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Acute rejection

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https://www.readbyqxmd.com/read/29779238/the-role-of-transbronchial-cryobiopsy-in-lung-transplantation
#1
M Angeles Montero, Javier de Gracia, Mario Culebras, Jacqueline Mugnier, Antonio Álvarez, Cristina Berastegui, Cristian Ortiz-Villalón
INTRODUCTION: Lung transplant monitoring is usually assessed by forceps transbronchial biopsies. These types of biopsies show limited reliability and high degree of variability due to insufficient material and compression artefact, which lead to misinterpretation and eventually mistreatment of the transplanted patients. The following study was undertaken to assess the diagnostic yield, histological quality and safety of cryobiopsy in comparison with conventional forceps biopsy for sampling lung tissue in transplant recipients...
May 19, 2018: Histopathology
https://www.readbyqxmd.com/read/29779167/mir-199b-5p-regulates-immune-mediated-allograft-rejection-after-lung-transplantation-through-the-gsk3%C3%AE-and-nf-%C3%AE%C2%BAb-pathways
#2
Linhai Zhu, Haichao Xu, Wang Lv, Zhehao He, Peng Ye, Yiqing Wang, Jian Hu
Emerging evidence indicates that acute rejection mainly associated with the inflammatory response is an independent risk factor for chronic rejection after lung transplantation. Monocytes are the main pro-inflammatory leukocytes infiltrating around the lesions and play vital roles in triggering the acute rejection. In the rat lung transplantation model, lipopolysaccharide (LPS)-induced severe acute rejection was strongly associated with advanced chronic rejection. The exact regulatory mechanism of pro-inflammation in monocytes is not yet clear...
May 19, 2018: Inflammation
https://www.readbyqxmd.com/read/29776597/the-role-of-fdg-pet-in-detecting-rejection-after-liver-transplantation
#3
Ashley M Watson, Neal Bhutiani, Prejesh Philips, Eric G Davis, Mary Eng, Robert M Cannon, Christopher M Jones
BACKGROUND: The activation and increased metabolic activity of T cells in acute cellular rejection could allow fluoro-2-deoxyglucose positron emission tomography to be utilized for detection of acute cellular rejection. The objective of this study was to evaluate the effectiveness of fluoro-2-deoxyglucose positron emission tomography in detecting acute cellular rejection in the clinical setting. METHODS: Fluoro-2-deoxyglucose positron emission tomography studies were performed on 88 orthotopic liver transplant patients at 7 and 17 days postoperatively (first positron emission tomography and second positron emission tomography, respectively)...
May 15, 2018: Surgery
https://www.readbyqxmd.com/read/29775877/communication-and-social-interaction-anxiety-enhance-interleukin-1-beta-and-cortisol-reactivity-during-high-stakes-public-speaking
#4
Brandon J Auer, Jessica L Calvi, Nicolas M Jordan, David Schrader, Jennifer Byrd-Craven
BACKGROUND: Worry or fear related to speaking in front of others, or more broadly, communicating and interacting with others, is common. At elevated levels, however, it may contribute to heightened stress reactivity during acute speaking challenges. The purpose of this study was to examine multi-system physiological stress reactivity in the context of high-stakes public speaking while considering the impact of hypothesized individual difference risk factors. METHODS: University student participants (n = 95) delivering speeches as a heavily-weighted component of their final grade had saliva samples collected immediately prior to speaking, immediately after, and 20 min after speech completion...
May 8, 2018: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29775554/outcomes-and-predictors-of-early-infection-after-heart-transplantation
#5
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29774602/pancreas-transplantation-using-compatible-but-non-identical-abo-blood-group-donors
#6
Santosh Nagaraju, Richard S Mangus, John A Powelson, Jonathan A Fridell
METHODS: A review of all pancreas transplants from a single institution from 01/2003 to 07/2016 (n=606) revealed 41 recipients of a NIC donor pancreas which were matched for age, race, gender, year and type of transplant with 41 ABO identical cases. Groups were compared for allograft survival, incidence of acute cellular rejection (ACR), length of hospital stay, 3-month readmissions and transfusion requirements. Serum haptoglobin and Lactate dehydrogenase were used to identify hemolysis in patients requiring repeated transfusions without overt blood loss...
May 17, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29769027/immune-monitoring-after-pediatric-liver-transplantation-the-prospective-chilsfree-cohort-study
#7
Imeke Goldschmidt, André Karch, Rafael Mikolajczyk, Frauke Mutschler, Norman Junge, Eva Doreen Pfister, Tamara Möhring, Lorenzo d'Antiga, Patrick McKiernan, Deirdre Kelly, Dominique Debray, Valérie McLin, Joanna Pawlowska, Loreto Hierro, Kerstin Daemen, Jana Keil, Christine Falk, Ulrich Baumann
BACKGROUND: Although trough levels of immunosuppressive drugs are largely used to monitor immunosuppressive therapy after solid organ transplantation, there is still no established tool that allows for a validated assessment of functional degree of immunosuppression or the identification of clinically relevant over- or under-immunosuppression, depending on graft homeostasis. Reliable non-invasive markers to predict biopsy proven acute rejection (BPAR) do not exist. Literature data suggest that longitudinal measurements of immune markers might be predictive of BPAR, but data in children are scarce...
