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Acute renal graft rejection

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https://www.readbyqxmd.com/read/27917694/outcomes-of-kidney-transplantation-in-alport-syndrome-compared-with-other-forms-of-renal-disease
#1
Yvelynne P Kelly, Anish Patil, Luke Wallis, Susan Murray, Saumitra Kant, Mohammed A Kaballo, Liam Casserly, Brendan Doyle, Anthony Dorman, Patrick O'Kelly, Peter J Conlon
INTRODUCTION: Alport syndrome is an inherited renal disease characterized by hematuria, renal failure, hearing loss and a lamellated glomerular basement membrane. Patients with Alport syndrome who undergo renal transplantation have been shown to have patient and graft survival rates similar to or better than those of patients with other renal diseases. METHODS: In this national case series, based in Beaumont Hospital Dublin, we studied the cohort of patients who underwent renal transplantation over the past 33 years, recorded prospectively in the Irish Renal Transplant Registry, and categorized them according to the presence or absence of Alport syndrome...
December 5, 2016: Renal Failure
https://www.readbyqxmd.com/read/27913812/association-between-cytokines-and-their-receptor-antagonist-gene-polymorphisms-and-clinical-risk-factors-and-acute-rejection-following-renal-transplantation
#2
SIqing Ding, Jianfei Xie, Qiquan Wan
BACKGROUND Acute rejection (AR) after renal transplantation affects both patient and graft survival. There is growing evidence of the genetic association between cytokine or its receptor antagonist and AR in solid organ transplantation. The objectives of this study were to investigate the role of recipient TNF β, IL-10, IL-1β, and IL-1 receptor antagonist (ra) gene polymorphism, as well as traditional clinical variables such as panel-reactive antibody (PRA) levels, donor type, and HLA mismatches in AR following renal transplantation...
December 3, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27907919/the-impact-of-health-care-appointment-non-adherence-on-graft-outcomes-in-kidney-transplantation
#3
David J Taber, James N Fleming, Cory E Fominaya, Mulugeta Gebregziabher, Kelly J Hunt, Titte R Srinivas, Prabhakar K Baliga, John W McGillicuddy, Leonard E Egede
BACKGROUND: Non-adherence to medication is a well-studied and known cause of late allograft loss, but it is difficult to measure and prospectively monitor. The aim of this study was to assess if appointment non-adherence was correlated with medication non-adherence and a predictor of graft outcomes. METHODS: This was a longitudinal cohort study that used the National United States Renal Data System and veterans affairs health records data with time-to-event analyses conducted to assess the impact on graft and patient survival...
December 2, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27888534/early-steroid-withdrawal-results-in-improved-patient-and-graft-survival-and-lower-risk-of-post-transplant-cardiovascular-risk-profiles-a-single-center-10-year-experience
#4
Reynold Lopez-Soler, Ryan Chan, Jessica Martinolich, Lisa Park, Ashar Ata, Nikolaos Chandolias, David Conti
Long term use of steroids results in predictable secondary effects that can lead to increased morbidity and mortality. In this study, we present 10 years' worth of data of early steroid withdrawal (ESW) immunosuppression consisting of Mycophenolate, Sirolimus, and Tacrolimus. From 2003 to 2013, 563 kidney transplant recipients were weaned off steroids prior to discharge. We compared outcomes with that of our 65 historical controls maintained on steroids. We analyzed graft and patient survival and determined the incidence of steroid-related comorbidities such as hypertension, hypercholesterolemia, diabetes, coronary artery disease, and weight gain...
November 26, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27887740/outcomes-of-renal-transplantation-in-patients-with-bipolar-affective-disorder-and-schizophrenia-a-national-retrospective-cohort-study
#5
Mary I Butler, Deirdre McCartan, Anne Cooney, Patrick O Kelly, Izhar Ahmed, Dilly Little, Siobhan MacHale, Peter Conlon
BACKGROUND: Patients with severe psychiatric disorders such as schizophrenia and bipolar affective disorder (BPAD) have in the past been excluded from organ transplantation programs based on their psychiatric illness. However, there is little data on the outcomes of renal transplantation in these patients and little evidence to support such exclusion. METHODS: We reviewed the database of the Irish National Renal Transplant Programme and identified all patients with a history of BPAD or schizophrenia who had received a transplant over a 28-year period...
