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https://www.readbyqxmd.com/read/28738403/developing-consensus-based-priority-outcome-domains-for-trials-in-kidney-transplantation-a-multinational-delphi-survey-with-patients-caregivers-and-health-professionals
#1
Bénédicte Sautenet, Allison Tong, Karine E Manera, Jeremy R Chapman, Anthony N Warrens, David Rosenbloom, Germaine Wong, John Gill, Klemens Budde, Lionel Rostaing, Lorna Marson, Michelle A Josephson, Peter P Reese, Timothy L Pruett, Camilla S Hanson, Donal O'Donoghue, Helen Tam-Tham, Jean-Michel Halimi, Jenny I Shen, John Kanellis, John D Scandling, Kirsten Howard, Martin Howell, Nick Cross, Nicole Evangelidis, Philip Masson, Rainer Oberbauer, Samuel Fung, Shilpa Jesudason, Simon Knight, Sreedhar Mandayam, Stephen P McDonald, Steve Chadban, Tasleem Rajan, Jonathan C Craig
BACKGROUND: Inconsistencies in outcome reporting and frequent omission of patient-centered outcomes can diminish the value of trials in treatment decision making. We identified critically important outcome domains in kidney transplantation based on the shared priorities of patients/caregivers and health professionals. METHODS: In a 3-round Delphi survey, patients/caregivers and health professionals rated the importance of outcome domains for trials in kidney transplantation on a 9-point Likert scale and provided comments...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28738239/delayed-graft-duodenal-perforation-due-to-impacted-food-five-years-after-simultaneous-pancreas-kidney-transplantation-a-case-report
#2
Taizo Sakata, Hideki Katagiri, Tadao Kubota, Takashi Sakamoto, Kentaro Yoshikawa, Alan Kawarai Lefor, Cheol Woong Jung, Toru Kojima
INTRODUCTION: Pancreas transplantation is the best treatment option in selected patients with type 1 diabetes mellitus. Here we report a patient with a nonmarginal duodenal perforation five years after a simultaneous pancreas-living donor kidney transplantation (SPLKT). PRESENTATION OF CASE: A 31-year old male who underwent SPLKT five years previously presented with severe abdominal pain. He had a marginal duodenal perforation four years later, treated by primary closure and drainage...
July 14, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28737661/toward-establishing-core-outcome-domains-for-trials-in-kidney-transplantation-report-of-the-standardized-outcomes-in-nephrology-kidney-transplantation-consensus-workshops
#3
Allison Tong, John Gill, Klemens Budde, Lorna Marson, Peter P Reese, David Rosenbloom, Lionel Rostaing, Germaine Wong, Michelle A Josephson, Timothy L Pruett, Anthony N Warrens, Jonathan C Craig, Benedicte Sautenet, Nicole Evangelidis, Angelique F Ralph, Camilla S Hanson, Jenny I Shen, Kirsten Howard, Klemens Meyer, Ronald D Perrone, Daniel E Weiner, Samuel Fung, Maggie K M Ma, Caren Rose, Jessica Ryan, Ling-Xin Chen, Martin Howell, Nicholas Larkins, Siah Kim, Sobhana Thangaraju, Angela Ju, Jeremy R Chapman
BACKGROUND: Treatment decisions in kidney transplantation requires patients and clinicians to weigh the benefits and harms of a broad range of medical and surgical interventions, but the heterogeneity and lack of patient-relevant outcomes across trials in transplantation makes these trade-offs uncertain, thus, the need for a core outcome set that reflects stakeholder priorities. METHODS: We convened 2 international Standardized Outcomes in Nephrology-Kidney Transplantation stakeholder consensus workshops in Boston (17 patients/caregivers; 52 health professionals) and Hong Kong (10 patients/caregivers; 45 health professionals)...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28737196/-results-of-a-national-program-of-pediatric-heart-transplantation-strengths-and-weakness
#4
Pedro Becker, Santiago Besa, Sergio Riveros, Rodrigo González, Alfonso Navia, Paulina Dellepiane, Daniel Springmuller, Gonzalo Urcelay
Pediatric heart transplantation is an effective therapy to treat advanced heart failure in children. OBJECTIVES: To analyze the immediate and mid-term results of pediatric patients listed for heart transplantation. PATIENTS AND METHODS: Registration of patients admitted to our transplant protocol between October 2001 and July 2016 were reviewed, analyzing demographic data, diagnosis, status at the time of listing, waiting time until transplantation, donor data, use of ventricular assist device, hemodynamic data, complications and global mortality...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28736027/suppression-of-delayed-xenograft-rejection-by-resveratrol-in-a-hamster-to-rat-cardiac-transplantation-model
#5
Y Lian, C Gao, Y Wu, J Xia, Y Leng, Y Liu, M Zhu, J Chen, Z Qi
