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Acute renal allograft rejection

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https://www.readbyqxmd.com/read/28512328/tacrolimus-blood-level-fluctuation-predisposes-to-coexisting-bk-virus-nephropathy-and-acute-allograft-rejection
#1
Chia-Lin Shen, An-Hang Yang, Tse-Jen Lien, Der-Cherng Tarng, Chih-Yu Yang
BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN patients with coexisting acute rejection, and 21 patients with BKVN alone. We retrospectively analyzed the dosage and blood concentrations of immunosuppressants during the 3-month period prior to the renal biopsy between the two patient groups...
May 16, 2017: Scientific Reports
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/28508971/short-term-outcome-and-quality-of-life-in-kidney-transplant-recipient-with-monoclonal-gammopathy
#3
Masaaki Yanishi, Hiroyasu Tsukaguchi, Takashi Yoshida, Hisanori Taniguchi, Kenji Yoshida, Takao Mishima, Yoshihiro Komai, Kaneki Yasuda, Masato Watanabe, Motohiko Sugi, Hidefumi Kinoshita, Tadashi Matsuda
Monoclonal gammopathy of undetermined significance (MGUS) is the common pre-malignant B cell disorders with a general prevalence of 3-5 % at age over 50. Because of the potential malignant transformation and immune insufficiency, pre-transplant MGUS recipient should be carefully followed after allograft transplantation. The post-transplant prognosis and quality of life (QOL) in patient with MGUS have not yet been fully determined. The aim of this study is to evaluate function and pathology of the renal allograft and self-assessment QOL changes during 2 years after transplantation in our case of MGUS-bearing recipient...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28501318/mortality-rehospitalization-and-post-transplant-complications-in-gender-mismatched-heart-transplant-recipients
#4
Anne Jalowiec, Kathleen L Grady, Connie White-Williams
BACKGROUND: Limited research has been published on outcomes in heart transplant (HT) recipients with gender-mismatched donors. OBJECTIVE: Compare 3-year post-transplant outcomes in 2 groups of gender-mismatched HT recipients and a no-mismatch group. METHODS: Sample: 347 HT recipients: 21.3% (74) received a heart from the opposite gender: Group 1: same gender donor/recipient (273, 78.7%); Group 2: female donor/male recipient (40, 11.5%); Group 3: male donor/female recipient (34, 9...
May 10, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28495618/a-model-of-acute-renal-allograft-rejection-in-outbred-yorkshire-piglets
#5
Randi Lassiter, Youli Wang, Xuexiu Fang, Matt Winn, Arina Ghaffari, Chak-Sum Ho, Sandra Helman, Ryan Jajosky, Daniel Kleven, N Stanley Nahman, Todd D Merchen
Pigs represent a desirable animal model for the study of rejection in kidney transplantation with inbred Yucatan miniature swine (YMS) the most commonly studied strain due to well defined swine leukocyte antigen (SLA) genotypes. However, limitations to YMS may include cost and availability. Outbred Yorkshire pigs are widely available and significantly cheaper than YMS. Recent advances in SLA genotyping have allowed its application to outbred strains. On this basis, we theorized that Yorkshire pigs would be a viable alternative to YMS for the study of rejection in kidney transplantation...
May 8, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28486415/the-presence-of-anti-angiotensin-ii-type-1-receptor-antibodies-adversely-affect-kidney-graft-outcomes
#6
Jian Zhang, Mingxu Wang, Jun Liang, Ming Zhang, Xiao-Hong Liu, Le Ma
The aim of this study was to determine whether anti-angiotensin type 1 receptor antibodies (AT1R-Abs) are related to acute rejection (AR) and kidney graft failure in renal transplantation. We searched electronic databases including MEDLINE, EMBASE, and the ISI Web of Science databases for all studies on the association between anti-angiotensin type 1 receptor antibodies and kidney allograft outcomes updated to November 2016. Reference lists from included articles were also reviewed. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were extracted or calculated using a random-effects model...
