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https://www.readbyqxmd.com/read/28719361/effectiveness-of-valganciclovir-900mg-versus-450mg-for-cytomegalovirus-prophylaxis-in-renal-transplantation-a-systematic-review-and-meta-analysis
#1
Wang Xin, Yang Hui, Zhang Xiaodong, Cui Xiangli, Wang Shihui, Liu Lihong
OBJECTIVES: Valganciclovir 900 mg/day is approved for cytomegalovirus (CMV) prophylaxis, but 450 mg/day is seems also effective. We systematically reviewed the efficacy and safety of low-dose versus high-dose valganciclovir prophylaxis in renal transplantation recipients. METHODS: An electronic search was conducted up to November 29, 2016. The primary outcomes were incidences of CMV, CMV disease, mortality and opportunistic infection. The second outcomes were acute rejection, allograft loss, adverse drug reaction (ADR)...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28716027/cytomegalovirus-viraemia-and-mortality-in-renal-transplant-recipients-in-the-era-of-antiviral-prophylaxis-lessons-from-the-western-australian-experience
#2
Linda A Selvey, Wai H Lim, Peter Boan, Ramyasuda Swaminathan, Claudia Slimings, Amy E Harrison, Aron Chakera
BACKGROUND: Cytomegalovirus (CMV) establishes a lifelong infection that is efficiently controlled by the immune system; this infection can be reactivated in case of immunosuppression such as following solid organ transplantation. CMV viraemia has been associated with CMV disease, as well as increased mortality and allograft failure. Prophylactic antiviral medication is routinely given to renal transplant recipients, but reactivation during and following cessation of antiviral prophylaxis is known to occur...
July 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28714235/tuberculosis-after-kidney-transplantation-is-associated-with-significantly-impaired-allograft-function
#3
Silvana Daher Costa, Tainá Veras de Sandes-Freitas, Camilla Neves Jacinto, Lorena Vasconcelos Mesquita Martiniano, Yago Sucupira Amaral, Fernando José Villar Nogueira Paes, Maria Luiza de Mattos Brito Oliveira Sales, Ronaldo de Matos Esmeraldo, Elizabeth de Francesco Daher
BACKGROUND: This study aimed to evaluate renal function before, during and after the course of tuberculosis (TB) disease in kidney transplant recipients; and assess the risk factors for non-recovery of baseline renal function. METHODS: We performed a retrospective, single-center cohort study, including all patients with confirmed or presumed TB diagnosis after kidney transplant (n=34, 2.1%). Renal function was assessed by serum creatinine (Cr) and glomerular filtration rate (GFR) adjusted for deaths and graft losses...
July 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28710896/renal-allograft-histology-at-10-years-after-transplantation-in-the-tacrolimus-era-evidence-of-pervasive-chronic-injury
#4
Mark D Stegall, Lynn D Cornell, Walter D Park, Byron H Smith, Fernando G Cosio
Improving long-term renal allograft survival remains an important unmet need. To assess the extent of histologic injury at 10 years after transplantation in functioning grafts, we studied 575 consecutive adult solitary renal transplants performed between 2002 and 2005-77% from living donors and 92% maintained on tacrolimus-based immunosuppression. Ten-year graft survival was 59% and death-censored graft survival was 74%. Surveillance allograft biopsies were assessed at implantation, 5 years and 10 years from 145 patients that reached 10 years...
July 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28709641/glucocest-magnetic-resonance-imaging-in%C3%A2-vivo-may-be-diagnostic-of-acute-renal-allograft-rejection
#5
Dominik Kentrup, Philipp Bovenkamp, Annika Busch, Katharina Schuette-Nuetgen, Helga Pawelski, Hermann Pavenstädt, Eberhard Schlatter, Karl-Heinz Herrmann, Jürgen R Reichenbach, Bettina Löffler, Barbara Heitplatz, Veerle Van Marck, Nirbhay N Yadav, Guanshu Liu, Peter C M van Zijl, Stefan Reuter, Verena Hoerr
Acute cellular renal allograft rejection (AR) frequently occurs after kidney transplantations. It is a sterile T-cell mediated inflammation leading to increased local glucose metabolism. Here we demonstrate in an allogeneic model of Brown Norway rat kidneys transplanted into uninephrectomized Lewis rats the successful implementation of the recently developed glucose chemical exchange saturation transfer (glucoCEST) magnetic resonance imaging. This technique is a novel method to assess and differentiate AR...
