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Acute rejection

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https://www.readbyqxmd.com/read/28921709/kidney-allograft-failure-in-the-steroid-free-immunosuppression-era-a-matched-case-control-study
#1
Mohamad M Alkadi, Jim Kim, Meredith J Aull, Joseph E Schwartz, John R Lee, Anthony Watkins, Jun B Lee, Darshana M Dadhania, Surya V Seshan, David Serur, Sandip Kapur, Manikkam Suthanthiran, Choli Hartono, Thangamani Muthukumar
We studied the causes and predictors of death-censored kidney allograft failure among 1670 kidney recipients transplanted at our center in the corticosteroid-free maintenance immunosuppression era. As of January 1, 2012, we identified 137 recipients with allograft failure; 130 of them (cases) were matched 1-1 for recipient age, calendar year of transplant and donor type with 130 recipients with functioning grafts (controls). Median time to allograft failure was 29 months (interquartile range 18-51). Physician validated and biopsy confirmed categories of allograft failure were: acute rejection (21%), glomerular disease (19%), transplant glomerulopathy (13%), interstitial fibrosis tubular atrophy (10%), and polyomavirus-associated nephropathy (7%)...
September 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28921638/graft-infiltrating-pd-l1-hi-cross-dressed-dendritic-cells-regulate-anti-donor-t-cell-responses-in-mouse-liver-transplant-tolerance
#2
Yoshihiro Ono, Angelica Perez-Gutierrez, Toshimasa Nakao, Helong Dai, Geoffrey Camirand, Osamu Yoshida, Shinichiro Yokota, Donna Beer Stolz, Mark A Ross, Adrian E Morelli, David A Geller, Angus W Thomson
While a key role of cross-dressing has been established in immunity to viral infection and more recently in the instigation of transplant rejection, its role in tolerance is unclear. Here, we investigated the role of intra-graft dendritic cells (DC) and cross-dressing in mouse major histocompatibility complex (MHC)-mismatched liver transplant tolerance that occurs without therapeutic immunosuppression. While donor interstitial DC diminished rapidly following transplantation, they were replaced in the liver by host DC that peaked on postoperative day (POD) 7 and persisted indefinitely...
September 16, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28920002/ep4-antagonism-by-e7046-diminishes-myeloid-immunosuppression-and-synergizes-with-treg-reducing-il-2-diphtheria-toxin-fusion-protein-in-restoring-anti-tumor-immunity
#3
Diana I Albu, Zichun Wang, Kuan-Chun Huang, Jiayi Wu, Natalie Twine, Sarah Leacu, Christy Ingersoll, Lana Parent, Winnie Lee, Diana Liu, Renee Wright-Michaud, Namita Kumar, Galina Kuznetsov, Qian Chen, Wanjun Zheng, Kenichi Nomoto, Mary Woodall-Jappe, Xingfeng Bao
Reprogramming of immunosuppressive tumor microenvironment (TME) by targeting alternatively activated tumor associated macrophages (M2TAM), myeloid-derived suppressor cells (MDSC), and regulatory T cells (Tregs), represents a promising strategy for developing novel cancer immunotherapy. Prostaglandin E2 (PGE2), an arachidonic acid pathway metabolite and mediator of chronic inflammation, has emerged as a powerful immunosuppressor in the TME through engagement with one or more of its 4 receptors (EP1-EP4). We have developed E7046, an orally bioavailable EP4-specific antagonist and show here that E7046 has specific and potent inhibitory activity on PGE2-mediated pro-tumor myeloid cell differentiation and activation...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28915690/efficacy-and-safety-of-a-reduced-calcineurin-inhibitor-dose-combined-with-mycophenolate-mofetil-in-liver-transplant-patients-with-chronic-renal-dysfunction
#4
Pusen Wang, Weitao Que, Hao Li, Lvnan Yan, Zhiren Fu, Qifa Ye, Guihua Chen, Kefeng Dou, Shichun Lu, Zhanyu Yang, Zhijun Zhu, Zhihai Peng, Lin Zhong
Calcineurin inhibitors (CNIs) are frequently given at a reduced dose in combination with mycophenolate mofetil (MMF) to avoid nephrotoxicity, but the optimal reduction in CNI dose has not been established. In this prospective, open-label, multicenter study, liver transplant recipients with chronic renal dysfunction who were administered a CNI-based immunosuppressive regimen were included in the intent-to-treat (ITT) population. The primary endpoint was declination in renal function, which was defined as a ≥ 20% decrease in the glomerular filtration rate during the year following regimen adjustment...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915452/bk-virus-replication-in-renal-transplant-recipients-analysis-of-potential-risk-factors-may-contribute-in-reactivation
#5
Mohammad Shenagari, Ali Monfared, Hadise Eghtedari, Aydin Pourkazemi, Tolou Hasandokht, Masoud Khosravi, Babak Asharfkhani
BACKGROUND: Considering the increasing problem of BK virus infection during post renal transplant surveillance, it is necessary to distinguish the main risk factors leading to reactivation of latent BK virus. Up to now, some probable risk factors have been investigated in some studies, but the results have been confusing and contradictory. OBJECTIVES: The goal of the present study was to determine the frequency and potential risk factors that may play a role in BK polyomavirus reactivation and nephropathy...
