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Acute renal allograft rejection

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https://www.readbyqxmd.com/read/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#1
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/29731057/clinical-outcomes-of-kidney-transplantation-in-patients-with-biopsy-proven-glomerulonephritis
#2
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/29725772/benefits-and-risks-of-protocol-biopsies-in-pediatric-renal-transplantation
#3
Roberto Gordillo, Raj Munshi, Eric J Monroe, Giridhar M Shivaram, Jodi M Smith
Protocol biopsies are defined as sampling of allograft tissue at predetermined times regardless of function. This procedure can be justified due to the lack of non-invasive methods to reliably diagnose rejection (acute or subclinical). Changes in creatinine are not seen with subclinical rejection or early acute rejection and do not always correlate with efficacy of treatment. Parents and providers are still hesitant to pursue protocol biopsy due to the potential complications and lack of definitive evidence of a benefit from doing this procedure...
May 3, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29719109/belatacept-during-pregnancy-in-renal-transplant-recipients-two-case-reports
#4
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/29701389/coronary-allograft-vasculopathy-after-cardiac-transplantation-prevalence-prognostic-and-risk-factors
#5
André Antunes, David Prieto, Carlos Pinto, Carlos Branco, Pedro Correia, Manuel Batista, Manuel Antunes
INTRODUCTION: Coronary allograft vasculopathy (CAV) is still a serious long-term complication after cardiac transplantation. PURPOSE: To evaluate the prevalence of CAV in a single institution, its impact on survival and to explore associated risk factors. METHODS: From November-2003 through June-2016, 316 patients were submitted to cardiac transplantation. After excluding those with paediatric age (n=8), those with previous renal or hepatic transplantation (n=2) and those who didn't survive the first year after cardiac transplantation (n=40), the study population resulted in 266 patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29693023/kidney-transplantation-the-challenge-of-human-leukocyte-antigen-and-its-therapeutic-strategies
#6
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
https://www.readbyqxmd.com/read/29676700/impact-of-allograft-nephrectomy-on-second-renal-transplant-outcome
#7
Masaki Muramatsu, Yoji Hyodo, Michael Sheaff, Arun Gupta, Neil Ashman, Atsushi Aikawa, Magdi Yaqoob, Carmelo Puliatti
OBJECTIVES: The impact of allograft nephrectomy on the outcome of a subsequent renal transplant is unclear. This study was conducted to assess the effects of the first allograft nephrectomy on outcomes of a second transplant. MATERIALS AND METHODS: This study included 118 patients who received a second transplant between 1994 and 2015. Before the second transplant, 59 patients did not undergo a first allograft nephrectomy (group A). Group B comprised 59 patients who had undergone a first allograft nephrectomy...
April 20, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29661456/severe-renal-allograft-rejection-resulting-from-lenalidomide-therapy-for-multiple-myeloma-case-report
#8
V Walavalkar, D B Adey, Z G Laszik, K-Y Jen
Lenalidomide, a thalidomide analogue, is an immunomodulatory drug currently used as a chemotherapeutic agent in treating certain hematologic malignancies, including multiple myeloma. The antineoplastic effect of lenalidomide may be due to its ability to modulate different components of the immune system as well as its antiangiogenic, antiproliferative, and direct cytotoxic activity. Given its immunomodulatory effects, lenalidomide may potentially elicit unintended immune activity against allografts in solid organ transplant recipients...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29659179/nk-cell-and-th17-responses-are-differentially-induced-in-murine-cytomegalovirus-infected-renal-allografts-and-vary-according-to-recipient-virus-dose-and-strain
#9
Mao Li, Srinivasa Boddeda, Bo Chen, Qiang Zeng, Trenton R Schoeb, Victoria M Velazquez, Masako Shimamura
Human cytomegalovirus (HCMV) donor positive (D+) serostatus with acute rejection is associated with renal allograft loss, but the impact of recipient positive (R+) serostatus is unclear. In an allogeneic renal transplant model, antiviral natural killer (NK) and CD8+ T cell memory responses in murine CMV (MCMV) D+/R+ transplants were compared to D-/R- and D+/R- transplants, with recipient infection varied by MCMV dose and strain. D+/R- transplants had high primary antiviral cytolytic (interferon-γ+) and cytotoxic (granzyme B+) NK responses, whereas NK memory responses were lower in D+/R+ recipients receiving a high primary MCMV dose...
