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Acute rejection

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https://www.readbyqxmd.com/read/28546901/macrophages-as-effectors-of-acute-and-chronic-allograft-injury
#1
Yianzhu Liu, Malgorzata Kloc, Xian C Li
Organ transplants give a second chance of life to patients with end-stage organ failure. However, the immuno-logical barriers prove to be very challenging to overcome and graft rejection remains a major hurdle to long-term transplant survival. For decades, adaptive immunity has been the focus of studies, primarily based on the belief that T cells are necessary and sufficient for rejection. With better-developed immunosuppressive drugs and protocols that effectively control adaptive cells, innate immune cells have emerged as key effector cells in triggering graft injury and have therefore attracted much recent attention...
December 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28546531/supplementary-administration-of-everolimus-reduces-cardiac-systolic-function-in-kidney-transplant-recipients
#2
Kazuma Tsujimura, Morihito Ota, Kiyoshi Chinen, Kiyomitsu Nagayama, Masato Oroku, Morikuni Nishihira, Yoshiki Shiohira, Masami Abe, Kunitoshi Iseki, Hideki Ishida, Kazunari Tanabe
BACKGROUND The effect of everolimus, one of the mammalian targets of rapamycin inhibitors, on cardiac function was evaluated in kidney transplant recipients. MATERIAL AND METHODS Seventy-six participants who underwent kidney transplant between March 2009 and May 2016 were retrospectively reviewed. To standardize everolimus administration, the following criteria were used: (1) the recipient did not have a donor-specific antigen before kidney transplantation; (2) the recipient did not have proteinuria and uncontrollable hyperlipidemia after kidney transplantation; and (3) acute rejection was not observed on protocol biopsy 3 months after kidney transplantation...
May 26, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28545984/efficacy-and-safety-of-de-novo-and-early-use-of-extended-release-tacrolimus-in-heart-transplantation
#3
Francisco González-Vílchez, José Luis Lambert, Diego Rangel, Luis Almenar, José Luis de la Fuente, Jesús Palomo, Beatriz Díaz Molina, Ernesto Lage, Ignacio Sánchez Lázaro, José A Vázquez de Prada
INTRODUCTION AND OBJECTIVES: The extended-release formulation of tacrolimus (ERT) allows once-daily dosage, thus simplifying the immunosuppressive regimen. This study aimed to describe the safety and efficacy of the de novo and early use of ERT in heart transplantation. METHODS: This was an observational, retrospective, multicenter study comparing the safety and efficacy of the de novo use of ERT (ERT group [n=94]), standard-release tacrolimus (SRT group [n=42]) and early conversion (EC) from SRT to ERT (EC group [n=44])...
May 22, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28544604/thymic-peripheral-crosstalk-in-lymphodepletion-therapy
#4
EDITORIAL
M E Snyder, D L Farber
T cell depletion is widely used as induction therapy in solid organ transplants and particularly in kidney transplantation, to reduce the episodes of acute cellular rejection. The resultant reduction in T cell numbers is usually temporary, as T cells are actively replenished due to thymic output and/or lymphopenia-induced proliferation of remaining, depletion-resistant T cells. However, the extent of T cell replenishment and the persistence of lymphopenia varies between individuals, with potential impacts on protective or pathogenic immune responses...
May 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28544362/cxcl10-and-il-6-markers-of-two-different-forms-of-intra-amniotic-inflammation-in-preterm-labor
#5
Roberto Romero, Piya Chaemsaithong, Noppadol Chaiyasit, Nikolina Docheva, Zhong Dong, Chong Jai Kim, Yeon Mee Kim, Jung-Sun Kim, Faisal Qureshi, Suzanne M Jacques, Bo Hyun Yoon, Tinnakorn Chaiworapongsa, Lami Yeo, Sonia S Hassan, Offer Erez, Steven J Korzeniewski
PROBLEM: To determine whether amniotic fluid (AF) CXCL10 concentration is associated with histologic chronic chorioamnionitis in patients with preterm labor (PTL) and preterm prelabor rupture of the membranes (PROM). METHOD OF STUDY: This study included 168 women who had an episode of PTL or preterm PROM. AF interleukin (IL)-6 and CXCL10 concentrations were determined by immunoassay. RESULTS: (i) Increased AF CXCL10 concentration was associated with chronic (OR: 4...
