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Kidney transplant

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https://www.readbyqxmd.com/read/29917152/glomerular-filtration-rate-in-patients-with-multiple-sclerosis-undergoing-stem-cell-transplantation-and-treated-with-cyclophosphamide
#1
Alejandro Ruiz-Argüelles, Jose M Gastélum-Cano, Mariana A Méndez-Huerta, Alma B Rodríguez-Gallegos, Guillermo J Ruiz-Argüelles
Background: Glomerular filtration rate (GFR) is partially impaired in patients with multiple sclerosis (MS). When given chemotherapy before receiving hematopoietic stem-cell transplantation, GFR might be further deteriorated. Objective: To measure the effect of cyclophosphamide on GFR in patients with MS who undergo chemotherapy. Methods: We estimated GFR based on creatinine and cystatin C plasma concentrations in patients undergoing autologous hematopoietic stem-cell transplantation to treat their MS...
June 15, 2018: Laboratory Medicine
https://www.readbyqxmd.com/read/29916987/the-evolution-of-kidney-transplantation-surgery-into-the-robotic-era-and-it-prospects-for-obese-recipients
#2
Ahmer M Hameed, Jinna Yao, Richard D M Allen, Wayne J Hawthorne, Henry C Pleass, Howard Lau
Robotic-assisted kidney transplantation (RAKT) represents the most recent innovation in the evolution of kidney transplantation surgery. Vascular techniques enabling kidney transplantation have existed since the early 20 century and contributed to the first successful open kidney transplant procedure in 1954. Technical advances have since facilitated minimally invasive laparoscopic and robotic techniques in live-donor surgery, and subsequently for the recipient procedure. This review follows the development of surgical techniques for kidney transplantation, with a special focus on the advent of robotic-assisted transplantation because of its potential to facilitate transplantation of those deemed previously too obese to transplant by standard means...
June 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29916848/pancreas-transplantation-in-type-2-diabetes-expanding-the-criteria
#3
Talal M Al-Qaoud, Jon S Odorico, Robert R Redfield
PURPOSE OF REVIEW: Pancreas transplantation in type 2 diabetes mellitus (T2DM) candidates remains disproportionately lower than in type 1 diabetes mellitus (T1DM); however, outcomes in carefully selected patients mirrors that of T1DM. Despite the 2014 United Network for Organ Sharing (UNOS) eligibility criteria for simultaneous pancreas/kidney transplant (SPK) transplantation in T2DM patients, an expected increase in the number of transplants was not observed. RECENT FINDINGS: In an updated International Pancreas and Transplant Registry (IPTR) analysis, 1514 primary deceased donor pancreas transplants were performed in T2DM recipients [1995-2015, SPK 88%, pancreas after kidney (PAK) 9%, pancreas transplant alone (PTA) 3%]...
June 18, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29915171/effects-of-immune-suppression-for-transplantation-on-inflammatory-colorectal-cancer-progression
#4
Imerio Angriman, Lucrezia Furian, Melania Scarpa, Matteo Fassan, Susan Morgan, Andrea Porzionato, Andromachi Kotsafti, Luca Saadeh, Cristina Silvestre, Raffaele De Caro, Amedeo Carraro, Umberto Tedeschi, Romeo Bardini, Paolo Rigotti, Massimo Rugge, Carlo Castoro, Ignazio Castagliuolo, Marco Scarpa
BACKGROUND: Ulcerative colitis patients and transplant recipients are at risk for colorectal cancer. Here, we show that immunosuppressive regimens for kidney transplants are associated with the progression of ulcerative colitis-related carcinogenesis. METHODS: We describe the case of a patient diagnosed with colorectal cancer in ulcerative colitis while on immunosuppressive therapy for a kidney transplant. The immunological microenvironment of the cancer and its mutational status were analyzed, and a mouse colon cancer model was created to replicate the unique clinical conditions...
June 19, 2018: Oncogenesis
https://www.readbyqxmd.com/read/29915167/outcomes-of-induction-therapy-with-rabbit-anti-thymocyte-globulin-in-heart-transplant-recipients-a-single-center-retrospective-cohort-study
#5
Tambi Jarmi, Nirav Patel, Sadaf Aslam, George Makdisi, Elias Doumit, Rahul Mhaskar, Branko Miladinovic, Mark Weston
BACKGROUND Induction immunosuppression is used in transplantation to prevent early acute rejection. The survival benefit of rabbit anti-thymocyte globulin (rATG) induction has not been established yet. We sought to determine the role of rATG in preventing rejection and improving overall survival. MATERIAL AND METHODS A retrospective cohort study was conducted from 2005 to 2009 and data of consecutive 268 heart transplant recipients were reviewed. RESULTS The data of 144 patients who received induction with rATG were compared to 124 patients who did not...