July 11, 2017: Kidney International
https://www.readbyqxmd.com/read/28709599/recurrence-of-glomerulonephritis-an-underestimated-and-unmet-medical-need
#6
Johan W de Fijter
Recurrent glomerulonephritis is increasingly recognized as an important contributor to premature renal allograft failure. The incidence of recurrent glomerulonephritis varies widely depending on original disease, renal biopsy policy, and time of observation. Biopsy-documented clinical recurrence rates underestimate the true prevalence. The impact of recurrent glomerulonephritis on graft survival parameters also widely varies and requires large collaborative efforts with more detailed and balanced evaluations, such as other major causes for chronic renal allograft dysfunction...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#7
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995-2015. Nineteen patients were switched from tacrolimus(n=15) or cyclosporin(n=4) to everolimus(n=4) or sirolimus(n=15) due to nephrotoxicity(n=5), malignancy(n=8), EBV viremia/reactive plasmacytic changes(n=5) and immune hemolytic anemia(n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28706180/serum-uric-acid-and-arterial-function-after-renal-transplantation
#8
Frederic Bauer, Nikolaos Pagonas, Felix S Seibert, Walter Zidek, Richard Viebahn, Nina Babel, Timm H Westhoff
BACKGROUND Hyperuricemia is associated with an increased risk of cardiovascular disease and chronic allograft nephropathy after renal transplantation. It has recently been demonstrated that treatment of asymptomatic hyperuricemia is associated with improved patient and graft survival; although, the underlying mechanisms remain elusive. The present study investigated the association of serum uric acid (SUA) and systemic arterial function after renal transplantation. MATERIAL AND METHODS In a cross-sectional study, arterial function was analyzed in 54 renal transplant recipients by means of pulse wave analysis...
July 14, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28705060/usefulness-of-multiparametric-ultrasound-for-evaluating-structural-abnormality-of-transplanted-kidney-can-we-predict-histologic-abnormality-on-renal-biopsy-in-advance
#9
Moon Gyu Yoo, Dae Chul Jung, Young Taik Oh, Sung Yoon Park, Kyunghwa Han
OBJECTIVE: The purpose of this study was to investigate the associations between microscopic abnormalities of transplanted kidneys and sonography-based imaging biomarkers, including elasticity, venous impedance index, arterial resistive index, and size. MATERIALS AND METHODS: Between 2011 and 2015, 159 recipients underwent sonography and biopsy of a transplanted kidney at our institution; 104 adult patients were included in this study. The maximal longitudinal length on gray-scale images, arterial resistive index, and venous impedance index on Doppler images and shear wave velocity on acoustic radiation force impulse imaging or Young modulus on supersonic shear imaging were measured before biopsy...
July 13, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28703928/regulatory-and-pro-inflammatory-cytokines-in-brazilian-living-related-renal-transplant-recipients-according-to-creatinine-plasma-levels
#10
Ana Paula Lucas Mota, Cristiane Alves da Silva Menezes, Patrícia Nessralla Alpoim, Carolina Neris Cardoso, Suellen Rodrigues Martins, Lorraine Vieira Alves, Olindo de Assis Martins-Filho, Karina Braga Gomes Borges, Luci Maria SantAna Dusse
AIM: The maintenance of stable graft function in renal transplanted recipients (RTR) is a challenge for healthcare staff. The ideal biomarkers must have significative predictive values to monitor the intricate renal function response triggered after renal transplantation. The main purpose in this study was to evaluate the regulatory and pro-inflammatory cytokines as biomarkers of allograft function in living-related renal transplant patients. METHODS: Regulatory and pro-inflammatory cytokine plasma levels were measured by flow cytometry in 120 living-related renal transplanted patients categorized into three groups according to creatinine plasma levels: creatinine less than 1...
