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Kidney Allograft Failure

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https://www.readbyqxmd.com/read/28810723/graft-survival-of-pediatric-kidney-transplant-recipients-selected-for-de-novo-steroid-avoidance-a-propensity-score-matched-study
#1
Edward J Nehus, Chunyan Liu, Bo Lu, Maurizio Macaluso, Mi-Ok Kim
Background: Steroid-avoidance protocols have gained popularity in pediatric kidney transplant recipients at low immunologic risk. The long-term safety of steroid avoidance in children with immunologic risk factors remains unknown. Methods: Pediatric kidney transplant recipients from 2004 to 2014 in the Organ Procurement and Transplantation Network database who received tacrolimus and mycophenolate immunosuppression were investigated. Propensity score matching was used to compare graft survival in 1624 children who received steroid avoidance with 1624 children who received steroid-based immunosuppression...
August 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28805345/laparoscopic-sleeve-gastrectomy-improves-renal-transplant-candidacy-and-post-transplant-outcomes-in-morbidly-obese-patients
#2
Y Kim, A D Jung, V K Dhar, J S Tadros, D P Schauer, E P Smith, D J Hanseman, M C Cuffy, R R Alloway, A R Shields, S A Shah, E S Woodle, T S Diwan
Morbid obesity is a barrier to KT due to inferior outcomes, including higher rates of new-onset diabetes after transplantation (NODAT), delayed graft function (DGF), and graft failure. LSG increases transplant eligibility by reducing body mass index (BMI) in KT candidates, but the effect of surgical weight loss on post-transplant outcomes is unknown. Reviewing single-center medical records, we identified all patients who underwent LSG prior to KT from 2011-2016 (n=20). Post-LSG kidney recipients were compared with similar-BMI recipients who did not undergo LSG, using 2:1 direct matching for patient factors...
August 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28775248/clinical-outcome-of-rituximab-and-intravenous-immunoglobulin-combination-therapy-in-kidney-transplant-recipients-with-chronic-active-antibody-mediated-rejection
#3
Tae Hyun Ban, Ji Hyun Yu, Byung Ha Chung, Bum Soon Choi, Cheol Whee Park, Yong-Soo Kim, Chul Woo Yang
BACKGROUND We previously reported that rituximab (RIT) and intravenous immunoglobulin (IVIg) combination therapy is effective in deterring the progression of chronic active antibody-mediated rejection (CAMR), but that report was based on the assessment of a small number of cases for a short period. MATERIAL AND METHODS Forty-three patients with CAMR were recruited during the study period after 2010. The patients were divided into high (n=17, 39.5%) and low proteinuria groups (n=26, 60.5%) based on spot urine protein-to-creatinine ratio of > or <3...
August 4, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28758329/kidney-allograft-offers-predictors-of-turndown-and-the-impact-of-late-organ-acceptance-on-allograft-survival
#4
J B Cohen, J Shults, D S Goldberg, P L Abt, D L Sawinski, P P Reese
There is growing interest in understanding patterns of organ acceptance and reducing discard. Little is known about how donor factors, timing of procurement, and geographic location affect organ offer decisions. We performed a retrospective cohort study of 47,563 deceased donor kidney match-runs from 2007-2013. Several characteristics unrelated to allograft quality were independently associated with later acceptance in the match-run: Public Health Service increased-risk donor status (adjusted odds ratio [aOR] 2...
July 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28730184/associations-between-deceased-donor-urine-mcp-1-and-kidney-transplant-outcomes
#5
S G Mansour, J Puthumana, P P Reese, I E Hall, M D Doshi, F L Weng, B Schröppel, H Thiessen-Philbrook, M Bimali, C R Parikh
INTRODUCTION: Existing methods to predict recipient allograft function during deceased-donor kidney procurement are imprecise. Understanding the potential renal reparative role for monocyte chemoattractant protein-1 (MCP-1), a cytokine involved in macrophage recruitment after injury, might help predict allograft outcomes. METHODS: We conducted a sub-study of the multicenter prospective Deceased Donor Study cohort, which evaluated deceased kidney donors from five organ procurement organizations from May 2010 to December 2013...