June 19, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29915131/medication-safety-principles-and-practice-in-ckd
#6
Chanel F Whittaker, Margaret A Miklich, Roshni S Patel, Jeffrey C Fink
Ensuring patient safety is a priority of medical care because iatrogenic injury has been a primary concern. Medications are an important source of medical errors, and kidney disease is a thoroughfare of factors threatening safe administration of medicines. Principal among these is reduced kidney function because almost half of all medications used are eliminated via the kidney. Additionally, kidney patients often suffer from multimorbidity, including diabetes, hypertension, and heart failure, with a range of prescribers who often do not coordinate treatments...
June 18, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29914760/three-cases-of-monoclonal-gammopathy-of-renal-significance-after-kidney-transplantation-de-novo-c3-glomerulopathy
#7
Núria Serra, Carme Facundo, Cristina Canal, Yolanda Arce, Nadia Ayasreh, Anna Vila, Beatriz Bardají, Irene Silva, Víctor López, Silvia Benito, Jose Ballarín, Lluís Guirado
Monoclonal gammopathy of renal significance includes all renal disorders caused by a monoclonal immunoglobulin secreted by a non-malignant B-cell clone. Patients with MGRS do not, by definition, meet criteria for multiple myeloma, with haematological disorders generally considered to be monoclonal gammopathy of undetermined significance. Nevertheless, the renal involvement can be serious and require specific treatment. Monoclonal gammopathy of renal significance is associated with a wide spectrum of disorders, including the recently discovered C3 glomerulopathy...
June 15, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29913200/increased-t-cell-immunosenescence-and-accelerated-maturation-phenotypes-in-older-kidney-transplant-recipients
#8
J M Schaenman, M Rossetti, T Sidwell, V Groysberg, G Sunga, Y Korin, E Liang, X Zhou, B Abdallah, E Lum, S Bunnapradist, T Pham, G Danovitch, E F Reed
Older kidney transplant recipients experience increased rates of infection and death, and less rejection, compared with younger patients. However, little is known about immune dysfunction in older compared with younger kidney transplant recipients and whether it is associated with infection. We evaluated T cell phenotypes including maturation, immune senescence, and exhaustion in a novel investigation into differences in older compared with younger patients receiving identical immune suppression regimens. We evaluated PBMC from 60 kidney transplant recipients (23 older and 37 matched younger patients) by multiparameter immune phenotyping...
June 15, 2018: Human Immunology
https://www.readbyqxmd.com/read/29913044/accommodation-in-abo-incompatible-organ-transplants
#9
REVIEW
Mayara Garcia de Mattos Barbosa, Marilia Cascalho, Jeffrey L Platt
Accommodation refers to a condition in which a transplant (or any tissue) appears to resist immune-mediated injury and loss of function. Accommodation was discovered and has been explored most thoroughly in ABO-incompatible kidney transplantation. In this setting, kidney transplants bearing blood group A or B antigens often are found to function normally in recipients who lack and hence produce antibodies directed against the corresponding antigens. Whether accommodation is owed to changes in anti-blood group antibodies, changes in antigen or a change in the response of the transplant to antibody binding are critically reviewed and a new working model that allows for the kinetics of development of accommodation is put forth...
May 2018: Xenotransplantation
https://www.readbyqxmd.com/read/29913034/new-insights-on-innate-b-cell-immunity-in-transplantation
#10
REVIEW
Emmanuel Zorn
Innate B cells and natural antibodies (Nabs) have been extensively studied in normal physiological conditions as well as in several diseases. However, their significance in the context of ABO-compatible solid organ transplantation is only emerging. This review summarizes recent studies exploring these often neglected innate immune elements in situations related to sensitization and clinical graft rejection. A focus is placed on class-switched IgG Nabs that develop amidst inflammation, rather than IgM Nabs abundant at the steady state, as new evidence point to their implication in serum reactivity to HLA and kidney graft failure...
