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Transplant rejection

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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
#1
M P Cristelli, R M Esmeraldo, C Motta Pinto, T V Sandes-Freitas, C Felipe, C F Lobo, L Viana, J Mansur, S Stopa, D W C Santos, P C Grenzi, W F Aguiar, H Tedesco-Silva, J O Medina-Pestana
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. This retrospective cohort study investigates the association between immunosuppression and CMV infection in D+/R- kidney transplant recipients receiving preemptive therapy. 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/29677072/state-of-the-art-role-of-the-dendritic-cell-in-induction-of-allograft-tolerance
#2
Sarah J Rosen, Paul E Harris, Mark A Hardy
Despite decades of research, the induction and maintenance of long-term allograft tolerance without immunosuppression remains an elusive goal in the field of solid organ and cell transplantation. Immunosuppressive medications frequently prevent or minimize acute cellular rejection but have failed to halt anti-donor antibody production and chronic organ rejection. Past efforts aimed at promoting lasting allograft tolerance have focused primarily on peripheral T cell depletion, augmentation of regulatory T cells, or induction via simultaneous hematopoietic stem cell transplantation and facilitation of donor chimerism...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29676812/impact-of-pretransplant-donor-specific-antibodies-on-kidney-allograft-recipients-with-negative-flow-cytometry-crossmatches
#3
Hyunwook Kwon, Young Hoon Kim, Ji Yoon Choi, Sung Shin, Joo Hee Jung, Su-Kil Park, Duck Jong Han
The Luminex test can detect low levels of donor-specific antibody (DSA) that cannot be detected by flow-cytometric crossmatching (FCXM) in kidney transplantation (KT). This study evaluated the impact of DSA on clinical outcomes in KT recipients negative on FCXM. Of 575 consecutive patients who underwent living donor KT between January 2013 and July 2016, 494 (85.9%) were DSA-negative and 81 (14.1%) were DSA-positive. Although rates of acute cellular rejection (ACR) at 1 year were similar in the two groups (P = 0...
April 20, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29676803/outcome-of-the-risk-stratified-desensitization-protocol-in-donor-specific-antibody-positive-living-kidney-transplant-recipients-a-retrospective-study
#4
Daigo Okada, Masayoshi Okumi, Yoichi Kakuta, Kohei Unagami, Junpei Iizuka, Toshio Takagi, Hideki Ishida, Kazunari Tanabe
Acceptable outcomes of donor-specific antibody (DSA)-positive living kidney transplantation (LKT) have recently been reported. However, LKT in crossmatch (XM)-positive patients remains at high-risk and requires an optimal desensitization protocol. We report our intermediate-term outcomes of XM-positive LKT versus XM-negative LKT in patients who underwent LKT between January 2012 and June 2015 in our institution. The rate of acute antibody-mediated rejection (ABMR) within 90 days post-operation, graft function, and patient and graft survival rates at 4 years were investigated...
April 20, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29676700/impact-of-allograft-nephrectomy-on-second-renal-transplant-outcome
#5
Masaki Muramatsu, Yoji Hyodo, Michael Sheaff, Arun Gupta, Neil Ashman, Atsushi Aikawa, Magdi Yaqoob, Carmelo Puliatti
OBJECTIVES: The impact of allograft nephrectomy on the outcome of a subsequent renal transplant is unclear. This study was conducted to assess the effects of the first allograft nephrectomy on outcomes of a second transplant. MATERIALS AND METHODS: This study included 118 patients who received a second transplant between 1994 and 2015. Before the second transplant, 59 patients did not undergo a first allograft nephrectomy (group A). Group B comprised 59 patients who had undergone a first allograft nephrectomy...
April 20, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29676031/treatment-of-recurrent-focal-segmental-glomerulosclerosis-post-kidney-transplantation-in-australian-and-new-zealand-children-a-retrospective-cohort-study
#6
Anna Francis, Madeleine Didsbury, Hugh McCarthy, Tonya Kara
Disease recurrence affects around a third of renal transplants for children with FSGS and is associated with poor graft outcomes. Unfortunately, there are no large trials guiding treatment for recurrent FSGS. We aimed to describe current therapies and treatment response for recurrent FSGS in 4 centres in Australia and New Zealand. Data were collected on children (age <18 years) with recurrent FSGS (1990-2015). We reviewed patient charts to obtain clinical information. Ethics approval was obtained from the relevant boards...
