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Chronic renal graft rejection

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https://www.readbyqxmd.com/read/27873464/hyalinosis-lesions-in-renal-transplant-biopsies-time-dependent-complexity-of-interpretation
#1
Gunilla Einecke, Jeff Reeve, Philip F Halloran
Because calcineurin inhibitor immunosuppressive drugs (CNIs) induce arteriolar hyalinosis (ah) in kidney transplants, ah lesions can potentially provide information about drug exposure. We studied the relationship of ah lesions to findings and outcomes in 562 indication biopsies taken 3 days to 35 years post-transplant. Prevalence of ah lesions increased with time post-transplant (TxBx). Ah-scores correlated with arterial intimal thickening and atrophy-fibrosis but, unlike atrophy-fibrosis, did not increase until after 500 days because of a background of ah1 lesions in early biopsies reflecting donor aging...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27848058/current-pathological-perspectives-on-chronic-rejection-in-renal-allografts
#2
REVIEW
Shigeo Hara
Chronic rejection in renal transplantation clinically manifests as slow deterioration in allograft function and is a major contributor of late renal graft loss. Most cases of chronic rejection involve chronic antibody-mediated rejection (ABMR) triggered by the interaction of donor-specific alloantibodies with endothelial cells of the microcirculation. The evolution of the Banff classification involved a major revision of the ABMR criteria during the 2000s and led to the inclusion of detailed pathological characteristics of chronic ABMR in the 2013 Banff scheme, including microcirculation damage observed as newly formed basement membranes and arterial fibrous intimal proliferation...
November 16, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27833442/stat4-gene-polymorphism-in-patients-after-renal-allograft-transplantation
#3
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
#4
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/27788796/surveillance-registry-of-sirolimus-use-in-recipients-of-kidney-allografts-from-expanded-criteria-donors
#5
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
https://www.readbyqxmd.com/read/27779800/the-expanded-criteria-donor-for-kidney-transplant-not-a-nearly-new-car
#6
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27777772/urothelial-carcinoma-of-donor-origin-in-a-kidney-transplant-patient
#7
Rosa M Michel Ortega, Daynna J Wolff, Cynthia A Schandl, Harry A Drabkin
BACKGROUND: Malignancy after transplantation is an uncommon multifactorial occurrence. Immunosuppression to prevent graft rejection is described as a major risk factor in malignancy development in the post-transplant state. Donor-derived malignancy is a rare reported complication. Herein, we review our patient history and discuss diagnostic strategies and the implications of immunosuppression for donor-derived malignancy. CASE PRESENTATION: This is a 69-year-old man with post-renal-transplant urothelial carcinoma determined to be of donor origin...
2016: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/27776444/impact-of-acute-kidney-injury-on-renal-allograft-survival
#8
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
https://www.readbyqxmd.com/read/27751774/polymorphism-in-programmed-cell-death-1-gene-is-strongly-associated-with-lung-and-kidney-allograft-survival-in-recipients-from-cmv-positive-donors
#9
Catherine Forconi, Philippe Gatault, Elodie Miquelestorena-Standley, Johan Noble, Sally Al-Hajj, Romain Guillemain, Marc Stern, Thomas Hoffmann, Louis Prat, Caroline Suberbielle, Emeline Masson, Anne Cesbron-Gautier, Catherine Gaudy-Graffin, Alain Goudeau, Gilles Thibault, Fabrice Ivanes, Roseline Guibon, Ihab Kazma, Yvon Lebranchu, Matthias Büchler, Antoine Magnan, Jean-Michel Halimi, Christophe Baron
BACKGROUND: Cytomegalovirus (CMV) has a role in chronic rejection and graft loss in kidney transplant (KTx) and lung transplant (LTx) recipients. In addition, donor CMV seropositivity is an independent risk factor for renal graft loss. The anti-CMV response might modulate this risk. Expression of programmed cell death 1 (PD-1), a receptor involved in viral-specific T-cell exhaustion, is influenced by a single nucleotide polymorphism called PD-1.3 (wild-type allele G, variant allele A)...
August 26, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27649571/the-spectrum-of-renal-allograft-failure
#10
Sourabh Chand, David Atkinson, Clare Collins, David Briggs, Simon Ball, Adnan Sharif, Kassiani Skordilis, Bindu Vydianath, Desley Neil, Richard Borrows
BACKGROUND: Causes of "true" late kidney allograft failure remain unclear as study selection bias and limited follow-up risk incomplete representation of the spectrum. METHODS: We evaluated all unselected graft failures from 2008-2014 (n = 171; 0-36 years post-transplantation) by contemporary classification of indication biopsies "proximate" to failure, DSA assessment, clinical and biochemical data. RESULTS: The spectrum of graft failure changed markedly depending on the timing of allograft failure...
