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Naoki Komine, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Takamitsu Inoue, Hiroshi Tsuruta, Shintaro Narita, Atsushi Komatsuda, Hiroshi Nanjo, Hideaki Kagaya, Takenori Niioka, Masatomo Miura, Yoko Mitobe, Tomonori Habuchi
The impact of CYP3A5 polymorphisms on clinical outcomes is controversial. The present study investigated the impact of CYP3A5 genetic differences on the development of interstitial fibrosis (IF) from 0 h to 1 year post-transplantation in biopsy sections from 96 living kidney recipients under the same target trough regimen of tacrolimus. The relationships between CYP3A5 polymorphisms and long-term graft function and death-censored graft survival were also examined. A quantitative analysis of IF was performed using computer-assisted imaging on virtual slides...
March 14, 2018: International Immunopharmacology
Kakharman Yesmembetov, Tokan Sultanaliyev, Adilbek Mukazhanov, Assan Zhexembayev, Gani Kuttymuratov, Zhanat Spatayev, Yevgeniy Mussin, Yerlan Umbetzhanov, Damesh Orazbayeva
OBJECTIVES: Liver transplant is the only treatment option for patients with end-stage liver disease. MATERIALS AND METHODS: Liver transplant procedures performed from June 2013 to March 2017 were evaluated. We evaluated the postoperative period in recipients of livers from deceased and living donors. RESULTS: Of 31 liver transplant procedures in 30 recipients, 12 were from deceased and 19 from living donors. The final analysis included 24 liver transplants (11 males, 13 females), with 10 from deceased and 14 from living donors...
March 2018: Experimental and Clinical Transplantation
Anupma Kaul, Shashi Kumar, Dharmendra Bhaduaria, Vinita Agrawal, R K Sharma, Narayan Prasad, Amit Gupta, Rishi Kumar
Reactivation of cytomegalovirus (CMV) and BK polyomavirus (BKV) can result in virus-associated tubulointerstitial nephritis in renal allografts. All those renal biopsies reported as viral cytopathic were isolated and examined by two independent renal histopathologists from our institute and classified as CMV, BKV, and CMV-BKV coinfection-associated viral cytopathic changes with confirmation through polymerase chain reaction technology in either serum or urine or both. All twenty patients were categorized as 10 in CMV, four in BKV, and six were in CMV-BKV coinfection...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Helong Dai, Longkai Peng, Fenghua Peng, Gongbin Lan, Yu Wang, Jingjing Chen, Lei Liu, Chen Gao, Yong Guo, Chunhua Fang, Manhua Nie, Wang Long, Shaojie Yu
Pediatric kidney donors remain underutilized due to the high risk of postoperative thrombosis. To address this problem, we developed a novel en bloc kidney transplantation technique using donor thoracic aorta and the distal abdominal aorta as inflow and outflow tracts, respectively. Briefly, 8 kidneys from deceased infant donors under 5 months old and with low body weight (1.9-4.9 kg) were transplanted en bloc into 4 pediatric and 4 adult patients. The donor's common iliac artery or external iliac artery was anastomosed to the recipient's distal external iliac artery or inferior epigastric artery, respectively, as an outflow tract...
February 15, 2018: American Journal of Transplantation
A L Herzog, C Kalogirou, C Wanner, K Lopau
INTRODUCTION: Data suggest an additional role of T cells in antibody-mediated rejections. In 2001 a protocol for AB0-incompatible kidney transplantation based on B-cell-depleting anti-CD20 antibody rituximab, antigen-specific blood group IgG immunoadsorption, intravenous immunoglobulins, and triple immunosuppression was introduced in Europe, which used induction therapy with the use of interleukin-2 receptor antibody (IL2-RA) basiliximab. We used thymoglobulin in AB0-incompatible patients as induction in the face of high immunologic risk...
