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Acute renal graft rejection

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https://www.readbyqxmd.com/read/29149982/marrow-mesenchymal-stem-cells-effectively-reduce-histologic-changes-in-a-rat-model-of-chronic-renal-allograft-rejection
#1
P Yu, Z Wang, Y Liu, Z Xiao, Y Guo, M Li, M Zhao
BACKGROUND: Chronic allograft rejection remains as the leading cause of the chronic renal grafts loss post-transplantation. No therapy has been found really effective to prevent and treat chronic allograft rejection. Mesenchymal stem cells (MSCs) have characteristics of immunomodulation and are expected to be used for inducing graft immune tolerance in organ transplantation. We investigated the efficacy and safety of early infusion of donor-derived marrow MSCs in a rat model of chronic renal allograft rejection...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29145879/allogeneic-mesenchymal-stem-cell-as-induction-therapy-to-prevent-both-delayed-graft-function-and-acute-rejection-in-deceased-donor-renal-transplantation-study-protocol-for-a-randomized-controlled-trial
#2
Qipeng Sun, Liangqing Hong, Zhengyu Huang, Ning Na, Xuefeng Hua, Yanwen Peng, Ming Zhao, Ronghua Cao, Qiquan Sun
BACKGROUND: Using kidneys from deceased donors is an available strategy to meet the growing need of grafts. However, higher incidences of delayed graft function (DGF) and acute rejection exert adverse effects on graft outcomes. Since ischemia-reperfusion injury (IRI) and ongoing process of immune response to grafts are the major causes of DGF and acute rejection, the optimal induction intervention should possess capacities of both repairing renal structure injury and suppressing immune response simultaneously...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29137592/isolated-v-lesion-in-an-abo-incompatible-kidney-transplant-recipient-receiving-rituximab
#3
Tomoaki Iwai, Junji Uchida, Kazuya Kabei, Shunji Nishide, Nobuyuki Kuwabara, Toshihide Naganuma, Norihiko Kumada, Yoshiaki Takemoto, Tatsuya Nakatani
We report an ABO-incompatible kidney transplant performed on a 69-year-old female patient, whose donor was her 69-year-old husband. The patient received an immunosuppressive protocol using rituximab without splenectomy. Renal biopsy was done on posttransplant day 8 due to poor early graft function, and an isolated v-lesion was found, which responded to steroid pulse therapy and gusperimus hydrochloride administration. Our results indicate that isolated v-lesions can occur in ABO-incompatible kidney transplant recipients receiving rituximab and that this finding should be treated as acute rejection...
November 15, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29135832/prognostic-value-of-the-persistence-of-c1q-binding-anti-hla-antibodies-in-acute-antibody-mediated-rejection-in-kidney-transplantation
#4
Elodie Bailly, Dany Anglicheau, Gilles Blancho, Philippe Gatault, Vincent Vuiblet, Valérie Chatelet, Emmanuel Morelon, Paolo Malvezzi, Anne Parissiadis, Jérôme Tourret, Gwendaline Guidicelli, Johnny Sayegh, Christiane Mousson, Philippe Grimbert, Isabelle Top, Moglie Le Quintrec, Raj Purgus, Pierre François Westeel, Barbara Proust, Valérie Chabot, Yvon Lebranchu, Frédéric Dehaut, Matthias Büchler
BACKGROUND: The differential pathogenicity of anti-HLA donor-specific antibodies (DSAs) is not fully understood. The presence of complement-binding DSAs help better defining the prognosis of acute antibody-mediated rejection (ABMR). The evolution of these antibodies after the treatment of ABMR is unknown. METHODS: We included patients from the French multicenter RITUX ERAH study diagnosed with acute antibody-mediated rejection (ABMR) within the first year of renal transplantation, with circulating anti-HLA DSAs and treated randomly by rituximab or placebo (and intravenous immunoglobulins, plasma exchange)...
