodies, had been on the active waiting list since 2013, and presented 335 positive crossmatches with deceased donors...
July 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30056903/endocan-concentration-in-kidney-transplant-recipients
#3
J Malyszko, E Koc-Żórawska, J S Malyszko
INTRODUCTION: Endocan is a novel soluble dermatan sulfate proteoglycan derived from endothelium. It has the capacity of binding to different biologically active molecules associated with cellular signaling, adhesion and regulating proliferation, differentiation, migration, and adhesion of different cell types in health and pathology. Elevated endocan levels are connected with endothelial activation/damage, neo-angiogenesis, and inflammation or carcinogenesis. MATERIALS AND METHODS: The level of serum endocan among 63 kidney transplant recipients on three immunosuppressives (calcineurin inhibitors, mycophenolate mofetil, steroids) in correlation with other markers of endothelial damage was estimated...
July 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30028473/comparison-of-the-t-cell-response-to-human-cytomegalovirus-hcmv-as-detected-by-cytokine-flow-cytometry-and-quantiferon-cmv-assay-in-hcmv-seropositive-kidney-transplant-recipients
#4
Elisa Gabanti, Daniele Lilleri, Lucia Scaramuzzi, Paola Zelini, Teresa Rampino, Giuseppe Gerna
Human cytomegalovirus (HCMV)-specific T-cell response in kidney transplant recipients (KTR) helps to identify patients at risk for severe infection. To assess the T-cell response, this study compared our in-house developed reference test, based on T-cell (both CD4+ and CD8+) stimulation by autologous HCMV-infected dendritic cells (iDC) and subsequent detection by cytokine flow cytometry (CFC-iDC), with the QuantiFERON-CMV (QF-CMV) assay. Fifty-three HCMVseropositive KTR were enrolled. At the DNAemia peak, 33 (62%) had low viral load (LVL, <3x105 DNA copies/mL) self-resolving infection, 19 (36%) high viral load (HVL, >3x105 DNA copies/mL) infection treated with antivirals, and one LVL patient (2%) tissue-invasive disease alone...
July 20, 2018: New Microbiologica
https://www.readbyqxmd.com/read/30022978/mouse-model-established-by-early-renal-transplantation-after-skin-allograft-sensitization-mimics-clinical-antibody-mediated-rejection
#5
Daqiang Zhao, Tao Liao, Siwen Li, Yannan Zhang, Haofeng Zheng, Jing Zhou, Fei Han, Yu Dong, Qiquan Sun
Antibody-mediated rejection (AMR) is the main barrier to renal graft survival, and mouse renal AMR models are important to study this process. Current mouse models are established by priming the recipient to donor skin for over 7 days before kidney transplantation. The robustness of AMR in these cases is too strong to mimic clinical AMR and it is unclear why altering the priming times ranging from 7 to 91 days fails to reduce the AMR potency in these models. In the present study, we found that the donor-recipient combination and skin graft size were determinants of donor-specific antibody (DSA) development patterns after skin transplantation...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/30009853/interferon-gamma-release-assay-for-tuberculosis-screening-of-solid-organ-transplant-recipients-is-cost-effective
#6
A Kowada
OBJECTIVES: Tuberculosis (TB) is a serious infectious disease with high mortality for solid-organ transplantation. Preventive therapy of latent tuberculosis infection (LTBI) has been considered to reduce TB risk and improve outcomes of transplantation. The aim of this study was to evaluate the cost-effectiveness of the interferon-gamma release assays (IGRAs); QuantiFERON® -TB Gold in-Tube (QFT) and T-SPOT® .TB (TSPOT)), for kidney, liver and lung transplant recipients in low TB incidence countries...