May 19, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28544101/belatacept-combined-with-transient-calcineurin-inhibitor-therapy-prevents-rejection-and-promotes-improved-long-term-renal-allograft-function
#6
A B Adams, J Goldstein, C Garrett, R Zhang, R E Patzer, K A Newell, N A Turgeon, A S Chami, A Guasch, A D Kirk, S O Pastan, T C Pearson, C P Larsen
Belatacept, a T cell costimulation-blocker demonstrated superior renal function, lower cardiovascular risk, and improved graft/patient survival in renal transplant recipients. Despite the potential benefits, adoption of belatacept has been limited in part due to concerns regarding higher rates and grades of acute rejection in clinical trials. Since July 2011 we have utilized belatacept-based immunosuppression regimens in clinical practice. In this retrospective analysis of 745 patients undergoing renal transplantation at our center, we compared patients treated with belatacept (n=535) to a historical cohort receiving a tacrolimus-based protocol (n=205)...
May 23, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28542109/application-and-interpretation-of-histocompatibility-data-in-pediatric-kidney-transplantation
#7
Hilda E Fernandez
PURPOSE OF REVIEW: Advances in technology to assess immunologic risk in solid organ transplant offer an opportunity to optimize the approach to pediatric deceased donor kidney transplant in the setting of a new allocation system in the United States. RECENT FINDINGS: Degree of human leukocyte antigen (HLA) mismatch, class II HLA mismatch, unacceptable antigens and donor-specific antibody (DSA) detected by solid-phase assays, and epitope matching pretransplant affect pediatric kidney transplant outcomes...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28541443/the-impact-of-multidisciplinary-care-on-early-morbidity-and-mortality-after-heart-transplantation
#8
Marie Schmidhauser, Julien Regamey, Nathalie Pilon, Manuel Pascual, Sam Rotman, Carlo Banfi, René Prêtre, Philippe Meyer, Jean-Philippe Antonietti, Roger Hullin
OBJECTIVES: The impact of multidisciplinary care on outcome after heart transplantation (HTx) remains unclear. METHODS: This retrospective study investigates the impact of multidisciplinary care on the primary end point 1-year all-cause mortality (ACM) and the secondary end point mean acute cellular rejection (ACR) grade within the first postoperative year. RESULTS: This study includes a total 140 HTx recipients (median age: 53.5 years; males: 80%; donor/recipient gender mismatch: 38...
May 24, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28540885/outcome-of-recipients-of-human-leukocyte-antigen-incompatible-kidney-transplants-who-underwent-desensitization-at-king-fahad-specialist-hospital-dammam-saudi-arabia
#9
Mohammed Abdulrahim Idris, Akhtar Hossain, Mohammed Abdulrahman Muntasir, Adnan Marmi, Ahmed Abdulfattah Aldajani, Yousef Mohammed Aljamaan, Mahmood Akhtar, Abdulrahman Housawi
In patients whom are highly sensitized immunologically, the benefit of kidney transplantation can be extended to this population through the utilization of organs from human leukocyte antigen incompatible (HLAi) donors. This retrospective observational study was designed to identify the incidence and predictors of acute antibody-mediated rejection/acute cellular rejection (AMR/ACR) in our kidney recipients from living kidney donors (sensitized and those with low immunologic risk). This single-center study has been conducted at King Fahad Specialist Hospital, Dammam (KFSH-D), Saudi Arabia; during the period of September 2008- August 2013...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540602/late-conversion-from-tacrolimus-to-a-belatacept-based-immuno-suppression-regime-in-kidney-transplant-recipients-improves-renal-function-acid-base-derangement-and-mineral-bone-metabolism
#10
Kevin Schulte, Clara Vollmer, Vera Klasen, Jan Hinrich Bräsen, Jodok Püchel, Christoph Borzikowsky, Ulrich Kunzendorf, Thorsten Feldkamp
BACKGROUND: Calcineurin inhibitor (CNI)-induced nephrotoxicity and chronic graft dysfunction with deteriorating glomerular filtration rate (GFR) are common problems of kidney transplant recipients. The aim of this study was to analyze the role of belatacept as a rescue therapy in these patients. METHODS: In this retrospective, observational study we investigated 20 patients (10 females, 10 males) who were switched from a CNI (tacrolimus) to a belatacept-based immunosuppression because of CNI intolerance or marginal transplant function...
