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Acute kidney rejection

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https://www.readbyqxmd.com/read/29766640/subclinical-inflammation-phenotypes-and-long-term-outcomes-after-pediatric-kidney-transplantation
#1
Michael E Seifert, Megan V Yanik, Daniel I Feig, Vera Hauptfeld-Dolejsek, Elizabeth C Mroczek-Musulman, David R Kelly, Frida Rosenblum, Roslyn B Mannon
The implementation of surveillance biopsies in pediatric kidney transplantation remains controversial. Surveillance biopsies detect subclinical injury prior to clinical dysfunction, which could allow for early interventions that prolong allograft survival. We conducted a single-center retrospective cohort study of 120 consecutive pediatric kidney recipients, of whom 103 had surveillance biopsies ≤ 6 months post-transplant. We tested the hypothesis that subclinical inflammation (borderline or T cell-mediated rejection without clinical dysfunction) is associated with a 5-year composite endpoint of acute rejection and allograft failure...
May 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29762458/association-between-duration-of-delayed-graft-function-acute-rejection-and-allograft-outcome-after-deceased-donor-kidney-transplantation
#2
Wai H Lim, David W Johnson, Armando Teixeira-Pinto, Germaine Wong
BACKGROUND: Prolonged duration of delayed graft function (DGF) may be associated with adverse allograft outcomes, but the association between threshold duration of DGF, acute rejection and long-term allograft loss remains undefined. We aimed to determine the impact of DGF duration on allograft outcomes and to assess whether this association was mediated by acute rejection. METHODS: Using data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry, Cox proportional modelling was used to determine the association between quartiles of DGF duration, acute rejection at 6 months and death-censored graft loss (DCGL)...
May 14, 2018: Transplantation
https://www.readbyqxmd.com/read/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#3
Johan Noble, Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
Cornerstone immunosuppressive therapy currently relies on immediate-release tacrolimus, a calcineurin inhibitor (CNI) that is potentially nephrotoxic and is more diabetogenic than cyclosporine A. Two new formulations of tacrolimus have been launched: an extended-release formulation (Advagraf®/Astagraf XL®, Astellas company) and a long-lasting formulation (Envarsus®, Veloxis company). Area covered: Herein, we assess the efficacy of an extended-release formulation of tacrolimus (Advagraf®/Astagraf XL®) used in conjunction with or without an induction therapy (i...
May 14, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29754746/rs3212227-snp-in-the-il12b-gene-prevents-delayed-graft-function-after-kidney-transplantation
#4
Vladimir Perovic, Milos Markovic, Milica Kravljaca, Emina Milosevic, Milica Djoric, Vera Pravica, Radomir Naumovic
BACKGROUND AND AIMS: Transplantation is the best treatment option for end stage kidney disease. The most common early complications in post-transplant period are acute rejection (AR) of the graft and delayed graft function (DGF). The underlying mechanisms in these events are heterogeneous and at least in part involve cytokine genes which regulate immune response to allograft. We have investigated whether functional single nucleotide polymorphisms (SNP) in the genes encoding IFN-γ (IFNG), TNF (TNFA), IL-10 (IL10) and p40 subunit of IL-12/IL-23 (IL12B) could predict risk of AR and DGF in kidney allograft recipients...
May 10, 2018: Archives of Medical Research
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#5
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29733487/the-prognostic-value-of-urinary-chemokines-at-6-months-after-pediatric-kidney-transplantation
#6
Claire Mockler, Atul Sharma, Ian W Gibson, Ang Gao, Alexander Wong, Julie Ho, Tom D Blydt-Hansen
Pediatric kidney transplantation is lifesaving, but long-term allograft survival is still limited by injury processes mediated by alloimmune inflammation that may otherwise be clinically silent. Chemokines associated with alloimmune inflammation may offer prognostic value early post-transplant by identifying patients at increased risk of poor graft outcomes. We conducted a single-center prospective cohort study of consecutive pediatric kidney transplant recipients (<19 years). Urinary CCL2 and CXCL10 measured at 6 months post-transplant were evaluated for association with long-term eGFR decline, allograft survival, and concomitant acute cellular rejection histology...
