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Acute renal allograft rejection

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https://www.readbyqxmd.com/read/27926596/donor-genotype-and-intragraft-expression-of-cyp3a5-reflect-the-response-to-steroid-treatment-during-acute-renal-allograft-rejection
#1
N V Rekers, T M Flaig, M J K Mallat, M J Spruyt-Gerritse, M Zandbergen, J D H Anholts, I M Bajema, M C Clahsen-van Groningen, J Yang, J W de Fijter, F H J Claas, S Brakemeier, N Lachmann, R Kreutz, E de Heer, K Budde, J Bolbrinker, M Eikmans
BACKGROUND: Glucocorticoid-refractory acute rejection is a risk factor for inferior renal allograft outcome. We investigated genetic predisposition to the response to steroid treatment of acute allograft rejection. METHODS: Single nucleotide polymorphisms of genes involved in glucocorticoid signaling (GR, GLCCI1) and drug metabolism and transport (CYP3A5, ABCB1, and PXR) were analyzed in kidney transplant recipients (1995-2005, Leiden cohort, n=153) treated with methylprednisolone...
December 6, 2016: Transplantation
https://www.readbyqxmd.com/read/27917694/outcomes-of-kidney-transplantation-in-alport-syndrome-compared-with-other-forms-of-renal-disease
#2
Yvelynne P Kelly, Anish Patil, Luke Wallis, Susan Murray, Saumitra Kant, Mohammed A Kaballo, Liam Casserly, Brendan Doyle, Anthony Dorman, Patrick O'Kelly, Peter J Conlon
INTRODUCTION: Alport syndrome is an inherited renal disease characterized by hematuria, renal failure, hearing loss and a lamellated glomerular basement membrane. Patients with Alport syndrome who undergo renal transplantation have been shown to have patient and graft survival rates similar to or better than those of patients with other renal diseases. METHODS: In this national case series, based in Beaumont Hospital Dublin, we studied the cohort of patients who underwent renal transplantation over the past 33 years, recorded prospectively in the Irish Renal Transplant Registry, and categorized them according to the presence or absence of Alport syndrome...
December 5, 2016: Renal Failure
https://www.readbyqxmd.com/read/27915964/posttransplant-de-novo-hepatitis-c-virus-infection-in-renal-transplant-recipients-its-impact-on-morbidity-and-mortality
#3
Farina M Hanif, S Muddasir Laeeq, Nasir Hassan Luck, Tahir Aziz, Zaigham Abbas, Muhammed Mubarak
OBJECTIVES: The clinical effects of hepatitis C virus infection acquired after transplant have not been thoroughly studied. We aimed to study hepatitis C virus-related morbidity and mortality with de novo hepatitis C virus infection after renal transplant. MATERIALS AND METHODS: Data from mortality files were retrospectively collected from January 2011 to January 2015. Patients were divided into 2 groups: hepatitis C virus positive (group A) and hepatitis C virus negative (group B)...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27913812/association-between-cytokines-and-their-receptor-antagonist-gene-polymorphisms-and-clinical-risk-factors-and-acute-rejection-following-renal-transplantation
#4
SIqing Ding, Jianfei Xie, Qiquan Wan
BACKGROUND Acute rejection (AR) after renal transplantation affects both patient and graft survival. There is growing evidence of the genetic association between cytokine or its receptor antagonist and AR in solid organ transplantation. The objectives of this study were to investigate the role of recipient TNF β, IL-10, IL-1β, and IL-1 receptor antagonist (ra) gene polymorphism, as well as traditional clinical variables such as panel-reactive antibody (PRA) levels, donor type, and HLA mismatches in AR following renal transplantation...
December 3, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27907919/the-impact-of-health-care-appointment-non-adherence-on-graft-outcomes-in-kidney-transplantation
#5
David J Taber, James N Fleming, Cory E Fominaya, Mulugeta Gebregziabher, Kelly J Hunt, Titte R Srinivas, Prabhakar K Baliga, John W McGillicuddy, Leonard E Egede
BACKGROUND: Non-adherence to medication is a well-studied and known cause of late allograft loss, but it is difficult to measure and prospectively monitor. The aim of this study was to assess if appointment non-adherence was correlated with medication non-adherence and a predictor of graft outcomes. METHODS: This was a longitudinal cohort study that used the National United States Renal Data System and veterans affairs health records data with time-to-event analyses conducted to assess the impact on graft and patient survival...