May 16, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29766640/subclinical-inflammation-phenotypes-and-long-term-outcomes-after-pediatric-kidney-transplantation
#8
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/29762458/association-between-duration-of-delayed-graft-function-acute-rejection-and-allograft-outcome-after-deceased-donor-kidney-transplantation
#9
Wai H Lim, David W Johnson, Armando Teixeira-Pinto, Germaine Wong
BACKGROUND: Prolonged duration of delayed graft function (DGF) may be associated with adverse allograft outcomes, but the association between threshold duration of DGF, acute rejection and long-term allograft loss remains undefined. We aimed to determine the impact of DGF duration on allograft outcomes and to assess whether this association was mediated by acute rejection. METHODS: Using data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry, Cox proportional modelling was used to determine the association between quartiles of DGF duration, acute rejection at 6 months and death-censored graft loss (DCGL)...
May 14, 2018: Transplantation
https://www.readbyqxmd.com/read/29761588/infection-is-the-chief-cause-of-mortality-and-non-death-censored-graft-loss-in-the-first-year-after-renal-transplantation-in-a-resource-limited-population-a-single-center-study
#10
Vikraman G, Sanjay Kumar Agarwal, Sandeep Agarwal, Sandeep Mahajan, Dipankar Bhowmik, Soumita Bagchi
BACKGROUND: Few studies have assessed the impact of infections after renal transplantation (RTX) in low and middle income countries. This single center study aimed to delineate the profile and impact of infections requiring hospitalisation (IRH) occurring in the first year after RTX in India. METHOD: Patients who underwent RTX between July 2012 and June 2015 were followed up for 12 months after transplantation. RESULTS: 60.2% of the 387 patients studied had atleast one IRH and total 492 infections were diagnosed...
May 14, 2018: Nephrology
https://www.readbyqxmd.com/read/29758531/capture-swallowing-and-egestion-of-microplastics-by-a-planktivorous-juvenile-fish
#11
Nicolas Christian Ory, Camila Gallardo, Mark Lenz, Martin Thiel
Microplastics (<5 mm) have been found in many fish species, from most marine environments. However, the mechanisms underlying microplastic ingestion by fish are still unclear, although they are important to determine the pathway of microplastics along marine food webs. Here we conducted experiments in the laboratory to examine microplastic ingestion (capture and swallowing) and egestion by juveniles of the planktivorous palm ruff, Seriolella violacea (Centrolophidae). As expected, fish captured preferentially black microplastics, similar to food pellets, whereas microplastics of other colours (blue, translucent, and yellow) were mostly co-captured when floating close to food pellets...
May 11, 2018: Environmental Pollution
https://www.readbyqxmd.com/read/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#12
Johan Noble, Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
Cornerstone immunosuppressive therapy currently relies on immediate-release tacrolimus, a calcineurin inhibitor (CNI) that is potentially nephrotoxic and is more diabetogenic than cyclosporine A. Two new formulations of tacrolimus have been launched: an extended-release formulation (Advagraf®/Astagraf XL®, Astellas company) and a long-lasting formulation (Envarsus®, Veloxis company). Area covered: Herein, we assess the efficacy of an extended-release formulation of tacrolimus (Advagraf®/Astagraf XL®) used in conjunction with or without an induction therapy (i...
May 14, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29754764/monitoring-of-early-humoral-immunity-to-identify-lung-recipients-at-risk-for-development-of-serious-infections-a-multicenter-prospective-study
#13
Elizabeth Sarmiento, Jose Cifrian, Leticia Calahorra, Carles Bravo, Sonia Lopez, Rosalia Laporta, Piedad Ussetti, Amparo Sole, Carmen Morales, Alicia de Pablos, Maria Jaramillo, Ikram Ezzahouri, Sandra García, Joaquin Navarro, Marcos Lopez-Hoyos, Javier Carbone
BACKGROUND: Infection is still a leading cause of death during the first year after lung transplantation. We performed a multicenter study among teaching hospitals to assess monitoring of early humoral immunity as a means of identifying lung recipients at risk of serious infections. METHODS: We prospectively analyzed 82 adult lung recipients at 5 centers in Spain. Data were collected before transplantation and at 7 and 30 days after transplantation. Biomarkers included IgG, IgM, IgA, complement factors C3 and C4, titers of antibodies to pneumococcal polysaccharide antigens (IgG, IgA, IgM) and antibodies to cytomegalovirus (IgG), and serum B-cell activating factor (BAFF) levels...
