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Renal graft biopsy

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https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#1
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29208204/durable-renal-response-after-combination-of-bortezomib-corticosteroids-rituximab-and-plasmapheresis-for-late-antibody-mediated-renal-transplant-rejection%C3%A2
#2
Yanli Ding, Jean Francis, Amitabh Gautam, Linda Pelletier, Vaishali Sanchorawala, Karen Quillen
Late occurrence of antibody-mediated rejection (AMR), defined as occurring 6 months after transplantation, is associated with poor renal allograft survival, compared to early acute AMR and acute cellular rejection. The proteasome inhibitor bortezomib has multiple immunomodulatory effects on plasma cells, the source of donor-specific HLA antibodies which mediate AMR. MATERIALS AND METHODS: Consecutive patients who presented with biopsy-proven AMR and donor-specific anti-HLA antibodies (DSA) at a single institution between July 2011 and February 2015 were included...
December 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29206350/isolated-v-lesion-in-kidney-transplant-recipients-characteristics-association-with-dsa-and-histological-follow-up
#3
Marion Rabant, Fanny Boullenger, Viviane Gnemmi, Gaëlle Pellé, François Glowacki, Alexandre Hertig, Isabelle Brocheriou, Caroline Suberbielle, Jean-Luc Taupin, Dany Anglicheau, Christophe Legendre, Jean-Paul Duong Van Huyen, David Buob
Isolated v-lesion (IvL) represents a rare and challenging situation in renal allograft biopsies because it is unknown whether IvL truly represents rejection, antibody- or T cell-mediated, or not. This multicentric retrospective study describes the clinicopathological features of IvL with an emphasis on the Donor Specific Antibodies (DSA) status, histological follow-up, and graft survival. Inclusion criteria were the presence of v-lesion with minimal interstitial (i≤1) and microvascular inflammation (g+ptc≤1)...
December 5, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29206090/utility-of-serial-protocol-biopsies-performed-after-1-year-in-predicting-long-term-kidney-allograft-function-according-to-histologic-phenotype
#4
Mareena S Zachariah, Alok K Dwivedi, Cindy S Yip, Shirley S Chang, Aijaz Gundroo, Rocco C Venuto, John Tomaszewski, Sunil K Patel, Rajeev Sharma
OBJECTIVES: Prognostic implications of early protocol biopsies have been studied; however, the value of late protocol biopsy in predicting graft outcome has not been well defined. Here, we compared the effects of early and late protocol biopsy histologic findings in stable kidney allografts and aimed to understand the significance of "borderline" rejection on allograft function. MATERIALS AND METHODS: We studied 261 biopsies from 159 renal transplant recipients who were on a steroid-free, calcineurin inhibitor and mycophenolate mofetil regimen and who received transplants between 2004 and 2012 with mean follow-up of 5 years...
