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Acute renal allograft rejection

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https://www.readbyqxmd.com/read/28338457/transplant-renal-vein-thrombosis
#1
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
#2
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. 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
https://www.readbyqxmd.com/read/28291548/the-role-of-interleukin-17a-in-the-pathogenesis-of-kidney-diseases
#3
REVIEW
Charlotte Cortvrindt, Reinhart Speeckaert, Alena Moerman, Joris R Delanghe, Marijn M Speeckaert
Being a member of the IL-17 family, comprising six structurally related ligands, IL-17A is a cytokine, produced by multiple cell types, such as CD4(+)αβ T cells, γδ T cells, natural killer cells, neutrophils, macrophages, dendritic cells, lymphoid tissue inducer cells, mast cells and plasma cells. IL-17A participates in tissue inflammation by inducing the expression of chemokines, proinflammatory cytokines and matrix metalloproteases. Besides its role in host defence against infectious diseases, IL-17A is involved in different autoimmune and inflammatory diseases...
March 10, 2017: Pathology
https://www.readbyqxmd.com/read/28289708/interruption-of-ox40l-signaling-prevents-costimulation-blockade-resistant-allograft-rejection
#4
William H Kitchens, Ying Dong, David V Mathews, Cynthia P Breeden, Elizabeth Strobert, Maria E Fuentes, Christian P Larsen, Mandy L Ford, Andrew B Adams
The potential of costimulation blockade to serve as a novel transplant immunosuppression strategy has been explored for over 20 years, culminating in the recent clinical approval of belatacept for renal transplant patients. Despite improving long-term graft function and survival compared with calcineurin inhibitors, clinical acceptance of belatacept has been hindered by elevated rates of acute rejection. We examined the signaling pathways required to activate costimulation blockade-resistant alloreactive T cells and identified the OX40/OX40L secondary costimulatory pathway as a promising target...
March 9, 2017: JCI Insight
https://www.readbyqxmd.com/read/28285802/long-term-prognosis-and-cost-effectiveness-of-left-ventricular-assist-device-as-bridge-to-transplantation-a-systematic-review
#5
Michael Seco, Dong Fang Zhao, Michael J Byrom, Michael K Wilson, Michael P Vallely, John F Fraser, Paul G Bannon
BACKGROUND: This systematic review aimed to evaluate the clinical outcomes and cost-effectiveness of left ventricular assist devices (LVADs) used as bridge to transplantation (BTT), compared to orthotopic heart transplantation (OHT) without a bridge. METHOD: Systematic searches were performed in electronic databases with available data extracted from text and digitized figures. Meta-analysis of short and long-term term post-transplantation outcomes was performed with summation of cost-effectiveness analyses...
March 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28262440/telomere-length-in-patients-with-pulmonary-fibrosis-associated-with-chronic-lung-allograft-dysfunction-and-post-lung-transplantation-survival
#6
Chad A Newton, Julia Kozlitina, Jefferson R Lines, Vaidehi Kaza, Fernando Torres, Christine Kim Garcia
BACKGROUND: Prior studies have shown that patients with pulmonary fibrosis with mutations in the telomerase genes have a high rate of certain complications after lung transplantation. However, few studies have investigated clinical outcomes based on leukocyte telomere length. METHODS: We conducted an observational cohort study of all patients with pulmonary fibrosis who underwent lung transplantation at a single center between January 1, 2007, and December 31, 2014...
February 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28260477/doppler-ultrasonography-findings-during-recovery-period-of-transplanted-kidney-after-infarction-and-necrosis-due-to-renal-vein-thrombosis-a-case-report
#7
Funda Ulu Ozturk, Nihal Uslu, Eda Yilmaz Akcay, Mehmet Haberal
A 47-year-old male patient underwent living-related renal transplant. On day 3 posttransplant, without evidence of associated clinical symptoms, the patient's serum creatinine levels had increased. The patient was given immunosuppressive medication, and a followup Doppler ultrasonography revealed hypoechoic areas in the inferior pole of the renal parenchyma. Eventually, on day 25, there was no perfusion in the superior and inferior poles of the transplanted kidney. No venous flow was shown in the middle segment, and only arterial vascularization with a high resistive index and negative diastolic phase was observed...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260445/renal-impairment-and-complication-after-kidney-transplant-at-queen-rania-abdulla-children-s-hospital
#8
Reham Issa Almardini, Ghazi Mohamad Salita, Mahdi Qasem Farah, Issa Ahmad Katatbeh, Katibh Al-Rabadi
OBJECTIVES: Kidney transplant is the treatment of choice for end-stage renal disease, but it is not without complications. We review the medical cause of significant renal impairment and complications that developed after kidney transplant in pediatric patients who required hospital admission and intervention and/or who were followed between 2007 and 2016. MATERIALS AND METHODS: A retrospective noninterventional chart review study was conducted in pediatric patients who received a kidney transplant and/or followed at the nephrology clinic at Queen Rania Abdulla Children's Hospital between 2007 and 2016...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260426/borderline-changes-on-dysfunctional-renal-allograft-biopsies-clinical-relevance-in-a-living-related-renal-transplant-setting
