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chronic allograft nephropathy

Wael M Hamza, Hanan H Ali, Samia M Gabal, Sawsan A Fadda
The chronic dysfunction stands as the most common cause of renal allograft loss. During the nineties of the past century, this condition was referred to as chronic allograft nephropathy (CAN). Since 2005, CAN has been assigned by the eighth Banff schema to four main categories via histopathological and immunohistochemical findings including chronic antibodymediated rejection (CAMR), chronic T-cell-mediated rejection (CTMR), chronic cyclosporine toxicity (CNITOX), and "interstitial fibrosis (IF)/tubular atrophy; not otherwise specified (NOS)" to eliminate the term CAN...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
F Toth, G Zadori, R Fedor, L Illesy, M Szabo-Pap, Z Kanyari, D A Kovacs, L Asztalos, B Nemes
INTRODUCTION: Approximately 10% of renal allografts fail during the first year after kidney transplantation (KT) and 3%-5% thereafter yearly. The indication and timing of allograft nephrectomy (AN) is still uncertain in some cases. The aim of this study was to reveal the ratio, etiology, and complications of AN at our center. MATERIAL AND METHODS: This is a retrospective study of all patients who underwent KT at our center between January 1, 2004 and December 31, 2014...
September 2016: Transplantation Proceedings
Darlene Vigil, Nikifor K Konstantinov, Marc Barry, Antonia M Harford, Karen S Servilla, Young Ho Kim, Yijuan Sun, Kavitha Ganta, Antonios H Tzamaloukas
Nephropathy secondary to BK virus, a member of the Papoviridae family of viruses, has been recognized for some time as an important cause of allograft dysfunction in renal transplant recipients. In recent times, BK nephropathy (BKN) of the native kidneys has being increasingly recognized as a cause of chronic kidney disease in patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression. In such patients renal dysfunction is often attributed to other factors including nephrotoxicity of medications used to prevent rejection of the transplanted organs...
September 24, 2016: World Journal of Transplantation
Francesca Saccon, Mariele Gatto, Anna Ghirardello, Luca Iaccarino, Leonardo Punzi, Andrea Doria
Galectins are evolutionary conserved β-galactoside binding proteins with a carbohydrate-recognition domain (CRD) of approximately 130 amino acids. In mammals, 15 members of the galectin family have been identified and classified into three subtypes according to CRD organization: prototype, tandem repeat-type and chimera-type galectins. Galectin-3 (gal-3) is the only chimera type galectin in vertebrates containing one CRD linked to an unusual long N-terminal domain which displays non-lectin dependent activities...
September 23, 2016: Autoimmunity Reviews
Takeshi Maehana, Toshiaki Tanaka, Hiroshi Kitamura, Nobuyuki Fukuzawa, Hideki Ishida, Hiroshi Harada, Kazunari Tanabe, Naoya Masumori
BACKGROUND: Heat shock protein 90 (HSP90), a molecular chaperone associated with the activation of client proteins, was recently reported to play an important role in immunologic reactions. To date, the role of HSP90 in solid organ transplantations has remained unknown. The aim of this study was to evaluate the relationship between serum HSP90α levels and acute allograft rejection after organ and tissue transplantation using serum samples from kidney allograft recipients, an in vitro antibody-mediated rejection model, and a murine skin transplantation...
2016: PloS One
H Maekawa, M Yazawa, K Koitabashi, N Imai, H Kawarazaki, R Nakazawa, H Sasaki, T Chikaraishi, Y Shibagaki
BACKGROUND: Hepatitis B virus (HBV) infection is a risk factor of mortality in kidney transplant recipients. However, information on the risk of HBV reactivation in kidney recipients with prior resolved HBV infection is limited. This study aimed to evaluate the safety of simply monitoring viral and liver markers in living donor kidney transplantation (LDKT) recipients with prior resolved HBV infection. METHODS: We retrospectively examined the clinical records of LDKT recipients...
