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https://www.readbyqxmd.com/read/29053910/a-simplified-protocol-using-rituximab-and-immunoglobulin-for-abo-incompatible-low-titer-living-donor-liver-transplantation
#1
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
BACKGROUND & AIMS: No consensus has been reached regarding optimal treatment strategies for ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). We introduce a simplified protocol using rituximab and intravenous immunoglobulin (IVIG). METHODS: Data were analyzed on adult patients who underwent ABO-I LDLT of which protocol added rituximab (300 mg/m(2) ) before surgery and IVIG (0.8 g/kg) on postoperative days 1 and 4 to the conventional immunosuppressive regimen used in ABO-compatible (ABO-C) LDLT, without plasmapheresis, splenectomy, or graft local infusion...
October 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29050128/-lung-transplantation-for-connective-tissue-disease-associated-interstitial-lung-disease-recipient
#2
J Zhang, B Wu, M Zhou, D Liu, L Fan, D Wei, H Yang, J Y Chen
Objective: To investigate the timing and complications of lung transplantation for the treatment of connective tissue disease-associated interstitial lung disease (CTD-ILD). Method: The clinical data of connective tissue-associated disease lung transplantation recipients from September, 2015 to February, 2017 were collected. Results: 11 patients with CTD-ILD were evaluated by lung transplantation and were treated with lung transplantation. Including 2 cases dermatomyositis/polymyositis and interstitial lung disease (PM/DM-ILD), 4 cases rheumatoid arthritis and interstitial lung disease (RA-ILD), 4 cases of primary Sjgren's syndrome and interstitial lung disease (pSS-ILD), 1 case of systemic sclerosis and interstitial lung disease (SSc-ILD)...
October 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29044999/macrophage-subpopulations-and-their-impact-on-chronic-allograft-rejection-versus-graft-acceptance-in-a-mouse-heart-transplant-model
#3
Yue Zhao, Song Chen, Peixiang Lan, Chenglin Wu, Yaling Dou, Xiang Xiao, Zhiqiang Zhang, Laurie Minze, Xiaoshun He, Wenhao Chen, Xian C Li
Macrophages infiltrating the allografts are heterogeneous, consisting of pro-inflammatory (M1 cells) as well as anti-inflammatory and fibrogenic phenotypes (M2 cells); they affect transplant outcomes via diverse mechanisms. Herein, we found that macrophage polarization into M1 and M2 subsets was critically dependent on TRAF6 and mTOR, respectively. In a heart transplant model we showed that macrophage-specific deletion of TRAF6 (LysM(C)(re) Traf6(fl/fl) ) or mTOR (LysM(C)(re) Mtor(fl/fl) ) did not affect acute allograft rejection...
October 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29038423/regulation-of-t-cell-alloimmunity-by-pi3k%C3%AE-and-pi3k%C3%AE
#4
Mayuko Uehara, Martina M McGrath, Shunsuke Ohori, Zhabiz Solhjou, Naima Banouni, Sujit Routray, Catherine Evans, Jonathan P DiNitto, Abdallah Elkhal, Laurence A Turka, Terry B Strom, Stefan G Tullius, David G Winkler, Jamil Azzi, Reza Abdi
Phosphatidylinositol-3-kinases (PI3K) γ and δ are preferentially enriched in leukocytes, and defects in these signaling pathways have been shown to impair T cell activation. The effects of PI3Kγ and PI3Kδ on alloimmunity remain underexplored. Here, we show that both PI3Kγ (-/-) and PI3Kδ (D910A/D910A) mice receiving heart allografts have suppression of alloreactive T effector cells and delayed acute rejection. However, PI3Kδ mutation also dampens regulatory T cells (Treg). After treatment with low dose CTLA4-Ig, PI3Kγ (-/-) , but not PI3Κδ (D910A/D910A) , recipients exhibit indefinite prolongation of heart allograft survival...
