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Acute renal allograft rejection

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https://www.readbyqxmd.com/read/28060446/successful-treatment-of-donor-derived-hepatitis-c-viral-infection-in-three-transplant-recipients-from-a-donor-at-increased-risk-for-bloodborne-pathogens
#1
Ashesh P Shah, Andrew Cameron, Pooja Singh, Adam M Frank, Jonathan M Fenkel
We report here the successful treatment of hepatitis C virus (HCV) transmitted from a nucleic acid testing (NAT)-negative donor to 3 HCV-negative recipients - 2 renal transplants and 1 liver. Both renal recipients underwent standard deceased-donor renal transplantation with immediate graft function. The liver recipient underwent standard orthotopic liver transplantation and recovered uneventfully. The donor was a 39-year-old woman with a terminal serum creatinine of 0.7 mg/dL. She was high risk for bloodborne pathogens, based upon a history of sexual contact with an HCV-infected male partner...
January 6, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28058228/corticosteroid-minimization-in-renal-transplantation-careful-patient-selection-enables-feasibility
#2
Georgios Vlachopanos, Julie M Bridson, Ajay Sharma, Ahmed Halawa
AIM: To explore the benefits and harms of corticosteroid (CS) minimization following renal transplantation. METHODS: CS minimization attempts to improve cardiovascular risk factors (hypertension, diabetes, dyslipidemia), to enhance growth in children, to ameliorate bone disease and to lead to better compliance with immunosuppressive agents. Nevertheless, any benefit must be carefully weighed against the reduction in net immunosuppression and the potential harm to renal allograft function and survival...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058220/tacrolimus-confers-lower-acute-rejection-rates-and-better-renal-allograft-survival-compared-to-cyclosporine
#3
Mahmoud Kamel, Manish Kadian, Titte Srinivas, David Taber, Maria Aurora Posadas Salas
AIM: To compare the impact of tacrolimus (FK) and cyclosporine (CYA) on acute rejection and graft survival and to assess the predominant causes of graft loss between patients receiving these two calcineurin inhibitors (CNIs). METHODS: Retrospective review of 1835 patients who received a kidney transplant (KTX) between 1999-2012. Patients were grouped based on initial CNI utilized: 1195 in FK group, 640 in CYA group. Data on baseline characteristics, clinical outcomes, and causes of graft loss in both groups were analyzed...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28051114/novel-therapeutics-identification-for-fibrosis-in-renal-allograft-using-integrative-informatics-approach
#4
Li Li, Ilana Greene, Benjamin Readhead, Madhav C Menon, Brian A Kidd, Andrew V Uzilov, Chengguo Wei, Nimrod Philippe, Bernd Schroppel, John Cijiang He, Rong Chen, Joel T Dudley, Barbara Murphy
Chronic allograft damage, defined by interstitial fibrosis and tubular atrophy (IF/TA), is a leading cause of allograft failure. Few effective therapeutic options are available to prevent the progression of IF/TA. We applied a meta-analysis approach on IF/TA molecular datasets in Gene Expression Omnibus to identify a robust 85-gene signature, which was used for computational drug repurposing analysis. Among the top ranked compounds predicted to be therapeutic for IF/TA were azathioprine, a drug to prevent acute rejection in renal transplantation, and kaempferol and esculetin, two drugs not previously described to have efficacy for IF/TA...
January 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28039098/efficacy-and-tolerability-of-interferon-free-antiviral-therapy-in-kidney-transplant-recipients-with-chronic-hepatitis-c
#5
Inmaculada Fernández, Raquel Muñoz-Gómez, Juan M Pascasio, Carme Baliellas, Natalia Polanco, Nuria Esforzado, Ana Arias, Martín Prieto, Lluis Castells, Valentín Cuervas-Mons, Olga Hernández, Javier Crespo, José L Calleja, Xavier Forns, María-Carlota Londoño
BACKGROUND AND AIMS: The development of direct-acting antivirals (DAAs) is a major step forward in the treatment of hepatitis C (HCV). The aims of the study were to evaluate the efficacy and tolerability of DAAs in kidney transplant (KT) recipients. METHODS: Hepa-C is a Spanish registry of patients treated with DAAs in which clinical, virological and analytical data were prospectively included. RESULTS: We report on the data from 103 KT recipients who received DAAs...
December 27, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/28031642/plausible-role-of-acute-hiv-infection-mediated-immune-activation-in-causing-renal-allograft-rejection-a-case-report
#6
Vivek Jayaschandran, Prejith P Rajendran, Mamata Khanal, Prathik Krishnan, Poornima Ramadas, Asha Alex, Lakshmi Nambiar, David A Hirschwerk, Joseph P McGowan, Nicole Ali, Amit Basu, Madhu Bhaskaran, Ernesto P Molmenti
Current research states that AIDS pathogenesis has its roots in a chronic activation of immune system secondary to human immunodeficiency virus (HIV)-induced proliferation of T cells, B cells, NK cells, and macrophages. Immune activation due to acute HIV infection can be highly detrimental to allograft survival in a renal transplant recipient. In this report, we describe a 32-year-old African-American male patient who underwent a second live donor renal transplant, following which he developed acute allograft rejection coincident with newly acquired HIV seropositivity...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28009783/treatment-of-acute-antibody-mediated-renal-allograft-rejection-with-cyclophosphamide
#7
Johannes Waiser, Michael Duerr, Klemens Budde, Birgit Rudolph, Kaiyin Wu, Friederike Bachmann, Fabian Halleck, Constanze Schönemann, Nils Lachmann
BACKGROUND: Antibody-mediated rejection (ABMR) is a major risk for renal allograft survival. Throughout decades, cyclophosphamide treatment has been proven to be effective in patients with antibody-associated autoimmune diseases. We investigated, whether cyclophosphamide combined with plasmapheresis (PPH) and intravenous immunoglobulins (IVIG) is an option for patients with ABMR. METHODS: Between March 2013 and November 2015, we initiated treatment of 13 consecutive patients with biopsy-proven acute ABMR with i...