January 2018: Transplantation Proceedings
Fabio Tattoli, Daniela Falconi, Chiara Bottaro, Maurizio Gherzi, Federico Marazzi, Marita Marengo, Ilaria Serra, Michela Tamagnone, Marco Formica
Bardet-Biedl Syndrome (BBS) is a rare multi-systemic disease with autosomal recessive transmission. BBS was at first considered to be homogeneous as for its genetics, but subsequent studies have shown an extensive gene variability. Currently, 21 genes (BBS1-21) present on different chromosomes have been mapped: these genes are responsible for BBS phenotypes and they show a great heterogeneity of mutations.The most common genes are BBS1 (locus 11q13) and BBS10.We show here the case of a 50 year old patient with BBS...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Arnaud Devresse, Marianne Leruez-Ville, Anne Scemla, Véronique Avettand-Fenoel, Lise Morin, Xavier Lebreton, Claire Tinel, Lucile Amrouche, Lionel Lamhaut, Marc Olivier Timsit, Julien Zuber, Christophe Legendre, Dany Anglicheau
BACKGROUND: donor (D)+/recipient (R)- serostatus is closely associated with a higher risk of cytomegalovirus (CMV) infection and disease. Antiviral prophylaxis is conventionally used in such patients, but late-onset CMV infection/disease still occurs after the discontinuation of prophylaxis. METHODS: we retrospectively analyzed the data of 215 low immunological risk patients who received kidney transplantation in our center between 2011 and 2016. RESULTS: ninety-seven patients received a combination of everolimus (EVL)/reduced doses of calcineurin inhibitors (CNI) (EVL group) de novo, and 118 received a combination of mycophenolic acid (MPA)/standard doses of CNI (MPA group) de novo...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Lin Zhou, Guo-Sheng Du, Li-Chao Pan, Yong-Gen Zheng, Zhi-Jia Liu, Hai-Da Shi, Shao-Zhen Yang, Xian-Jie Shi, Meng Xuan, Li-Kui Feng, Zhi-Dong Zhu
There is currently no consensus on the most suitable therapeutic approach for psoriasis (PS) co-existing with posthepatic cirrhosis (PCs) and hepatocellular carcinoma (HCC) following liver transplantation (LT). The present study provides an analysis of the therapeutic experience of such patients. Five LT recipients (two with PC and three with HCC) with accompanying PS were included. The induction program consisted of methylprednisolone plus basiliximab treatment. The initial postoperative treatment scheme consisted of tacrolimus (FK506) plus mycophenolate mofetil (MMF) and hormone; the latter was withdrawn 1 week after LT...
December 2017: Oncology Letters
L Stranavova, P Hruba, E Girmanova, I Tycova, A Slavcev, J Fronek, J Slatinska, P Reinke, H-D Volk, O Viklicky
Cytomegalovirus (CMV) infection influences both short and long term outcomes in immunosuppressed organ transplant recipients. The aim of this study was to evaluate the effect of different induction immunosuppression regimens on CMV specific T cell response in patients with already established CMV immunity. In 24 seropositive living donor kidney recipients, the frequency of CMV specific T cells was determined by ELISPOT (Enzyme-Linked ImmunoSpot) assay prior and 6 months after transplantation. Recipients' peripheral blood mononuclear cells were stimulated with immediate-early (IE1) and phosphoprotein 65 (pp65) CMV-derived peptide pools and the number of cells producing interferon gamma (IFN-gamma) was assessed...
January 5, 2018: Physiological Research
Benedetta Chiodini, Jean Herman, Ksenija Lolin, Brigitte Adams, Elise Hennaut, Pierre Lingier, Dimitri Mikhalski, Thierry Schurmans, Noël Knops, Karl M Wissing, Daniel Abramowicz, Khalid Ismaili
Kidney transplantation (KT) is often delayed in small children because of fear of post-operative complications. We report early and long-term outcomes in children transplanted at ≤15 kg in the two largest Belgian pediatric transplant centers. Outcomes before (period1) and since the introduction of basiliximab and mycophenolate-mofetil in 2000 (period2) were compared. Seventy-t wo KTs were realized between 1978 and 2016: 38 in period1 and 34 in period2. Organs came from deceased donors in 48 (67%) cases. Surgical complications occurred in 25 KTs (35%) with no significant difference between the two periods...
December 27, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
Caroline Wehmeier, Patricia Hirt-Minkowski, Patrizia Amico, Argyrios Georgalis, Helmut Hopfer, Jürg Steiger, Michael Dickenmann, Stefan Schaub
Steroid withdrawal following renal transplantation is challenging and widely debated. This retrospective study aimed at investigating the frequency and determinants of successful steroid withdrawal guided by surveillance biopsies. We analysed 156 pre-transplant DSA-negative renal transplants receiving basiliximab induction and maintenance immunosuppression with tacrolimus-mycophenolate-steroids. The absence of rejection in surveillance biopsies at 3 or 6 months post-transplant initiated steroid withdrawal, which was monitored by subsequent indication and/or surveillance biopsies...
December 23, 2017: Clinical Transplantation
Jiang Li, Qing-Jun Guo, Jin-Zhen Cai, Cheng Pan, Zhong-Yang Shen, Wen-Tao Jiang
Simultaneous liver, pancreas-duodenum, and kidney transplantation has been rarely reported in the literature. Here we present a new and more efficient en bloc technique that combines classic orthotopic liver and pancreas-duodenum transplantation and heterotopic kidney transplantation for a male patient aged 44 years who had hepatitis B related cirrhosis, renal failure, and insulin dependent diabetes mellitus (IDDM). A quadruple immunosuppressive regimen including induction with basiliximab and maintenance therapy with tacrolimus, mycophenolate mofetil, and steroids was used in the early stage post-transplant...
December 7, 2017: World Journal of Gastroenterology: WJG
(no author information available yet)
Calcineurin inhibitors (CNIs, eg, tacrolimus) reduce short-term kidney transplant failure, but chronic nephrotoxicity may contribute to late transplant loss. Elective conversion to inhibitors of the mammalian target of rapamycin (mTOR, eg, sirolimus) pathway might avoid long-term CNI renal damage and improve outcomes. The 3C Study was a pragmatic randomized controlled trial of sequential randomizations between alemtuzumab and basiliximab induction therapy (at the time of surgery) and between tacrolimus and sirolimus maintenance therapy at 6 months posttransplantation...
