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Acute renal graft rejection

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https://www.readbyqxmd.com/read/28802764/factors-influencing-renal-graft-survival-7-year-experience-of-a-single-center
#1
Rūta Auglienė, Eglė Dalinkevičienė, Vytautas Kuzminskis, Mindaugas Jievaltas, Laima Peleckaitė, Agnė Gryguc, Edgaras Stankevičius, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: The demand for kidney transplants exceeds the existing supply. This leads to a recently growing interest of research in the area of factors that could prolong graft long-term outcomes and survival. In Lithuania, approximately 90% of kidney transplantations are from deceased donors. Donor organs are received and shared only inside the country territory in Lithuania; therefore, donor data is accurate and precise. This study was performed to present particularities of kidney transplantation data in Lithuania and to identify the effect of donor and recipient factors and histologic findings on renal graft outcomes...
July 29, 2017: Medicina
https://www.readbyqxmd.com/read/28794296/recurrent-aa-amyloidosis-combined-with-chronic-active-antibody-mediated-rejection-after-kidney-transplantation
#2
Min-Kyung Yeo, Young Rok Ham, Song-Yi Choi, Yong-Moon Lee, Moon Hyang Park, Kwang-Sun Suh
Kidney transplantation for amyloidosis remains a contentious issue. Recurrence of amyloidosis is one of the risks of transplantation. Chronic active antibody-mediated rejection is an important cause of chronic allograft dysfunction. A 47-year-old woman underwent kidney transplantation due to renal AA amyloidosis with unknown etiology. Six years posttransplantation, a kidney biopsy showed AA amyloidosis with chronic active antibody-mediated rejection. Donor-specific antibody class II was positive. The patient underwent intravenous plasmapheresis and treatment with rituximab and colchicine...
July 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28792635/favorable-results-in-abo-incompatible-renal-transplantation-without-b-cell-targeted-therapy-advantages-and-disadvantages-of-rituximab-pretreatment
#3
Manabu Okada, Yoshihiko Watarai, Kenta Iwasaki, Kenta Murotani, Kenta Futamura, Takayuki Yamamoto, Takahisa Hiramitsu, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Asami Takeda, Kunio Morozumi, Kazuharu Uchida, Takaaki Kobayashi
The effectiveness of desensitization with rituximab in ABO-incompatible renal transplantation (ABO-I) has been widely reported. However, ABO-I outcomes are still worse than those of ABO-identical or ABO-compatible renal transplantation (ABO-Id/C). We retrospectively examined the outcomes in consecutive living donor ABO-Id/C (n = 412) and ABO-I (n = 205) cases to elucidate the causes of inferiority in ABO-I. ABO-I cases included recipients treated with rituximab (RIT, n = 131), splenectomy (SPX, n = 21), or neither because of low anti-A/B antibody titers (NoR/S, n = 53)...
August 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28762681/-novel-antiviral-agents-for-the-treatment-of-hcv-among-renal-transplant-recipients
#4
REVIEW
Fabrizio Fabrizi, Francesca M Donato, Piergiorgio Messa
The frequency of hepatitis C virus infection remains high in renal transplant recipients and plays a detrimental role on survival in this population. According to the latest evidence, the adjusted relative risk of mortality and graft loss for anti-HCV seropositive versus anti-HCV negative renal transplant recipients was 1.85 with a 95% confidence interval (CI) of 1.49 ; 2.31 (P < 0.0001) and 1.76 (95% CI, 1.46 ; 2.11) (P < 0.0001), respectively. Interferon-based regimens have been recommended for the treatment of hepatitis C after renal transplantation only in selected circumstances because of an increased risk of acute rejection due to the immuno-stimulatory properties of interferon...
August 1, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28761593/case-series-transplantation-of-kidneys-from-donors-with-renal-artery-aneurysm
#5
Mahmoud Alameddine, Zhobin Moghadamyeghaneh, Giselle Guerra, Mahmoud Morsi, Mohammed Osman, V J Chia, George W Burke, Linda Chen, Rodrigo Vianna, Ian Zheng, Javier González, Gaetano Ciancio
INTRODUCTION: With the present disparity between organ availability and recipient demands, we reported our experience in transplanting kidneys with renal artery aneurysm after back-table reconstruction. METHODS: Four patients were identified. The repair consisted of excision of the aneurysm with ostial closure, and for one of the cases, an ovarian vein patch was used. We reviewed the safety and outcomes of this procedure. All donors were asymptomatic before surgery and were diagnosed incidentally during living donor evaluation...