April 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29676018/conversion-from-tacrolimus-mycophenolate-mofetil-to-tacrolimus-mtor-immunosuppression-after-kidney-pancreas-transplantation-reduces-the-incidence-of-both-bk-and-cmv-viremia
#7
Richard J Knight, Edward A Graviss, Duc T Nguyen, Samantha A Kuten, Samir J Patel, Lillian Gaber, A Osama Gaber
BACKGROUND: We sought to determine if conversion from tacrolimus/mycophenolate mofetil (TAC-MMF) to tacrolimus/mTOR inhibitor (TAC-mTOR) immunosuppression would reduce the incidences of BK and CMV viremia after kidney/pancreas (KP) transplantation. METHODS: In this single center review, the TAC-mTOR cohort (n=39) was converted at one month post-transplant to an mTOR inhibitor and reduced dose tacrolimus. Outcomes were compared to a cohort of KP recipients (n=40) maintained on TAC-MMF...
April 19, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29673076/suppressed-calcineurin-dependent-gene-expression-identifies-lung-allograft-recipients-at-increased-risk-of-infection
#8
John R Greenland, Tiffany Chong, Angelia S Wang, Emily Martinez, Pavan Shrestha, Jasleen Kukreja, Steven R Hays, Jeffrey A Golden, Jonathan P Singer, Qizhi Tang
Lung transplant immunosuppression regimens generally include the calcineurin inhibitor tacrolimus. We hypothesized that mean residual expression (MRE) of calcineurin-dependent genes assesses rejection and infection risk better than tacrolimus trough. We prospectively followed 44 lung allograft recipients 2 to 18 months post-transplant and measured changes in whole blood IL-2, interferon-γ, and GM-CSF gene expression following a tacrolimus dose. Post-transplant duration, immunosuppressive medication levels, and bronchoscopic rejection and infection assessments were compared with MRE using generalized-estimating equation-adjusted models...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29673068/molecular-definition-of-the-transplantation-antigens
#9
REVIEW
Peter Parham
In the first half of the twentieth century, the Major Histocompatibility Complex (MHC) of the laboratory mouse, the H-2 complex, was defined by a combination of serology and genetics. In the second half of the twentieth century, its human counterpart, the Human Leukocyte Antigen (HLA) complex was similarly defined and shown to mediate rejection of allogeneic kidney grafts. The clinical relevance of the transplantation antigens created the field of transplant immunology, which aimed to reduce graft rejection by HLA matching of transplant donors and recipients, and to use immunosuppressive drugs to prevent and treat rejection...
April 19, 2018: FEBS Journal
https://www.readbyqxmd.com/read/29673063/uv-light-crosslinking-regresses-mature-corneal-blood-and-lymphatic-vessels-and-promotes-subsequent-high-risk-corneal-transplant-survival
#10
Yanhong Hou, Viet Nhat Hung Le, Gábor Tóth, Sebastian Siebelmann, Jens Horstmann, Tim Gabriel, Felix Bock, Claus Cursiefen
Immunological graft rejection is the main complication after corneal transplantation into pathologically prevascularized so-called high risk eyes. Aim of this study was to evaluate whether UV-light crosslinking can regress pathological corneal blood and lymphatic vessels, and thereby improve subsequent graft survival. Using the murine model of suture-induced corneal neovascularization, we found that corneal crosslinking with ultraviolet (UV) A-light and riboflavin regressed both preexisting blood and lymphatic vessels significantly via inducing apoptosis in vascular endothelial cells...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29673058/pediatric-heart-transplantation-across-a-positive-crossmatch-first-year-results-from-the-ctotc-04-multi-institutional-study
#11
S Webber, A Zeevi, K Mason, L Addonizio, E Blume, A Dipchand, R Shaddy, B Feingold, C Canter, D Hsu, W Mahle, B Armstrong, Y Morrison, D Ikle, H Diop, J Odim
Sensitization is common in pediatric heart transplant candidates and wait list mortality is high. Transplantation across a positive crossmatch may reduce wait time, but is considered high risk. We prospectively recruited consecutive candidates at 8 North American centers. At transplantation, subjects were categorized as non-sensitized or sensitized (presence of ≥1 HLA antibody with MFI ≥1,000 using single antigen beads). Sensitized subjects were further classified as CDC-crossmatch positive or negative and as DSA positive or negative...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29672702/the-disappointing-contribution-of-anti-human-leukocyte-antigen-donor-specific-antibodies-characteristics-for-predicting-allograft-loss
#12
Maxime Courant, Jonathan Visentin, Gabriel Linares, Valérie Dubois, Sébastien Lepreux, Gwendaline Guidicelli, Olivier Thaunat, Pierre Merville, Lionel Couzi, Jean-Luc Taupin
Background: Pathogenicity of donor-specific antibodies (DSAs) can be assessed using the single-antigen flow beads (SAFB) assays through mean fluorescence intensity (MFI) with or without serum ethylenediaminetetraacetic acid (EDTA) treatment, measurement of C1q or C3d binding and/or their intragraft detection [graft-bound donor-specific antibody (gDSA)]. We aimed to investigate which of these markers best associates with antibody-mediated rejection (ABMR) and kidney allograft loss at the time of a for-cause biopsy...