October 16, 2017: Nature Communications
https://www.readbyqxmd.com/read/29037296/tuberculosis-in-recipients-of-solid-organ-transplants-during-1995-2015-in-cali-colombia
#5
J F García-Goez, G A Munera, V Rojas, R Pacheco, J A Caylá, J M Miro
SETTING: Tuberculosis (TB) in solid-organ transplants (SOTs) is an important opportunistic infection associated with mortality and graft loss. SOT recipients carry a higher risk of contracting active TB than the general population. Clinical and radiographic presentations are non-specific, and sputum smear and culture have low yields. TB patients with SOTs require standard anti-tuberculosis treatment. However, rifampicin (RMP) use is associated with a 30% rate of acute graft rejection (AGR) and a 20% rate of transplant loss...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29037222/the-efficacy-and-stability-of-an-information-and-communication-technology-based-centralized-monitoring-system-of-adherence-to-immunosuppressive-medication-in-kidney-transplant-recipients-study-protocol-for-a-randomized-controlled-trial
#6
Hee-Yeon Jung, Sook Jin Seong, Ji-Young Choi, Jang-Hee Cho, Sun-Hee Park, Chan-Duck Kim, Young-Ran Yoon, Hyung-Kee Kim, Seung Huh, Se-Hee Yoon, Jong Soo Lee, Yong-Lim Kim
BACKGROUND: Immunosuppression non-adherence in kidney transplant recipients (KTRs) not only increases the risk of medical intervention due to acute rejection and graft loss but burdens the socioeconomic system in the form of increased healthcare costs. An aggressive preemptive effort by healthcare professionals, geared to ensure adherence to immunosuppressants in KTRs, is significant and imperative. METHODS/DESIGN: This study was designed as a prospective, open-label, multicenter, randomized controlled study aimed at evaluating the efficacy and stability of an information and communication technology (ICT)-based centralized monitoring system in boosting medication adherence in KTRs...
October 16, 2017: Trials
https://www.readbyqxmd.com/read/29035392/long-term-outcome-of-mixed-chimerism-after-stem-cell-transplantation-for-thalassemia-major-conditioned-with-busulfan-and-cyclophosphamide
#7
N A Fouzia, E S Edison, K M Lakshmi, A Korula, S R Velayudhan, P Balasubramanian, A Abraham, A Viswabandya, B George, V Mathews, A Srivastava
Mixed chimerism (MC) occurs frequently after allogeneic hematopoietic stem cell transplantation (HSCT) for thalassemia major (TM) and may be associated with rejection. We report the outcome of MC in 132 TM patients conditioned with Busulphan/Cyclophosphamide, who had successful engraftment and had ⩾1 year follow-up. Chimerism was first assessed at day +28, then every 3-9 months or more frequently if there was MC. If rejection was suspected, immunosuppression was stopped and donor-lymphocyte infusion (DLI) was given if there was no response...
October 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29030994/transplant-tourism-following-the-declaration-of-istanbul-poor-outcomes-and-nephrologist-dilemma
#8
Meteb M AlBugami, Fahad E AlOtaibe, Abdulnaser M AlAbadi, Khaled Hamawi, Khalid Bel'eed-Akkari
BACKGROUND: Transplant tourism (TT) violates many international laws and documents. Despite all efforts, TT seems to be increasing. The aim of this study is to review outcomes of recipients of commercially transplanted kidneys since the Declaration of Istanbul. METHODS: All recipients of kidney transplantation done abroad and then returned to our center, from September 2008 to December 2015, were included (tourists). Demographics and outcomes were collected from patients' charts...
October 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28994226/proteinuria-in-pediatric-renal-transplant-recipients
#9
Songül Yılmaz, Z Birsin Özçakar, Aysel Taktak, Eda Didem Kurt-Şükür, Nilgün Çakar, Fatoş Yalçınkaya
Proteinuria has been shown to be an important and potentially treatable risk factor for graft loss. The aim of this study was to evaluate prevalence, etiology, and outcome of proteinuria during the follow-up of children with renal transplantation. We retrospectively reviewed the files of renal transplanted children between 2006 and 2016 in our center. All patients were interpreted with respect to the demographic data and clinical and laboratory features including information about proteinuria. Chi-square test and Mann-Whitney U test were used for analysis...