April 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29620612/tofacitinib-halts-progression-of-graft-dysfunction-in-a-rat-model-of-mixed-cellular-and-humoral-rejection
#10
Jordi Rovira, María J Ramírez-Bajo, Elisenda Banon-Maneus, Marta Lazo-Rodríguez, Daniel Moya-Rull, Natalia Hierro-Garcia, Valeria Tubita, Gastón J Piñeiro, Ignacio Revuelta, Pedro Ventura-Aguiar, David Cucchiari, Federico Oppenheimer, Mercè Brunet, Josep M Campistol, Fritz Diekmann
BACKGROUND: The progression from acute to chronic antibody-mediated rejection in kidney transplant recipients is usually not prevented by current therapeutic options. Here, we investigated whether the use of tofacinitib, a Janus kinase 3 inhibitor, was capable of preventing the progression of allograft dysfunction in a Fisher-to-Lewis rat model of kidney transplantation. METHODS: Rats were treated from the third week after transplantation in order to allow the development of rejection...
April 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29620542/donor-specific-hla-dq-antibodies-may-contribute-to-poor-graft-outcome-after-heart-transplantation
#11
Osama Omrani, Moheeb Alawwami, Jehad Buraiki, Nedim Selimovic
BACKGROUND: HLA-DQ donor-specific antibodies (DSA) are implicated in allograft dysfunction after renal and lung transplantation. Limited data exists on the impact of HLA-DQ antibodies on heart transplant patients. OBJECTIVE: To investigate the impact of DSA formation on allograft function and outcomes in heart transplant patients. DESIGN: Retrospective cohort study. SETTING: Collating post-transplantation patient data from computerized database in a tertiary hospital in Riyadh, Saudi Arabia from January 2006 to October 2014...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29605470/outcomes-associated-with-mammalian-target-of-rapamycin-mtor-inhibitors-in-heart-transplant-recipients-a-meta-analysis
#12
Douglas L Jennings, Nicholas Lange, Michael Shullo, Farhana Latif, Susan Restaino, Veli K Topkara, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Maryjane Farr, Paolo Colombo, William L Baker
BACKGROUND: Data evaluating mTOR inhibitor use heart transplant (HT) patients comes from relatively small studies and controversy exists regarding their specific role. We performed a meta-analysis of randomized trials to evaluate the efficacy and safety of mTOR inhibitors in HT patients. METHODS: We performed a systematic literature search of Medline and Embase through July 2017 identifying studies evaluating mTOR inhibitors in HT patients reporting effects on coronary allograft vasculopathy (CAV), renal function, acute cellular rejection (ACR), cytomegalovirus (CMV) infection, and discontinuation due to adverse drug events (ADE)...
March 24, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29594146/early-conversion-from-tacrolimus-to-belatacept-in-a-highly-sensitized-renal-allograft-recipient-with-calcineurin-inhibitor-induced-de-novo-post-transplant-hemolytic-uremic-syndrome
#13
Vasishta S Tatapudi, Bonnie E Lonze, Ming Wu, Robert A Montgomery
Background: Kidney transplantation is the first-line therapy for patients with end-stage renal disease since it offers greater long-term survival and improved quality of life when compared to dialysis. The advent of calcineurin inhibitor (CNI)-based maintenance immunosuppression has led to a clinically significant decline in the rate of acute rejection and better short-term graft survival rates. However, these gains have not translated into improvement in long-term graft survival. CNI-related nephrotoxicity and metabolic side effects are thought to be partly responsible for this...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29574612/effect-of-bmi-on-allograft-function-and-survival-in-pediatric-renal-transplant-recipients
#14
Erica Winnicki, Madan Dharmar, Daniel J Tancredi, Stephanie Nguyen, Lavjay Butani
OBJECTIVE: To determine whether pre-transplant body mass index (BMI) affects renal allograft function and survival in pediatric renal transplant recipients. STUDY DESIGN: This is a retrospective cohort study using the Organ Procurement and Transplantation Network data from 2000 to 2013 to compare time to total allograft loss (allograft failure or death), prevalence of delayed graft function, prevalence of acute rejection, and estimated glomerular filtration rate (eGFR) post-transplant in pediatric renal transplant recipients categorized by BMI z-score...
March 25, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29539614/methods-of-blood-oxygen-level-dependent-magnetic-resonance-imaging-analysis-for-evaluating-renal-oxygenation
#15
Fen Chen, Shulin Li, Dong Sun
Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) has recently been utilized as a noninvasive tool for evaluating renal oxygenation. Several methods have been proposed for analyzing BOLD images. Regional ROI selection is the earliest and most widely used method for BOLD analysis. In the last 20 years, many investigators have used this method to evaluate cortical and medullary oxygenation in patients with ischemic nephropathy, hypertensive nephropathy, diabetic nephropathy, chronic kidney disease (CKD), acute kidney injury and renal allograft rejection...