April 17, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29672580/value-of-perioperative-genitourinary-screening-culture-and-colonization-status-in-predicting-early-urinary-tract-infection-after-renal-transplantation
#13
Ahram Han, Sanghyun Ahn, Seung-Kee Min, Jongwon Ha, Yon Su Kim, Curie Ahn, Sang-Il Min
BACKGROUND: We aimed to assess whether patients colonized with certain organisms in the genitourinary tract would have greater urinary tract infection (UTI) risk during the post-transplantation period, and whether information on the perioperatively colonized organisms may help identify the causal organisms during early UTI. METHODS: We retrospectively reviewed the culture results of preoperative urine, preoperative urethral swab, and postoperative urinary catheter tip specimens of 420 renal transplant recipients...
2018: PloS One
https://www.readbyqxmd.com/read/29670764/corticosteroid-weaning-in-stable-heart-transplant-patients-guidance-by-serum-cortisol-level
#14
David A Baran, Cheryl Rosenfeld, Mark J Zucker
Background: Despite earlier studies describing the feasibility of steroid weaning in heart transplant patients, the majority of patients are maintained on steroid therapy for life. We examined a strategy based on a single morning serum cortisol measurement. Methods: We assigned stable posttransplant patients, who were maintained on tacrolimus, mycophenolate mofetil, and corticosteroids, into one of two groups based on a screening morning cortisol level. Patients with a cortisol < 8 micrograms/deciliter were assigned to a "maintenance" group and the others were assigned to the weaning group and steroids were tapered off over 4-6 weeks...
2018: Journal of Transplantation
https://www.readbyqxmd.com/read/29670408/acute-hepatitis-e-in-a-renal-transplantation-recipient-a-case-report
#15
Mitsutoshi Shindo, Hiroaki Takemae, Takafumi Kubo, Masatsugu Soeno, Tetsuo Ando, Yoshiyuki Morishita
Hepatitis E is caused by infection with the hepatitis E virus (HEV). HEV is transmitted orally via HEV-contaminated food or drink. Hepatitis E usually shows mild symptoms and is self-limiting in the general population; however, it may progress to chronic hepatitis in immunosuppressed patients such as recipients of organ transplantation. However, a few cases of acute hepatitis E have been reported in organ transplantation recipients. We herein report a case of acute hepatitis E in a 31-year-old male renal transplant recipient...
2018: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29669332/paritaprevir-ritonavir-ombitasvir-plus-dasabuvir-regimen-in-the-treatment-of-genotype-1-chronic-hepatitis-c-infection-in-patients-with-severe-renal-impairment-and-end-stage-renal-disease-a-real-life-cohort
#16
Jan Sperl, Miluse Kreidlova, Dusan Merta, Klara Chmelova, Renata Senkerikova, Sona Frankova
BACKGROUND/AIMS: Chronic hepatitis C (HCV) virus infection reactivates under immunosuppressive drugs and therefore has a negative impact on long-term survival of kidney transplant recipients. Treatment-induced clearance of hepatitis C virus (HCV) in kidney transplant candidates prevents virus reactivation after transplantation. Paritaprevir/Ritonavir/Ombitasvir with Dasabuvir (PrOD) represents a highly effective treatment regimen for HCV genotype 1 (GT1), also suitable for patients with end-stage renal disease (ESRD)...
