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Kidney transplant fail

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https://www.readbyqxmd.com/read/28086979/b-cell-repertoires-in-hla-sensitized-kidney-transplant-candidates-undergoing-desensitization-therapy
#1
John F Beausang, H Christina Fan, Rene Sit, Maria U Hutchins, Kshama Jirage, Rachael Curtis, Edward Hutchins, Stephen R Quake, Julie M Yabu
BACKGROUND: Kidney transplantation is the most effective treatment for end-stage renal disease. Sensitization refers to pre-existing antibodies against human leukocyte antigen (HLA) protein and remains a major barrier to successful transplantation. Despite implementation of desensitization strategies, many candidates fail to respond. Our objective was to determine whether measuring B cell repertoires could differentiate candidates that respond to desensitization therapy. METHODS: We developed an assay based on high-throughput DNA sequencing of the variable domain of the heavy chain of immunoglobulin genes to measure changes in B cell repertoires in 19 highly HLA-sensitized kidney transplant candidates undergoing desensitization and 7 controls with low to moderate HLA sensitization levels...
January 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28086881/dengue-fever-in-renal-transplant-patients-a-systematic-review-of-literature
#2
Ranga Migara Weerakkody, Jean Ansbel Patrick, Mohammed Hussain Rezvi Sheriff
BACKGROUND: Dengue fever in renal transplanted patients has not been studied well, and we review all the literature about episodes dengue fever in renal transplant patients. METHODS: The aim was to describe clinico-pathological characteristics, immunosuppressive protocols, need renal outcome and mortality. PubMed, LILACS, Google Scholar and Research Gate were searched for "Dengue" and "Renal/Kidney Transplantation" with no date limits. Hits were analyzed by two researchers separately...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28062570/moving-biomarkers-toward-clinical-implementation-in-kidney-transplantation
#3
Madhav C Menon, Barbara Murphy, Peter S Heeger
Long-term kidney transplant outcomes remain suboptimal, delineating an unmet medical need. Although current immunosuppressive therapy in kidney transplant recipients is effective, dosing is conventionally adjusted empirically on the basis of time after transplant or altered in response to detection of kidney dysfunction, histologic evidence of allograft damage, or infection. Such strategies tend to detect allograft rejection after significant injury has already occurred, fail to detect chronic subclinical inflammation that can negatively affect graft survival, and ignore specific risks and immune mechanisms that differentially contribute to allograft damage among transplant recipients...
January 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28058698/high-soluble-cd30-levels-and-associated-anti-hla-antibodies-in-patients-with-failed-renal-allografts
#4
Gonca E Karahan, Yasar Caliskan, Kursat Ozdilli, Cigdem Kekik, Huseyin Bakkaloglu, Bahar Caliskan, Aydin Turkmen, Mehmet S Sever, Fatma S Oguz
INTRODUCTION: Serum soluble CD30 (sCD30), a 120-kD glycoprotein that belongs to the tumor necrosis factor receptor family, has been suggested as a marker of rejection in kidney transplant patients. The aim of this study was to evaluate the relationship between sCD30 levels and anti-HLA antibodies, and to compare sCD30 levels in patients undergoing hemodialysis (HD) with and without failed renal allografts and transplant recipients with functioning grafts. METHODS: 100 patients undergoing HD with failed grafts (group 1), 100 patients undergoing HD who had never undergone transplantation (group 2), and 100 kidney transplant recipients (group 3) were included in this study...
December 26, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28052095/metabolomic-profiling-in-individuals-with-a-failing-kidney-allograft
#5
Roberto Bassi, Monika A Niewczas, Luigi Biancone, Stefania Bussolino, Sai Merugumala, Sara Tezza, Francesca D'Addio, Moufida Ben Nasr, Alessandro Valderrama-Vasquez, Vera Usuelli, Valentina De Zan, Basset El Essawy, Massimo Venturini, Antonio Secchi, Francesco De Cobelli, Alexander Lin, Anil Chandraker, Paolo Fiorina
BACKGROUND: Alteration of certain metabolites may play a role in the pathophysiology of renal allograft disease. METHODS: To explore metabolomic abnormalities in individuals with a failing kidney allograft, we analyzed by liquid chromatography-mass spectrometry (LC-MS/MS; for ex vivo profiling of serum and urine) and two dimensional correlated spectroscopy (2D COSY; for in vivo study of the kidney graft) 40 subjects with varying degrees of chronic allograft dysfunction stratified by tertiles of glomerular filtration rate (GFR; T1, T2, T3)...
