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induction of immunosuppression in renal transplantation

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https://www.readbyqxmd.com/read/30056888/effect-of-thrombophilic-factors-on-renal-graft-function-a-single-center-experience
#1
A Furmańczyk-Zawiska, T Bączkowska, D Dęborska-Materkowska, S Nazarewski, M Kosieradzki, M Durlik
BACKGROUND: Optimization of immunosuppressive therapy reduced the incidence of acute rejection, and therefore vascular complications, including graft thrombosis, which have emerged as the main cause of graft loss in the early post-transplant period. A thrombophilic condition may lead to renal graft loss. The aim of the study was to assess renal graft function in thrombophilic renal recipients receiving anticoagulation treatment. METHODS: This is a retrospective study including 29 renal recipients (ktx group) with a history of thrombosis and confirmed thrombophilic factor...
July 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30005996/low-risk-prostate-cancer-prior-to-or-after-kidney-transplantation
#2
REVIEW
Michael Stöckle, Kerstin Junker, Paolo Fornara
CONTEXT: Organ transplantation requires immunosuppression, which was regarded as a risk factor for tumor induction and tumor progression in all types of malignancy. Until recently, any form of active neoplasia was, therefore, regarded as contraindicative to organ transplantation. However, there is growing evidence that the increased tumor risk by immunosuppression is restricted to particular subgroups of malignancy, whereas others such as prostate cancer (PCa) are not negatively influenced...
July 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29957160/multifocal-soft-tissue-cryptococcosis-in-a-renal-transplant-recipient-the-importance-of-suspecting-atypical-pathogens-in-the-immunocompromised-host
#3
Saira Ajmal, Michael Keating, Mark Wilhelm
Cryptococcal infection has been documented in 2.8% of solid-organ transplant recipients, with the median time to disease onset being 21 months. Renal transplant recipients account for the majority of cases. Most patients present with central nervous system or disseminated disease, with only a minority having cutaneous manifestations. We present the case of a 47-year-old female renal transplant recipient who presented with refractory acute cellulitis 7 months after transplant. She had received thymoglobulin induction and was on a maintenance immunosuppressive regimen of tacrolimus, mycophenolic acid, and prednisone (5 mg/d)...
June 28, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29908044/utilization-and-efficacy-of-elbasvir-grazoprevir-for-treating-hepatitis-c-virus-infection-after-liver-transplantation
#4
Satoshi Miuma, Hisamitsu Miyaaki, Akihiko Soyama, Masaaki Hidaka, Mitsuhisa Takatsuki, Hidetaka Shibata, Naota Taura, Susumu Eguchi, Kazuhiko Nakao
AIM: Recently, elbasvir/grazoprevir combination therapy (EBR/GZR) was reported to have excellent antiviral effects for chronic genotype 1 hepatitis C virus (HCV) infection. However, it has not been recommended for patients with post-liver transplant (LT) HCV re-infections because of a lack of evidence for effectiveness and drug-drug interactions. METHODS: We report the usage of EBR/GZR in five post-LT HCV re-infected patients with the kinetics of renal function and tacrolimus trough levels during and after therapy...
June 16, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29900661/allograft-and-patient-survival-after-sequential-hsct-and-kidney-transplantation-from-the-same-donor-a-multicenter-analysis
#5
Michael Eder, Christoph Schwarz, Michael Kammer, Niels Jacobsen, Masouridi Levrat Stavroula, Morton J Cowan, Tepsiri Chongkrairatanakul, Robert Gaston, Rommel Ravanan, Hideki Ishida, Anette Bachmann, Sergio Alvarez, Martina Koch, Cyril Garrouste, Ulrich A Duffner, Brett Cullis, Nicolaas Schaap, Michael Medinger, Søren Schwartz Sørensen, Eva-Maria Dauber, Georg Böhmig, Heinz Regele, Gabriela A Berlakovich, Thomas Wekerle, Rainer Oberbauer
Tolerance induction through simultaneous hematopoietic stem cell and renal transplantation has shown promising results, but it is hampered by the toxicity of preconditioning therapies and graft-versus-host disease (GVHD). Moreover, renal function has never been compared to conventionally transplanted patients, thus, whether donor-specific tolerance results in improved outcomes remains unanswered. We collected follow-up data of published cases of renal transplantations after hematopoietic stem cell transplantation from the same donor and compared patient and transplant kidney survival as well as function with caliper-matched living-donor renal transplantations from the Austrian dialysis and transplant registry...
