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acute graft rejection

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https://www.readbyqxmd.com/read/29240626/first-report-of-biventricular-percutaneous-impella-ventricular-assist-device-use-in-pediatric-patients
#1
Javier J Lasa, Daniel A Castellanos, Susan W Denfield, William J Dreyer, Sebastian C Tume, Henri Justino, Athar M Qureshi
There is a growing interest in the use of percutaneously delivered ventricular assist devices (PVAD) in the pediatric patient population. A 16 year old female and 18 year old male both status post heart transplantation presented with evidence of graft rejection and acute severe global systolic and diastolic heart failure necessitating hemodynamic catheterization and inotropic support. Both underwent percutaneous Impella CP LVAD (Abiomed, Danvers, MA) placement with close monitoring of right ventricular function...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29237252/usefulness-of-valacyclovir-prophylaxis-for-cytomegalovirus-infection-after-anti-thymocyte-globulin-as-rejection-therapy
#2
Eun Jeong Ko, Ji Hyun Yu, Chul Woo Yang, Byung Ha Chung
Background/Aims: Anti-thymocyte globulin (ATG) treatment for acute T-cell mediated rejection (TCMR) can increase the risk of cytomegalovirus (CMV) infection. We aimed to evaluate the effect of valacyclovir prophylaxis against CMV infection after ATG administration as anti-rejection therapy. Methods: We retrospectively analyzed 55 kidney transplant recipients (KTRs) receiving ATG for steroid resistant TCMR. In all KTRs, we used intravenous ganciclovir during ATG injection...
December 15, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29236209/adverse-events-under-tacrolimus-and-cyclosporine-in-the-first-3-years-post-renal-transplantation-in-children
#3
Pauline Lancia, Beate Aurich, Phuong Ha, Anne Maisin, Véronique Baudouin, Evelyne Jacqz-Aigrain
BACKGROUND: Progress in immunosuppression has reduced acute rejection, graft loss and mortality after renal transplantation. Adverse drug reactions are well described in adults but few data are available in children. Our objectives were to analyse the adverse events reported in the first 3 years post-transplantation in children receiving tacrolimus or cyclosporine-based immunosuppression and compare them with the information of the Summary of Product Characteristics. METHODS: This retrospective study included all children who underwent a renal transplant at Hospital Robert Debré between 2002 and 2015...
December 13, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29234201/acute-and-chronic-rejection-after-liver-transplantation-what-a-clinician-needs-to-know
#4
REVIEW
Narendra S Choudhary, Sanjiv Saigal, Rinkesh K Bansal, Neeraj Saraf, Dheeraj Gautam, Arvinder S Soin
While antibody mediated hyper-acute vasculitic rejection is rare in liver transplant recipients, acute and chronic rejection have clinical significance. The liver allograft behaves differently to other solid organ transplants as acute rejection generally does not impair graft survival and chronic rejection (CR) is uncommon. The incidence of acute and chronic rejection has declined in current era due to improved immunosuppressive regimens. Acute rejection generally improves with steroid boluses and steroid resistant rejection is uncommon...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29233031/the-endoscopic-surveillance-of-the-transplanted-small-intestine-a-single-center-experience-and-a-proposal-for-a-grading-score
#5
Jonas Varkey, Per-Ove Stotzer, Magnus Simrén, Gustaf Herlenius, Mihai Oltean
OBJECTIVE: Microscopic examination of endoscopic biopsies forms the basis of acute cellular rejection (ACR) monitoring after intestinal transplantation (ITx). The endoscopy findings during acute rejection (AR) are known but a grading system for its severity is lacking. We designed and implemented a five-stage grading score based on acknowledged endoscopic features of AR, to allow a faster preliminary diagnosis of AR and intra- and interpatient comparisons. METHODS: Two investigators reviewed and graded the endoscopy reports after 28 ITx using a novel score and correlated the results with pathology findings...