July 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28760116/impact-of-sex-disparities-on-outcomes-of-living-donor-kidney-transplant-in-egypt-data-of-979-patients
#6
Yasser Elsayed Matter, Muhammed Ahmed Elhadedy, Tarek Medhat Abbas, Mohamed Ahmed Zahab, Mohammed Ashraf Fouda, Ayman Fathi Refaie, Hussein Attia Sheashaa, Mohamed Hamed Abbas, Ahmed Abdelfattah Denewar, Ayman Maher Nagib
OBJECTIVES: Renal transplant is the criterion standard for treatment of end-stage renal disease. The effects of disparities between men and women on renal transplant outcomes have been evaluated in many studies but with debatable results. It has been suggested that female kidney donors have poor outcomes after transplant compared with male kidney donors, especially when implanted in a male recipient. The aim of the study was to evaluate the effects of sex on living-donor kidney transplant outcome...
June 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28760115/a-model-of-acute-antibody-mediated-renal-allograft-rejection-in-the-sensitized-rata
#7
Sharmila Ramessur Chandran, William R Mulley, John Kanellis, David J Nikolic-Paterson, Frank Y Ma
OBJECTIVES: Antibody-mediated rejection in transplant recipients with preexisting donor-specific antibodies is a challenging clinical situation. However, we lack suitable animal models to study this scenario. The aim of this study was to develop an animal model of acute antibody-mediated rejection of renal allografts in sensitized recipients. MATERIALS AND METHODS: We used major histocompatibility complex class I and II incompatible rat strains (Dark Agouti RT1av1 and Lewis RT1l), which develop aggressive rejection...
July 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28759468/the-evaluation-of-critically-ill-transplant-patients-with-infectious-diarrhea
#8
Diana F Florescu
PURPOSE OF REVIEW: The review summarizes the epidemiology, risk factors, clinical presentation, diagnosis and management of the most important etiologic agents of infectious diarrhea in critically ill transplant recipients. RECENT FINDINGS: Diarrhea, frequently caused by infectious pathogens, can cause significant morbidity and mortality in transplant recipients. Diarrhea can lead to severe dehydration, acute renal failure, medication toxicity, rejection, graft-versus-host disease and impairs patients' quality of life...
July 29, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28736014/efficacy-and-safety-of-generic-mycophenolate-mofetil-my-rept-500-milligram-tablets-in-primary-liver-transplant-recipients
#9
S K Hong, K-W Lee, K C Yoon, H-S Kim, H Kim, N-J Yi, K-S Suh
BACKGROUND: Generic immunosuppressants may be cost-effective if clinical outcomes are equivalent to the brand-name medications. Mycophenolate mofetil in the form of My-rept may be cost-effective being a generic immunosuppressant, which is available as a 500-mg tablet as well as a 250-mg capsule (Chong Kun Dang Pharmaceutical Corporation, Seoul, Korea). OBJECTIVE: This study aimed to evaluate the efficacy, safety, cost-effectiveness, and convenience of My-rept 500-mg tablets in liver transplant recipients...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28726586/application-of-ureterorenoscope-and-flexible-ureterorenoscope-lithotripsy-in-removing-calculus-from-extracorporeal-living-donor-renal-graft-a-single-center-experience
#10
Chun-Hua Lin, Zuo-Fu Zhang, Jiahui Wang, Lu-Xin Yu, Wen-Ting Wang, Lei Shi, Xiang-Nan Lin
Here, we reported our clinical application of ureterorenoscope (URS) and flexible URS lithotripsy in stone removal on 10 cases of excised living donor kidney graft. After the extraction of donor kidney by retroperitoneal laparoscopy, the donor graft was perfused with 4 °C HCA solution. Calculus between 2-4 mm were removed intact with lithotomy forceps under direct vision of URS. Larger calculi of >4 mm were fractured with flexible URS combining holmium laser lithotripsy. Fragments of the calculus were extracted with basket extractor and lithotomy forceps...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28714558/everolimus-and-reduced-calcineurin-inhibitor-therapy-in-pediatric-liver-transplant-recipients-results-from-a-multicenter-prospective-study
#11
Rainer Ganschow, Bo-Goran Ericzon, Anil Dhawan, Khalid Sharif, El-Djouher Martzloff, Barbara Rauer, Jennifer Ng, Patricia Lopez
In a 24-month, multicenter, single-arm, prospective study, 56 pediatric liver transplant patients with or without basiliximab induction were converted at 1-6 months post-transplant from standard calcineurin inhibitor (CN) therapy (± mycophenolic acid), to everolimus with reduced exposure to CNI (tacrolimus n=50, cyclosporine n=6). Steroid therapy was optional. Recruitment was stopped prematurely due to high rates of PTLD, treatment-related serious infections leading to hospitalization and premature study drug discontinuation...
