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Acute renal graft rejection

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https://www.readbyqxmd.com/read/28420067/kidney-transplantation-for-end-stage-renal-disease-in-lupus-nephritis-a-very-safe-procedure-a-single-latin-american-transplant-center-experience
#1
J Naranjo-Escobar, E Manzi, J G Posada, L Mesa, G J Echeverri, C Duran, J Schweneiberg, L A Caicedo, J I Villegas, G J Tobón
Background Lupus nephritis (LN) is one of the most frequent complications of SLE and occurs in up to 50% of cases depending on the studied population. Of these, approximately 20% progress to end-stage renal disease (ESRD), with the treatment of choice being a kidney transplant. Objective The objective of this study was to describe the clinical outcome of patients transplanted due to LN, compared with patients transplanted for other causes, in a Latin American population from the Fundación Valle del Lili in Cali, Colombia...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28418009/effect-of-umod-genotype-on-long-term-graft-survival-after-kidney-transplantation-in-patients-treated-with-cyclosporine-based-therapy
#2
E Abdel-Hady Algharably, J Beige, R Kreutz, J Bolbrinker
The genetic rs12917707-G>T variant in uromodulin (UMOD) has been associated with renal function, chronic kidney disease and hypertension with the minor T-allele showing a protective effect. Hypertension and nephrotoxicity are adverse effects of chronic cyclosporine treatment. We tested whether UMOD rs12917707-T in donor kidneys associates with long-term graft survival in 393 Caucasian patients with stable graft function for more than 10 weeks after kidney transplantation treated with a cyclosporine-based maintenance therapy (mean graft survival 9 years)...
April 18, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28415773/effects-of-cd20-b-cell-infiltration-into-allografts-on-kidney-transplantation-outcomes-a-systematic-review-and-meta-analysis
#3
REVIEW
Yingying Lu, Bingjue Li, Qixia Shen, Rending Wang, Zhimin Chen, Hong Jiang, Jianghua Chen
The effects of CD20+ B-cell infiltration during acute rejection on graft outcomes are controversial. The objective of this systematic review and meta-analysis was to clarify this issue. We performed a systematic literature search for studies published up to January 14, 2016. A total of 5 studies, with 200 patients, were included. The presence of CD20+ B cells in renal biopsies during allograft rejection was associated with graft loss and steroid resistance. No association of CD20+ B-cell infiltration with C4d-positive staining of the peritubular capillaries in renal biopsies was found in the analysis of patients who experienced kidney graft rejection...
March 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28411360/liver-transplant-in-children-with-hepatoblastoma
#4
Razieh Abdolvahabi, Abdolfatah Sarrafnejad, Mohsen Nafar, Davood Jafari, Efat Razaghi, Mahboob Lessan-Pezashki, Mir Saeed Yekaninejad, Ehsan Sharif-Paghaleh, Aliakbar Amirzargar
OBJECTIVES: Toll-like receptors play an important role in innate and adaptive immune responses and can induce acute graft rejection, especially in the early phase after transplant. The aim of this study was to evaluate the possible association between TLR2, TLR4, and CD14 polymorphisms and acute renal rejection. MATERIALS AND METHODS: Our study included 239 patients seen between 2013 and 2015. Patients were classified into 3 groups: acute rejection group (71 patients), stable graft function group (71 patients), and healthy control group (97 patients)...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28405599/absence-of-intragraft-b-cells-in-rejection-biopsies-after-rituximab-induction-therapy-consequences-for-clinical-outcome
#5
Martijn W F van den Hoogen, Eric J Steenbergen, Marije C Baas, Sandrine Florquin, Luuk B Hilbrands
BACKGROUND: The pathophysiological role of intragraft B cells during renal allograft rejection is unclear. METHODS: We studied B-cell infiltration during acute rejection in 53 patients who participated in a clinical trial in which adult renal transplant patients were randomized between a single intraoperative dose of rituximab (375 mg/m(2)) or placebo as induction therapy. Two independent pathologists scored all biopsies in a blinded fashion according to the Banff classification and scored for the presence of B cells and plasma cells using CD79a and CD138 as markers...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28384413/comparative-effectiveness-of-tacrolimus-based-steroid-sparing-versus-steroid-maintenance-regimens-in-kidney-transplantation-results-from-discrete-event-simulation