May 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28538652/association-between-delayed-graft-function-and-graft-loss-in-donation-after-cardiac-death-kidney-transplants-a-paired-kidney-registry-analysis
#11
Wai H Lim, Stephen P McDonald, Graeme R Russ, Jeremy R Chapman, Maggie Km Ma, Henry Pleass, Bryon Jaques, Germaine Wong
BACKGROUND: Delayed graft function (DGF) is an established complication after donation after cardiac death (DCD) kidney transplants, but the impact of DGF on graft outcomes is uncertain. To minimize donor variability and bias, a paired donor kidney analysis was undertaken where 1 kidney developed DGF and the other did not develop DGF using data from the Australia and New Zealand Dialysis and Transplant Registry. METHODS: Using paired DCD kidney data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between DGF, graft and patient outcomes between 1994 and 2012 using adjusted Cox regression models...
June 2017: Transplantation
https://www.readbyqxmd.com/read/28538050/molecular-imaging-of-acute-cardiac-transplant-rejection-animal-experiments-and-prospects
#12
Yihan Chen, Li Zhang, Jinfeng Liu, Pingyu Zhang, Xiaoyuan Chen, Mingxing Xie
Acute rejection (AR) remains the biggest challenge during the 1st year after heart transplantation despite advances in immunosuppressive therapy. The early detection and curbing of AR are crucial to the survival of transplant recipients. However, as the gold standard for AR, endomyocardial biopsy has several limitations because of its inherent invasiveness and morbidity. Traditional imaging techniques such as echocardiography and cardiac magnetic resonance imaging are of certain value for AR, but their diagnostic criteria and accuracy remain in question...
May 19, 2017: Transplantation
https://www.readbyqxmd.com/read/28536887/ficolin-2-gene-rs7851696-polymorphism-is-associated-with-delayed-graft-function-and-acute-rejection-in-kidney-allograft-recipients
#13
Ewa Dabrowska-Zamojcin, Michal Czerewaty, Damian Malinowski, Maciej Tarnowski, Sylwia Słuczanowska-Głabowska, Leszek Domanski, Krzysztof Safranow, Andrzej Pawlik
Ficolin-2 is an activator of the complement system that acts via the lectin pathway. Complement activation plays a substantial role in the renal injury inherent to kidney transplantation. In this study, we examined the associations between ficolin-2 gene polymorphisms in exon 8 and kidney allograft function. This study comprised 270 Caucasian deceased-donor renal transplant recipients. The following parameters were recorded in each case: delayed graft function (DGF), acute rejection (AR), and chronic allograft dysfunction...
