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Kidney Allograft Failure

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https://www.readbyqxmd.com/read/29791046/impact-of-intensive-dosing-of-mycophenolate-on-pancreas-allograft-survival
#1
Jillian L Descourouez, Margaret Jorgenson, Nathan Menninga, Glen Leverson, Jon Odorico, Robert Redfield
PURPOSE: Evaluate the effect of mycophenolate (mycophenolic acid, MPA) dose on pancreas allograft survival following simultaneous pancreas kidney (SPK) transplant. METHODS: This was an observational study of adult SPK recipients transplanted between 1/1/2002-6/30/2015. Recipients were divided into cohorts based on MPA dose at discharge; high dose (HD) 1000mg three times daily mycophenolate mofetil (MMF) and standard dose (SD) 1000mg twice daily MMF. Primary outcome was pancreas allograft survival...
May 23, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29766640/subclinical-inflammation-phenotypes-and-long-term-outcomes-after-pediatric-kidney-transplantation
#2
Michael E Seifert, Megan V Yanik, Daniel I Feig, Vera Hauptfeld-Dolejsek, Elizabeth C Mroczek-Musulman, David R Kelly, Frida Rosenblum, Roslyn B Mannon
The implementation of surveillance biopsies in pediatric kidney transplantation remains controversial. Surveillance biopsies detect subclinical injury prior to clinical dysfunction, which could allow for early interventions that prolong allograft survival. We conducted a single-center retrospective cohort study of 120 consecutive pediatric kidney recipients, of whom 103 had surveillance biopsies ≤ 6 months post-transplant. We tested the hypothesis that subclinical inflammation (borderline or T cell-mediated rejection without clinical dysfunction) is associated with a 5-year composite endpoint of acute rejection and allograft failure...
May 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29765590/a-case-of-rhabdomyolysis-after-kidney-transplantation-successfully-managed-with-intensive-continuous-dialysis
#3
Rauf Shahbazov, Michael Fox, Jennifer L Alejo, Malik A Anjum, Feredun Azari, Alden Doyle, Avinash Agarwal, Kenneth L Brayman
Rhabdomyolysis is characterized by muscle cell death which can result in acute kidney injury from pigment nephropathy. We present a patient who developed rhabdomyolysis immediately after deceased donor kidney transplantation surgery and was managed with continuous renal replacement therapy that resulted in successful salvage of the kidney allograft. Patients who develop acute kidney failure requiring renal replacement therapy generally have a poor prognosis. It is worth noting that while continuous veno-venous hemofiltration (CVVHF) offers greater volume support and continuous clearance compared to hemodialysis (HD), recent studies have demonstrated no clinically significant improvement in clinical outcome between the two...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29760559/smoking-and-outcomes-in-kidney-transplant-recipients-a-post-hoc-survival-analysis-of-the-favorit-trial
#4
Larry A Weinrauch, Brian Claggett, Jiankang Liu, Peter V Finn, Matthew R Weir, Daniel E Weiner, John A D'Elia
Background: Tobacco use remains an international health problem with between 10% and 40% of adults currently using tobacco. Given the rising number of patients either awaiting or having received a kidney transplant and the absence of smoking cessation as the criterion for transplantation in guidelines, we explored the association between smoking status and clinical outcomes in kidney transplant recipients. Patients and methods: In this post hoc analysis of the Folic Acid for Vascular Outcome Reduction in Transplant trial, the associations between smoking status, defined as never having smoked, formerly or currently smoking, and both all-cause mortality and graft survival were assessed using Cox proportional hazards models...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29738696/serum-human-epididymis-secretory-protein-4-as-a-potential-biomarker-of-renal-fibrosis-in-kidney-transplantation-recipients
#5
Jinmei Luo, Fen Wang, Jianxin Wan, Zhuangjian Ye, Chumei Huang, Yuesu Cai, Min Liu, Ben-Quan Wu, Laisheng Li
BACKGROUND: Renal fibrosis remains an important cause of kidney allograft failure. The objective of this study was to evaluate the performance of serum human epididymis secretory protein 4 (HE4) as a biomarker for renal fibrosis in kidney transplant recipients. METHODS: A total of 103 kidney transplantation patients were enrolled in this study, and serum HE4 concentrations were detected using the chemiluminescent microparticle immunoassay. Renal biopsy was carried out, and histological findings were assessed by immunohistochemistry...
