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Transplant rejection

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https://www.readbyqxmd.com/read/29053921/integrated-kidney-exosome-analysis-ikea-for-the-detection-of-kidney-transplant-rejection
#1
Jongmin Park, Hsing-Ying Lin, Jean Pierre Assaker, Sangmoo Jeong, Chen-Han Huang, Ahmed Kurdi, Kyungheon Lee, Kyle Fraser, Changwook Min, Siawosh Eskandari, Sujit Routray, Bakhos A Tannous, Reza Abdi, Leonardo Riella, Anil Chandraker, Cesar M Castro, Ralph Weissleder, Hakho Lee, Jamil R Azzi
Kidney transplant patients require life-long surveillance to detect allograft rejection. Repeated biopsy, albeit the clinical gold standard, is an invasive procedure with the risk of complications and comparatively high cost. Conversely, serum creatinine or urinary proteins are non-invasive alternatives, but are late markers with low specificity. We here report a new urine-based platform to detect kidney transplant rejection. Termed iKEA (integrated kidney exosome analysis), the approach detects extracellular vesicles (EVs) released by immune cells into urine; we reasoned that T cells, attacking kidney allografts, would shed EVs, which in turn can be used as surrogate marker for inflammation...
October 20, 2017: ACS Nano
https://www.readbyqxmd.com/read/29053910/a-simplified-protocol-using-rituximab-and-immunoglobulin-for-abo-incompatible-low-titer-living-donor-liver-transplantation
#2
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
BACKGROUND & AIMS: No consensus has been reached regarding optimal treatment strategies for ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). We introduce a simplified protocol using rituximab and intravenous immunoglobulin (IVIG). METHODS: Data were analyzed on adult patients who underwent ABO-I LDLT of which protocol added rituximab (300 mg/m(2) ) before surgery and IVIG (0.8 g/kg) on postoperative days 1 and 4 to the conventional immunosuppressive regimen used in ABO-compatible (ABO-C) LDLT, without plasmapheresis, splenectomy, or graft local infusion...
October 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29052906/evaluation-of-adherence-and-tolerability-of-prolonged-release-tacrolimus-advagraf-%C3%A2-in-kidney-transplant-patients-in-germany-a-multicenter-non-interventional-study
#3
Lukas J Lehner, Petra Reinke, Jan Hörstrup, Thomas Rath, Barbara Suwelack, Bernhard K Krämer, Klemens Budde, Bernhard Banas
This study assessed adherence to prolonged-release tacrolimus (PR-T)-based immunosuppression during routine maintenance of renal transplant recipients in Germany. Patients had received PR-T for ≥1 month at inclusion. Data were collected during four visits (V): baseline (V1), 6 (V2), 12 (V3) and 18 (V4) months. Composite primary endpoint: non-adherence at V4, defined as self-reported non-adherence on the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS©), investigator-rated non-adherence, and/or V4 tacrolimus trough level outside a pre-defined range...
October 20, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29051396/facial-transplantation-an-update-of-results-and-perspectives-from-tissue-engineering
#4
Francesco Simonacci, Roberto Toni, Edoardo Raposio
BACKGROUND/AIM: Facial transplantation is a revolutionary procedure developed recently, which is indicated if autologous transfers fail to restore human appearance. More than 30 patients have undergone facial transplantation in different centers worldwide. Here, we provide an update on its main anatomical, surgical, immunological, ethical, and follow- up aspects. We also provide innovative perspectives of regenerative medicine and tissue engineering that could hold promise for this emerging surgical field...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29050128/-lung-transplantation-for-connective-tissue-disease-associated-interstitial-lung-disease-recipient
#5
J Zhang, B Wu, M Zhou, D Liu, L Fan, D Wei, H Yang, J Y Chen
Objective: To investigate the timing and complications of lung transplantation for the treatment of connective tissue disease-associated interstitial lung disease (CTD-ILD). Method: The clinical data of connective tissue-associated disease lung transplantation recipients from September, 2015 to February, 2017 were collected. Results: 11 patients with CTD-ILD were evaluated by lung transplantation and were treated with lung transplantation. Including 2 cases dermatomyositis/polymyositis and interstitial lung disease (PM/DM-ILD), 4 cases rheumatoid arthritis and interstitial lung disease (RA-ILD), 4 cases of primary Sjgren's syndrome and interstitial lung disease (pSS-ILD), 1 case of systemic sclerosis and interstitial lung disease (SSc-ILD)...