May 23, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/28535529/looking-into-the-graft-without-a-biopsy-biomarkers-of-acute-rejection-in-renal-transplantation
#14
Andrea Angeletti, Paolo Cravedi
Immunosuppression in kidney transplantation is still largely driven by center-specific protocols and adjusted according to the presence of graft dysfunction, drug toxicity or infection. Due to the current inability to titrate immunosuppression to the needs of every single patient, this approach is burdened by an increased risk of under or over-immunosuppression. To extend allograft survival, immunosuppression should be decided based on reliable biomarkers capable of quantifying the alloimmune response and/or noninvasively diagnosing acute rejection...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535527/treatment-of-acute-antibody-mediated-rejection
#15
Giorgia Comai, Matteo Ravaioli, Olga Baraldi, Vania Cuna, Lorenzo Gasperoni, Giovanni Liviano D''Arcangelo, Maria Cappuccilli, Antonio D Pinna, Claudio Ronco, Gaetano La Manna
Acute antibody-mediated rejection (AMR) remains an important challenge in the field of kidney transplantation despite the advances in immunosuppressive strategies, and has been recognized as an important cause of allograft dysfunction and graft loss. The treatments of acute AMR are not standardized and poor evidence is currently available on the effectiveness of therapy regimens with combinations of drugs. Standard treatment for acute AMR is based on 3 cornerstones: removal of donor-specific antibodies (DSAs) from the bloodstream, reduction of DSAs synthesis, and inhibition of the interaction between DSAs and human leukocyte antigen antigens on donor's cells...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28533501/post-transplant-diabetes-mellitus-after-kidney-transplant-in-hispanics-and-caucasians-treated-with-tacrolimus-based-immunosuppression
#16
Pedro W Baron, Sergio Infante, Regina Peters, Jerusalem Tilahun, Jill Weissman, Lauren Delgado, Arputharaj Higgins Kore, W Lawrence Beeson, Michael E de Vera
BACKGROUND Development of post-transplant diabetes mellitus after kidney transplant (PTDM) significantly increases kidney graft loss and mortality. Several risk factors for PTDM have been reported, including Hispanic ethnicity and the use of calcineurin inhibitors and corticosteroids. The incidence and impact of PTDM in the Hispanic kidney transplant population is unknown. MATERIAL AND METHODS We retrospectively reviewed the medical records of 155 Hispanic and 124 Caucasian patients, who were not diabetics and underwent kidney transplant between January 2006 and December 2011...
May 23, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28532691/bio-synthetic-materials-for-immunomodulation-of-islet-transplants
#17
Greg A Foster, Andrés J García
Clinical islet transplantation is an effective therapy in restoring physiological glycemic control in type 1 diabetics. However, allogeneic islets derived from cadaveric sources elicit immune responses that result in acute and chronic islet destruction. To prevent immune destruction of islets, transplant recipients require lifelong delivery of immunosuppressive drugs, which are associated with debilitating side effects. Biomaterial-based strategies to eliminate the need for immunosuppressive drugs are an emerging therapy for improving islet transplantation...
May 19, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28516112/hemorrhagic-cystitis-in-a-liver-transplant-recipient-secondary-to-bk-virus
#18
Faisal Kamal, Bilal Ali, Matthew Barnes, Sehrish Kamal, Satheesh Nair, Humberto Gonzalez
The association between BK virus infection and hemorrhagic cystitis (HC) in hematopoietic stem cell transplant (HSCT) recipients is well established. However, BK virus-associated HC has not been described in liver transplant (LT) recipients. We present a case of BK virus-associated HC in a LT recipient. Our patient presented with worsening liver function tests 2 years after transplantation and was found to have acute cellular rejection. He was treated with increased immunosuppression and subsequently developed hematuria...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28515595/percutaneous-transhepatic-techniques-for-management-of-biliary-anastomotic-strictures-in-living-donor-liver-transplant-recipients
#19
Chinmay B Kulkarni, Nirmal K Prabhu, Nazar P Kader, Ramiah Rajeshkannan, Sreekumar K Pullara, Srikanth Moorthy
AIM: To retrospectively analyze the percutaneous transhepatic techniques and their outcome in the management of biliary strictures in living donor liver transplant (LDLT) recipients. MATERIALS AND METHODS: We retrieved the hospital records of 400 LDLT recipients between 2007 and 2015 and identified 45 patients with biliary strictures. Among them, 17 patients (37.8%) (Male: female = 13:4; mean age, 36.1 ± 17.5 years) treated by various percutaneous transhepatic biliary techniques alone or in combination with endoscopic retrograde cholangiopancreatography (ERCP) were included in the study...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28512755/evaluation-of-safety-of-concomitant-splenectomy-in-living-donor-liver-transplantation
#20
Amr Badawy, Yuhei Hamaguchi, Satoru Seo, Tochimi Kaido, Hideaki Okajima, Shinji Uemoto
In Asian countries, concomitant splenectomy in living donor liver transplantation (LDLT) is indicated to modulate the portal vein pressure in the small sized graft to protect against small for size syndrome. While concomitant splenectomy in deceased donor liver transplantation is almost contraindicated based on western reports of increased mortality and morbidity rate due to septic complications, there are few studies about that in LDLT. So, we retrospectively investigated the clinical outcome of adult LDLT at Kyoto University Hospital from July 2010 to July 2016...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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