May 7, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29731098/efficacy-and-safety-of-induction-therapy-in-kidney-transplantation-a-network-meta-analysis
#7
S D Hwang, J H Lee, S W Lee, K-M Park, J K Kim, M-J Kim, J H Song
BACKGROUND: Rejection and infection can occur after kidney transplantation and are important factors in preserving graft kidney function. The use of immunosuppressant agents in transplantation is therefore important, and the question of which induction therapy should be used as an immunosuppressant is controversial. OBJECTIVE: The goal of this study was to assess the comparative benefits and harms of various maintenance immunosuppressive induction agents in adults undergoing kidney transplantation by using a network meta-analysis and to generate rankings of the different immunosuppressive regimens according to their safety and efficacy...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731097/desensitization-with-the-use-of-an-antibody-removal-free-protocol-in-abo-incompatible-kidney-transplant-recipients-with-a-low-anti-a-b-antibody-titer
#8
K Nanmoku, T Shinzato, T Kubo, T Shimizu, T Kimura, T Yagisawa
BACKGROUND: Desensitization for ABO-incompatible (ABOi) kidney transplantation mainly comprises removal of antibodies with the use of apheresis and suppression of antibody (Ab) production with the use of rituximab. This study aimed to estimate the outcomes of ABOi kidney transplantation with the use of an Ab removal-free protocol to avoid complications associated with apheresis. METHODS: A total of 32 de novo consecutive adults who underwent ABOi living-donor kidney transplantation were retrospectively evaluated...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731065/vdj-gene-usage-of-b-cell-receptors-in-peripheral-blood-of-abo-incompatible-kidney-transplantation-patients
#9
H J Jeon, T Fang, J-G Lee, J Y Jang, K Kim, S Choi, J-J Yan, J H Ryu, T Y Koo, C Ahn, J Yang
INTRODUCTION: B cell subtypes and immunoglobulin variable (V), diversity (D), joining (J) gene segment usage of B cell receptors in ABO-incompatible (ABOi) kidney transplantation (KT) in comparison to ABO-compatible KT have not been studied. The aims of this study were to analyze the VDJ gene segment usages of B cell receptors in peripheral blood of ABOi KT recipients. METHODS: Eighteen ABOi KT patients with accommodation (ABOiA), 10 ABO-compatible stable KT patients (ABOcS), and 10 ABOi KT patients with biopsy-proven acute antibody-mediated rejection (ABOiR) at day 10 after transplantation were selected...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731057/clinical-outcomes-of-kidney-transplantation-in-patients-with-biopsy-proven-glomerulonephritis
#10
H Park, W Y Park, S S Kang, S M Yeo, S Han, S B Park, K Jin
BACKGROUND: The clinical outcomes after kidney transplantation (KT) according to the types of glomerulonephritis (GN) as the cause of end-stage renal disease (ESRD) are various, but there are not many studies on this. METHODS: Among 1,253 patients who had KT between November 1982 and January 2017, 183 recipients with biopsy-proven GN as the primary cause of ESRD were enrolled. We analyzed the incidence of recurrent GN and the factors associated with recurrence and graft and patient survivals...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731055/is-the-clinical-outcome-good-or-bad-in-patients-hospitalized-within-1-year-after-kidney-transplantation
#11
W Y Park, S S Kang, K Jin, S B Park, S Han
BACKGROUND: Although the hospitalization rate at early period of kidney transplantation (KT) is still high, the association between the hospitalization within 1 year after KT and graft survival is unclear. We investigated the incidence and causes of hospitalization and clinical outcome of the patients hospitalized within 1 year after KT. METHODS: We retrospectively analyzed 174 KT recipients (KTRs) hospitalized within 1 year after KT between 2013 and 2015. RESULTS: Among them, 84 (48%) KTRs were admitted within 1 year after KT, and the number of hospitalizations was 116...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29725592/urinary-virome-perturbations-in-kidney-transplantation
#12
Tara K Sigdel, Neil Mercer, Sharvin Nandoe, Carrie D Nicora, Kristin Burnum-Johnson, Wei-Jun Qian, Minnie M Sarwal
