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Acute rejection

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https://www.readbyqxmd.com/read/28212151/antibody-mediated-rejection-in-the-cardiac-allograft-diagnosis-treatment-and-future-considerations
#1
M Elizabeth H Hammond, Abdallah G Kfoury
PURPOSE OF REVIEW: This review summarizes the latest publications dealing with antibody-mediated rejection (AMR) and defines areas of controversy and future steps that may improve the outcome for patients with this virulent form of rejection. RECENT FINDINGS: Recent progress includes publication of standardized pathologic criteria for acute AMR by the International Society for Heart and Lung Transplantation (ISHLT) and guidelines for treatment of acute AMR by the American Heart Association, endorsed by ISHLT as well...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28211259/liver-transplantation-from-a-deceased-donor-with-%C3%AE-thalassemia-intermedia-is-not-contraindicated-a-case-report
#2
Ersin Gumus, Osman Abbasoglu, Cahit Tanyel, Fatma Gumruk, Hasan Ozen, Aysel Yuce
The use of extended criteria donors who might have previously been deemed unsuitable is an option to increase the organ supply for transplantation. This report presents a pediatric case of a successful liver transplantation from a donor with β-thalassemia intermedia. A patient, 6-year-old female, with a diagnosis of cryptogenic liver cirrhosis underwent deceased donor liver transplantation from a thalassemic donor. Extreme hyperferritinemia was detected shortly after transplantation. The most probable cause of hyperferritinemia was iron overload secondary to transplantation of a hemosiderotic liver...
February 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28211139/scabies-in-a-bilateral-hand-allograft-recipient-an-additional-mimicker-of-acute-skin-rejection-in-vascularized-composite-allotransplantation
#3
Jean Kanitakis, Emmanuel Morelon
Vascularized composite tissue allografts include skin, which frequently undergoes, in the early post-graft period, acute rejections. The diagnosis of acute rejection may be difficult as it can be mimicked by several dermatoses. We present a bilateral hand allograft recipient who developed, 16.5 years post-graft, cutaneous lesions raising suspicion about rejection. Physical examination and skin biopsy were diagnostic of scabies. This ectoparasitosis should be added in the list of dermatoses that can mimic allograft rejection in vascular composite allografts...
February 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28211034/infectious-complications-as-the-leading-cause-of-death-after-kidney-transplantation-analysis-of-more-than-10-000-transplants-from-a-single-center
#4
Flávio de Castro Rodrigues Ferreira, Marina Pontello Cristelli, Mayara Ivani Paula, Henrique Proença, Claudia Rosso Felipe, Helio Tedesco-Silva, José Osmar Medina-Pestana
AIM: To identify specific causes of graft failure in a large sample of kidney transplant patients from a middle-income, developing country. METHODS: Retrospective cohort study analyzing all consecutive single kidney transplants (KTs) performed at a single center in Brazil between January 1st 1998 and December 31st 2013. The database closing date was December 31st 2014. RESULTS: Out of 10,400 KTs, there were 1191 (11.45%) deaths with a functioning graft, 40 cases (0...
February 17, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28210263/a-paradigm-shift-on-the-question-of-b-cells-in-transplantation-recent-insights-on-regulating-the-alloresponse
#5
REVIEW
Daniel J Firl, Gilles Benichou, James I Kim, Heidi Yeh
B lymphocytes contribute to acute and chronic allograft rejection through their production of donor-specific antibodies (DSAs). In addition, B cells present allopeptides bound to self-MHC class II molecules and provide costimulation signals to T cells, which are essential to their activation and differentiation into memory T cells. On the other hand, both in laboratory rodents and patients, the concept of effector T cell regulation by B cells is gaining traction in the field of transplantation. Specifically, clinical trials using anti-CD20 monoclonal antibodies to deplete B cells and reverse DSA had a deleterious effect on rates of acute cellular rejection; a peculiar finding that calls into question a central paradigm in transplantation...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28209246/the-clinical-course-of-iga-nephropathy-after-kidney-transplantation-and-its-management
#6
REVIEW
Sophia Lionaki, Konstantinos Panagiotellis, Christine Melexopoulou, John N Boletis
Immunoglobulin (Ig) A nephropathy is one of the most common primary glomerulonephritides worldwide causing end stage renal disease in up to 20-40% of affected patients, nearly two decades post diagnosis. Kidney transplantation is the treatment of choice for patients with renal failure, secondary to glomerular diseases. However, IgA nephropathy has a strong tendency to recur in the graft, and although initially thought to be a benign condition, several reports of graft loss, due to recurrent IgA nephropathy, there have been over the last three decades...