December 12, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29219790/hepatitis-c-virus-infection-in-kidney-transplant-patients-current-treatment-options
#6
Pavlina Dzekova-Vidimliski, Aleksandar Sikole
Hepatitis C virus infection is highly prevalent among kidney transplant recipients, occurring consequently to their previous treatment with hemodialysis. Hepatitis C virus infection has been associated with lower graft and patient survival compared with that shown in patients without infection. The lower survival has been associated with the posttransplant progression of liver disease and increased risk for development of extrahepatic complications. The choice of immunosuppressive drugs could significantly affect the course of the infection with an accelerated viral replication after kidney transplant...
December 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29218087/the-cytoskeleton-protein-%C3%AE-actin-may-mediate-t-cell-apoptosis-during-acute-rejection-reaction-after-liver-transplantation-in-a-rat-model
#7
Xiaolong Chen, Jun Zheng, Jianye Cai, Hui Li, Shihui Li, Li Wang, Daorou Cheng, Huaxin Chen, Yang Yang, Guihua Chen, Qi Zhang, Yanwen Peng, Qiyou Wang, Genshu Wang
Cytoskeletal proteins and associated regulatory proteins are essential for maintaining cell structure and growth. β-actin is a major component of the cytoskeleton, and β-actin remodeling is involved in lymphocyte migration, infiltration and apoptosis. However, little is known about whether changes in β-actin expression affect lymphocyte cell fate, particularly during acute rejection after liver transplantation in a rat model. In our studies, grafts were harvested on days 5, 7 or 9 after xenogeneic rat liver transplantation...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29217423/pre-transplant-at1r-antibodies-correlate-with-early-allograft-rejection
#8
Alison J Gareau, Chris Wiebe, Denise Pochinco, Ian W Gibson, Julie Ho, David N Rush, Peter W Nickerson
Studies investigating the potential pathogenic effects of non-HLA antibodies (Ab) have identified Ab against the angiotensin II type 1 receptor (AT1R-Ab) as a risk factor for rejection and kidney graft loss. This study sought to validate the risk of AT1R-Ab for acute rejection and to explore the role of other non-HLA Abs in this capacity. Pre- and post-transplant sera from a cohort of 101 patients (n=453 samples total) were tested for AT1R-Ab and other non-HLA Ab using a commercially available ELISA kit and the Luminex platform, respectively...
December 4, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/29215835/-matrix-metalloproteinase-1-8-9-and-the-risk-of-cardiovascular-complications-in-patients-with-chd-before-and-after-myocardial-revascularization
#9
E V Shkorik, E V Markelova, A A Silaev, B I Geltser, A A Semenikhin, L N Fedjanina
There is still a great need for detection of biomarkers for early prediction and diagnosis of cardiovascular complications (CVC) in patients with CHD. Objective: To determine the role of MMP-1, 8, 9 in the risk of CCO in patients with CHD before and after coronary artery bypass grafting (CABG). Methods. The study included 75 patients with coronary heart disease before and after myocardial revascularization by CABG, including 40 men and 35 women aged from 45 to 74 years. Patients were divided into two groups: I group - 25 patients with CVC registered after CABG (acute myocardial infarction, ischemic stroke, pulmonary thromboembolism Branch); II group - 50 patients with coronary heart disease without complications after myocardial revascularization...
April 2017: Patologicheskaia Fiziologiia i èksperimental'naia Terapiia
https://www.readbyqxmd.com/read/29215395/topical-tacrolimus-as-adjuvant-therapy-to-corticosteroids-in-acute-endothelial-graft-rejection-after-penetrating-keratoplasty-a-randomized-controlled-trial
#10
Mohammad Nasser Hashemian, Golshan Latifi, Reza Ghaffari, Hamed Ghassemi, Mehran Zarei Ghanavati, Seyed-Farzad Mohammadi, Mehdi Yasseri, Mohammad Reza Fallah Tafti, Zahra Fallah Tafti
PURPOSE: To evaluate the efficacy of topical tacrolimus 0.05% as adjuvant therapy to corticosteroids in the treatment of acute endothelial rejection of a penetrating keratoplasty (PKP) graft. METHODS: Patients with the clinical diagnosis of acute endothelial rejection of a PKP graft were randomized into 2 groups-group 1: receiving topical tacrolimus 0.05% as adjuvant therapy to corticosteroid treatment and group 2: receiving only corticosteroid treatment. Main outcome measures were rejection reversal, time to rejection reversal, and recurrence of rejection...
