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https://www.readbyqxmd.com/read/28523715/dual-en-bloc-technique-for-adult-renal-transplantation
#1
Kim Chi Tran, David Li, Ali Taqi, Alp Sener, Vivian C McAlister, Patrick P Luke
INTRODUCTION: We describe and provide follow-up for a novel simplified technique permitting dual en-bloc (DEB) transplantation of adult organs using single in situ arterial and venous anastomoses. METHODS: Twenty-two adult DEB transplants were performed at our centre between 2001 and 2012, utilizing 44 kidneys en bloc. Results were compared with 20 solitary transplants from expanded criteria donors (ECD) associated with lower terminal serum creatinines and Remuzzi biopsy scores vs...
May 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28509126/gram-negative-sepsis-following-biopsy-of-a-transplant-recipient-with-asymptomatic-allograft-pyelonephritis
#2
Hassan Al-Khayyat, Nigel Toussaint, Steve Holt, Peter Hughes
Pyelonephritis post-renal transplantation is common and in up to 50% of cases can be asymptomatic. Transplant pyelonephritis shares a lot of histopathological features with acute cellular rejection. We present a case of asymptomatic acute graft pyelonephritis where a renal biopsy was complicated by sepsis, and discuss the difficulties in interpretation of renal histology in the setting of transplant pyelonephritis where rejection may also be a possibility, but differentiation is challenging.
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28507917/systemic-meta-analysis-assessing-the-short-term-applicability-of-early-conversion-to-mammalian-target-of-rapamycin-inhibitors-in-kidney-transplant
#3
Jayant Kumar, Isabella Reccia, Tomokazu Kusano, Bridson M Julie, Ajay Sharma, Ahmed Halawa
AIM: To consolidate the present evidence of effectiveness in renal functioning and graft survival following early introduction of mammalian target of rapamycin (mTOR) inhibitors with or without calcineurin inhibitors (CNIs) in renal transplant recipients. METHODS: We analysed the current literature following PROSPERO approval describing the role of immunosuppressive agent, mTOR inhibitors as an alternative to CNI within six months of renal transplant by searching the PubMed, EMBASE, Cochrane, Crossref, and Scopus using MeSH terms...
April 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28489277/pancreas-after-islet-pai-transplantation-in-non-uremic-type-1-diabetes-a-strategy-for-restoring-durable-insulin-independence
#4
S A Wisel, J M Gardner, G R Roll, J Harbell, C E Freise, S Feng, S M Kang, R Hirose, D B Kaufman, A Posselt, P G Stock
Islet transplantation offers a minimally-invasive approach for beta cell replacement in diabetic patients with hypoglycemic unawareness. Attempts at insulin independence may require multiple islet re-infusions from distinct donors, thus increasing the risk for allogeneic sensitization. Currently, solid organ pancreas transplant is the only remaining surgical option following failed islet transplantation in the US. However, the immunologic impact of repeated exposure to donor antigens on subsequent pancreas transplantation is unclear...
May 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28473689/polyomavirus-nephropathy-in-native-kidneys-of-an-immunocompetent-individual
#5
Sihyung Park, Yang Wook Kim, Yoo Jin Lee, Kang Min Park, Jin Han Park, Bo Mi Kim, Bong Soo Park
BACKGROUND Polyomavirus nephropathy has emerged as an important cause of graft loss in kidney transplant recipients. Polyomavirus rarely affects the native kidneys of an immunocompetent individual. Until now, polyomavirus nephropathy in native kidneys of an immunocompetent individual has not been reported, as far as we know. CASE REPORT A 34-year-old man was transferred from a local clinic to be evaluated for the cause of azotemia. Serum creatinine was 2.85 mg/dL. We performed renal biopsy to identify the cause of azotemia...