#6
Vibha C A Desai, Yann Ferrand, Teresa M Cavanaugh, Christina M L Kelton, J Jaime Caro, Jens Goebel, Pamela C Heaton
BACKGROUND: Corticosteroids used as immunosuppressants to prevent acute rejection (AR) and graft loss (GL) following kidney transplantation are associated with serious cardiovascular and other adverse events. Evidence from short-term randomized controlled trials suggests that many patients on a tacrolimus-based immunosuppressant regimen can withdraw from steroids without increased AR or GL risk. OBJECTIVES: To measure the long-term tradeoff between GL and adverse events for a heterogeneous-risk population and determine the optimal timing of steroid withdrawal...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28380212/upregulation-of-microrna-142-3p-in-the-peripheral-blood-and-urinary-cells-of-kidney-transplant-recipients-with-post-transplant-graft-dysfunction
#7
T D Domenico, G Joelsons, R M Montenegro, R C Manfro
We analyzed microRNA (miR)-142-3p expression in leucocytes of the peripheral blood and urinary sediment cell samples obtained from kidney transplant recipients who developed graft dysfunction. Forty-one kidney transplant recipients with kidney graft dysfunction and 8 stable patients were included in the study. The groups were divided according to histological analysis into acute rejection group (n=23), acute tubular necrosis group (n=18) and stable patients group used as a control for gene expression (n=8)...
April 3, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28376778/outcomes-for-primary-kidney-transplantation-from-donation-after-citizens-death-in-china-a-single-center-experience-of-367-cases
#8
Wujun Xue, Puxun Tian, Heli Xiang, Xiaoming Ding, Xiaoming Pan, Hang Yan, Jun Hou, Xinshun Feng, Linjuan Liu, Chenguang Ding, Xiaohui Tian, Yang Li, Jin Zheng
BACKGROUND: The cases of donation after brain death followed by circulatory death (DBCD) and donation after cardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the outcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its potential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD and DCD transplant and the main risk factors for DGF in DBCD...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28370148/the-serial-duplex-index-improves-differential-diagnosis-of-acute-renal-transplant-dysfunction
#9
Markus Meier, Lutz Fricke, Katrin Eikenbusch, Emma Smith, Jan Kramer, Hendrik Lehnert, Martin Nitschke
OBJECTIVES: Renal duplex sonography represents a standard noninvasive diagnostic procedure to demonstrate morphologic changes in acute kidney transplant dysfunction. We investigated whether a newly developed serial duplex index (SDI) can differentiate between acute cellular rejection and acute vascular rejection more effectively than the established Doppler parameters of the resistive index (RI) and pulsatility index (PI) in recently transplanted patients. METHODS: Serial duplex scans of patients with histologically proven acute tubular necrosis (n = 25), acute cellular rejection (n = 28), acute vascular rejection (n = 18), and normal graft function (n = 50, partially protocol biopsied) were retrospectively analyzed...
April 3, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28359782/in-vivo-il-4-prevents-allo-antigen-driven-cd8-ctl-development
#10
Charles S Via, Kateryna Soloviova, Maksym Puliaiev, Roman Puliav, Irina Puliaeva, Suzanne C Morris, Fred D Finkelman
IL-4 has been shown to suppress acute graft vs. host disease (GVHD) in irradiated hosts. Here we evaluated whether IL-4 suppresses acute GVHD in the un-irradiated parent-into-F1 GVHD model with relevance to renal allograft rejection. IL-4 completely suppressed CD8 CTL when administered with donor cells however this effect was lost if its administration was delayed 3days. IL-4 did not inhibit donor CD8(+) T cell homing to the host spleen but rather prevented donor CD8(+) T cell differentiation into CTLs. Studies with IL-4Rα-deficient donor cells or recipient mice demonstrated that IL-4 effects on the host, rather than, or in addition to IL-4 effects on donor cells, were critical for suppression of CTL...
