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https://www.readbyqxmd.com/read/28933341/c4d-expressing-glomerulopathy-and-proteinuria-post-transplantation-of-a-%C3%A2-too-big-for-size-mismatched-kidney-allograft-an-unusual-case-with-good-outcome%C3%A2
#1
Francois Gougeon, Alexei V Mikhailov, Keisha Gibson, Tomasz Kozlowski, Harsharan K Singh, Volker Nickeleit
A 5-year-old severely growth-retarded child with tubulointerstitial, oliguric end-stage renal disease received an adult-size kidney transplant. Three years post grafting under standard triple immunosuppression (mycophenolate mofetil, tacrolimus, and prednisone) de novo nephrotic range proteinuria without the nephrotic syndrome developed. Graft function was normal (serum creatinine: 0.2 - 0.3 mg/dL), there were no donor-specific HLA antibodies (DSA), and the urine sediment was inactive. Two biopsies collected 3 and 4 years post-transplantation showed severe glomerular capillary wall remodeling and associated pseudolinear C4d staining as morphologic correlates for the proteinuria...
September 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28932575/pediatric-lung-transplantation
#2
REVIEW
Christian Benden
Pediatric lung transplantation has been undertaken since the 1980s, and it is today considered an accepted therapy option in carefully selected children with end-stage pulmonary diseases, providing carefully selected children a net survival benefit and improved health-related quality of life. Nowadays, >100 pediatric lung transplants are done worldwide every year. Here, specific pediatric aspects of lung transplantation are reviewed such as the surgical challenge, effects of immunosuppression on the developing pediatric immune system, and typical infections of childhood, as it is vital to comprehend that children undergoing lung transplants present a real challenge as children are not 'just small adults'...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28930756/dynamics-of-glucose-metabolism-after-kidney-transplantation
#3
Martina Guthoff, Robert Wagner, Karoline Weichbrodt, Silvio Nadalin, Alfred Königsrainer, Hans-Ulrich Häring, Andreas Fritsche, Nils Heyne
BACKGROUND/AIMS: Posttransplantation diabetes mellitus (PTDM) impacts patient and allograft survival after kidney transplantation. Prediabetes, which is an independent risk factor for PTDM, is modifiable also in a post-transplant setting. Understanding the risks and dynamics of impaired glucose metabolism after transplantation is a key component for targeted intervention. METHODS: A retrospective chart analysis of all adult non-diabetic renal allograft recipients (n=251, 2007-2014) was performed...
September 20, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28927645/angiotensin-ii-type-1-receptor-antibodies-are-associated%C3%A2-with-inflammatory-cytokines-and-poor-clinical-outcomes-in-pediatric-kidney-transplantation
#4
Meghan H Pearl, Qiuheng Zhang, Miguel Fernando Palma Diaz, Jonathan Grotts, Maura Rossetti, David Elashoff, David W Gjertson, Patricia Weng, Elaine F Reed, Eileen Tsai Chambers
Angiotensin II type 1 receptor (AT1R) antibody has been linked to poor allograft outcomes in adult kidney transplantation. However, its clinical consequences in children are unknown. To study this, we examined the relationship of AT1R antibody with clinical outcomes, biopsy findings, inflammatory cytokines, and HLA donor-specific antibodies (DSA) in a cohort of pediatric renal transplant recipients. Sixty-five patients were longitudinally monitored for AT1R antibody, HLA DSA, IL-8, TNF-α, IL-1β, IFN-γ, IL-17, and IL-6, renal dysfunction, hypertension, rejection, and allograft loss during the first two years post transplantation...
