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Acute kidney rejection

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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
#1
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/28731207/polyclonal-and-monoclonal-antibodies-for-treating-acute-rejection-episodes-in-kidney-transplant-recipients
#2
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
#3
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/28726586/application-of-ureterorenoscope-and-flexible-ureterorenoscope-lithotripsy-in-removing-calculus-from-extracorporeal-living-donor-renal-graft-a-single-center-experience
#4
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
https://www.readbyqxmd.com/read/28714235/tuberculosis-after-kidney-transplantation-is-associated-with-significantly-impaired-allograft-function
#5
Silvana Daher Costa, Tainá Veras de Sandes-Freitas, Camilla Neves Jacinto, Lorena Vasconcelos Mesquita Martiniano, Yago Sucupira Amaral, Fernando José Villar Nogueira Paes, Maria Luiza de Mattos Brito Oliveira Sales, Ronaldo de Matos Esmeraldo, Elizabeth de Francesco Daher
BACKGROUND: This study aimed to evaluate renal function before, during and after the course of tuberculosis (TB) disease in kidney transplant recipients; and assess the risk factors for non-recovery of baseline renal function. METHODS: We performed a retrospective, single-center cohort study, including all patients with confirmed or presumed TB diagnosis after kidney transplant (n=34, 2.1%). Renal function was assessed by serum creatinine (Cr) and glomerular filtration rate (GFR) adjusted for deaths and graft losses...
July 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28709641/glucocest-magnetic-resonance-imaging-in%C3%A2-vivo-may-be-diagnostic-of-acute-renal-allograft-rejection
#6
Dominik Kentrup, Philipp Bovenkamp, Annika Busch, Katharina Schuette-Nuetgen, Helga Pawelski, Hermann Pavenstädt, Eberhard Schlatter, Karl-Heinz Herrmann, Jürgen R Reichenbach, Bettina Löffler, Barbara Heitplatz, Veerle Van Marck, Nirbhay N Yadav, Guanshu Liu, Peter C M van Zijl, Stefan Reuter, Verena Hoerr
Acute cellular renal allograft rejection (AR) frequently occurs after kidney transplantations. It is a sterile T-cell mediated inflammation leading to increased local glucose metabolism. Here we demonstrate in an allogeneic model of Brown Norway rat kidneys transplanted into uninephrectomized Lewis rats the successful implementation of the recently developed glucose chemical exchange saturation transfer (glucoCEST) magnetic resonance imaging. This technique is a novel method to assess and differentiate AR...
July 11, 2017: Kidney International
https://www.readbyqxmd.com/read/28708813/application-and-interpretation-of-histocompatibility-data-in-liver-transplantation
#7
Russell N Wesson, Eric W Etchill, Jacqueline Garonzik-Wang
PURPOSE OF REVIEW: There has been a resurgence of interest in histocompatibility as it applies to liver transplantation. The association of persistent and de-novo donor specific antibody (DSA) and outcomes after liver transplantation continues to be investigated. RECENT FINDINGS: Consensus continues to evolve regarding the existence of acute and chronic antibody-mediated rejection (AMR) and pathogenicity of DSA and associated pathologic findings after liver transplantation...
July 13, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28707779/belatacept-rescue-therapy-in-kidney-transplant-recipients-with-vascular-lesions-a-case-control-study
#8
D Bertrand, L Cheddani, I Etienne, A François, M Hanoy, C Laurent, L Lebourg, F Le Roy, L Lelandais, M C Loron, M Godin, D Guerrot
Immunosuppression in kidney transplant recipients with decreased graft function and severe histological vascular changes can be particularly challenging. Belatacept could be a valuable option, as a rescue therapy in this context. We report a retrospective case control study comparing a CNI to belatacept switch in 17 patients with vascular damage and low eGFR to a control group of 18 matched patients with CNI continuation. Belatacept switch was performed on average 51.5 months after kidney transplantation (6...