May 5, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28467296/immunohistopathologic-characterization-of-plasma-cell-rich-acute-rejection-in-living-related-renal-transplant-recipients
#6
Muhammed Mubarak, Khawar Abbas, Mirza Naqi Zafar, Tahir Aziz
OBJECTIVES: Our aim was to analyze the immunohistopathologic features of plasma cell-rich acute rejection in a living-related renal transplant setting. MATERIALS AND METHODS: Renal allograft biopsies of 50 cases of plasma cell-rich acute rejection were reviewed, and the main immunohistopathologic features were analyzed. The biopsies were studied using light microscopy, immunofluorescence, and immunohistochemistry and reported according to Banff classification. Biopsy findings were correlated with graft function and outcome...
May 3, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28457402/early-vascular-thrombosis-after-kidney-transplantation-can-we-predict-patients-at-risk
#7
R A P de Freitas, M L de Lima, M Mazzali
BACKGROUND: Renal transplant is the therapy of choice for patients with chronic renal disease. In recent years, improvement in immunosuppressive drugs reduced early graft loss associated with acute rejection. However, vascular thrombosis, accounting for 5% of early graft loss, can sensitize the recipient for human leukocyte antibodies, reducing the chance for a second transplant. The aim of this study was to identify risk factors for vascular thrombosis in a single transplant center, to design specific prevention protocol...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457396/nephrotic-range-proteinuria-in-renal-transplantation-clinical-and-histologic-correlates-in-a-10-year-retrospective-study
#8
R Leal, H Pinto, A Galvão, L Santos, C Romãozinho, F Macário, R Alves, J Pratas, V Sousa, C Marinho, L Prado E Castro, M Campos, A Mota, A Figueiredo
INTRODUCTION: There is a high incidence of nephrotic proteinuria in renal transplant recipients, which is an accurate predictor of graft loss. Despite this, its histologic correlates and prognostic implications are still not well characterized. We assessed the clinical and histological correlates of kidney transplantation patients with nephrotic range proteinuria. METHODS: We have retrospectively analyzed clinical and histological data from 50 kidney transplantation biopsy specimens from 44 renal transplant recipients with nephrotic range proteinuria between 2006 and 2015...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28455659/differential-expression-of-circulating-mir-21-mir-142-3p-and-mir-155-in-renal-transplant-recipients-with-impaired-graft-function
#9
Sepideh Zununi Vahed, Ahmad Poursadegh Zonouzi, Hossein Ghanbarian, Morteza Ghojazadeh, Nasser Samadi, Yadollah Omidi, Mohammadreza Ardalan
BACKGROUND: The discovery of circulating microRNAs (miRNAs), as potential noninvasive diagnostic biomarkers, has opened new avenues of research for identifying patients with chronic failure in renal transplantation. The present study aimed to investigate the expression levels of four immune-related miRNAs (miR-21, miR-31, miR-142-3p and miR-155) in plasma samples of renal recipients. METHODS: The plasma expression levels of the miRNAs were evaluated by quantitative real-time PCR (qPCR) in 53 renal recipients with long-term stable allograft function, SGF (N = 27), and with biopsy-proven interstitial fibrosis and tubular atrophy (IFTA) (N = 26) and also healthy controls (N = 15)...
April 28, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28438129/severe-type-1-upgrading-leprosy-reaction-in-a-renal-transplant-recipient-a-paradoxical-manifestation-associated-with-deficiency-of-antigen-specific-regulatory-t-cells
#10
Ana Paula Vieira, Maria Angela Bianconcini Trindade, Flávio Jota de Paula, Neusa Yurico Sakai-Valente, Alberto José da Silva Duarte, Francine Brambate Carvalhinho Lemos, Gil Benard
BACKGROUND: Due to its chronic subclinical course and large spectrum of manifestations, leprosy often represents a diagnostic challenge. Even with proper anti-mycobacteria treatment, leprosy follow up remains challenging: almost half of leprosy patients may develop reaction episodes. Leprosy is an infrequent complication of solid organ transplant recipients. This case report illustrates the challenges in diagnosing and managing leprosy and its reactional states in a transplant recipient...