September 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28924461/do-the-benefits-of-transplant-tourism-amongst-nigerian-patients-outweigh-the-risks-a-single-center-experience
#5
C O Amira, B T Bello
BACKGROUND: Transplant tourism (TT) is the term used to describe travel outside one's country of abode for the sole purpose of obtaining organ transplantation services. OBJECTIVE: This study describes the characteristics and outcomes of kidney transplant tourists who were followed up in our institution. METHODS: A retrospective study was conducted on patients who underwent kidney transplantation outside the country and were followed up in our institution from 2007 to 2015...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28923650/does-renal-tubular-injury-induced-local-tissue-hypoxia-involve-post-transplantation-erythrocytosis
#6
A Unal, S Ata, C Karakurkcu, M Z Ciraci, I Kocyigit, M H Sipahioglu, B Tokgoz, O Oymak
BACKGROUND: The pathogenesis of post-transplantation erythrocytosis (PTE) is not well understood and appears to be multifactorial. Our hypothesis in this study was that several factors, including toxicity of calcineurin inhibitor, immunologic factors, and chronic allograft nephropathy, can trigger local tissue hypoxia in peritubular interstitium, which is where production of erythropoietin (EPO) takes place. This local interstitial tissue hypoxia can cause an increase in renal EPO production, which induces the development of PTE...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28921748/increased-risk-organ-transplantation-in-the-pediatric-population
#7
Sean M Wrenn, Peter W Callas, Trishul Kapoor, Alia F Aunchman, Adam N Paine, Jaime A Pineda, Carlos E Marroquin
IRD organs are classified by the Public Health Service to be at above-average risk for harboring human immunodeficiency virus, hepatitis C, and hepatitis B. Traditionally underutilized, there exists even greater reluctance for their use in pediatric patients. We performed a retrospective analysis via the United Network for Organ Sharing database of all pediatric renal and hepatic transplants performed from 2004 to 2008 in the United States. Primary outcomes were patient and graft survival. Proportional hazards regression was performed to control for potentially confounding factors...
September 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28920046/the-effect-of-intraoperative-alkali-treatment-on-recovery-from-atracurium-induced-neuromuscular-blockade-in-renal-transplantation-a-randomized-trial
#8
Navid Noraee, Mohammad Fathi, Majid Golestani Eraghi, Ali Dabbagh, Nilofar Massoudi
BACKGROUND: Intraoperative care and anesthesia method in patients undergoing allograft renal transplantation surgery are very necessary. Acid-base imbalance can alter neuromuscular blockade and recovery time. OBJECTIVES: The aim of the present study was to investigate the effect of acid-base balance on atracurium blockade in renal transplantation. METHODS: In this randomized-controlled trial, 31 end-stage renal disease (ESRD) patients undergoing renal transplantation were randomly assigned into two equal groups...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28918487/clinical-risk-stratification-of-paediatric-renal-transplant-recipients-using-c1q-and-c3d-fixing-of-de-novo-donor-specific-antibodies
#9
Jon Jin Kim, Olivia Shaw, Chloe Martin, George Michaelides, Ramnath Balasubramaniam, Neil J Sebire, Nizam Mamode, Anthony Dorling, Robert Vaughan, Stephen D Marks
INTRODUCTION: We have previously shown that children who developed de novo donor-specific human leukocyte antigen (HLA) antibodies (DSA) had greater decline in allograft function. We hypothesised that patients with complement-activating DSA would have poorer renal allograft outcomes. METHODS: A total of 75 children developed DSA in the original study. The first positive DSA sample was subsequently tested for C1q and C3d fixing. The primary event was defined as 50% reduction from baseline estimated glomerular filtration rate and was analysed using the Kaplan-Meier estimator...
September 16, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28916346/radiofrequency-ablation-of-t1a-renal-cell-carcinomas-within-renal-transplant-allografts-oncologic-outcomes-and-graft%C3%A2-viability
#10
Derek W Cool, John R Kachura
PURPOSE: To evaluate oncologic outcomes and graft viability after percutaneous RF ablation of renal cell carcinoma (RCC) developing within renal transplant allografts. MATERIALS AND METHODS: A single-institution, retrospective study reviewed all patients treated with RF ablation for RCC between February 2004 and May 2016. Ten patients were identified (age 49.6 y ± 12.6; 9 men, 1 woman) with 12 biopsy-confirmed RCC tumors within the allograft (all T1a, mean diameter 2...