December 5, 2017: Cornea
https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#11
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29208204/durable-renal-response-after-combination-of-bortezomib-corticosteroids-rituximab-and-plasmapheresis-for-late-antibody-mediated-renal-transplant-rejection%C3%A2
#12
Yanli Ding, Jean Francis, Amitabh Gautam, Linda Pelletier, Vaishali Sanchorawala, Karen Quillen
Late occurrence of antibody-mediated rejection (AMR), defined as occurring 6 months after transplantation, is associated with poor renal allograft survival, compared to early acute AMR and acute cellular rejection. The proteasome inhibitor bortezomib has multiple immunomodulatory effects on plasma cells, the source of donor-specific HLA antibodies which mediate AMR. MATERIALS AND METHODS: Consecutive patients who presented with biopsy-proven AMR and donor-specific anti-HLA antibodies (DSA) at a single institution between July 2011 and February 2015 were included...
December 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29206090/utility-of-serial-protocol-biopsies-performed-after-1-year-in-predicting-long-term-kidney-allograft-function-according-to-histologic-phenotype
#13
Mareena S Zachariah, Alok K Dwivedi, Cindy S Yip, Shirley S Chang, Aijaz Gundroo, Rocco C Venuto, John Tomaszewski, Sunil K Patel, Rajeev Sharma
OBJECTIVES: Prognostic implications of early protocol biopsies have been studied; however, the value of late protocol biopsy in predicting graft outcome has not been well defined. Here, we compared the effects of early and late protocol biopsy histologic findings in stable kidney allografts and aimed to understand the significance of "borderline" rejection on allograft function. MATERIALS AND METHODS: We studied 261 biopsies from 159 renal transplant recipients who were on a steroid-free, calcineurin inhibitor and mycophenolate mofetil regimen and who received transplants between 2004 and 2012 with mean follow-up of 5 years...
December 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29205755/short-term-outcomes-of-pediatric-liver-transplant-recipients-after-transition-to-adult-healthcare-service
#14
Alberto Ferrarese, Giacomo Germani, Silvia Lazzaro, Mara Cananzi, Francesco Paolo Russo, Marco Senzolo, Martina Gambato, Alberto Zanetto, Umberto Cillo, Enrico Gringeri, Giorgio Perilongo, Patrizia Burra
BACKGROUND AND AIMS: Survival rates after liver transplantation (LT) in pediatric recipients has significantly improved overtime. However, data regarding outcomes after transition from Pediatric to Adult Healthcare Service (AHS) are still lacking. Therefore, we aimed to prospectively evaluate the outcome of LT recipients after transition; to access patients' non-adherence and identify potential risk factors for non-adherence. METHODS: All consecutive adolescent LT recipients moving to the AHS at Padua University Hospital were evaluated between 2010-2015...
December 5, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29199482/low-dose-anti-thymocyte-globulin-reduces-chronic-graft-versus-host-disease-incidence-rates-after-matched-unrelated-donor-transplantation
#15
Anand Tandra, Fahrettin Covut, Brenda Cooper, Richard Creger, Lauren Brister, Bernadette McQuigg, Paolo Caimi, Ehsan Malek, Ben Tomlinson, Hillard M Lazarus, Folashade Otegbeye, Merle Kolk, Marcos de Lima, Leland Metheny
Anti-thymocyte globulin (ATG) is often added to hematopoietic stem cell transplant conditioning regimens to prevent graft rejection and reduce graft-versus-host disease (GVHD). Doses used in retrospective and prospective clinical trials have ranged from 2.5 to 20 mg/kg with rates of grade II-IV acute GVHD and chronic GVHD up to 40 and 60%, respectively. We retrospectively compared outcomes in recipients of matched unrelated donor (MUD) grafts given low dose rabbit ATG IV 3 mg/kg (n = 52) versus recipients of matched related donor (MRD) grafts (n = 48) without ATG...
