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Kidney transplant fail

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https://www.readbyqxmd.com/read/28921746/identification-of-occult-active-infection-using-pet-ct-in-a-combined-liver-kidney-transplant-candidate
#1
Julien Al Shakarchi, Desley Neil, Graham Lipkin, Ahmed Elsharkawy, Nicholas Inston
This case describes a patient being considered for combined liver-kidney transplantation for Caroli's disease with a failed renal transplant. A chronic septic focus could not be located with standard imaging techniques, such as ultrasonography and computed tomography. This case report highlights the observation that a retained non-functioning transplant can be the cause of fever of unknown origin and PET-CT can be useful in diagnosing these challenging cases. This article is protected by copyright. All rights reserved...
September 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28912007/adventitial-adipogenic-degeneration-is-an-unidentified-contributor-to-aortic-wall-weakening-in-the-abdominal-aortic-aneurysm
#2
Stefan A Doderer, Gabor Gäbel, Vivianne B C Kokje, Bernd H Northoff, Lesca M Holdt, Jaap F Hamming, Jan H N Lindeman
OBJECTIVE: The processes driving human abdominal aortic aneurysm (AAA) progression are not fully understood. Although antiinflammatory and proteolytic strategies effectively quench aneurysm progression in preclinical models, so far all clinical interventions failed. These observations hint at an incomplete understanding of the processes involved in AAA progression and rupture. Interestingly, strong clinical and molecular associations exist between popliteal artery aneurysms (PAAs) and AAAs; however, PAAs have an extremely low propensity to rupture...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28870676/hypothermic-oxygenated-perfusion-hope-for-fatty-liver-grafts-in-rats-and-humans
#3
P Kron, A Schlegel, L Mancina, P-A Clavien, P Dutkowski
BACKGROUND: Pretreatment of marginal organs by perfusion is a promising opportunity to consider more organs for transplantation. Protection of human DCD (donation after cardiac death) livers by a novel machine perfusion technique, hypothermic oxygenated perfusion (HOPE), was recently established. Here we tested in a rodent transplant model, whether HOPE is also useful for fatty liver grafts. METHODS: Rats were fed over 3 weeks with a special Methionine-Choline-Deficient-Diet (MCDD) to induce severe hepatic macrosteatosis (≥60%)...
September 1, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28858176/midterm-outcomes-of-12-renal-transplant-recipients-treated-with-eculizumab-to-prevent-atypical-hemolytic-syndrome-recurrence
#4
Charlène Levi, Véronique Frémeaux-Bacchi, Julien Zuber, Marion Rabant, Magali Devriese, Renaud Snanoudj, Anne Scemla, Lucile Amrouche, Arnaud Mejean, Christophe Legendre, Rebecca Sberro-Soussan
BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is an orphan disease with a high rate of recurrence after kidney transplantation. However, reports of successful prevention of posttransplant aHUS recurrence with eculizumab emerged a few years ago. To further delineate its optimal use, we describe the largest series of kidney transplant recipients treated with prophylactic eculizumab. METHODS: Twelve renal transplant recipients with aHUS-related end stage renal disease received eculizumab: 10 from day 0 and 2 at the time of recurrence (days 6 and 25)...
August 25, 2017: Transplantation
https://www.readbyqxmd.com/read/28856290/recommendations-for-the-treatment-of-hepatitis-c-in-2017
#5
REVIEW
Waldemar Halota, Robert Flisiak, Jacek Juszczyk, Piotr Małkowski, Małgorzata Pawłowska, Krzysztof Simon, Krzysztof Tomasiewicz
The goals of treatment is to eliminate HCV infection, stop or reverse histological changes, reduce the risk of hepatocellular carcinoma development and transmission of the infection to other individuals. According to the recommendation of the Polish Group of Experts for HCV in 2017 all patients with chronic HCV infection should receive treatment, but it is not recommended in patients at high risk of short overall survival. If access to therapy is restricted, priority should be given to patients whose HCV infection can lead to an unfavourable outcome of the disease within a short time frame, particular to individuals with liver cirrhosis, rapidly progressing liver fibrosis, extrahepatic manifestations of HCV infection, chronic kidney diseases, patients before and after organ transplantation...