September 8, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28912844/triptolide-inhibits-cd4-memory-t-cell-mediated-acute-rejection-and-prolongs-cardiac-allograft-survival-in-mice
#6
Shuiwei Qiu, Dingliang Lv
There have been numerous investigations into the immunosuppressive effects of triptolide; however, its inhibitory effects on memory T cells remain to be elucidated. Using a cluster of differentiation (CD)4(+) memory T-cell transfer model, the aim of the present study was to determine the inhibitory effects of triptolide on CD4(+) memory T cell-mediated acute rejection and to determine the potential underlying mechanisms. At 4 weeks after skin transplantation, mouse cervical heart transplantation was performed following the transfer of CD4(+) memory T cells...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28906029/il-6-production-by-monocytes-is-associated-with-graft-function-decline-in-patients-with-borderline-changes-suspicious-for-acute-t-cell-mediated-rejection-a-pilot-study
#7
Olivier Désy, Stéphanie Béland, Patrice Vallin, Julie Riopel, Eva Latulippe, Nader Najafian, Anil Chandraker, Mohsen Agharazii, Ibrahim Batal, Sacha A De Serres
Although borderline changes (BL) suspicious for acute T-cell-mediated rejection represents a diagnostic category its clinical relevance is questioned leading to heterogeneous therapeutic management. We hypothesized that measuring IL-6 secretion by peripheral blood mononuclear cells identifies patients with ongoing graft damage. We examined the association between secreted IL-6 and the change in estimated glomerular filtration rate at 6 months after the biopsy (ΔeGFR). We then conducted phenotypic and functional studies on patient and mouse innate immune cells in the blood and the kidney...
September 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28905834/microsporidial-infection-masquerading-as-graft-rejection-post-descemet-s-stripping-automated-endothelial-keratoplasty
#8
Lumbini Devi, N Venkatesh Prajna, Muthiah Srinivasan, Naveen Radhakrishnan, Manoranjan Das
A 51-year-old immunocompetent male with a history of Fuchs' endothelial dystrophy and immature cataract who underwent Descemet's stripping automated endothelial keratoplasty with intraocular lens implantation in both eyes presented with redness and defective vision of 1-day duration in his left eye. Slit lamp examination revealed coarse superficial punctate lesions with graft edema. He was diagnosed with acute graft rejection and treated with topical steroids. Two days later, symptoms worsened in his left eye with the involvement of his right eye showing a similar clinical picture...
September 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28904429/correlation-of-pretransplant-donor-specific-antibody-assay-using-luminex-crossmatch-with-graft-outcome-in-renal-transplant-patients
#9
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/28901391/protective-effects-of-heme-oxygenase-1-transduced-bone-marrow-derived-mesenchymal-stem-cells-on-reduced%C3%A2-size-liver-transplantation-role-of-autophagy-regulated-by-the-erk-mtor-signaling-pathway
#10
Raorao Wang, Zhongyang Shen, Liu Yang, Mingli Yin, Weiping Zheng, Bin Wu, Tao Liu, Hongli Song
Autophagy is a critical lysosomal pathway that degrades cytoplasmic components to maintain cell homeostasis and provide substrates for energy metabolism. A study revealed that heme oxygenase-1 (HO-1)-transduced bone marrow-derived mesenchymal stem cells (BM-MSCs) could protect 50% reduced-size liver transplantation (RSLT) in a rat model. However, the mechanisms remain mostly unknown. The aim of the present study was to explore the effects and related mechanism of autophagy on the protection conferred by HO-1-transduced BM-MSCs (HO-1/BM-MSCs) on 50% RSLT in a rat model...