October 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29045076/outside-in-hla-class-i-signaling-regulates-icam-1-clustering-and-endothelial-monocyte-interactions-via-mtor-in-transplant-antibody-mediated-rejection
#6
Sahar Salehi, Rebecca A Sosa, Yi-Ping Jin, Shoichi Kageyama, Michael C Fishbein, Enrique Rozengurt, Jerzy W Kupiec-Weglinski, Elaine F Reed
Antibody-mediated rejection (AMR) resulting in transplant allograft vasculopathy (TAV) is the major obstacle for long-term survival of solid organ transplants. AMR is caused by donor-specific antibodies to HLA which contribute to TAV by initiating outside-in signaling transduction pathways that elicit monocyte recruitment to activated endothelium. Mechanistic target of rapamycin (mTOR) inhibitors can attenuate TAV; therefore, we sought to understand the mechanistic underpinnings of mTOR signaling in HLA class I Ab-mediated endothelial cell activation and monocyte recruitment...
October 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29044999/macrophage-subpopulations-and-their-impact-on-chronic-allograft-rejection-versus-graft-acceptance-in-a-mouse-heart-transplant-model
#7
Yue Zhao, Song Chen, Peixiang Lan, Chenglin Wu, Yaling Dou, Xiang Xiao, Zhiqiang Zhang, Laurie Minze, Xiaoshun He, Wenhao Chen, Xian C Li
Macrophages infiltrating the allografts are heterogeneous, consisting of pro-inflammatory (M1 cells) as well as anti-inflammatory and fibrogenic phenotypes (M2 cells); they affect transplant outcomes via diverse mechanisms. Herein, we found that macrophage polarization into M1 and M2 subsets was critically dependent on TRAF6 and mTOR, respectively. In a heart transplant model we showed that macrophage-specific deletion of TRAF6 (LysM(C)(re) Traf6(fl/fl) ) or mTOR (LysM(C)(re) Mtor(fl/fl) ) did not affect acute allograft rejection...
October 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29043387/cyp3a-genotypes-of-donors-but-not-those-of-the-patients-increase-the-risk-of-acute-rejection-in-renal-transplant-recipients-on-calcineurin-inhibitors-a-pilot-study
#8
Guillermo Gervasini, Guadalupe García-Pino, Esther Vergara, Sonia Mota-Zamorano, Montserrat García-Cerrada, Enrique Luna
PURPOSE: We aimed to determine whether polymorphisms in CYP3A genes may affect the risk of acute rejection episodes (ARE) in renal transplant recipients treated with calcineurin inhibitors (CNIs). METHODS: One hundred and thirty seven patients and their respective donors were screened, by RT-PCR techniques, for three polymorphisms previously related with CNI pharmacokinetics and pharmacodynamics (CYP3A4*1B, CYP3A4*22 and CYP3A5*3). Genotypes of donors and recipients were associated by logistic regression models with ARE risk and exposure to CNIs...
October 18, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29042454/complement-activating-anti-hla-antibodies-in-kidney-transplantation-allograft-gene-expression-profiling-and-response-to-treatment
#9
Carmen Lefaucheur, Denis Viglietti, Luis G Hidalgo, Lloyd E Ratner, Serena M Bagnasco, Ibrahim Batal, Olivier Aubert, Babak J Orandi, Federico Oppenheimer, Oriol Bestard, Paolo Rigotti, Anna V Reisaeter, Nassim Kamar, Yvon Lebranchu, Jean-Paul Duong Van Huyen, Patrick Bruneval, Denis Glotz, Christophe Legendre, Jean-Philippe Empana, Xavier Jouven, Dorry L Segev, Robert A Montgomery, Adriana Zeevi, Philip F Halloran, Alexandre Loupy
Complement-activating anti-HLA donor-specific antibodies (DSAs) are associated with impaired kidney transplant outcome; however, whether these antibodies induce a specific rejection phenotype and influence response to therapy remains undetermined. We prospectively screened 931 kidney recipients for complement-activating DSAs and used histopathology, immunostaining, and allograft gene expression to assess rejection phenotypes. Effector cells were evaluated using in vitro human cell cultures. Additionally, we assessed the effect of complement inhibition on kidney allograft rejection phenotype and the clinical response to complement inhibition in 116 independent kidney recipients with DSAs at transplant receiving rejection prophylaxis with eculizumab or standard of care (plasma exchange and intravenous Ig) at ten international centers...
October 17, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29039465/essential-role-of-microrna-650-in-the-regulation-of-b-cell-cll-lymphoma-11b-gene-expression-following-transplantation-a-novel-mechanism-behind-the-acute-rejection-of-renal-allografts
#10
Peng Jin, Hongxi Chen, Jinliang Xie, Cheng Zhou, Xiangrong Zhu
Kidney transplantation is an effective final therapeutic procedure for patients with end-stage kidney failure. Although advanced immunosuppressive therapy is administered following transplantation, certain patients still suffer from acute allograft rejection. MicroRNAs (miRs) have a potential diagnostic and therapeutic value for acute renal allograft rejection; however, their underlying mechanism of action is largely unknown. In the present study, an increased level of miR-650 was identified to be associated with the downregulation of B-cell CLL/lymphoma 11B (BCL11B) expression in acute renal allograft rejection...