September 13, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28914777/the-usefulness-of-contrast-enhanced-ultrasound-in-the-assessment-of-early-kidney-transplant-function-and-complications
#11
REVIEW
Sara Álvarez Rodríguez, Vital Hevia Palacios, Enrique Sanz Mayayo, Victoria Gómez Dos Santos, Víctor Díez Nicolás, María Dolores Sánchez Gallego, Javier Lorca Álvaro, Francisco Javier Burgos Revilla
OBJECTIVES: The routine diagnostic method for assessment of renal graft dysfunction is Doppler ultrasound. However, contrast-enhanced ultrasound (CEUS) may provide more information about parenchymal flow and vascular status of kidney allografts. The aim of the study was to assess the effectiveness of CEUS in the immediate post-transplant period, focusing on acute vascular complications. A brief review of available literature and a report of our initial experience is made. MATERIAL AND METHODS: 15 kidney transplant (KT) cases with clinical suspicion of acute surgical complication were assessed with CEUS and conventional Doppler ultrasound (US)...
September 15, 2017: Diagnostics
https://www.readbyqxmd.com/read/28905454/management-considerations-in-the-failing-renal-allograft
#12
REVIEW
Tom Lea-Henry, Bobby Chacko
Patients with a failed or failing renal transplant are increasing in number. Graft failure resulting in dialysis re-initiation is not uncommon, yet there are limited data to guide management of these patients. Physician practices vary regarding timing of dialysis initiation and the timing and extent of immunosuppression withdrawal. The risks of immunosuppression withdrawal need to be carefully balanced against the benefits of continuing low-dose therapy. The latter helps minimise the risk of sensitisation and has been proposed to possibly slow the loss of residual renal function; however, the use of common immunosuppressive agents may contribute to cardiovascular disease, malignancy, and infection, the major causes of death following the loss of a renal transplant...
September 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28904437/cryptococcal-infection-in-transplant-kidney-manifesting-as-chronic-allograft-dysfunction
#13
C Agrawal, V Sood, A Kumar, V Raghavan
Invasive fungal infections (IFIs) are a significant cause of morbidity in solid organ transplant (SOT) recipients. Common causes among them are Aspergillus, Candida, and Cryptococcus. Antifungal prophylaxis has led to decrease in overall incidence of IFI; however, there is very little decline in the incidence of Cryptococcal infections of SOT recipients because effective prophylaxis is not available against this infectious agent. Spectrum of manifestation of Cryptococcal infection varies in immunocompetent and immunocompromised host with subclinical and self-limiting with lungs being the primary site in immunocompetent and central nervous system as the most common site in an immunocompromised host...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28904433/risk-factors-for-urinary-tract-infections-in-renal-allograft-recipients-experience-of-a-tertiary-care-center-in-hyderabad-south-india
#14
M V N L R Mohan, M Neeraja, S Sudhaharan, S B Raju, T Gangadhar, V Lakshmi
Renal transplantation is an effective and commonly performed procedure for end-stage renal disease. Urinary tract infections are a major cause of morbidity and mortality in renal transplant patients. As data on postrenal transplant urinary tract infections from the Indian subcontinent are limited, the present study was conducted to estimate the burden of urinary tract infections in this vulnerable group of patients. This was a prospective study on patients undergoing renal transplantation in 2014 at our tertiary hospital in South India with a follow-up of 2 years to evaluate the risk factors for urinary tract infections...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28904429/correlation-of-pretransplant-donor-specific-antibody-assay-using-luminex-crossmatch-with-graft-outcome-in-renal-transplant-patients
#15
M Vimal, M P Chacko, G Basu, D Daniel
The significance of pretransplant anti-human leukocyte antigen antibody levels that are detectable by more sensitive platforms (including the Luminex platform) yet undetected by complement-dependent cytotoxicity (CDC) assay remains unclear. The aim of this study was to determine the clinical significance of the donor-specific antibody (DSA) assay Luminex crossmatch and its impact on short-term renal graft outcome such as acute rejections, graft survival, and graft function. The results of pretransplant DSA-lymphocyte crossmatching (LCXM) assay in 126 renal allograft recipients whose CDCs crossmatches were negative were retrospectively analyzed for correlation with posttransplant outcomes...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28904428/collapsing-glomerulopathy-a-troublemaker-for-the-renal-allograft-lessons-learnt
