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Antibody mediated rejection

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https://www.readbyqxmd.com/read/29757906/preventing-antibody-mediated-rejection-during-transplantation-the-potential-of-tfr-cells
#1
Peter T Sage
No abstract text is available yet for this article.
May 1, 2018: Transplantation
https://www.readbyqxmd.com/read/29757900/detection-of-complement-binding-donor-specific-antibodies-not-igg-antibody-strength-nor-c4d-status-at-antibody-mediated-rejection-diagnosis-is-an-independent-predictor-of-kidney-graft-failure
#2
Jorge Malheiro, Sofia Santos, Sandra Tafulo, Leonídio Dias, La Salete Martins, Isabel Fonseca, Manuela Almeida, Sofia Pedroso, Idalina Beirão, António Castro-Henriques, António Cabrita
BACKGROUND: Antibody-mediated rejection (ABMR) remains associated with reduced kidney graft survival and no clear prognostic marker is available. METHODS: We investigated whether donor-specific antibodies (DSA) ability to bind C1q in comparison with ABMR C4d status, both indirect signs of complement activation, improve risk stratification at time of ABMR. Hence, among 467 patients in whom ≥1 graft biopsy was performed between 2008 and 2015, we included 56 with ABMR according to Banff'15 criteria...
May 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29755922/the-approach-to-antibodies-after-heart-transplantation
#3
Olivia N Gilbert, Patricia P Chang
a Purpose of review: This review summarizes recent data about antibodies after cardiac transplantation; what testing modalities are available and how frequently to employ them; as well as when treatment is necessary. b Recent findings: Technologies available for antibody detection have progressed over the past couple decades. New and preformed antibodies are associated with worse outcomes in transplant recipients. c Summary: The frequency of screening for post-transplant antibodies and for antibody-mediated rejection (AMR) should be based on risk stratification...
September 2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#4
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...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29751884/acute-chronic-and-humoral-rejection-pathologic-features-under-current-immunosuppressive-regimes
#5
REVIEW
Jamie Koo, Hanlin L Wang
Under current immunosuppressive regimes, T-cell-mediated acute and chronic rejection remain common and important posttransplant complications. The definition of humoral (antibody-mediated) rejection has been greatly expanded in recent years. The histopathologic assessment of allograft biopsies continues to serve an important role in the diagnosis of rejection and to facilitate patient management. The diagnosis of both acute and chronic antibody-mediated rejection requires integration of the results of donor-specific antibody testing and C4d immunostaining, as well as exclusion of other potential etiologies of allograft dysfunction...
June 2018: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29747114/effect-of-double-filtration-plasmapheresis-for-antibody-mediated-rejection-on-hemostasis-parameters-and-thrombin-generation
#6
R Marlu, P Malvezzi, L Seyve, T Jouve, J Maurizi, F Defendi, P L Carron, M Christophe, A Le Gouellec, B Polack, L Rostaing
INTRODUCTION: Donor-specific alloantibodies (DSAs) cause kidney-allograft loss in chronic antibody-mediated rejection (CAMR). Treatment relies on blocking antibody-producing cells and removing DSAs by apheresis: e.g., double-filtration plasmapheresis (DFPP). MATERIALS AND METHODS: To determine the impact of DFPP (6 or 8 sessions/patient) on clotting factors and natural anticoagulants, and on thrombin generation, we performed a prospective and observational study in five CAMR kidney-transplant patients who received DFPP plus rituximab therapy...
April 20, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29746495/tacrolimus-intra-patient-variability-is-not-associated-with-chronic-active-antibody-mediated-rejection
#7
Kasia A Sablik, Marian C Clahsen-van Groningen, Dennis A Hesselink, Teun van Gelder, Michiel G H Betjes
BACKGROUND: Chronic active antibody mediated rejection (c-aABMR) is a major cause of long-term kidney allograft loss. It is hypothesized that frequent sub-therapeutic exposure to immunosuppressive drugs, in particular tacrolimus (Tac), is a risk factor for the development of c-aABMR. The intra-patient variability (IPV) in Tac exposure may serve as a substitute biomarker for underexposure and/or non-adherence. In this study, the association between Tac IPV and the development of c-aABMR was investigated...
2018: PloS One
https://www.readbyqxmd.com/read/29742565/current-challenges-and-opportunities-in-the-management-of-antibody-mediated-rejection-in-lung-transplantation
#8
Amanda L Hulbert, Elizabeth N Pavlisko, Scott M Palmer
PURPOSE OF REVIEW: There is increasing recognition of the importance of antibody-mediated rejection (AMR) after lung transplantation. The development of donor-specific antibodies, a key feature of AMR, occurs in approximately 30% of lung transplant recipients and is associated with poor posttransplant outcomes. This review highlights recently developed AMR diagnostic criteria in lung transplantation, potential mechanisms that mediate the development of AMR, and discusses current and emerging treatment strategies for this significant, graft-limiting complication...