December 2, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27898462/recent-advances-in-allograft-vasculopathy
#6
Jonathan Merola, Daniel D Jane-Wit, Jordan S Pober
PURPOSE OF REVIEW: Despite considerable advances in controlling acute rejection, the longevity of cardiac and renal allografts remains significantly limited by chronic rejection in the form of allograft vasculopathy. This review discusses recently reported mechanistic insights of allograft vasculopathy pathogenesis as well as recent clinical evaluations of new therapeutic approaches. RECENT FINDINGS: Although adaptive immunity is the major driver of allograft vasculopathy, natural killer cells mediate vasculopathic changes in a transplanted mouse heart following treatment with donor-specific antibody (DSA)...
November 24, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27871782/association-of-high-hla-e-expression-during-acute-cellular-rejection-and-numbers-of-hla-class-i-leader-peptide-mismatches-with-reduced-renal-allograft-survival
#7
Hana Guberina, Vera Rebmann, Bettina Wagner, Fabiola da Silva Nardi, Phillip Dziallas, Sebastian Dolff, Anja Bienholz, Jeremias Wohlschlaeger, Agnes Bankfalvi, Falko M Heinemann, Oliver Witzke, Yvonne M Zoet, Frans H J Claas, Peter A Horn, Andreas Kribben, Ilias I N Doxiadis
Non-classical Human Leukocyte Antigen (HLA)-E preferentially presents leader peptides derived from classical HLA-class I molecules. HLA-E can trigger opposed immune responses by interacting with inhibitory NKG2A or by activating NKG2C receptors on NK and T-cells. We studied the impact of HLA-E on renal allograft survival during acute cellular rejection. HLA-E expression was up-regulated in acute cellular rejection (ACR) biopsies (n=12) compared to biopsies from 13 renal allografts with no rejection-signs. HLA-E up-regulation was correlated with numbers of HLA-class I leader peptide mismatches (p=0...
November 4, 2016: Immunobiology
https://www.readbyqxmd.com/read/27871759/rabbit-atg-or-basiliximab-induction-for-rapid-steroid-withdrawal-after-renal-transplantation-harmony-an-open-label-multicentre-randomised-controlled-trial
#8
Oliver Thomusch, Michael Wiesener, Mirian Opgenoorth, Andreas Pascher, Rainer Peter Woitas, Oliver Witzke, Bernd Jaenigen, Markus Rentsch, Heiner Wolters, Thomas Rath, Tülay Cingöz, Urs Benck, Bernhard Banas, Christian Hugo
BACKGROUND: Standard practice for immunosuppressive therapy after renal transplantation is quadruple therapy using antibody induction, low-dose tacrolimus, mycophenolate mofetil, and corticosteroids. Long-term steroid intake significantly increases cardiovascular risk factors with negative effects on the outcome, especially post-transplantation diabetes associated with morbidity and mortality. In this trial, we examined the efficacy and safety parameters of rapid steroid withdrawal after induction therapy with either rabbit antithymocyte globulin (rabbit ATG) or basiliximab in immunologically low-risk patients during the first year after kidney transplantation...
November 18, 2016: Lancet
https://www.readbyqxmd.com/read/27870356/clinical-and-immunological-relevance-of-antibodies-in-solid-organ-transplantation
#9
REVIEW
N K Mehra, A K Baranwal
The two important issues affecting recipients of solid organ transplants and of importance to immunologists are (i) sensitization of the recipient to HLA antigens and the resultant humoral immune response leading to the development of anti-HLA antibodies; and ii) development of robust assays for early detection of humoral rejection post-transplant. Evidence from several studies clearly indicates that presence of circulating anti-HLA antibodies especially donor specific leads to early graft loss and high titres of DSA may even lead to hyperacute or accelerated acute rejection...
December 2016: International Journal of Immunogenetics
https://www.readbyqxmd.com/read/27862352/de-novo-donorspecific-anti-hla-antibodies-after-kidney-transplantation-are-associated-with-impaired-graft-outcome-independently-of-their-c1q-binding-ability
#10
Teresa Kauke, Cornelia Oberhauser, Viviane Lin, Michaela Coenen, Michael Fischereder, Andrea Dick, Ulf Schoenermarck, Markus Guba, Joachim Andrassy, Jens Werner, Bruno Meiser, Martin Angele, Manfred Stangl, Antje Habicht
BACKGROUND: Many aspects of post-transplant monitoring of donorspecific (DSA) and non-donorspecific (nDSA) anti-HLA antibodies on renal allograft survival are still unclear. Differentiating them by their ability to bind C1q may offer a better risk assessment. METHODS: We retrospectively investigated the clinical relevance of de novo C1q-binding anti-HLA antibodies on graft outcome in 611 renal transplant recipients. Acute rejection (AR), renal function and graft survival were assessed within a mean follow-up of 6...