April 13, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29669260/limited-impact-of-pre-existing-donor-specific-hla-antibodies-dsa-on-long-term-allograft-survival-after-first-adult-liver-transplantation
#17
Martina Koch, Matthias Marget, Martina Sterneck, Lutz Fischer, Hansjörg Thude, Björn Nashan
The relevance of pre-existing HLA-antibodies (HLA-Ab) in liver transplantation (LTx) is controversial. While livers are allocated without HLA match or preoperative crossmatch testing, several studies point to an impact of donor specific antibodies (DSA) for acute rejection, bile duct complications or even graft loss. To investigate the role of DSA in long term liver allograft survival we analysed 177 pre transplant sera of first LTx patients with luminex single antigen technology defining a MFI of >1500 as positive...
April 15, 2018: Human Immunology
https://www.readbyqxmd.com/read/29668755/effect-of-post-transplant-glycemic-control-on-long-term-clinical-outcomes-in-kidney-transplant-recipients-with-diabetic-nephropathy-a-multicenter-cohort-study-in-korea
#18
Yong Chul Kim, Nara Shin, Sunhwa Lee, Huh Hyuk, Young Hoon Kim, Hyosang Kim, Su-Kil Park, Jang-Hee Cho, Chan-Duck Kim, Jongwon Ha, Dong-Wan Chae, Jung Pyo Lee, Yon Su Kim
PURPOSE: Diabetic nephropathy is the leading cause of end stage renal disease. The number of kidney transplantation (KT) due to diabetic nephropathy is increasing and there is debate on glycemic control after KT. In this study, we used a multi-center database to determine the relationship between post-transplant glycemic control and the outcomes of KT in patients with diabetic nephropathy. METHODS: We conducted a retrospective chart review of kidney transplant recipients (KTRs) with diabetic nephropathy from three tertiary hospitals to analyze the association between post-transplant glycemic control and the clinical outcomes of graft failure, including patient death and biopsy-proven acute rejection (BPAR)...
2018: PloS One
https://www.readbyqxmd.com/read/29668120/cytomegalovirus-infection-in-living-donor-liver-transplant-recipients-significantly-impacts-the-early-post-transplant-outcome-a-single-center-experience
#19
Sanjay Kumar Yadav, Sanjiv Saigal, Narendra Singh Choudhary, Sujeet Saha, Jayant Kumar Sah, Neeraj Saraf, Naveen Kumar, Sanjay Goja, Amit Rastogi, Prashant Bhangui, A S Soin
BACKGROUND: Cytomegalovirus (CMV) is the most common viral infection in liver transplant recipients that influences the outcomes of liver transplantation. However, its impact on early outcomes following living donor liver transplantation (LDLT) is not fully defined in the Indian subcontinent. This study was done to assess the impact of CMV infection on early post-transplant outcomes in LDLT recipients. METHODS: Out of 272 LDLTs performed from January 2012 to April 2013, 151 recipients underwent CMV viral load analysis in plasma within 90 days post LDLT based on clinical suspicion...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29668074/a-20-year-experience-with-nocardiosis-in-solid-organ-transplant-sot-recipients-in-the-southwestern-united-states-a-single-center-study
#20
Aneela Majeed, Norman Beatty, Ahmad Iftikhar, Adeela Mushtaq, Julia Fisher, Pryce Gaynor, Jeeyong C Kim, Jose Luis Marquez, Francisco E Mora, Anca Georgescu, Tirdad Zangeneh
BACKGROUND: Nocardiosis is a life-threatening opportunistic infection. Solid organ transplant (SOT) recipients are at higher risk (incidence 0.04% to 3.5%) of developing nocardiosis. Rate of nocardiosis in the Southwestern US may be high due to environmental factors. METHODS: We performed a retrospective review study on 54 SOT patients diagnosed with Nocardia between 1997 and 2016 at our center. To explore the association of various risk factors with both the development of disseminated disease and mortality, a series of Fisher's exact tests was used...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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