October 17, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29039058/recurrent-and-de-novo-glomerulonephritis-following-renal-transplantation-higher-rates-of-rejection-and-lower-graft-survival
#11
Safak Mirioglu, Yasar Caliskan, Yagmur Goksoy, Sibel Gulcicek, Yasemin Ozluk, Irem Sarihan, Nurhan Seyahi, Isin Kilicaslan, Aydin Turkmen, Mehmet Sukru Sever
PURPOSE: In this retrospective study with case-control design, we aimed to determine the clinical and pathological characteristics of post-transplant glomerulonephritis (GN), and their effects on transplant recipients. METHODS: One hundred and twenty renal transplant recipients with biopsy-proven recurrent or de novo primary GN were compared with two matched control groups including 120 transplant recipients with nonrecurrent primary GN (nonrecurrent GN group) and 120 transplant recipients with non-GN etiology (non-GN group)...
October 16, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29038423/regulation-of-t-cell-alloimmunity-by-pi3k%C3%AE-and-pi3k%C3%AE
#12
Mayuko Uehara, Martina M McGrath, Shunsuke Ohori, Zhabiz Solhjou, Naima Banouni, Sujit Routray, Catherine Evans, Jonathan P DiNitto, Abdallah Elkhal, Laurence A Turka, Terry B Strom, Stefan G Tullius, David G Winkler, Jamil Azzi, Reza Abdi
Phosphatidylinositol-3-kinases (PI3K) γ and δ are preferentially enriched in leukocytes, and defects in these signaling pathways have been shown to impair T cell activation. The effects of PI3Kγ and PI3Kδ on alloimmunity remain underexplored. Here, we show that both PI3Kγ (-/-) and PI3Kδ (D910A/D910A) mice receiving heart allografts have suppression of alloreactive T effector cells and delayed acute rejection. However, PI3Kδ mutation also dampens regulatory T cells (Treg). After treatment with low dose CTLA4-Ig, PI3Kγ (-/-) , but not PI3Κδ (D910A/D910A) , recipients exhibit indefinite prolongation of heart allograft survival...
October 16, 2017: Nature Communications
https://www.readbyqxmd.com/read/29038386/effect-of-statins-on-patients-and-graft-survival-in-kidney-transplant-recipients-a-survival-meta-analysis
#13
Zohre Rostami, Mahdi Moteshaker Arani, Mahmood Salesi, Mahdi Safiabadi, Behzad Einollahi
INTRODUCTION: Modifying cardiovascular risk factors is very important for the patients after kidney transplantation. Statins are a potentially beneficial intervention for kidney transplant patients, and the effect of statins on cardiovascular outcomes in patients with chronic kidney disease varies according to the stages. This systematic review summarizes the potential beneficial effects of statins on kidney allograft outcome. MATERIALS AND METHODS: A systematic review and meta-analysis was conducted by literature search using the PubMed, Science Direct, Scopus, ISI Web of Knowledge, and Google Scholar...
October 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/29037296/tuberculosis-in-recipients-of-solid-organ-transplants-during-1995-2015-in-cali-colombia
#14
J F García-Goez, G A Munera, V Rojas, R Pacheco, J A Caylá, J M Miro
SETTING: Tuberculosis (TB) in solid-organ transplants (SOTs) is an important opportunistic infection associated with mortality and graft loss. SOT recipients carry a higher risk of contracting active TB than the general population. Clinical and radiographic presentations are non-specific, and sputum smear and culture have low yields. TB patients with SOTs require standard anti-tuberculosis treatment. However, rifampicin (RMP) use is associated with a 30% rate of acute graft rejection (AGR) and a 20% rate of transplant loss...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29037222/the-efficacy-and-stability-of-an-information-and-communication-technology-based-centralized-monitoring-system-of-adherence-to-immunosuppressive-medication-in-kidney-transplant-recipients-study-protocol-for-a-randomized-controlled-trial
#15
Hee-Yeon Jung, Sook Jin Seong, Ji-Young Choi, Jang-Hee Cho, Sun-Hee Park, Chan-Duck Kim, Young-Ran Yoon, Hyung-Kee Kim, Seung Huh, Se-Hee Yoon, Jong Soo Lee, Yong-Lim Kim
BACKGROUND: Immunosuppression non-adherence in kidney transplant recipients (KTRs) not only increases the risk of medical intervention due to acute rejection and graft loss but burdens the socioeconomic system in the form of increased healthcare costs. An aggressive preemptive effort by healthcare professionals, geared to ensure adherence to immunosuppressants in KTRs, is significant and imperative. METHODS/DESIGN: This study was designed as a prospective, open-label, multicenter, randomized controlled study aimed at evaluating the efficacy and stability of an information and communication technology (ICT)-based centralized monitoring system in boosting medication adherence in KTRs...