July 24, 2018: Journal of Infection
https://www.readbyqxmd.com/read/30009843/allograft-rejection-is-associated-with-the-development-of-functional-ige-specific-for-donor-mhc-antigens
#7
Andreas M Farkas, Ulrike Baranyi, Georg A Böhmig, Lukas Unger, Stefan Hopf, Markus Wahrmann, Heinz Regele, Benedikt Mahr, Christoph Schwarz, Karin Hock, Nina Pilat, Ivan Kristo, Jasmin Mraz, Christian Lupinek, Josef Thalhamer, Gregor Bond, Lorenz Kuessel, Elizabeth Wlodek, Jack Martin, Menna Clatworthy, Gavin Pettigrew, Rudolf Valenta, Thomas Wekerle
BACKGROUND: Donor-specific antibodies (DSA) of the IgG isotype are routinely measured for diagnostic purposes in renal transplant recipients and are associated with antibody-mediated rejection and long-term graft loss. OBJECTIVE: This study aimed to investigate if MHC-specific antibodies of the IgE isotype are induced during the rejection of allografts. METHODS: Anti-MHC/HLA IgE was measured in sera of mice grafted with skin or heart transplants from various donor strains and in sera of kidney transplant patients with high levels of HLA-IgG...
July 12, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29996127/serum-calcification-propensity-and-fetuin-a-biomarkers-of-cardiovascular-disease-in-kidney-transplant-recipients
#8
Andrew Bostom, Andreas Pasch, Tracy Madsen, Mary B Roberts, Nora Franceschini, Dominik Steubl, Pranav S Garimella, Joachim H Ix, Katherine R Tuttle, Anastasia Ivanova, Theresa Shireman, Reginald Gohh, Basma Merhi, Petr Jarolim, John W Kusek, Marc A Pfeffer, Simin Liu, Charles B Eaton
BACKGROUND: "T50," shortened transformation time from primary to secondary calciprotein particles may reflect deranged mineral metabolism predisposing to vascular calcification and cardiovascular disease (CVD). The glycoprotein fetuin-A is a major T50 determinant. METHODS: The Folic Acid For Vascular Outcome Prevention In Transplantation (FAVORIT) cohort is a completed, large, multiethnic controlled clinical trial cohort of chronic, stable kidney transplant recipients (KTRs)...
July 11, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29989033/combining-sensitive-crossmatch-assays-with-donor-recipient-human-leukocyte-antigen-eplet-matching-predicts-living-donor-kidney-transplant-outcome
#9
Maria Meneghini, Edoardo Melilli, Jaume Martorell, Ignacio Revuelta, Elisabet Rigol-Monzó, Anna Manonelles, Nuria Montero, David Cucchiari, Fritz Diekmann, Josep M Cruzado, Salvador Gil-Vernet, Josep M Grinyó, Oriol Bestard
Introduction: Despite the different assays available for immune-risk stratification before living-donor kidney transplantation (LDKT), the precise type and number of tests to perform remain uncertain. Methods: In a cohort of 330 consecutive LDKT patients, all of which were complement-dependent cytotoxicity (CDC)-crossmatch negative, we retrospectively analyzed the impact on main clinical outcomes of most sensitive immunoassays (complement-dependent cytotoxicity-panel-reactive antibody [CDC-PRA], flow cytometry crossmatch [FC-XM], donor-specific antibodies [DSAs], and their complement-binding capacity DSA-C3d]), together with donor/recipient HLA eplet matching...
July 2018: KI Reports
https://www.readbyqxmd.com/read/29976918/effect-of-preformed-or-de-novo-anti-hla-antibodies-on-function-and-graft-survival-in-kidney-transplant-recipients
#10
Marcos Vinicius de Sousa, Ana Claudia Gonçalez, Ricardo de Lima Zollner, Marilda Mazzali
BACKGROUND Donor-specific antibodies (DSA), directed against human leucocyte antigens (HLA), are associated with increased risk for graft rejection in kidney transplantation. Anti-HLA antibodies detection by Luminex™ present high sensitivity and accuracy, but its interpretation after transplantation is not completely clear. The aim of this study was to evaluate the impact of anti-HLA antibodies, preformed or de novo, on renal function, graft survival, and incidence of antibody-mediated acute rejection (AMR)...