February 2, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28207630/clinical-trials-for-immunosuppression-in-transplantation-the-case-for-reform-and-change-in-direction
#7
Philip J O'Connell, Dirk Kuypers, Roslyn R Mannon, Michael Abecassis, Stephen Chadban, John S Gill, Barbara Murphy, Peter W Nickerson, Jesse D Schold, Peter Stock, Daniel Seron, Rita Alloway, Jonathan Bromberg, Klemens Budde, Stanley Jordan, Christophe Legendre, Carmen Lefaucheur, Minnie Sarwall, Dorry Segev, Mark D Stegall, Stefan G Tullius, Germaine Wong, E Steve Woodle, Nancy Ascher, Randall E Morris
Currently trials of immunosuppression in transplantation are in decline because their objectives remain focused on improving acute rejection rates and graft survival in the first 12 months. With 1 year renal graft survival rates of greater than 90% the best that can be hoped for is noninferiority trial outcomes compared to current standard of care. Current trial design is not leading to novel therapies improving long term outcomes and safety, and hence important unmet clinical needs in transplantation remain unanswered...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28203415/changes-in-the-action-potential-and-transient-outward-potassium-current-in-cardiomyocytes-during-acute-cardiac-rejection-in-rats
#8
Wenqi Luo, Yixin Jia, Shuai Zheng, Yan Li, Jie Han, Xu Meng
BACKGROUND: Acute cardiac rejection contributes to the changes in the electrophysiological properties of grafted hearts. However, the electrophysiological changes of cardiomyocytes during acute cardiac rejection are still unknown. An understanding of the electrophysiological mechanisms of cardiomyocytes could improve the diagnosis and treatment of acute cardiac rejection. So it is important to characterize the changes in the action potential (AP) and the transient outward potassium current (Ito ) in cardiomyocytes during acute cardiac rejection...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28194427/the-hyperlipidemia-caused-by-overuse-of-glucocorticoid-after-liver-transplantation-and-the-immune-adjustment-strategy
#9
Xueqin Meng, Xinhua Chen, Liming Wu, Shusen Zheng
The overuse of glucocorticoid may cause the metabolic disorders affecting the long term outcome of liver transplantation. This study aims to investigate the immune adjustment strategy by decreasing use of glucocorticoid after liver transplantation. The follow-up study was carried out on liver function and lipid metabolism. This study included adult recipients of liver transplantation. There were 3 groups according to their use of glucocorticoid: long term (>3 months, n = 18), short term (<3 months, n = 20), and control group (no use of glucocorticoid, radical hepatic resection, n = 22)...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28191475/the-potential-of-micrornas-as-novel-biomarkers-for-transplant-rejection
#10
REVIEW
Matthias Hamdorf, Satoru Kawakita, Matthew Everly
The control of gene expression by microRNAs (miRNAs, miR) influences many cellular functions, including cellular differentiation, cell proliferation, cell development, and functional regulation of the immune system. Recently, miRNAs have been detected in serum, plasma, and urine and circulating miR profiles have been associated with a variety of diseases. Rejection is one of the major causes of allograft failure and preventing and treating acute rejection are the central task for clinicians working with transplant patients...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28188669/orthogonal-comparison-of-molecular-signatures-of-kidney-transplants-with-subclinical-and-clinical-acute-rejection-equivalent-performance-is-agnostic-to-either-technology-or-platform
#11
S M Kurian, E Velazquez, R Thompson, T Whisenant, S Rose, N Riley, F Harrison, T Gelbart, J J Friedewald, J Charrette, S Brietigam, J Peysakhovich, M R First, M M Abecassis, D R Salomon
We performed orthogonal technology comparisons of concurrent peripheral blood and biopsy tissue samples from 69 kidney transplant recipients, who underwent a comprehensive algorithm-driven clinical phenotyping. The sample cohort included patients with normal protocol biopsies and stable transplant function (TX, n=25), subclinical acute rejection (subAR, n=23), and clinical acute rejection (cAR, n=21). Comparisons between microarray and RNA sequencing (RNA-seq) signatures were performed, demonstrating a strong correlation between the blood and tissue compartments for both technology platforms...