September 20, 2016: Psychosomatics
https://www.readbyqxmd.com/read/27873516/cyclosporine-sparing-effect-of-enteric-coated-mycophenolate-sodium-in-de-novo-kidney-transplantation
#6
Su Hyung Lee, Jae Berm Park, Chang Kwon Oh, Myoung Soo Kim, Sung Joo Kim, Jongwon Ha
PURPOSE: The increased tolerability of enteric-coated mycophenolate sodium (EC-MPS), compared to mycophenolate mofetil, among kidney transplant recipients has the potential to facilitate cyclosporine (CsA) minimization. Therefore, a prospective trial to determine the optimum EC-MPS dose in CsA-based immunosuppression regimens is necessary. MATERIALS AND METHODS: A comparative, parallel, randomized, open-label study was performed for 140 patients from four centers to compare the efficacy and tolerability of low dose CsA with standard dose EC-MPS (the investigational group) versus standard dose CsA with low dose EC-MPS (the control group) for six months in de novo kidney transplant recipients...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27872835/six-end-stage-renal-disease-patients-benefited-from-first-non-simultaneous-single-center-6-way-kidney-exchange-transplantation-in-india
#7
Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Varsha B Trivedi, Minaxi H Patel, Hargovind L Trivedi
AIM: To avoid desensitization protocols and ABO incompatible kidney transplantation (KT) due to high costs and increased risk of infections from intense immunosuppression. METHODS: We present institutional ethical review board - approved study of single center 6-way kidney exchange transplantation. The participants comprised ABO incompatibility (n = 1); positive cross-match and/or presence of donor specific antibody (n = 5). The average time required from registration in kidney paired donation (KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo...
November 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27871759/rabbit-atg-or-basiliximab-induction-for-rapid-steroid-withdrawal-after-renal-transplantation-harmony-an-open-label-multicentre-randomised-controlled-trial
#8
Oliver Thomusch, Michael Wiesener, Mirian Opgenoorth, Andreas Pascher, Rainer Peter Woitas, Oliver Witzke, Bernd Jaenigen, Markus Rentsch, Heiner Wolters, Thomas Rath, Tülay Cingöz, Urs Benck, Bernhard Banas, Christian Hugo
BACKGROUND: Standard practice for immunosuppressive therapy after renal transplantation is quadruple therapy using antibody induction, low-dose tacrolimus, mycophenolate mofetil, and corticosteroids. Long-term steroid intake significantly increases cardiovascular risk factors with negative effects on the outcome, especially post-transplantation diabetes associated with morbidity and mortality. In this trial, we examined the efficacy and safety parameters of rapid steroid withdrawal after induction therapy with either rabbit antithymocyte globulin (rabbit ATG) or basiliximab in immunologically low-risk patients during the first year after kidney transplantation...
November 18, 2016: Lancet
https://www.readbyqxmd.com/read/27870356/clinical-and-immunological-relevance-of-antibodies-in-solid-organ-transplantation
#9
REVIEW
N K Mehra, A K Baranwal
The two important issues affecting recipients of solid organ transplants and of importance to immunologists are (i) sensitization of the recipient to HLA antigens and the resultant humoral immune response leading to the development of anti-HLA antibodies; and ii) development of robust assays for early detection of humoral rejection post-transplant. Evidence from several studies clearly indicates that presence of circulating anti-HLA antibodies especially donor specific leads to early graft loss and high titres of DSA may even lead to hyperacute or accelerated acute rejection...
December 2016: International Journal of Immunogenetics
https://www.readbyqxmd.com/read/27866541/-influencing-factors-for-postoperative-survival-of-patients-with-stage-iii-silicosis-treated-by-lung-transplantation
#10
W J Mao, X W Nie, W Xia, M F Zheng, R Chen, Y J He, F Liu, S G Ye, R G Lu, J Y Chen
Objective: To investigate the clinical effect, postoperative complications, and causes of death in the treatment of stage III silicosis with lung transplantation and the influencing factors for survival. Methods: A retrospective analysis was performed for the clinical data of 32 patients with stage III silicosis who underwent lung transplantation in our hospital from September 2002 to September 2015. The survival, causes of death, and postoperative complications were analyzed. The Kaplan-Meier method was used to plot survival curves, the log-rank test was used to compare the influence of each factor on survival rates, and the multivariate Cox proportional hazards regression model was used to evaluate the influence of each factor on survival...
