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https://www.readbyqxmd.com/read/28332959/de-novo-donor-specific-antibody-formation-in-tacrolimus-based-mycophenolate-versus-mammalian-target-of-rapamycin-immunosuppressive-regimens
#1
Zain Mithani, Jane Gralla, Oluwafisayo Adebiyi, Patrick Klem, James E Cooper, Alexander C Wiseman
OBJECTIVES: De novo donor-specific antibody formation posttransplant is associated with decreased graft survival. It is not known whether mammalian target of rapamycin inhibitors may be advantageous or detrimental compared with mycophenolate in the prevention of de novo donor-specific antibody formation. MATERIALS AND METHODS: We compared 66 kidney and kidney-pancreas transplant recipients who received tacrolimus, mammalian target of rapamycin inhibitor, and prednisone (group 1; 36 of whom received everolimus and 30 of whom received sirolimus) versus 132 patients who received tacrolimus, mycophenolate, and prednisone (group 2) matched for age, sex, race, and type/timing of transplant from 2007 to 2012...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28332287/pretransplant-numbers-of-cd16-monocytes-as-a-novel-biomarker-to-predict-acute-rejection-after-kidney-transplantation-a-pilot-study
#2
Thierry P P van den Bosch, Luuk B Hilbrands, Rens Kraaijeveld, Nicolle H R Litjens, Farhad Rezaee, Daan Nieboer, Ewout W Steyerberg, Judith A van Gestel, Dave L Roelen, Marian C Clahsen-van Groningen, Carla C Baan, Ajda T Rowshani
Acute rejection is one of the major immunological determinants of kidney graft function and survival. Early biomarkers to predict rejection are lacking. Emerging evidence reveals a crucial role for the monocyte-macrophage lineage cells in the pathogenesis of rejection. We hypothesized that higher pre-transplant numbers of proinflammatory CD16+ monocytes can predict rejection. The study cohort consisted of 104 kidney transplant recipients (58 no-rejections and 46 biopsy-proven rejections), and 33 healthy individuals...
March 23, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28331443/pacemaker-use-following-heart-transplantation
#3
Hari R Mallidi, Michael Bates
BACKGROUND: The incidence of permanent pacemaker implantation after orthotopic heart transplantation has been reported to be 2%-24%. Transplanted hearts usually exhibit sinus rhythm in the operating room following reperfusion, and most patients do not exhibit significant arrhythmias during the postoperative period. However, among the patients who do exhibit abnormalities, pacemakers may be implanted for early sinus node dysfunction but are rarely used after 6 months. Permanent pacing is often required for atrioventricular block...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331179/hyperosmolarity-impedes-the-cross-priming-competence-of-dendritic-cells-in-a-trif-dependent-manner
#4
Zoran V Popovic, Maria Embgenbroich, Federica Chessa, Viola Nordström, Mahnaz Bonrouhi, Thomas Hielscher, Norbert Gretz, Shijun Wang, Daniel Mathow, Thomas Quast, Jan-Gero Schloetel, Waldemar Kolanus, Sven Burgdorf, Hermann-Josef Gröne
Tissue osmolarity varies among different organs and can be considerably increased under pathologic conditions. Hyperosmolarity has been associated with altered stimulatory properties of immune cells, especially macrophages and dendritic cells. We have recently reported that dendritic cells upon exposure to hypertonic stimuli shift their profile towards a macrophage-M2-like phenotype, resulting in attenuated local alloreactivity during acute kidney graft rejection. Here, we examined how hyperosmotic microenvironment affects the cross-priming capacity of dendritic cells...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28330670/layered-fibrotic-plaques-are-the-predominant-component-in-cardiac-allograft-vasculopathy-systematic-findings-and-risk-stratification-by-oct
#5
Tor Skibsted Clemmensen, Niels Ramsing Holm, Hans Eiskjær, Brian Bridal Løgstrup, Evald Høj Christiansen, Jouke Dijkstra, Trine Ørhøj Barkholt, Christian Juhl Terkelsen, Michael Maeng, Steen Hvitfeldt Poulsen
OBJECTIVES: The aims of this study were to characterize cardiac allograft vasculopathy (CAV) phenotypes using optical coherence tomography (OCT) and to evaluate the prognostic significance of OCT-determined CAV severity. BACKGROUND: Intravascular OCT enables in vivo characterization of CAV microstructure after heart transplantation. METHODS: Sixty-two patients undergoing heart transplantation were enrolled at routine angiography from September 2013 through October 2015 and prospectively followed until censoring on May 27, 2016...