December 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29198660/utility-of-oxford-classification-in-post-transplant-immunoglobulin-a-nephropathy
#5
V Agrawal, A Singh, A Kaul, R Verma, M Jain, R Pandey
BACKGROUND: With increasing graft survival, post-transplant immunoglobulin A nephropathy (IgAN) has emerged as an important cause of chronic graft dysfunction in renal allograft recipients. We studied the clinico-pathological features of post-transplant IgAN regardless of the primary disease. The aim was to study the usefulness of the Oxford classification in predicting survival. METHODS: Indication graft biopsy specimens (n = 915) were received during a 10-year period; 27 biopsy specimens from 22 patients were diagnosed as IgAN...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198657/association-of-brain-dead-donors-terminal-inflammation-with-delayed-graft-function-in-kidney-transplant-recipients
#6
D Cucchiari, J Rovira, D Paredes, P Ventura-Aguiar, A Sanchez-Escuredo, M Solé, R Adalia, F Oppenheimer, F Diekmann, I Revuelta
BACKGROUND: Systemic inflammation affects kidney function in a wide range of diseases. Even in kidney transplant recipients, higher levels of C-reactive protein (CRP) are invariably associated with both worse short- and long-term graft outcomes. However, little is known about systemic inflammation in kidney donors and, notably, brain death causes a strong systemic inflammatory response. OBJECTIVE: To analyze the role of systemic inflammation of brain-dead donors on short-term kidney graft outcomes (ie, delayed graft function [DGF], defined as the need of dialysis during the first week after transplantation)...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198655/clinical-and-pathological-analyses-of-cases-of-acute-vascular-rejection-after-kidney-transplantation
#7
T Shimizu, H Ishida, N Hayakawa, R Shibahara, K Tanabe
BACKGROUND: We performed a clinical and pathological analysis of cases of acute vascular rejection (AVR), characterized by intimal arteritis and transmural arteritis (Banff v score) after kidney transplantation, in an attempt to clarify the mechanisms underlying the development and prognostic significance of AVR. METHODS: AVR (Banff score: v >0) was diagnosed in 31 renal allograft biopsy specimens (BS) obtained from 31 renal transplant patients receiving follow-up care at the Department of Urology, Tokyo Women's Medical University, between January 2010 and April 2016...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29191961/intragraft-molecular-pathways-associated-with-tolerance-induction-in-renal-transplantation
#8
Lorenzo Gallon, James M Mathew, Sai Vineela Bontha, Catherine I Dumur, Pranav Dalal, Lakshmi Nadimpalli, Daniel G Maluf, Aneesha A Shetty, Suzanne T Ildstad, Joseph R Leventhal, Valeria R Mas
The modern immunosuppression regimen has greatly improved short-term allograft outcomes but not long-term allograft survival. Complications associated with immunosuppression, specifically nephrotoxicity and infection risk, significantly affect graft and patient survival. Inducing and understanding pathways underlying clinical tolerance after transplantation are, therefore, necessary. We previously showed full donor chimerism and immunosuppression withdrawal in highly mismatched allograft recipients using a bioengineered stem cell product (FCRx)...
November 30, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29185962/renal-outcome-of-kidney-transplantation-in-korean-recipients-with-anca-associated-vasculitis
#9
Eun Seong Park, Sung Soo Ahn, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
OBJECTIVES: We investigated renal outcome of kidney-transplantation in Korean recipients with biopsy-proven renal involvement of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in a single centre. METHODS: We reviewed the medical records of 144 Korean patients and included 3 female patients with microscopic polyangiitis (MPA) and one male patient with eosinophilic granulomatosis with polyangiitis (EGPA) in this study. We obtained clinical and laboratory data related to kidney-transplantation, analysed renal outcome of kidney-transplantation in 4 recipients with AAV and compared it with those of previous studies...
November 27, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29185410/parvovirus-b19-a-rare-cause-of-post-renal-transplant-anemia
#10
Waqar Ahmed, Rizwan Ul Haq Dogar, Sumit Acharya
Parvovirus B19 infection should be contemplated as one of the differential diagnoses of persistent anemia in transplanted patients. There must be high index of suspicion of Parvovirus B19, when post-transplant patients present with refractory and severe anemia with reticulocytopenia and all the other common causes of anemia such as blood loss, adverse effects of immunosuppressant agents and graft dysfunction has been ruled out. In suspected patients, diagnosis is confirmed by serological tests (IgM and IgG), PCR from blood and/or bone marrow and by bone marrow biopsy finding of pure red cell aplasia...
December 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29184911/kidney-transplant-recipients-with-primary-membranous-glomerulonephritis-have-a-higher-risk-of-acute-rejection-compared-with-other-primary-glomerulonephritides
#11
Tripti Singh, Brad Astor, Weixiong Zhong, Didier Mandelbrot, Arjang Djamali, Sarah Panzer
Background: Despite being the leading cause of graft failure, there is a lack of published data about the rates of rejection in kidney transplant patients with glomerulonephritis as the cause of end-stage renal disease. Methods: We examined all consecutive adult (>18 years) renal transplant recipients with biopsy-proven native renal glomerular disease who underwent kidney transplant between 1994 and 2013. Glomerulonephritis groups included were IgA nephropathy (IgAN) (N = 306), focal segmental glomerulosclerosis (FSGS) (N = 298), membranous nephropathy (MN) (N = 81), and lupus nephritis (LN) (N = 177)...
