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Kidney transplant donor

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https://www.readbyqxmd.com/read/28638610/looking-for-the-needle-in-the-kidney-transplantation-haystack
#1
Josep M Cruzado, Edoardo Melilli
The diagnosis of acute rejection still relies on renal allograft biopsy. In fact, histological features including C4d staining can be useful to differentiate cellular and antibody-mediated acute rejection. However, the pathogenic mechanism to define the type of rejection is usually assessed by anti-HLA donor specific antibodies (DSA) monitoring. Suspicion of acute rejection is usually based on renal function deterioration. This method has low sensitivity. Moreover, creatinine increase follows graft injury and therefore the diagnosis is performed when there is an ongoing acute rejection...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28637095/selective-cd28-blockade-results-in-superior-inhibition-of-donor-specific-t-follicular-helper-cell-and-antibody-responses-relative-to-ctla-4-ig
#2
I R Badell, G M La Muraglia, D Liu, M E Wagener, G Ding, M L Ford
Donor-specific antibodies (DSA) are a barrier to improved long-term outcomes following kidney transplantation. Costimulation blockade with CTLA-4-Ig has shown promise as a potential therapeutic strategy to control DSA. T follicular helper (Tfh) cells, a subset of CD4(+) T cells required for optimum antibody production, are reliant on the CD28 costimulatory pathway. We have previously shown that selective CD28 blockade leads to superior allograft survival through improved control of CD8(+) T cells relative to CTLA-4-Ig, but the impact of CD28-specific blockade on CD4(+) Tfh cells is unknown...
June 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28637093/intra-abdominal-cooling-system-limits-ischemia-reperfusion-injury-during-robot-assisted-renal-transplantation
#3
Raphael P H Meier, Vincent Piller, Monika E Hagen, Charles Joliat, Jean-Bernard Buchs, Antonio Nastasi, Raphael Ruttimann, Nicolas C Buchs, Solange Moll, Jean-Paul Vallée, François Lazeyras, Philippe Morel, Leo Bühler
Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follow: Robotic renal transplantation with (n=11) and without (n=6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n=6). Renal cortex temperature, magnetic resonance imaging and histology were analyzed...
June 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28636137/the-experience-of-waiting-for-a-kidney-transplant-a-qualitative-study
#4
Tania Burns, Ritin Fernandez, Moira Stephens
BACKGROUND: In Australia over 1100 people are living on dialysis while waiting for a kidney transplant from a deceased donor. Worldwide there are an estimated 170,000 people who wait an average of three years before an organ becomes available. OBJECTIVE: To provide an understanding of the lived experience of people waiting on dialysis for a kidney transplant from a deceased donor. APPROACH: A qualitative descriptive research design was used...
June 21, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28636074/optimizing-outcomes-in-pancreas-transplantation-impact-of-organ-preservation-time
#5
Ehren N Rudolph, Ty B Dunn, David E R Sutherland, Raja Kandaswamy, Erik B Finger
Recent changes to pancreas graft allocation policy have increased the number of organs available for regional and distant sharing, which results in a corresponding increase in preservation time. We sought to systematically assess the impact of cold ischemia time (CIT) on outcomes posttransplant. A retrospective review of 1,253 pancreas transplants performed at a single transplant center was performed to correlate CIT to transplant outcomes. The rate of technical failure (TF) increased with 20+ hours of CIT, with a 2...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28634772/the-effect-of-desensitization-therapy-in-kidney-transplantation
#6
Yong Chul Kim, Mi-Yeon Yu, Jung Pyo Lee, Hajeong Lee, Sang-Il Min, Jongwon Ha, Yon Su Kim
BACKGROUND: Desensitization therapy may enable the patient to get allograft in sensitized recipient or solve the organ shortage in ABO-incompatible relationship in kidney transplantation (KT). However, the graft outcome and morbidity remains unclear. METHODS: We retrospectively analyzed 845 KT patients from January 2010 to February 2016 at Seoul National University Hospital. The patients were divided into three groups as follows: HLA-incompatible (HLAi) group, ABO-incompatible (ABOi) group, and control group...
June 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28631900/-experimental-development-and-rationale-for-a-renal-decellularization-protocol-with-subsequent-comprehensive-assessment-of-the-biological-scaffold
#7
P V Glybochko, S N Alekseenko, E A Gubareva, E V Kuevda, A A Basov, A S Sotnichenko, S S Dzhimak, I S Gumenyuk, I Kh Egiev, V N Chechelyan, R Z Nakokhov, O M Lyasota, Yu V Teterin
Chronic renal failure (CRF) is one of the most challenging problems of contemporary medicine. Patients with chronic renal failure usually need renal replacement therapy as either hemodialysis, peritoneal dialysis or a kidney transplant. The latter is the most promising option for end-stage kidney disease. However, the shortage of donor organs, the complexity of their delivery, the difficulty in finding an immunologically compatible donor and the need for lifelong immunosuppression triggered advances in modern tissue engineering...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28629951/immunogenicity-of-class-i-hla-but-not-preformed-low-mfi-donor-specific-antibodies-correlates-with-outcomes-after-first-renal-transplantation
#8
A Lobashevsky, W Goggins, K Rosner, T Taber
BACKGROUND: The role of low levels of circulating donor specific antibodies (DSA) producing negative flow cytometry cross match is not completely defined. The purpose of this study was to examine the clinical significance of preexisting low levels of class I DSAs in flow cytometry cross match (FC CM) negative first kidney transplant recipients (KTRs). METHODS: All of the KTRs (n=41) had low levels of anti-class I antibodies only. The kidney transplant outcome was evaluated by the development of a deleterious effect (DE) in recipients in the study cohort (Group 1: DE+, Group 2: DE-)...