April 24, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28435308/association-of-the-ppp3ca-c-249g-a-variant-with-clinical-outcomes-of-tacrolimus-based-therapy-in-kidney-transplant-recipients
#11
Patricia C Salgado, Fabiana Dv Genvigir, Claudia R Felipe, Helio Tedesco-Silva, Jose O Medina-Pestana, Sonia Q Doi, Mario H Hirata, Rosario Dc Hirata
BACKGROUND: The effects of genetic variants related to the pharmacodynamic mechanisms of immunosuppressive drugs on their therapeutic efficacy and safety have been poorly explored. This study was performed to investigate the influence of the PPP3CA c.249G>A variant on the clinical outcomes of kidney transplant recipients. PATIENTS AND METHODS: A total of 148 Brazilian patients received tacrolimus (TAC)-based immunosuppressive therapy for 90 days post-kidney transplantation...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28418354/-clinical-and-morphological-signs-of-viral-damage-to-a-kidney-transplant
#12
S E Solovyeva, E M Paltseva, M M Morozova, M M Kaabak, N A Krainik, A V Matveev
AIM: Тo compare morphological changes and results of immunohistochemical (IHC) identification of viruses (polyomaviruses, adenoviruses, and herpesviruses) in the biopsy specimens with their clinical manifestations in recipients of renal transplants. MATERIAL AND METHODS: Morphological and IHC studies were conducted using 71 needle renal transplant biopsy specimens from patients in the study group and 10 renal biopsy specimens from those in the control group. A number of clinical indicators were estimated...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28415773/effects-of-cd20-b-cell-infiltration-into-allografts-on-kidney-transplantation-outcomes-a-systematic-review-and-meta-analysis
#13
REVIEW
Yingying Lu, Bingjue Li, Qixia Shen, Rending Wang, Zhimin Chen, Hong Jiang, Jianghua Chen
The effects of CD20+ B-cell infiltration during acute rejection on graft outcomes are controversial. The objective of this systematic review and meta-analysis was to clarify this issue. We performed a systematic literature search for studies published up to January 14, 2016. A total of 5 studies, with 200 patients, were included. The presence of CD20+ B cells in renal biopsies during allograft rejection was associated with graft loss and steroid resistance. No association of CD20+ B-cell infiltration with C4d-positive staining of the peritubular capillaries in renal biopsies was found in the analysis of patients who experienced kidney graft rejection...
March 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28405599/absence-of-intragraft-b-cells-in-rejection-biopsies-after-rituximab-induction-therapy-consequences-for-clinical-outcome
#14
Martijn W F van den Hoogen, Eric J Steenbergen, Marije C Baas, Sandrine Florquin, Luuk B Hilbrands
BACKGROUND: The pathophysiological role of intragraft B cells during renal allograft rejection is unclear. METHODS: We studied B-cell infiltration during acute rejection in 53 patients who participated in a clinical trial in which adult renal transplant patients were randomized between a single intraoperative dose of rituximab (375 mg/m(2)) or placebo as induction therapy. Two independent pathologists scored all biopsies in a blinded fashion according to the Banff classification and scored for the presence of B cells and plasma cells using CD79a and CD138 as markers...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28405598/clearance-of-bk-virus-nephropathy-by-combination-antiviral-therapy-with-intravenous-immunoglobulin
#15
Kathy Kable, Carmen D Davies, Philip J O'connell, Jeremy R Chapman, Brian John Nankivell
BACKGROUND: Reactivation of BK polyoma virus causes a destructive virus allograft nephropathy (BKVAN) with graft loss in 46%. Treatment options are limited to reduced immunosuppression and largely ineffective antiviral agents. Some studies suggest benefit from intravenous immunoglobulin (IVIG). METHODS: We evaluated effectiveness of adjuvant IVIG to eliminate virus from blood and tissue, in a retrospective, single-center cohort study, against standard-of-care controls...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28403541/histopathological-evaluation-of-pretransplant-donor-biopsies-in-expanded-criteria-donors-with-high-kidney-donor-profile-index
