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Transplant rejection

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https://www.readbyqxmd.com/read/28107397/efficacy-and-safety-of-everolimus-for-maintenance-immunosuppression-of-kidney-transplantation-a-meta-analysis-of-randomized-controlled-trials
#1
Jinyu Liu, Dong Liu, Juan Li, Lan Zhu, Chengliang Zhang, Kai Lei, Qiling Xu, Ruxu You
BACKGROUND: Conversion to everolimus is often used in kidney transplantation to overcome calcineurin inhibitor (CNI) nephrotoxicity but there is conflicting evidence for this approach. OBJECTIVES: To investigate the benefits and harm from randomized clinical trials (RCTs) involving the conversion from CNI to everolimus after kidney transplantation. METHODS: Databases were searched up to March 2016. Two reviewers independently assessed trials for eligibility and quality, and extracted data...
2017: PloS One
https://www.readbyqxmd.com/read/28105976/early-subretinal-allograft-rejection-is-characterized-by-innate-immune-activity
#2
Kevin P, Toby M, Deborah M, Cliona O Farrelly, David J
<p>Successful subretinal transplantation is limited by considerable early graft loss, despite pharmacological suppression of adaptive immunity. We postulated that early innate immune activity is a dominant factor in determining graft survival and chose a non-immunosuppressed mouse model of retinal pigment epithelial (RPE) cell transplantation to explore this.</p><p>Expression of almost all measured cytokines by DH01 RPE cells increased significantly following graft preparation and the neutrophil chemoattractant, KC/GRO/CINC, was most significantly increased...
January 20, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28105753/efficacy-and-safety-of-high-dose-chemotherapy-with-autologous-stem-cell-transplantation-in-senior-versus-younger-adults-with-newly-diagnosed-multiple-myeloma
#3
Li-Wen Huang, Wendi Bacon, Constance Cirrincione, Bercedis Peterson, Gwynn Long, David Rizzieri, Keith M Sullivan, Kelly Corbet, Mitchell Horwitz, Nelson Chao, Cristina Gasparetto, Sascha A Tuchman
We retrospectively studied 340 fit patients with multiple myeloma (MM) who underwent autologous stem cell transplantation (ASCT). We hypothesized that progression-free survival (PFS) of older patients was non-inferior to that of younger patients after ASCT. Our null hypothesis was that the PFS hazard ratio (HR) for a 5-year increase in age was ≥1.05; the alternative (non-inferiority) hypothesis was that the HR was ≤1. The observed HR was 0.94 (95% confidence interval [CI] 0.86-1.03); since the CI upper bound was <1...
January 19, 2017: Hematological Oncology
https://www.readbyqxmd.com/read/28104301/differences-in-pathologic-features-and-graft-outcomes-in-antibody-mediated-rejection-of-renal-allografts-due-to-persistent-recurrent-versus-de-novo-donor-specific-antibodies
#4
Mark Haas, James Mirocha, Nancy L Reinsmoen, Ashley A Vo, Jua Choi, Joseph M Kahwaji, Alice Peng, Rafael Villicana, Stanley C Jordan
Antibody-mediated rejection (ABMR) of renal allografts occurs in two forms. Type 1 ABMR results from persistence and/or a rebound of preexisting donor-specific antibodies in sensitized patients and usually occurs early post-transplantation. Type 2 ABMR is associated with de novo donor-specific antibodies and usually occurs over one year post-transplantation. It is generally accepted that types 1 and 2 also differ with regard to certain pathologic features including the frequencies of C4d positivity and concurrent cell-mediated rejection...