2017: PloS One
https://www.readbyqxmd.com/read/28011070/prevention-and-management-of-lymphocele-formation-following-kidney-transplantation
#6
REVIEW
Mohammad Golriz, Miriam Klauss, Martin Zeier, Arianeb Mehrabi
Despite preventive methods, lymphoceles frequently form following kidney transplantation (KTx), with an incidence of 0.6%-51%. Here, we summarize the current strategies for preventing and managing this complication, and describe the approach used in our department. Rapid diagnosis and early treatment of lymphoceles through a well-defined approach can prevent or reduce the risk of organ loss. Diagnosis can be made by ultrasound, computed tomography, or magnetic resonance imaging and laparoscopic fenestration is the current therapy of choice when non-surgical methods fail...
November 16, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/28005001/recurrent-urinary-tract-infection-among-renal-transplant-recipients-risk-factors-and-long-term-outcome
#7
Khaled Abdel Tawab, Osama Gheith, Torki Al Otaibi, Naryanam Nampoory, Hany Mansour, Medhat A Halim, Prasad Nair, Tarek Said, Mohamed Abdelmonem, Ayman El-Sayed, Waleed Awadain
OBJECTIVES: Urinary tract infection is the most common type of bacterial infection in kidney transplant procedures, with adverse effects on graft and patient survival. We aimed to evaluate the risk factors of recurrent urinary tract infection in renal transplant recipients and its impact on patient and graft survival. MATERIALS AND METHODS: In a cohort of 1019 patients who were transplanted between 2000 and 2010 at Hamed Al-Essa Organ Transplant Center in Kuwait, 86% developed at least 1 episode of urinary tract infection, with only 6...
December 22, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27997816/recent-early-clinical-drug-development-for-acute-kidney-injury
#8
Kevin M Gallagher, Stephen O'neill, Ewen M Harrison, James A Ross, Stephen J Wigmore, Jeremy Hughes
Despite significant need and historical trials, there are no effective drugs in use for the prevention or treatment of acute kidney injury (AKI). There are several promising agents in early clinical development for AKI and two trials have recently been terminated. There are also exciting new findings in pre-clinical AKI research. There is a need to take stock of current progress in the field to guide future drug development for AKI. Areas covered: The main clinical trial registries, PubMed and pharmaceutical company website searches were used to extract the most recent clinical trials for sterile, transplant and sepsis-associated AKI...
December 27, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27988989/single-center-outcomes-of-combined-heart-and-liver-transplantation-in-the-failing-fontan
#9
B A D'Souza, S Fuller, L P Gleason, N Hornsby, J Wald, K Krok, A Shaked, L R Goldberg, A Pochettino, K M Olthoff, Y Y Kim
Long-term outcomes of the Fontan operation include Fontan failure and liver disease. Combined heart-liver transplantation (CHLT) is an option for select patients although limited data exist on this strategy. A retrospective review of Fontan patients 18 years or older referred for cardiac transplant evaluation between 2000 and 2013 at the Hospital of the University of Pennsylvania was performed. All patients were considered for potential CHLT. Clinical variables such as demographics, perioperative factors, and short-term outcomes were reviewed...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27921039/clinical-manifestation-and-management-of-adpkd-in-western-countries
#10
REVIEW
Claudia Sommerer, Martin Zeier
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease in Western countries. The prevalence is between 2.4/10,000 and 3.9/10,000. ADPKD represents a systemic disease resulting in deterioration in renal function. Until now, mutations in two genes (PKD1 and PKD2) have been identified. Recently, the European Medicines Agency (EMA) approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency connected with ADPKD in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921038/the-clinical-manifestation-and-management-of-autosomal-dominant-polycystic-kidney-disease-in-china
#11
REVIEW
Cheng Xue, Chen-Chen Zhou, Ming Wu, Chang-Lin Mei
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenic hereditary kidney disease characterized by progressive enlargement of renal cysts. The incidence is 1-2‰ worldwide. Mutations in two genes (PKD1 and PKD2) cause ADPKD. Currently, there is no pharmaceutical treatment available for ADPKD patients in China. Summary: This review focused on advances in clinical manifestation, gene diagnosis, risk factors, and management of ADPKD in China. There is an age-dependent increase in total kidney volume (TKV) and decrease in renal function in Chinese ADPKD patients...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27920860/a-long-standing-external-iliac-artery-pseudoaneurysm-in-a-patient-with-a-history-of-a-failed-kidney-transplant
#12
Satyam Veean, Neil Patel, Daniel Lee, Hoang Vo, Eran Rotem
This is a case of a 66-year-old African American male with history of end stage renal disease due to polycystic disease and failed right kidney transplant. He presents with asymptomatic hematuria, and diagnostic angiography was performed which showed incidental anastomotic site pseudoaneurysm. Our patient had an unusual presentation of a pseudoaneurysm. Pseudoaneurysms associated with failed renal transplants are typically detected within weeks after transplantation and along with failure of the transplant...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#13
