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Acute renal graft rejection

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https://www.readbyqxmd.com/read/29761588/infection-is-the-chief-cause-of-mortality-and-non-death-censored-graft-loss-in-the-first-year-after-renal-transplantation-in-a-resource-limited-population-a-single-center-study
#1
Vikraman G, Sanjay Kumar Agarwal, Sandeep Agarwal, Sandeep Mahajan, Dipankar Bhowmik, Soumita Bagchi
BACKGROUND: Few studies have assessed the impact of infections after renal transplantation (RTX) in low and middle income countries. This single center study aimed to delineate the profile and impact of infections requiring hospitalisation (IRH) occurring in the first year after RTX in India. METHOD: Patients who underwent RTX between July 2012 and June 2015 were followed up for 12 months after transplantation. RESULTS: 60.2% of the 387 patients studied had atleast one IRH and total 492 infections were diagnosed...
May 14, 2018: Nephrology
https://www.readbyqxmd.com/read/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#2
Johan Noble, Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
Cornerstone immunosuppressive therapy currently relies on immediate-release tacrolimus, a calcineurin inhibitor (CNI) that is potentially nephrotoxic and is more diabetogenic than cyclosporine A. Two new formulations of tacrolimus have been launched: an extended-release formulation (Advagraf®/Astagraf XL®, Astellas company) and a long-lasting formulation (Envarsus®, Veloxis company). Area covered: Herein, we assess the efficacy of an extended-release formulation of tacrolimus (Advagraf®/Astagraf XL®) used in conjunction with or without an induction therapy (i...
May 14, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#3
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29731057/clinical-outcomes-of-kidney-transplantation-in-patients-with-biopsy-proven-glomerulonephritis
#4
H Park, W Y Park, S S Kang, S M Yeo, S Han, S B Park, K Jin
BACKGROUND: The clinical outcomes after kidney transplantation (KT) according to the types of glomerulonephritis (GN) as the cause of end-stage renal disease (ESRD) are various, but there are not many studies on this. METHODS: Among 1,253 patients who had KT between November 1982 and January 2017, 183 recipients with biopsy-proven GN as the primary cause of ESRD were enrolled. We analyzed the incidence of recurrent GN and the factors associated with recurrence and graft and patient survivals...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29725772/benefits-and-risks-of-protocol-biopsies-in-pediatric-renal-transplantation
#5
Roberto Gordillo, Raj Munshi, Eric J Monroe, Giridhar M Shivaram, Jodi M Smith
Protocol biopsies are defined as sampling of allograft tissue at predetermined times regardless of function. This procedure can be justified due to the lack of non-invasive methods to reliably diagnose rejection (acute or subclinical). Changes in creatinine are not seen with subclinical rejection or early acute rejection and do not always correlate with efficacy of treatment. Parents and providers are still hesitant to pursue protocol biopsy due to the potential complications and lack of definitive evidence of a benefit from doing this procedure...
May 3, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29723212/from-arterial-stiffness-to-kidney-graft-microvasculature-mortality-and-graft-survival-within-a-cohort-of-220-kidney-transplant-recipients
#6
Lynda Cheddani, Camélia Radulescu, Michel Chaignon, Alexandre Karras, Yann Neuzillet, Jean-Paul Duong, Nahid Tabibzadeh, Emmanuel Letavernier, Michel Delahousse, Jean-Philippe Haymann
BACKGROUND: Aortic stiffness assessed by carotid-femoral pulse wave velocity (CF-PWV) is a predictor of mortality in several populations. However, little is known in kidney transplant recipients. Our objectives were to evaluate the ability of CF-PWV measured 3 months following transplantation to predict mortality, graft loss and its potential links to measured Glomerular Filtration Rate (mGFR) or kidney graft microvasculature parameters. METHODS: The study is based on a monocentric retrospective cohort including 220 adult kidney graft recipients evaluated three months after transplantation...