November 13, 2017: Transplantation
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#5
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29110799/acute-postoperative-management-after-lung-transplantation
#6
REVIEW
Christopher Potestio, Desmond Jordan, Bessie Kachulis
Despite many advances in the field of lung transplantation, lung transplant recipients have the lowest median survival of any solid organ transplant population. Complications such as reperfusion injury, graft rejection, infection, and anastomotic breakdown increase morbidity and mortality during the immediate postoperative period. Ventilator management with lung protective strategies can not only minimize ventilator time and mitigate the risk of ventilator-associated pneumonia, but it may also decrease the risk of primary graft dysfunction and graft failure...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29108517/inferior-long-term-outcomes-for-kidney-transplant-recipients-with-an-immunologically-mediated-primary-renal-disease
#7
Evaldo Favi, José Alberto Rodrigues Pedroso, Maria Paola Salerno, Gionata Spagnoletti, Jacopo Romagnoli, Franco Citterio
OBJECTIVES: Recurrent glomerulonephritis can negatively affect kidney allograft survival. However, how primary renal disease affects transplant outcomes in the new era of immunosuppression remains unclear. MATERIALS AND METHODS: We categorized 426 kidney transplant recipients (performed from 1996 to 2007) into 4 disease groups: (1) 99 recipients with biopsy-proven immunologically mediated kidney disease, (2) 40 recipients with urologic disease, (3) 67 recipients with polycystic kidney disease, and (4) 220 recipients with other causes of terminal renal failure/uncertain kidney disease...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29106285/liver-kidney-simultaneous-transplantation-in-adult-patients-with-primary-hyperoxaluria-experience-at-hospital-universitario-12-de-octubre
#8
Javier Martínez Caballero, Alberto Marcacuzco Quinto, Iago Justo Alonso, Oana Anisa Nutu, Alejandro Manrique Municio, Jorge Calvo Pulido, Félix Cambra Molero, Óscar Caso Maestro, Carlos Jiménez Romero
Primary hyperoxaluria (PH) is a metabolic liver disease with an autosomal recessive inheritance that results in oxalate overproduction that cannot be metabolized by the liver. Urinary excretion of oxalate results in lithiasis and nephrocalcinosis leading to a progressive loss of renal function that often requires renal replacement therapy despite medical treatment. Type 1 PH is the most common form and is due to a deficiency in the alanine-glycolate aminotransferase enzyme found in hepatic peroxisomes. Therefore, a liver-kidney simultaneous transplant (LKST) is the definitive treatment for end-stage renal disease (ESRD) patients...
November 6, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29105843/the-liver-recipient-with-acute-renal-dysfunction-a-single-institution-evaluation-of-the-simultaneous-liver-kidney-transplant-candidate
#9
Kunal Yadav, Oscar K Serrano, Kent J Peterson, Timothy L Pruett, Raja Kandaswamy, Ananta Bangdiwala, Hassan Ibrahim, Ajay Israni, John Lake, Srinath Chinnakotla
The Organ Procurement Transplant Network (OPTN) listing criteria for simultaneous liver-kidney transplant (SLK) are not well defined. Concerns remain about rising numbers of SLKs, which divert quality kidneys from candidates awaiting kidney transplants (KT). We performed a retrospective review of liver transplants (LT) at our center from 2004-14; 127 recipients (Liver transplant alone; 102 LTA, 25 SLK) were identified with short-term preoperative kidney dysfunction (creatinine >4 mg/dL or preoperative hemodialysis [HD] for <6 wks)...
November 4, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29104861/graft-loss-among-renal-transplant-recipients-with-early-reduction-of-immunosuppression-for-bk-viremia
#10
Marwan M Azar, Roland Assi, Aziz K Valika, David B Banach, Isaac E Hall, Marie-Louise Landry, Maricar F Malinis
AIM: To review the incidence of graft loss and acute rejection among renal transplant recipients with early reduction of immunosuppression for BK viremia. METHODS: We performed a retrospective analysis of consecutive de-novo kidney-only transplants from January 2009 to December 2012 to evaluate the incidence of Polyoma-virus associated nephropathy (PyVAN). Recipient plasma was screened for BKV DNA via quantitative polymerase chain reaction (PCR) at months 1, 3, 6, 9 and 12 post-transplant and on worsening graft function...
