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Acute kidney rejection

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https://www.readbyqxmd.com/read/28236795/therapeutic-monitoring-of-pediatric-transplant-patients-with-conversion-to-generic-tacrolimus
#1
Natalia Riva, Paulo Cáceres Guido, Nieves Licciardone, Oscar Imventarza, Marta Monteverde, Raquel Staciuk, Alberto Charroqui, Paula Schaiquevich
OBJECTIVE: Therapeutic monitoring during interchange of tacrolimus commercial formulations is essential to ensure similar exposure in transplant patients. However, there are limited data in the pediatric transplant population. This study aims to evaluate exposure, safety and efficacy in maintenance pediatric transplant patients under generic tacrolimus substitution. METHOD: Pediatric patients who underwent interchange of tacrolimus formulations were detected by the Service of Pharmacy and included in this study...
March 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28219603/acute-rejection-of-a-kidney-transplant-in-a-patient-with-common-variable-immunodeficiency-a-case-report
#2
O Al Nimri, A Rajput, E Martinez, J M Fahrenholz, P Paueksakon, A Langone, B P Concepcion
Common variable immunodeficiency is a primary immunodeficiency characterized by hypogammaglobulinemia and recurrent bacterial infections. We report a case of a 44-year-old male patient with end-stage renal disease and an established diagnosis of common variable immunodeficiency who underwent a living unrelated kidney transplant. He remained nearly infection free on maintenance immunoglobulin replacement. However, his posttransplant course was complicated by acute rejection that ultimately led to allograft loss...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28211034/infectious-complications-as-the-leading-cause-of-death-after-kidney-transplantation-analysis-of-more-than-10-000-transplants-from-a-single-center
#3
Flávio de Castro Rodrigues Ferreira, Marina Pontello Cristelli, Mayara Ivani Paula, Henrique Proença, Claudia Rosso Felipe, Helio Tedesco-Silva, José Osmar Medina-Pestana
AIM: To identify specific causes of graft failure in a large sample of kidney transplant patients from a middle-income, developing country. METHODS: Retrospective cohort study analyzing all consecutive single kidney transplants (KTs) performed at a single center in Brazil between January 1st 1998 and December 31st 2013. The database closing date was December 31st 2014. RESULTS: Out of 10,400 KTs, there were 1191 (11.45%) deaths with a functioning graft, 40 cases (0...
February 17, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28209246/the-clinical-course-of-iga-nephropathy-after-kidney-transplantation-and-its-management
#4
REVIEW
Sophia Lionaki, Konstantinos Panagiotellis, Christine Melexopoulou, John N Boletis
Immunoglobulin (Ig) A nephropathy is one of the most common primary glomerulonephritides worldwide causing end stage renal disease in up to 20-40% of affected patients, nearly two decades post diagnosis. Kidney transplantation is the treatment of choice for patients with renal failure, secondary to glomerular diseases. However, IgA nephropathy has a strong tendency to recur in the graft, and although initially thought to be a benign condition, several reports of graft loss, due to recurrent IgA nephropathy, there have been over the last three decades...
February 2, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28188669/orthogonal-comparison-of-molecular-signatures-of-kidney-transplants-with-subclinical-and-clinical-acute-rejection-equivalent-performance-is-agnostic-to-either-technology-or-platform
#5
S M Kurian, E Velazquez, R Thompson, T Whisenant, S Rose, N Riley, F Harrison, T Gelbart, J J Friedewald, J Charrette, S Brietigam, J Peysakhovich, M R First, M M Abecassis, D R Salomon
We performed orthogonal technology comparisons of concurrent peripheral blood and biopsy tissue samples from 69 kidney transplant recipients, who underwent a comprehensive algorithm-driven clinical phenotyping. The sample cohort included patients with normal protocol biopsies and stable transplant function (TX, n=25), subclinical acute rejection (subAR, n=23), and clinical acute rejection (cAR, n=21). Comparisons between microarray and RNA sequencing (RNA-seq) signatures were performed, demonstrating a strong correlation between the blood and tissue compartments for both technology platforms...