May 5, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29731069/bk-virus-infection-in-thai-kidney-transplant-recipients-a-single-center-experience
#6
P Skulratanasak, J Mahamongkhonsawata, M Chayakulkeereeb, N Larpparisutha, N Premasathiana, A Vongwiwatana
INTRODUCTION: BK virus-associated nephropathy (BKVAN) is a significant cause of allograft dysfunction and failure in kidney transplant recipients. Early detection and proper adjustment of immunosuppression is the best method for treatment of this condition and to improve long-term allograft outcome. Here, we reported the prevalence and risk factors of BK virus (BKV) infection in our population. METHODS: We retrospectively reviewed kidney transplant recipients at Siriraj Hospital between January 2012 and December 2015 who had been investigated using real-time polymerase chain reaction BK viral load...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731057/clinical-outcomes-of-kidney-transplantation-in-patients-with-biopsy-proven-glomerulonephritis
#7
H Park, W Y Park, S S Kang, S M Yeo, S Han, S B Park, K Jin
BACKGROUND: The clinical outcomes after kidney transplantation (KT) according to the types of glomerulonephritis (GN) as the cause of end-stage renal disease (ESRD) are various, but there are not many studies on this. METHODS: Among 1,253 patients who had KT between November 1982 and January 2017, 183 recipients with biopsy-proven GN as the primary cause of ESRD were enrolled. We analyzed the incidence of recurrent GN and the factors associated with recurrence and graft and patient survivals...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29730854/renal-involvement-in-antiphospholipid-syndrome
#8
REVIEW
Francisco Vileimar Andrade de Azevedo, Diego Germano Maia, Jozelio Freire de Carvalho, Carlos Ewerton Maia Rodrigues
This is a review of scientific publications on renal involvement in antiphospholipid syndrome (APS), with focus on clinical and histopathological findings and treatment. A search for English-language articles on renal involvement in APS covering the period 1980-2017 was conducted in Medline/PubMed and Scopus databases using the MeSH terms "antiphospholipid syndrome", "antiphospholipid antibodies", "glomerulonephritis" and "thrombotic microangiopathy" (TMA). APS nephropathy is primarily the result of thromboses in renal arteries or veins, intraparenchymatous arteries and glomerular capillaries...
May 5, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29725635/vascular-endothelial-growth-factor-gene-polymorphism-is-associated-with-long-term-kidney-allograft-outcomes
#9
Swayam Prakash, Manas Ranjan Patel, Suraksha Agrawal, Rahul M Jindal, Narayan Prasad
Introduction: Vascular endothelial growth factor (VEGF) regulates vasculogenesis in physiological and pathological states. We evaluated the role of VEGF single-nucleotide polymorphisms (SNPs) -1154 G/A, -2578 C/A, +936 C/T, and -2549 Ins/Del in chronic allograft nephropathy. Methods: Blood samples were collected before renal transplantation, and DNA was extracted. Genotyping of VEGF SNPs -1154 G/A (rs1570360), -2578 C/A (rs699947), +936 C/T (rs112005313), and -2549 Ins/Del (18bpindel) polymorphisms were carried out...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29724188/the-effect-of-spironolactone-on-calcineurin-inhibitor-induced-nephrotoxicity-a-multicenter-randomized-double-blind-clinical-trial-the-spiren-trial
#10
Line Aas Mortensen, Helle C Thiesson, Birgitte Tougaard, Martin Egfjord, Anne Sophie Lind Fischer, Claus Bistrup
BACKGROUND: Calcineurin inhibitor induced nephrotoxicity contributes to late allograft failure in kidney transplant patients. Evidence points towards aldosterone to play a role in the development of fibrosis in multiple organs. Animal studies have indicated a beneficial effect of mineralocorticoid receptor antagonists preventing calcineurin inhibitor induced nephrotoxicity. Only few studies have explored this effect in humans. The objective of this study is to evaluate the effect of spironolactone on glomerular filtration rate and fibrosis in kidney transplant patients...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29724174/eculizumab-as-salvage-therapy-for-recurrent-monoclonal-gammopathy-induced-c3-glomerulopathy-in-a-kidney-allograft