November 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29164120/expression-of-mitochondrial-encoded-genes-in-blood-differentiate-acute-renal-allograft-rejection
#12
Silke Roedder, Tara Sigdel, Szu-Chuan Hsieh, Jennifer Cheeseman, Diana Metes, Camila Macedo, Elaine F Reed, H A Gritsch, Adriana Zeevi, Ron Shapiro, Allan D Kirk, Minnie M Sarwal
Despite potent immunosuppression, clinical and biopsy confirmed acute renal allograft rejection (AR) still occurs in 10-15% of recipients, ~30% of patients demonstrate subclinical rejection on biopsy, and ~50% of them can show molecular inflammation, all which increase the risk of chronic dysfunction and worsened allograft outcomes. Mitochondria represent intracellular endogenous triggers of inflammation, which can regulate immune cell differentiation, and expansion and cause antigen-independent graft injury, potentially enhancing the development of acute rejection...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29162680/peritoneal-dialysis-in-orthotopic-liver-transplantation-recipients
#13
Nalinee Saiprasertkit, Camila Nihei, Joanne M Bargman
BACKGROUND: In many dialysis programs, there is resistance to initiating peritoneal dialysis (PD) in liver transplant patients needing renal replacement therapy. This retrospective study reviews the outcome of PD in liver transplant patients at a major transplantation and dialysis center. METHOD: We performed a retrospective cohort study in patients who underwent liver transplants and received PD between 1991 and 2016. Patient demographics, laboratory parameters, and adverse events were collected from our electronic database...
November 21, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29157988/de-novo-thrombotic-microangiopathy-after-kidney-transplantation
#14
REVIEW
Neetika Garg, Helmut G Rennke, Martha Pavlakis, Kambiz Zandi-Nejad
Thrombotic microangiopathy (TMA) is a serious complication of transplantation that adversely affects kidney transplant recipient and allograft survival. Post-transplant TMA is usually classified into two categories: 1) recurrent TMA and 2) de novo TMA. Atypical hemolytic uremic syndrome (aHUS) resulting from dysregulation and over-activation of the alternate complement pathway is a rare disease but the most common diagnosis associated with recurrence in the allografts. De novo TMA, on the other hand, represents an overwhelming majority of the cases of post-transplant TMA and is a substantially more heterogeneous entity than recurrent aHUS...
November 4, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/29154394/fibrin-thrombi-in-deceased-donor-kidneys-prevalence-and-influence-on-graft-function-and-graft-survival-in-transplanted-patients
#15
Ditte Hansen, Sara Rørvig, Claus B Andersen, Søren S Sørensen
Fibrin thrombi (FT) are occasionally found in the pre-implantation biopsy of kidneys from deceased donors. The aim of this study was to monitor the prevalence and answer the question whether FT has any impact on future graft function in a Danish patient cohort. We looked for FT in all donor kidney biopsies taken at the time of renal transplantation in a Danish transplantation unit during a 10-year period. Every recipient transplanted with a FT donor kidney (n = 15) were matched with up to five control recipients (n = 69), and graft function and graft survival were assessed...
November 20, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/29153902/robotic-buccal-mucosal-graft-ureteroplasty-for-complex-ureteral-stricture
#16
Sohrab Arora, Logan Campbell, Mouafak Tourojman, Daniel Pucheril, Lamont R Jones, Craig Rogers
OBJECTIVE: To demonstrate robot-assisted ureterolysis and buccal mucosal graft (BMG) ureteroplasty for the management of a complex, long recurrent ureteral stricture developing after ureterolysis, and also to demonstrate the use of near-infrared fluorescence (NIRF) imaging and intraoperative ureteroscopy during this procedure. METHODS: A 58-year-old man with a history of cabergoline treatment and a cardiac catheterization through the left groin presented with left flank pain and hydronephrosis...