September 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/27862352/de-novo-donorspecific-anti-hla-antibodies-after-kidney-transplantation-are-associated-with-impaired-graft-outcome-independently-of-their-c1q-binding-ability
#11
Teresa Kauke, Cornelia Oberhauser, Viviane Lin, Michaela Coenen, Michael Fischereder, Andrea Dick, Ulf Schoenermarck, Markus Guba, Joachim Andrassy, Jens Werner, Bruno Meiser, Martin Angele, Manfred Stangl, Antje Habicht
BACKGROUND: Many aspects of post-transplant monitoring of donorspecific (DSA) and non-donorspecific (nDSA) anti-HLA antibodies on renal allograft survival are still unclear. Differentiating them by their ability to bind C1q may offer a better risk assessment. METHODS: We retrospectively investigated the clinical relevance of de novo C1q-binding anti-HLA antibodies on graft outcome in 611 renal transplant recipients. Acute rejection (AR), renal function and graft survival were assessed within a mean follow-up of 6...
November 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27862340/everolimus-with-early-withdrawal-or-reduced-dose-calcineurin-inhibitors-improves-renal-function-in-liver-transplant-recipients-a-systematic-review-and-meta-analysis
#12
Michael Lin, Sahil Mittal, Farhad Sahebjam, Abbas Rana, Gagan K Sood
Calcineurin inhibitors (CNI) are the mainstay of immunosuppression after liver transplantation (LT), but CNIs are associated with significant nephrotoxicity. Recently, mTOR inhibitors such as sirolimus and everolimus (EVR) have been used with or without CNIs in LT recipients for their renal-sparing effect. We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) that examined the effect of EVR with CNI minimization or withdrawal on renal function in LT recipients. RCT of primary adult LT recipients with baseline GFR >30 mL/min who received EVR with CNI minimization or withdrawal were included...
November 16, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27861809/immune-monitoring-in-renal-transplantation-the-search-for-biomarkers
#13
Richard Danger, Birgit Sawitzki, Sophie Brouard
It is now widely accepted that in order to improve long-term graft function and survival, a more personalized immunosuppressive treatment of transplant patients according to the individual anti-donor immune response status is needed. This applies to the identification of potentially "high-risk" patients likely to develop acute rejection episodes or display an accelerated decline of graft function, patients who might need immunosuppression intensification, and operationally tolerant patients suitable for immunosuppression minimization or weaning off...
November 10, 2016: European Journal of Immunology
https://www.readbyqxmd.com/read/27858871/case-report-brincidofovir-induced-reversible-severe-acute-kidney-injury-in-2-solid-organ-transplant-for-treatment-of-cytomegalovirus-infection
#14
Emmanuel Faure, Tatiana Galperine, Olivier Cannesson, Sophie Alain, Viviane Gnemmi, Celine Goeminne, Annie Dewilde, Johana Béné, Mohamed Lasri, Célia Lessore de Sainte Foy, Arnaud Lionet
RATIONALE: Resistant cytomegalovirus-mediated infections are increasing in solid organ recipient with few available alternative treatments. Brincidofovir is an oral broad-spectrum antiviral in development for prevention and treatment of viral infection, particularly cytomegalovirus. PATIENTS CONCERNS: Although brincidofovir is an analogue of cidofovir, previous studies reported no renal toxicity. DIAGNOSES: Here, we report 2 cases of severe tubular necrosis in solid organ recipients, 1 heart and 1 kidney transplant...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27851743/effect-of-the-obesity-epidemic-on-kidney-transplantation-obesity-is-independent-of-diabetes-as-a-risk-factor-for-adverse-renal-transplant-outcomes
#15
Jennifer M Kwan, Zahraa Hajjiri, Ahmed Metwally, Patricia W Finn, David L Perkins
BACKGROUND: Obesity is a growing epidemic in most developed countries including the United States resulting in an increased number of obese patients with end-stage renal disease. A previous study has shown that obese patients with end-stage renal disease have a survival benefit with transplantation compared with dialysis. However, due to serious comorbidities, many centers place restrictions on the selection of obese patients for transplantation. Further, due to obese patients having an increased risk of diabetes, it is unclear whether obesity can be an independent risk, independent of diabetes for increasing adverse renal transplant outcomes...