February 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28182044/efficacy-and-safety-of-early-tacrolimus-conversion-to-sirolimus-after-kidney-transplantation-long-term-results-of-a-prospective-randomized-study
#6
A E El-Agroudy, S M Alarrayed, S M Al-Ghareeb, E Farid, H Alhelow, S Abdulla
We report a prospective, open-label, randomized study to evaluate the safety and efficacy of converting patients with a stable renal function from tacrolimus (Tac)-based regimen to a sirolimus (SRL)-based regimen after kidney transplantation. Fifty-eight low-risk renal allograft recipients who receiving Tac 6 months posttransplant, were randomly assigned to continue Tac (n = 29) or convert to SRL (n = 29). We evaluated the 3-year outcomes including patient and graft survival, graft function, and safety profile...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28182043/deceased-donor-renal-transplantation-a-single-center-experience
#7
N Gopalakrishnan, T Dineshkumar, J Dhanapriya, R Sakthirajan, T Balasubramaniyan, N D Srinivasa Prasad, K Thirumalvalavan, S Murugananth, K Kawaskar
Deceased donor renal transplantation (DDRT) constitutes less than 5% of all kidney transplantats in India. A retrospective analysis of 173 deceased donor renal transplants performed in a public funded government hospital was done. Mean age of the recipients was 36 years (male:female ratio 2.4:1), and that of the donors was 32.3 years (male:female ratio 6:1). The cold ischemic time was 340 ± 170 minutes. Mean follow-up period was 36 months. Forty one patients died, 75% of them in the first post - transplant year...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28176336/effect-of-hypothermic-machine-perfusion-on-the-preservation-of-kidneys-donated-after-cardiac-death-a-single-center-randomized-controlled-trial
#8
Wei Wang, Dawei Xie, Xiaopeng Hu, Hang Yin, Hang Liu, Xiaodong Zhang
To assess the application of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors, 24 pairs of DCD kidneys were randomly divided into two groups: one of the paired kidneys from the same donor was perfused with the LifePort machine (hypothermic machine perfusion [HMP]), and the contralateral kidney was prepared using common static cold preservation (CCP). The two groups were compared with respect to the incidence of delayed graft function (DGF), level of graft function, and pathological changes in time-zero biopsy specimens...
February 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28168079/successful-treatment-of-plasma-cell-rich-acute-rejection-using-pulse-steroid-therapy-alone-a-case-report
#9
Yo Komatsuzaki, Yasuyuki Nakada, Izumi Yamamoto, Mayuko Kawabe, Takafumi Yamakawa, Ai Katsuma, Haruki Katsumata, Aki Mafune, Akimitsu Kobayashi, Yusuke Koike, Hiroki Yamada, Jun Miki, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Keitaro Yokoyama, Hiroyasu Yamamoto, Takashi Yokoo
Despite the recent development of immunosuppressive agents, plasma cell-rich acute rejection (PCAR) has remained refractory to treatment. Herein, we report an unusual case of PCAR that responded well to pulse steroid therapy alone. A 47-year-old man was admitted for a protocol biopsy three months after kidney transplantation, with a stable serum creatinine level of 1.6 mg/dL. Histological examination showed focal aggressive tubulointerstitial inflammatory cell infiltration of predominantly polyclonal mature plasma cells, leading to our diagnosis of PCAR...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28166398/belatacept-after-kidney-transplantation-in-adolescents-a-retrospective-study
#10
Christian Lerch, Nele K Kanzelmeyer, Thurid Ahlenstiel-Grunow, Kerstin Froede, Martin Kreuzer, Jens Drube, Murielle Verboom, Lars Pape
Regardless of recipient age at kidney transplantation (KTx), patients are at greatest risk for graft loss in adolescence, partly due to non-adherence to an oral immunosuppressive regimen. Belatacept, a non-nephrotoxic, first-in-class immunosuppressant that inhibits co-stimulation of T-cells, requires intravenous application only every 4 weeks, potentially leading to better adherence. However, it is only approved for use in adults. We report here the findings of the first study of belatacept in adolescents, comprising all patients in our department switched to belatacept post-KTx...
