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https://www.readbyqxmd.com/read/30107078/histological-picture-of-antibody-mediated-rejection-without-donor-specific-anti-hla-antibodies-clinical-presentation-and-implications-for-outcome
#1
Aleksandar Senev, Maarten Coemans, Evelyne Lerut, Vicky Van Sandt, Liesbeth Daniëls, Dirk Kuypers, Ben Sprangers, Marie-Paule Emonds, Maarten Naesens
In this cohort study (n=935 transplantations), we investigated the phenotype and risk of graft failure in patients with histological criteria for antibody-mediated rejection (ABMR) in the absence of circulating donor-specific anti-HLA antibodies (DSA), and compared this to patients with definite ABMR and HLA-DSA-positivity. The histological picture did not differ between HLA-DSA-positive (n=85) and HLA-DSA-negative (n=123) cases of ABMR histology, apart from increased C4d deposition in the peritubular capillaries in HLA-DSA positive cases...
August 14, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/30102719/microrna-regulation-in-blood-cells-of-renal-transplanted-patients-with-interstitial-fibrosis-tubular-atrophy-and-antibody-mediated-rejection
#2
Mareen Matz, Frederik Heinrich, Christine Lorkowski, Kaiyin Wu, Jens Klotsche, Qiang Zhang, Nils Lachmann, Pawel Durek, Klemens Budde, Mir-Farzin Mashreghi
Interstitial fibrosis/tubular atrophy (IFTA) is associated with reduced allograft survival, whereas antibody-mediated rejection (ABMR) is the major cause for renal allograft failure. To identify specific microRNAs and their regulation involved in these processes, total RNA from blood cells of 16 kidney transplanted (KTx) patients with ABMR, stable graft function (SGF) and with T-cell mediated rejection (TCMR) was isolated. MicroRNA expression was determined by high-throughput sequencing. Differentially expressed candidate microRNAs were analyzed with RT-PCR in patients with SGF (n = 53), urinary tract infection (UTI) (n = 17), borderline rejection (BL) (n = 19), TCMR (n = 40), ABMR (n = 22) and IFTA (n = 30)...
2018: PloS One
https://www.readbyqxmd.com/read/30057639/pathological-assessment-of-allograft-nephrectomy-an-iranian-experience
#3
Hamid Mazdak, Mojgan Ghavami, Shahaboddin Dolatkhah, Parnaz Daneshpajouhnejad, Mehdi Fesharakizadeh, Shahriar Fesharakizadeh, Abdolamir Atapour, Parvin Mahzouni, Mozaffar Hashemi, Roxana Salajegheh, Diana Taheri
Background: The aim of this study was to determine the pathologic causes of renal allograft failure in transplant nephrectomy specimens. Materials and Methods: In this cross-sectional study performed in the referral transplant center of Isfahan, Iran, medical files of all patients who underwent nephrectomy in 2008-2013 were studied. Age at transplantation, sex, donor's characteristics, causes of primary renal failure, duration of allograft function, and pathologic reasons of nephrectomy were extracted...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/30007072/early-allograft-inflammation-and-scarring-associate-with-graft-dysfunction-and-poor-outcomes-in-renal-transplant-recipients-with-delayed-graft-function-a-prospective-single-center-cohort-study
#4
Aravind Cherukuri, Rajil Mehta, Puneet Sood, Sundaram Hariharan
Early histological progression that associates with delayed graft function (DGF) and its relationship to graft outcomes is less well-understood. We systematically evaluated early acute and chronic histological changes associated with DGF through serial biopsies (protocol: 3 and 12 months; for-cause) and related them to graft outcomes. 56/294 (19.04%) of our patients had DGF. DGF was associated with a progressive increase in both Banff 't' and 'i' scores from 2 weeks to 3 and 12 months with a resultant increase in T cell mediated rejection (TCMR) that was significantly greater than those with primary graft function (PGF)...
July 14, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29968416/cell-mediated-rejection-revisited-past-current-and-future-directions
#5
REVIEW
Shigeo Hara
The Banff histopathology classification system is the gold standard for assessing the causes of kidney allograft dysfunction triggered by antibody-mediated and T-cell-mediated immune reactions, thereby providing mechanistic insight and guiding therapeutic decisions. The original Banff classification (1993) consisted of four histological categories representing cell-mediated rejection: interstitial inflammation (i), tubulitis (t), endoarteritis (v), and transplant glomerulitis (g). The revised Banff 2007 classification added total inflammation score (ti) from both scarred and unscarred areas based on evolving interpretations of interstitial infiltrates...