March 27, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28356665/renal-allograft-eosinophilia-an-unusual-presentation-of-sudden-graft-dysfunction
#11
A Yuvaraj, S Ghosh, G Abraham, P Koshy
We present a case of sudden allograft dysfunction 11 months after renal transplantation which presented as severe peripheral and allograft eosinophilia and was managed as a case of an acute cellular rejection with significant interstitial graft eosinophilic infiltration. Patient had partial response to antirejection therapy and eventually ended up in a chronic allograft dysfunction.
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28356080/patient-reported-non-adherence-and-immunosuppressant-trough-levels-are-associated-with-rejection-after-renal-transplantation
#12
Jennifer Scheel, Sandra Reber, Lisa Stoessel, Elisabeth Waldmann, Sabine Jank, Kai-Uwe Eckardt, Franziska Grundmann, Frank Vitinius, Martina de Zwaan, Anna Bertram, Yesim Erim
BACKGROUND: Different measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels). METHODS: Patient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were ≥12 months post-transplantation...
March 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28342287/longitudinal-evaluation-of-perfusion-changes-in-acute-and-chronic-renal-allograft-rejection-using-arterial-spin-labeling-in-translational-mouse-models
#13
Katja Hueper, Martina Schmidbauer, Anja Thorenz, Jan H Bräsen, Marcel Gutberlet, Michael Mengel, Dagmar Hartung, Rongjun Chen, Martin Meier, Hermann Haller, Frank Wacker, Song Rong, Faikah Gueler
PURPOSE: To examine the longitudinal changes of renal perfusion due to acute and chronic renal allograft rejection by using arterial spin labeling (ASL) MRI in translational mouse models of isogenic and allogenic kidney transplantation (ktx). MATERIALS AND METHODS: Acute rejection was induced by allogenic ktx of C57BL/6 (B6)-kidney grafts to BALB/c-recipients with prolonged cold ischemia (CIT) of 60 minutes (n = 13). To induce chronic rejection BALB/c-kidneys were transplanted into B6-recipients with short CIT of 30 minutes (n = 22)...
March 25, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28340819/influence-of-proton-pump-inhibitors-on-mycophenolic-acid-pharmacokinetics-in-patients-with-renal-transplantation-and-the-relationship-with-cytochrome-2c19-gene-polymorphism
#14
H S Ciftci, M S Karadeniz, T Tefik, Y Caliskan, H Yazıcı, E Demir, A Turkmen, I Nane, F S Oguz, F Aydin
BACKGROUND: Most patients have serious digestive complications after renal transplantation. Therefore, it is important to protect gastrointestinal function to improve the survival rate of transplant patients. Proton pump inhibitors (PPIs) such as lansoprazole and rabeprazole are widely administered to renal transplant patients with mycophenolic acid (MPA) in the perioperative period. PPIs are metabolized by cytochrome (CYP) 2C19 enzymes. Mycophenolate sodium (MYF) and mycophenolate mofetil (MMF) have been used in immunosuppression...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340817/efficacy-and-safety-of-atg-fresenius-as-an-induction-agent-in-living-donor-kidney-transplantation
#15
M Yilmaz, T Ö Sezer, E Günay, I Solak, A Çeltik, C Hoşcoşkun, H Töz
BACKGROUND: Induction therapy is mostly recommended for deceased-donor transplantation, whereas it has some controversies in live-donor transplantation. In this study, we described the outcomes of live-donor renal transplant recipients who received ATG-Fresenius (ATG-F) induction. METHODS: Live-donor transplantations in patients over 18 years old with ATG-F induction between 2009 and 2015 were included. All patients received quadruple immunosuppression, one of which was ATG-F induction...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340814/evaluation-of-th17-and-th1-immune-response-profile-in-patients-after-renal-transplant
#16
A Erol, E Arpali, B Murat Yelken, B Kocak, Y K Calıskan, I Nane, A Turkmen, F Savran Oguz