September 6, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28900605/histopathological-analysis-of-infiltrating-t-cell-subsets-in-acute-t-cell-mediated-rejection-in-the-kidney-transplant
#11
Francisco Salcido-Ochoa, Susan Swee-Shan Hue, Siyu Peng, Zhaoxiang Fan, Reiko Lixiang Li, Jabed Iqbal, John Carson Allen, Alwin Hwai Liang Loh
AIM: To compare the differential immune T cell subset composition in patients with acute T cell-mediated rejection in the kidney transplant with subset composition in the absence of rejection, and to explore the association of their respective immune profiles with kidney transplant outcomes. METHODS: A pilot cross-sectional histopathological analysis of the immune infiltrate was performed using immunohistochemistry in a cohort of 14 patients with acute T cell-mediated rejection in the kidney transplant and 7 kidney transplant patients with no rejection subjected to biopsy to investigate acute kidney transplant dysfunction...
August 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28900245/the-role-of-metronomic-capecitabine-for-treatment-of-recurrent-hepatocellular-carcinoma-after-liver-transplantation
#12
Matteo Ravaioli, Alessandro Cucchetti, Antonio Daniele Pinna, Vanessa De Pace, Flavia Neri, Maria Aurelia Barbera, Lorenzo Maroni, Giorgio Frega, Andrea Palloni, Stefania De Lorenzo, Maria Cristina Ripoli, Maria Abbondanza Pantaleo, Matteo Cescon, Massimo Del Gaudio, Giovanni Brandi
The management of recurrent hepatocellular carcinoma untreatable with surgical options is based on systemic therapy with sorafenib. Due to the high rates of adverse events connected to the therapy with sorafenib, metronomic capecitabine seems a promising strategy for these patients. We analyzed the data of 38 patients with hepatocellular carcinoma recurrent after liver transplantation performed at our center. We compared the outcome of 17 patients receiving metronomic capecitabine versus 20 patients experiencing best supportive care and versus the data of the literature about treatment with sorafenib...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28898563/direct-acting-antiviral-agents-based-regimen-for-hcv-recurrence-after-combined-liver-kidney-transplantation-results-from-the-anrs-co23-cupilt-study
#13
Sébastien Dharancy, Audrey Coilly, Claire Fougerou-Leurent, Christophe Duvoux, Nassim Kamar, Vincent Leroy, Albert Tran, Pauline Houssel-Debry, Valérie Canva, Christophe Moreno, Filoména Conti, Jérome Dumortier, Vincent Di Martino, Sylvie Radenne, Victor De Ledinghen, Louis D'Alteroche, Christine Silvain, Camille Besch, Philippe Perré, Danielle Botta-Fridlund, Claire Francoz, François Habersetzer, Hélène Montialoux, Armand Abergel, Maryline Debette-Gratien, Alexandra Rohel, Emilie Rossignol, Didier Samuel, Jean-Charles Duclos-Vallée, Georges-Philippe Pageaux
HCV infection is associated with reduced patient survival following combined liver-kidney transplantation (LKT). The aim of this study was to assess the efficacy and safety of second generation direct active antiviral (DAAs) in this difficult-to-treat population. The ANRS CO23 CUPILT study is a prospective cohort including transplant recipients with recurrent HCV treated with DAAs. The present work focused on recipients with recurrent HCV following LKT. The study population included 23 patients. All patients received at least one NS5B inhibitor (Sofosbuvir) in their antiviral regimen an average of 90 months after LKT...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28895794/effect-of-a-short-course-treatment-with-synbiotics-on-plasma-p-cresol-concentration-in-kidney-transplant-recipients
#14
Bruna Guida, Mauro Cataldi, Andrea Memoli, Rossella Trio, Martina di Maro, Lucia Grumetto, Ivana Capuano, Stefano Federico, Antonio Pisani, Massimo Sabbatini
OBJECTIVE: We evaluated whether a short-term course with synbiotics may lower plasma p-Cresol concentrations in kidney transplant patients (KTRs) who accumulate this uremic toxin both because of increased production by their dysbiotic gut microbiome and because of reduced elimination by the transplanted kidneys. METHODS: Thirty-six KTRs (29 males, mean age 49.6 ± 9.1 years) with transplant vintage > 12 months, stable graft function, and no episode of acute rejection or infection in the last 3 months were enrolled in this single-center, parallel-group, double-blinded, randomized (2:1 synbiotic to placebo) study...