October 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28990220/low-dose-basiliximab-induction-therapy-in-heart-transplantation
#10
Veraprapas Kittipibul, Pakpoom Tantrachoti, Pat Ongcharit, Aekarach Ariyachaipanich, Sarawut Siwamogsatham, Supaporn Sritangsirikul, Kanokwan Thammanatsakul, Sarinya Puwanant
We prospectively studied efficacy and safety outcomes of two 10-mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2-week assessment post-transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT grade ≥ 2R. By the 1-year assessment post-transplant, there were 1 (6%) infectious death, no graft failure, 2 (12%) grade 2R ACRs, 6 (35%) asymptomatic CMV infections, and 4 (25%) treated infections...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28988984/prevention-of-chronic-renal-allograft-rejection-by-as2553627-a-novel-jak-inhibitor-in-a-rat-transplantation-model
#11
Koji Nakamura, Yuka Kawato, Yoko Kaneko, Kaori Hanaoka, Kaori Kubo, Tomonori Nakanishi, Masashi Maeda, Hidehiko Fukahori, Misato Ito, Takahisa Noto, Masamichi Inami, Jun Hirose, Tatsuaki Morokata
BACKGROUND: Janus kinase (JAK) inhibitors are thought to be promising candidates to aid renal transplantation. However, the effectiveness of JAK inhibitors against features of chronic rejection, including interstitial fibrosis/tubular atrophy (IF/TA) and glomerulosclerosis, has not been elucidated. Here, we investigated the effect of AS2553627, a novel JAK inhibitor, on the development of chronic rejection in rat renal transplantation. METHODS: Lewis (LEW) to Brown Norway (BN) rat renal transplantation was performed...
October 5, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28988422/comparison-of-two-cytoreductive-regimens-for-%C3%AE-%C3%AE-t-cell-depleted-haploidentical-hsct-in-pediatric-malignancies-improved-engraftment-and-outcome-with-tbi-based-regimen
#12
Elad Jacoby, Nira Varda-Bloom, Gal Goldstein, Daphna Hutt, Chaim Churi, Helly Vernitsky, Amos Toren, Bella Bielorai
BACKGROUND: Graft manipulation using selective depletion of αβ-T cells provides a source of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) enriched in effector cells. We report our experience implementing this haplo-HSCT for high-risk malignancies in pediatric patients focusing on the conditioning regimen. PROCEDURE: We performed a retrospective study of patients who underwent T-cell receptor αβ-depleted haplo-HSCT for high-risk pediatric malignancies...
October 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28986715/induction-therapy-of-basiliximab-versus-antithymocyte-globulin-in-renal-allograft-a-systematic-review-and-meta-analysis
#13
Kun Wang, Xianlin Xu, Min Fan
OBJECTIVE: The aim of this meta-analysis was to evaluate the efficacy of basiliximab versus antithymocyte globulin for induction therapy in renal allograft. METHODS: Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify prospective randomized controlled trials that compared basiliximab with antithymocyte globulin (ATG) for induction therapy in renal transplantation. RevMan 5.1 software and Stat Manager V4...
October 6, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28979784/seventy-seven-kidney-paired-donation-transplantations-at-a-single-transplant-centre-in-india-led-to-an-increase-in-living-donor-kidney-transplantations-in-2015
#14
Vivek B Kute, Himanshu V Patel, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Priya S Shah, Umesh T Varyani, Pavan S Wakhare, Saiprasad G Shinde, Vijay A Ghodela, Varsha B Trivedi, Minaxi H Patel, Hargovind L Trivedi
BACKGROUND: To ascertain the validity of kidney paired donations (KPDs) as an alternative strategy for increasing living donor kidney transplantations (LDKTs) in an LDKT-dominated transplant programme since directed kidney transplantation, ABO-incompatible or crossmatch-positive pairs are not feasible due to costs and infectious complications. METHODS: This was a prospective single-centre study of 77 KPD transplantations (25 two-way, 7 three-way and 1 six-way exchange) from 1 January 2015 to 1 January 2016 of 158 registered donor recipient pairs...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28978275/low-immunogenic-endothelial-cells-maintain-morphofunctional-properties-needed-for-tissue-engineering
#15
Skadi Lau, Dorothee Eicke, Marco Carvalho Oliveira, Bettina Wiegmann, Claudia Schrimpf, Axel Haverich, Rainer Blasczyk, Mathias Wilhelmi, Constanςa Figueiredo, Ulrike Böer
The limited availability of native vessels suitable for the application as hemodialysis shunts or bypass material demands new strategies in cardiovascular surgery. Tissue engineered vascular grafts containing autologous cells are considered as ideal vessel replacements due to the low risk of rejection. However, endothelial cells (EC), which are central components of natural blood vessels, are difficult to obtain from elderly patients of poor health. Umbilical cord blood represents a promising alternative source for EC but their allogeneic origin corresponds with the risk of rejection after allotransplantation...