BACKGROUND: Delayed xenograft rejection (DXR) is an insurmountable barrier for xenotransplantation. Previous studies reported that hamster hearts transplanted into rats undergo DXR and stop functioning after the cessation of immunosuppression. Herein, we investigated the effects of resveratrol on preventing DXR in a hamster-to-rat vascularized cardiac xenograft model. METHODS: Hamster hearts were engrafted into Lewis rat recipients. Recipient rats received a graft acceptance-inducing treatment of leflunomide and FK506 for 2 weeks to prevent acute xenograft rejection (AXR)...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736026/yogurt-feeding-induced-the-prolongation-of-fully-major-histocompatibility-complex-mismatched-murine-cardiac-graft-survival-by-induction-of-cd4-foxp3-cells
#6
M Uchiyama, E Yin, T Yanagisawa, X Jin, M Hara, S Matsuyama, T Imazuru, K Uchida, M Kawamura, M Niimi
Yogurt is a nutrient-rich food and the beneficial effects of yogurt on both health and immunomodulatory effects are well documented. In this pilot study, we investigated the effects of commercially produced yogurt R-1 on alloimmune responses in a murine cardiac transplantation model. The R-1 is produced by Meiji Co., Ltd., and contains live and active lactic acid bacteria (lactobacillus bulgaricus OLL1073R-1) mainly. CBA (H2(k)) mice underwent transplantation of a C57BL/6 (H2(b); B6) heart and received oral administration of 1 mL, 0...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736014/efficacy-and-safety-of-generic-mycophenolate-mofetil-my-rept-500-milligram-tablets-in-primary-liver-transplant-recipients
#7
S K Hong, K-W Lee, K C Yoon, H-S Kim, H Kim, N-J Yi, K-S Suh
BACKGROUND: Generic immunosuppressants may be cost-effective if clinical outcomes are equivalent to the brand-name medications. Mycophenolate mofetil in the form of My-rept may be cost-effective being a generic immunosuppressant, which is available as a 500-mg tablet as well as a 250-mg capsule (Chong Kun Dang Pharmaceutical Corporation, Seoul, Korea). OBJECTIVE: This study aimed to evaluate the efficacy, safety, cost-effectiveness, and convenience of My-rept 500-mg tablets in liver transplant recipients...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736013/outcomes-of-highly-sensitized-patients-undergoing-simultaneous-liver-and-kidney-transplantation-a-single-center-experience-with-desensitization
#8
J A Steggerda, A Kang, S-H Pan, V Sundaram, N N Nissen, A S Klein, T Todo, A Annamalai, A Vo, S C Jordan, I K Kim
BACKGROUND: Preformed donor-specific human leukocyte antigen antibodies (DSAs) in patients undergoing simultaneous liver and kidney transplantation (SLKT) are an independent risk factor for poorer patient and renal allograft survival. The outcomes of patients highly sensitized (HS) against HLA antigens undergoing SLKT and select HS SLKT recipients undergoing desensitization at a high-volume desensitization center were investigated. METHODS: Seventy-five patients undergoing SLKT at a high-volume desensitization center between January 1, 2001, and December 31, 2015, were retrospectively reviewed...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735996/effect-of-hla-matching-on-pediatric-renal-transplant-graft-survival-in-china
#9
H Zhao, X Lai, J Lu, Y Lin, P Wang, L Zhu, L Wu, Z Xiao, Q Wang, J Tan
INTRODUCTION: Kidney transplantation (KTX) has become one of the most effective therapies of choice for pediatric patients with end-stage renal disease (ESRD). The extent to which HLA mismatching influences graft survival following KTX has not been clarified. PATIENTS AND METHODS: The effect of HLA amino acid residue matching on graft survival was assessed in 36 pediatric patients in whom complete donor-recipient HLA data were available. HLA-A, -B, -DR and HLA-A+B+DR loci residue mismatches were separately analyzed...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735993/comparison-of-clinical-outcomes-between-spousal-and-living-related-donor-kidney-transplantation-in-mainland-china-a-single-center-experience
#10
M Shao, Y Ming, K Cheng, M Yang, Q Ye
Shortage of donors still is the major obstacle for kidney transplantation. Living-related donors are the major resource of kidney transplantation at present. To expand the donor pool, spousal-donor kidney transplantation as one of the types of living-unrelated donors has been used to alleviate the organ shortage. A total of 116 living-kidney transplantations were retrospectively analyzed. We classified these recipients into two groups: a spousal-donor group (n = 50) and a living-related donor group (n = 66), and analyzed the outcome of transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735989/outcome-of-pretransplantation-therapeutic-plasma-exchange-in-highly-sensitized-deceased-donor-kidney-transplant-recipients