April 6, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29754746/rs3212227-snp-in-the-il12b-gene-prevents-delayed-graft-function-after-kidney-transplantation
#14
Vladimir Perovic, Milos Markovic, Milica Kravljaca, Emina Milosevic, Milica Djoric, Vera Pravica, Radomir Naumovic
BACKGROUND AND AIMS: Transplantation is the best treatment option for end stage kidney disease. The most common early complications in post-transplant period are acute rejection (AR) of the graft and delayed graft function (DGF). The underlying mechanisms in these events are heterogeneous and at least in part involve cytokine genes which regulate immune response to allograft. We have investigated whether functional single nucleotide polymorphisms (SNP) in the genes encoding IFN-γ (IFNG), TNF (TNFA), IL-10 (IL10) and p40 subunit of IL-12/IL-23 (IL12B) could predict risk of AR and DGF in kidney allograft recipients...
May 10, 2018: Archives of Medical Research
https://www.readbyqxmd.com/read/29752586/comparison-of-tracheal-reconstruction-with-allograft-fresh-xenograft-and-artificial-trachea-scaffold-in-a-rabbit-model
#15
Jae Yeon Lee, Jeong Hun Park, Dong-Woo Cho
This study evaluated the possibility of tracheal reconstruction with allograft, pig-to-rabbit fresh xenograft or use of a tissue-engineered trachea, and compared acute rejection of three different transplanted tracheal segments in rabbits. Eighteen healthy New Zealand White rabbits weighing 2.5-3.1 kg were transplanted with three different types of trachea substitutes. Two rabbits and two alpha 1, 3-galactosyltransferase gene-knockout pigs weighing 5 kg were used as donors. The rabbits were divided into three groups: an allograft control group consisting of rabbit-to-rabbit allotransplantation animals (n = 6), a fresh xenograft group consisting of pig-to-rabbit xenotransplantation animals (n = 6), and an artificial trachea scaffold group (n = 6)...
May 12, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#16
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29751884/acute-chronic-and-humoral-rejection-pathologic-features-under-current-immunosuppressive-regimes
#17
REVIEW
Jamie Koo, Hanlin L Wang
Under current immunosuppressive regimes, T-cell-mediated acute and chronic rejection remain common and important posttransplant complications. The definition of humoral (antibody-mediated) rejection has been greatly expanded in recent years. The histopathologic assessment of allograft biopsies continues to serve an important role in the diagnosis of rejection and to facilitate patient management. The diagnosis of both acute and chronic antibody-mediated rejection requires integration of the results of donor-specific antibody testing and C4d immunostaining, as well as exclusion of other potential etiologies of allograft dysfunction...
June 2018: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29750725/face-transplant-status-of-current-supporting-technology-to-plan-and-perform-the-operation-and-monitor-the-graft-in-the-postoperative-period
#18
Edward J Caterson, Justin C McCarty
Face transplant has rapidly advanced since the first operation in 2005, and to date, 40 partial or full-face transplants have been performed. The safety and efficacy of this operation are aided at all phases by supporting technologies. These include advanced imaging techniques to plan the operation, devices to monitor the flap in the immediate perioperative period, and noninvasive imaging and serum markers to monitor for acute and chronic rejection. Some of the technologies, such as those used in the immediate perioperative period, have extensive evidence supporting their use, whereas those to detect acute or chronic rejection remain investigational...
May 10, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29750317/mycophenolate-mofetil-for-sustained-remission-in-nephrotic-syndrome
#19
Uwe Querfeld, Lutz T Weber
The clinical application of mycophenolate mofetil (MMF) has significantly widened beyond the prophylaxis of acute and chronic rejections in solid organ transplantation. MMF has been recognized as an excellent treatment option in many immunologic glomerulopathies. For children with frequently relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS) experiencing steroid toxicity, MMF has been recommended as a steroid-sparing drug. Uncontrolled studies in patients with FRNS and SDSN have shown that many patients can achieve sustained remission of proteinuria with MMF monotherapy...
May 11, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29749699/histological-findings-in-protocol-biopsies-following-pediatric-liver-transplant-low-incidence-of-abnormalities-at-5-years
#20
Amin Sheikh, Kai Y Chau, Helen M Evans
Histological abnormalities, including chronic hepatitis, fibrosis, and steatosis, are increasingly reported in liver biopsies of children after LT. These changes may be progressive and represent a form of rejection. Liver biochemistry is often initially normal. Our LT program began in 2002, utilizing tacrolimus and low-dose steroids for the first year post-LT. Patients undergo a protocol biopsy at 1 year post-LT prior to stopping steroids, then at 5 years and every 5 years thereafter. Target tacrolimus levels are 5-8 μg/L and 3-5 μg/L after 3 and 12 months, respectively...
May 11, 2018: Pediatric Transplantation
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