March 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28328727/strategies-for-deep-anterior-lamellar-keratoplasty-after-hydrops-in-keratoconus
#6
Matthias Fuest, Jodhbir S Mehta
Corneal hydrops affects approximately 2.5% of keratoconus (KC) cases, predominantly young males approximately 25 years of age with steep cones. Often, patients are left with a vision-reducing corneal scar frequently necessitating surgical treatment. Penetrating keratoplasty (PK) has worse survival outcomes in hydrops than in general KC cases. Deep anterior lamellar keratoplasty (DALK) is a nonpenetrating technique believed to achieve equal or better outcomes in visual acuity, graft survival, endothelial rejection rates, and endothelial cell survival in comparison with PK, while maintaining globe integrity and the patients' Descemet membrane (DM) and endothelium...
March 21, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28321326/first-canadian-case-report-of-kidney-transplantation-from-an-hiv-positive-donor-to-an-hiv-positive-recipient
#7
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/28321218/the-induction-and-maintenance-of-transplant-tolerance-engages-both-regulatory-and-anergic-cd4-t-cells
#8
Alix Besançon, Marije Baas, Tania Goncalves, Fabrice Valette, Herman Waldmann, Lucienne Chatenoud, Sylvaine You
Therapeutic tolerance to self-antigens or foreign antigens is thought to depend on constant vigilance by Foxp3(+) regulatory T cells (Tregs). Previous work using a pancreatic islet allograft model and a short pulse of CD3 antibody therapy has shown that CD8(+) T cells become anergic and use TGFβ and coinhibitory signaling as their contribution to the tolerance process. Here, we examine the role of CD4(+) T cells in tolerization by CD3 antibodies. We show that both Foxp3(+) Tregs and CD4(+) T cell anergy play a role in the induction of tolerance and its maintenance...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28320631/outcomes-of-adolescent-recipients-after-lung-transplantation-an-analysis-of-the-international-society-for-heart-and-lung-transplantation-registry
#9
Miranda A Paraskeva, Leah B Edwards, Bronwyn Levvey, Josef Stehlik, Samuel Goldfarb, Roger D Yusen, Glen P Westall, Greg I Snell
BACKGROUND: Recipient adolescent age for non-lung solid-organ transplantation is associated with higher rates of rejection, graft loss and mortality. Although there have been no studies specifically examining adolescent outcomes after lung transplantation (LTx), limited data from the International Society of Heart and Lung Transplantation (ISHLT) Registry suggest that a similar association may exist. Recently, adolescence has been defined as 10 to 24 years of age, taking into account the biologic and sociologic transitions that occur during this age interval...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28320360/a-prospective-analysis-of-pinch-grafting-of-chronic-leg-ulcers-in-a-series-of-elderly-patients-in-rural-cameroon
#10
Benjamin Momo Kadia, Christian Akem Dimala, Desmond Aroke, Cyril Jabea Ekabe, Reine Suzanne Mengue Kadia, Alain Chichom Mefire
BACKGROUND: Chronic leg ulcers (CLUs) pose serious public health concerns worldwide. They mainly affect the elderly population. Pinch grafting (PG) could be used to treat a variety of CLUs. However, in Cameroon, there is scarce data on the outcome of PG of CLUs in elderly patients in rural hospitals where most of these patients seek for medical attention and where clinicians rely on unconventional wound dressing methods to treat CLUs. Our objective was to describe the outcome of PG of CLUs in elderly patients in rural Cameroon...