July 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29957546/development-of-a-standardized-real-time-pcr-for-torque-teno-viruses-ttv-viral-load-detection-and-quantification-a-new-tool-for-immune-monitoring
#11
Dorian Kulifaj, Bénédicte Durgueil-Lariviere, Faustine Meynier, Eliza Munteanu, Nicolas Pichon, Manon Dubé, Martine Joannes, Marie Essig, Sébastien Hantz, Côme Barranger, Sophie Alain
BACKGROUND: Torque teno viruses (TTV) are small DNA viruses whose replication is closely linked to immune status. A growing number of publications underlined the potential of TTV viral load as an indicator of immunosuppression. OBJECTIVES: To demonstrate the analytical performance of the first standardized RUO (Research Use Only) assay to detect and quantify human TTV DNA in whole blood and plasma. STUDY DESIGN: We established analytical performances for TTV load measurement in various populations...
August 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29935708/innate-networking-thrombotic-microangiopathy-the-activation-of-coagulation-and-complement-in-the-sensitized-kidney-transplant-recipient
#12
REVIEW
Miriam Manook, Jean Kwun, Steven Sacks, Anthony Dorling, Nizam Mamode, Stuart Knechtle
Thrombotic microangiopathy (TMA) is a histological feature of antibody-mediated rejection and has the potential to cause problematic graft dysfunction, particularly for highly sensitized cross-match positive kidney transplant recipients. Prompt recognition of pertinent histopathological and systemic features of TMA in kidney transplantation is necessary. Underlying mechanisms of this process involve the activation of both complement and coagulation systems as a response to HLA antibody. As serine proteases, coagulation and complement cascades exhibit similar characteristics with respect to homeostatic function...
July 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29798728/high-expression-of-foxp3-mrna-in-blood-and-urine-as-a-predictive-marker-in-kidney-transplantation
#13
Mehri Barabadi, Sanaz Keshavarz Shahbaz, Farshad Foroughi, Morteza Hosseinzadeh, Mohsen Nafar, Mir Saeed Yekaninejad, Aliakbar Amirzargar
BACKGROUND: Diagnosis of allograft dysfunction by noninvasive biomarker tests is preferable to invasive allograft biopsies and has been extensively considered in recent years. This study aims to evaluate blood and urinary forkhead box P3 (FOXP3) messenger RNA (mRNA) expression in renal transplant recipients in an attempt to determine whether differential diagnosis of graft dysfunction is feasible using mRNA profiles. METHODS: We analyzed FOXP3 mRNA expression in paired urinary and peripheral blood mononuclear cell (PBMC) samples...
June 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29797402/cost-effectiveness-of-using-kidneys-from-hepatitis-c-nucleic-acid-test-positive-donors-for-transplantation-in-hepatitis-c-negative-recipients
#14
Matthew Kadatz, Scott Klarenbach, Jagbir Gill, John S Gill
Kidneys from deceased donors who are hepatitis C virus (HCV) nucleic acid test positive are infrequently used for transplantation in HCV-negative patients due to concerns about disease transmission. With the development of direct-acting antivirals (DAAs) for HCV, there is now potential to use these kidneys in HCV-negative candidates. However, the high cost of DAAs poses a challenge to adoption of this strategy. We created a Markov model to examine the cost-effectiveness of using deceased donors infected with HCV for kidney transplantation in uninfected waitlist candidates...