July 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28706977/acute-rejection-after-kidney-transplantation-associates-with-circulating-micrornas-and-vascular-injury
#9
Roel Bijkerk, Barend W Florijn, Meriem Khairoun, Jacques M G J Duijs, Gurbey Ocak, Aiko P J de Vries, Alexander F Schaapherder, Marko J K Mallat, Johan W de Fijter, Ton J Rabelink, Anton Jan van Zonneveld, Marlies E J Reinders
BACKGROUND: Acute rejection (AR) of kidney transplants is associated with the loss of endothelial integrity, microvascular rarefaction and, ultimately, graft dysfunction. Circulating angiogenic microRNAs (miRNAs) may serve as markers for microvascular injury. Here, we investigated the short- and long-term effects of AR after kidney transplantation on systemic vascular injury and the associated circulating miRNA profile. METHODS: Systemic vascular injury was determined by measuring capillary tortuosity and density within the oral mucosa as well as by assessing circulating levels of angiopoietin-2/angiopoietin-1 ratio, vascular endothelial growth factor and soluble thrombomodulin...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28704335/mesenchymal-stromal-cell-therapy-for-solid-organ-transplantation
#10
Marlies E J Reinders, Cees van Kooten, Ton J Rabelink, Johan W de Fijter
Improvement of long term outcome of kidney transplantation has reached its limits, due to consequences of efficient, but nonspecific immunosuppressive drugs. Mesenchymal Stromal Cells (MSC) have been proposed as an alternative strategy for more refined therapy. The interest in MSCs comes from their antiinflammatory properties on the 1 hand and their propensity to ameliorate tissue damage and mediate repair on the other hand. First clinical trials have demonstrated that administration of MSCs in kidney transplant recipients is safe and feasible and follow-up studies have been initiated with the desired clinical efficacy to reduce ischemia reperfusion injury, to prevent/reverse acute transplant rejection, and to improve long-term transplant survival with minimization of immunosuppression...
July 12, 2017: Transplantation
https://www.readbyqxmd.com/read/28700465/alemtuzumab-versus-antithymocyte-globulin-induction-therapies-in-kidney-transplantation-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
Jianming Zheng, Wenli Song
Alemtuzumab (ALEM) is widely used as an induction therapy for organ transplantation, and numerous randomized controlled trials (RCTs) have been published to evaluate its efficacy and safety in kidney transplantation as compared with antithymocyte globulin (ATG). The purpose of this study was to compare the benefits and safety of ALEM with those of ATG for induction therapy.A systematic literature search in three electronic databases, including PubMed, EmBase, and Cochrane Library, since inception through October 2016, was conducted to identify potential RCTs for inclusion...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#12
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Genomics, proteomics and molecular biology lead to tremendous advances in all fields of medical sciences. Among these the finding of biomarkers as non invasive indicators of biologic processes represents a useful tool in the field of transplantation. In addition to define the principal characteristics of the biomarkers, this review will examine the biomarker usefulness in the different clinical phases following renal transplantation. Biomarkers of ischemia-reperfusion injury and of delayed graft function are extremely important for an early diagnosis of these complications and for optimizing the treatment...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28697714/association-between-overweight-and-renal-transplant-outcomes-a-meta-analysis
#13
Congran Li, Hailong Jin, Li Xiao, Zhouli Li, Ming Cai, Bingyi Shi
OBJECTIVES: Our study aimed to evaluate the effects of being overweight on kidney transplant. MATERIALS AND METHODS: Our study evaluated kidney transplant recipients with body mass index ranging from 25 to 30 kg/m² versus patients with body mass index ranging from 18.5 to 29.9 kg/m², who were identified through PubMed, Embase, and Cochrane Library searches up to October 2015. Outcomes analyzed included delayed graft function, acute rejection, graft loss, and patient survival...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28694560/peritransplant-soluble-cd30-as-a-risk-factor-for-slow-kidney-allograft-function-early-acute-rejection-worse-long-term-allograft-function-and-patients-survival
#14
Andriy V Trailin, Tetyana I Ostapenko, Tamara N Nykonenko, Svitlana N Nesterenko, Olexandr S Nykonenko
BACKGROUND: We aimed to determine whether serum soluble CD30 (sCD30) could identify recipients at high risk for unfavorable early and late kidney transplant outcomes. METHODS: Serum sCD30 was measured on the day of kidney transplantation and on the 4th day posttransplant. We assessed the value of these measurements in predicting delayed graft function, slow graft function (SGF), acute rejection (AR), pyelonephritis, decline of allograft function after 6 months, and graft and patient survival during 5 years of follow-up in 45 recipients...
2017: Disease Markers
https://www.readbyqxmd.com/read/28686316/is-pre-transplant-sensitization-against-angiotensin-ii-type1-receptor-still-a-risk-factor-of-graft-and-patient-outcome-in-kidney-transplantation-in-the-anti-hla-luminex-era
#15
C Deltombe, F Gillaizeau, D Anglicheau, E Morelon, K Trébern-Launay, F Le Borgne, M Rimbert, P Guérif, S Malard-Castagnet, Y Foucher, M Giral
AIMS: We aimed to assess the correlation of anti-angiotensin II type 1 receptor antibodies (anti-AT1R-Abs) before transplantation on a multicentric cohort of kidney transplant recipients (2008-2012), under Tacrolimus and Mycofenolate mofetil (MMF), screened by Luminex technology for anti -HLA immunization. METHODS: Anti-AT1R-antibody levels were measured by ELISA in pre-transplantation sera of 940 kidney recipients from 3 French centers of the DIVAT cohort. Multivariable Cox models estimated the association between pre-transplant anti-angiotensin II type 1 receptor antibodies and time to acute rejection episodes (ARE) or time to graft failure...
