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acute graft rejection

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https://www.readbyqxmd.com/read/28719059/pancreatic-allograft-thrombosis-suggestion-for-a-ct-grading-system-and-management-algorithm
#1
Abdul Hakeem, John Chen, Satheesh Iype, Menna Clatworthy, Christopher Watson, Edmund M Godfrey, Sara Upponi, Kourosh Saeb-Parsy
Pancreatic allograft thrombosis (PAT) remains the leading cause of non-immunological graft failure. Herein we propose a new CT grading system of PAT to identify risk factors for allograft loss and outline a management algorithm by retrospective review of consecutive pancreatic transplants between 2009-2014. Triple-phase CT scans were graded independently by two radiologists as; Grade 0 - no thrombosis, Grade 1 - peripheral thrombosis, Grade 2 - intermediate non-occlusive thrombosis and Grade 3 - central occlusive thrombosis...
July 18, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28714558/everolimus-and-reduced-calcineurin-inhibitor-therapy-in-pediatric-liver-transplant-recipients-results-from-a-multicenter-prospective-study
#2
Rainer Ganschow, Bo-Goran Ericzon, Anil Dhawan, Khalid Sharif, El-Djouher Martzloff, Barbara Rauer, Jennifer Ng, Patricia Lopez
In a 24-month, multicenter, single-arm, prospective study, 56 pediatric liver transplant patients with or without basiliximab induction were converted at 1-6 months post-transplant from standard calcineurin inhibitor (CN) therapy (± mycophenolic acid), to everolimus with reduced exposure to CNI (tacrolimus n=50, cyclosporine n=6). Steroid therapy was optional. Recruitment was stopped prematurely due to high rates of PTLD, treatment-related serious infections leading to hospitalization and premature study drug discontinuation...
July 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28714235/tuberculosis-after-kidney-transplantation-is-associated-with-significantly-impaired-allograft-function
#3
Silvana Daher Costa, Tainá Veras de Sandes-Freitas, Camilla Neves Jacinto, Lorena Vasconcelos Mesquita Martiniano, Yago Sucupira Amaral, Fernando José Villar Nogueira Paes, Maria Luiza de Mattos Brito Oliveira Sales, Ronaldo de Matos Esmeraldo, Elizabeth de Francesco Daher
BACKGROUND: This study aimed to evaluate renal function before, during and after the course of tuberculosis (TB) disease in kidney transplant recipients; and assess the risk factors for non-recovery of baseline renal function. METHODS: We performed a retrospective, single-center cohort study, including all patients with confirmed or presumed TB diagnosis after kidney transplant (n=34, 2.1%). Renal function was assessed by serum creatinine (Cr) and glomerular filtration rate (GFR) adjusted for deaths and graft losses...
July 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28709842/what-compatibility-in-2017-for-the-haematopoietic-stem-cell-transplantation
#4
X Lafarge
The diversification of potential donors to perform stem cell allografts now enables to propose a compatible graft cell source adapted to the different clinical situations. Transplants with a geno-identical sibling donor, otherwise with the most HLA-compatible unrelated donor, remain the first-line solutions. Alternative transplants allow to graft patients having no donors in international registries, owing to the rarity of their HLA typing. They are carried out with fairly incompatible grafts and are therefore limited by the existence in the recipient of preformed anti-HLA antibodies which predispose to their rejection...
July 11, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28708813/application-and-interpretation-of-histocompatibility-data-in-liver-transplantation
#5
Russell N Wesson, Eric W Etchill, Jacqueline Garonzik-Wang
PURPOSE OF REVIEW: There has been a resurgence of interest in histocompatibility as it applies to liver transplantation. The association of persistent and de-novo donor specific antibody (DSA) and outcomes after liver transplantation continues to be investigated. RECENT FINDINGS: Consensus continues to evolve regarding the existence of acute and chronic antibody-mediated rejection (AMR) and pathogenicity of DSA and associated pathologic findings after liver transplantation...