October 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/29103079/effectiveness-of-kidney-transplantation-in-hiv-infected-recipients-under-combination-antiretroviral-therapy-a-single-cohort-experience-brescia-northern-italy
#11
Ilaria Izzo, Salvatore Casari, Nicola Bossini, Maria Antonia Forleo, Silvio Sandrini, Emanuele Focà, Nigritella Brianese, Giulia Zambolin, Claudia Chirico, Giovanni Cancarini, Francesco Castelli
PURPOSE: Kidney transplantation was recently introduced for the treatment of end stage renal disease (ESRD) in HIV-infected patients. We report the results of the first 28 procedures at our centre. METHODS: A retrospective study was conducted on HIV-infected patients evaluated for kidney transplantation between January 2005 and October 2016. Patients were selected and monitored by the kidney transplantation and infectious diseases teams, according to the national protocol...
November 4, 2017: Infection
https://www.readbyqxmd.com/read/29092871/heart-transplant-outcomes-in-patients-with-pretransplant-diabetes-mellitus
#12
Anne Jalowiec, Kathleen L Grady, Connie White-Williams
BACKGROUND: Findings on outcomes of heart transplant patients who had diabetes mellitus before transplant are conflicting. OBJECTIVE: To compare survival, hospitalization, and complications in heart transplant recipients during the first 3 years after surgery in recipients with or without diabetes mellitus before transplant. METHODS: Of 347 recipients, 64 were diabetic (35.9% taking insulin; mean age 56 years; 17.2% females; 12.5% minorities) and 283 were not (mean age 51 years; 20...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29068092/high-dose-mizoribine-combined-with-calcineurin-inhibitor-cyclosporine-or-tacrolimus-basiliximab-and-corticosteroids-for-renal-transplantation-a-japanese-multicenter-study
#13
Tsukasa Nishioka, Norio Yoshimura, Hidetaka Ushigome, Yoshihiko Watarai, Kenji Nishimura, Kiyokazu Akioka, Nobuyuki Nakamura, Mutsushi Kawakita, Kenji Yuzawa, Tatsuya Nakatani
OBJECTIVE: To evaluate the utility and safety of high-dose mizoribine combination therapy using cyclosporine and tacrolimus as calcineurin inhibitors in patients undergoing kidney transplant. METHODS: The present study enrolled 156 patients who received kidney transplants in 18 institutions between 2009 and 2013. ABO-incompatible and/or pre-sensitized recipients were excluded. Immunosuppression used cyclosporine (88) or tacrolimus (68) as a calcineurin inhibitor, and the dosage was adjusted based on blood concentrations...
October 25, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29061332/human-plasmacytoid-dendritic-cells-acquire-phagocytic-capacity-by-tlr9-ligation-in-the-presence-of-soluble-factors-produced-by-renal-epithelial-cells
#14
Jurjen M Ruben, Gina Stella García-Romo, Eytan Breman, Sandra van der Kooij, Anke Redeker, Ramon Arens, Cees van Kooten
Plasmacytoid dendritic cells (pDCs) are antigen presenting cells specialized in viral recognition through Toll-like receptor (TLR)7 and TLR9, and produce vast amounts of interferon alpha upon ligation of these TLRs. We had previously demonstrated a strong influx of pDCs in the tubulointerstitium of renal biopsies at the time of acute rejection. However, the role of human pDCs in mediating acute or chronic allograft rejection remains elusive. pDCs are thought to have a limited capacity to ingest apoptotic cells, critical for inducing CD4(+) T cell activation via indirect antigen presentation and subsequent activation of antibody producing B cells...
October 20, 2017: Kidney International
https://www.readbyqxmd.com/read/28994226/proteinuria-in-pediatric-renal-transplant-recipients
#15
Songül Yılmaz, Z Birsin Özçakar, Aysel Taktak, Eda Didem Kurt-Şükür, Nilgün Çakar, Fatoş Yalçınkaya
Proteinuria has been shown to be an important and potentially treatable risk factor for graft loss. The aim of this study was to evaluate prevalence, etiology, and outcome of proteinuria during the follow-up of children with renal transplantation. We retrospectively reviewed the files of renal transplanted children between 2006 and 2016 in our center. All patients were interpreted with respect to the demographic data and clinical and laboratory features including information about proteinuria. Chi-square test and Mann-Whitney U test were used for analysis...