November 18, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27833442/stat4-gene-polymorphism-in-patients-after-renal-allograft-transplantation
#11
Ewa Dąbrowska-Żamojcin, Violetta Dziedziejko, Krzysztof Safranow, Leszek Domański, Sylwia Słuczanowska-Głabowska, Andrzej Pawlik
INTRODUCTION: STAT4 (signal transducer and activator of transcription 4) is involved in the regulation of innate and adaptive immune responses. Some studies have suggested that STAT4 may be involved in the immune response after graft transplantation. Several polymorphisms in the STAT4 gene have been identified. The most commonly studied polymorphism in the STAT4 gene is rs7574865. In our study, we examined whether this polymorphism is associated with the early and late functions of renal allografts...
2016: Central-European Journal of Immunology
https://www.readbyqxmd.com/read/27820833/multiparametric-functional-mri-a-tool-to-uncover-subtle-changes-following-allogeneic-renal-transplantation
#12
Mike Notohamiprodjo, Aivars Kalnins, Martin Andrassy, Manuel Kolb, Benjamin Ehle, Susanna Mueller, Michael N Thomas, Jens Werner, Markus Guba, Konstantin Nikolaou, Joachim Andrassy
PURPOSE: To investigate multiparametric functional MRI to characterize acute rejection in a murine allogeneic renal transplant model and evaluate the effect of novel therapeutics. MATERIAL AND METHODS: We performed allogeneic and syngeneic orthotopic transplantations (Balb/c to C57Bl/6 and C57Bl/6 to C57Bl/6). Allogeneic Groups (n = 5) were either treated with the anti-CCL2-Spiegelmer (mNOX-E36) in monotherapy or in combination with low doses of Ciclosporin-A (10mg/kgBW/d) for 10 days...
2016: PloS One
https://www.readbyqxmd.com/read/27812144/diagnostic-performance-of-fas-ligand-mrna-expression-for-acute-rejection-after-kidney-transplantation-a-systematic-review-and-meta-analysis
#13
Baoli Heng, Hongwen Ding, Haolin Ren, Liping Shi, Jie Chen, Xun Wu, Caiyong Lai, Ganshen Yu, Yin Xu, Zexuan Su
BACKGROUND: The value of Fas ligand (FASL) as a diagnostic immune marker for acute renal rejection is controversial; this meta-analysis aimed to clarify the role of FASL in acute renal rejection. METHODS: The relevant literature was included by systematic searching the MEDLINE, EMBASE, and Cochrane Library databases. Accuracy data for acute rejection (AR) and potential confounding variables (the year of publication, area, sample source, quantitative techniques, housekeeping genes, fluorescence staining, sample collection time post-renal transplantation, and clinical classification of AR) were extracted after carefully reviewing the studies...
2016: PloS One
https://www.readbyqxmd.com/read/27805521/smoking-is-related-to-postoperative-pulmonary-complications-and-graft-outcomes-in-renal-transplant-patients
#14
Balam Er Dedekargınoğlu, Gaye Ulubay, Elif Küpeli, Mahir Kırnap, Füsun Öner Eyüboğlu, Mehmet Haberal
OBJECTIVES: Renal transplant is an important treatment option for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk compared with maintenance dialysis in patients with end-stage renal disease. Several immunologic and nonimmunologic factors are responsible for graft outcomes in renal transplant patients. Our study was performed to evaluate the role of smoking on postoperative pulmonary complications and graft outcomes in renal transplant patients...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27798244/the-emerging-importance-of-non-hla-autoantibodies-in-kidney-transplant-complications
#15
Héloise Cardinal, Mélanie Dieudé, Marie-Josée Hébert
Antibodies that are specific to organ donor HLA have been involved in the majority of cases of antibody-mediated rejection in solid organ transplant recipients. However, recent data show that production of non-HLA autoantibodies can occur before transplant in the form of natural autoantibodies. In contrast to HLAs, which are constitutively expressed on the cell surface of the allograft endothelium, autoantigens are usually cryptic. Tissue damage associated with ischemia-reperfusion, vascular injury, and/or rejection creates permissive conditions for the expression of cryptic autoantigens, allowing these autoantibodies to bind antigenic targets and further enhance vascular inflammation and renal dysfunction...