2016: PloS One
https://www.readbyqxmd.com/read/27631127/heat-shock-protein-90%C3%AE-is-a-potential-serological-biomarker-of-acute-rejection-after-renal-transplantation
#11
Takeshi Maehana, Toshiaki Tanaka, Hiroshi Kitamura, Nobuyuki Fukuzawa, Hideki Ishida, Hiroshi Harada, Kazunari Tanabe, Naoya Masumori
BACKGROUND: Heat shock protein 90 (HSP90), a molecular chaperone associated with the activation of client proteins, was recently reported to play an important role in immunologic reactions. To date, the role of HSP90 in solid organ transplantations has remained unknown. The aim of this study was to evaluate the relationship between serum HSP90α levels and acute allograft rejection after organ and tissue transplantation using serum samples from kidney allograft recipients, an in vitro antibody-mediated rejection model, and a murine skin transplantation...
2016: PloS One
https://www.readbyqxmd.com/read/27595515/renal-graft-survival-according-to-banff%C3%A2-2013-classification-in-indication-biopsies
#12
Carlos Arias-Cabrales, Dolores Redondo-Pachón, María José Pérez-Sáez, Javier Gimeno, Ignacio Sánchez-Güerri, Sheila Bermejo, Adriana Sierra, Carla Burballa, Marisa Mir, Marta Crespo, Julio Pascual
INTRODUCTION: The impact of acute rejection in kidney graft survival is well known, but the prognosis of other diagnoses is uncertain. We evaluated the frequency and impact on graft survival of different diagnostic categories according to the Banff 2013 classification in a cohort of renal transplant recipients. MATERIAL AND METHODS: Retrospective study of 495 renal biopsies by indication in 322 patients from 1990-2014. Two independent observers reviewed the histological reports, reclassifying according to the Banff 2013 classification...
November 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27569937/comparative-analysis-of-outcomes-of-kidney-transplantation-in-patients-with-aa-amyloidosis-and-chronic-glomerulonephritis
#13
T Sahutoglu, K Atay, Y Caliskan, E Kara, H Yazici, A Turkmen
BACKGROUND: Amyloid A (AA) amyloidosis is a multisystemic, progressive, and severe disease. Renal involvement is a prominent feature of the disease, and the outcome of patients on dialysis is poor. We aimed to analyze the outcomes of kidney transplantation in patients with AA amyloidosis in comparison with chronic glomerulonephritis (CGN). METHODS: Charts of patients who underwent kidney transplantation between 1988 and 2012 were reviewed; 41 patients with AA amyloidosis were identified, and 41 age- and sex-matched control patients with chronic CGN were included...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27569936/pilot-randomized-trial-of-tacrolimus-everolimus-vs-tacrolimus-enteric-coated-mycophenolate-sodium-in-adult-primary-kidney-transplant-recipients-at-a-single-center
#14
G Ciancio, P Tryphonopoulos, J J Gaynor, G Guerra, J Sageshima, D Roth, L Chen, W Kupin, A Mattiazzi, L Tueros, S Flores, L Hanson, R H Powell, P Ruiz, R Vianna, G W Burke
BACKGROUND: Recent studies suggest that the combination of tacrolimus (TAC) and everolimus (EVL) could become a viable option for use as standard maintenance immunosuppression in non-highly sensitized kidney transplant recipients. METHODS: We conducted a single-center, open-label, randomized pilot trial comparing two maintenance immunosuppression regimens in non-highly sensitized, adult, primary kidney transplant recipients: (TAC/EVL, Group A) vs our standard maintenance regimen of TAC plus enteric-coated mycophenolate mofetil (TAC/EC-MPS, Group B)...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27563301/antibody-dependent-nk-cell-activation-is-associated-with-late-kidney-allograft-dysfunction-and-the-complement-independent-alloreactive-potential-of-donor-specific-antibodies
#15
Tristan Legris, Christophe Picard, Dilyana Todorova, Luc Lyonnet, Cathy Laporte, Chloé Dumoulin, Corinne Nicolino-Brunet, Laurent Daniel, Anderson Loundou, Sophie Morange, Stanislas Bataille, Henri Vacher-Coponat, Valérie Moal, Yvon Berland, Francoise Dignat-George, Stéphane Burtey, Pascale Paul
Although kidney transplantation remains the best treatment for end-stage renal failure, it is limited by chronic humoral aggression of the graft vasculature by donor-specific antibodies (DSAs). The complement-independent mechanisms that lead to the antibody-mediated rejection (ABMR) of kidney allografts remain poorly understood. Increasing lines of evidence have revealed the relevance of natural killer (NK) cells as innate immune effectors of antibody-dependent cellular cytotoxicity (ADCC), but few studies have investigated their alloreactive potential in the context of solid organ transplantation...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27503081/renal-transplantation-in-human-immunodeficiency-virus-infected-recipients-a-case-control-study-from-the-brazilian-experience