July 2018: Nephrology
https://www.readbyqxmd.com/read/29916985/impact-of-the-current-versus-the-previous-diagnostic-threshold-on-the-outcome-of-patients-with-borderline-changes-suspicious-for-t-cell-mediated-rejection-diagnosed-on-indication-biopsies
#6
Michael McRae, François Bouchard-Boivin, Stéphanie Béland, Réal Noël, Isabelle Côté, Isabelle Lapointe, Julie Lesage, Eva Latulippe, Julie Riopel, Dominick Santoriello, Syed A Husain, Olivier Désy, Isabelle Houde, Ibrahim Batal, Sacha A De Serres
BACKGROUND: Since the borderline changes suspicious for acute T-cell-mediated rejection (BL) category was broadened, there has been a debate regarding the right threshold for tubulitis (t) and interstitial inflammation (i) scores. METHODS: We studied a first cohort of 111 patients with BL found on an indication biopsy between 2006 and 2016 and compared those with scores of t1i0 (BLt1i0) to those with higher scores (BL≥t1i1). A second cohort of 56 patients with BL was used for external validation...
June 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29891963/clinical-significance-of-ccr7-cd8-t-cells-in-kidney-transplant-recipients-with-allograft-rejection
#7
Kyoung Woon Kim, Bo-Mi Kim, Kyoung Chan Doh, Mi-La Cho, Chul Woo Yang, Byung Ha Chung
The regulatory function of CCR7+ CD8+ T cells against effector T-cells involved in T-cell mediated rejection (TCMR) in kidney transplant recipients was investigated. In vitro experiments explored the ability of CCR7+ CD8+ T cells to suppress T-cell proliferation under T-cell activation conditions or during coculture with human renal proximal tubular epithelial cells (HRPTEpiC). In an ex vivo experiment, the proportion of CCR7+ /CD8+ , FOXP3+ /CCR7+ CD8+ T and effector T-cell subsets were compared between the normal biopsy control (NC, n = 17) and TCMR group (n = 17)...
June 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29731924/the-spectrum-of-histopathological-changes-in-the-renal-allograft-a-12-months-protocol-biopsy-study
#8
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/29696778/evolution-of-renal-function-and-urinary-biomarker-indicators-of-inflammation-on-serial-kidney-biopsies-in-pediatric-kidney-transplant-recipients-with-and-without-rejection
#9
Christine M Mincham, Ian W Gibson, Atul Sharma, Chris Wiebe, Rupasri Mandal, David Rush, Peter Nickerson, Julie Ho, David S Wishart, Tom D Blydt-Hansen
Urinary CXCL10 and metabolites are biomarkers independently associated with TCMR. We sought to test whether these biomarkers fluctuate in association with histological severity of TCMR over short time frames. Forty-nine pairs of renal biopsies obtained 1-3 months apart from 40 pediatric renal transplant recipients were each scored for TCMR acuity score (i + t; Banff criteria). Urinary CXCL10:Cr and TCMR MDS were obtained at each biopsy and were tested for association with changes between biopsies in acuity, estimated GFR (ΔeGFR), and 12-month ΔeGFR...
August 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29687946/does-tubulitis-without-interstitial-inflammation-represent-borderline-acute-t-cell-mediated-rejection
#10
Brian J Nankivell, Chow H P'Ng, Jeremy R Chapman
Tubulitis without interstitial inflammation (Banff i0), termed "isolated tubulitis" (ISO-T), has been controversially included within the Banff "borderline" category of acute T cell mediated rejection (TCMR). This single-center, retrospective, observational study of 2055 consecutive biopsies from 775 recipients, determined the clinical significance of ISO-T. ISO-T prevalence was 19.1%, comprising mild tubulitis (i0t1) in 97.2%. Independent clinical predictors of tubulitis were HLA mismatch, prior TCMR and antibody-mediated rejection, pulse corticosteroids, and BKVAN (P = ...
