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Acute kidney rejection

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https://www.readbyqxmd.com/read/28638610/looking-for-the-needle-in-the-kidney-transplantation-haystack
#1
Josep M Cruzado, Edoardo Melilli
The diagnosis of acute rejection still relies on renal allograft biopsy. In fact, histological features including C4d staining can be useful to differentiate cellular and antibody-mediated acute rejection. However, the pathogenic mechanism to define the type of rejection is usually assessed by anti-HLA donor specific antibodies (DSA) monitoring. Suspicion of acute rejection is usually based on renal function deterioration. This method has low sensitivity. Moreover, creatinine increase follows graft injury and therefore the diagnosis is performed when there is an ongoing acute rejection...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28636627/plasma-cell-neoplasia-after-kidney-transplantation-french-cohort-series-and-review-of-the-literature
#2
Raphaël Kormann, Hélène François, Thibault Moles, Jacques Dantal, Nassim Kamar, Karine Moreau, Thomas Bachelet, Anne-Elisabeth Heng, Antoine Garstka, Charlotte Colosio, Didier Ducloux, Johnny Sayegh, Benjamin Savenkoff, Denis Viglietti, Rebecca Sberro, Eric Rondeau, Julie Peltier
Although post-transplant lymphoproliferative disorder (PTLD) is the second most common type of cancer in kidney transplantation (KT), plasma cell neoplasia (PCN) occurs only rarely after KT, and little is known about its characteristics and evolution. We included twenty-two cases of post-transplant PCN occurring between 1991 and 2013. These included 12 symptomatic multiple myeloma, eight indolent myeloma and two plasmacytomas. The median age at diagnosis was 56.5 years and the median onset after transplantation was 66...
2017: PloS One
https://www.readbyqxmd.com/read/28634772/the-effect-of-desensitization-therapy-in-kidney-transplantation
#3
Yong Chul Kim, Mi-Yeon Yu, Jung Pyo Lee, Hajeong Lee, Sang-Il Min, Jongwon Ha, Yon Su Kim
BACKGROUND: Desensitization therapy may enable the patient to get allograft in sensitized recipient or solve the organ shortage in ABO-incompatible relationship in kidney transplantation (KT). However, the graft outcome and morbidity remains unclear. METHODS: We retrospectively analyzed 845 KT patients from January 2010 to February 2016 at Seoul National University Hospital. The patients were divided into three groups as follows: HLA-incompatible (HLAi) group, ABO-incompatible (ABOi) group, and control group...
June 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28631715/-concurrence-of-acute-graft-rejection-and-polyomavirus-nephropathy-a-clinical-case
#4
Yu G Motin, O V Omelchenko, T P Bukiy, N P Bgatova, A Yu Gryzlov
The paper describes a case of diagnosing acute renal graft rejection concurrent with polyomavirus nephropathy. Histochemical and electron microscopic methods were used to examine biopsy specimens, which showed morphological changes occurring in the allograft, the ultrastructural characteristics of polyomavirus and the features of its spread in kidney tissue structures.
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28631040/biomarkers-to-detect-rejection-after-kidney-transplantation
#5
Vikas R Dharnidharka, Andrew Malone
Detecting acute rejection in kidney transplantation has been traditionally done using histological analysis of invasive allograft biopsies, but this method carries a risk and is not perfect. Transplant professionals have been working to develop more accurate or less invasive biomarkers that can predict acute rejection or subsequent worse allograft survival. These biomarkers can use tissue, blood or urine as a source. They can comprise individual molecules or panels, singly or in combination, across different components or pathways of the immune system...
June 19, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28628770/a-comparative-analysis-between-proteasome-and-immunoproteasome-inhibition-in-cellular-and-humoral-alloimmunity
#6
Theodoros Eleftheriadis, Georgios Pissas, Georgia Antoniadi, Vassilios Liakopoulos, Ioannis Stefanidis
Triggered by the successful administration of the proteasome inhibitor bortezomib in kidney transplant recipients with acute or chronic antibody-mediated rejection, we evaluated the effect of the proteasome inhibitor CEP-18770 and of the selective immunoproteasome inhibitor ONX-0914 on cellular and humoral alloimmunity. Cellular alloimmunity was assessed by cell proliferation in a two-way mixed lymphocyte reaction (MLR) with human peripheral blood mononuclear cells (PBMC). For assessing humoral alloimmunity we developed a method, where humoral alloimmunity was induced in one-way MLR...