#9
Muhammed Mubarak, Shaheera Shakeel, Khawar Abbas, Tahir Aziz, Mirza Naqi Zafar, Syed Anwer Naqvi, Syed Adibul Hasan Rizvi
OBJECTIVES: Our aim was to determine the clinical significance of borderline lymphocytic infiltrates on indicated renal allograft biopsies in a living related renal transplant setting. MATERIALS AND METHODS: The study was conducted at the histopathology department of Sindh Institute of Urology and Transplantation. A retrospective review of 421 renal transplant patients was conducted from October 2007 to September 2008 to identify patients in whom a histologic diagnosis of borderline changes was made on dysfunctional renal allograft biopsies...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28221173/new-developments-in-transplant-proteomics
#10
Julie Ho, Patricia Hirt-Minkowski, John A Wilkins
PURPOSE OF REVIEW: Despite modern immunosuppression, renal allograft rejection remains a major contributor to graft loss. Novel biomarkers may help improve posttransplant outcomes through the early detection and treatment of rejection. Our objective is to provide an overview of proteomics, review recent discovery-based rejection studies, and explore innovative approaches in biomarker development. RECENT FINDINGS: Urine MMP7 was identified as a biomarker of subclinical and clinical rejection using two-dimensional liquid chromatography tandem-mass spectrometry (LC-MS/MS) and improved the overall diagnostic discrimination of urine CXCL10 : Cr alone for renal allograft inflammation...
February 17, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28219603/acute-rejection-of-a-kidney-transplant-in-a-patient-with-common-variable-immunodeficiency-a-case-report
#11
O Al Nimri, A Rajput, E Martinez, J M Fahrenholz, P Paueksakon, A Langone, B P Concepcion
Common variable immunodeficiency is a primary immunodeficiency characterized by hypogammaglobulinemia and recurrent bacterial infections. We report a case of a 44-year-old male patient with end-stage renal disease and an established diagnosis of common variable immunodeficiency who underwent a living unrelated kidney transplant. He remained nearly infection free on maintenance immunoglobulin replacement. However, his posttransplant course was complicated by acute rejection that ultimately led to allograft loss...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219580/use-of-anti-thymocyte-globulin-for-induction-therapy-in-cardiac-transplantation-a-review
#12
V Ruan, L S C Czer, M Awad, M Kittleson, J Patel, F Arabia, F Esmailian, D Ramzy, J Chung, M De Robertis, A Trento, J A Kobashigawa
The most common causes of death after heart transplantation (HTx) include acute rejection and multi-organ failure in the early period and malignancy and cardiac allograft vasculopathy (CAV) in the late period. Polyclonal antibody preparations such as rabbit anti-thymocyte globulin (ATG) may reduce early acute rejection and the later occurrence of CAV after HTx. ATG therapy depletes T cells, modulates adhesion and cell-signaling molecules, interferes with dendritic cell function, and induces B-cell apoptosis and regulatory and natural killer T-cell expansion...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28212151/antibody-mediated-rejection-in-the-cardiac-allograft-diagnosis-treatment-and-future-considerations
#13
M Elizabeth H Hammond, Abdallah G Kfoury
PURPOSE OF REVIEW: This review summarizes the latest publications dealing with antibody-mediated rejection (AMR) and defines areas of controversy and future steps that may improve the outcome for patients with this virulent form of rejection. RECENT FINDINGS: Recent progress includes publication of standardized pathologic criteria for acute AMR by the International Society for Heart and Lung Transplantation (ISHLT) and guidelines for treatment of acute AMR by the American Heart Association, endorsed by ISHLT as well...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28182044/efficacy-and-safety-of-early-tacrolimus-conversion-to-sirolimus-after-kidney-transplantation-long-term-results-of-a-prospective-randomized-study
#14
A E El-Agroudy, S M Alarrayed, S M Al-Ghareeb, E Farid, H Alhelow, S Abdulla
We report a prospective, open-label, randomized study to evaluate the safety and efficacy of converting patients with a stable renal function from tacrolimus (Tac)-based regimen to a sirolimus (SRL)-based regimen after kidney transplantation. Fifty-eight low-risk renal allograft recipients who receiving Tac 6 months posttransplant, were randomly assigned to continue Tac (n = 29) or convert to SRL (n = 29). We evaluated the 3-year outcomes including patient and graft survival, graft function, and safety profile...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28164508/urinary-neutrophil-gelatinase-associated-lipocalin-does-not-distinguish-acute-rejection-from-other-causes-of-acute-kidney-injury-in-pediatric-renal-transplant-recipients
#15
Tomas Seeman, Karel Vondrak, Jiri Dusek, Nadezda Simankova, Jakub Zieg, Jaromir Hacek, Maria Chadimova, Bruno Sopko, Magdalena Fortova
BACKGROUND: The aim of this prospective single center study was to investigate the ability of urinary neutrophil gelatinase-associated lipocalin (NGAL) to distinguish acute rejection from other causes of acute kidney injury (AKI) in children after renal transplantation. METHODS: Fifteen children fulfilled the inclusion criteria (acute kidney injury (AKI) with allograft biopsy, at least 21 days after renal transplantation, no sepsis) during 2013 - 2014 in our pediatric transplantation center...