2018: PloS One
https://www.readbyqxmd.com/read/29722128/five-year-outcomes-in-kidney-transplant-patients-randomized-to-everolimus-with-cyclosporine-withdrawal-or-low-exposure-cyclosporine-versus-standard-therapy
#7
Claudia Sommerer, Michael Duerr, Oliver Witzke, Frank Lehner, Wolfgang Arns, Volker Kliem, Daniel Ackermann, Markus Guba, Johannes Jacobi, Ingeborg A Hauser, Rolf Stahl, Petra Reinke, Thomas Rath, Justyna Veit, Arianeb Mehrabi, Martina Porstner, Klemens Budde
HERAKLES was a one-year randomized, multicenter trial. Patients were randomized at three months after kidney transplantation to remain on cyclosporine-based therapy, switch to everolimus without a calcineurin inhibitor (CNI), or switch to everolimus with low-exposure cyclosporine. Overall, 417/497 (83.9%) patients from the core study entered a four-year extension study. The randomized regimen was continued to year 5 in 75.9%, 41.9% and 24.6% of patients in the standard-CNI, CNI-free and low-CNI groups, respectively...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29709248/identifying-risk-profiles-in-liver-transplant-candidates-and-implications-for-induction-immunosuppression
#8
REVIEW
Umberto Cillo, Wolf O Bechstein, Gabriela Berlakovich, Philipp Dutkowski, Frank Lehner, Silvio Nadalin, Faouzi Saliba, Hans J Schlitt, Johann Pratschke
Changes in recipient and donor characteristics are redefining the role of induction in liver transplant recipients. Older recipients are more common, with greater concomitant comorbidity. Moderate or severe renal dysfunction is now estimated to affect 40% of liver transplant recipients. Donors are also becoming older, and other factors such as more frequent non-alcoholic fatty liver disease (NAFLD) compromise the quality of some grafts. Rejection rates are now relatively low (~10%) but some patients have a markedly increased risk such as younger recipients and those undergoing re-transplantation...
April 13, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29707626/single-graft-utilization-from-donors-with-severe-acute-kidney-injury-after-circulatory-death
#9
Yusuke Tomita, Kazuhiro Iwadoh, Yuichi Ogawa, Katsuyuki Miki, Kotaro Kai, Akihito Sannomiya, Toru Murakami, Ichiro Koyama, Kumiko Kitajima, Ichiro Nakajima, Shohei Fuchinoue
Chronic shortages of organs for transplantation have led to the use of marginal kidneys from donors after circulatory death with acute kidney injury (AKI), but the utilization of kidneys with severe AKI is not well established. We retrospectively analyzed eight kidney transplantation (KTx) cases from donation after circulatory death (DCD) with terminal creatinine (t-Cr) concentrations higher than 10.0 mg/dL and/or oliguria for more than 5 days (AKI network criteria: stage III). Although all patients showed delayed graft function, no cases of primary nonfunction (PNF) were found...
April 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29693023/kidney-transplantation-the-challenge-of-human-leukocyte-antigen-and-its-therapeutic-strategies
#10
REVIEW
Tilahun Alelign, Momina M Ahmed, Kidist Bobosha, Yewondwossen Tadesse, Rawleigh Howe, Beyene Petros
Kidney transplantation remains the treatment of choice for end-stage renal failure. When the immune system of the recipient recognizes the transplanted kidney as a foreign object, graft rejection occurs. As part of the host immune defense mechanism, human leukocyte antigen (HLA) is a major challenge for graft rejection in transplantation therapy. The impact of HLA mismatches between the donor and the potential recipient prolongs the time for renal transplantation therapy, tethered to dialysis, latter reduces graft survival, and increases mortality...
2018: Journal of Immunology Research
https://www.readbyqxmd.com/read/29676700/impact-of-allograft-nephrectomy-on-second-renal-transplant-outcome
#11
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
#12
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/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/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
#14
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/29661425/soluble-cd30-acute-rejection-and-graft-survival-pre-and-6-month-post-transplant-determinations-when-is-the-best-time-to-measure
#15
M I de Holanda, T Matuck, D D B M de Carvalho, E M F L Domingues, R Curvo, D S Glasberg, A M G Santos, Á M Borela, L C Pôrto
BACKGROUND: Pretransplantation soluble CD30 (sCD30) has been shown to be a good predictor of acute rejection (AR) and graft loss. This study aimed to evaluate the effectiveness of sCD30 measured pretransplant and up to 6 months after transplantation as a predictor of AR, graft loss, and survival at 5 years post-transplantation. Subjects were patients receiving living donor renal transplants at Bonsucesso Federal Hospital (Rio de Janeiro) in 2006 and between August 2010 and May 2011. METHODS: sCD30 was analyzed in samples collected pretransplantation and 7, 14, and 21, 28 days and 3, 4, 5, and 6 months post-transplantation from 73 kidney recipients...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29660004/renal-transplant-outcomes-and-de-novo-donor-specific-anti-human-leukocyte-antigen-antibodies-a-systematic-review
#16
Ankit Sharma, Joshua R Lewis, Wai H Lim, Suetonia Palmer, Giovanni Strippoli, Jeremy R Chapman, Stephen I Alexander, Jonathan C Craig, Germaine Wong
Background: Pre-transplant donor-specific anti-human leukocyte antigen antibodies (DSAs) are known risk factors for acute rejection and reduced graft survival after kidney transplantation. DSAs may also develop de novo DSAs (dnDSAs) after transplantation but the clinical implications of these antibodies remain uncertain. Methods: We undertook a systematic review of observational studies that examined the association between dnDSAs and graft and patient outcomes (through August 2017) with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system of reporting used to assess the quality of evidence available...