#16
A R Vicari, F Spuldaro, T V Sandes-Freitas, M P Cristelli, L R Requião-Moura, J O Reusing, L C Pierrotti, M L Oliveira, C M Girão, G Gadonski, L V Kroth, L M Deboni, G F Ferreira, H Tedesco-Silva, R Esmeraldo, E David-Neto, D Saitovitch, E Keitel, V D Garcia, A Pacheco-Silva, J O Medina-Pestana, R C Manfro
BACKGROUND: Highly active antiretroviral therapy has turned human immunodeficiency virus (HIV)-infected patients with end-stage renal disease into suitable candidates for renal transplantation. We present the Brazilian experience with kidney transplantation in HIV-infected recipients observed in a multicenter study. METHODS: HIV-infected kidney transplant recipients and matched controls were evaluated for the incidence of delayed graft function (DGF), acute rejection (AR), infections, graft function, and survival of patients and renal grafts...
October 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27498586/kidney-transplantation-after-liver-transplantation
#17
Li-Yang Wu, Hang Liu, Wei Liu, Han Li, Xiao-Dong Zhang
Kidney transplantation after liver transplantation (KALT) offers longer survival and a better quality of life to liver transplantation recipients who develop chronic renal failure. This article aimed to discuss the efficacy and safety of KALT compared with other treatments. The medical records of 5 patients who had undergone KALT were retrospectively studied, together with a literature review of studies. Three of them developed chronic renal failure after liver transplantation because of calcineurin inhibitor (CNI)-induced nephrotoxicity, while the others had lupus nephritis or non-CNI drug-induced nephrotoxicity...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27496432/impact-of-obesity-on-renal-graft-function-analysis-of-kidney-grafts-from-the-same-donor
#18
Z Wołyniec, A Dębska-Ślizień, W Wołyniec, B Rutkowski
BACKGROUND: The epidemic of obesity has led to dilemmas facing all nephrologists who care for patients with chronic kidney disease and who must make decisions regarding whether or not the patient can undergo transplantation. The aim of the study was to assess the outcome of transplantation among obese compared to nonobese recipients. To minimize donor variability and bias, paired kidney analysis was applied. MATERIALS AND METHODS: Patients with a body mass index >30 who received transplants in our unit between January 2000 and December 2010 were selected...
June 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27454318/local-gene-therapy-with-indoleamine-2-3-dioxygenase-protects-against-development-of-transplant-vasculopathy-in-chronic-kidney-transplant-dysfunction
#19
D Vavrincova-Yaghi, L E Deelman, H van Goor, M A Seelen, P Vavrinec, I P Kema, P Gomolcak, A Benigni, R H Henning, M Sandovici
Chronic transplant dysfunction (CTD) is the primary cause of late allograft loss in kidney transplantation. Indoleamine 2,3-dioxygenase (IDO) is involved in fetomaternal tolerance and gene therapy with IDO inhibits acute rejection following kidney transplantation. The aim of this study is to investigate whether gene therapy with IDO is able to attenuate CTD. Transplantation was performed in a rat Dark-Agouti to Wistar-Furth CTD model. Donor kidneys were incubated either with an adenovirus carrying IDO gene, a control adenovirus or saline...
July 25, 2016: Gene Therapy
https://www.readbyqxmd.com/read/27447127/clinical-outcome-of-norovirus-infection-in-renal-transplant-patients
#20
Susanne Brakemeier, Styliani I Taxeidi, Michael Dürr, Jörg Hofmann, Danilo Schmidt, Friederike Bachmann, Jens Gaedeke, Klemens Budde
Transplant patients are at increased risk for developing severe norovirus (NoV) infections with secondary complications such as rejection episodes and acute transplant failure. This single-center retrospective study included all kidney transplant patients tested positive for NoV RNA between January 2007 and December 2011. Data were compared to a control group of 528 kidney transplant patients without NoV infection. Sixty-five kidney transplant patients were recorded NoV RNA positive. Of these, 26 patients (40%) presented with acute transplant failure (AKI)...
October 2016: Clinical Transplantation
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