July 2017: KI Reports
https://www.readbyqxmd.com/read/28727227/long-term-outcomes-of-simultaneous-heart-and-kidney-transplantation-in-pediatric-recipients
#6
Patricia L Weng, Juan Carlos Alejos, Nancy Halnon, Qiuheng Zhang, Elaine F Reed, Eileen Tsai Chambers
Pediatric sHKTx has become an effective therapy for patients with combined cardiac and renal failure. Often, these patients develop human leukocyte antigen antibodies from their previous allografts and are therefore more difficult to re-transplant. We describe the largest case series of a predominantly sensitized pediatric sHKTx with emphasis on medical management and patient outcomes. Demographics, clinical characteristics, antibody, and biopsy data were retrospectively collected from University of California, Los Angeles database and correlated with short- and long-term patient and allograft outcomes of all sHKTx performed between 2002 and 2015...
July 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28708813/application-and-interpretation-of-histocompatibility-data-in-liver-transplantation
#7
Russell N Wesson, Eric W Etchill, Jacqueline Garonzik-Wang
PURPOSE OF REVIEW: There has been a resurgence of interest in histocompatibility as it applies to liver transplantation. The association of persistent and de-novo donor specific antibody (DSA) and outcomes after liver transplantation continues to be investigated. RECENT FINDINGS: Consensus continues to evolve regarding the existence of acute and chronic antibody-mediated rejection (AMR) and pathogenicity of DSA and associated pathologic findings after liver transplantation...
July 13, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28700465/alemtuzumab-versus-antithymocyte-globulin-induction-therapies-in-kidney-transplantation-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Jianming Zheng, Wenli Song
Alemtuzumab (ALEM) is widely used as an induction therapy for organ transplantation, and numerous randomized controlled trials (RCTs) have been published to evaluate its efficacy and safety in kidney transplantation as compared with antithymocyte globulin (ATG). The purpose of this study was to compare the benefits and safety of ALEM with those of ATG for induction therapy.A systematic literature search in three electronic databases, including PubMed, EmBase, and Cochrane Library, since inception through October 2016, was conducted to identify potential RCTs for inclusion...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28631039/graft-nephrectomy-in-children
#9
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/28625949/discussion-on-the-risk-factors-of-developing-cardiovascular-diseases-cvd-after-the-kidney-transplantation
#10
Kai Wang, Qing-Shan Qu, Shu-Zhai Miao, Yanxuan Zhang, Xin Jing
To discuss the risk factors of developing cardiovascular disease (CVD) after the kidney transplantation. Retrospective analysis on the data of 1106 patients who had been underwent kidney allotransplantation in People's Hospital of Zhengzhou from July, 2010 to Dec, 2014 and conformed to the inclusion criteria was taken. Cox proportional hazard model was used to analyze the risk factors of developing CVD after the kidney transplantation. 7 days, 1 month, 3 months, 6 months and 12 months before and after the operation, the data collection and following-up visits were respectively arranged...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28613392/donor-recipient-matching-based-on-predicted-recognizable-hla-epitopes-predicts-the-incidence-of-de-novo-donor-specific-hla-antibodies-following-renal-transplantation
#11
Nils Lachmann, Matthias Niemann, Petra Reinke, Klemens Budde, Danilo Schmidt, Fabian Halleck, Axel Pruß, Constanze Schönemann, Eric Spierings, Oliver Staeck
De novo donor-specific HLA antibodies (dnDSA) are recognized as risk factor for premature allograft failure. Determinants of DSA specificity are generated via the indirect allorecognition pathway. Here, we present supportive data for the relevance of predicted indirectly recognizable HLA epitopes (PIRCHE) to predict dnDSA following kidney transplantation. A total of 2,787 consecutive kidney transplants performed 1995-2015 without preformed DSA have been analyzed. De novo DSA were detected by single antigen bead assay...