January 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28104166/kidney-donor-risk-index-as-the-predictor-for-the-short-term-clinical-outcomes-after-kidney-transplant-from-deceased-donor-with-acute-kidney-injury
#5
H Jun, C W Jung, S Lim, M G Kim
BACKGROUND: The Kidney Donor Risk Index (KDRI) scoring system for deceased donors has been widely introduced for postoperative evaluation of graft function. We analyzed the usefulness of the KDRI in deceased donors with acute kidney injury (AKI). METHODS: Forty-nine recipients from deceased donors with AKI between January 2009 and December 2014 were reviewed retrospectively. Data collected from donor medical records included age, height, weight, hypertension or diabetes history, cause of death, serum creatinine (sCr), and donation after cardiac death...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104165/highly-immunogenic-dqb1-mismatch-eplets-are-associated-with-development-of-chronic-active-antibody-mediated-rejection-a-first-report-from-japan
#6
D Iwami, K Hotta, H Sasaki, T Hirose, H Higuchi, Y Takada, N Shinohara
BACKGROUND: De novo donor-specific antibody (dnDSA), especially against class II HLA, correlates with chronic active antibody-mediated rejection (CAAMR), which eventually leads to graft loss. It would be helpful if we could identify the patients at high risk of dnDSA development in terms of histocompatibility. Structure-based matching strategy assessing mismatched epitopes/eplets by comparing polymorphic amino acid sequences can predict the risk of development of dnDSA and CAAMR. However, it has not been evaluated in Japanese patients whose diversity in HLA is limited...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104163/hyperuricemia-and-acute-renal-failure-in-renal-transplant-recipients-treated-with-high-dose-mizoribine
#7
K Akioka, T Ishikawa, M Osaka, Y Kadotani, K Okugawa, K Nakano, Y Osaka, K Tsuchiya, H Sako
BACKGROUND: Hyperuricemia is a common adverse event frequently found in renal transplant recipients with mizoribine (MZ). Hyperuricemia itself will be a cause of renal dysfunction, and renal dysfunction also will be a cause of hyperuricemia simultaneously. This study investigates frequency of hyperuricemia and renal failure in renal transplant recipients treated with high-dose MZ. PATIENTS AND METHODS: From December 2007 to October 2015, there was a total of 32 living related renal transplant recipients treated with high-dose MZ...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104159/similar-anemic-control-between-chronic-kidney-diseases-in-patients-with-and-without-transplantation-on-entry-to-dialysis
#8
K Yamazaki, K Sakai, Y Ohashi, H Nihei, T Itabashi, M Muramatsu, T Kawamura, S Shishido, A Aikawa
BACKGROUND: Transplant recipients are supposedly in a more anemic, catabolic, and even inflammatory state at re-entering hemodialysis due to chronic rejection. The goal of this study was to clarify how transplant recipients can re-enter dialysis safely by focusing on control of anemia. METHODS: From 2012 to 2014, a total of 29 transplant recipients re-entered hemodialysis because of chronic rejection (ie, the chronic kidney disease with transplant [CKDT] group)...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104157/clinical-courses-of-graft-failure-caused-by-chronic-allograft-dysfunction-in-kidney-transplantation
#9
T Fujiwara, S Teruta, S Tsudaka, K Ota, H Matsuda
BACKGROUND: Chronic allograft dysfunction (CAD) is a main cause of graft failure in kidney transplantation. METHODS: We retrospectively analyzed 279 kidney transplant recipients who survived with a functioning graft for at least 2 years. CAD was defined as chronic graft deterioration, excluding other specific causes. We defined the pattern of decline in estimated glomerular filtration rate (eGFR), as follows: (1) "plateau" was defined as decline in eGFR ≤2 mL/min/1...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104155/immunosuppression-modification-by-everolimus-with-minimization-of-calcineurin-inhibitors-recovers-kidney-graft-function-even-in-patients-with-very-late-conversion-and-also-with-poor-graft-function
#10
M Nojima, Y Yamada, Y Higuchi, K Shimatani, A Kanematsu, S Yamamoto