December 4, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29198695/-snowmelt-sign-and-corkscrew-microvessels-predicting-epithelium-regeneration-after-acute-rejection-of-small-bowel-transplantation-a-case-report
#16
C-S Chung, T-H Lee, C-T Chiu, Y Chen
Intestinal failure characterized by inadequate maintenance of nutrition via normal intestinal function comprises a group of disorders with many different causes. If parenteral nutrition dependency develops, which is associated with higher mortality and complications, it is considered for intestine transplantation. However, the graft failure rate is not low, and acute cellular rejection is one of the most important reasons for graft failure. As a result, early identification of rejection and timely modification of anti-rejection medications have been considered to be associated with better graft and patient survival rates...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198667/donation-after-circulatory-arrest-in-pancreas-transplantation-a-report-of-10-cases
#17
J A Fridell, R S Mangus, C M Thomas, C A Kubal, J A Powelson
INTRODUCTION: Transplantation of pancreas allografts procured from donation after circulatory death (DCD) remains uncommon. This study reviews a series of pancreas transplants at a single center to assess the donor and recipient characteristics for DCD pancreas transplant and to compare clinical outcomes. METHODS: DCD procurement was performed with a 5-minute wait time from pronouncement of death to first incision. In 2 patients, tissue plasminogen activator was infused as a thrombolytic during the donor flush...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198655/clinical-and-pathological-analyses-of-cases-of-acute-vascular-rejection-after-kidney-transplantation
#18
T Shimizu, H Ishida, N Hayakawa, R Shibahara, K Tanabe
BACKGROUND: We performed a clinical and pathological analysis of cases of acute vascular rejection (AVR), characterized by intimal arteritis and transmural arteritis (Banff v score) after kidney transplantation, in an attempt to clarify the mechanisms underlying the development and prognostic significance of AVR. METHODS: AVR (Banff score: v >0) was diagnosed in 31 renal allograft biopsy specimens (BS) obtained from 31 renal transplant patients receiving follow-up care at the Department of Urology, Tokyo Women's Medical University, between January 2010 and April 2016...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29191961/intragraft-molecular-pathways-associated-with-tolerance-induction-in-renal-transplantation
#19
Lorenzo Gallon, James M Mathew, Sai Vineela Bontha, Catherine I Dumur, Pranav Dalal, Lakshmi Nadimpalli, Daniel G Maluf, Aneesha A Shetty, Suzanne T Ildstad, Joseph R Leventhal, Valeria R Mas
The modern immunosuppression regimen has greatly improved short-term allograft outcomes but not long-term allograft survival. Complications associated with immunosuppression, specifically nephrotoxicity and infection risk, significantly affect graft and patient survival. Inducing and understanding pathways underlying clinical tolerance after transplantation are, therefore, necessary. We previously showed full donor chimerism and immunosuppression withdrawal in highly mismatched allograft recipients using a bioengineered stem cell product (FCRx)...
November 30, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29189482/analysis-of-biomarkers-within-the-initial-2-years-posttransplant-and-5-year-kidney-transplant-outcomes-results-from-clinical-trials-in-organ-transplantation-17
#20
Geovani Faddoul, Girish N Nadkarni, Nancy D Bridges, Jens Goebel, Donald E Hricik, Richard Formica, Madhav C Menon, Yvonne Morrison, Barbara Murphy, Kenneth Newell, Peter Nickerson, Emilio D Poggio, David Rush, Peter S Heeger
BACKGROUND: An early posttransplant biomarker/surrogate marker for kidney allograft loss has the potential to guide targeted interventions. Previously published findings, including results from the Clinical Trials in Organ Transplantation (CTOT)-01 study, showed that elevated urinary chemokine CXCL9 levels and elevated frequencies of donor-reactive interferon gamma-(IFNγ)-producing T cells by enzyme linked immunosorbent spot (ELISPOT) assay associated with acute cellular rejection within the first year and with lower 1-year posttransplant estimated glomerular filtration rate (eGFR)...
November 20, 2017: Transplantation
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