April 24, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29661426/delayed-graft-function-predictive-factors-and-7-year-outcome-of-deceased-donor-kidney-transplant-recipients-with-different-immunologic-profiles
#11
A H D S Quintella, M F Lasmar, R A Fabreti-Oliveira, E Nascimento
BACKGROUND: Delayed graft function (DGF) is the major post-transplant cause of deleterious effects to the allograft and is associated with poor allograft survival. The aim of this study was to report the outcomes of 236 kidney transplant recipients with different immunologic profiles. METHODS: All patients underwent transplantation (2008-2016) with a deceased donor at the University Hospital of the Faculty of Medical Science, Belo Horizonte, Minas Gerais, Brazil...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29501487/bowman-capsulitis-predicts-poor-kidney-allograft-outcome-in-t-cell-mediated-rejection
#12
Alexander J Gallan, Woojin James Chon, Michelle A Josephson, Patrick N Cunningham, Kammi J Henriksen, Anthony Chang
Acute T cell-mediated rejection (TCMR) is an important cause of renal allograft loss. The Banff classification for tubulointerstitial (type I) rejection is based on the extent of both interstitial inflammation and tubulitis. Lymphocytes may also be present between parietal epithelial cells and Bowman capsules in this setting, which we have termed "capsulitis." We conducted this study to determine the clinical significance of capsulitis. We identified 42 patients from the pathology archives at The University of Chicago with isolated Banff type I TCMR from 2010 to 2015...
June 2018: Human Pathology
https://www.readbyqxmd.com/read/29479453/practice-patterns-in-the-treatment-and-monitoring-of-acute-t-cell-mediated-kidney-graft-rejection-in-canada
#13
Julie Leblanc, Peter Subrt, Michèle Paré, David Hartell, Lynne Sénécal, Tom Blydt-Hansen, Héloïse Cardinal
Background: One of the goals of the Canadian National Transplant Research Program (CNTRP) is to develop novel therapies for acute rejection that could positively affect graft outcomes with greater efficacy or less toxicity. To develop innovative management strategies for kidney graft rejection, new modalities need to be compared with current clinical practices. However, there are no standardized practices concerning the management of acute T cell-mediated rejection (TCMR). Objectives: To describe clinicians' practice patterns in the diagnosis, treatment, and monitoring of acute TCMR in Canada...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29470345/summary-of-2017-fda-public-workshop-antibody-mediated-rejection-in-kidney-transplantation
#14
Ergun Velidedeoglu, Marc W Cavaillé-Coll, Shukal Bala, Ozlem A Belen, Yan Wang, Renata Albrecht
Despite major advances in understanding the pathophysiology of antibody-mediated rejection (AMR); prevention, diagnosis and treatment remain unmet medical needs. It appears that early T cell-mediated rejection, de novo donor-specific antibody (dnDSA) formation and AMR result from patient or physician initiated suboptimal immunosuppression, and represent landmarks in an ongoing process rather than separate events. On April 12 and 13, 2017, the Food and Drug Administration sponsored a public workshop on AMR in kidney transplantation to discuss new advances, importance of immunosuppressive medication nonadherence in dnDSA formation, associations between AMR, cellular rejection, changes in glomerular filtration rate, and challenges of clinical trial design for the prevention and treatment of AMR...
June 2018: Transplantation
https://www.readbyqxmd.com/read/29464837/isolated-vascular-v-lesions-in-liver-allografts-how-to-approach-this-unusual-finding
#15
H L Stevenson, M M Prats, K Isse, A Zeevi, Y Avitzur, V L Ng, A J Demetris
According to the Banff criteria for kidney allografts, isolated vascular or "v" lesions are defined as intimal inflammation, age-inappropriate fibro-intimal hyperplasia, or both, without the presence of associated interstitial T cell-mediated rejection (TCMR). In general, these lesions portend a worse outcome for kidney allografts, particularly in those where the "v" lesions are identified in patients with coexistent donor specific antibodies (DSA) or later after transplantation. Although affected arteries are rarely sampled in liver allograft biopsies, we identified nine patients at a mean of 1805 days posttransplantation and compared these to matched controls...