June 16, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28626071/nlrx1-dampens-oxidative-stress-and-apoptosis-in-tissue-injury-via-control-of-mitochondrial-activity
#7
Geurt Stokman, Lotte Kors, Pieter J Bakker, Elena Rampanelli, Nike Claessen, Gwendoline J D Teske, Loes Butter, Harmen van Andel, Marius A van den Bergh Weerman, Per W B Larsen, Mark C Dessing, Coert J Zuurbier, Stephen E Girardin, Sandrine Florquin, Jaklien C Leemans
Mitochondrial dysfunction is the most prominent source of oxidative stress in acute and chronic kidney disease. NLRX1 is a receptor of the innate immune system that is ubiquitously expressed and localized in mitochondria. We investigated whether NLRX1 may act at the interface of metabolism and innate immunity in a model of oxidative stress. Using a chimeric mouse model for renal ischemia-reperfusion injury, we found that NLRX1 protects against mortality, mitochondrial damage, and epithelial cell apoptosis in an oxidative stress-dependent fashion...
June 16, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28625949/discussion-on-the-risk-factors-of-developing-cardiovascular-diseases-cvd-after-the-kidney-transplantation
#8
Kai Wang, Qing-Shan Qu, Shu-Zhai Miao, Yanxuan Zhang, Xin Jing
To discuss the risk factors of developing cardiovascular disease (CVD) after the kidney transplantation. Retrospective analysis on the data of 1106 patients who had been underwent kidney allotransplantation in People's Hospital of Zhengzhou from July, 2010 to Dec, 2014 and conformed to the inclusion criteria was taken. Cox proportional hazard model was used to analyze the risk factors of developing CVD after the kidney transplantation. 7 days, 1 month, 3 months, 6 months and 12 months before and after the operation, the data collection and following-up visits were respectively arranged...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28617169/the-frequency-and-associated-factors-for-bk-virus-infection-in-a-center-performing-mainly-living-kidney-transplantations
#9
Selma Alagoz, Mert Kuskucu, Sibel Gulcicek, Serkan Feyyaz Yalin, Meric Oruc, Kenan Midilli, Erkan Yılmaz, Mehmet Riza Altiparmak, Nurhan Seyahi
PURPOSE: BK virus (BKV) nephropathy has increasingly become an important cause of morbidity in renal transplant recipients. We evaluated the frequency and associated factors for BKV infection in a center performing mainly living donor transplantations over a long time period. METHODS: One hundred consecutive renal transplant patients were included. Quarterly visits were planned to examine urine for decoy cells and to measure the BKV DNA in the blood and urine. Renal biopsy was performed in case of deteriorated allograft function...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28611987/complement-in-kidney-transplantation
#10
REVIEW
Marek Cernoch, Ondrej Viklicky
The complement system is considered to be an important part of innate immune system with a significant role in inflammation processes. The activation can occur through classical, alternative, or lectin pathway, resulting in the creation of anaphylatoxins C3a and C5a, possessing a vast spectrum of immune functions, and the assembly of terminal complement cascade, capable of direct cell lysis. The activation processes are tightly regulated; inappropriate activation of the complement cascade plays a significant role in many renal diseases including organ transplantation...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28605781/everolimus-with-cyclosporine-withdrawal-or-low-exposure-cyclosporine-in-kidney-transplantation-from-month-3-a-multicentre-randomized-trial
#11
Klemens Budde, Martin Zeier, Oliver Witzke, Wolfgang Arns, Frank Lehner, Markus Guba, Johannes Jacobi, Volker Kliem, Petra Reinke, Ingeborg A Hauser, Bruno Vogt, Rolf Stahl, Thomas Rath, Michael Duerr, Eva-Maria Paulus, Christoph May, Martina Porstner, Claudia Sommerer
Background.: Randomized trials have shown that early adoption of everolimus-based immunosuppressive regimens without a calcineurin inhibitor (CNI) improves long-term kidney graft function, but the optimal strategy for CNI minimization remains uncertain. Methods.: In a prospective, randomized, multicentre, 12-month trial, 499 de novo kidney transplant patients were randomized at Month 3 to (i) remain on standard CNI (cyclosporine) therapy with mycophenolic acid, (ii) convert to everolimus with mycophenolic acid or (iii) start everolimus with reduced CNI and no mycophenolic acid (clinical trials registry: ClinicalTrials...