June 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29740433/syk-inhibition-induces-apoptosis-in-germinal-center-like-b-cells-by-modulating-the-antiapoptotic-protein-myeloid-cell-leukemia-1-affecting-b-cell-activation-and-antibody-production
#9
Nathalie Roders, Florence Herr, Gorbatchev Ambroise, Olivier Thaunat, Alain Portier, Aimé Vazquez, Antoine Durrbach
B cells play a major role in the antibody-mediated rejection (AMR) of solid organ transplants, a major public health concern. The germinal center (GC) is involved in the generation of donor-specific antibody-producing plasma cells and memory B cells, which are often poorly controlled by current treatments. Myeloid cell leukemia-1 (Mcl-1), an antiapoptotic member of the B-cell lymphoma-2 family, is essential for maintenance of the GC reaction and B-cell differentiation. During chronic AMR (cAMR), tertiary lymphoid structures resembling GCs appear in the rejected organ, suggesting local lymphoid neogenesis...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29737533/a-randomized-first-in-human-healthy-volunteer-trial-of-bivv009-a-humanized-antibody-for-the-specific-inhibition-of-the-classical-complement-pathway
#10
Johann Bartko, Christian Schoergenhofer, Michael Schwameis, Christa Firbas, Martin Beliveau, Colin Chang, Jean-Francois Marier, Darrell Nix, James C Gilbert, Sandip Panicker, Bernd Jilma
Aberrant activation of the classical complement pathway is the common underlying pathophysiology of orphan diseases such as bullous pemphigoid, antibody-mediated rejection of organ transplants, cold agglutinin disease and warm autoimmune haemolytic anaemia. Therapeutic options for these complement-mediated disorders are limited and BIVV009, a humanized monoclonal antibody directed against complement factor C1s, may be potentially useful for inhibition of the classical complement pathway. A phase-1, first-in-human, double-blind, randomized, placebo-controlled, dose-escalation trial of single and multiple doses of BIVV009 or placebo was conducted in 64 volunteers to evaluate safety, tolerability, pharmacokinetic, and pharmacodynamic profiles...
May 8, 2018: Clinical Pharmacology and Therapeutics
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/29731774/b7-h1-expression-is-required-for-human-endometrial-regenerative-cells-in-the-prevention-of-transplant-vasculopathy-in-mice
#12
Kui Ye, Xu Lan, Grace Wang, Baoren Zhang, Xiaoxi Xu, Xiang Li, Yiming Zhao, Hao Wang
Vasculopathy is one of the primary pathological changes in chronic rejection of vascularized allograft transplantation. Endometrial regenerative cells (ERCs) are mesenchymal-like stromal cells with immunosuppressive effect. B7-H1 is a negative costimulator that mediates active immune suppression. The aim of this study was to investigate the requirement of B7-H1 in the immunoregulation of ERCs in preventing transplant vasculopathy of aorta allografts. The results showed that B7-H1 expression on ERCs was upregulated by IFN- γ in a dose-dependent manner and it was required for ERCs to inhibit the proliferation of peripheral blood mononuclear cells (PBMCs) in vitro ...