February 6, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28166393/donor-specific-antibodies-c1q-binding-improvement-in-kidney-graft-management
#11
Sylvie Ferrari-Lacraz
The diagnosis of acute antibody mediated rejection (ABMR) after kidney transplantation is based on three parameters: 1) decreased renal function, 2) histopathological signs of rejection, 3) presence of Donor Specific Antibody (DSA) [1]. Patient survival, as well as graft survival have improved since 5 to 10 years [2], thanks to several factors, including better management of patients, better immunosuppressive regimens, detection and avoidance of DSA. Although anti-HLA antibodies follow-up have improved ABMR management, its treatment remains challenging, and outcome may be worsened because of a delay in the diagnosis...
February 6, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28164508/urinary-neutrophil-gelatinase-associated-lipocalin-does-not-distinguish-acute-rejection-from-other-causes-of-acute-kidney-injury-in-pediatric-renal-transplant-recipients
#12
Tomas Seeman, Karel Vondrak, Jiri Dusek, Nadezda Simankova, Jakub Zieg, Jaromir Hacek, Maria Chadimova, Bruno Sopko, Magdalena Fortova
BACKGROUND: The aim of this prospective single center study was to investigate the ability of urinary neutrophil gelatinase-associated lipocalin (NGAL) to distinguish acute rejection from other causes of acute kidney injury (AKI) in children after renal transplantation. METHODS: Fifteen children fulfilled the inclusion criteria (acute kidney injury (AKI) with allograft biopsy, at least 21 days after renal transplantation, no sepsis) during 2013 - 2014 in our pediatric transplantation center...
January 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28160552/conversion-to-mammalian-target-of-rapamycin-inhibitors-in-kidney-transplant-recipients-with-de-novo-cancers
#13
Chi Yuen Cheung, Maggie Kam Man Ma, Wai Leung Chak, Ka Foon Chau, Sydney Chi Wai Tang
OBJECTIVE: To investigate the impact of mammalian target of rapamycin (mTOR) inhibitor conversion together with minimization of calcineurin inhibitor on allograft outcome and patient survival in kidney transplant recipients with post-transplant cancers. METHODS: A retrospective study of all kidney transplant recipients diagnosed to have post-transplant cancers between the period 1/1/1994 and 30/6/2015. Patients were divided into 2 groups: mTOR inhibitor group and non-conversion group...
January 30, 2017: Oncotarget
https://www.readbyqxmd.com/read/28160460/the-timing-of-immunomodulation-induced-by-mesenchymal-stromal-cells-determines-the-outcome-of-the-graft-in-experimental-renal-allotransplantation
#14
Ana Merino, Elia Ripoll, Laura de Ramon, Nuria Bolaños, Montserrat Goma, Oriol Bestard, Nuria Lloberas, Josep M Grinyo, Juan Torras
<p>The immunomodulatory characteristics of mesenchymal stromal cells (MSCs) may lead to multifaceted strategies in rejection of organ transplantation. This study was designed to investigate the effect of the donor-type MSCs from Wistar rats firstly on the immune system of immunocompetent Lewis rats and secondly the rejection responses in a renal transplantation model of Wistar to Lewis.</p><p>In the first experimental model, MSCs from bone marrow induced a systemic immune response in the immunocompetent Lewis rats, characterized by two different phases...
February 3, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28157649/prograf-produces-more-benefits-for-cyp3a5-low-expression-patients-in-early-stage-after-kidney-transplantation
#15
Bohan Fan, Kui Qiu, Yihang Jiang, Xiaopeng Hu, Hang Yin, Wei Wang, Liang Ren, Hang Liu, Wei Wang, Xiaodong Zhang
OBJECTIVE: This study is to analyze concentration changes of the prolonged-release and shorter-acting formulation of tacrolimus in patients with different CYP3A5 genotypes after kidney transplantation. METHODS: A single-factor retrospective analysis was performed in patients underwent allogeneic kidney transplantation with postoperative administration of Advagraf or Prograf in our hospital from May 2013 to June 2014. The CYP3A5 genotypes were determined, and tacrolimus trough concentrations in whole blood were measured within 28days after transplantation...