The human microbiome is important for health and plays a role in essential metabolic functions and protection from certain pathogens. Conversely, dysbiosis of the microbiome is seen in the context of various diseases. Recent studies have highlighted that a complex microbial community containing hundreds of bacteria colonizes the healthy urinary tract, but little is known about the human urinary viruses in health and disease. To evaluate the human urinary virome in the context of kidney transplantation (tx), variations in the composition of the urinary virome were evaluated in urine samples from normal healthy volunteers as well as patients with kidney disease after they had undergone kidney tx...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29723212/from-arterial-stiffness-to-kidney-graft-microvasculature-mortality-and-graft-survival-within-a-cohort-of-220-kidney-transplant-recipients
#13
Lynda Cheddani, Camélia Radulescu, Michel Chaignon, Alexandre Karras, Yann Neuzillet, Jean-Paul Duong, Nahid Tabibzadeh, Emmanuel Letavernier, Michel Delahousse, Jean-Philippe Haymann
BACKGROUND: Aortic stiffness assessed by carotid-femoral pulse wave velocity (CF-PWV) is a predictor of mortality in several populations. However, little is known in kidney transplant recipients. Our objectives were to evaluate the ability of CF-PWV measured 3 months following transplantation to predict mortality, graft loss and its potential links to measured Glomerular Filtration Rate (mGFR) or kidney graft microvasculature parameters. METHODS: The study is based on a monocentric retrospective cohort including 220 adult kidney graft recipients evaluated three months after transplantation...
2018: PloS One
https://www.readbyqxmd.com/read/29722128/five-year-outcomes-in-kidney-transplant-patients-randomized-to-everolimus-with-cyclosporine-withdrawal-or-low-exposure-cyclosporine-versus-standard-therapy
#14
Claudia Sommerer, Michael Duerr, Oliver Witzke, Frank Lehner, Wolfgang Arns, Volker Kliem, Daniel Ackermann, Markus Guba, Johannes Jacobi, Ingeborg A Hauser, Rolf Stahl, Petra Reinke, Thomas Rath, Justyna Veit, Arianeb Mehrabi, Martina Porstner, Klemens Budde
HERAKLES was a one-year randomized, multicenter trial. Patients were randomized at three months after kidney transplantation to remain on cyclosporine-based therapy, switch to everolimus without a calcineurin inhibitor (CNI), or switch to everolimus with low-exposure cyclosporine. Overall, 417/497 (83.9%) patients from the core study entered a four-year extension study. The randomized regimen was continued to year 5 in 75.9%, 41.9% and 24.6% of patients in the standard-CNI, CNI-free and low-CNI groups, respectively...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29719109/belatacept-during-pregnancy-in-renal-transplant-recipients-two-case-reports
#15
Jenna Combs, Anna Kagan, Mark Boelkins, Lisa Coscia, Michael Moritz, R Michael Hofmann
Impaired fertility is common among patients with chronic organ failure, including end stage renal disease (ESRD). Women of child-bearing age undergoing transplantation may experience rapid return of fertility. Pregnancy post-transplant presents numerous risks for the patient, fetus, and allograft. Maternal risks include hypertension and preeclampsia. Allograft risks include acute rejection and failure of the organ, and fetal risks include miscarriage, birth defects from immunosuppressants, premature delivery, and low birth weight...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29709320/reactivation-of-hepatitis-b-virus-in-kidney-transplant-recipients-with-previous-clinically-resolved-infection-a-single-center-experience
#16
Catarina Meng, Carolina Belino, Luciano Pereira, Ana Pinho, Susana Sampaio, Isabel Tavares, Manuela Bustorff, António Sarmento, Manuel Pestana
BACKGROUND: Hepatitis B virus (HBV) reactivation in kidney transplant recipients (KTR) involves important morbidity and mortality. Despite being more common in patients who are HBsAg-positive, it may occur in patients with clinically resolved infection (HBsAg-negative and anti-HBc-positive), in whom the presence of the protective anti-HB antibody is thought to decrease the risk of reactivation. Data regarding reactivation rates in this population are scarce. OBJECTIVE: To retrospectively evaluate the risk of HBV reactivation in KTR with previously resolved infection...