May 2018: Xenotransplantation
https://www.readbyqxmd.com/read/29912046/changes-in-utilization-and-discard-of-hcv-antibody-positive-deceased-donor-kidneys-in-the-era-of-direct-acting-antiviral-therapy
#11
Mary G Bowring, Lauren M Kucirka, Allan B Massie, Tanveen Ishaque, Sunjae Bae, Ashton A Shaffer, Jacqueline Garonzik Wang, Mark Sulkowski, Niraj Desai, Dorry L Segev, Christine M Durand
BACKGROUND: The availability of direct-acting antiviral (DAA) therapy might have impacted use of HCV-infected (HCV+) deceased-donor kidneys for transplantation. METHODS: We used 2005-2018 SRTR data to identify 18 936 candidates willing to accept HCV+ kidneys and 3348 HCV+ recipients of HCV+ kidneys. We compared willingness to accept, utilization, discard, and posttransplant outcomes associated with HCV+ kidneys between 2 treatment eras (Interferon [IFN] era: 1/1/2005-12/5/2013 versus DAA era: 12/6/2013-8/2/2018)...
June 13, 2018: Transplantation
https://www.readbyqxmd.com/read/29911961/liver-donation-after-brain-death-following-intentional-ingestion-of-99-e-cigarette-liquid-nicotine-10-ml
#12
Jinwoong Lee, Yeonho You, Jung Soo Park, Jin Hong Min, Insool Yoo, Wonjoon Jeong, Yongchul Cho, Seung Ryu, Seungwhan Kim, Sung Uk Cho, Se Kwang Oh, Junwan Lee, Hong Joon Ahn, Sang Min Jung
Incidences of brain death due to nicotine overdose by e-cigarettes have been increasing. In such cases, liver donation has been not reported because of the secondary damage to the liver due to metabolism of large amounts of nicotine. However, kidneys have been considered acceptable for transplant. Here, we present a successful case of liver transplant from a brain-dead donor due to intentional nicotine ingestion who did not have extensive steatosis. To the best of our knowledge, this is the first report of such a case...
June 18, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29911959/conversion-from-steroid-to-everolimus-in-maintenance-kidney-transplant-recipients-with-posttransplant-diabetes-mellitus
#13
Koji Nanmoku, Akira Kurosawa, Taro Kubo, Takahiro Shinzato, Toshihiro Shimizu, Takaaki Kimura, Takashi Yagisawa
OBJECTIVES: Although steroid withdrawal has been attempted to ameliorate various complications in kidney transplant recipients, a steroid-sparing strategy has more frequently led to acute rejection. We investigated the use of everolimus to safely overcome steroid withdrawal in kidney transplant recipients with posttransplant diabetes mellitus under maintenance immunosuppressive therapy. MATERIALS AND METHODS: A total of 75 de novo consecutive kidney transplant recipients received conventional immunosuppressive therapy comprising tacrolimus (trough level of 5 ng/mL), mycophenolate mofetil (1000 mg), and methylprednisolone (4 mg)...
June 18, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29911044/advanced-diabetic-nephropathy-with-clean-eyes-an-extreme-phenotype
#14
Debmalya Sanyal, Sudip Chatterjee
Introduction: It is generally accepted that renal and eye changes in diabetes are concordant. There are however a fair number of patients with diabetes who have end-stage renal disease (ESRD) without any of the typical eye changes. The present study highlights the discordance between retinopathy and nephropathy and describes a series of patients of long-standing diabetes undergoing renal transplant who had little or no evidence of retinopathy. Methods: All patients with ESRD undergoing renal transplants underwent comprehensive fundus evaluation including dilated indirect ophthalmoscopy, slit lamp biomicroscopy, and fundus photography...
March 2018: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29910042/belimumab-in-kidney-transplantation-an-experimental-medicine-randomised-placebo-controlled-phase-2-trial
#15
Gemma D Banham, Shaun M Flint, Nicholas Torpey, Paul A Lyons, Don N Shanahan, Adele Gibson, Christopher J E Watson, Ann-Marie O'Sullivan, Joseph A Chadwick, Katie E Foster, Rachel B Jones, Luke R Devey, Anna Richards, Lars-Peter Erwig, Caroline O Savage, Kenneth G C Smith, Robert B Henderson, Menna R Clatworthy
BACKGROUND: B cells produce alloantibodies and activate alloreactive T cells, negatively affecting kidney transplant survival. By contrast, regulatory B cells are associated with transplant tolerance. Immunotherapies are needed that inhibit B-cell effector function, including antibody secretion, while sparing regulators and minimising infection risk. B lymphocyte stimulator (BLyS) is a cytokine that promotes B-cell activation and has not previously been targeted in kidney transplant recipients...