June 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28600850/eight-year-follow-up-in-pediatric-living-donor-kidney-recipients-receiving-alemtuzumab-induction
#12
Michael M Kaabak, Nadeen N Babenko, Ron Shapiro, Alexey A Maschan, Allan K Zokoev, Stanislav V Schekaturov, Julia N Vyunkova, Olga V Dymova
Recipient lymphocytes are crucial for direct and indirect pathways of allorecognition. We proposed that the administration of alemtuzumab several weeks pretransplantation could eradicate peripheral lymphatic cells and promote donor-specific acceptance. This was a single-center, retrospective review of 101 consecutive living donor kidney transplantations in pediatric patients (age 7 months-18 years), performed between September 2006 and April 2010. IS protocol included two 30 mg doses of alemtuzumab: The first was given 12-29 days prior to transplantation, and the second at the time of transplantation...
June 10, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28587616/a-double-blind-randomised-controlled-investigation-into-the-efficacy-of-mirococept-apt070-for-preventing-ischaemia-reperfusion-injury-in-the-kidney-allograft-empirikal-study-protocol-for-a-randomised-controlled-trial
#13
Theodoros Kassimatis, Anass Qasem, Abdel Douiri, Elizabeth G Ryan, Irene Rebollo-Mesa, Laura L Nichols, Roseanna Greenlaw, Jonathon Olsburgh, Richard A Smith, Steven H Sacks, Martin Drage
BACKGROUND: Delayed graft function (DGF) is traditionally defined as the requirement for dialysis during the first week after transplantation. DGF is a common complication of renal transplantation, and it negatively affects short- and long-term graft outcomes. Ischaemia reperfusion injury (IRI) is a prime contributor to the development of DGF. It is well established that complement system activation plays a pivotal role in the pathogenesis of IRI. Mirococept is a highly effective complement inhibitor that can be administered ex vivo to the donor kidney just before transplantation...
June 6, 2017: Trials
https://www.readbyqxmd.com/read/28583569/beneficial-effects-of-high-dose-mizoribine-on-abo-incompatible-living-related-kidney-transplantation-two-year-results-by-a-japanese-multicenter-study
#14
S Harada, T Nakamura, H Ushigome, N Akutsu, K Akioka, T Nakatani, N Yoshimura
BACKGROUND: Mizoribine (MZ) has been developed as an immunosuppressive agent in Japan, but it has a less-potent immunosuppressive effect up to 3 mg/kg/d. In the previous study, a Japanese multicenter study, we reported that high-dose MZ, at 6 mg/kg/d, with a calcineurin inhibitor was effective and safe in reducing the frequency of cytomegalovirus (CMV)-related events in ABO-incompatible (ABO-i) living-related kidney transplantation (LKT). In the present study, therefore, we investigated the effects of high-dose MZ with a CNI in ABO-i LKT recipients in a Japanese multicenter study...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28583522/effect-of-changes-in-body-mass-index-on-cardiovascular-outcomes-in-kidney-transplant-recipients
#15
K Y Kim, J-H Cho, H-Y Jung, J-Y Choi, S-H Park, C-D Kim, Y-L Kim, H Ro, S Lee, S-Y Han, C W Jung, J B Park, M S Kim, J Yang, C Ahn
BACKGROUND: A higher body mass index (BMI) before kidney transplantation (KT) is associated with increased mortality and allograft loss in kidney transplant recipients (KTRs). However, the effect of changes in BMI after KT on these outcomes remains uncertain. The aim of this study was to investigate the effect of baseline BMI and changes in BMI on clinical outcomes in KTRs. METHODS: A total of 869 KTRs were enrolled from a multicenter observational cohort study from 2012 to 2015...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28583517/association-studies-of-bone-morphogenetic-protein-2-gene-polymorphisms-with-acute-rejection-in-kidney-transplantation-recipients
#16
M-S Park, S K Kim, H J Park, H Seok, S W Kang, S H Lee, Y G Kim, J Y Moon, T H Kim, Y H Kim, S W Kang, J-H Chung, K H Jeong
OBJECTIVE: Bone morphogenetic proteins (BMP) belong to the transforming growth factor beta superfamily of proteins. This study was performed to evaluate the association of BMP gene polymorphisms with acute renal allograft rejection (AR) and graft dysfunction (GD) in Koreans. METHODS: Three hundred thirty-one patients who had kidney transplantation procedures were recruited. Transplantation outcomes were determined in terms of AR and GD criteria. We selected six single nucleotide polymorphisms (SNPs): rs1979855 (5' near gene), rs1049007 (Ser87Ser), rs235767 (intron), rs1005464 (intron), rs235768 (Arg190Ser), and rs3178250 (3; untranslated region)...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28581202/switch-to-an-everolimus-facilitated-cyclosporine-a-sparing-immunosuppression-improves-glycemic-control-in-selected-kidney-transplant-recipients
#17
Florian Kälble, Jörg Seckinger, Matthias Schaier, Christian Morath, Vedat Schwenger, Martin Zeier, Claudia Sommerer
BACKGROUND: Mammalian target of rapamycin inhibitors (mToRi) allow calcineurin inhibitor (CNI) sparing therapy in renal transplant recipients with possible beneficial effects on the long-term allograft function and cardiovascular risk. The influence of mToRi on glucose metabolism is still under discussion. METHODS: In a retrospective analysis, renal allograft recipients switched from a cyclosporine A (CsA) to an everolimus (EVR) based immunosuppression in the first year after transplantation were compared with patients on continued CsA treatment...
