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https://www.readbyqxmd.com/read/29113470/posttransplant-immune-activation-innocent-bystander-or-insidious-culprit-of-posttransplant-accelerated-atherosclerosis
#1
Didier Ducloux, Jamal Bamoulid, Thomas Crepin, Jean-Michel Rebibou, Cecile Courivaud, Philippe Saas
Cardiovascular disease is a major cause of morbidity, disability, and mortality in kidney transplant patients. Cumulative reports indicate that the excessive risk of cardiovascular events is not entirely explained by the increased prevalence of traditional cardiovascular risk factors. Atherosclerosis is a chronic inflammatory disease, and it has been postulated that posttransplant immune disturbances may explain the gap between the predicted and observed risks of cardiovascular events. Although concordant data suggest that innate immunity contributes to the posttransplant accelerated atherosclerosis, only few arguments plead for a role of adaptive immunity...
September 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29105189/cyclophosphamide-induced-tolerance-in-kidney-transplantation-avoids-long-term-immunosuppressive-therapy
#2
REVIEW
Ario Takeuchi, Koji Kato, Koichi Akashi, Masatoshi Eto
There has recently been remarkable progress in immunosuppressive agents, such as tacrolimus and cyclosporine. Therefore, the rate of organ establishment has improved in transplantation. However, immunosuppressive agents generally suppress the function of T cells. Thus, opportunistic infections, such as cytomegalovirus infection, are still a major problem in kidney transplantation. Induction of specific tolerance to avoid immunosuppressive drug therapy after kidney transplantation is considered as the ultimate goal of transplantation...
November 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29068092/high-dose-mizoribine-combined-with-calcineurin-inhibitor-cyclosporine-or-tacrolimus-basiliximab-and-corticosteroids-for-renal-transplantation-a-japanese-multicenter-study
#3
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
https://www.readbyqxmd.com/read/29029524/comparative-efficacy-and-safety-of-antibody-induction-therapy-for-the-treatment-of-kidney-a-network-meta-analysis
#4
Mingjie Shao, Tingting Tian, Xinyan Zhu, Yingzi Ming, Yasuko Iwakiri, Shaojun Ye, Qifa Ye
To evaluate the efficacy and safety of antibody induction therapies in kidney transplantation. Systematic literature searches were undertaken using MEDLINE, Embase, and Cochrane Library database from 1980 to 2016. Randomized controlled trials (RCTs) comparing three antibody induction therapies (alemtuzumab, interleukin-2 receptor antibodies and antithymocyte globulin) between each other were identified. Bayesian network meta-analysis was used to combine both the direct and indirect evidence on treatment efficacy and its safety...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29025381/adenovirus-infection-as-a-cause-of-fever-of-unknown-origin-and-allograft-dysfunction-in-a-kidney-transplant-recipient
#5
Michelle Saliba, Hala Kfoury Assouf, Souodod Abbas, Pierre Abi Hanna, Gaby Kamel, Antoine Barbari
With the recent introduction of more potent modern immunosuppressive regimens in solid-organ transplant, new types of viral infections such as adenovirus are emerging as a potential cause for graft dysfunction and loss. We report a case of 41-year-old male patient with end-stage renal disease from recurrent kidney stones who underwent kidney transplant from a deceased 12-year-old female donor. He developed adenoviral infection with acute cystitis, microscopic hematuria, and necrotizing interstitial nephritis associated with graft dysfunction within the first month of the postoperative period...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28987961/the-effect-of-genetic-variants-affecting-nk-cell-function-on-cardiovascular-health-and-the-burden-of-cmv
#6
Shelley Waters, Silvia Lee, Jacquita S Affandi, Ashley Irish, Patricia Price
Renal transplant recipients (RTR) display high burdens of cytomegalovirus (CMV) and accelerated cardiovascular change. NK cells can control CMV and may contribute to vascular pathologies. Polymorphisms in genes encoding the inhibitory receptor LILRB1 and its ligand HLA-G, and the activating receptor NKG2C may illuminate the role of NK cells in vascular health and CMV immunity. We assessed 81 healthy adults and 82 RTR >2 years after transplantation. RTR had higher humoral and T-cell responses to CMV, and impaired vascular health...
October 5, 2017: Human Immunology
https://www.readbyqxmd.com/read/28986189/prevention-of-cytomegalovirus-reactivation-in-haploidentical-stem-cell-transplantation
#7
Aimee E Hammerstrom, Lindsey R Lombardi, Sai Ravi Pingali, Gabriela Rondon, Julianne Chen, Denái R Milton, Roy F Chemaly, Richard E Champlin, Alison Gulbis, Stefan O Ciurea
Cytomegalovirus (CMV) infection can increase the morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Because of a higher degree of immunosuppression, haploidentical transplant recipients may be at an increased risk of viral infections, particularly CMV. We retrospectively analyzed 86 haploidentical HCT recipients at our institution to determine whether a more intensified antiviral strategy would reduce the incidence of CMV reactivation compared with a traditional antiviral prophylaxis regimen...