March 8, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29539601/renal-function-variability-an-independent-risk-factor-for-graft-loss-and-death-following-kidney-transplantation
#16
Nicole A Pilch, Vinayak Rohan, Vinaya Rao, Patrick D Mauldin, Zemin Su, Derek A Dubay, Thomas A Morinelli, David J Taber
BACKGROUND: Several studies have been performed to evaluate surrogate markers of long-term allograft function in renal transplant recipients. These include serum creatinine, estimated glomerular filtration rate (eGFR), slope of eGFR, and more recently eGFR variability. The aim of this study was to measure eGFR slope while assessing the variability of this slope and if high variability occurring at any time post-transplant was predictive of poorer long-term outcomes in a large cohort of kidney transplant recipients...
2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29534686/unexpected-presentation-of-allograft-dysfunction-triggered-by-page-kidney-phenomenon-immediately-after-kidney-transplantation-a-case-report
#17
Shunta Hori, Mitsuru Tomizawa, Fumisato Maesaka, Takuya Owari, Yosuke Morizawa, Yasushi Nakai, Makito Miyake, Tatsuo Yoneda, Nobumichi Tanaka, Katsunori Yoshida, Kiyohide Fujimoto
BACKGROUND: Page kidney phenomenon is caused by strong renal parenchymal compression and leads to renal hypoperfusion and microvascular ischemia, resulting in renal dysfunction and hypertension. Although the development of Page kidney phenomenon in allograft is rare, most of its cases are induced by allograft biopsy or trauma. We observed a case of Page kidney phenomenon that was induced by unusual causes immediately after kidney transplantation. CASE PRESENTATION: A 66-year-old man, whose wife donated a kidney, underwent ABO-compatible living kidney transplantation...
March 13, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29528010/de-novo-thrombotic-microangiopathy-in-renal-transplant-patients
#18
B Handan Özdemir, Alev Ok Atılgan, Eda Yılmaz Akçay, Gökçe Özdemir, Ebru Ayvazoğlu Soy, Aydıncan Akdur, Mehmet Haberal
OBJECTIVES: Thrombotic microangiopathy is a form of renal capillary injury possibly associated with calcineurin inhibitor toxicity, acute humoral rejection, infections, and recurrent diseases. Here, we examined its incidence in patients diagnosed with acute and chronic active humoral rejection, polyomavirus nephropathy, acute cellular rejection, and immunoglobulin A recurrence. MATERIALS AND METHODS: In total, 272 renal allograft recipients who met the inclusion criteria were reevaluated for presence of renal thrombotic microangiopathy...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29527990/pretransplant-renal-arterial-vasculopathy-of-donor-predicts-poor-renal-allograft-survival
#19
B Handan Özdemir, F Nurhan Özdemir, Pelin Börcek, Çiğdem Sercan, Gökçe Özdemir, Ebru H Ayvazoğlu Soy, Mehmet Haberal
OBJECTIVES: Transplant vasculopathy is a significant predictor of poor outcome. We investigated whether age or pretransplant renal arterial vasculopathy of grafted kidneys affected allograft survival. MATERIALS AND METHODS: This study included 148 recipients and their donors. All donors underwent pretransplant renal arterial biopsy, with renal artery vascular score determined for each artery. Chronic rejection and graft loss were noted for all patients. RESULTS: Variable grades of pretransplant renal arterial lesions were noted in 103 donors (69...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29515027/interferon-%C3%AE-converts-human-microvascular-pericytes-into-negative-regulators-of-alloimmunity-through-induction-of-indoleamine-2-3-dioxygenase-1
#20
Rebecca Liu, Jonathan Merola, Thomas D Manes, Lingfeng Qin, Gregory T Tietjen, Francesc López-Giráldez, Verena Broecker, Caodi Fang, Catherine Xie, Ping-Min Chen, Nancy C Kirkiles-Smith, Dan Jane-Wit, Jordan S Pober
Early acute rejection of human allografts is mediated by circulating alloreactive host effector memory T cells (TEM). TEM infiltration typically occurs across graft postcapillary venules and involves sequential interactions with graft-derived endothelial cells (ECs) and pericytes (PCs). While the role of ECs in allograft rejection has been extensively studied, contributions of PCs to this process are largely unknown. This study aimed to characterize the effects and mechanisms of interactions between human PCs and allogeneic TEM...
March 8, 2018: JCI Insight
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