February 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28187998/a-systematic-review-of-the-use-of-rituximab-for-the-treatment-of-antibody-mediated-renal-transplant-rejection
#12
REVIEW
Philip S Macklin, Peter J Morris, Simon R Knight
Rituximab is a B-lymphocyte depleting agent that is used to treat hematological malignancies and autoimmune diseases. Recently, it has gained interest as an immunomodulatory agent in renal transplantation. This systematic review evaluates the evidence for its use in the treatment of acute and chronic antibody-mediated renal transplant rejection (AAMR; CAMR). A systematic search of four databases and three trial registries was conducted. The small number and heterogeneous nature of included studies precluded meta-analysis and thus a narrative review was conducted...
January 24, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28182044/efficacy-and-safety-of-early-tacrolimus-conversion-to-sirolimus-after-kidney-transplantation-long-term-results-of-a-prospective-randomized-study
#13
A E El-Agroudy, S M Alarrayed, S M Al-Ghareeb, E Farid, H Alhelow, S Abdulla
We report a prospective, open-label, randomized study to evaluate the safety and efficacy of converting patients with a stable renal function from tacrolimus (Tac)-based regimen to a sirolimus (SRL)-based regimen after kidney transplantation. Fifty-eight low-risk renal allograft recipients who receiving Tac 6 months posttransplant, were randomly assigned to continue Tac (n = 29) or convert to SRL (n = 29). We evaluated the 3-year outcomes including patient and graft survival, graft function, and safety profile...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28182043/deceased-donor-renal-transplantation-a-single-center-experience
#14
N Gopalakrishnan, T Dineshkumar, J Dhanapriya, R Sakthirajan, T Balasubramaniyan, N D Srinivasa Prasad, K Thirumalvalavan, S Murugananth, K Kawaskar
Deceased donor renal transplantation (DDRT) constitutes less than 5% of all kidney transplantats in India. A retrospective analysis of 173 deceased donor renal transplants performed in a public funded government hospital was done. Mean age of the recipients was 36 years (male:female ratio 2.4:1), and that of the donors was 32.3 years (male:female ratio 6:1). The cold ischemic time was 340 ± 170 minutes. Mean follow-up period was 36 months. Forty one patients died, 75% of them in the first post - transplant year...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28181088/risk-factors-for-injuries-associated-with-damage-claims-following-groin-hernia-repair
#15
P Nordin, J Ahlberg, H Johansson, H Holmberg, L Hafström
PURPOSE: Surgical repair of groin hernia should be carried out with minimal complication rates, and it is important to have regular quality control and accurate means of assessment. The Swedish healthcare system has a mutual insurance company (LÖF) that receives claims from patients who have suffered healthcare-related damage or malpractice. The Swedish Hernia Register (SHR) currently covers around 98% of all Swedish groin hernia operations. The aim of this study was to analyse damage claims following groin hernia repair surgery and link these with entries in the SHR, in order to identify risk factors and causes of injuries and malpractice associated with hernia repair...
February 8, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28176336/effect-of-hypothermic-machine-perfusion-on-the-preservation-of-kidneys-donated-after-cardiac-death-a-single-center-randomized-controlled-trial
#16
Wei Wang, Dawei Xie, Xiaopeng Hu, Hang Yin, Hang Liu, Xiaodong Zhang
To assess the application of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors, 24 pairs of DCD kidneys were randomly divided into two groups: one of the paired kidneys from the same donor was perfused with the LifePort machine (hypothermic machine perfusion [HMP]), and the contralateral kidney was prepared using common static cold preservation (CCP). The two groups were compared with respect to the incidence of delayed graft function (DGF), level of graft function, and pathological changes in time-zero biopsy specimens...