June 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29319615/clinical-and-pathological-features-of-plasma-cell-rich-acute-rejection-after-kidney-transplantation
#16
Jumpei Hasegawa, Kazuho Honda, Kazuya Omoto, Sachiko Wakai, Hiroki Shirakawa, Masayoshi Okumi, Hideki Ishida, Shohei Fuchinoue, Motoshi Hattori, Kazunari Tanabe
BACKGROUND: Plasma cell-rich acute rejection (PCAR) is a rare type of allograft rejection characterized by the presence of mature plasma cells. In general, the prognosis of PCAR is poor, and its clinical and pathological features remain unclear. METHODS: We performed a retrospective observational study and compared allograft survival between kidney transplant recipients who developed PCAR and those who did not develop PCAR. We further analyzed clinical and pathological risk factors for allograft failure in PCAR patients...
May 2018: Transplantation
https://www.readbyqxmd.com/read/29305091/aryl-hydrocarbon-receptor-expression-by-macrophages-and-lymphocytes-within-infiltrates-in-bk-polyomavirus-associated-nephropathy
#17
Yassine Bouatou, Geurt Stokman, Nike Claessen, Joris J T H Roelofs, Frederike Bemelman, Jesper Kers, Sandrine Florquin
BACKGROUND: BK virus nephropathy (BKPyVN) is a major complication after renal transplantation. Little is known about the intra renal immune response during BKPyVN. The role of macrophages remains elusive. The activation of aryl hydrocarbon receptor (AHR) - a transcription factor involved in drug metabolism - plays a key role in inflammation and viral tolerance through modulation of macrophages polarization. Since AHR has not been studied in kidney transplantation, our aim was to compare the AHR expression within renal grafts in BKPyVN with T-cell mediated rejection (TCMR) as a control...
April 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29288556/rna-expression-profiling-of-nonhuman-primate-renal-allograft-rejection-identifies-tolerance
#18
R N Smith, M Matsunami, B A Adam, I A Rosales, T Oura, A B Cosimi, T Kawai, M Mengel, R B Colvin
Tolerance induction to prevent allograft rejection is a long-standing clinical goal. However, convincing and dependable tolerance identification remains elusive. Hypothesizing that intragraft RNA expression is informative in both rejection and tolerance, we profile intrarenal allograft RNA expression in a mixed chimerism renal allograft model of cynomolgus monkeys and identify biologically significant tolerance. Analysis of 67 genes identified 3 dominant factors, each with a different pattern of gene expressions, relating to T cell-mediated rejection (TCMR), chronic antibody-mediated rejection (CAMR), or Tolerance...
June 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29286578/rna-expression-profiling-of-renal-allografts-in-a-nonhuman-primate-identifies-variation-in-nk-and-endothelial-gene-expression
#19
R N Smith, B A Adam, I A Rosales, M Matsunami, T Oura, A B Cosimi, T Kawai, M Mengel, R B Colvin
RNA transcript expression estimates are a promising method to study the mechanisms and classification of renal allograft rejections. Here we use the Nanostring platform to profile RNA expression in renal allografts in a nonhuman primate (NHP), the Cynomolgus monkey. We analyzed protocol and indication 278 archival renal allograft samples, both protocol and indication from 76 animals with diagnoses of chronic antibody-mediated rejection (CAMR), acute cellular rejection (TCMR), and MIXED (both CAMR and TCMR), plus normals and samples with no pathological rejection using a Cynomolgus-specific probe set of 67 genes...
June 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29274236/successful-steroid-withdrawal-guided-by-surveillance-biopsies-a-single-center-experience
#20
Caroline Wehmeier, Patricia Hirt-Minkowski, Patrizia Amico, Argyrios Georgalis, Helmut Hopfer, Jürg Steiger, Michael Dickenmann, Stefan Schaub
Steroid withdrawal following renal transplantation is challenging and widely debated. This retrospective study aimed at investigating the frequency and determinants of successful steroid withdrawal guided by surveillance biopsies. We analyzed 156 pretransplant DSA-negative renal transplants receiving basiliximab induction and maintenance immunosuppression with tacrolimus-mycophenolate-steroids. The absence of rejection in surveillance biopsies at 3 or 6 months post-transplant initiated steroid withdrawal, which was monitored by subsequent indication and/or surveillance biopsies...
March 2018: Clinical Transplantation
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