BACKGROUND: Renal transplantation (RT) is the best treatment option for patients with end-stage renal disease (ESRD) because it improves both quality of life and survival. However, allograft rejection remains the most important barrier to successful transplantation. Underlying immunologic mechanisms should be understood to develop appropriate treatment strategies. METHODS: In this prospective study, we followed renal transplant recipients for 6 months. The study population comprised 50 recipients of renal transplants, and these were divided into 2 groups: 44 patients with stable graft function (SGF) and 6 patients with rejection (RX)...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28338457/transplant-renal-vein-thrombosis
#17
Khaled El Zorkany, Julie-Michelle Bridson, Ajay Sharma, Ahmed Halawa
Transplant renal vein thrombosis usually occurs early after surgery with a reported prevalence of 0.1% to 4.2%. It is a devastating event that ultimately leads to graft loss in almost all cases. There are many predisposing factors related to donor, recipient, surgery, and immunosuppression, with mechanical factors being considered the most common causes of transplant renal vein thrombosis. The clinical manifestations of acute renal vein thrombosis are nonspecific and are not dissimilar to the features of urine leak, urinary obstruction, or severe acute rejection...
April 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28321326/first-canadian-case-report-of-kidney-transplantation-from-an-hiv-positive-donor-to-an-hiv-positive-recipient
#18
Georges Ambaraghassi, Héloïse Cardinal, Daniel Corsilli, Claude Fortin, Marie-Chantal Fortin, Valérie Martel-Laferrière, Jacques Malaise, Michel R Pâquet, Danielle Rouleau
RATIONALE: Kidney transplantation has become standard of care for carefully selected patients living with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) in the highly active antiretroviral therapy (HAART) era. American and European prospective cohort studies have reported similar patient and graft survival compared with HIV-negative kidney transplant recipients. Despite an increased rate of acute rejection, partially due to drug interactions, HIV immunovirologic parameter generally remains under control during immunosuppression...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28316087/influence-of-abcc2-cyp2c8-and-cyp2j2-polymorphisms-on-tacrolimus-and-mycophenolate-sodium-based-treatment-in-brazilian-kidney-transplant-recipients
#19
Fabiana D V Genvigir, Alvaro M Nishikawa, Claudia R Felipe, Helio Tedesco-Silva, Nagilla Oliveira, Antony B C Salazar, Jose O Medina-Pestana, Sonia Q Doi, Mario H Hirata, Rosario D C Hirata
STUDY OBJECTIVE: To investigate the influence of single nucleotide polymorphisms (SNPs) in genes encoding metabolizing enzymes (CYP2C8, CYP2J2, and UGT2B7) and transporters (ABCC2 and ABCG2) on dose and/or dose-adjusted trough blood concentrations (C/D ratio), clinical outcomes, and occurrence of adverse events of tacrolimus and mycophenolate sodium in Brazilian kidney transplant recipients. DESIGN: Pharmacogenetic analysis of patients enrolled in a previously published study...
March 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28289708/interruption-of-ox40l-signaling-prevents-costimulation-blockade-resistant-allograft-rejection
#20
William H Kitchens, Ying Dong, David V Mathews, Cynthia P Breeden, Elizabeth Strobert, Maria E Fuentes, Christian P Larsen, Mandy L Ford, Andrew B Adams
The potential of costimulation blockade to serve as a novel transplant immunosuppression strategy has been explored for over 20 years, culminating in the recent clinical approval of belatacept for renal transplant patients. Despite improving long-term graft function and survival compared with calcineurin inhibitors, clinical acceptance of belatacept has been hindered by elevated rates of acute rejection. We examined the signaling pathways required to activate costimulation blockade-resistant alloreactive T cells and identified the OX40/OX40L secondary costimulatory pathway as a promising target...
March 9, 2017: JCI Insight
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