February 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28174669/cell-therapy-for-liver-disease-using-bioimaging-rats
#17
REVIEW
Junko Haga, Shin Enosawa, Eiji Kobayashi
Advances in stem cell research suggest that cell therapy is a potential alternative to liver transplantation. The use of individualized and minimally invasive cell therapy is desirable to avoid rejection and reduce patient burden. While allo-hepatocyte transplantation has been performed for metabolic hepatic disease, auto-bone marrow transplantation (BMT) has shifted toward mesenchymal stem cells (MSCs) transplantation for liver cirrhosis. In this article, an overview of cell transplantation research for liver disease is provided through our recent rat studies...
January 8, 2017: Cell Medicine
https://www.readbyqxmd.com/read/28169418/allogeneic-transplantation-using-cd34-selected-peripheral-blood-progenitor-cells-combined-with-non-mobilized-donor-t%C3%A2-cells-for-refractory-severe-aplastic-anaemia
#18
Enkhtsetseg Purev, Xin Tian, Georg Aue, Jeremy Pantin, Phuong Vo, Reem Shalabi, Robert N Reger, Lisa Cook, Catalina Ramos, Elena Cho, Tat'yana Worthy, Hanh Khuu, David Stroncek, Neal S Young, Richard W Childs
Allogeneic haematopoietic stem cell transplantation is curative for severe aplastic anaemia (SAA) unresponsive to immunosuppressive therapy. To reduce chronic graft-versus-host disease (GVHD), which occurs more frequently after peripheral blood stem cell (PBSC) transplantation compared to bone-marrow transplantation (BMT), and to prevent graft rejection, we developed a novel partial T-cell depleted transplant that infuses high numbers of granulocyte colony-stimulating factor-mobilized CD34(+) selected PBSCs combined with a BMT-equivalent dose of non-mobilized donor T-cells...
February 7, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28168079/successful-treatment-of-plasma-cell-rich-acute-rejection-using-pulse-steroid-therapy-alone-a-case-report
#19
Yo Komatsuzaki, Yasuyuki Nakada, Izumi Yamamoto, Mayuko Kawabe, Takafumi Yamakawa, Ai Katsuma, Haruki Katsumata, Aki Mafune, Akimitsu Kobayashi, Yusuke Koike, Hiroki Yamada, Jun Miki, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Keitaro Yokoyama, Hiroyasu Yamamoto, Takashi Yokoo
Despite the recent development of immunosuppressive agents, plasma cell-rich acute rejection (PCAR) has remained refractory to treatment. Herein, we report an unusual case of PCAR that responded well to pulse steroid therapy alone. A 47-year-old man was admitted for a protocol biopsy three months after kidney transplantation, with a stable serum creatinine level of 1.6 mg/dL. Histological examination showed focal aggressive tubulointerstitial inflammatory cell infiltration of predominantly polyclonal mature plasma cells, leading to our diagnosis of PCAR...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28166398/belatacept-after-kidney-transplantation-in-adolescents-a-retrospective-study
#20
Christian Lerch, Nele K Kanzelmeyer, Thurid Ahlenstiel-Grunow, Kerstin Froede, Martin Kreuzer, Jens Drube, Murielle Verboom, Lars Pape
Regardless of recipient age at kidney transplantation (KTx), patients are at greatest risk for graft loss in adolescence, partly due to non-adherence to an oral immunosuppressive regimen. Belatacept, a non-nephrotoxic, first-in-class immunosuppressant that inhibits co-stimulation of T-cells, requires intravenous application only every 4 weeks, potentially leading to better adherence. However, it is only approved for use in adults. We report here the findings of the first study of belatacept in adolescents, comprising all patients in our department switched to belatacept post-KTx...
February 6, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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