December 11, 2017: American Journal of Transplantation
Y Kumai, O Seguchi, T Sato, K Wada, M Shiozawa, C Yokota, K Kuroda, S Nakajima, T Sato, M Yanase, Y Matsumoto, S Fukushima, T Fujita, J Kobayashi, N Fukushima
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a transient cerebrovascular disorder putatively caused by some immunosuppressive agents. CASE REPORT: We recently encountered a 47-year-old female patient diagnosed with dilated cardiomyopathy who developed RCVS after heart transplantation. A triple-drug regimen consisting of tacrolimus, mycophenolate mofetil, and a corticosteroid was started after surgery. On postoperative day (POD) 11, the patient developed a severe headache, although computed tomography of the head demonstrated no signs of hemorrhage or infarction...
December 2017: Transplantation Proceedings
Margaret R Jorgenson, Jillian L Descourouez, Tripti Singh, Brad C Astor, Sarah E Panzer
STUDY OBJECTIVE: To evaluate the risk of posttransplantation malignancy in renal transplant recipients exposed to pretransplantation cyclophosphamide for the treatment of glomerular nephropathy (GN). DESIGN: Retrospective cohort study. SETTING: Tertiary academic medical center. PATIENTS: Six hundred adult renal transplant recipients were transplanted between 1993 and 2014; 54 patients were exposed to pretransplantation cyclophosphamide for treatment of GN (GN-CYC group), and 546 patients with polycystic kidney disease were not exposed to pretransplantation cyclophosphamide (PKD group)...
November 14, 2017: Pharmacotherapy
Tsukasa Nishioka, Norio Yoshimura, Hidetaka Ushigome, Yoshihiko Watarai, Kenji Nishimura, Kiyokazu Akioka, Nobuyuki Nakamura, Mutsushi Kawakita, Kenji Yuzawa, Tatsuya Nakatani
OBJECTIVE: To evaluate the utility and safety of high-dose mizoribine combination therapy using cyclosporine and tacrolimus as calcineurin inhibitors in patients undergoing kidney transplant. METHODS: The present study enrolled 156 patients who received kidney transplants in 18 institutions between 2009 and 2013. ABO-incompatible and/or pre-sensitized recipients were excluded. Immunosuppression used cyclosporine (88) or tacrolimus (68) as a calcineurin inhibitor, and the dosage was adjusted based on blood concentrations...
October 25, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
Rodrigo B Martino, Eserval Rocha Júnior, Valdano Manuel, Vinicius Rocha-Santos, Luis Augusto C D'Albuquerque, Wellington Andraus
BACKGROUND Adequate portal venous flow is required for successful liver transplantation. Reduced venous flow and blood flow 'steal' by collateral vessels are a concern, and when there is a prominent splenorenal shunt present, ligation of the left renal vein has been recommended to improve portal venous blood flow. CASE REPORT A 51-year-old man who had undergone right nephrectomy in childhood required liver transplantation for liver cirrhosis and hepatocellular carcinoma due to hepatitis C virus (HCV) infection...
October 11, 2017: American Journal of Case Reports
Veraprapas Kittipibul, Pakpoom Tantrachoti, Pat Ongcharit, Aekarach Ariyachaipanich, Sarawut Siwamogsatham, Supaporn Sritangsirikul, Kanokwan Thammanatsakul, Sarinya Puwanant
We prospectively studied efficacy and safety outcomes of two 10-mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2-week assessment post-transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT grade ≥ 2R. By the 1-year assessment post-transplant, there were 1 (6%) infectious death, no graft failures, 2 (12%) grade 2R ACRs, 6 (35%) asymptomatic cytomegalovirus (CMV) infections, and 4 (25%) treated infections...
December 2017: Clinical Transplantation
Kun Wang, Xianlin Xu, Min Fan
OBJECTIVE: The aim of this meta-analysis was to evaluate the efficacy of basiliximab versus antithymocyte globulin for induction therapy in renal allograft. METHODS: Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify prospective randomized controlled trials that compared basiliximab with antithymocyte globulin (ATG) for induction therapy in renal transplantation. RevMan 5.1 software and Stat Manager V4...
October 6, 2017: Clinical and Experimental Nephrology
T Butler, N Hayde
BACKGROUND: Delayed graft function (DGF) is defined as the need for dialysis within 1 week of transplantation and occurs in 20%-50% of deceased-donor kidney transplant recipients. Although recovery from DGF often occurs within a few days, many cases may take weeks to months before the transplant function begins. The delay in function increases the complexity of recipient care, makes the diagnosis of acute rejection more difficult, prolongs length of stay, and increases hospital costs...
October 2017: Transplantation Proceedings
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