June 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28606904/transition-structures-and-timing-of-transfer-from-paediatric-to-adult-based-care-after-kidney-transplantation-in-germany-a-qualitative-study
#12
Jenny Prüfe, Marie-Luise Dierks, Dirk Bethe, Martina Oldhafer, Silvia Müther, Julia Thumfart, Markus Feldkötter, Anja Büscher, Katja Sauerstein, Matthias Hansen, Martin Pohl, Jens Drube, Florian Thiel, Susanne Rieger, Ulrike John, Christina Taylan, Katalin Dittrich, Sabine Hollenbach, Günter Klaus, Henry Fehrenbach, Birgitta Kranz, Carmen Montoya, Bärbel Lange-Sperandio, Bettina Ruckenbrod, Heiko Billing, Hagen Staude, Reinhard Brunkhorst, Krisztina Rusai, Lars Pape, Martin Kreuzer
OBJECTIVES: It is known that transition, as a shift of care, marks a vulnerable phase in the adolescents' lives with an increased risk for non-adherence and allograft failure. Still, the transition process of adolescents and young adults living with a kidney transplant in Germany is not well defined. The present research aims to assess transition-relevant structures for this group of young people. Special attention is paid to the timing of the process. SETTING: In an observational study, we visited 21 departments of paediatric nephrology in Germany...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28602210/renal-allograft-outcome-after-simultaneous-heart-and-kidney-transplantation
#13
Avishay Grupper, Ayelet Grupper, Richard C Daly, Naveen L Pereira, Matthew A Hathcock, Walter K Kremers, Fernando G Cosio, Brooks S Edwards, Sudhir S Kushwaha
Chronic kidney disease frequently accompanies end-stage heart failure and may result in consideration of simultaneous heart and kidney transplantation (SHKT). In recent years, there has been a significant increase in SHKT. This single-center cohort consisted of 35 patients who underwent SHKT during 1996 to 2015. The aim of this study was to review factors that may predict better long-term outcome after SKHT. Thirteen patients (37%) had delayed graft function (DGF) after transplant (defined as the need for dialysis during the first 7 days after transplant), which was significantly associated with mechanical circulatory support device therapy and high right ventricular systolic pressure before transplant...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28573187/the-risk-of-transplant-failure-with-hla-mismatch-in-first-adult-kidney-allografts-2-living-donors-summary-guide
#14
Robert C Williams, Gerhard Opelz, E Jennifer Weil, Chelsea J McGarvey, Harini A Chakkera
BACKGROUND: Allografts from living donors survive longer than those from deceased donors but the role of HLA mismatching in living kidney donation is still in question. We examined the effect of HLA compatibility on kidney allograft survival from living donors by studying all first adult kidney transplants performed in the United States over 25 years. METHODS: Using the United Network for Organ Sharing data, we identified first kidney transplants between October 1, 1987, and December 31, 2013...
May 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28562595/pre-transplant-immune-factors-may-be-associated-with-bk-polyomavirus-reactivation-in-kidney-transplant-recipients
#15
David DeWolfe, Jinal Gandhi, Matthew R Mackenzie, Thomas A Broge, Evelyn Bord, Amaara Babwah, Didier A Mandelbrot, Martha Pavlakis, Francesca Cardarelli, Raphael Viscidi, Anil Chandraker, Chen S Tan
BK polyomavirus (BKPyV) reactivation in kidney transplant recipients can lead to allograft damage and loss. The elements of the adaptive immune system that are permissive of reactivation and responsible for viral control remain incompletely described. We performed a prospective study evaluating BKPyV-specific T-cell response, humoral response and overall T-cell phenotype beginning pre-transplant through one year post-transplant in 28 patients at two centers. We performed an exploratory analysis of risk factors for the development of viremia and viruria as well as compared the immune response to BKPyV in these groups and those who remained BK negative...