May 9, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28467296/immunohistopathologic-characterization-of-plasma-cell-rich-acute-rejection-in-living-related-renal-transplant-recipients
#7
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/28463861/everolimus-immunosuppression-for-renal-protection-reduction-of-allograft-vasculopathy-and-prevention-of-allograft-rejection-in-de-novo-heart-transplant-recipients-could-we-have-it-all
#8
Einar Gude, Lars Gullestad, Arne K Andreassen
PURPOSE OF REVIEW: De-novo introduction of everolimus (Eve) in heart transplant recipients opens for early reduction of calcineurin inhibitors (CNI) and potential of preserving renal function, attenuate progression of coronary allograft vasculopathy (CAV) and maintain rejection efficacy. RECENT FINDINGS: The first trials demonstrated adequate rejection prophylaxis and favorable outcomes on CAV, but observed enhanced nephrotoxicity because of insufficient CNI reduction...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28415773/effects-of-cd20-b-cell-infiltration-into-allografts-on-kidney-transplantation-outcomes-a-systematic-review-and-meta-analysis
#9
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/28411307/ferumoxytol-is-not-retained-in-kidney-allografts-in-patients-undergoing-acute-rejection
#10
Maryam Aghighi, Laura Pisani, Ashok J Theruvath, Anne M Muehe, Jessica Donig, Ramsha Khan, Samantha J Holdsworth, Neeraja Kambham, Waldo Concepcion, Paul C Grimm, Heike E Daldrup-Link
PURPOSE: To evaluate whether ultrasmall superparamagnetic iron oxide nanoparticle (USPIO)-enhanced magnetic resonance imaging (MRI) can detect allograft rejection in pediatric kidney transplant patients. PROCEDURES: The USPIO ferumoxytol has a long blood half-life and is phagocytosed by macrophages. In an IRB-approved single-center prospective clinical trial, 26 pediatric patients and adolescents (age 10-26 years) with acute allograft rejection (n = 5), non-rejecting allografts (n = 13), and normal native kidneys (n = 8) underwent multi-echo T2* fast spoiled gradient-echo (FSPGR) MRI after intravenous injection (p...
April 14, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28405599/absence-of-intragraft-b-cells-in-rejection-biopsies-after-rituximab-induction-therapy-consequences-for-clinical-outcome
#11
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/28370148/the-serial-duplex-index-improves-differential-diagnosis-of-acute-renal-transplant-dysfunction
#12
Markus Meier, Lutz Fricke, Katrin Eikenbusch, Emma Smith, Jan Kramer, Hendrik Lehnert, Martin Nitschke
OBJECTIVES: Renal duplex sonography represents a standard noninvasive diagnostic procedure to demonstrate morphologic changes in acute kidney transplant dysfunction. We investigated whether a newly developed serial duplex index (SDI) can differentiate between acute cellular rejection and acute vascular rejection more effectively than the established Doppler parameters of the resistive index (RI) and pulsatility index (PI) in recently transplanted patients. METHODS: Serial duplex scans of patients with histologically proven acute tubular necrosis (n = 25), acute cellular rejection (n = 28), acute vascular rejection (n = 18), and normal graft function (n = 50, partially protocol biopsied) were retrospectively analyzed...
April 3, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28364323/circulating-and-renal-expression-of-hla-g-prevented-chronic-renal-allograft-dysfunction-in-japanese-recipients
#13
Yuki Okushi, Kazuaki Okino, Kiyotaka Mukai, Yuki Matsui, Norifumi Hayashi, Keiji Fujimoto, Hiroki Adachi, Hideki Yamaya, Hitoshi Yokoyama
BACKGROUND: Although the risk of acute rejection has been studied in renal transplanted patients, there is little data about the long-term renal survival effects of non-classical human leukocyte antigen class I (HLA-G) in Japanese patients. METHOD: We investigated the changes in the estimated glomerular filtration rate (eGFR) for Japanese, and factors affecting the eGFR in 141 adult Japanese subjects whose allografts had survived for at least 1 year. Clinical background data, gender, HLA matching status, the total ischemic time, ABO incompatibility, immunosuppressive therapy, and the serum soluble(s) HLA-G5 level were examined...