#16
K V Kanodia, A V Vanikar, L K Nigam, R D Patel, K S Suthar, H V Patel, H L Trivedi
Collapsing glomerulopathy (CG) is a well-recognized distinct morphological pattern of proliferative parenchymal injury leading to rapid graft failure. We conducted a single-center retrospective study to evaluate the prevalence, clinicopathological features, and prognosis of CG in renal transplant recepient. We analyzed 2518 renal allograft biopsies performed from 2007 to 2015 and correlated their clinicopathological features. The prevalence of CG was 0.83% (21 out of 2518) of allograft biopsies with a higher prevalence of 1...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28902772/urinary-cxcl10-chemokine-is-associated-with-alloimmune-and-virus-compartment-specific-renal-allograft-inflammation
#17
Julie Ho, Stefan Schaub, Chris Wiebe, Ang Gao, Caroline Wehmeier, Michael T Koller, Hans H Hirsch, Helmut Hopfer, Peter Nickerson, Patricia Hirt-Minkowski
BACKGROUND: Urinary CXCL10 is a promising biomarker for subclinical tubulointerstitial inflammation, but limited data exists regarding its correlation with (micro)vascular inflammation. Furthermore, no study has evaluated whether concomitant serum CXCL10 improves the discrimination for (micro)vascular inflammation. METHODS: We investigated whether serum/urinary CXCL10 reflect subclinical inflammation within different renal compartments. Patients (n=107) with 107 surveillance biopsies were classified as: normal histology (n=47), normal histology with BKV or CMV viremia (n=17), moderate-severe tubulointerstitial inflammation (tubulitis ≥2, n=18), pure microvascular inflammation (n=15), and isolated v lesions (n=10)...
September 12, 2017: Transplantation
https://www.readbyqxmd.com/read/28895201/long-term-kidney-transplant-survival-in-patients-with-continent-urinary-diversion
#18
Romain Fournier, Ricardo Codas-Duarte, Theresa Daily, Xavier Martin, Lionel Badet, Hakim Fassi-Fehri
OBJECTIVES: To report the long-term survival of transplanted kidneys in patients with a continent urinary diversion. METHODS: Between January 1987 and July 2015, 16 patients with a median age of 37 years (range 21-63 years) underwent kidney transplantation on a continent urinary diversion. A total of 14 patients presented irreversible dysfunction of the lower urinary tract, and two patients had required radical cystectomy because of bladder cancer. All continent urinary diversions were carried out before the transplantation...
September 11, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28894795/liver-enzymes-and-the-development-of-posttransplantation-diabetes-mellitus-in-renal-transplant-recipients
#19
Gerald Klaassen, Eva Corpeleijn, Nicole P E Deetman, Gerjan J Navis, Stephan J L Bakker, Dorien M Zelle
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) is common in renal transplant recipients (RTR), increasing the risk of graft failure, cardiovascular disease, and mortality. Early detection of a high risk for PTDM is warranted. Because liver function and liver fat are involved, we investigated whether serum liver markers are associated with future PTDM in RTR. METHODS: Between 2001 and 2003, 606 RTR with a functioning allograft beyond the first year after transplantation were included of which 500 participants (56% men; age, 50 ± 12 years) were free of diabetes at baseline and had liver enzyme values (1 missing) available...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28892898/atypical-presentation-of-isolated-cerebral-aspergillosis-in-a-renal-allograft-recipient
#20
Minaxi H Patel, Aruna V Vanikar, Himanshu V Patel, Rashmi D Patel
The immunosuppressive state in organ transplantation leads to infectious complications responsible for high mortality rate. Fungal infections account for 5% of all infections in Renal Transplantation (RT) recipients. Aspergillus species are filamentous fungi frequently causing fungal infections in RT recipients. Lungs and paranasal sinuses are the usual portal of entry from where it disseminates to other organs. Here, we are reporting a case of 14-year-old boy with RT from mother's kidney, who had atypical presentation of isolated cerebral aspergillosis at 19 months post-transplant without identified portal of entry...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
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