October 3, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28979335/incidence-of-ganciclovir-resistance-in-cmv-positive-renal-transplant-recipients-and-its-association-with-ul97-gene-mutations
#8
Hamid Reza Aslani, Shadi Ziaie, Jamshid Salamzadeh, Sara Zaheri, Fariba Samadian, Shayan Mastoor-Tehrani
Human cytomegalovirus (CMV) remains the most common infection affecting organ transplant recipients. Despite advances in the prophylaxis and acute treatment of CMV, it remains an important pathogen affecting the short- and long-term clinical outcome of solid organ transplant recipient. The emergence of CMV resistance in a patient reduces the clinical efficacy of antiviral therapy, complicates therapeutic and clinical management decisions, and in some cases results in loss of the allograft and/or death of the patient...
2017: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/28975107/risk-factors-for-cytomegalovirus-disease-in-seropositive-renal-transplant-recipients-a-single-center-case-controlled-study
#9
Viviana Navarro-Rodríguez, Alvaro Herrera-Munoz, Adrián Castro, Allan Ramos-Esquivel
BACKGROUND: Risk factors for cytomegalovirus (CMV) disease in renal transplant recipients have been evaluated in industrialized countries with relatively low CMV seroprevalence. OBJECTIVES: We aimed to determine which factors are related to this illness in a high CMV seroprevalence country. PATIENTS AND METHODS: A case-control study was performed with data from a 5-year follow-up of 260 kidney transplant recipients at our center. Odds ratios were calculated using the Mantel-Haenszel method...
July 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28946964/cytomegalovirus-infection-after-kidney-transplantation-and-long-term-graft-loss
#10
María Ovidia López-Oliva, Julio Flores, Rosario Madero, Fernando Escuin, María José Santana, Teresa Bellón, Rafael Selgas, Carlos Jiménez
BACKGROUND: Despite the use of prevention strategies, cytomegalovirus (CMV) infection is the most common viral complication after renal transplant and its impact on long-term outcomes is still open to debate. OBJECTIVE: To evaluate the incidence of CMV infection and disease during the use of prevention strategies in our centre and to analyse the association between CMV infection and long-term patient and graft survival and other potentially clinical events related with CMV...
September 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28943566/deep-ulcers-in-the-ileum-associated-with-mycophenolate-mofetil
#11
Akira Sonoda, Kurato Wada, Kazuhiro Mizukami, Kensuke Fukuda, Mitsutaka Shuto, Kazuhisa Okamoto, Ryo Ogawa, Tadayoshi Okimoto, Kazunari Murakami
A 54-year-old man was treated with mycophenolate mofetil (MMF) after undergoing living donor renal transplantation. Two years later, he experienced repeated episodes of diarrhea, and his C-reactive protein (CRP) level was found to be 12.63 mg/dL. Ileocolonoscopy showed multiple deep, punched-out ulcers that were similar to Behçet's disease (BD) and cytomegalovirus (CMV) in the ileum. CMV infection was suspected. However, anti-cytomegalovirus agents were ineffective. The patient was subsequently diagnosed with gastrointestinal toxicity of MMF and MMF was switched to mizoribine...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28940831/low-dose-valganciclovir-prophylaxis-for-cytomegalovirus-in-intermediate-risk-r-renal-transplant-recipients-single-center-experience
#12
Salman Khan, Clara Fischman, Shirish Huprikar
Renal transplant recipients (RTR) who are seropositive for CMV (R+) are considered to be at intermediate-risk for CMV disease. Current guidelines recommend high-dose valganciclovir (VGCV) prophylaxis because of limited data on the efficacy of low-dose VGCV. We describe our experience with using low-dose VGCV in R+ RTR. We retrospectively reviewed a cohort of 316 R+ RTR at our institution between 2002 and 2006. The primary endpoint was CMV disease at 1 year post transplant. The incidence of CMV disease at 12 months after transplantation was only 3% (6/221) in the D+R+ and 4% (4/95) in the D-R+ RTR...