2017: PloS One
https://www.readbyqxmd.com/read/28561006/strategies-for-long-term-preservation-of-kidney-graft-function
#16
REVIEW
Thomas Wekerle, Dorry Segev, Robert Lechler, Rainer Oberbauer
Kidney transplantation has become a routine procedure in the treatment of patients with kidney failure, and requires collaboration of experts from different disciplines, such as nephrology, surgery, immunology, pathology, infectious disease medicine, cardiology, and oncology. Grafts can be obtained from deceased or living donors, with different logistical requirements and implications for long-term graft patency. 1-year graft survival rates are greater than 95% in many centres but improvement of long-term function remains a challenge...
May 27, 2017: Lancet
https://www.readbyqxmd.com/read/28560019/post-transplantation-nephroptosis-causing-recurrent-episodes-of-acute-renal-failure-and-hypertension-secondary-to-intermittent-vascular-torsion-of-intraperitoneal-renal-allograft
#17
Austin R Dosch, Madeleine Pahl, Uttam Reddy, Clarence E Foster, Hirohito Ichii
Nephroptosis is a rare complication in renal transplantation, but one with significant associated risk. Due to non-specific clinical features, there may be a substantial delay in diagnosis and loss of the transplanted kidney due to renal pedicle thrombosis. We present a case of post-transplantation nephroptosis after simultaneous pancreas and kidney transplant, which resulted in accelerated hypertension and reversible acute kidney injury >1 year after transplantation. Prompt detection of this rare entity leading to expeditious surgical intervention is necessary to preserve viability of the renal allograft...
May 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28556588/effects-of-dna-methylation-on-progression-to-interstitial-fibrosis-and-tubular-atrophy-in-renal-allograft-biopsies-a-multi-omics-approach
#18
Sai Vineela Bontha, Daniel G Maluf, Kellie J Archer, Catherine I Dumur, Mikhail Dozmorov, Anne King, Enver Akalin, Thomas F Mueller, Lorenzo Gallon, Valeria R Mas
Progressive fibrosis of the interstitium is the dominant final pathway in renal destruction in native and transplanted kidneys. Over time, the continuum of molecular events following immunological and non-immunological insults lead to interstitial fibrosis and tubular atrophy (IFTA) and culminate in kidney failure. We hypothesize that these insults trigger changes in DNA methylation (DNAm) patterns which in turn could exacerbate injury and slow down the regeneration processes, leading to fibrosis development and graft dysfunction...
May 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28520146/association-of-tenofovir-disoproxil-fumarate-with-primary-allograft-survival-in-hiv-positive-kidney-transplant-recipients
#19
Suzanne M Boyle, Gregory Malat, Meera N Harhay, Dong H Lee, Lisa Pang, Sindhura Talluri, Akshay Sharma, Tiffany E Bias, Karthik Ranganna, Alden M Doyle
BACKGROUND: Tenofovir disoproxil fumarate (TDF) is an antiretroviral agent frequently used to treat human immunodeficiency virus (HIV). There are concerns regarding its potential to cause acute kidney injury, chronic kidney disease, and proximal tubulopathy. Although TDF can effectively suppress HIV after kidney transplantation, it is unknown whether use of TDF-based antiretroviral therapy (ART) after kidney transplantation adversely affects allograft survival. METHODS: We examined 104 HIV+ kidney transplant (KT) recipients at our center between 2001 and 2014...
August 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28487457/do-outcomes-after-kidney-transplantation-differ-for-black-patients-in-england-versus-new-york-state-a-comparative-population-cohort-analysis
#20
Sanna Tahir, Holly Gillott, Francesca Jackson-Spence, Jay Nath, Jemma Mytton, Felicity Evison, Adnan Sharif
OBJECTIVES: Inferior outcomes for black kidney transplant recipients in the USA may not be generalisable elsewhere. In this population cohort analysis, we compared outcomes for black kidney transplant patients in England versus New York State. DESIGN: Retrospective, comparative, population cohort study utilising administrative data registries. SETTINGS AND PARTICIPANTS: English data were derived from Hospital Episode Statistics, while New York State data were derived from Statewide Planning and Research Cooperative System...
May 9, 2017: BMJ Open
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