#11
Philipp Moog, Philipp J Jost, Maike Büttner-Herold
BACKGROUND: Monoclonal gammopathy causes several kinds of renal pathology. A rare and special form is monoclonal gammopathy-induced C3 glomerulopathy (MG-C3G). Like idiopathic C3G, MG-C3G frequently leads to end-stage renal disease. MG-C3G frequently recurs after renal transplantation, leading to graft failure in most of the patients. While there is some evidence for successful treatment of recurrent idiopathic C3 glomerulopathy with eculizumab after renal transplantation, nothing is known about its efficacy in the setting of recurrent MG-C3G...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29719109/belatacept-during-pregnancy-in-renal-transplant-recipients-two-case-reports
#12
Jenna Combs, Anna Kagan, Mark Boelkins, Lisa Coscia, Michael Moritz, R Michael Hofmann
Impaired fertility is common among patients with chronic organ failure, including end stage renal disease (ESRD). Women of child-bearing age undergoing transplantation may experience rapid return of fertility. Pregnancy post-transplant presents numerous risks for the patient, fetus, and allograft. Maternal risks include hypertension and preeclampsia. Allograft risks include acute rejection and failure of the organ, and fetal risks include miscarriage, birth defects from immunosuppressants, premature delivery, and low birth weight...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29718591/glomerular-crescents-are-associated-with-worse-graft-outcome-in-allograft-iga-nephropathy
#13
Sehoon Park, Chung Hee Baek, Hyunjeong Cho, Mi-Yeon Yu, Yong Chul Kim, Heounjeong Go, Young Hoon Kim, Jung Pyo Lee, Sang Il Min, Jongwon Ha, Kyung Chul Moon, Yon Su Kim, Curie Ahn, Su-Kil Park, Hajeong Lee
The prognosis of patients with allograft IgA nephropathy (IgAN) requires further investigation. We performed a bi-center retrospective cohort study on kidney transplant recipients diagnosed with IgAN in allograft biopsy. Recipients without allograft IgAN but with known IgAN before transplantation were included as the control group. We investigated the associations between clinicopathological characteristics, including allograft crescents, and the risk of death-censored graft failure. In total, 1,256 IgAN patients in both pre- and post-transplant stages were included...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29705074/kidney-transplantation-in-hiv-positive-patients-a-single-center-16-year-experience
#14
Gregory E Malat, Suzanne M Boyle, Rahul M Jindal, Stephen Guy, Gary Xiao, Meera N Harhay, Dong H Lee, Karthik M Ranganna, Mysore S Anil Kumar, Alden M Doyle
Hahnemann University Hospital has performed 120 kidney transplantations in human immunodeficiency virus (HIV)-positive individuals during the last 16 years. Our patient population represents ∼10% of the entire US population of HIV-positive kidney recipients. In our earlier years of HIV transplantation, we noted increased rejection rates, often leading to graft failure. We have established a multidisciplinary team and over the years have made substantial protocol modifications based on lessons learned. These modifications affected our approach to candidate evaluation, donor selection, perioperative immunosuppression, and posttransplantation monitoring and resulted in excellent posttransplantation outcomes, including 100% patient and graft survival at 1 year and patient and graft survival at 3 years of 100% and 96%, respectively...
April 25, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29704558/genome-wide-association-studies-in-kidney-transplantation-advantages-and-constraints
#15
EDITORIAL
Jianxin Yang, Frans H J Claas, Michael Eikmans
Since the discovery of the human leukocyte antigen (HLA) system, the role of HLA molecules in the field of transplantation has been appreciated: better matching leads to better graft function. Since then, the association of other genetic polymorphisms with clinical outcome has been investigated in many studies. Genome-wide association studies (GWAS) represent a powerful tool to identify causal genetic variants, by simultaneously analyzing millions of single nucleotide polymorphisms scattered across the genome...