June 16, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28624888/steady-state-pharmacokinetics-of-mycophenolic-acid-in-renal-transplant-patients-exploratory-analysis-of-the-effects-of-cyclosporine-recipients-and-donors-abcc2-gene-variants-and-their-interactions
#9
N Božina, Z Lalić, S Nađ-Škegro, A Borić-Bilušić, T Božina, Ž Kaštelan, V Trkulja
PURPOSE: The study aims to evaluate the impact of recipients' and donors' polymorphisms in multidrug resistance-associated protein 2 (MRP2) gene ABCC2 -24C>T and 1249G>A on disposition of mycophenolic acid (MPA) and their interaction with cyclosporine (CsA) (compared to tacrolimus, TAC) in stable de novo adult renal transplant patients of Croatian origin. METHODS: A total of 68 recipient-donor pairs were genotyped. Steady-state pharmacokinetics of MPA was assessed by the model-independent method...
June 18, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28624489/association-of-genetic-polymorphisms-of-macrophage-inhibitory-factor-mif-and-b-cell-activating-factor-baff-with-the-detection-of-donor-specific-antibodies-in-kidney-allograft-recipients
#10
Youngil Chang, Tariq Shah, David I Min
The posttransplant development of donor specific antibodies (DSA) initiates the antibody mediated rejection (AMR), which is associated with the increased rate of graft loss. One of the characteristics of AMR is the infiltration of innate immune system including macrophages, monocytes, neutrophils or NK cells. Macrophage inhibitory factor (MIF) and B-cell activating factor (BAFF) are well known cytokines that are associated with the activation of the innate immune system which can damage kidney allograft. In this article, the association of the genetic polymorphisms of MIF and BAFF with the development of DSA including Class I and II in kidney transplant patients is investigated...
June 14, 2017: Human Immunology
https://www.readbyqxmd.com/read/28621640/clinical-and-biochemical-characteristics-of-brain-dead-donors-as-predictors-of-early-and-long-term-renal-function-after-transplant
#11
Ewa Kwiatkowska, Leszek Domański, Joanna Bober, Krzysztof Safranow, Andrzej Pawlik, Kazimierz Ciechanowski, Magda Wiśniewska, Karolina Kędzierska
OBJECTIVES: Organs from brain-dead donors are the main source of allografts for transplant. Comparisons between living-donor and brain-dead donor kidneys show that the latter are more likely to demonstrate delayed graft function and lower long-term survival. This study aimed to assess the effects of various clinical and biochemical factors of donors on early- and long-term renal function after transplant. MATERIALS AND METHODS: We analyzed data from kidney recipients treated between 2006 and 2008 who received organs from brain-dead donors...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28621638/urologic-complications-after-renal-transplant-a-single-center-experience
#12
Hakan Sözen, Metin Onaran, Onur Özen, Aydın Dalgıç
OBJECTIVES: Urologic complications after kidney transplant are associated with significant morbidity, mortality, and prolonged hospital stay. An intervention or second surgical procedure is frequently required. Here, we report urologic complications in adult kidney recipients. MATERIALS AND METHODS: Since 2006, 171 adult kidney transplant procedures have been performed at the Gazi University Transplantation Center (Ankara, Turkey). Among these patients, there were 65 adult female (38%) and 106 adult male (62%) recipients...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28621636/is-brain-dead-donor-fluid-therapy-with-colloids-associated-with-better-kidney-grafts
#13
Niko Limnell, Alexey A Schramko
OBJECTIVES: Fluid therapy is required to maintain perfusion to donor organs. Recent reviews on the choices of fluids have emphasized the safety of using crystalloids, as opposed to fluid therapy with colloids, which has been reported to be either unequivocally or potentially harmful in a number of studies on various patient populations. We aimed to analyze whether the type of fluid administered to donors is connected with kidney transplant outcomes. MATERIALS AND METHODS: A total of 100 consecutive brain-dead multiorgan donors and their respective 181 kidney recipients were studied retrospectively...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#14
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28620650/graft-function-and-intermediate-term-outcomes-of-kidney-transplants-improved-in-the-last-decade-analysis-of-the-united-states-kidney-transplant-database
#15
Douglas Scott Keith, Gayle Vranic, Angie Nishio-Lucar
BACKGROUND: Previous analyses of the United States transplant database regarding long-term outcomes in kidney transplantation have shown minimal improvement in the rate of long-term graft loss. This study sought to analyze intermediate-term outcomes and graft function at 6 months in kidney transplantation in adult living and deceased donor recipients in the last decade. METHODS: Survival analysis was performed based on the year of transplant between 6 months and 3 years' posttransplant...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28620390/belatacept-does-not-inhibit-follicular-t-cell-dependent-b-cell-differentiation-in-kidney-transplantation