2016: PloS One
https://www.readbyqxmd.com/read/27833442/stat4-gene-polymorphism-in-patients-after-renal-allograft-transplantation
#16
Ewa Dąbrowska-Żamojcin, Violetta Dziedziejko, Krzysztof Safranow, Leszek Domański, Sylwia Słuczanowska-Głabowska, Andrzej Pawlik
INTRODUCTION: STAT4 (signal transducer and activator of transcription 4) is involved in the regulation of innate and adaptive immune responses. Some studies have suggested that STAT4 may be involved in the immune response after graft transplantation. Several polymorphisms in the STAT4 gene have been identified. The most commonly studied polymorphism in the STAT4 gene is rs7574865. In our study, we examined whether this polymorphism is associated with the early and late functions of renal allografts...
2016: Central-European Journal of Immunology
https://www.readbyqxmd.com/read/27819323/donor-and-recipient-genetic-variants-in-nlrp3-associate-with-early-acute-rejection-following-kidney-transplantation
#17
Mark C Dessing, Jesper Kers, Jeffrey Damman, Gerjan J Navis, Sandrine Florquin, Jaklien C Leemans
NLRP3 (NOD-like receptor family, pyrin domain containing 3) is a member of the inflammasome family and is of special interest in renal disease. Experimental studies have shown that Nlrp3 plays a significant role in the induction of renal damage and dysfunction in acute and chronic renal injury. However, the role of NLRP3 in human renal disease is completely unknown. From a retrospective cohort study, we determined in 1271 matching donor and recipient samples if several NLRP3 single nucelotide polymorphisms (SNPs) were associated with primary non-function (PNF), delayed graft function (DGF), biopsy-proven acute rejection (BPAR) and death-censored graft and patient survival...
November 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27805521/smoking-is-related-to-postoperative-pulmonary-complications-and-graft-outcomes-in-renal-transplant-patients
#18
Balam Er Dedekargınoğlu, Gaye Ulubay, Elif Küpeli, Mahir Kırnap, Füsun Öner Eyüboğlu, Mehmet Haberal
OBJECTIVES: Renal transplant is an important treatment option for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk compared with maintenance dialysis in patients with end-stage renal disease. Several immunologic and nonimmunologic factors are responsible for graft outcomes in renal transplant patients. Our study was performed to evaluate the role of smoking on postoperative pulmonary complications and graft outcomes in renal transplant patients...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27795623/rituximab-in-the-treatment-of-refractory-late-acute-antibody-mediated-rejection-our-initial-experience
#19
M Surendra, S B Raju, N Raju, S Chandragiri, K K Mukku, M S Uppin
Antibody-mediated rejection (AMR) is not uncommon after renal transplantation and is harder to handle compared to cell-mediated rejection. When refractory to conventional therapies, rituximab is an attractive option. This study aims to examine the effectiveness of rituximab in refractory late acute AMR. This is a retrospective study involving nine renal transplant recipients. Four doses of rituximab were administered at weekly interval for 4 weeks, at a dose of 375 mg/m(2). The mean age of patients was 35.3 ± 7...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27788796/surveillance-registry-of-sirolimus-use-in-recipients-of-kidney-allografts-from-expanded-criteria-donors
#20
G Laham, R Scuteri, P Cornicelli, M Arriola, P M Raffaele, M Davalos Michel, N Imperiali, R M Fortunato, E C Maggiora, M V Sal, G Soler Pujol
BACKGROUND: The use of expanded criteria donor (ECD) kidneys has increased the overall availability of renal transplants. This study assessed the use of sirolimus in patients receiving Argentina-ECD kidneys. METHODS: This observational, open-label, 1-arm, prospective, longitudinal pilot study was conducted at 8 transplant centers in Argentina. Adults receiving kidney transplants (without pancreas) from ECDs were eligible if they were converted to sirolimus 1 to 36 months' posttransplantation, with sirolimus becoming base therapy within 1 month after conversion...
October 2016: Transplantation Proceedings
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