#16
A Sánchez-Escuredo, A Sagasta, I Revuelta, L M Rodas, D Paredes, M Musquera, F Diekmann, J M Campistol, M Solé, F Oppenheimer
There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pre-transplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those marginal kidneys in the highest calculated KDPI risk group (>91%) that appropriate for single transplantation. A retrospective study was conducted of 485 consecutive kidneys procured from a single center and transplanted if the RS was <4...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28396741/renal-allograft-granulomatous-interstitial-nephritis-observations-of-an-uncommon-injury-pattern-in-22-transplant-recipients
#17
Alton B Farris, Carla L Ellis, Thomas E Rogers, W James Chon, Anthony Chang, Shane M Meehan
Background: Granulomatous interstitial nephritis (GIN) is uncommon in native kidneys, and descriptions in allografts are few. We report clinical and pathologic findings in 22 allograft recipients with GIN identified in renal allograft biopsies and nephrectomies. Methods: Renal allografts with GIN were retrieved from the pathology files of two academic medical centers. Available clinical and pathologic data were compiled retrospectively for a 23-year period. Results: GIN was present in 23 specimens from 22 patients (15 males and 7 females) with allograft dysfunction [serum creatinine averaged 3...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28380212/upregulation-of-microrna-142-3p-in-the-peripheral-blood-and-urinary-cells-of-kidney-transplant-recipients-with-post-transplant-graft-dysfunction
#18
T D Domenico, G Joelsons, R M Montenegro, R C Manfro
We analyzed microRNA (miR)-142-3p expression in leucocytes of the peripheral blood and urinary sediment cell samples obtained from kidney transplant recipients who developed graft dysfunction. Forty-one kidney transplant recipients with kidney graft dysfunction and 8 stable patients were included in the study. The groups were divided according to histological analysis into acute rejection group (n=23), acute tubular necrosis group (n=18) and stable patients group used as a control for gene expression (n=8)...
April 3, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28372986/assessing-the-potential-of-angiotensin-ii-type-1-receptor-and-donor-specific-anti-endothelial-cell-antibodies-to-predict-long-term-kidney-graft-outcome
#19
David F Pinelli, John J Friedewald, Kelley M K Haarberg, Shree L Radhakrishnan, Jennifer R Zitzner, Wendy E Hanshew, Anat R Tambur
Endothelial cell antigens have been reported as potential targets for antibodies in the context of organ transplantation, leading to increased risk for graft failure. Serum samples from 142 consecutive living donor kidney recipients were tested for the presence of antibodies to angiotensin II - type 1 receptor (AT1R), donor endothelial cells, and donor HLA. Graft survival was monitored for five years post-transplant, and secondary outcomes, including biopsy-proven rejection, proteinuria, biopsy-proven vasculopathy, and renal function based on serum creatinine were also assessed for the first two to three years...
March 31, 2017: Human Immunology
https://www.readbyqxmd.com/read/28371289/prolonged-cold-ischemia-time-results-in-local-and-remote-organ-dysfunction-in-a-murine-model-of-vascularized-composite-transplantation
#20
Néha Datta, Sean G Devaney, Ronald W Busuttil, Kodi Azari, Jerzy W Kupiec-Weglinski
Vascularized composite allotransplantation (VCA) is a viable reconstructive option for complex tissue defects. Although grafts with large muscular component may be uniquely susceptible to ischemia/reperfusion (I/R) syndrome, the safe cold ischemia time in VCA has not been established. We investigated the effects of cold ischemia on innate immune response and recipient survival in a murine orthotopic hindlimb transplantation model. Surprisingly, mice receiving grafts exposed to 6h or longer of cold storage demonstrated reduced survival and massive elevations in serum creatinine, BUN and creatine kinase, as compared to 1h of cold storage recipients...
March 30, 2017: American Journal of Transplantation
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