June 5, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28576438/increase-of-allosensitization-after-a-kidney-graft-failure-predictors-and-effect-on-retransplantation-outcomes
#18
Andreia Campos, Jorge Malheiro, Sandra Tafulo, Sofia Santos, Leonídeo Dias, La Salete Martins, Manuela Almeida, Sofia Pedroso, A Castro Henriques, António Cabrita
Patients who are candidates for a second kidney transplant (SKT) frequently have a higher level of panel reactive antibodies (PRA). We assessed the allosensitisation change after a first graft failure (GF), its predictors and impact on retransplantat outcomes. We retrospectively selected 140 adult patients who received a SKT. Recipient and donor characteristics were analyzed. We defined the delta PRA (dPRA) as the difference between peak PRA before the SKT and first one (cohort median value=+10%). Logistic regression analysis was used to determine risk factors for dPRA≥10% and acute rejection (AR) in the SKT...
May 30, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28573190/randomized-trial-of-machine-perfusion-versus-cold-storage-in-recipients-of-deceased-donor-kidney-transplants-with-high-incidence-of-delayed-graft-function
#19
Helio Tedesco-Silva, Juliano Chrystian Mello Offerni, Vanessa Ayres Carneiro, Mayara Ivani de Paula, Elias David Neto, Francine Brambate Carvalhinho Lemos, Lúcio Roberto Requião Moura, Alvaro Pacheco E Silva Filho, Mirian de Fátima de Morais Cunha, Erica Francisco da Silva, Luiz Antonio Miorin, Daniela Priscila Demetrio, Paulo Sérgio Luconi, Waldere Tania da Silva Luconi, Savina Adriana Bobbio, Liz Milstein Kuschnaroff, Irene Lourdes Noronha, Sibele Lessa Braga, Renata Cristina Barsante, João Cezar Mendes Moreira, Ida Maria Maximina Fernandes-Charpiot, Mario Abbud-Filho, Luis Gustavo Modelli de Andrade, Paula Dalsoglio Garcia, Luciana Tanajura Santamaria Saber, Alan Fernandes Laurindo, Pedro Renato Chocair, Américo Lourenço Cuvello Neto, Juliana Aparecida Zanocco, Antonio Jose Duboc de Almeida Soares Filho, Wilson Ferreira Aguiar, Jose Medina Pestana
BACKGROUND: This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). METHODS: In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF...
May 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28571996/the-effect-of-the-use-of-a-tnf-alpha-inhibitor-in-hypothermic-machine-perfusion-on-kidney-function-after-transplantation
#20
Piotr Diuwe, Piotr Domagala, Magdalena Durlik, Janusz Trzebicki, Andrzej Chmura, Artur Kwiatkowski
One of the most important problems in transplantation medicine is the ischemia/reperfusion injury of the organs to be transplanted. The aim of the present study was to assess the effect of tumor necrosis factor-alpha (TNF-alpha) inhibitor etanercept on the machine perfusion hypothermia of renal allograft kidney function and organ perfusion. No statistically significant differences were found in the impact of the applied intervention on kidney machine perfusion during which the average flow and vascular resistance were evaluated...
May 29, 2017: Contemporary Clinical Trials
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