October 17, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27788796/surveillance-registry-of-sirolimus-use-in-recipients-of-kidney-allografts-from-expanded-criteria-donors
#16
G Laham, R Scuteri, P Cornicelli, M Arriola, P M Raffaele, M Davalos Michel, N Imperiali, R M Fortunato, E C Maggiora, M V Sal, G Soler Pujol
BACKGROUND: The use of expanded criteria donor (ECD) kidneys has increased the overall availability of renal transplants. This study assessed the use of sirolimus in patients receiving Argentina-ECD kidneys. METHODS: This observational, open-label, 1-arm, prospective, longitudinal pilot study was conducted at 8 transplant centers in Argentina. Adults receiving kidney transplants (without pancreas) from ECDs were eligible if they were converted to sirolimus 1 to 36 months' posttransplantation, with sirolimus becoming base therapy within 1 month after conversion...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788793/tissue-expression-of-aquaporin-2-is-correlated-to-urine-output-and-allograft-function-in-sensitized-kidney-transplant-patients
#17
K Klein, S Rübenacker, S M Schaefer, L P Kihm, V Schwenger, S Macher-Goeppinger, P Schemmer, C Süsald, M Zeier, C Morath, L E Becker
BACKGROUND: Salt and water disturbances often occur during acute kidney allograft dysfunction that contribute to graft failure, but this condition has been poorly investigated in the alloreactivity setting. We evaluated the tissue expression of aquaporins (AQP1 and AQP2) and the epithelial sodium channel (ENAC) in kidney biopsy specimens from sensitized kidney transplant recipients. METHODS: Eighty-six biopsy specimens from 33 sensitized patients were divided into 3 groups according to clinical context: time-zero (n = 9), protocol (n = 9), and indication (n = 68)...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27785759/co-stimulation-blockade-plus-t-cell-depletion-in-transplant-patients-towards-a-steroid-and-calcineurin-inhibitor-free-future
#18
Florence Herr, Melanie Brunel, Nathalie Roders, Antoine Durrbach
Long-term survival of solid allografts depends on both immunosuppressive efficacy and reducing the side effects associated with these therapies. Immunotherapies developed over the past 15 years to prevent organ rejection have greatly improved cardiovascular and renal function compared with classical therapies, such as calcineurin inhibitors and corticosteroids. Immunotherapies that target T cells through the co-stimulation blockade (CTLA-4-Ig) improve renal function and the survival of grafts and patients, but are associated with higher rates of T-cell-mediated acute rejection...
November 2016: Drugs
https://www.readbyqxmd.com/read/27784285/inhibition-of-histone-methyltransferase-ezh2-ameliorates-early-acute-renal-allograft-rejection-in-rats
#19
Long Li, Yi Zhang, Ming Xu, Ruiming Rong, Jina Wang, Tongyu Zhu
BACKGROUND: Although histone methyltransferases EZH2 has been proved to have significant regulatory effect on the immune rejection after hematopoietic stem cell transplantation, its role in solid-organ transplantation remains uncovered. In this study, we investigate whether histone methylation regulation can impact renal allograft rejection in rat models. RESULTS: Allogeneic rat renal transplantation model (Wistar to Lewis) was established, and the recipients were administrated with EZH2 inhibitor DZNep after transplantation...
October 26, 2016: BMC Immunology
https://www.readbyqxmd.com/read/27777773/antitumor-activity-of-nivolumab-on-hemodialysis-after-renal-allograft-rejection
#20
Michael Ong, Andrea Marie Ibrahim, Samuel Bourassa-Blanchette, Christina Canil, Todd Fairhead, Greg Knoll
BACKGROUND: Nivolumab (Opdivo™) is a novel IgG4 subclass programmed death-1 (PD-1) inhibiting antibody that has demonstrated breakthrough-designation anti-tumor activity. To date, clinical trials of nivolumab and other checkpoint inhibitors have generally excluded patients with solid organ transplantation and patients with concurrent immunosuppression. However, organ transplant recipients are at high-risk of development of malignancy as a result of suppressed immune surveillance of cancer...
2016: Journal for Immunotherapy of Cancer
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