October 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28988984/prevention-of-chronic-renal-allograft-rejection-by-as2553627-a-novel-jak-inhibitor-in-a-rat-transplantation-model
#16
Koji Nakamura, Yuka Kawato, Yoko Kaneko, Kaori Hanaoka, Kaori Kubo, Tomonori Nakanishi, Masashi Maeda, Hidehiko Fukahori, Misato Ito, Takahisa Noto, Masamichi Inami, Jun Hirose, Tatsuaki Morokata
BACKGROUND: Janus kinase (JAK) inhibitors are thought to be promising candidates to aid renal transplantation. However, the effectiveness of JAK inhibitors against features of chronic rejection, including interstitial fibrosis/tubular atrophy (IF/TA) and glomerulosclerosis, has not been elucidated. Here, we investigated the effect of AS2553627, a novel JAK inhibitor, on the development of chronic rejection in rat renal transplantation. METHODS: Lewis (LEW) to Brown Norway (BN) rat renal transplantation was performed...
October 5, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28986715/induction-therapy-of-basiliximab-versus-antithymocyte-globulin-in-renal-allograft-a-systematic-review-and-meta-analysis
#17
Kun Wang, Xianlin Xu, Min Fan
OBJECTIVE: The aim of this meta-analysis was to evaluate the efficacy of basiliximab versus antithymocyte globulin for induction therapy in renal allograft. METHODS: Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify prospective randomized controlled trials that compared basiliximab with antithymocyte globulin (ATG) for induction therapy in renal transplantation. RevMan 5.1 software and Stat Manager V4...
October 6, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28976570/renal-transplant-acute-rejection-with-lower-mycophenolate-mofetil-dosing-and-proton-pump-inhibitors-or-histamine-2-receptor-antagonists
#18
Kajal S Patel, Brian R Stephany, Julie F Barnes, Seth R Bauer, Michael L Spinner
BACKGROUND: Pharmacokinetic data show reduced mycophenolic acid levels in renal transplant recipients taking mycophenolate mofetil (MMF) and proton pump inhibitors (PPIs) concomitantly. This reduced exposure could increase rejection risk. The typical initial MMF dose post-renal transplant is 2 g daily, which often requires dose reduction secondary to side effects. Existing studies have not shown significant acute rejection differences for patients taking MMF-PPI versus MMF-ranitidine...
October 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28975804/rejection-evaluation-after-renal-transplantation-using-mr-diffusion-tensor-imaging
#19
Emin Deger, Azim Celik, Hamad Dheir, Volkan Turunc, Ahmet Yardimci, Mert Torun, Mutlu Cihangiroglu
Background Renal allograft dysfunction monitoring is mainly performed using the serum creatinine (SC) level, Doppler ultrasound (US), or renal biopsy. Recently proposed diffusion-based magnetic resonance imaging (MRI) methods have been explored as new, non-invasive tools for assessing renal function after transplantation. Purpose To investigate the value of fractional anisotropy (FA) measurements in the evaluation of acute rejection cases after renal transplant. Material and Methods Doppler US and MRI diffusion tensor imaging (DTI) were performed in 21 patients with graft dysfunction requiring graft biopsy after renal transplantation and in 21 patients with normal graft function...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28969763/peri-and-postsurgical-evaluations-of-renal-transplant
#20
REVIEW
Belkis Erbas
Renal transplantation is the best treatment of choice for patient with chronic renal insufficiency because it provides better quality of life and longer survival. Survival rates for grafts and patients have improved over the recent decades because of significant evolution of surgical techniques and immunosuppressive treatment. However, renal transplantation is still associated with several complications, which may result in poor outcome. Cause of allograft dysfunction, which occurs in the early or late post-transplantation period, should be recognized immediately, so that it can be managed correctly...
November 2017: Seminars in Nuclear Medicine
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