June 13, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29861562/carcinoma-of-the-tongue-in-renal-transplant-recipients-an-unusual-spectrum-of-de-novo-malignancy-at-a-tertiary-care-center-in-india-over-a-period-of-26-years
#6
G Narayan, R Jha, P Srikant, S Sinha, G Swarnalata, K V V N Raju
Renal transplant recipients are at a higher risk of malignancy. We report our experience and the critical differences in the presentation of malignancy in kidney transplant patients performed at our tertiary care center and followed up over the period of 1990-2015. A total of 338 live donor transplants performed in 332 patients were analyzed. Induction immunosuppression was used in 22 cases with interleukin-2 (IL-2) receptor antibody. Overall 299 patients were continued on calcineurin inhibitor (CNI)-based triple drug immunosuppression, 33 were off CNI with 13 of them receiving sirolimus additionally...
March 2018: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29809309/cytomegalovirus-prophylaxis-in-seropositive-renal-transplant-recipients-receiving-thymoglobulin-induction-therapy-outcome-and-risk-factors-for-late-cmv-disease
#7
Jose O Reusing, Emanoela B Feitosa, Fabiana Agena, Lígia C Pierrotti, Luiz S F Azevedo, Camille N Kotton, Elias David-Neto
BACKGROUND: Anti-thymocyte globulin (ATG) therapy is a risk factor for cytomegalovirus (CMV) disease in renal transplant (RTx) recipients and therefore antiviral prophylaxis is commonly used. We evaluated the outcome of our current policy of 90 days of CMV prophylaxis in seropositive recipients given ATG and the risk factors for the occurrence of CMV disease after prophylaxis. METHODS: We studied a retrospective cohort of 423 RTx (2010-2014) CMV-seropositive adults given ATG induction therapy...
May 29, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29809299/disseminated-mycobacterium-bovis-infection-post-kidney-transplant-following-remote-intravesical-bcg-therapy-for-bladder-cancer
#8
Jennifer Ziegler, Julie Ho, Ian W Gibson, Jasmir G Nayak, Markus Stein, Andrew Walkty, Pamela Orr
Intravesical Bacillus Camlette-Guérin (BCG) is the treatment of choice for non-muscle invasive bladder cancer, and has been used successfully for over 40 years. A rare and potentially fatal complication of intravesical BCG therapy is BCG-induced sepsis. We report a rare case in which a patient with end-stage renal disease secondary to chronic granulomatous interstitial nephritis underwent remote, pre-transplant intravesical BCG treatment for high-grade non-invasive papillary bladder carcinoma. The patient subsequently received a deceased donor kidney transplant 5 years after BCG therapy, with thymoglobulin induction therapy and standard triple maintenance immunosuppression...
May 29, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#9
Johan Noble, Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
Cornerstone immunosuppressive therapy currently relies on immediate-release tacrolimus, a calcineurin inhibitor (CNI) that is potentially nephrotoxic and is more diabetogenic than cyclosporine A. Two new formulations of tacrolimus have been launched: an extended-release formulation (Advagraf®/Astagraf XL®, Astellas company) and a long-lasting formulation (Envarsus®, Veloxis company). Area covered: Herein, we assess the efficacy of an extended-release formulation of tacrolimus (Advagraf®/Astagraf XL®) used in conjunction with or without an induction therapy (i...