March 20, 2017: BMC Dermatology
https://www.readbyqxmd.com/read/28318723/pan-european-survey-of-the-topical-ocular-use-of-cyclosporine-a
#11
A Labbé, C Baudouin, D Ismail, M Amrane, J-S Garrigue, A Leonardi, F C Figueiredo, G Van Setten, M Labetoulle
OBJECTIVE: To assess medical practices surrounding the use of topical ocular cyclosporine A across European Union nations. METHODS: Key stakeholders (ophthalmologists, hospital pharmacists, regulatory health authorities) from European Union member states were interviewed by telephone using a semi-structured, open-ended questionnaire. Ophthalmologists responded to questions about practice patterns of cyclosporine A use (prescription frequency, indication, dosage), pharmacists about cyclosporine A formulations (composition, manufacturing process, quality control, distribution), and the regulatory authorities about market authorization and pharmacovigilance for various cyclosporine A products...
March 16, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28318622/computer-assisted-topological-analysis-of-renal-allograft-inflammation-adds-to-risk-evaluation-at-diagnosis-of-humoral-rejection
#12
Antoine Sicard, Vannary Meas-Yedid, Maud Rabeyrin, Alice Koenig, Stephanie Ducreux, Frederique Dijoud, Valerie Hervieu, Lionel Badet, Emmanuel Morelon, Jean Christophe Olivo-Marin, Valerie Dubois, Olivier Thaunat
Antibody-mediated rejection is associated with heterogeneous kidney allograft outcomes. Accurate evaluation of risk for graft loss at time of diagnosis is necessary to offer personalized treatment. In contrast with serological and molecular assessment, morpho-histological evaluation of antibody-mediated rejection lesions has not significantly evolved. This relies on Banff classifications designed to be of diagnostic discriminatory power rather than prognostic and face quantitative and qualitative limitations...
March 15, 2017: Kidney International
https://www.readbyqxmd.com/read/28317398/cardiac-transplantation-towards-a-new-noninvasive-approach-of-cardiac-allograft-rejection
#13
Sophie I Mavrogeni, George Athanasopoulos, Aggeliki Gouziouta, Evangelos Leontiadis, Stamatis Adamopoulos, Genovefa Kolovou
Cardiac allograft rejection (CAR) may occur after transplantation and remains silent, until hemodynamic deterioration takes place. Endomyocardial biopsy (EMB) is applied to early detect CAR. Although, flexible bioptoms have decreased the incidence of lethal complications, EMB remains an invasive procedure carrying risk of tamponade and permanent heart block. Therefore, a new non-invasive approach is needed. Areas covered: AlloMap molecular expression testing and graft-derived cell-free DNA (GcfDNA) test can be used as blood indices of acute and chronic CAR, respectively...
March 21, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28316600/methylation-of-foxp3-tsdr-underlies-the-impaired-suppressive-function-of-tregs-from-long-term-belatacept-treated-kidney-transplant-patients
#14
Evelyn Katy Alvarez Salazar, Arimelek Cortés-Hernández, Germán Rodrigo Alemán-Muench, Josefina Alberú, Jesús R Rodríguez-Aguilera, Félix Recillas-Targa, Victoria Chagoya de Sánchez, Eric Cuevas, Eduardo Mancilla-Urrea, María Pérez García, Guillermo Mondragón-Ramírez, Mario Vilatobá, Ian Bostock, Erick Hernández-Méndez, David De Rungs, Eduardo A García-Zepeda, Gloria Soldevila
Regulatory T cells (Tregs) are considered key players in the prevention of allograft rejection in transplanted patients. Belatacept (BLT) is an effective alternative to calcineurin inhibitors that appears to preserve graft survival and function; however, the impact of this drug in the homeostasis of Tregs in transplanted patients remains controversial. Here, we analyzed the phenotype, function, and the epigenetic status of the Treg-specific demethylated region (TSDR) in FOXP3 of circulating Tregs from long-term kidney transplant patients under BLT or Cyclosporine A treatment...