June 2017: Clin Exp Hepatol
https://www.readbyqxmd.com/read/28839429/partial-external-biliary-diversion-in-bile-salt-export-pump-deficiency-association-between-outcome-and-mutation
#6
Philipp Ellinger, Jan Stindt, Carola Dröge, Katharina Sattler, Claudia Stross, Stefanie Kluge, Diran Herebian, Sander H J Smits, Martin Burdelski, Sebastian Schulz-Jürgensen, Antje Ballauff, Jan Schulte Am Esch, Ertan Mayatepek, Dieter Häussinger, Ralf Kubitz, Lutz Schmitt
AIM: To investigate the relation of two different mutations to the outcome of partial external biliary diversion (PEBD) in severe bile salt export pump (BSEP) deficiency. METHODS: Mutations in the gene encoding BSEP leading to severe BSEP deficiency in two unrelated patients were identified by genomic sequencing. Native liver biopsies and transiently transfected human embryonic kidney (HEK) 293 cells expressing either wild-type or mutated BSEP were subjected to immunofluorescence analysis to assess BSEP transporter localization...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28776960/role-of-de-novo-donor-specific-anti-hla-antibodies-in-kidney-graft-failure-a-case-control-study
#7
A Castro, J Malheiro, S Tafulo, L Dias, L S Martins, I Fonseca, I Beirão, A Castro-Henriques, A Cabrita
The role of de novo donor-specific anti-human leukocyte antigen (anti-HLA) antibodies (dnDSA) within the pathways leading to graft failure remains not fully understood. We investigated 56 patients who were transplanted between 2002 and 2014 with kidney graft failure (cases), for a possible association of development of dnDSA with graft failure. The 56 patients with failed transplants were matched with 56 patients with a functioning graft at present for the variables deceased or living donor, transplant number, transplant year, recipient age and gender, donor age and gender, dialysis vintage time, transplant induction therapy...
August 4, 2017: HLA
https://www.readbyqxmd.com/read/28771743/laryngeal-abscess-formation-in-an-immunosuppressed-patient-a-case-report
#8
Derek L Vanhille, Joel H Blumin
Prior to the onset of the antibiotic era, laryngeal perichondritis and abscess formation were more frequent complications of systemic infections. We report a case of 54-year-old male who was medically immunosuppressed after kidney transplantation and developed multiple pseudomonas abscesses of his larynx. After failing initial treatment and with worsening signs and symptoms, the patient eventually was treated with a prolonged course of intravenous and oral antibiotics, with resolution of his symptoms and clinical findings...
August 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28761232/medication-adherence-in-kidney-transplant-recipients-in-an-urban-indian-setting
#9
U R Adhikari, A Taraphder, A Hazra, T Das
Medication nonadherence is a known problem after renal transplantation and can vary from one setting to another. Since it can lead to negative outcomes, it is important to develop intervention strategies to enhance adherence in a given setting using determinants identified through exploratory studies. We explored nonadherence in renal transplant recipients. A longitudinal survey was done with adult renal transplant recipients at a tertiary care public and two private hospitals of Kolkata. Subjects were followed-up for 1 year...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28756427/thrombolysis-a-useful-tool-in-the-primary-pci-cupboard
#10
Konstantin Schwarz, Deepak Goyal, Helen Routledge
A 44-year-old woman presented to the emergency department with central crushing chest pain and dynamic anterior ST elevation on a background of a known left bundle-branch block on her electrocardiogram. Past medical history included insulin-dependent diabetes, asthma, fibromyalgia, and a gradually failing kidney transplant. This case demonstrates the rarely utilized niche role for intracoronary thrombolysis in STEMI treatment in the modern angioplasty era.
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28735998/assessment-of-spleen-filtrate-function-in-renal-transplant-recipients-using-technetium-99m-stannous-colloid-liver-spleen-scan
#11
N C Araújo, M B Neves, C A Mandarim-de-Lacerda, M M C Orlando
BACKGROUND: Functional hyposplenism (FH) is indicated by an anatomically present spleen that fails to take up radiolabeled colloid. The occurrence of FH has been reported in a small group of renal transplant recipients based on hematologic parameters. The aim of this study was to replicate this association in a larger group of renal transplant recipients with the use of technetium-99m-stannous colloid liver-spleen scan to assess the spleen function. METHODS: This survey based on single samples enrolled 101 unselected adult patients with functional kidney grafts >180 days after transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735354/transplantation-sites-for-human-and-murine-islets
#12
Rebecca A Stokes, Kim Cheng, Amit Lalwani, Michael M Swarbrick, Helen E Thomas, Thomas Loudovaris, Tom W Kay, Wayne J Hawthorne, Philip J O'Connell, Jenny E Gunton
AIMS/HYPOTHESIS: Beta cell replacement is a potential cure for type 1 diabetes. In humans, islet transplants are currently infused into the liver via the portal vein, although this site has disadvantages. Here, we investigated alternative transplantation sites for human and murine islets in recipient mice, comparing the portal vein with quadriceps muscle and kidney, liver and spleen capsules. METHODS: Murine islets were isolated from C57BL6/J mice and transplanted into syngeneic recipients...