September 22, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28933173/-cytomegalovirus-and-polyomavirus-infection-after-renal-transplantation
#13
Jana Machová, Tomáš Reischig
Viral infections are among the most common infectious complications affecting transplant recipients. Due to immunosuppressive therapy predominantly affecting cellular immunity and thus successfully reducing the incidence of acute rejection, there is a higher incidence of viral infections. Herpesviruses and polyomaviruses are ubiquitous pathogens which have the ability to persist in a state of latent infection. In addition to post-transplant reactivation, donor-induced primoinfection can also occur, leading to increased morbidity and contributing to decreased survival of patients...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28894795/liver-enzymes-and-the-development-of-posttransplantation-diabetes-mellitus-in-renal-transplant-recipients
#14
Gerald Klaassen, Eva Corpeleijn, Nicole P E Deetman, Gerjan J Navis, Stephan J L Bakker, Dorien M Zelle
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) is common in renal transplant recipients (RTR), increasing the risk of graft failure, cardiovascular disease, and mortality. Early detection of a high risk for PTDM is warranted. Because liver function and liver fat are involved, we investigated whether serum liver markers are associated with future PTDM in RTR. METHODS: Between 2001 and 2003, 606 RTR with a functioning allograft beyond the first year after transplantation were included of which 500 participants (56% men; age, 50 ± 12 years) were free of diabetes at baseline and had liver enzyme values (1 missing) available...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28867309/b-cell-activating-factor-baff-reflects-patients-immunological-risk-profile-after-kidney-transplantation
#15
A Schuster, B Jung, J Hofbauer, L Kühne, D Zecher, B Banas, T Bergler
The B-cell activating factor BAFF plays an important role in the development and maturation of B-lymphocytes, which can contribute to the generation of donor-specific antibodies and thus may influence graft function and graft survival. Inconsistent data on the role of BAFF levels after renal transplantation for the formation of donor-specific antibodies and the contribution for allograft rejection exist. The aim of the current study was to determine to what extent the degree of pre-immunization is reflected by each patient's BAFF levels before transplantation and in the follow-up...
September 1, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28846558/improved-outcomes-of-kidney-transplantation-in-infants-age-2-years-a-single-center-experience
#16
Blanche M Chavers, Michelle N Rheault, Arthur J Matas, Scott C Jackson, Marie E Cook, Thomas E Nevins, John S Najarian, Srinath Chinnakotla
BACKGROUND: Infants (age < 2 years) with end stage renal disease (ESRD) have increased morbidity and mortality. We evaluated our long-term outcomes of kidney transplants (KTx) in infants. METHODS: Between 1984-2014, 136 infants underwent KTx. We examined trends in survival rates and complications by era (1984-1993 [Era 1], 1994-2003 [Era 2], 2004-2014 [Era 3]). RESULTS: Patients were 92.6% Caucasian and 70.6% male. PostTx initial length of hospital stay declined 37% over the 30-year period (p <0...
August 24, 2017: Transplantation
https://www.readbyqxmd.com/read/28844151/high-dose-acyclovir-for-cytomegalovirus-prophylaxis-in-seropositive-abdominal-transplant-recipients
#17
Margaret R Jorgenson, Jillian L Descourouez, Glen E Leverson, Erin K McCreary, Michael R Lucey, Jeannina A Smith, Robert R Redfield
BACKGROUND: Following abdominal solid organ transplant (aSOT), valganciclovir (VGC) is recommended for cytomegalovirus (CMV) prophylaxis. This agent is associated with efficacy concerns, toxicity, and emergence of ganciclovir resistance. OBJECTIVE: To evaluate the incidence of high-dose acyclovir (HD-A) prophylaxis failure in seropositive aSOT recipients (R+). METHODS: This was a retrospective, single-center study of R+ transplanted without lymphocyte-depleting induction between January 1, 2000, and June 30, 2013, discharged with 3 months of HD-A prophylaxis (800 mg 4 times daily)...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28838440/ganciclovir-dosing-strategies-and-development-of-cytomegalovirus-resistance-in-a-kidney-transplant-recipient-a-case-report
#18
I A Echenique, D Beltran, L Ramirez-Ruiz, N Najafian, N Agrawal
In renal transplant recipients, delayed graft function and accompanying renal impairment may lead to therapeutic underexposure of valganciclovir. We describe a case of a cytomegalovirus (CMV)-seronegative kidney transplant recipient from a CMV-seropositive donor, whose course was complicated during valganciclovir prophylaxis by CMV disease, ultimately progressing to ganciclovir, foscarnet, and cidofovir resistance. Assessments and adjustments for renal dysfunction, according to both Cockgroft-Gault and Modification of Diet in Renal Disease study equations, are described...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28836934/sirolimus-associated-with-tacrolimus-at-low-doses-in-elderly-kidney-transplant-patients-a-prospective-randomized-controlled-trial
#19
Cristiane Akemi Kojima, Hong Si Nga, Henrique Mochida Takase, Ariane Moyses Bravin, Márcia de Fátima Faraldo Martinez Garcia, Paula Dalsoglio Garcia, Mariana Moraes Contti, Luis Gustavo Modelli de Andrade
OBJECTIVES: There is no consensus on the best immunosuppressive regimen for elderly renal transplant recipients. The objective of this study was to assess cytomegalovirus infection incidence and kidney transplant outcomes in elderly recipients treated with mammalian target of rapamycin inhibitors sirolimus/ tacrolimus at low doses compared with those receiving tacrolimus/mycophenolate sodium. MATERIALS AND METHODS: In this single-center prospective randomized study (Trial Registration No...
August 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28761224/mucormycosis-and-cytomegalovirus-co-infection-in-renal-transplant-recipients
#20
COMMENT
K L Gupta
No abstract text is available yet for this article.
July 2017: Indian Journal of Nephrology
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