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https://www.readbyqxmd.com/read/27910187/ureteral-stent-duration-and-the-risk-of-bk-polyomavirus-viremia-or-bacteriuria-after-kidney-transplantation
#1
Jonathan T Wingate, Jared Brandenberger, Andrew Weiss, Lauren G Scovel, Christian S Kuhr
OBJECTIVES: Ureteral stents are used in kidney transplantation (KTX) to decrease post-operative complications, but are associated with BK polyomavirus viremia (BKV). Our primary outcome was to determine the association between ureteral stent duration and BKV. Secondary outcome measures were the association between bacteriuria and stent duration or use of ureteral stent strings. METHODS: Between January 2010 and January 2015, 403 patients underwent KTX at Virginia Mason Medical Center and met inclusion criteria...
December 2, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27900977/unconventional-strategies-in-the-battle-of-focal-and-segmental-glomerulosclerosis
#2
Satish Mendonca, R S V Kumar, Devika Gupta, Pooja Gupta, Satish Barki, M L Sharma
A 24-year-old male presented with classic features of the nephrotic syndrome. An initial renal biopsy revealed minimal change disease and thereafter, a second biopsy showed features of focal and segmental glomerulosclerosis. There was no response to conventional immunosuppression, and the patient had to be given rituximab; in spite of this, he went on to develop end-stage renal disease. He continued to have heavy proteinuria leading to severe hypoalbuminemia, thrombosis, infections, and malnutrition, placing the patient in a life-threatening situation...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900974/disseminated-mycobacteria-chelonae-infection-in-a-kidney-pancreas-transplant-recipient-a-case-report-and-review-of-the-literature
#3
Shafi Malik, Ananda Ghosh, Shahid Husain
A 40-year-old male with a long-standing history of type 1 diabetes with end-stage renal failure underwent combined kidney-pancreas (KP) transplant from a standard criteria donor. Post-operative course was uncomplicated with good primary function of both transplant grafts. Induction was with thymoglobulin and maintenance immunosuppression was with tacrolimus, mycophenolate mofetil and prednisolone. Nine weeks post-transplant, the patient developed dysfunction of both grafts. Panel reactive antibody testing revealed that the patient had developed a de novo donor-specific antibody and considering an antibody-mediated rejection the patient was treated with intravenous pulse methyl prednisone 500 mg ×3 doses, IV immunoglobulin 2 mg/kg in two divided doses, and ATG 7 mg/kg (total dose of 700 mg)...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27895419/acute-kidney-injury-and-post-reperfusion-syndrome-in-liver-transplantation
#4
REVIEW
Ilaria Umbro, Francesca Tinti, Irene Scalera, Felicity Evison, Bridget Gunson, Adnan Sharif, James Ferguson, Paolo Muiesan, Anna Paola Mitterhofer
In the past decades liver transplantation (LT) has become the treatment of choice for patients with end stage liver disease (ESLD). The chronic shortage of cadaveric organs for transplantation led to the utilization of a greater number of marginal donors such as older donors or donors after circulatory death (DCD). The improved survival of transplanted patients has increased the frequency of long-term complications, in particular chronic kidney disease (CKD). Acute kidney injury (AKI) post-LT has been recently recognized as an important risk factor for the occurrence of de novo CKD in the long-term outcome...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27894836/use-of-complement-binding-assays-to-assess-the-efficacy-of-antibody-mediated-rejection-therapy-and-prediction-of-graft-survival-in-kidney-transplantation
#5
Daniel S Ramon, Yihung Huang, Lili Zhao, TrisAnn Rendulic, Jeong M Park, Randall S Sung, Milagros Samaniego
BACKGROUND: The Luminex(®) single antigen bead assay (SAB) is the method of choice for monitoring the treatment for antibody-mediated rejection (AMR). A ⩾50% reduction of the dominant donor-specific antibody (IgG-DSA) mean fluorescence intensity (MFI) has been associated with improved kidney allograft survival, and C1q-fixing DSA activity is associated with poor outcomes in patients with AMR. We aimed to investigate if C1q-DSA can be used as a reliable predictor of response to therapy and allograft survival in patients with biopsy-proven AMR...
