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Chronic renal graft rejection

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https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#1
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29198660/utility-of-oxford-classification-in-post-transplant-immunoglobulin-a-nephropathy
#2
V Agrawal, A Singh, A Kaul, R Verma, M Jain, R Pandey
BACKGROUND: With increasing graft survival, post-transplant immunoglobulin A nephropathy (IgAN) has emerged as an important cause of chronic graft dysfunction in renal allograft recipients. We studied the clinico-pathological features of post-transplant IgAN regardless of the primary disease. The aim was to study the usefulness of the Oxford classification in predicting survival. METHODS: Indication graft biopsy specimens (n = 915) were received during a 10-year period; 27 biopsy specimens from 22 patients were diagnosed as IgAN...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29187340/enzyme-linked-immunosorbent-spot-elispot-monitoring-of-cytokine-producing-cells-for-the-prediction-of-acute-rejection-in-renal-transplant-patients
#3
Fatemeh Mohammadi, Ghasem Solgi, Maryam Tajik, Pedram Ahmadpoor, Hasan Nikoeinejad, Behzad Einollahi, Banafsheh Nazari, Mahboob Lessan-Pezeshki, Aliakbar Amirzargar
The purpose of this study was to evaluate T-cell immunity markers using serial post-transplantation monitoring of cytokine-producing cells during the first post-transplant months for the prediction of acute rejection and potentially chronic rejection of kidney allograft. We followed 57 kidney allograft recipients for meanly 3 years post-transplantation. Blood samples were collected pre-transplant, 2, 4 and 12 weeks post-transplant. The frequencies of IL-10-, IL-17- and IFN-γ-producing cells were determined in all time-points using ELISPOT assay...
September 1, 2017: European Cytokine Network
https://www.readbyqxmd.com/read/29181237/prediction-of-kidney-graft-rejection-using-artificial-neural-network
#4
Leili Tapak, Omid Hamidi, Payam Amini, Jalal Poorolajal
Objectives: Kidney transplantation is the best renal replacement therapy for patients with end-stage renal disease. Several studies have attempted to identify predisposing factors of graft rejection; however, the results have been inconsistent. We aimed to identify prognostic factors associated with kidney transplant rejection using the artificial neural network (ANN) approach and to compare the results with those obtained by logistic regression (LR). Methods: The study used information regarding 378 patients who had undergone kidney transplantation from a retrospective study conducted in Hamadan, Western Iran, from 1994 to 2011...
October 2017: Healthcare Informatics Research
https://www.readbyqxmd.com/read/29164120/expression-of-mitochondrial-encoded-genes-in-blood-differentiate-acute-renal-allograft-rejection
#5
Silke Roedder, Tara Sigdel, Szu-Chuan Hsieh, Jennifer Cheeseman, Diana Metes, Camila Macedo, Elaine F Reed, H A Gritsch, Adriana Zeevi, Ron Shapiro, Allan D Kirk, Minnie M Sarwal
Despite potent immunosuppression, clinical and biopsy confirmed acute renal allograft rejection (AR) still occurs in 10-15% of recipients, ~30% of patients demonstrate subclinical rejection on biopsy, and ~50% of them can show molecular inflammation, all which increase the risk of chronic dysfunction and worsened allograft outcomes. Mitochondria represent intracellular endogenous triggers of inflammation, which can regulate immune cell differentiation, and expansion and cause antigen-independent graft injury, potentially enhancing the development of acute rejection...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29149982/marrow-mesenchymal-stem-cells-effectively-reduce-histologic-changes-in-a-rat-model-of-chronic-renal-allograft-rejection
#6
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/29135832/prognostic-value-of-the-persistence-of-c1q-binding-anti-hla-antibodies-in-acute-antibody-mediated-rejection-in-kidney-transplantation
#7
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/29110796/long-term-outcomes-and-management-of-the-heart-transplant-recipient
#8
REVIEW
Sharon L McCartney, Chetan Patel, J Mauricio Del Rio
Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart transplantation is currently 10.7 years. While early graft failure and multiorgan system dysfunction are the most important causes of early mortality, malignancy, rejection, infection, and cardiac allograft vasculopathy contribute to late mortality. Chronic renal dysfunction is common after heart transplantation and occurs in up to 68% of patients by year 10, with 6...
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
#9
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/29108511/effects-of-benign-prostate-hyperplasia-on-allografts-in-kidney-transplant
#10
Ali Murat Gokce, Mehmet Remzi Erdem, Ruhi Caglar, Cevdet Kaya, Leyla Ozel, Mesut Izzet Titiz
OBJECTIVES: Benign prostate hyperplasia is frequently diagnosed in elderly chronic renal failure patients. Although it is asymptomatic because urine flow declines in those with chronic renal failure, it may become symptomatic when urine flow increases after renal transplant. Untreated benign prostate hyperplasia may lead to several complications that adversely affect the kidney allograft. MATERIALS AND METHODS: Our retrospective study investigated data from 286 male transplant patients...