July 13, 2017: Nephrology
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#11
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Genomics, proteomics and molecular biology lead to tremendous advances in all fields of medical sciences. Among these the finding of biomarkers as non invasive indicators of biologic processes represents a useful tool in the field of transplantation. In addition to define the principal characteristics of the biomarkers, this review will examine the biomarker usefulness in the different clinical phases following renal transplantation. Biomarkers of ischemia-reperfusion injury and of delayed graft function are extremely important for an early diagnosis of these complications and for optimizing the treatment...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28696249/haploinsufficiency-of-the-transcription-factor-ets-1-is-renoprotective-in-dahl-salt-sensitive-rats
#12
Wenguang Feng, Bo Chen, Dongqi Xing, Xingsheng Li, Huma Fatima, Edgar A Jaimes, Paul W Sanders
Studies using Dahl salt-sensitive (SS) rats identified specific quantitative trait loci that predispose animals to hypertension-associated albuminuria and kidney injury. We explored the hypothesis that kidney-specific expression of the transcription factor Ets-1, located within one of these loci on chromosome 8, mediates glomerular injury in SS hypertension. During the first week on a high-salt diet, SS rats and SS rats with only one functioning Ets-1 gene (ES rats) demonstrated similar increases in BP. However, serum creatinine concentration, albuminuria, and glomerular expression of ETS-1 and two ETS-1 targets, MCP-1 and MMP2, did not increase as substantially in ES rats as in SS rats...
July 10, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28693502/the-role-of-thrombectomy-and-diffusion-weighted-imaging-with-mri-in-post-transplant-renal-vein-thrombosis-a-case-report
#13
Paraish Misra, Anish Kirpalani, General Leung, Paraskevi A Vlachou, Jason Y Lee, Serge Jothy, Jeffrey Zaltzman, Darren A Yuen
BACKGROUND: Surgical thrombectomy in the context of acute renal vein thrombosis (RVT) post-transplantation has had limited success, with considerable variation in the surgical techniques used. Unfortunately, it is usually followed by allograft nephrectomy within a few days if rapid allograft recovery does not ensue. We report a case of acute RVT in which nephrectomy was not performed despite a prolonged requirement for dialysis post-thrombectomy, but with recovery of renal function 2 weeks later...
July 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28691954/maintenance-belatacept-based-immunosuppression-in-lung-transplantation-recipients-who-failed-calcineurin-inhibitors
#14
Carlo J Iasella, Ryan J Winstead, Cody A Moore, Bruce A Johnson, Ayelet T Feinberg, Matthew R Morrell, J W Awori Hayanga, Elizabeth A Lendermon, Adriana Zeevi, John F McDyer, Christopher R Ensor
BACKGROUND: Traditional immunosuppressive regimens (ISR) used in lung transplantation rely on calcineurin inhibitors (CNI) that occasionally cause severe adverse reactions necessitating discontinuation. Belatacept is a novel costimulation antagonist approved for use in renal transplantation which lacks data in lung transplantation. This series aims to describe the response to belatacept ISR in 11 lung transplantation recipients after CNI failure. METHODS: Single center, retrospective medical record review of adult lung transplant recipients (LTR) before and after conversion to belatacept-based ISR...
July 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28686681/kir-and-their-hla-class-i-ligands-two-more-pieces-towards-completing-the-puzzle-of-chronic-rejection-and-graft-loss-in-kidney-transplantation
#15
Roberto Littera, Gianbenedetto Piredda, Davide Argiolas, Sara Lai, Elena Congeddu, Paola Ragatzu, Maurizio Melis, Elisabetta Carta, Maria Benigna Michittu, Donatella Valentini, Luisella Cappai, Rita Porcella, Francesco Alba, Maria Serra, Valentina Loi, Roberta Maddi, Sandro Orrù, Giorgio La Nasa, Giovanni Caocci, Roberto Cusano, Marcella Arras, Mauro Frongia, Antonello Pani, Carlo Carcassi
BACKGROUND: Kidney transplantation is a life-saving treatment for patients with end-stage renal disease. However, despite progress in surgical techniques and patient management, immunological rejection continues to have a negative impact on graft function and overall survival. Incompatibility between donors and recipients for human leukocyte antigens (HLA) of the major histocompatibility complex (MHC) generates a series of complex cellular and humoral immune response mechanisms that are largely responsible for rejection and loss of graft function...