November 25, 2016: Human Immunology
https://www.readbyqxmd.com/read/27889778/primary-intestinal-hodgkin-lymphoma-mimicking-intraabdominal-abscess-in-a-renal-transplant-recipient-a-case-report
#6
Biljana Mihaljevic, Darko Antic, Vojin Vukovic, Maja Perunicic Jovanovic, Visnja Lezaic, Nemanja Zaric, Mirko Kerkez, Vladimir Djordjevic
INTRODUCTION: Post-transplant lymphoproliferative disease (PTLD) comprises a variety of lymphoid and plasma cell disorders arising in patients with a solid organ transplant. Monomorphic lymphomas represent the most significant part of this wide spectrum, with the overall risk rising with the aggressiveness of lymphoid proliferation in comparison to the general population. The development of Hodgkin lymphoma is very rare in transplant recipients, comprising less than 6% of all monomorphic PTLD, while cases of primary intestinal Hodgkin lymphoma in these circumstances are anecdotal...
2016: Oncology Research and Treatment
https://www.readbyqxmd.com/read/27889299/safety-and-efficacy-outcomes-3-years-after-switching-to-belatacept-from-a-calcineurin-inhibitor-in-kidney-transplant-recipients-results-from-a-phase-2-randomized-trial
#7
Josep M Grinyó, Maria Del Carmen Rial, Josefina Alberu, Steven M Steinberg, Roberto C Manfro, Georgy Nainan, Flavio Vincenti, Charlotte Jones-Burton, Nassim Kamar
BACKGROUND: In a phase 2 study, kidney transplant recipients of low immunologic risk who switched from a calcineurin inhibitor (CNI) to belatacept had improved kidney function at 12 months postconversion versus those continuing CNI therapy, with a low rate of acute rejection and no transplant loss. STUDY DESIGN: 36-month follow-up of the intention-to-treat population. SETTING & PARTICIPANTS: CNI-treated adult kidney transplant recipients with stable transplant function (estimated glomerular filtration rate [eGFR], 35-75mL/min/1...
November 23, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27888673/clinical-correlates-of-pp65-antigenemia-monitoring-in-the-first-months-of-post-kidney-transplant-in-patients-undergoing-universal-prophylaxis-or-preemptive-therapy
#8
Fabiana Rabe Carvalho, Rachel Ingrid Juliboni Cosendey, Cintia Fernandes Souza, Thalia Medeiros, Paulo Alexandre Menezes, Andrea Alice Silva, Jorge Reis Almeida, Jocemir Ronaldo Lugon
INTRODUCTION: Human cytomegalovirus (HCMV) is a major cause of morbidity in kidney transplant patients. OBJECTIVES: We aimed to study viral replication and serological response in the first months post kidney transplant in patients undergoing universal prophylaxis or preemptive therapy and correlate the findings with the clinical course of HCMV infection. PATIENTS AND METHODS: Independent from the clinical strategy adopted for managing HCMV infection, prophylaxis versus preemptive therapy, the pp65 antigenemia assay and serological response were assessed on the day of transplantation, and then weekly during the first three months of post-transplant...
November 23, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27888573/b-cell-activating-factor-baff-a-predictor-of-antibody-mediated-rejection-in-kidney-transplantation-recipients
#9
Wannarat Pongpirul, Wiwat Chancharoenthana, Krit Pongpirul, Asada Leelahavanichakul, Wipawee Kittikowit, Kamonwan Jutivorakool, Bunthoon Nonthasoot, Yingyos Avihingsanon, Somchai Eiam-Ong, Kearkiat Praditpornsilpa, Natavudh Townamchai
BACKGROUND: Donor-specific antibody (DSA) is a widely-used biomarker for antibody-mediated rejection (ABMR) but correctly indicates only 30-40% of patients with ABMR. Additional biomarkers of ABMR in kidney transplant recipients are needed. METHODS: All 68 kidney transplanted-recipients enrolled in this study were negative for graft rejection as determined by surveillance-biopsy ELISA at day 7 post-transplantation. Allograft biopsy was then performed at 6 months post-transplantation for subclinical-ABMR detection...