April 25, 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29698955/serum-uromodulin-a-biomarker-of-long-term-kidney-allograft-failure
#16
Andrew Bostom, Dominik Steubl, Pranav S Garimella, Nora Franceschini, Mary B Roberts, Andreas Pasch, Joachim H Ix, Katherine R Tuttle, Anastasia Ivanova, Theresa Shireman, S Joseph Kim, Reginald Gohh, Daniel E Weiner, Andrew S Levey, Chi-Yuan Hsu, John W Kusek, Charles B Eaton
BACKGROUND: Uromodulin is a kidney-derived glycoprotein and putative tubular function index. Lower serum uromodulin was recently associated with increased risk for kidney allograft failure in a preliminary, longitudinal single-center -European study involving 91 kidney transplant recipients (KTRs). METHODS: The Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) trial is a completed, large, multiethnic controlled clinical trial cohort, which studied chronic, stable KTRs...
2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29693023/kidney-transplantation-the-challenge-of-human-leukocyte-antigen-and-its-therapeutic-strategies
#17
REVIEW
Tilahun Alelign, Momina M Ahmed, Kidist Bobosha, Yewondwossen Tadesse, Rawleigh Howe, Beyene Petros
Kidney transplantation remains the treatment of choice for end-stage renal failure. When the immune system of the recipient recognizes the transplanted kidney as a foreign object, graft rejection occurs. As part of the host immune defense mechanism, human leukocyte antigen (HLA) is a major challenge for graft rejection in transplantation therapy. The impact of HLA mismatches between the donor and the potential recipient prolongs the time for renal transplantation therapy, tethered to dialysis, latter reduces graft survival, and increases mortality...
2018: Journal of Immunology Research
https://www.readbyqxmd.com/read/29628415/review-management-of-patients-with-kidney-allograft-failure
#18
REVIEW
Kim L W Bunthof, Marc Hazzan, Luuk B Hilbrands
Late allograft loss in kidney transplant recipients remains a common problem and is associated with high mortality and morbidity. The management of patients with a failed kidney allograft includes a few major dilemmas: when to start dialysis, what is the optimal management regarding immunosuppression, and should an allograft nephrectomy be performed. In suitable candidates for a repeated transplantation there are additional matters to take in consideration. In this review we will discuss these dilemmas by providing an overview of current evidence and gaps in our knowledge...
March 29, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29602833/post-transplant-natural-antibodies-associate-with-kidney-allograft-injury-and-reduced-long-term-survival
#19
Sarah B See, Olivier Aubert, Alexandre Loupy, Yokarla Veras, Xavier Lebreton, Baoshan Gao, Christophe Legendre, Dany Anglicheau, Emmanuel Zorn
Background The development of antibodies specific to HLA expressed on donor tissue (donor-specific antibodies [DSAs]) is a prominent risk factor for kidney graft loss. Non-HLA antibodies with pathogenic potential have also been described, including natural antibodies (Nabs). These IgG Nabs bind to immunogenic self-determinants, including oxidation-related antigens. Methods To examine the relationship of Nabs with graft outcomes, we assessed Nabs in blinded serum specimens collected from a retrospective cohort of 635 patients who received a transplant between 2005 and 2010 at Necker Hospital in Paris, France...
March 30, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29596992/complement-fixing-donor-specific-anti-hla-antibodies-and-kidney-allograft-failure
#20
Helena B Cazarote, Silvia Shimakura, Joana S Valdameri, Fabiana L C Contieri, Cristina Q C von Glehn, Carlos M Aita, Michelle F Susin, Vanessa Santos Sotomaior, Renata Glehn-Ponsirenas
Detection of donor-specific antibodies (DSA) has improved the risk classification and post-transplant evaluation of kidney recipients. Moreover, assessment of DSA C1q-binding ability has been shown to improve the individual risk classification of transplant patients for allograft loss, especially when detected after transplantation. The aim of this study was to evaluate the additional clinical impact of C1q-binding DSA detection in a population that was extensively monitored for DSA and MFI alterations. Forty-two kidney allograft recipients were followed-up at multiple time points for up to 5 years after transplantation for the presence of anti-HLA DSA-IgG total...
March 26, 2018: Transplant Immunology
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