July 13, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28707779/belatacept-rescue-therapy-in-kidney-transplant-recipients-with-vascular-lesions-a-case-control-study
#6
D Bertrand, L Cheddani, I Etienne, A François, M Hanoy, C Laurent, L Lebourg, F Le Roy, L Lelandais, M C Loron, M Godin, D Guerrot
Immunosuppression in kidney transplant recipients with decreased graft function and severe histological vascular changes can be particularly challenging. Belatacept could be a valuable option, as a rescue therapy in this context. We report a retrospective case control study comparing a CNI to belatacept switch in 17 patients with vascular damage and low eGFR to a control group of 18 matched patients with CNI continuation. Belatacept switch was performed on average 51.5 months after kidney transplantation (6...
July 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28706981/outcomes-of-liver-transplant-recipients-with-autoimmune-liver-disease-using-long-term-dual-immunosuppression-regimen-without-corticosteroid
#7
Sanjaya K Satapathy, Ollie D Jones, Jason M Vanatta, Faisal Kamal, Satish K Kedia, Yu Jiang, Satheesh P Nair, James D Eason
BACKGROUND: Liver transplant (LT) recipients with autoimmune liver disease (primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis) are at increased risk of developing acute cellular rejection (ACR), and in many cases graft failure due to recurrent disease. We describe our experience with dual immunosuppression without steroid maintenance and analyze its effect on disease recurrence; ACR; patient and graft survivals; and complications, such as sepsis and de novo malignancy...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706977/acute-rejection-after-kidney-transplantation-associates-with-circulating-micrornas-and-vascular-injury
#8
Roel Bijkerk, Barend W Florijn, Meriem Khairoun, Jacques M G J Duijs, Gurbey Ocak, Aiko P J de Vries, Alexander F Schaapherder, Marko J K Mallat, Johan W de Fijter, Ton J Rabelink, Anton Jan van Zonneveld, Marlies E J Reinders
BACKGROUND: Acute rejection (AR) of kidney transplants is associated with the loss of endothelial integrity, microvascular rarefaction and, ultimately, graft dysfunction. Circulating angiogenic microRNAs (miRNAs) may serve as markers for microvascular injury. Here, we investigated the short- and long-term effects of AR after kidney transplantation on systemic vascular injury and the associated circulating miRNA profile. METHODS: Systemic vascular injury was determined by measuring capillary tortuosity and density within the oral mucosa as well as by assessing circulating levels of angiopoietin-2/angiopoietin-1 ratio, vascular endothelial growth factor and soluble thrombomodulin...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28700465/alemtuzumab-versus-antithymocyte-globulin-induction-therapies-in-kidney-transplantation-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Jianming Zheng, Wenli Song
Alemtuzumab (ALEM) is widely used as an induction therapy for organ transplantation, and numerous randomized controlled trials (RCTs) have been published to evaluate its efficacy and safety in kidney transplantation as compared with antithymocyte globulin (ATG). The purpose of this study was to compare the benefits and safety of ALEM with those of ATG for induction therapy.A systematic literature search in three electronic databases, including PubMed, EmBase, and Cochrane Library, since inception through October 2016, was conducted to identify potential RCTs for inclusion...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28698834/biomarkers-in-renal-transplantation-an-updated-review
#10
REVIEW
Maurizio Salvadori, Aris Tsalouchos
Genomics, proteomics and molecular biology lead to tremendous advances in all fields of medical sciences. Among these the finding of biomarkers as non invasive indicators of biologic processes represents a useful tool in the field of transplantation. In addition to define the principal characteristics of the biomarkers, this review will examine the biomarker usefulness in the different clinical phases following renal transplantation. Biomarkers of ischemia-reperfusion injury and of delayed graft function are extremely important for an early diagnosis of these complications and for optimizing the treatment...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28697714/association-between-overweight-and-renal-transplant-outcomes-a-meta-analysis