January 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28160552/conversion-to-mammalian-target-of-rapamycin-inhibitors-in-kidney-transplant-recipients-with-de-novo-cancers
#16
Chi Yuen Cheung, Maggie Kam Man Ma, Wai Leung Chak, Ka Foon Chau, Sydney Chi Wai Tang
OBJECTIVE: To investigate the impact of mammalian target of rapamycin (mTOR) inhibitor conversion together with minimization of calcineurin inhibitor on allograft outcome and patient survival in kidney transplant recipients with post-transplant cancers. METHODS: A retrospective study of all kidney transplant recipients diagnosed to have post-transplant cancers between the period 1/1/1994 and 30/6/2015. Patients were divided into 2 groups: mTOR inhibitor group and non-conversion group...
January 30, 2017: Oncotarget
https://www.readbyqxmd.com/read/28160460/the-timing-of-immunomodulation-induced-by-mesenchymal-stromal-cells-determines-the-outcome-of-the-graft-in-experimental-renal-allotransplantation
#17
Ana Merino, Elia Ripoll, Laura de Ramon, Nuria Bolaños, Montserrat Goma, Oriol Bestard, Nuria Lloberas, Josep M Grinyo, Juan Torras
<p>The immunomodulatory characteristics of mesenchymal stromal cells (MSCs) may lead to multifaceted strategies in rejection of organ transplantation. This study was designed to investigate the effect of the donor-type MSCs from Wistar rats firstly on the immune system of immunocompetent Lewis rats and secondly the rejection responses in a renal transplantation model of Wistar to Lewis.</p><p>In the first experimental model, MSCs from bone marrow induced a systemic immune response in the immunocompetent Lewis rats, characterized by two different phases...
February 3, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28135784/morphologic-patterns-and-treatment-of-transplant-glomerulopathy-a-retrospective-analysis
#18
Rui Abreu, Fernanda Carvalho, Helena Viana, Isabel Mesquita, Marília Possante, Inês Aires, Fernando Caeiro, Cecília Silva, Patrícia Cotovio, Aníbal Ferreira, Francisco Remédio, Fernando Nolasco
Transplant glomerulopathy is mainly due to chronic antibody-mediated rejection and actually represents a major cause of long-term allograft failure. The lack of effective treatment remains a serious problem in transplantation. A retrospective and uni-center study was performed in 48 kidney allograft recipients with transplant glomerulopathy between January 2010 and December 2015. Median time for diagnosis was 7.1 (3.6-11.8) years post-transplant. Light microscopy showed severity of transplant glomerulopathy in the majority of patients (cg1=10...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28129389/limited-clinical-utility-of-remote-ischemic-conditioning-in-renal-transplantation-a-meta-analysis-of-randomized-controlled-trials
#19
Chang-Cheng Zhou, Yu-Zheng Ge, Wen-Tao Yao, Ran Wu, Hui Xin, Tian-Ze Lu, Ming-Hao Li, Kai-Wei Song, Min Wang, Yun-Peng Zhu, Meng Zhu, Li-Guo Geng, Xiao-Fei Gao, Liu-Hua Zhou, Sheng-Li Zhang, Jia-Geng Zhu, Rui-Peng Jia
OBJECTIVE: We conducted this meta-analysis of randomized controlled trials (RCTs) to investigate whether remote ischemic conditioning (RIC) could improve graft functions in kidney transplantation. METHODS: PubMed, Web of Science, and Cochrane Library were comprehensively searched to identify all eligible studies by October 5, 2016. The treatment effects were examined with risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI)...
2017: PloS One
https://www.readbyqxmd.com/read/28115329/protocol-of-a-randomised-controlled-open-label-trial-of-ex-vivo-normothermic-perfusion-versus-static-cold-storage-in-donation-after-circulatory-death-renal-transplantation
#20
Sarah A Hosgood, Kourosh Saeb-Parsy, Colin Wilson, Christopher Callaghan, Dave Collett, Michael L Nicholson
INTRODUCTION: Ex vivo normothermic perfusion (EVNP) is a novel technique that reconditions the kidney and restores renal function prior to transplantation. Phase I data from a series of EVNP in extended criteria donor kidneys have established the safety and feasibility of the technique in clinical practice. METHODS AND ANALYSIS: This is a UK-based phase II multicentre randomised controlled trial to assess the efficacy of EVNP compared with the conventional static cold storage technique in donation after circulatory death (DCD) kidney transplantation...
January 23, 2017: BMJ Open
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