May 23, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29731063/factors-associated-with-waiting-time-to-deceased-donor-kidney-transplantation-in-transplant-candidates
#15
J-H Ryu, T Y Koo, J Y Ha, M R Jung, J W Ha, J Yang
Although a nationwide activation system has been developed to increase deceased donor kidney transplantation (DDKT), there is still enormous discrepancy between transplant need and deceased donor supply in Korea, and therefore waiting time to DDKT is still long. We need to determine the current status of waiting time and the risk factors for long waiting time. We retrospectively analyzed the medical records of the patients on the wait list for DDKT at the Seoul National University Hospital from 2000 to 2017...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661424/intravenous-immunoglobulin-and-rituximab-in-hla-highly-sensitized-kidney-transplant-recipients
#16
S Querido, A Weigert, T Adragão, J Henriques, R Birne, P Matias, C Jorge, C Nascimento, M Bruges, D Machado
INTRODUCTION: HLA-sensitized patients are penalized both in the access to kidney transplantation (KT) and, once transplanted, in the incidence of rejections and long-term allograft survival despite aggressive induction and maintenance therapy. METHODS: This study retrospectively evaluates the impact of combining T- and B-cell-depleting agents and intravenous immunoglobulin for induction therapy in 45 highly sensitized KT patients (anti-panel reactive antibodies >60%, positive flow cytometry crossmatch or donor specific antibodies at the time of transplantation)...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29594146/early-conversion-from-tacrolimus-to-belatacept-in-a-highly-sensitized-renal-allograft-recipient-with-calcineurin-inhibitor-induced-de-novo-post-transplant-hemolytic-uremic-syndrome
#17
Vasishta S Tatapudi, Bonnie E Lonze, Ming Wu, Robert A Montgomery
Background: Kidney transplantation is the first-line therapy for patients with end-stage renal disease since it offers greater long-term survival and improved quality of life when compared to dialysis. The advent of calcineurin inhibitor (CNI)-based maintenance immunosuppression has led to a clinically significant decline in the rate of acute rejection and better short-term graft survival rates. However, these gains have not translated into improvement in long-term graft survival. CNI-related nephrotoxicity and metabolic side effects are thought to be partly responsible for this...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29520177/functional-evaluation-of-transplanted-kidneys-with-reduced-field-of-view-diffusion-weighted-imaging-at-3t
#18
Yuan Xie, Yanjun Li, Jiqiu Wen, Xue Li, Zhe Zhang, Jianrui Li, Yan'e Zhao, Peng Wang, Jun Zhang, Ying Tian, Long Jiang Zhang, Guang Ming Lu
Objective: To determine the feasibility of reduced field-of-view diffusion-weighted imaging (rFOV DWI) with multi-b values to detect functional variability in transplanted kidneys. Materials and Methods: Using a 3T MRI scanner, multi-b rFOV DWI of transplanted kidney or native kidney was performed in 40 renal transplantation recipients and 18 healthy volunteers. The patients were stratified, according to an estimated glomerular filtration rate (eGFR): Group 1, eGFR ≥ 60 mL/min/1...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29499059/progranulin-serum-levels-in-human-kidney-transplant-recipients-a-longitudinal-study
#19
Bruna Bellincanta Nicoletto, Elis Forcellini Pedrollo, Larissa Salomoni Carpes, Natália Gomes Coloretti, Thaiana Cirino Krolikowski, Gabriela Corrêa Souza, Luiz Felipe Santos Gonçalves, Roberto Ceratti Manfro, Luis Henrique Canani
BACKGROUND: The adipokine progranulin has metabolic proprieties, playing a role in obesity and insulin resistance. Its levels seems to be dependent of renal function, since higher progranulin concentration is observed in patients with end-stage kidney disease. However, the effect of kidney transplantation on progranulin remains unknown. OBJECTIVE: To assess the serum progranulin levels in kidney transplant recipients before and after kidney transplantation. METHODS: Forty-six prospective kidney transplant recipients were included in this longitudinal study...
2018: PloS One
https://www.readbyqxmd.com/read/29471254/uplc-ms-ms-assay-validation-for-tacrolimus-quantitative-determination-in-peripheral-blood-t-cd4-and-b-cd19-lymphocytes
#20
Paschoalina Romano, Maria da Luz Fernandes, Pérsio de Almeida Rezende Ebner, Nayara Duarte de Oliveira, Larissa Mitsue Okuda, Fabiana Agena, Maria Elizabete Mendes, Nairo Massakazu Sumita, Verônica Coelho, Elias David-Neto, Nelson Zocoler Galante
Monitoring tacrolimus (Tac) exposure in cell matrices enriched with lymphocytes can improve Tac therapeutic drug monitoring (TDM) in solid organ transplant recipients. An UPLC-MS/MS based assay for Tac quantification in peripheral blood T CD4+ and B CD19+ lymphocytes was developed. Peripheral blood mononuclear cells (PBMC) were obtained by density gradient centrifugation and highly purified (purity >90%) T CD4+ and B CD19+ cell suspensions were acquired by magnetic negative selection from whole blood of 6 healthy volunteers...
April 15, 2018: Journal of Pharmaceutical and Biomedical Analysis
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