November 26, 2016: Nephrology
https://www.readbyqxmd.com/read/27888569/providing-coverage-for-the-unique-life-long-health-care-needs-of-living-kidney-donors-within-the-framework-of-financial-neutrality
#10
John S Gill, Francis Delmonico, Scott Klarenbach, Alexander Morgan Capron
Organ donation should neither enrich nor impose financial burdens on donors. We describe the scope of health care required for all living kidney donors that reflects contemporary understanding of long-term donor health outcomes, propose an approach to identify donor health conditions which should be covered within the framework of financial neutrality, and propose strategies to pay for this care. Despite the Affordable Care Act in the United States, donors continue to have inadequate coverage for important health conditions that are either donation related or may compromise post-donation kidney function...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888534/early-steroid-withdrawal-results-in-improved-patient-and-graft-survival-and-lower-risk-of-post-transplant-cardiovascular-risk-profiles-a-single-center-10-year-experience
#11
Reynold Lopez-Soler, Ryan Chan, Jessica Martinolich, Lisa Park, Ashar Ata, Nikolaos Chandolias, David Conti
Long term use of steroids results in predictable secondary effects that can lead to increased morbidity and mortality. In this study, we present 10 years' worth of data of early steroid withdrawal (ESW) immunosuppression consisting of Mycophenolate, Sirolimus, and Tacrolimus. From 2003 to 2013, 563 kidney transplant recipients were weaned off steroids prior to discharge. We compared outcomes with that of our 65 historical controls maintained on steroids. We analyzed graft and patient survival and determined the incidence of steroid-related comorbidities such as hypertension, hypercholesterolemia, diabetes, coronary artery disease, and weight gain...
November 26, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27888276/communicating-about-choices-in-transplantation-coach-results-of-a-pilot-test-using-matched-controls
#12
Heather M Traino, Stacy M West, Camilla W Nonterah, Jennifer Russell, Eva Yuen
INTRODUCTION: Previous research highlights the difficulties patients with end-stage renal disease awaiting kidney transplant experience while attempting to manage both the logistical and the content-related aspects of discussions about transplantation. This article presents pilot results of the behavioral communication intervention program, Communicating about Choices in Transplantation (COACH), designed to improve transplant candidates' communication about transplantation. RESEARCH QUESTIONS: As compared to matched controls, increases in knowledge of deceased and living donor transplantation, communication self-efficacy, intentions to hold conversations about transplantation, and self-reported discussion were expected for pilot participants from pre- and postassessment; decreases in conversational difficulties were also posited...
November 25, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27888093/randomized-trial-of-ratg-daclizumab-vs-ratg-alemtuzumab-as-dual-induction-therapy-in-renal-transplantation-results-at-8-years-of-follow-up
#13
Gaetano Ciancio, Jeffrey J Gaynor, Giselle Guerra, Junichiro Sageshima, David Roth, Linda Chen, Warren Kupin, Adela Mattiazzi, Lissett Tueros, Sandra Flores, Lois Hanson, Phillip Ruiz, Rodrigo Vianna, George W Burke
Our goal in using dual induction therapy is to bring the kidney transplant recipient closer (through more effectively timed lymphodepletion) to an optimally immunosuppressed state. Here, we report long-term results of a prospective randomized trial comparing (Group I,N=100) rATG/Dac (3 rATG, 2 Dac doses) vs. (Group II,N=100) rATG/Alemtuzumab(C1H) (1 dose each), using reduced tacrolimus dosing, EC-MPS, and early corticosteroid withdrawal. Lower EC-MPS dosing was targeted in Group II to avoid severe leukopenia...
November 22, 2016: Transplant Immunology
https://www.readbyqxmd.com/read/27887677/outcome-disparities-between-african-americans-and-caucasians-in-contemporary-kidney-transplant-recipients
#14
David J Taber, Leonard E Egede, Prabhakar K Baliga
BACKGROUND: Racial disparities in African-American (AA) kidney transplant have persisted for nearly 40 years, with limited data available on the scope of this issue in the contemporary era of transplantation. METHODS: Descriptive retrospective cohort study of US registry data including adult solitary kidney transplants between Jan 1, 2005 to Dec 31, 2009. RESULTS: 60,695 recipients were included; 41,426 Caucasians (68%) and 19,269 AAs (32%)...
November 18, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27881245/the-transplantex-initiative
#15
EDITORIAL
Seiamak Bahram, Raphael Carapito, Pierre-Antoine Gourraud, Dominique Charron
TRANSPLANTEX, a French "investment for the future" initiated consortium of leading transplant units and research laboratories across France and a number of European countries aims to unravel, through mainly high-throughput genomics (and other omics) analyses of donor and recipients, novel (a) non-HLA, histocompatibility antigens, whether inside, or outside the MHC; (b) pre/post transplantation biomarkers. This shall lead to our better understanding of the pathophysiology of (and eventually designing better therapeutics for) the graft-versus-host disease in hematopoietic cell transplants and that of chronic graft rejection after kidney transplant...