#11
Congran Li, Hailong Jin, Li Xiao, Zhouli Li, Ming Cai, Bingyi Shi
OBJECTIVES: Our study aimed to evaluate the effects of being overweight on kidney transplant. MATERIALS AND METHODS: Our study evaluated kidney transplant recipients with body mass index ranging from 25 to 30 kg/m² versus patients with body mass index ranging from 18.5 to 29.9 kg/m², who were identified through PubMed, Embase, and Cochrane Library searches up to October 2015. Outcomes analyzed included delayed graft function, acute rejection, graft loss, and patient survival...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28695576/mechanical-ventilation-and-extracorporeal-membrane-oxygenation-as-a-bridging-strategy-to-lung-transplantation-significant-gains-in-survival
#12
Awori J Hayanga, Angela L Du, Kyla Joubert, Tuft Marie, Rachel Baird, Joseph Pilewski, Mathew Morrell, Jonathan D'Cunha, Norihisa Shigemura
Mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) are increasingly used to bridge patients to lung transplantation. We investigated the impact of using MV, with or without ECMO, prior to lung transplantation on survival after transplantation by performing a retrospective analysis of 826 patients who underwent transplantation at our high-volume center. Recipient characteristics and posttransplant outcomes were analyzed. Most lung transplant recipients (729 patients) did not require bridging; 194 of these patients were propensity matched with patients who were bridged using MV alone (48 patients) or MV and ECMO (49 patients)...
July 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28694560/peritransplant-soluble-cd30-as-a-risk-factor-for-slow-kidney-allograft-function-early-acute-rejection-worse-long-term-allograft-function-and-patients-survival
#13
Andriy V Trailin, Tetyana I Ostapenko, Tamara N Nykonenko, Svitlana N Nesterenko, Olexandr S Nykonenko
BACKGROUND: We aimed to determine whether serum soluble CD30 (sCD30) could identify recipients at high risk for unfavorable early and late kidney transplant outcomes. METHODS: Serum sCD30 was measured on the day of kidney transplantation and on the 4th day posttransplant. We assessed the value of these measurements in predicting delayed graft function, slow graft function (SGF), acute rejection (AR), pyelonephritis, decline of allograft function after 6 months, and graft and patient survival during 5 years of follow-up in 45 recipients...
2017: Disease Markers
https://www.readbyqxmd.com/read/28686316/is-pre-transplant-sensitization-against-angiotensin-ii-type1-receptor-still-a-risk-factor-of-graft-and-patient-outcome-in-kidney-transplantation-in-the-anti-hla-luminex-era
#14
C Deltombe, F Gillaizeau, D Anglicheau, E Morelon, K Trébern-Launay, F Le Borgne, M Rimbert, P Guérif, S Malard-Castagnet, Y Foucher, M Giral
AIMS: We aimed to assess the correlation of anti-angiotensin II type 1 receptor antibodies (anti-AT1R-Abs) before transplantation on a multicentric cohort of kidney transplant recipients (2008-2012), under Tacrolimus and Mycofenolate mofetil (MMF), screened by Luminex technology for anti -HLA immunization. METHODS: Anti-AT1R-antibody levels were measured by ELISA in pre-transplantation sera of 940 kidney recipients from 3 French centers of the DIVAT cohort. Multivariable Cox models estimated the association between pre-transplant anti-angiotensin II type 1 receptor antibodies and time to acute rejection episodes (ARE) or time to graft failure...
July 7, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28682798/accommodation-and-related-conditions-in-vascularized-composite-allografts
#15
Jeffrey L Platt, Christina L Kaufman, Mayara Garcia de Mattos Barbosa, Marilia Cascalho
PURPOSE OF REVIEW: The outcome of vascularized composite allografts (VCA) often appear unrelated to the presence of donor-specific antibodies (DSA) in blood of the recipient or deposition of complement in the graft. The attenuation of injury and the absence of rejection in other types of grafts despite manifest donor-specific immunity have been explained by accommodation (acquired resistance to immune-mediated injury), adaptation (loss of graft antigen) and/or enhancement (antibody-mediated antigen blockade)...