October 5, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28976570/renal-transplant-acute-rejection-with-lower-mycophenolate-mofetil-dosing-and-proton-pump-inhibitors-or-histamine-2-receptor-antagonists
#16
Kajal S Patel, Brian R Stephany, Julie F Barnes, Seth R Bauer, Michael L Spinner
BACKGROUND: Pharmacokinetic data show reduced mycophenolic acid levels in renal transplant recipients taking mycophenolate mofetil (MMF) and proton pump inhibitors (PPIs) concomitantly. This reduced exposure could increase rejection risk. The typical initial MMF dose post-renal transplant is 2 g daily, which often requires dose reduction secondary to side effects. Existing studies have not shown significant acute rejection differences for patients taking MMF-PPI versus MMF-ranitidine...
October 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28975804/rejection-evaluation-after-renal-transplantation-using-mr-diffusion-tensor-imaging
#17
Emin Deger, Azim Celik, Hamad Dheir, Volkan Turunc, Ahmet Yardimci, Mert Torun, Mutlu Cihangiroglu
Background Renal allograft dysfunction monitoring is mainly performed using the serum creatinine (SC) level, Doppler ultrasound (US), or renal biopsy. Recently proposed diffusion-based magnetic resonance imaging (MRI) methods have been explored as new, non-invasive tools for assessing renal function after transplantation. Purpose To investigate the value of fractional anisotropy (FA) measurements in the evaluation of acute rejection cases after renal transplant. Material and Methods Doppler US and MRI diffusion tensor imaging (DTI) were performed in 21 patients with graft dysfunction requiring graft biopsy after renal transplantation and in 21 patients with normal graft function...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28974434/graft-immunologic-events-in-deceased-donor-kidney-transplant-recipients-with-preformed-hla-donor-specific-antibodies
#18
Xicohténcatl Ixtlapale-Carmona, Adriana Arvizu, Adrian De-Santiago, Norma González-Tableros, Mayra López, Natalia Castelán, Lluvia A Marino, Norma O Uribe-Uribe, Alan G Contreras, Mario Vilatobá, Luis E Morales-Buenrostro, Josefina Alberú
INTRODUCTION: Pretransplant donor-specific HLA alloantibodies detected with the Single Antigen Bead (SAB) assay reflect an increased risk for acute antibody-mediated rejection (AMR). We herein report the incidence of both acute AMR and acute cellular rejection (ACR) during the first year posttransplantation, in a cohort of kidney transplant recipients (KTR) of deceased donor (DD) grafts, according to their DSA status. Pretransplant DSA do not preclude DD-KT in negative CDC-XM recipients at our center...
September 30, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28970838/successful-treatment-of-t-cell-mediated-acute-rejection-with-delayed-ctla4-ig-in-mice
#19
James S Young, Stella H-W Khiew, Jinghui Yang, Augustin Vannier, Dengping Yin, Roger Sciammas, Maria-Luisa Alegre, Anita S Chong
Clinical observations that kidney transplant recipients receiving belatacept who experienced T cell-mediated acute rejection can be successfully treated and subsequently maintained on belatacept-based immunosuppression suggest that belatacept is able to control memory T cells. We recently reported that treatment with CTLA4-Ig from day 6 posttransplantation successfully rescues allografts from acute rejection in a BALB/c to C57BL/6 heart transplant model, in part, by abolishing B cell germinal centers and reducing alloantibody titers...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28969763/peri-and-postsurgical-evaluations-of-renal-transplant
#20
REVIEW
Belkis Erbas
Renal transplantation is the best treatment of choice for patient with chronic renal insufficiency because it provides better quality of life and longer survival. Survival rates for grafts and patients have improved over the recent decades because of significant evolution of surgical techniques and immunosuppressive treatment. However, renal transplantation is still associated with several complications, which may result in poor outcome. Cause of allograft dysfunction, which occurs in the early or late post-transplantation period, should be recognized immediately, so that it can be managed correctly...
November 2017: Seminars in Nuclear Medicine
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