BACKGROUND: Although kidney graft survival within 5 years after transplantation is now achieved in >95% of recipients, chronic graft deterioration remains a factor limiting long-term survival. Chronic nephrotoxicity induced by calcineurin inhibitors (CNIs) is one of the major causes of chronic graft injury; thus, minimization of CNIs by administration of everolimus (EVR) is expected to relieve their toxic effects. METHODS: Fifty-six kidney transplant recipients receiving CNI-based immunosuppression (tacrolimus, n = 34; cyclosporine, n = 22) were analyzed...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104152/experience-of-quatro-therapy-with-everolimus-to-minimize-calcineurin-inhibitor-for-kidney-transplant-recipients
#11
N Nakamura, T Miyazaki, H Matsuzaki, R Furuya, S Miyajima, S Irie, H Matsuoka, M Tanaka
BACKGROUND: This study was divided into three phases, on the occasion of the introduction of everolimus (EVR) in our hospital. METHODS: In the first phase, a study group of six maintenance patients (three living related donors, three deceased donors) who had a history of malignant disease with less than 500 mg/day of proteinuria were enrolled; a high serum creatinine and upper limit of duration after kidney transplant operation was not considered. EVR was discontinued in four of the six patients because of side effects or worsening renal function...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104150/comparison-of-mizoribine-and-mycophenolate-mofetil-with-a-tacrolimus-based-immunosuppressive-regimen-in-living-donor-kidney-transplantation-recipients-a-retrospective-study-in-china
#12
Y Shi, H Liu, X-G Chen, Z-Y Shen
BACKGROUND: A retrospective study was conducted to investigate the prevalence of gastrointestinal (GI) symptoms as well as the efficacy and safety of mizoribine (MZR) and mycophenolate mofetil (MMF) in Chinese living-donor kidney transplantation (LDKT). METHODS: Forty-two recipients enrolled between January 2012 and March 2014 were treated with either MZR (n = 22) or MMF (n = 20). All patients were treated in combination with a tacrolimus-based immunosuppressive regimen, besides the study drugs...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104146/successful-rescue-of-late-onset-antibody-mediated-rejection-12-years-after-living-donor-intestinal-transplantation-a-case-report
#13
G S Wu, Q C Zhao, Z S Li, Y Wu, W Z Wang, M B Li, H Shi, M Wang, D L Chen, J Y Zheng, X Wang, D M Fan
BACKGROUND: Antibody-mediated rejection (ABMR) has recently surfaced as a potential form of graft dysfunction after intestinal transplantation. METHODS: We present a case of an intestinal transplant recipient who developed late-onset ABMR 12 years after living-donor transplantation. An 18-year-old male recipient with a history of extensive intestinal resection secondary to acute bowel volvulus exhibited an excellent baseline immune profile for transplantation, including ABO-identical and HLA-haploidentical to the donor; a negative cross-match with a panel reactive antibody of 3...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104144/pancreas-transplantation-after-liver-transplantation-a-case-report
#14
J H Ryu, T B Lee, Y M Park, K H Yang, C W Chu, J H Lee, B H Choi
Our aim was to describe the clinical indications, surgical technique, and clinical outcomes of a pancreas transplantation, performed 4 years after liver transplantation, as treatment for new-onset, uncontrolled diabetes mellitus in a 53-year-old man. Liver transplantation was performed for end-stage liver disease secondary to hepatitis B virus infection and hepatocellular carcinoma. The patient had no history of diabetes prior to the liver transplantation. The decision to proceed with a pancreas transplantation was made when the patient's blood sugar levels could not be normalized despite insulin doses >100 IU/d...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104140/a-case-report-of-the-resolution-of-multiple-recalcitrant-verrucae-in-a-renal-transplant-recipient-after-a-mycophenolate-mofetil-dose-reduction
#15
M M Ash, P S Jolly
Renal transplant recipients are at an increased risk of developing verrucae due to chronic immunosuppression, and certain therapies may confer a greater risk. Herein, we describe a 51-year-old woman with a 10-year-old unrelated kidney transplant who developed numerous therapy-resistant verrucae while on mycophenolate mofetil and tacrolimus maintenance immunosuppression. Over several years of immunosuppressant therapy, she declined the approach of reducing her mycophenolate mofetil dose to potentially improve her verrucae...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104138/a2-to-b-blood-type-incompatible-deceased-donor-kidney-transplantation-in-a-recipient-infected-with-the-human-immunodeficiency-virus-a-case-report