October 31, 2017: Experimental and Clinical Transplantation
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
#11
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/29026877/prolonged-delayed-renal-graft-function-secondary-to-venous-hypertension
#12
Suraj Mishra, Gaurav Gupta, I Moinuddin, Brian Strife, Uma Prasad, D Massey, Anne King, Dhiren Kumar, Chandra S Bhati
The case of a 39-year-old highly sensitized woman who underwent second renal transplantation after being on warfarin because of a history of frequent thromboses of her left femoral arteriovenous graft (AVG) is reported here. The patient received a flow cytometric positive crossmatch kidney transplant from a deceased donor. Her posttransplant course was complicated by prolonged delayed graft function (DGF) lasting for 9 months. Antibody-mediated rejection occurred in the immediate postoperative period. This resolved after treatment, and resolution was confirmed by repeat biopsy...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29022104/deriving-and-understanding-the-risk-of-post-transplant-recurrence-of-nephrotic-syndrome-in-the-light-of-current-molecular-and-genetic-advances
#13
REVIEW
Agnieszka Bierzynska, Moin A Saleem
After renal transplantation, recurrence of the original disease is the second most common cause of graft loss, after rejection. The most dramatic manifestation of this phenomenon is in patients with nephrotic syndrome (NS). NS is a descriptive term describing a clinical picture centred on proteinuria arising from damage to the glomerular filtration barrier (GFB). There are many different drivers of that damage, ranging from immune dysregulation to genetic disorders and chronic disease/infections. The main categories in childhood are "idiopathic" (presumed immune mediated) and genetic NS, with further stratification of the idiopathic group according to steroid responses...
October 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28988984/prevention-of-chronic-renal-allograft-rejection-by-as2553627-a-novel-jak-inhibitor-in-a-rat-transplantation-model
#14
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/28969763/peri-and-postsurgical-evaluations-of-renal-transplant
#15
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
https://www.readbyqxmd.com/read/28953652/successful-kidney-transplantation-across-a-positive-complement-dependent-cytotoxicity-crossmatch-by-using-c1q-assay-directed-bortezomib-assisted-desensitization-a-case-report
#16
Juhan Lee, Borae G Park, Hyang Sook Jeong, Youn Hee Park, Sinyoung Kim, Beom Seok Kim, Hye Jin Kim, Kyu Ha Huh, Hyeon Joo Jeong, Yu Seun Kim
RATIONALE: Human leukocyte antigen (HLA) is the major immunologic barrier in kidney transplantation (KT). Various desensitization protocols to overcome the HLA barrier have increased the opportunity for transplantation in sensitized patients. In addition, technological advances in solid-phase assays have permitted more comprehensive assessment of donor-specific antibodies. Although various desensitization therapies and immunologic techniques have been developed, the final transplantation decision is still based on the classic complement-dependent cytotoxicity (CDC) crossmatch (XM) technique...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28933341/c4d-expressing-glomerulopathy-and-proteinuria-post-transplantation-of-a-%C3%A2-too-big-for-size-mismatched-kidney-allograft-an-unusual-case-with-good-outcome%C3%A2
#17
Francois Gougeon, Alexei V Mikhailov, Keisha Gibson, Tomasz Kozlowski, Harsharan K Singh, Volker Nickeleit
A 5-year-old severely growth-retarded child with tubulointerstitial, oliguric end-stage renal disease received an adult-size kidney transplant. Three years post grafting under standard triple immunosuppression (mycophenolate mofetil, tacrolimus, and prednisone) de novo nephrotic range proteinuria without the nephrotic syndrome developed. Graft function was normal (serum creatinine: 0.2 - 0.3 mg/dL), there were no donor-specific HLA antibodies (DSA), and the urine sediment was inactive. Two biopsies collected 3 and 4 years post-transplantation showed severe glomerular capillary wall remodeling and associated pseudolinear C4d staining as morphologic correlates for the proteinuria...
September 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28924461/do-the-benefits-of-transplant-tourism-amongst-nigerian-patients-outweigh-the-risks-a-single-center-experience
#18
C O Amira, B T Bello
BACKGROUND: Transplant tourism (TT) is the term used to describe travel outside one's country of abode for the sole purpose of obtaining organ transplantation services. OBJECTIVE: This study describes the characteristics and outcomes of kidney transplant tourists who were followed up in our institution. METHODS: A retrospective study was conducted on patients who underwent kidney transplantation outside the country and were followed up in our institution from 2007 to 2015...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28913939/elderly-living-donor-kidney-transplantation-allows-worthwhile-outcomes-the-japan-academic-consortium-of-kidney-transplantation-study
#19
Masayoshi Okumi, Kohei Unagami, Yoichi Kakuta, Atsuhiko Ochi, Toshio Takagi, Hideki Ishida, Kazunari Tanabe
OBJECTIVE: To compare transplant outcomes among elderly (aged ≥60 years) and non-elderly recipients, and to evaluate the acceptability of elderly living donor kidney transplantation in practice after consideration of living donor type. METHODS: We included 830 adult patients with living donor kidney transplantation between 2000 and 2011 in this retrospective cohort study. We compared death-censored graft survival, patient survival, biopsy-proven rejection, complications, and renal function in elderly (n = 119) and non-elderly recipients (n = 278)...
September 14, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28904428/collapsing-glomerulopathy-a-troublemaker-for-the-renal-allograft-lessons-learnt
#20
K V Kanodia, A V Vanikar, L K Nigam, R D Patel, K S Suthar, H V Patel, H L Trivedi
Collapsing glomerulopathy (CG) is a well-recognized distinct morphological pattern of proliferative parenchymal injury leading to rapid graft failure. We conducted a single-center retrospective study to evaluate the prevalence, clinicopathological features, and prognosis of CG in renal transplant recepient. We analyzed 2518 renal allograft biopsies performed from 2007 to 2015 and correlated their clinicopathological features. The prevalence of CG was 0.83% (21 out of 2518) of allograft biopsies with a higher prevalence of 1...
September 2017: Indian Journal of Nephrology
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