October 16, 2017: Trials
https://www.readbyqxmd.com/read/29035589/the-activity-of-nintedanib-in-an-animal-model-of-allogenic-left-lung-transplantation-resembling-aspects-of-allograft-rejection
#16
Marietta von Suesskind-Schwendi, Elke Boxhammer, Stephan W Hirt, Stephan Schreml, Christof Schmid, Lutz Wollin, Karla Lehle
AIM OF THE STUDY: The prevention and treatment of chronic lung allograft dysfunction (CLAD) after lung transplantation (LTx) remain unsatisfactory. Growth factors may play an important role in the development of CLAD. This study evaluated the effects of nintedanib, a receptor tyrosine kinase inhibitor, in the treatment of CLAD after experimental LTx. MATERIALS AND METHODS: A rat model of left lung allo-transplantation (Fisher 344 to Wistar Kyoto) was used to evaluate the effect of nintedanib (50 mg/kg per day) on the development of CLAD...
October 16, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29035428/initial-report-of-the-korean-organ-transplant-registry-kotry-heart-transplantation
#17
Hae Young Lee, Eun Seok Jeon, Seok Min Kang, Jae Joong Kim
BACKGROUND AND OBJECTIVES: The Korean Organ Transplant Registry (KOTRY), which was the first national transplant registry in Korea, was founded by the Korean Society for Transplantation and the Korean Center for Disease Control in 2014. Here, we present the initial report of the Korean Heart Transplant Registry. METHODS: A total of 183 heart transplantation (HTPL) patients performed at 4 nationally representative hospitals were collected from April 2014 to December 2015...
August 16, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29035392/long-term-outcome-of-mixed-chimerism-after-stem-cell-transplantation-for-thalassemia-major-conditioned-with-busulfan-and-cyclophosphamide
#18
N A Fouzia, E S Edison, K M Lakshmi, A Korula, S R Velayudhan, P Balasubramanian, A Abraham, A Viswabandya, B George, V Mathews, A Srivastava
Mixed chimerism (MC) occurs frequently after allogeneic hematopoietic stem cell transplantation (HSCT) for thalassemia major (TM) and may be associated with rejection. We report the outcome of MC in 132 TM patients conditioned with Busulphan/Cyclophosphamide, who had successful engraftment and had ⩾1 year follow-up. Chimerism was first assessed at day +28, then every 3-9 months or more frequently if there was MC. If rejection was suspected, immunosuppression was stopped and donor-lymphocyte infusion (DLI) was given if there was no response...
October 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29034347/using-a-weaning-immunosuppression-protocol-in-liver-transplantation-recipients-with-hepatocellular-carcinoma-a-compromise-between-the-risk-of-recurrence-and-the-risk-of-rejection
#19
REVIEW
Roberta Angelico, Alessandro Parente, Tommaso Maria Manzia
Hepatocellular carcinoma (HCC) recurrence rate after liver transplantation (LT) is still up to 15-20%, despite a careful selection of candidates and optimization of the management within the waiting list. To reduce tumour recurrence, the currently adopted post-transplant strategies are based on the administration of a tailored immunosuppression (IS) regimen. Drug-induced depression of the immune system is essential in preventing graft rejection, however has a well-established association with oncogenesis. The immune system has a key role as a defending mechanism against cancer development, preventing vascular invasion and metastasis...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29032269/second-hematopoietic-sct-for-thalassemia-major-improved-clinical-outcomes-with-a-treosulfan-based-conditioning-regimen
#20
Anu Korula, Nisham P N, Anup Devasia, Kavitha M Lakshmi, Aby Abraham, Eunice Sindhuvi, Biju George, Alok Srivastava, Vikram Mathews
Graft rejection (GR) following an allo-SCT occurs in 10-20% of patients with β thalassemia major (TM). There is limited data on the clinical profile and long term outcome of patients who have had a graft rejection. We undertook a retrospective analysis of patients who had a graft failure post allogeneic SCT for TM at our center. From October, 1991 to June 2016, 55/506 (11%) patients transplanted for TM had a graft failure. An additional 7 patients with graft failure following an allo-SCT done at other centers were referred to us for a second transplant...
October 12, 2017: Biology of Blood and Marrow Transplantation
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