2017: PloS One
https://www.readbyqxmd.com/read/28686294/nfat-regulated-cytokine-gene-expression-during-tacrolimus-therapy-early-after-renal-transplantation
#16
Sara Bremer, Nils T Vethe, Morten Skauby, Margrete Kasbo, Elisabet D Johansson, Karsten Midtvedt, Stein Bergan
AIMS: Despite pharmacokinetic monitoring of calcineurin inhibitors, the long-term outcome after transplantation (Tx) is still hampered by the side effects of these drugs. The aim of this study was to characterize the nuclear factor of activated T cells (NFAT)-regulated gene expression as a potential pharmacodynamic biomarker for further individualization of tacrolimus (Tac) therapy. METHODS: In 29 renal allograft recipients samples were drawn once pre-Tx, and before and 1...
July 7, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28684646/association-between-reperfusion-renal-allograft-biopsy-findings-and-transplant-outcomes
#17
Sumit Mohan, Eric Campenot, Mariana C Chiles, Dominick Santoriello, Eric Bland, R John Crew, Paul Rosenstiel, Geoffrey Dube, Ibrahim Batal, Jai Radhakrishnan, P Rodrigo Sandoval, James Guarrera, M Barry Stokes, Vivette D'Agati, David J Cohen, Lloyd E Ratner, Glen Markowitz
Biopsy findings at the time of procurement of deceased donor kidneys remain the most common reason cited for kidney discard. To determine the value of renal allograft histology in predicting outcomes, we evaluated the significance of histologic findings, read by experienced renal pathologists, in 975 postreperfusion biopsy specimens collected from 2005 to 2009 after living donor (n=427) or deceased donor (n=548) renal transplant. We evaluated specimens for the degree of glomerulosclerosis, interstitial fibrosis and tubular atrophy, and vascular disease; specimens with a score of 0 or 1 (scale, 0-3) for each parameter were considered optimal...
July 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28668445/comparison-of-four-measures-in-reducing-length-of-stay-in-burns-an-asian-centre-s-evolved-multimodal-burns-protocol
#18
Si Jack Chong, Yee Onn Kok, Abby Choke, Esther W X Tan, Kok Chai Tan, Bien-Keem Tan
INTRODUCTION: Multidisciplinary burns care is constantly evolving to improve outcomes given the numerous modalities available. We examine the use of Biobrane, micrografting, early renal replacement therapy and a strict target time of surgery within 24h of burns on improving outcomes of length of stay, duration of surgery, mean number of surgeries and number of positive tissue cultures in a tertiary burns centre. METHODS: A post-implementation prospective cohort of inpatient burns patients from 2014 to 2015 (n=137) was compared against a similar pre-implementation cohort from 2013 to 2014 (n=93) using REDCAP, an electronic database...
June 28, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28665959/increased-migration-of-antigen-presenting-cells-to-newly-formed-lymphatic-vessels-in-transplanted-kidneys-by-glycol-split-heparin
#19
Ditmer T Talsma, Kirankumar Katta, Miriam Boersema, Saritha Adepu, Annamaria Naggi, Giangiacomo Torri, Coen Stegeman, Gerjan Navis, Harry van Goor, Jan-Luuk Hillebrands, Saleh Yazdani, Jacob van den Born
BACKGROUND: Chronic renal transplant dysfunction is characterized by loss of renal function and tissue remodeling, including chronic inflammation and lymph vessel formation. Proteoglycans are known for their chemokine presenting capacity. We hypothesize that interruption of the lymphatic chemokine-proteoglycan interaction interferes with the lymphatic outflow of leukocytes from the renal graft and might decrease the anti-graft allo-immune response. METHODS: In a rat renal chronic transplant dysfunction model (female Dark-Agouti to male Wistar Furth), chemokines were profiled by qRT-PCR in microdissected tubulo-interstitial tissue...
2017: PloS One
https://www.readbyqxmd.com/read/28664821/de-novo-iga-nephropathy-in-a-renal-allograft
#20
Amir Shabaka, Isabel Pérez-Flores, José Antonio Cortés, Ana Isabel Sánchez-Fructuoso
Posttransplant glomerulonephritis is a complication of kidney transplant that can impair graft function and long-term graft survival. De novo immunoglobulin A disease in kidney allografts appears to be much less common than the recurrent disease, and in most cases it is diagnosed in protocol biopsies with no clinical evidence of disease or in association with other renal transplant pathologies such as chronic rejection. We present a case of de novo immunoglobulin A nephropathy presenting with overt proteinuria, microscopic hematuria, and progressive deterioration of renal function 30 months after renal transplant...
June 28, 2017: Experimental and Clinical Transplantation
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