July 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28714235/tuberculosis-after-kidney-transplantation-is-associated-with-significantly-impaired-allograft-function
#12
Silvana Daher Costa, Tainá Veras de Sandes-Freitas, Camilla Neves Jacinto, Lorena Vasconcelos Mesquita Martiniano, Yago Sucupira Amaral, Fernando José Villar Nogueira Paes, Maria Luiza de Mattos Brito Oliveira Sales, Ronaldo de Matos Esmeraldo, Elizabeth de Francesco Daher
BACKGROUND: This study aimed to evaluate renal function before, during and after the course of tuberculosis (TB) disease in kidney transplant recipients; and assess the risk factors for non-recovery of baseline renal function. METHODS: We performed a retrospective, single-center cohort study, including all patients with confirmed or presumed TB diagnosis after kidney transplant (n=34, 2.1%). Renal function was assessed by serum creatinine (Cr) and glomerular filtration rate (GFR) adjusted for deaths and graft losses...
July 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#13
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Genomics, proteomics and molecular biology lead to tremendous advances in all fields of medical sciences. Among these the finding of biomarkers as non invasive indicators of biologic processes represents a useful tool in the field of transplantation. In addition to define the principal characteristics of the biomarkers, this review will examine the biomarker usefulness in the different clinical phases following renal transplantation. Biomarkers of ischemia-reperfusion injury and of delayed graft function are extremely important for an early diagnosis of these complications and for optimizing the treatment...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28697714/association-between-overweight-and-renal-transplant-outcomes-a-meta-analysis
#14
Congran Li, Hailong Jin, Li Xiao, Zhouli Li, Ming Cai, Bingyi Shi
OBJECTIVES: Our study aimed to evaluate the effects of being overweight on kidney transplant. MATERIALS AND METHODS: Our study evaluated kidney transplant recipients with body mass index ranging from 25 to 30 kg/m² versus patients with body mass index ranging from 18.5 to 29.9 kg/m², who were identified through PubMed, Embase, and Cochrane Library searches up to October 2015. Outcomes analyzed included delayed graft function, acute rejection, graft loss, and patient survival...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28695576/mechanical-ventilation-and-extracorporeal-membrane-oxygenation-as-a-bridging-strategy-to-lung-transplantation-significant-gains-in-survival
#15
Awori J Hayanga, Angela L Du, Kyla Joubert, Tuft Marie, Rachel Baird, Joseph Pilewski, Mathew Morrell, Jonathan D'Cunha, Norihisa Shigemura
Mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) are increasingly used to bridge patients to lung transplantation. We investigated the impact of using MV, with or without ECMO, prior to lung transplantation on survival after transplantation by performing a retrospective analysis of 826 patients who underwent transplantation at our high-volume center. Recipient characteristics and posttransplant outcomes were analyzed. Most lung transplant recipients (729 patients) did not require bridging; 194 of these patients were propensity matched with patients who were bridged using MV alone (48 patients) or MV and ECMO (49 patients)...