December 2017: Urology
https://www.readbyqxmd.com/read/29145879/allogeneic-mesenchymal-stem-cell-as-induction-therapy-to-prevent-both-delayed-graft-function-and-acute-rejection-in-deceased-donor-renal-transplantation-study-protocol-for-a-randomized-controlled-trial
#17
Qipeng Sun, Liangqing Hong, Zhengyu Huang, Ning Na, Xuefeng Hua, Yanwen Peng, Ming Zhao, Ronghua Cao, Qiquan Sun
BACKGROUND: Using kidneys from deceased donors is an available strategy to meet the growing need of grafts. However, higher incidences of delayed graft function (DGF) and acute rejection exert adverse effects on graft outcomes. Since ischemia-reperfusion injury (IRI) and ongoing process of immune response to grafts are the major causes of DGF and acute rejection, the optimal induction intervention should possess capacities of both repairing renal structure injury and suppressing immune response simultaneously...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29137592/isolated-v-lesion-in-an-abo-incompatible-kidney-transplant-recipient-receiving-rituximab
#18
Tomoaki Iwai, Junji Uchida, Kazuya Kabei, Shunji Nishide, Nobuyuki Kuwabara, Toshihide Naganuma, Norihiko Kumada, Yoshiaki Takemoto, Tatsuya Nakatani
We report an ABO-incompatible kidney transplant performed on a 69-year-old female patient, whose donor was her 69-year-old husband. The patient received an immunosuppressive protocol using rituximab without splenectomy. Renal biopsy was done on posttransplant day 8 due to poor early graft function, and an isolated v-lesion was found, which responded to steroid pulse therapy and gusperimus hydrochloride administration. Our results indicate that isolated v-lesions can occur in ABO-incompatible kidney transplant recipients receiving rituximab and that this finding should be treated as acute rejection...
November 15, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29132985/validation-of-kdri-kdpi-for-the-selection-of-expanded-criteria-kidney-donors
#19
Juan Antonio Retamero Díaz, Mercedes Cava Molina, Belen M Cobacho Tornel, Juan Bravo Soto, Antonio Osuna Ortega, Francisco O'Valle Ravassa, Raimundo García Del Moral Garrido
INTRODUCTION: KDRI / KDPI are tools use in kidney donor evaluation. It has been proposed as a substitute of, or complementary to preimplantation renal biopsy. These scores has not been validated in Spain. OBJECTIVE: 1) To investigate the concordance between KDPI and histological scores (preimplantation renal biopsy) and 2) To assess the relationship between KDRI, KDPI and histological score on graft survival in the expanded criteria donors group. METHODOLOGY: Retrospective cohort study from 1 January 1998 until 31 December 2010...
November 10, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29117638/renal-transplant-outcomes-in-primary-fsgs-compared-with-other-recipients-and-risk-factors-for-recurrence-a-national-review-of-the-irish-transplant-registry
#20
S Cormican, C Kennedy, P O'Kelly, B Doyle, A Dorman, A Awan, P J Conlon
INTRODUCTION: Primary focal segmental glomerular sclerosis (p-FSGS) is commonly complicated by recurrence (r-FSGS) post-transplantation. Our objective was to describe Irish outcomes for transplantation after ESRD due to p-FSGS, specifically rates of, and treatments for, r-FSGS. PATIENTS AND METHODS: Irish patients with biopsy proven FSGS were identified from the Irish National Kidney Transplant database (1982-2015). Medical record review was performed to identify predictors of r-FSGS and treatments for r-FSGS...
November 8, 2017: Clinical Transplantation
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