#11
P Tipjaiaue, A Ingsathit, P Kantachuvesiri, S Rattanasiri, D Thammanichanond, T Mongkolsuk, N Arpornsujaritkun, V Sumethkul, S Kantachuvesiri
BACKGROUND: Sensitization is associated with a high rate of post-transplantation rejection. A desensitization protocol using therapeutic plasma exchange (TPE) was proposed to reduce anti-HLA antibody before transplantation, but there has been limited data regarding the efficacy of pretransplantation TPE in highly sensitized deceased-donor kidney transplantation (DDKT). METHODS: A retrospective cohort study of 142 patients who received DDKT was conducted and divided into two groups: a high-panel-reactive antibody (PRA) >50% group and a low-PRA ≤50% group...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28734583/kidney-transplantation-from-hla-incompatible-live-donors-efficiency-and-outcome-of-32-patients-after-desensitisation
#12
Constantino Fernández, María Calvo, Natacha Leite, Andrés López, Tamara Ferreiro, Roi Ribera, Rocío Seijo, Ángel Alonso
Desensitisation is a procedure undergone by the recipient of a kidney transplant from a donor who is cross-match positive. The aim of this study was to present the outcomes from our hospital of kidney transplant recipients from HLA-incompatible live donors after desensitisation. We studied 32 patients aged 46±14 years with a mean fluorescence intensity (MFI) versus class I HLA of 7979±4089 and 6825±4182 MFI versus class II and relative intensity scale (RIS) of 8.9±7.6. The complement-dependent cytotoxicity (CDC) cross-matching test was positive in 18 patients, flow cytometry was positive in 7 patients and donor-specific antibodies (DEA) were detected in 7...
July 19, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28733202/v%C3%AE-4-%C3%AE-%C3%AE-t-cells-provide-an-early-source-of-il-17a-and-accelerate-skin-graft-rejection
#13
Yashu Li, Zhenggen Huang, Rongshuai Yan, Meixi Liu, Yang Bai, Guangping Liang, Xiaorong Zhang, Xiaohong Hu, Jian Chen, Chibing Huang, Baoyi Liu, Gaoxing Luo, Jun Wu, Weifeng He
Activated γδ T cells have been shown to accelerate allograft rejection. However, the precise role of skin-resident γδT cells and their subsets - Vγ5 (epidermis), Vγ1 and Vγ4 (dermis) - in skin graft rejection have not been identified. Here, using a male to female skin transplantation model, we demonstrated that Vγ4 T cells, rather than Vγ1 or Vγ5 T cells, accelerated skin graft rejection and that IL-17A was essential for Vγ4 T cell-mediated skin graft rejection. Moreover, we found that Vγ4 T cells were required for early IL-17A production in the transplanted area, both in skin grafts and in the host epidermis around grafts...
July 18, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28732720/impact-on-mid-term-kidney-graft-outcomes-of-pretransplant-anti-hla-antibodies-detected-by-solid-phase-assays-do-donor-specific-antibodies-tell-the-whole-story
#14
Jorge Malheiro, Sandra Tafulo, Leonídio Dias, La Salete Martins, Isabel Fonseca, Idalina Beirão, António Castro-Henriques, António Cabrita
The detrimental impact of preformed anti-HLA donor-specific antibodies (DSA) is well defined, contrarily to non-donor-specific antibodies (NDSA). We sought to evaluate their clinical impact in a cohort of 724 kidney graft recipients in whom anti-HLA antibodies were thoroughly screened and identified in pre-transplant sera by solid-phase assays. NDSA or DSA were detected in 100 (13.8%) and 47 (6.5%) recipients respectively, while 577 (79.7%) were non-allosensitized (NaS). Incidence of antibody-mediated rejection at 1-year was 0...
July 18, 2017: Human Immunology
https://www.readbyqxmd.com/read/28732438/investigation-of-killer-immunoglobulin-like-receptor-kir-and-hla-genotypes-to-predict-the-occurrence-of-acute-allograft-rejection-after-kidney-transplantation
#15
Davood Jafari, Mohsen Nafar, Mir Saeed Yekaninejad, Razieh Abdolvahabi, Mahboob Lesan Pezeshki, Efat Razaghi, Ali Akbar Amirzargar
After kidney transplantation, natural killer (NK) cells play a pivotal role in triggering the immune response to the allogeneic grafts primarily by their killer-cell immunoglobulin-like receptors (KIR). This process may be one mechanism that contributes to graft rejection. In this study, we have evaluated whether acute rejection after kidney transplantation was associated with predicted NK cell alloreactivity based on KIR gene and ligand along with KIR/HLA compound genotype analysis. After kidney transplantation, natural killer (NK) cells play a pivotal role in triggering the immune response to the allogeneic grafts primarily by their killer-cell immunoglobulin-like receptors (KIR)...