July 5, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28682561/-immunosuppression-in-kidney-transplantation-a-way-between-efficacy-and-toxicity
#16
Costanza Casati, Alberto Menegotto, Maria Luisa Querques, Federica Ravera, Giacomo Colussi
Renal transplantation is the best treatment for patients with end-stage renal disease. Over the last decades, the introduction of new immunosuppressive agents resulted into the reduction of the incidence of acute rejection and early graft loss. Despite this progress, there has been little improvement in the average life of the transplant. The main reasons of late failure are patient's death due to several complications (e.g. cancer, infectious or metabolic), and progressive deterioration of renal function caused by immunological and non-immunological factors...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28679466/successful-launch-of-an-abo-incompatible-kidney-transplantation-program-to-overcome-the-shortage-of-compatible-living-donors-experience-at-a-single-center%C3%A2
#17
Seung Hwan Song, Juhan Lee, Beom Seok Kim, Sinyoung Kim, Jae Geun Lee, Hyeon Joo Jeong, Yu Seun Kim, Myoung Soo Kim, Hyun Ok Kim, Soon Il Kim, Kyu Ha Huh
AIMS: ABO-incompatible (ABOi) kidney transplantation (KT) is being increasingly performed to overcome donor shortages. However, debate persists regarding the post-transplant outcomes of ABOi KT vs. that of ABO-compatible (ABOc) KT. METHODS: A total 454 recipients who underwent living-donor KT (LDKT) between June 2010 and July 2014 at Severance Hospital (Seoul) were retrospectively reviewed. 100 ABOi and 354 ABOc KTs were compared. Recipients with a pretransplant positive crossmatch to their donors, pretransplant donor-specific anti-HLA antibody (DSA), or high panel reactive antibody (PRA ≥ 50%) were excluded from both the ABOi and ABOc KT groups...
July 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28676864/innate-immune-response-in-kidney-ischemia-reperfusion-injury-potential-target-for-therapy
#18
REVIEW
Aleksandra Kezić, Natasa Stajic, Friedrich Thaiss
Acute kidney injury caused by ischemia and subsequent reperfusion is associated with a high rate of mortality and morbidity. Ischemia/reperfusion injury in kidney transplantation causes delayed graft function and is associated with more frequent episodes of acute rejection and progression to chronic allograft nephropathy. Alloantigen-independent inflammation is an important process, participating in pathogenesis of injurious response, caused by ischemia and reperfusion. This innate immune response is characterized by the activity of classical cells belonging to the immune system, such as neutrophils, macrophages, dendritic cells, lymphocytes, and also tubular epithelial cells and endothelial cells...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28676335/thymoglobuline-plus-basiliximab-a-mixed-cocktail-to-start
#19
EDITORIAL
Spagnoletti Gionta, Salerno Maria Paola, Calia Rosaria, Romagnoli Jacopo, Citterio Franco
Recent results reported by Ciancio et al. have demonstrated the long term successful use of dual induction therapy in kidney transplant recipients. Our experience using an "induction cocktail", thymoglobuline plus basiliximab, started in 2007 and we have treated 235 patients through the past 10years. In our population, we used a combination of CNIs and MMF or mTORi as maintenance therapy. Our results in term of patient and graft survival, acute rejection rate, renal function and incidence of post-transplant lymphoproliferative disorder support the data reported by Ciancio...
July 1, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28675360/four-years-of-hepatic-transplantation-in-the-republic-of-moldova
#20
Vladimir Hotineanu, Adrian Hotineanu, Serghei Burgoci, Grigore Ivancov, Natalia Taran, Angela Peltec, Dumitru Cazacu, Vitalie Sîrghi
Ever since the first liver transplant in the Republic of Moldova in 2013 we have performed 30 liver transplantations, the first having been performed in collaboration with the surgical team from Romania, led by Professor Irinel Popescu. The serious deficit of available cadaveric organs has forced us to begin with right hemi-liver transplantation from a living donor. In one third of liver transplantations we used right hemi-liver graft from a living donor, and in 2/3 of cases whole liver graft was harvested from brain-dead donors...
May 2017: Chirurgia
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