April 11, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29659179/nk-cell-and-th17-responses-are-differentially-induced-in-murine-cytomegalovirus-infected-renal-allografts-and-vary-according-to-recipient-virus-dose-and-strain
#17
Mao Li, Srinivasa Boddeda, Bo Chen, Qiang Zeng, Trenton R Schoeb, Victoria M Velazquez, Masako Shimamura
Human cytomegalovirus (HCMV) donor positive (D+) serostatus with acute rejection is associated with renal allograft loss, but the impact of recipient positive (R+) serostatus is unclear. In an allogeneic renal transplant model, antiviral natural killer (NK) and CD8+ T cell memory responses in murine CMV (MCMV) D+/R+ transplants were compared to D-/R- and D+/R- transplants, with recipient infection varied by MCMV dose and strain. D+/R- transplants had high primary antiviral cytolytic (interferon-γ+) and cytotoxic (granzyme B+) NK responses, whereas NK memory responses were lower in D+/R+ recipients receiving a high primary MCMV dose...
April 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29620612/tofacitinib-halts-progression-of-graft-dysfunction-in-a-rat-model-of-mixed-cellular-and-humoral-rejection
#18
Jordi Rovira, María J Ramírez-Bajo, Elisenda Banon-Maneus, Marta Lazo-Rodríguez, Daniel Moya-Rull, Natalia Hierro-Garcia, Valeria Tubita, Gastón J Piñeiro, Ignacio Revuelta, Pedro Ventura-Aguiar, David Cucchiari, Federico Oppenheimer, Mercè Brunet, Josep M Campistol, Fritz Diekmann
BACKGROUND: The progression from acute to chronic antibody-mediated rejection in kidney transplant recipients is usually not prevented by current therapeutic options. Here, we investigated whether the use of tofacinitib, a Janus kinase 3 inhibitor, was capable of preventing the progression of allograft dysfunction in a Fisher-to-Lewis rat model of kidney transplantation. METHODS: Rats were treated from the third week after transplantation in order to allow the development of rejection...
April 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29620542/donor-specific-hla-dq-antibodies-may-contribute-to-poor-graft-outcome-after-heart-transplantation
#19
Osama Omrani, Moheeb Alawwami, Jehad Buraiki, Nedim Selimovic
BACKGROUND: HLA-DQ donor-specific antibodies (DSA) are implicated in allograft dysfunction after renal and lung transplantation. Limited data exists on the impact of HLA-DQ antibodies on heart transplant patients. OBJECTIVE: To investigate the impact of DSA formation on allograft function and outcomes in heart transplant patients. DESIGN: Retrospective cohort study. SETTING: Collating post-transplantation patient data from computerized database in a tertiary hospital in Riyadh, Saudi Arabia from January 2006 to October 2014...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29619905/etiological-analysis-of-graft-dysfunction-following-living-kidney-transplantation-a-report-of-366-biopsies
#20
Jin Zhang, Jiang Qiu, Guo-Dong Chen, Chang-Xi Wang, Chang Wang, Shuang-Jin Yu, Li-Zhong Chen
AIM: The aim of this study is to investigate the clinical features of graft dysfunction following living kidney transplantation and to assess its causes. METHODS: We retrospectively analyzed a series of 366 living kidney transplantation indication biopsies with a clear etiology and diagnosis from July 2003 to June 2016 at our center. The classifications and diagnoses were performed based on clinical and pathological characteristics. All biopsies were evaluated according to the Banff 2007 schema...
November 2018: Renal Failure
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