June 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#10
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
July 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29731924/the-spectrum-of-histopathological-changes-in-the-renal-allograft-a-12-months-protocol-biopsy-study
#11
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/29709248/identifying-risk-profiles-in-liver-transplant-candidates-and-implications-for-induction-immunosuppression
#12
REVIEW
Umberto Cillo, Wolf O Bechstein, Gabriela Berlakovich, Philipp Dutkowski, Frank Lehner, Silvio Nadalin, Faouzi Saliba, Hans J Schlitt, Johann Pratschke
Changes in recipient and donor characteristics are redefining the role of induction in liver transplant recipients. Older recipients are more common, with greater concomitant comorbidity. Moderate or severe renal dysfunction is now estimated to affect 40% of liver transplant recipients. Donors are also becoming older, and other factors such as more frequent non-alcoholic fatty liver disease (NAFLD) compromise the quality of some grafts. Rejection rates are now relatively low (~10%) but some patients have a markedly increased risk such as younger recipients and those undergoing re-transplantation...
July 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29707628/poor-patient-and-graft-outcome-after-induction-treatment-by-antithymocyte-globulin-in-recipients-of-a-kidney-graft-after-nonrenal-organ-transplantation
#13
Hoa Le Mai, Michèle Treilhaud, Shani Leviatan Ben-Arye, Hai Yu, Hélène Perreault, Evelyn Ang, Katy Trébern-Launay, Julie Laurent, Stéphanie Malard-Castagnet, Anne Cesbron, Thi Van Ha Nguyen, Sophie Brouard, Lionel Rostaing, Pauline Houssel-Debry, Christophe Legendre, Sophie Girerd, Michèle Kessler, Emmanuel Morelon, Antoine Sicard, Valérie Garrigue, Georges Karam, Xi Chen, Magali Giral, Vered Padler-Karavani, Jean Paul Soulillou
Background: End-stage renal failure occurs in a substantial number of patients having received a nonrenal transplantation (NRT), for whom a kidney transplantation is needed. The medical strategy regarding the use of immunosuppression (IS) for a kidney graft in patients after an NRT is not well established. The prekidney grafts long-term IS advocates for a mild induction, such as using anti-IL-2R antibodies, whereas addition of new incompatibilities and anti-HLA preimmunization may suggest using stronger IS such as induction by polyclonal antithymocyte globulins (ATG)...
April 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29701351/heart-transplantation-early-results-of-two-different-regimes-of-immnunosuppression
#14
Carlos Branco, David Prieto, André Antunes, Manuel Batista, Manuel J Antunes
INTRODUCTION: The management of induction and maintenance immunosuppression therapy after heart transplantation (HT) remains a controversial issue. The dosage and the timing has been a changing target. We aimed at evaluate the incidence of acute cellular rejection (ACR) [≥1R grade], major infection and survival in first year after HT in patients receiving two different induction immunosuppression regimes and with a reduction in intensity of triple maintenance immunosuppression dose...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29679515/the-influence-of-mtor-inhibitors-on-the-incidence-of-cmv-infection-in-high-risk-donor-positive-recipient-negative-d-r-kidney-transplant-recipients
#15
Marina Pontello Cristelli, Ronaldo Matos Esmeraldo, Cahue Motta Pinto, Taina Veras Sandes-Freitas, Claudia Felipe, Clarissa Ferreira Lobo, Laila Viana, Juliana Mansur, Suelen Stopa, Daniel Wagner Castro Santos, Patricia Cristina Grenzi, Wilson Ferreira Aguiar, Helio Tedesco-Silva, Jose Osmar Medina Pestana
INTRODUCTION: Several studies and meta-analysis suggest the mTOR inhibitors are associated with reduced incidence of CMV infection after kidney transplantation, although their effects on the high-risk population have not been investigated thoroughly. OBJECTIVE: This retrospective cohort study investigates the association between immunosuppression and CMV infection in D+/R- kidney transplant recipients receiving preemptive therapy. METHODS: All patients received rabbit anti-thymocyte globulin, tacrolimus, prednisone and azathioprine (AZA), mycophenolate (MPA) or everolimus (EVR)...