2018: Stem Cells International
https://www.readbyqxmd.com/read/29731065/vdj-gene-usage-of-b-cell-receptors-in-peripheral-blood-of-abo-incompatible-kidney-transplantation-patients
#13
H J Jeon, T Fang, J-G Lee, J Y Jang, K Kim, S Choi, J-J Yan, J H Ryu, T Y Koo, C Ahn, J Yang
INTRODUCTION: B cell subtypes and immunoglobulin variable (V), diversity (D), joining (J) gene segment usage of B cell receptors in ABO-incompatible (ABOi) kidney transplantation (KT) in comparison to ABO-compatible KT have not been studied. The aims of this study were to analyze the VDJ gene segment usages of B cell receptors in peripheral blood of ABOi KT recipients. METHODS: Eighteen ABOi KT patients with accommodation (ABOiA), 10 ABO-compatible stable KT patients (ABOcS), and 10 ABOi KT patients with biopsy-proven acute antibody-mediated rejection (ABOiR) at day 10 after transplantation were selected...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731056/clinical-significance-of-macrophage-polarization-in-antibody-mediated-rejection-of-renal-allograft
#14
J Kim, S-E Choi, B J Lim, Y S Kim, K H Huh, J Lee, S I Kim, M S Kim, H J Jeong
BACKGROUND: The significance of proinflammatory M1 (classically activated) and profibrotic M2 (alternatively activated) macrophages in antibody-mediated rejection (ABMR) after kidney transplantation has not been investigated. METHODS: Fifty-five biopsy-confirmed ABMR samples were stained with MRP 8/14 (a marker of M1 macrophages) and CD163 (a marker of M2 macrophages), and positive cells were counted in glomeruli and the tubulointerstitium, respectively. Patients were classified into M1 and M2 polarization groups according to the glomerular and tubulointerstitial M1:M2 ratio, and the results were compared with Banff scores, serum creatinine level, estimated glomerular filtration rate (eGFR), and graft survival...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29729067/pathological-antibody-mediated-rejection-in-pediatric-heart-transplant-recipients-immunologic-risk-factors-hemodynamic-significance-and-outcomes
#15
Seth A Hollander, David M Peng, Marcos Mills, Gerald J Berry, Marny Fedrigo, Doff B McElhinney, Christopher S Almond, David N Rosenthal
Biopsy-diagnosed pAMR has been observed in over half of pediatric HT recipients within 6 years of transplantation. We report the incidence and outcomes of pAMR at our center. All endomyocardial biopsies for all HT recipients transplanted between 2010 and 2015 were reviewed and classified using contemporary ISHLT guidelines. Graft dysfunction was defined as a qualitative decrement in systolic function by echocardiogram or an increase of ≥3 mm Hg in atrial filling pressure by direct measurement. Among 96 patients, pAMR2 occurred in 7 (7%) over a median follow-up period of 3...
May 4, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29707626/single-graft-utilization-from-donors-with-severe-acute-kidney-injury-after-circulatory-death
#16
Yusuke Tomita, Kazuhiro Iwadoh, Yuichi Ogawa, Katsuyuki Miki, Kotaro Kai, Akihito Sannomiya, Toru Murakami, Ichiro Koyama, Kumiko Kitajima, Ichiro Nakajima, Shohei Fuchinoue
Chronic shortages of organs for transplantation have led to the use of marginal kidneys from donors after circulatory death with acute kidney injury (AKI), but the utilization of kidneys with severe AKI is not well established. We retrospectively analyzed eight kidney transplantation (KTx) cases from donation after circulatory death (DCD) with terminal creatinine (t-Cr) concentrations higher than 10.0 mg/dL and/or oliguria for more than 5 days (AKI network criteria: stage III). Although all patients showed delayed graft function, no cases of primary nonfunction (PNF) were found...
April 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29705074/kidney-transplantation-in-hiv-positive-patients-a-single-center-16-year-experience
#17
Gregory E Malat, Suzanne M Boyle, Rahul M Jindal, Stephen Guy, Gary Xiao, Meera N Harhay, Dong H Lee, Karthik M Ranganna, Mysore S Anil Kumar, Alden M Doyle
Hahnemann University Hospital has performed 120 kidney transplantations in human immunodeficiency virus (HIV)-positive individuals during the last 16 years. Our patient population represents ∼10% of the entire US population of HIV-positive kidney recipients. In our earlier years of HIV transplantation, we noted increased rejection rates, often leading to graft failure. We have established a multidisciplinary team and over the years have made substantial protocol modifications based on lessons learned. These modifications affected our approach to candidate evaluation, donor selection, perioperative immunosuppression, and posttransplantation monitoring and resulted in excellent posttransplantation outcomes, including 100% patient and graft survival at 1 year and patient and graft survival at 3 years of 100% and 96%, respectively...
April 25, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29704327/morphological-characterization-of-chronic-antibody-mediated-rejection-in-abo-identical-or-compatible-pediatric-liver-graft-recipients
#18
Myriam Dao, Dalila Habès, Jean-Luc Taupin, Charlotte Mussini, Marie-José Redon, Caroline Suberbielle, Emmanuel Jacquemin, Emmanuel Gonzales, Catherine Guettier
ASBTRACT This study aims to define the morphological profile associated with the presence of donor-specific antibodies (DSA) and/or C4d immunostaining in ABO-identical or compatible pediatric liver grafts. Ten-year protocol liver graft biopsies performed at 131.3 ± 15.3 months post-transplantation in 53 pediatric liver graft recipients were reviewed. Immunostaining for C4d was systematically performed and semi-quantitatively analyzed. DSA were concurrently quantified and results were available for 44 patients...
April 27, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29687946/does-tubulitis-without-interstitial-inflammation-represent-borderline-acute-t-cell-mediated-rejection
#19
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-centre, 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=0...
April 24, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#20
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
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