2017: Frontiers in Immunology
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
#15
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/28315636/pembrolizumab-for-metastatic-melanoma-in-a-renal-allograft-recipient-with-subsequent-graft-rejection-and-treatment-response-failure-a-case-report
#16
Vineet Kwatra, Narayan V Karanth, Kelum Priyadarshana, Michail Charakidis
BACKGROUND: Transplant patients were excluded from the pivotal phase III trials of checkpoint inhibitors in metastatic melanoma. The efficacy and toxicity profiles of checkpoint inhibitors in this cohort of patients are not well described. To the best of our knowledge, this is the first case report of a renal transplant patient with stage IV melanoma treated with a programmed cell death protein 1 checkpoint inhibitor that led to both treatment failure and renal graft rejection. CASE PRESENTATION: We present a case of a 58-year-old white man with a long-standing cadaveric renal transplant who was diagnosed with a B-Raf Proto-Oncogene, Serine/Threonine Kinase wild-type metastatic melanoma...
March 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28314504/low-ejection-fraction-in-donor-hearts-is-not-directly-associated-with-increased-recipient-mortality
#17
Carol W Chen, Michael H Sprys, Ann C Gaffey, Jennifer J Chung, Kenneth B Margulies, Michael A Acker, Pavan Atluri
BACKGROUND: Reduced left ventricular ejection fraction (EF) in the donor heart is often a contraindication for transplant. However, small studies have validated the use of hearts with evidence of myocardial dysfunction to boost the number of organs available for transplant. We hypothesize that donor hearts with reduced EF undergo myocardial recovery after transplant and result in equivalent recipient survival compared with grafts with normal function. METHODS: We examined post-operative outcomes of heart recipients in the database of the United Network for Organ Sharing...
February 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28314503/standard-donor-lung-procurement-with-normothermic-ex-vivo-lung-perfusion-a-prospective-randomized-clinical-trial
#18
Alexis Slama, Lukas Schillab, Maximilian Barta, Aris Benedek, Andreas Mitterbauer, Konrad Hoetzenecker, Shahrokh Taghavi, Gyoergy Lang, Jose Matilla, Hendrik Ankersmit, Helmut Hager, Georg Roth, Walter Klepetko, Clemens Aigner
BACKGROUND: Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. We performed a prospective randomized trial to investigate the role of EVLP in standard lung transplantation (Tx)...
February 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28314079/low-serum-testosterone-is-associated-with-graft-function-early-after-heart-transplantation
#19
Gregor Poglajen, Mojca Jensterle, Nika Kravos, Andrej Janež, Bojan Vrtovec
BACKGROUND: We sought to investigate a correlation between serum testosterone levels and graft function early after heart transplantation. METHODS: In a cross-sectional study we measured serum testosterone levels 4 weeks after heart transplantation in 49 consecutive male recipients. Echocardiography was done to evaluate graft function. Low serum testosterone was defined as <11 nmol/L. RESULTS: Low serum testosterone was present in 21 (43%) recipients (Group A), and 28 (57%) had normal testosterone levels (Group B)...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28306671/noninvasive-monitoring-of-acute-and-chronic-rejection-in-heart-transplantation
#20
Maria G Crespo-Leiro, Gonzalo Barge-Caballero, David Couto-Mallon
PURPOSE OF REVIEW: Recent years have seen advances in the early detection of cardiac graft rejection. RECENT FINDINGS: We review the possibilities offered by tissue Doppler imaging and speckle tracking echocardiography, cardiac magnetic resonance, cardiac computed tomography, single positron emission tomography, gene expression profiling, and quantitation of donor-derived cell-free DNA, and microRNAs. SUMMARY: Noninvasive monitoring of acute and chronic rejection after cardiac transplantation is an unmet need and remains a challenge...
March 16, 2017: Current Opinion in Cardiology
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