July 7, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28682798/accommodation-and-related-conditions-in-vascularized-composite-allografts
#16
Jeffrey L Platt, Christina L Kaufman, Mayara Garcia de Mattos Barbosa, Marilia Cascalho
PURPOSE OF REVIEW: The outcome of vascularized composite allografts (VCA) often appear unrelated to the presence of donor-specific antibodies (DSA) in blood of the recipient or deposition of complement in the graft. The attenuation of injury and the absence of rejection in other types of grafts despite manifest donor-specific immunity have been explained by accommodation (acquired resistance to immune-mediated injury), adaptation (loss of graft antigen) and/or enhancement (antibody-mediated antigen blockade)...
July 5, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28682561/-immunosuppression-in-kidney-transplantation-a-way-between-efficacy-and-toxicity
#17
Costanza Casati, Alberto Menegotto, Maria Luisa Querques, Federica Ravera, Giacomo Colussi
Renal transplantation is the best treatment for patients with end-stage renal disease. Over the last decades, the introduction of new immunosuppressive agents resulted into the reduction of the incidence of acute rejection and early graft loss. Despite this progress, there has been little improvement in the average life of the transplant. The main reasons of late failure are patient's death due to several complications (e.g. cancer, infectious or metabolic), and progressive deterioration of renal function caused by immunological and non-immunological factors...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28680827/clinical-analysis-of-single-filtration-plasmapheresis-using-continuous-renal-replacement-therapy-machines-in-kidney-transplantation
#18
Eunsoo Lim, Yujeong Kim, Jong Cheol Jeong, Inwhee Park, Heungsoo Kim, Su Hyung Lee, Chang-Kwon Oh, Gyu-Tae Shin
BACKGROUND: Plasmapheresis has become an essential element of kidney transplantation (KT). In the present study, we report clinical outcomes of filtration plasmapheresis using continuous renal replacement therapy machines with a single filter for the first time in Korea. METHODS: We retrospectively analyzed six patients who underwent filtration plasmapheresis for KT in our center; plasmapheresis was performed using the Plasmaflex (Baxter(®)) with a TPE 2000 filter set (Baxter(®)) in our hemodialysis unit...
June 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28679466/successful-launch-of-an-abo-incompatible-kidney-transplantation-program-to-overcome-the-shortage-of-compatible-living-donors-experience-at-a-single-center%C3%A2
#19
Seung Hwan Song, Juhan Lee, Beom Seok Kim, Sinyoung Kim, Jae Geun Lee, Hyeon Joo Jeong, Yu Seun Kim, Myoung Soo Kim, Hyun Ok Kim, Soon Il Kim, Kyu Ha Huh
AIMS: ABO-incompatible (ABOi) kidney transplantation (KT) is being increasingly performed to overcome donor shortages. However, debate persists regarding the post-transplant outcomes of ABOi KT vs. that of ABO-compatible (ABOc) KT. METHODS: A total 454 recipients who underwent living-donor KT (LDKT) between June 2010 and July 2014 at Severance Hospital (Seoul) were retrospectively reviewed. 100 ABOi and 354 ABOc KTs were compared. Recipients with a pretransplant positive crossmatch to their donors, pretransplant donor-specific anti-HLA antibody (DSA), or high panel reactive antibody (PRA ≥ 50%) were excluded from both the ABOi and ABOc KT groups...
July 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28676864/innate-immune-response-in-kidney-ischemia-reperfusion-injury-potential-target-for-therapy
#20
REVIEW
Aleksandra Kezić, Natasa Stajic, Friedrich Thaiss
Acute kidney injury caused by ischemia and subsequent reperfusion is associated with a high rate of mortality and morbidity. Ischemia/reperfusion injury in kidney transplantation causes delayed graft function and is associated with more frequent episodes of acute rejection and progression to chronic allograft nephropathy. Alloantigen-independent inflammation is an important process, participating in pathogenesis of injurious response, caused by ischemia and reperfusion. This innate immune response is characterized by the activity of classical cells belonging to the immune system, such as neutrophils, macrophages, dendritic cells, lymphocytes, and also tubular epithelial cells and endothelial cells...
2017: Journal of Immunology Research
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