November 2016: Human Immunology
https://www.readbyqxmd.com/read/27875005/asunaprevir-daclatasvir-and-sofosbuvir-ledipasuvir-for-recurrent-hepatitis-c-following-living-donor-liver-transplantation
#16
Kiyohiko Omichi, Nobuhisa Akamatsu, Kazuhiro Mori, Junichi Togashi, Junichi Arita, Junichi Kaneko, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Norihiro Kokudo
AIM: This study aimed to clarify the efficacy and safety of interferon-free therapy using asunaprevir and daclatasvir, or sofosbuvir and ledipasuvir for post living donor liver transplantation (LDLT) recipients with hepatitis C virus (HCV). METHODS: A retrospective cohort study of LDLT recipients with HCV genotype 1b treated with asunaprevir (100 mg twice daily) and daclatasvir (60 mg once daily), or sofosbuvir (400 mg/day) and ledipasvir (90 mg/day) was conducted...
November 22, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/27873516/cyclosporine-sparing-effect-of-enteric-coated-mycophenolate-sodium-in-de-novo-kidney-transplantation
#17
Su Hyung Lee, Jae Berm Park, Chang Kwon Oh, Myoung Soo Kim, Sung Joo Kim, Jongwon Ha
PURPOSE: The increased tolerability of enteric-coated mycophenolate sodium (EC-MPS), compared to mycophenolate mofetil, among kidney transplant recipients has the potential to facilitate cyclosporine (CsA) minimization. Therefore, a prospective trial to determine the optimum EC-MPS dose in CsA-based immunosuppression regimens is necessary. MATERIALS AND METHODS: A comparative, parallel, randomized, open-label study was performed for 140 patients from four centers to compare the efficacy and tolerability of low dose CsA with standard dose EC-MPS (the investigational group) versus standard dose CsA with low dose EC-MPS (the control group) for six months in de novo kidney transplant recipients...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27873464/hyalinosis-lesions-in-renal-transplant-biopsies-time-dependent-complexity-of-interpretation
#18
Gunilla Einecke, Jeff Reeve, Philip F Halloran
Because calcineurin inhibitor immunosuppressive drugs (CNIs) induce arteriolar hyalinosis (ah) in kidney transplants, ah lesions can potentially provide information about drug exposure. We studied the relationship of ah lesions to findings and outcomes in 562 indication biopsies taken 3 days to 35 years post-transplant. Prevalence of ah lesions increased with time post-transplant (TxBx). Ah-scores correlated with arterial intimal thickening and atrophy-fibrosis but, unlike atrophy-fibrosis, did not increase until after 500 days because of a background of ah1 lesions in early biopsies reflecting donor aging...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27871893/clinical-effects-of-pre-transplant-serum-25-hydroxyvitamin-d-level-on-post-transplant-immunologic-and-non-immunologic-outcomes-in-kidney-transplant-recipients
#19
Tae Hyun Ban, Jeong Ho Kim, Han Beol Jang, Yoon Seo Lee, Bum Soon Choi, Cheol Whee Park, Chul Woo Yang, Yong-Soo Kim, Byung Ha Chung
BACKGROUND: The aim of this study was to investigate the effects of pre-transplant serum 25-hydroxyvitamin D (25(OH)D) level on non-immunologic and immunologic aspects of post-transplant clinical outcomes in kidney transplant recipients (KTRs). METHODS: We investigated 174 KTRs with low immunologic risk at baseline. We divided the patients into three groups according to baseline serum 25(OH)D level and compared the post-transplant clinical outcomes of acute rejection, infectious complications, and osteoporosis among the groups...
November 18, 2016: Transplant Immunology
https://www.readbyqxmd.com/read/27871759/rabbit-atg-or-basiliximab-induction-for-rapid-steroid-withdrawal-after-renal-transplantation-harmony-an-open-label-multicentre-randomised-controlled-trial
#20
Oliver Thomusch, Michael Wiesener, Mirian Opgenoorth, Andreas Pascher, Rainer Peter Woitas, Oliver Witzke, Bernd Jaenigen, Markus Rentsch, Heiner Wolters, Thomas Rath, Tülay Cingöz, Urs Benck, Bernhard Banas, Christian Hugo
BACKGROUND: Standard practice for immunosuppressive therapy after renal transplantation is quadruple therapy using antibody induction, low-dose tacrolimus, mycophenolate mofetil, and corticosteroids. Long-term steroid intake significantly increases cardiovascular risk factors with negative effects on the outcome, especially post-transplantation diabetes associated with morbidity and mortality. In this trial, we examined the efficacy and safety parameters of rapid steroid withdrawal after induction therapy with either rabbit antithymocyte globulin (rabbit ATG) or basiliximab in immunologically low-risk patients during the first year after kidney transplantation...
November 18, 2016: Lancet
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