June 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/28731910/new-answers-to-old-conundrums-what-antibodies-exosomes-and-inflammasomes-bring-to-the-conversation-canadian-national-transplant-research-program-international-summit-report
#16
Mélanie Dieudé, Lori J West, Daniel A Muruve, Lakshman Gunaratman, Thalachallour Mohanakumar, Emmanuel Zorn, Christopher W Cairo, Darren H Freed, Kirk R Schultz, Robert L Fairchild, Marie-Josée Hébert
Antibody-mediated injury is a major cause of allograft dysfunction and loss. Antibodies to ABH(O) blood group antigens are classical mediators of ABO-incompatible (ABOi) graft rejection, while donor-specific anti-HLA antibodies and, more recently, autoantibodies are appreciated as important contributors to allograft inflammation and dysfunction. In August 2016, the International Summit of the Canadian National Transplant Research Program focused on recent advances in the field of antibody-mediated rejection...
July 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28731207/polyclonal-and-monoclonal-antibodies-for-treating-acute-rejection-episodes-in-kidney-transplant-recipients
#17
REVIEW
Angela C Webster, Sunny Wu, Krishna Tallapragada, Min Young Park, Jeremy R Chapman, Sue J Carr
BACKGROUND: Registry data shows that the incidence of acute rejection has been steadily falling. Approximately 10% to 35% of kidney recipients will undergo treatment for at least one episode of acute rejection within the first post-transplant year. Treatment options include pulsed steroid therapy, the use of an antibody preparation, the alteration of background immunosuppression, or combinations of these options. Over recent years, new treatment strategies have evolved, and in many parts of the world there has been an increase in use of tacrolimus and mycophenolate and a reduction in the use of cyclosporin and azathioprine use as baseline immunosuppression to prevent acute rejection...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28730648/calcineurin-inhibitor-withdrawal-or-tapering-for-kidney-transplant-recipients
#18
REVIEW
Krishna M Karpe, Girish S Talaulikar, Giles D Walters
BACKGROUND: Calcineurin inhibitors (CNI) can reduce acute transplant rejection and immediate graft loss but are associated with significant adverse effects such as hypertension and nephrotoxicity which may contribute to chronic rejection. CNI toxicity has led to numerous studies investigating CNI withdrawal and tapering strategies. Despite this, uncertainty remains about minimisation or withdrawal of CNI. OBJECTIVES: This review aimed to look at the benefits and harms of CNI tapering or withdrawal in terms of graft function and loss, incidence of acute rejection episodes, treatment-related side effects (hypertension, hyperlipidaemia) and death...
July 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28730633/pd-1-expression-on-cd8-t-cells-regulates-their-differentiation-within-lung-allografts-and-is-critical-for-tolerance-induction
#19
T Takahashi, H M Hsiao, S Tanaka, W Li, R Higashikubo, D Scozzi, A Bharat, J H Ritter, A S Krupnick, A E Gelman, D Kreisel
Immunological requirements for rejection and tolerance induction differ between various organs. While memory CD8(+) T cells are considered a barrier to immunosuppression-mediated acceptance of most tissues and organs, tolerance induction after lung transplantation is critically dependent on central memory CD8(+) T lymphocytes. Here we demonstrate that costimulation blockade-mediated tolerance after lung transplantation is dependent on PD-1 expression on CD8(+) T cells. In the absence of PD-1 expression, CD8(+) T cells form prolonged interactions with graft-infiltrating CD11c(+) cells, their differentiation is skewed towards an effector memory phenotype and grafts are rejected acutely...
July 20, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28726586/application-of-ureterorenoscope-and-flexible-ureterorenoscope-lithotripsy-in-removing-calculus-from-extracorporeal-living-donor-renal-graft-a-single-center-experience
#20
Chun-Hua Lin, Zuo-Fu Zhang, Jiahui Wang, Lu-Xin Yu, Wen-Ting Wang, Lei Shi, Xiang-Nan Lin
Here, we reported our clinical application of ureterorenoscope (URS) and flexible URS lithotripsy in stone removal on 10 cases of excised living donor kidney graft. After the extraction of donor kidney by retroperitoneal laparoscopy, the donor graft was perfused with 4 °C HCA solution. Calculus between 2-4 mm were removed intact with lithotomy forceps under direct vision of URS. Larger calculi of >4 mm were fractured with flexible URS combining holmium laser lithotripsy. Fragments of the calculus were extracted with basket extractor and lithotomy forceps...
November 2017: Renal Failure
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