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27900974/disseminated-mycobacteria-chelonae-infection-in-a-kidney-pancreas-transplant-recipient-a-case-report-and-review-of-the-literature
#14
Shafi Malik, Ananda Ghosh, Shahid Husain
A 40-year-old male with a long-standing history of type 1 diabetes with end-stage renal failure underwent combined kidney-pancreas (KP) transplant from a standard criteria donor. Post-operative course was uncomplicated with good primary function of both transplant grafts. Induction was with thymoglobulin and maintenance immunosuppression was with tacrolimus, mycophenolate mofetil and prednisolone. Nine weeks post-transplant, the patient developed dysfunction of both grafts. Panel reactive antibody testing revealed that the patient had developed a de novo donor-specific antibody and considering an antibody-mediated rejection the patient was treated with intravenous pulse methyl prednisone 500 mg ×3 doses, IV immunoglobulin 2 mg/kg in two divided doses, and ATG 7 mg/kg (total dose of 700 mg)...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900108/high-dose-chemotherapy-with-autologous-peripheral-blood-stem-cell-transplantation-for-choriocarcinoma-a-case-report-and-literature-review
#15
Eiko Yamamoto, Kaoru Niimi, Kayo Fujikake, Tetsuya Nishida, Makoto Murata, Ayako Mitsuma, Yuichi Ando, Fumitaka Kikkawa
Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the second chemotherapeutic regimen. We herein present the case of a 36-year-old patient who had choriocarcinoma with metastases to the lungs, liver and kidneys. The 5th and 6th regimens with cisplatin for choriocarcinoma failed and the patient developed brain metastases...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27875647/what-pacemakers-can-teach-us-about-the-ethics-of-maintaining-artificial-organs
#16
Katrina Hutchison, Robert Sparrow
One day soon it may be possible to replace a failing heart, liver, or kidney with a long-lasting mechanical replacement or perhaps even with a 3-D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period affect patients and their doctors and the responsibilities of those who manufacture such devices? Drawing on lessons from the history of the cardiac pacemaker, this article offers an initial survey of the ethical issues posed by the need to maintain and service artificial organs...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27866309/osteoporosis-in-patients-with-diabetes-after-kidney-transplantation
#17
REVIEW
Elvira O Gosmanova, Aidar R Gosmanov
Preexisting diabetes increases risk of fractures after kidney transplantation (KT). However, little is known about mechanisms and prevention of increased fragility in these patients. Pathophysiology of osteoporosis after KT is complex and characterized by high prevalence of adynamic bone disease. Despite high prevalence of preexisting diabetes in KT recipients, diabetes patients were underrepresented in the studies that explored mechanisms and treatments of osteoporosis after KT. Therefore, caution should be exercised before considering conventional fracture prevention strategies in this unique group of patients...
November 19, 2016: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/27862962/effect-of-replacing-race-with-apolipoprotein-l1-genotype-in-calculation-of-kidney-donor-risk-index
#18
B A Julian, R S Gaston, W M Brown, A M Reeves-Daniel, A K Israni, D P Schladt, S O Pastan, S Mohan, B I Freedman, J Divers
Renal allografts from deceased African Americans with two apolipoprotein L1 gene (APOL1) renal-risk variants fail sooner than kidneys from donors with fewer variants. Kidney Donor Risk Index (KDRI) was developed to evaluate organ offers by predicting allograft longevity and includes African American race as a risk factor. Substituting APOL1 genotype for race may refine the KDRI. For 622 deceased African American kidney donors, we applied 10-fold cross-validation approach to estimate contribution of APOL1 variants to a revised KDRI...
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27805505/challenges-for-renal-retransplant-an-overview
#19
Mohamed Adel Bakr, Ahmed Abdelfattah Denewar, Mohamed Hamed Abbas
Despite many achievements in renal transplant in the past few years regarding immunosuppression and tissue matching, the rates of early and late graft loss and return to dialysis are still high. Many of those with primary graft failure will be listed for a kidney retransplant, as this allows for better quality of life than dialysis. Many challenges face those requiring renal retransplant, including first graft nephrectomy and whether site of retransplant should be ipsilateral or contralateral, whether to conduct preemptive retransplant or wait while on dialysis, additional immunologic factors, immunosuppression after retransplant, cancer risk, BK virus infection, and retransplant in pediatrics...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27798517/incidence-and-indications-for-late-allograft-pancreatectomy-while-on-continued-immunosuppression
#20
Sandesh Parajuli, Jon Odorico, Brad C Astor, Arjang Djamali, Hans Sollinger, Robert Redfield, Dixon Kaufman, Didier A Mandelbrot
BACKGROUND: There are limited data about the incidence and indications for late allograft pancreatectomy while on continued immunosuppression for functional kidney allografts. METHODS: We analyzed recipients of simultaneous pancreas and kidney (SPK) and pancreas after kidney (PAK) transplants between January 1994 and July 2013. Patients with functional kidney but failed pancreas allografts after 90 days were included. RESULTS: Out of 1022 SPK or PAK recipients, 246 satisfied these criteria...
October 28, 2016: Transplantation
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