April 27, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29707626/single-graft-utilization-from-donors-with-severe-acute-kidney-injury-after-circulatory-death
#17
Yusuke Tomita, Kazuhiro Iwadoh, Yuichi Ogawa, Katsuyuki Miki, Kotaro Kai, Akihito Sannomiya, Toru Murakami, Ichiro Koyama, Kumiko Kitajima, Ichiro Nakajima, Shohei Fuchinoue
Chronic shortages of organs for transplantation have led to the use of marginal kidneys from donors after circulatory death with acute kidney injury (AKI), but the utilization of kidneys with severe AKI is not well established. We retrospectively analyzed eight kidney transplantation (KTx) cases from donation after circulatory death (DCD) with terminal creatinine (t-Cr) concentrations higher than 10.0 mg/dL and/or oliguria for more than 5 days (AKI network criteria: stage III). Although all patients showed delayed graft function, no cases of primary nonfunction (PNF) were found...
April 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29694722/transplantation-of-hepatitis-c-virus-infected-kidneys-into-hepatitis-c-virus-uninfected-recipients
#18
REVIEW
Meghan E Sise, Donald F Chute, Jenna L Gustafson, David Wojciechowski, Nahel Elias, Raymond T Chung, Winfred W Williams
Long wait times for kidney transplant and the high risk of mortality on dialysis have prompted investigation into strategies to increase organ allocation and decrease discard rates of potentially viable kidneys. Organs from hepatitis C virus (HCV) antibody positive donors are often rejected; nearly 500 HCV-infected kidneys are discarded annually in the United States. Due the opioid epidemic, the number of HCV-infected donors has increased because of a rise in both new HCV infections and drug-related deaths...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29694721/hepatitis-c-virus-infection-in-kidney-transplantation-changing-paradigms-with-novel-agents
#19
REVIEW
Yuvaram N V Reddy, David Nunes, Vipul Chitalia, Craig E Gordon, Jean M Francis
Hepatitis C virus (HCV) is a common cause of increased morbidity and mortality in kidney transplant patients. It is associated with posttransplant glomerulonephritis, chronic allograft nephropathy, and New Onset Diabetes after Transplant (NODAT). In the past, HCV was difficult to treat due to the presence of interferon alpha-based therapies that were difficult to tolerate and were associated with adverse side-effects, such as the risk of rejection. With the advent of oral directly acting antiviral therapies, the landscape for HCV and transplantation has changed...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29693023/kidney-transplantation-the-challenge-of-human-leukocyte-antigen-and-its-therapeutic-strategies
#20
REVIEW
Tilahun Alelign, Momina M Ahmed, Kidist Bobosha, Yewondwossen Tadesse, Rawleigh Howe, Beyene Petros
Kidney transplantation remains the treatment of choice for end-stage renal failure. When the immune system of the recipient recognizes the transplanted kidney as a foreign object, graft rejection occurs. As part of the host immune defense mechanism, human leukocyte antigen (HLA) is a major challenge for graft rejection in transplantation therapy. The impact of HLA mismatches between the donor and the potential recipient prolongs the time for renal transplantation therapy, tethered to dialysis, latter reduces graft survival, and increases mortality...
2018: Journal of Immunology Research
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