March 31, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28359782/in-vivo-il-4-prevents-allo-antigen-driven-cd8-ctl-development
#14
Charles S Via, Kateryna Soloviova, Maksym Puliaiev, Roman Puliav, Irina Puliaeva, Suzanne C Morris, Fred D Finkelman
IL-4 has been shown to suppress acute graft vs. host disease (GVHD) in irradiated hosts. Here we evaluated whether IL-4 suppresses acute GVHD in the un-irradiated parent-into-F1 GVHD model with relevance to renal allograft rejection. IL-4 completely suppressed CD8 CTL when administered with donor cells however this effect was lost if its administration was delayed 3days. IL-4 did not inhibit donor CD8(+) T cell homing to the host spleen but rather prevented donor CD8(+) T cell differentiation into CTLs. Studies with IL-4Rα-deficient donor cells or recipient mice demonstrated that IL-4 effects on the host, rather than, or in addition to IL-4 effects on donor cells, were critical for suppression of CTL...
March 27, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28356665/renal-allograft-eosinophilia-an-unusual-presentation-of-sudden-graft-dysfunction
#15
A Yuvaraj, S Ghosh, G Abraham, P Koshy
We present a case of sudden allograft dysfunction 11 months after renal transplantation which presented as severe peripheral and allograft eosinophilia and was managed as a case of an acute cellular rejection with significant interstitial graft eosinophilic infiltration. Patient had partial response to antirejection therapy and eventually ended up in a chronic allograft dysfunction.
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28356080/patient-reported-non-adherence-and-immunosuppressant-trough-levels-are-associated-with-rejection-after-renal-transplantation
#16
Jennifer Scheel, Sandra Reber, Lisa Stoessel, Elisabeth Waldmann, Sabine Jank, Kai-Uwe Eckardt, Franziska Grundmann, Frank Vitinius, Martina de Zwaan, Anna Bertram, Yesim Erim
BACKGROUND: Different measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels). METHODS: Patient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were ≥12 months post-transplantation...
March 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28342287/longitudinal-evaluation-of-perfusion-changes-in-acute-and-chronic-renal-allograft-rejection-using-arterial-spin-labeling-in-translational-mouse-models
#17
Katja Hueper, Martina Schmidbauer, Anja Thorenz, Jan H Bräsen, Marcel Gutberlet, Michael Mengel, Dagmar Hartung, Rongjun Chen, Martin Meier, Hermann Haller, Frank Wacker, Song Rong, Faikah Gueler
PURPOSE: To examine the longitudinal changes of renal perfusion due to acute and chronic renal allograft rejection by using arterial spin labeling (ASL) MRI in translational mouse models of isogenic and allogenic kidney transplantation (ktx). MATERIALS AND METHODS: Acute rejection was induced by allogenic ktx of C57BL/6 (B6)-kidney grafts to BALB/c-recipients with prolonged cold ischemia (CIT) of 60 minutes (n = 13). To induce chronic rejection BALB/c-kidneys were transplanted into B6-recipients with short CIT of 30 minutes (n = 22)...
March 25, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28340814/evaluation-of-th17-and-th1-immune-response-profile-in-patients-after-renal-transplant
#18
A Erol, E Arpali, B Murat Yelken, B Kocak, Y K Calıskan, I Nane, A Turkmen, F Savran Oguz
BACKGROUND: Renal transplantation (RT) is the best treatment option for patients with end-stage renal disease (ESRD) because it improves both quality of life and survival. However, allograft rejection remains the most important barrier to successful transplantation. Underlying immunologic mechanisms should be understood to develop appropriate treatment strategies. METHODS: In this prospective study, we followed renal transplant recipients for 6 months. The study population comprised 50 recipients of renal transplants, and these were divided into 2 groups: 44 patients with stable graft function (SGF) and 6 patients with rejection (RX)...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28338457/transplant-renal-vein-thrombosis
#19
Khaled El Zorkany, Julie-Michelle Bridson, Ajay Sharma, Ahmed Halawa
Transplant renal vein thrombosis usually occurs early after surgery with a reported prevalence of 0.1% to 4.2%. It is a devastating event that ultimately leads to graft loss in almost all cases. There are many predisposing factors related to donor, recipient, surgery, and immunosuppression, with mechanical factors being considered the most common causes of transplant renal vein thrombosis. The clinical manifestations of acute renal vein thrombosis are nonspecific and are not dissimilar to the features of urine leak, urinary obstruction, or severe acute rejection...
April 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#20
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. In all, 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T cells were measured using an interferon-γ Elispot assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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