April 21, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29661440/renopancreatic-transplantation-evaluation-of-15-years-in-131-patients
#16
C G Marmanillo, C Langaro, J E Nicoluzzi, R T Belila, M Macri, R Zamprogna, M Luvizotto, M Takahashi
BACKGROUND: The most common multiple-organ transplant is the simultaneous pancreas-kidney transplantation (SPK). It is usually offered to patients who have insulin-dependent diabetes mellitus and those with diabetic nephropathy and renal failure that has already been established. In this study we present the results of 15 years of SPK in a transplant hospital center in Paraná, Brazil, and evaluated survival, immunosuppression, and transplant-related problems. METHODS: This study was a retrospective analysis of 131 SPK transplants performed at the Angelina Caron Hospital between January 2001 and December 2015...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579884/prevalence-and-survival-of-cancer-after-pancreas-kidney-transplantation
#17
M V Pendón-Ruiz de Mier, M L Agüera, M D Navarro, A Rodriguez-Benot, P Aljama
BACKGROUND: Malignancy is an important cause of mortality in solid organ transplantation. There have been few studies of de novo solid organ malignancy (NSOM) after pancreas-kidney transplantation (PKT). The aim of this study was analyze the prevalence of NSOM and transplant outcomes. METHODS: We studied the development of NSOM after PKT in our center from May 1990 to February 2017. We analyzed demographic characteristics, prevalence of cancer, and survival after cancer diagnosis...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579825/renal-transplantation-in-second-level-private-hospitals-in-the-state-of-mexico
#18
A Armenta Bautista, A Armenta Álvarez, E Mancilla Urrea, G Mondragón, S Aburto Mendoza, R Pérez Mendoza, R González González, M S Escalona Delgado, R Arroyo Borrego, C A Vilchis Canales, C Rocio Lagunas, I Santana Serrano, H Armenta Álvarez, D Valle Ponce
BACKGROUND: Kidney transplantation (KT) is the replacement therapy of choice in patients with end-stage renal disease (ESRD). Here we show a cohort of kidney transplant recipients from the period of May 1994 to May 2016 in 2 2nd-level private hospitals from the city of Toluca in the state of Mexico. METHODS: We checked the clinical files of all the patients that received KT in the period of study. RESULTS: We report 25 KT: 23 performed in Sanatorio Toluca and 2 in Sanatorio Florencia; 16 (64%) male and 9 (26%) female; mean age 36...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579822/highly-hla-sensitized-kidney-transplant-patients-in-a-transplant-center
#19
P K Garcia, J Toro, C Borda, C Gonzalez, M P Rodriguez, K Contreras
INTRODUCTION: Approximately 10% to 30% of patients on renal transplant waiting lists are sensitized, which gives them more time on the waiting list. Transplantation in this setting has a greater risk of rejection and decreased graft survival. New strategies of donor allocation through virtual crossmatching and optimization of immunosuppressive therapies in induction and maintenance have allowed the allocation of organs for this population, which in other circumstances would not be chosen for a kidney transplant...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29515582/cd4-t-cell-help-is-mandatory-for-naive-and-memory-donor-specific-antibody-responses-impact-of-therapeutic-immunosuppression
#20
Chien-Chia Chen, Alice Koenig, Carole Saison, Suzan Dahdal, Guillaume Rigault, Thomas Barba, Morgan Taillardet, Dimitri Chartoire, Michel Ovize, Emmanuel Morelon, Thierry Defrance, Olivier Thaunat
Antibody-mediated rejection is currently the leading cause of transplant failure. Prevailing dogma predicts that B cells differentiate into anti-donor-specific antibody (DSA)-producing plasma cells only with the help of CD4+ T cells. Yet, previous studies have shown that dependence on helper T cells decreases when high amounts of protein antigen are recruited to the spleen, two conditions potentially met by organ transplantation. This could explain why a significant proportion of transplant recipients develop DSA despite therapeutic immunosuppression...
2018: Frontiers in Immunology
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