July 22, 2017: Diabetologia
https://www.readbyqxmd.com/read/28697719/high-position-of-the-third-renal-transplant-and-alternative-urinary-tract-reconstruction-in-a-complicated-case
#13
Wilhelmina M van den Dool, Andrzej G Baranski
The decision-making process for treatment of patients with end-stage renal failure, multiple failed renal transplants, and severe comorbidities can be exceedingly difficult due to the inapplicability of many common surgery methods. In this article, we report the treatment of such a patient who underwent a third renal transplant and subsequently developed a ureteral stenosis. The third kidney had been transplanted with a high abdominal position and a partially intra- and retroperitoneally placed ureter due to a bilaterally obtained iliac fossa and severe abdominal adhesions...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28654216/mechanistic-sharing-between-nk-cells-in-abmr-and-effector-t-cells-in-tcmr
#14
M D Parkes, P F Halloran, L G Hidalgo
Human organ allograft rejection depends on effector lymphocytes: NK cells in antibody-mediated rejection (ABMR) and effector T cells in T cell-mediated rejection (TCMR). We hypothesized that NK cell CD16a stimulation and CD8 T cell TCR/CD3 stimulation represent highly similar effector systems, and should lead to shared molecular changes between ABMR and TCMR. We studied similarity between soluble proteins and the transcripts induced in CD16a stimulated NK cells and TCR/CD3-stimulated T cells in vitro. Of 30 soluble mediators tested, CD16a-activated NK cells and CD3/TCR activated T cells produced the same limited set of five mediators-CCL3, CCL4, CSF2, IFNG, and TNF-and failed to produce 25 others...
June 27, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28637076/-clinical-course-of-an-early-childhood-onset-granulomatosis-with-polyangiitis
#15
Marco Krasselt, Matthias Pierer, Kerstin Amann, Anette Bachmann, Tom H Lindner
History A 26-year-old male patient presented with an eight-week history of unspecific symptoms such as weight loss and fever. Besides, he also suffered from haemoptysis, cough, and arthralgia. Since the age of twelve years, the patient has been treated for Wegner's granulomatosis. At the age of 20 years he received a kidney transplant which failed only four years later. Investigations The relapse we clinically suspected was confirmed by CT scan showing bilateral pulmonary manifestations. Moreover, we found highly positive antibodies against proteinase 3...
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28631039/graft-nephrectomy-in-children
#16
Benedict L Phillips, Chris J Callaghan
Kidney transplantation is recognised as the gold standard treatment of end-stage renal disease in most children, with excellent graft survival rates. When graft failure occurs, renal transplant recipients (RTRs) have the option of removal of the transplant (graft nephrectomy [GN]), or leaving the failed transplant in situ. The aims of this review are to discuss the indications for GN, surgical techniques, outcomes after GN (including risks of allosensitisation and the impact on subsequent transplants), and the possible role of routine GN in the asymptomatic RTR with a failed renal allograft...
June 19, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28624104/acute-kidney-injury-after-liver-transplantation-recent-insights-and-future-perspectives
#17
REVIEW
Jubi E de Haan, Ewout J Hoorn, Hilde R H de Geus
Acute kidney injury (AKI) is a common postoperative complication after liver transplantation (LT). The occurrence of postoperative AKI after LT (Post-LT AKI) is associated with inferior patient and graft outcomes. Post-LT AKI is multifactorial in origin and has been related to the severity of liver disease, pre-LT renal dysfunction, graft quality, perioperative events and toxicity of immunosuppressive therapy. Furthermore it is thought that hepatic ischaemia reperfusion injury might be a driving force in the aetiology of post-LT AKI...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#18
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28620390/belatacept-does-not-inhibit-follicular-t-cell-dependent-b-cell-differentiation-in-kidney-transplantation
#19
Gretchen N de Graav, Dennis A Hesselink, Marjolein Dieterich, Rens Kraaijeveld, Wenda Verschoor, Dave L Roelen, Nicolle H R Litjens, Anita S Chong, Willem Weimar, Carla C Baan
Humoral alloreactivity has been recognized as a common cause of kidney transplant dysfunction. B-cell activation, differentiation, and antibody production are dependent on IL-21(+)CXCR5(+)follicular T-helper (Tfh) cells. Here, we studied whether belatacept, an inhibitor of the costimulatory CD28-CD80/86-pathway, interrupts the crosstalk between Tfh- and B-cells more efficiently than the calcineurin inhibitor tacrolimus. The suppressive effects of belatacept and tacrolimus on donor antigen-driven Tfh-B-cell interaction were functionally studied in peripheral blood mononuclear cells from 40 kidney transplant patients randomized to a belatacept- or tacrolimus-based immunosuppressive regimen...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28583574/long-term-clinical-outcomes-of-first-and-second-kidney-transplantation-in-patients-with-biopsy-proven-iga-nephropathy
#20
Y Kim, S M Yeo, S S Kang, W Y Park, K Jin, S B Park, U J Park, H T Kim, S Han
INTRODUCTION: The recurrence of IgA nephropathy (IgAN) after kidney transplantation (KT) has an effect on graft survival, but there are few reports about long-term clinical outcomes of KT with recurrent IgAN. This study shows the long-term clinical outcomes of KT in patients with IgAN. METHODS: All recipients who had biopsy-proven IgAN were followed from February 1990 to February 2016. We analyzed overall graft and patient survival rates, incidence of recurrent IgAN, factors affecting graft survival, and IgAN recurrence...
June 2017: Transplantation Proceedings
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