September 12, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28894794/short-and-long-term-outcomes-of-de-novo-liver-transplant-patients-treated-with-once-daily-prolonged-release-tacrolimus
#15
Yuichiro Okumura, Takehiro Noda, Hidetoshi Eguchi, Yoshifumi Iwagami, Daisaku Yamada, Tadafumi Asaoka, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Yutaka Takeda, Masahiro Tanemura, Shigeru Marubashi, Koji Umeshita, Yuichiro Doki, Masaki Mori
BACKGROUND: Tacrolimus is the key immunosuppressive drug for liver transplantation. Once-daily prolonged-release tacrolimus (TAC-PR) exhibits good drug adherence but has difficulty controlling the trough level in the early phase of liver transplantation. The aim of this study was to compare the feasibility and efficacy of immediately starting oral TAC-PR versus traditional twice-daily tacrolimus (TAC-BID) in de novo liver transplantation recipients. METHODS: The study included 28 patients treated with conventional TAC-BID and 60 patients treated with TAC-PR (median follow-up 70...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28894081/eculizumab-in-renal-transplantation-a-2017-update
#16
Ryszard Grenda, Magdalena Durlik
Despite ongoing progress in renal transplantation, there are still emerging challenges in this field, including consequences of ischemia-reperfusion injury (IRI), pre-existing and produced de novo anti-HLA donor-specific antibodies (DSA), and acute/chronic humoral rejection (AMR), as well as the recurrence of atypical hemolytic-uremic syndrome (aHUS) in genetically predisposed patients. All these conditions are related to the prominent role of the complement system and are deleterious to the fate of the renal graft...
September 12, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28888697/response-to-unfairness-across-the-suicide-risk-spectrum
#17
Jessica M Carbajal, Jorge L Gamboa, Jordan Moore, Favrin Smith, Lou Ann Eads, Jeffrey L Clothier, Ricardo Cáceda
Suicidal behavior is frequently triggered by social crises, such as familial, romantic, social or work-related conflict. A variety of cognitive and social functioning impairments has been associated with suicidal thoughts and acts. One of the precipitating and perpetuating factors of social conflict is the desire for retribution after a perceived offense, even at one's own detriment. We utilized the Ultimatum Game-a behavioral economic task which examines the behavioral response to perceived unfairness-in order to characterize the response to unfairness across the acute suicide risk spectrum...
August 26, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28885716/micrornas-are-potential-objective-and-early-biomarkers-for-acute-rejection-of-transplanted-limbs-in-a-rat-model
#18
Hiroki Oda, Ryosuke Ikeguchi, Tomoki Aoyama, Souichi Ohta, Takashi Noguchi, Yukitoshi Kaizawa, Hirofumi Yurie, Hisataka Takeuchi, Koji Yamamoto, Shuichi Matsuda
BACKGROUND: Limb transplantation is considered to be a treatment option for amputees. Visual skin inspection and histological assessment are used to assess rejection, but these techniques are largely subjective. Using a rat model, we examined the potential of several microRNAs (miRNAs) to be used as objective and minimally invasive biomarkers of acute rejection of transplanted limbs. METHODS: Three Brown Norway rats and 15 Lewis rats were assigned to 2 groups. In the allograft group, 3 Brown Norway rats were used as the donors and 6 Lewis rats as the recipients...
September 8, 2017: Microsurgery
https://www.readbyqxmd.com/read/28882367/defining-the-phenotype-of-antibody-mediated-rejection-in-kidney-transplantation-advances-in-diagnosis-of-antibody-injury
#19
REVIEW
Neetika Garg, Milagros D Samaniego, Dana Clark, Arjang Djamali
The diagnostic criteria for antibody-mediated rejection (ABMR) are constantly evolving in light of the evidence. Inclusion of C4d-negative ABMR has been one of the major advances in the Banff Classification in recent years. Currently Banff 2015 classification requires evidence of donor specific antibodies (DSA), interaction between DSA and the endothelium, and acute tissue injury (in the form of microvasculature injury (MVI); acute thrombotic microangiopathy; or acute tubular injury in the absence of other apparent cause)...
August 15, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28880456/urinary-mir-155-5p-and-cxcl10-as-prognostic-and-predictive-biomarkers-of-rejection-graft-outcome-and-treatment-response-in-kidney-transplantation
#20
Olga Millán, Klemens Budde, Claudia Sommerer, Irene Aliart, Olesja Rissling, Beatriz Bardaji, Maaren Matz, Martin Zeier, Irene Silva, Lluis Guirado, Mercè Brunet
BACKGROUND AND PURPOSE: MicroRNAs (miRNAs) may be useful biomarkers of rejection and allograft outcome in kidney transplantation. Elevated urinary CXCL10 levels have been associated with acute rejection (AR) and may predict allograft failure. We examined the correlation of miRNA, CXCL10 levels and immunosuppressive drug exposure with AR and graft function in kidney transplant recipients. EXPERIMENTAL APPROACH: Eighty de novo kidney transplant recipients were recruited from four European centres...
September 7, 2017: British Journal of Clinical Pharmacology
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