#16
Gretchen N de Graav, Dennis A Hesselink, Marjolein Dieterich, Rens Kraaijeveld, Wenda Verschoor, Dave L Roelen, Nicolle H R Litjens, Anita S Chong, Willem Weimar, Carla C Baan
Humoral alloreactivity has been recognized as a common cause of kidney transplant dysfunction. B-cell activation, differentiation, and antibody production are dependent on IL-21(+)CXCR5(+)follicular T-helper (Tfh) cells. Here, we studied whether belatacept, an inhibitor of the costimulatory CD28-CD80/86-pathway, interrupts the crosstalk between Tfh- and B-cells more efficiently than the calcineurin inhibitor tacrolimus. The suppressive effects of belatacept and tacrolimus on donor antigen-driven Tfh-B-cell interaction were functionally studied in peripheral blood mononuclear cells from 40 kidney transplant patients randomized to a belatacept- or tacrolimus-based immunosuppressive regimen...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28618165/herpes-simplex-virus-2-transmission-following-solid-organ-transplantation-donor-derived-infection-and-transplantation-from-prior-organ-recipients
#17
Nenad Macesic, Ian J Abbott, Matthew Kaye, Julian Druce, Allan R Glanville, Paul J Gow, Peter D Hughes, Tony M Korman, William R Mulley, Phillip J O'Connell, Helen Opdam, Miranda Paraskeva, Matthew C Pitman, Stella Setyapranata, William D Rawlinson, Paul D R Johnson
BACKGROUND: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2-infected recipient who subsequently became a donor. METHODS: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized...
June 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28617169/the-frequency-and-associated-factors-for-bk-virus-infection-in-a-center-performing-mainly-living-kidney-transplantations
#18
Selma Alagoz, Mert Kuskucu, Sibel Gulcicek, Serkan Feyyaz Yalin, Meric Oruc, Kenan Midilli, Erkan Yılmaz, Mehmet Riza Altiparmak, Nurhan Seyahi
PURPOSE: BK virus (BKV) nephropathy has increasingly become an important cause of morbidity in renal transplant recipients. We evaluated the frequency and associated factors for BKV infection in a center performing mainly living donor transplantations over a long time period. METHODS: One hundred consecutive renal transplant patients were included. Quarterly visits were planned to examine urine for decoy cells and to measure the BKV DNA in the blood and urine. Renal biopsy was performed in case of deteriorated allograft function...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28613436/the-incremental-cost-of-incompatible-living-donor-kidney-transplant-a-national-cohort-analysis
#19
David Axelrod, Krista L Lentine, Mark A Schnitzler, Xun Luo, Huiling Xiao, Babak J Orandi, Allan Massie, Jacqueline Garonzik-Wang, Mark D Stegall, Stanley C Jordan, Jose Oberholzer, Ty B Dunn, Lloyd E Ratner, Sandip Kapur, Ronald P Pelletier, John P Roberts, Marc L Melcher, Pooja Singh, Debra L Sudan, Marc P Posner, Jose M El-Amm, Ron Shapiro, Matthew Cooper, George S Lipkowitz, Michael A Rees, Christopher L Marsh, Bashir R Sankari, David A Gerber, Paul W Nelson, Jason Wellen, Adel Bozorgzadeh, A Osama Gaber, Robert A Montgomery, Dorry L Segev
Incompatible living donor kidney transplant (ILDKT) has been established as an effective option for end stage renal disease (ESRD) patients with willing but HLA incompatible live donors, reducing mortality and improving quality of life. Depending upon antibody titer, ILDKT can require highly resource intensive procedure including intravenous immunoglobulin, plasma exchange and/or cell depleting antibody treatment as well as protocol biopsies and DSA testing. This study sought to compare the cost and Medicare reimbursement, exclusive of organ acquisition payment, for ILDKT recipients (N=926) with varying antibody titers to matched compatible transplants (N=2762) performed between 2002-2011...
June 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28613392/donor-recipient-matching-based-on-predicted-recognizable-hla-epitopes-predicts-the-incidence-of-de-novo-donor-specific-hla-antibodies-following-renal-transplantation
#20
Nils Lachmann, Matthias Niemann, Petra Reinke, Klemens Budde, Danilo Schmidt, Fabian Halleck, Axel Pruß, Constanze Schönemann, Eric Spierings, Oliver Staeck
De novo donor-specific HLA antibodies (dnDSA) are recognized as risk factor for premature allograft failure. Determinants of DSA specificity are generated via the indirect allorecognition pathway. Here, we present supportive data for the relevance of predicted indirectly recognizable HLA epitopes (PIRCHE) to predict dnDSA following kidney transplantation. A total of 2,787 consecutive kidney transplants performed 1995-2015 without preformed DSA have been analyzed. De novo DSA were detected by single antigen bead assay...
June 14, 2017: American Journal of Transplantation
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