January 31, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28145624/severe-intellectual-disability-is-not-a-contraindication-to-kidney-transplantation-in-children
#16
Ashton Chen, Alan Farney, Gregory B Russell, Linda Nicolotti, Robert Stratta, Jeffrey Rogers, Jen-Jar Lin
Renal transplantation in children with ID is controversial. Acceptability of these children as candidates varies between programs. Limited outcome data in pediatric renal TXP recipients with cognitive impairment diminish their access to TXP. A retrospective chart review was performed of all children who underwent renal transplantation between January 1, 2002 and June 30, 2012 (N=72). Patients were divided into two groups, those with ID prior to transplantation (n=10) and those without (non-ID; n=62). Graft survival and BPAR episodes were compared between the two groups using Kaplan-Meier estimates...
February 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28141897/association-of-clinical-events-with-everolimus-exposure-in-kidney-transplant-patients-receiving-low-doses-of-tacrolimus
#17
F Shihab, Y Qazi, S Mulgaonkar, K McCague, D Patel, V R Peddi, D Shaffer
: A key objective in the use of immunosuppression following kidney transplantation is to attain the optimal balance between efficacy and safety. In a Phase IIIb, multi-center, randomized, open-label, non-inferiority study, incidence of clinical events, renal dysfunction and adverse events (AEs) were analyzed at 12 months in 309 de novo renal transplant recipients receiving everolimus (EVR), low-dose Tac (LTac) and prednisone. Cox proportional hazard regression modeling was used to estimate the probability of clinical events at specified combinations of time-normalized EVR and Tac trough concentrations...
January 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28138224/comparison-of-the-long-term-efficacy-and-safety-of-generic-tacrobell-with-original-tacrolimus-prograf-in-kidney-transplant-recipients
#18
Seung Yeon Son, Hye Ryoun Jang, Jung Eun Lee, Heejin Yoo, Kyunga Kim, Jae Berm Park, Sung Joo Kim, Ha Young Oh, Wooseong Huh
This study aimed to evaluate the long-term efficacy and safety of a generic tacrolimus (Tacrobell [TCB]) compared to the original tacrolimus (Prograf [PGF]) in kidney transplant recipients. In this retrospective observational study, we analyzed the data from 444 patients who took TCB as a first-line immunosuppressive drug and 245 patients who took PGF. The 5-year graft survival rate was 92% for patients in the PGF group and 97% for patients in the TCB group, respectively. Cox proportional hazards for a one-sided, noninferiority model showed noninferiority (upper confidence interval [CI] limit of the hazard ratio [HR]<1...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28137532/efficacy-of-cordyceps-sinensis-as-an-adjunctive-treatment-in-kidney-transplant-patients-a-systematic-review-and-meta-analysis
#19
REVIEW
Bee Yean Ong, Zoriah Aziz
OBJECTIVES: Cordyceps sinensis (cordyceps) is a fungus used in traditional Chinese medicine as adjuvant immunosuppressive agent in patients with kidney transplant. This review evaluates current evidence on the efficacy and safety of natural and fermented cordyceps preparations in patients with kidney transplant. METHODS: English and Chinese electronic databases including The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and CNKI (China National Knowledge Infrastructure) were searched up to December 2015 for relevant randomized controlled trials...
February 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28135784/morphologic-patterns-and-treatment-of-transplant-glomerulopathy-a-retrospective-analysis
#20
Rui Abreu, Fernanda Carvalho, Helena Viana, Isabel Mesquita, Marília Possante, Inês Aires, Fernando Caeiro, Cecília Silva, Patrícia Cotovio, Aníbal Ferreira, Francisco Remédio, Fernando Nolasco
Transplant glomerulopathy is mainly due to chronic antibody-mediated rejection and actually represents a major cause of long-term allograft failure. The lack of effective treatment remains a serious problem in transplantation. A retrospective and uni-center study was performed in 48 kidney allograft recipients with transplant glomerulopathy between January 2010 and December 2015. Median time for diagnosis was 7.1 (3.6-11.8) years post-transplant. Light microscopy showed severity of transplant glomerulopathy in the majority of patients (cg1=10...
January 30, 2017: Clinical Transplantation
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