December 22, 2016: Transplantation
https://www.readbyqxmd.com/read/28004997/effect-of-long-term-low-dose-aspirin-therapy-on-renal-graft-function
#8
Hatem Ali, Ahmed Shaaban, Asam Murtaza, Laura E Howell, Aimun Ahmed
OBJECTIVES: Despite improvements in immunosuppressive protocols for renal transplant, long-term success of renal transplant is still limited by the occurrence of interstitial fibrosis and tubular atrophy. Some studies have shown that aspirin decreases the severity of kidney ischemia-reperfusion injury and the development of tubular atrophy in animal models. This study aimed to assess the effects of aspirin therapy started at the time of transplant on long-term graft function. MATERIALS AND METHODS: We compared renal graft function of 82 patients on low-dose aspirin 75 mg once daily who underwent renal transplant between 1 January 2000 and 31 December 2010 from a single center with 65 patients not taking aspirin...
December 22, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28001189/acute-myeloid-leukemia-after-kidney-transplantation-a-case-report-and-literature-review
#9
Francesca Cardarelli, Vanesa Bijol, Anil Chandraker, Cindy Varga, Leonardo V Riella
The incidence of malignancy is greater in kidney transplant recipients compared to the general population, though the higher risk is not equally distributed to all types of cancers. In face of the increased longevity of renal transplant recipients, certain cancers, such as acute leukemias, are becoming more prevalent. Acute myeloid leukemia (AML) typically presents with cytopenias and infections, both common findings after kidney transplantation. Therefore, the diagnosis of AML may be initially overlooked in these patients...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27965714/doppler-ultrasound-in-kidney-diseases-a-key-parameter-in-clinical-long-term-follow-up
#10
REVIEW
Leonardo Spatola, Simeone Andrulli
Doppler ultrasound has been extensively used in detecting reno-vascular diseases, showing to be a non-invasive, safe, low cost and repeatable tool. The Renal Resistive Index (RRI) [(peak systolic velocity - end diastolic velocity)/peak systolic velocity] is a semi-quantitative index derived by Doppler evaluation of renal vascular bed. Normally RRI is in the range of 0.47-0.70, it increases with aging and, usually, it shows a difference between the two kidneys less than 5-8 %. RRI is an important prognostic marker in chronic kidney diseases (CKD), both in diabetic and non-diabetic kidney diseases, because, in longitudinal prospective studies, it significantly correlated with hemodynamic (ABPM, SBP, DBP, pulse pressure) and histopathological parameters (glomerular sclerosis, arteriolosclerosis, interstitial fibrosis/tubular atrophy, interstitial infiltration)...
December 2016: Journal of Ultrasound
https://www.readbyqxmd.com/read/27932166/renal-allograft-failure-after-ipilimumab-therapy-for-metastatic-melanoma-a-case-report-and-review-of-the-literature
#11
A Jose, P Yiannoullou, S Bhutani, H Denley, M Morton, M Picton, A Summers, D van Dellen, T Augustine
Transplant recipients are at an increased risk of malignant melanoma, a result of chronic immunosuppression. Ipilimumab is a newer biological agent targeting T lymphocytes to potentiate an immune response against melanoma, and the use of this agent results in a new adverse effect profile that the clinician must be aware of while a patient is on therapy. We report the case of a male renal transplant recipient who developed graft failure while treated with ipilimumab and minimal immunosuppressive therapy for metastatic ocular melanoma, with biopsy evidence of glomerulonephritis and acute rejection...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932107/antibody-mediated-acute-vascular-rejection-of-kidney-allografts-fifteen-year-follow-up
#12
B Rodríguez Cubillo, I Pérez Flores, N Calvo, A Pascual, J A Cortés, M A Moreno, J Blanco, A Sánchez Fructuoso
BACKGROUND: Although acute vascular rejection (AVR) is associated with a high risk of graft loss, it remains unclear whether AVR with accompanied cellular or humoral rejection (AHR) has dissimilar outcomes. The aim of this study was to examine the association between subtypes of AVR and graft loss. METHODS: We assessed patients who provided biopsy samples for acute allograft rejection from 1998 to 2014. To investigate distinct rejection patterns, we retrospectively assessed rejection episodes with review of graft histology as well as donor-specific anti-HLA antibodies when available...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27926596/donor-genotype-and-intragraft-expression-of-cyp3a5-reflect-the-response-to-steroid-treatment-during-acute-renal-allograft-rejection
#13
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
#14
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
#15
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
#16
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
#17
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...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/27898462/recent-advances-in-allograft-vasculopathy
#18
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)...
February 2017: 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
#19
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
#20
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...
December 17, 2017: Lancet
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