July 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28682561/-immunosuppression-in-kidney-transplantation-a-way-between-efficacy-and-toxicity
#16
Costanza Casati, Alberto Menegotto, Maria Luisa Querques, Federica Ravera, Giacomo Colussi
Renal transplantation is the best treatment for patients with end-stage renal disease. Over the last decades, the introduction of new immunosuppressive agents resulted into the reduction of the incidence of acute rejection and early graft loss. Despite this progress, there has been little improvement in the average life of the transplant. The main reasons of late failure are patient's death due to several complications (e.g. cancer, infectious or metabolic), and progressive deterioration of renal function caused by immunological and non-immunological factors...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28679466/successful-launch-of-an-abo-incompatible-kidney-transplantation-program-to-overcome-the-shortage-of-compatible-living-donors-experience-at-a-single-center%C3%A2
#17
Seung Hwan Song, Juhan Lee, Beom Seok Kim, Sinyoung Kim, Jae Geun Lee, Hyeon Joo Jeong, Yu Seun Kim, Myoung Soo Kim, Hyun Ok Kim, Soon Il Kim, Kyu Ha Huh
AIMS: ABO-incompatible (ABOi) kidney transplantation (KT) is being increasingly performed to overcome donor shortages. However, debate persists regarding the post-transplant outcomes of ABOi KT vs. that of ABO-compatible (ABOc) KT. METHODS: A total 454 recipients who underwent living-donor KT (LDKT) between June 2010 and July 2014 at Severance Hospital (Seoul) were retrospectively reviewed. 100 ABOi and 354 ABOc KTs were compared. Recipients with a pretransplant positive crossmatch to their donors, pretransplant donor-specific anti-HLA antibody (DSA), or high panel reactive antibody (PRA ≥ 50%) were excluded from both the ABOi and ABOc KT groups...
July 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28676335/thymoglobuline-plus-basiliximab-a-mixed-cocktail-to-start
#18
EDITORIAL
Spagnoletti Gionta, Salerno Maria Paola, Calia Rosaria, Romagnoli Jacopo, Citterio Franco
Recent results reported by Ciancio et al. have demonstrated the long term successful use of dual induction therapy in kidney transplant recipients. Our experience using an "induction cocktail", thymoglobuline plus basiliximab, started in 2007 and we have treated 235 patients through the past 10years. In our population, we used a combination of CNIs and MMF or mTORi as maintenance therapy. Our results in term of patient and graft survival, acute rejection rate, renal function and incidence of post-transplant lymphoproliferative disorder support the data reported by Ciancio...
July 1, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28671951/an-adjustable-predictive-score-of-graft-survival-in-kidney-transplant-patients-and-the-levels-of-risk-linked-to-de-novo-donor-specific-anti-hla-antibodies
#19
Aurélie Prémaud, Matthieu Filloux, Philippe Gatault, Antoine Thierry, Matthias Büchler, Eliza Munteanu, Pierre Marquet, Marie Essig, Annick Rousseau
Most predictive models and scores of graft survival in renal transplantation include factors known before transplant or at the end of the first year. They cannot be updated thereafter, even in patients developing donor-specific anti-HLA antibodies and acute rejection.We developed a conditional and adjustable score for prediction of graft failure (AdGFS) up to 10 years post-transplantation in 664 kidney transplant patients. AdGFS was externally validated and calibrated in 896 kidney transplant patients.The final model included five baseline factors (pretransplant non donor-specific anti-HLA antibodies, donor age, serum creatinine measured at 1 year, longitudinal serum creatinine clusters during the first year, proteinuria measured at 1 year), and two predictors updated over time (de novo donor-specific anti-HLA antibodies and first acute rejection)...
2017: PloS One
https://www.readbyqxmd.com/read/28658202/pharmacokinetics-and-clinical-outcomes-of-generic-tacrolimus-hexal-versus-branded-tacrolimus-in-de-novo-kidney-transplant-patients-a-multicenter-randomized-trial
#20
Wolfgang Arns, Andrea Huppertz, Thomas Rath, Stephan Ziefle, Lars C Rump, Anita Hansen, Klemens Budde, Lukas J Lehner, Maria Shipkova, Daniel Baeumer, Irena Kroeger, Christian Sieder, Thomas Klein, Peter Schenker
BACKGROUND: Scrupulous comparison of the pharmacokinetic and clinical characteristics of generic tacrolimus formulations versus the reference drug (Prograf) is essential. Pharmacokinetics of the TacHexal formulation are similar to Prograf in stable renal transplant patients but data in de novo patients is lacking. METHODS: De novo kidney transplant patients were randomized to generic tacrolimus (Tacrolimus Hexal [TacHexal]) or Prograf in a 6-month open-label study...
June 28, 2017: Transplantation
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