June 14, 2018: Lancet
https://www.readbyqxmd.com/read/29909373/what-insights-do-patients-and-caregivers-have-on-acute-kidney-injury-and-posthospitalisation-care-a-single-centre-qualitative-study-from-toronto-canada
#16
Samuel A Silver, Marianne Saragosa, Neill K Adhikari, Chaim M Bell, Ziv Harel, Andrea Harvey, Abhijat Kitchlu, Javier A Neyra, Ron Wald, Lianne Jeffs
OBJECTIVES: Hospitalisation with acute kidney injury (AKI) is associated with short-term and long-term adverse events, but patient and caregiver experiences with AKI are not well described. We sought to better understand patient and caregiver perspectives after a hospitalisation with AKI to inform discharge strategies that may improve outcomes for this high-risk population. DESIGN: Qualitative study with semistructured interviews. SETTING: Tertiary care hospital in Toronto, Ontario, Canada...
June 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29909107/comparative-utilization-and-temporal-trends-in-cardiac-stress-testing-in-u-s-medicare-beneficiaries-with-and-without-chronic-kidney-disease
#17
Charles A Herzog, Tanya Natwick, Shuling Li, David M Charytan
OBJECTIVES: The authors aimed to analyze temporal trends in cardiac stress testing in U.S. Medicare beneficiaries from 2008 to 2012, types of stress testing, and comparative utilization related to the presence and severity of chronic kidney disease (CKD). BACKGROUND: A long-held perception depicts patients with CKD as being treated less intensively for cardiovascular disease than nonrenal patients. We wondered whether use of diagnostic testing for ischemic heart disease is affected by the presence of CKD...
June 8, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29908844/tissue-associated-self-antigens-containing-exosomes-role-in-allograft-rejection
#18
Monal Sharma, Ranjithkumar Ravichandran, Sandhya Bansal, Ross M Bremner, Michael A Smith, T Mohanakumar
Exosomes are extracellular vesicles that express self-antigens (SAgs) and donor human leukocyte antigens. Tissue-specific exosomes can be detected in the circulation following lung, heart, kidney and islet cell transplantations. We collected serum samples from patients who had undergone lung (n=30), heart (n=8), or kidney (n=15) transplantations to isolate circulating exosomes. Exosome purity was analyzed by Western blot, using CD9 exosome-specific markers. Tissue-associated lung SAgs, collagen V (Col-V) and K-alpha 1 tubulin (Kα1T), heart SAgs, myosin and vimentin, and kidney SAgs, fibronectin and collagen IV (Col-IV), were identified using western blot...
June 14, 2018: Human Immunology
https://www.readbyqxmd.com/read/29908316/the-clinical-significance-of-epitope-mismatch-load-in-kidney-transplantation-a-multicentre-study
#19
Liesbeth Daniëls, Maarten Naesens, Jean-Louis Bosmans, Daniel Abramowicz, Evi Nagler, Steven Van Laecke, Patrick Peeters, Dirk Kuypers, Marie-Paule Emonds
Since the advent of kidney transplantation a key strategy for maximising graft survival by avoiding allorecognition has been to minimise HLA mismatching between donor and recipient. As HLA antibodies are now recognised as being specific for epitopes and donor-recipient HLA mismatch at the amino acid level can now be determined, HLA epitope mismatch load could be a better predictor for dnDSA development than classical HLA antigen mismatch calculation. This hypothesis has been investigated by other studies and the aim of our multicentre study was to confirm this observation in our population...
June 13, 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29907735/identification-of-proteins-potentially-associated-with-renal-aging-in-rats
#20
Diangeng Li, Delong Zhao, Weiguang Zhang, Qian Ma, Dong Liu, Qi Huang, Ying Zheng, Xueyuan Bai, Xuefeng Sun, Xiangmei Chen
We established a young (Y)-old (O) rat kidney transplantation model. With this model, we detected no age-related differences in renal structure between Y→Y and Y→O kidneys or O→O and O→Y kidneys. However, we did detect differences in levels of the senescence markers β-gal and p16 as well as the inflammatory cytokines TNF-α and IL-1β. Using proteomics analysis we detected 66 proteins associated with suppression of aging and 73 proteins associated with enhancement of aging. After construction of a protein-protein interaction network, a total of 73 nodes and 99 edges were analyzed using MCODE, and three significant modules were selected...
June 14, 2018: Aging
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