#16
R C Forbes, A DeMers, B P Concepcion, D R Moore, H M Schaefer, D Shaffer
BACKGROUND: With the introduction of the Kidney Allocation System in the United States in December 2014, transplant centers can list eligible B blood type recipients for A2 organ offers. There have been no prior reports of ABO incompatible A2 to B deceased donor kidney transplantation in human immunodeficiency virus-positive (HIV+) recipients to guide clinicians on enrolling or performing A2 to B transplantations in HIV+ candidates. We are the first to report a case of A2 to B deceased donor kidney transplantation in an HIV+ recipient with good intermediate-term results...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104135/renal-allograft-aspergillus-infection-presenting-with-obstructive-uropathy-a-case-report
#17
L Sadagah, M Alharbi, M Alshomrani, A Almalki
BACKGROUND: Isolated renal allograft aspergillosis is rare and usually presents with fever and decreased glomerular filtration rate. Presentation with obstructive uropathy caused by aspergillus fungal balls is much less common. We report a young male patient who presented with obstructive uropathy secondary to isolated renal allograft aspergillus infection 6 weeks after transplant. He was treated with nephrectomy and antifungal medications. CASE PRESENTATION: A 29-year-old Saudi male patient had a recent living non-related kidney transplantation in Pakistan...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104134/eculizumab-and-belatacept-for-de-novo-atypical-hemolytic-uremic-syndrome-associated-with-cfhr3-cfhr1-deletion-in-a-kidney-transplant-recipient-a-case-report
#18
P Dedhia, A Govil, G Mogilishetty, R R Alloway, E S Woodle, B G Abu Jawdeh
BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is associated with significant morbidity and mortality and occurs due to genetic or acquired abnormalities that result in the dysregulation of the alternative complement pathway. CASE REPORT: We report a case of post-living kidney transplantation de novo aHUS in a setting of heterozygous deletion in the complement factor H-related protein (CFHR)3-CFHR1 gene. The aHUS episode was possibly triggered by antibody-mediated rejection or tacrolimus...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104127/calcineurin-inhibitor-induced-pain-syndrome-in-abo-incompatible-living-kidney-transplantation-a-case-report
#19
S Ishida, M Kato, T Fujita, Y Funahashi, N Sassa, Y Matsukawa, Y Yoshino, T Yamamoto, T Katsuno, S Maruyama, M Gotoh
BACKGROUND: Calcineurin-inhibitor-induced pain syndrome (CIPS) was used as a reference in the literature as reflex sympathetic dystrophy syndrome related to calcineurin inhibitors. Much of the literature describes CIPS that occurred after kidney and bone marrow transplantation. We describe a rare case of CIPS in induction immunosuppression before kidney transplantation, under administration of an anti-rheumatoid drug. METHODS: A 53-year-old woman had pre-status of ABO-incompatible living kidney transplantation...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104125/efficacy-of-eculizumab-therapy-for-atypical-hemolytic-uremic-syndrome-recurrence-and-antibody-mediated-rejection-progress-after-renal-transplantation-with-preformed-donor-specific-antibodies-case-report
#20
T Yamamoto, Y Watarai, K Futamura, M Okada, M Tsujita, T Hiramitsu, N Goto, S Narumi, A Takeda, T Kobayashi
Atypical hemolytic uremic syndrome (aHUS) develops as the result of unregulated complement progression and precipitates de novo thrombotic microangiopathy. Plasma therapy is used to control the progression of the complement cascade, but that therapy is not effective in all patients and is accompanied by risk of infection and/or allergy. Eculizumab has been reported as an efficient therapy for aHUS. We report the case of a 35-year old woman who underwent effective eculizumab therapy for aHUS recurrence and antibody-mediated rejection (AMR) progress after renal transplantation with preformed donor-specific antibodies (DSA)...
January 2017: Transplantation Proceedings
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