July 2016: Transplantation Proceedings
Jian Shi, Xianlin Xu, Fengbao Luo, Qianqian Shi, Xiaozhou He, Ying Xia
The aim of this study was to investigate follicular helper T (Tfh) cell response and its difference between renal graft and spleen in a rat renal transplantation model undergoing chronic allograft nephropathy (CAN). Orthotopical kidney transplantations were performed on Fischer (F344) rats and transplanted to Lewis rats, using syngeneic Lewis-Lewis grafts as controls. Tissue samples were collected at 8 weeks post-transplantation. The status of Tfh cell response was assessed by measuring the levels of transcription factor B-cell lymphoma 6 (Bcl-6), interleukin 21 (IL-21), chemokine receptor type 5 (CXCR5), and B cell activating factor belonging to the TNF family (BAFF)...
August 12, 2016: Cell Transplantation
Q Shen, H Xu, X Y Fang, H M Liu, Y H Zhai, X Zhang, Y H Zhu, L Zeng, L Zhang
OBJECTIVE: To explore the feasibility and clinical significance of pediatric renal transplantation using organ donations from pediatric patients donors. METHOD: Clinical data of children who underwent renal transplantation using organ donations from pediatric patients between September 2011 and December 2014 were retrospectively analyzed, including diagnosis and treatment before transplant, transplant operation, immunosuppression, complication and prognosis. RESULT: Totally 39 cases received pediatric organ donation-pediatric kidney transplantation...
July 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Burcin Ekser, Richard S Mangus, Chandrashekhar A Kubal, Jonathan A Fridell, John A Powelson, Santosh Nagaraju, Plamen Mihaylov, Carrie L Phillips, Romil Saxena, William C Goggins
BACKGROUND: Enteric hyperoxaluria (EH) occurs with a rate of 5-24% in patients with inflammatory bowel disease, ileal resection and modern bariatric surgery. The excessive absorption of calcium oxalate causes chronic kidney disease (CKD) in patients with EH. In the literature, a single experience was reported in combined intestine-kidney transplantation (CIKTx) in patients with CKD due to EH. METHODS: After a report of 2 successful cases of CIKTx in patients with EH and CKD, one was performed at our center in a 59-year-old Caucasian female who developed intestinal failure with total parenteral nutrition (TPN) dependence after a complication post-bariatric surgery...
2016: American Journal of Nephrology
Laura R Harskamp, Ron T Gansevoort, Harry van Goor, Esther Meijer
The epidermal growth factor receptor (EGFR) pathway has a critical role in renal development, tissue repair and electrolyte handling. Numerous studies have reported an association between dysregulation of this pathway and the initiation and progression of various chronic kidney diseases such as diabetic nephropathy, chronic allograft nephropathy and polycystic kidney disease through the promotion of renal cell proliferation, fibrosis and inflammation. In the oncological setting, compounds that target the EGFR pathway are already in clinical use or have been evaluated in clinical trials; in the renal setting, therapeutic interventions targeting this pathway by decreasing ligand availability with disintegrin and metalloproteinase inhibitors or with ligand-neutralizing antibodies, or by inhibiting receptor activation with tyrosine kinase inhibitors or monoclonal antibodies are only just starting to be explored in animal models of chronic kidney disease and in patients with autosomal dominant polycystic kidney disease...
August 2016: Nature Reviews. Nephrology
Valter Duro Garcia, Gisele Meinerz, Elizete Keitel
INTRODUCTION: Improving long-term survival in kidney transplantation is one of the main goals in modern immunosuppressive research. Current standard immunosuppression based in a combination of calcineurin inhibitors (CNI) and antiproliferatives, with or without steroids, has improved short-term graft survival. In the last decade, belatacept has been evaluated as a CNI free option regimen addressing better kidney transplant outcomes. AREAS COVERED: This paper reviewed the indications, mechanisms of action, pharmacology and published trials using belatacept in different clinical situations...
August 2016: Expert Opinion on Drug Safety
Maria Del Pilar Sosa Peña, Reynold Lopez-Soler, J Andres Melendez
Despite increasing numbers of patients on dialysis, the numbers of renal transplants performed yearly have remained relatively static. During the last 50 years, there have been many advances in the pharmacology of prevention of organ rejection. However, most patients will suffer from a slow but steady decline in renal function leading to graft loss. The most common cause of long-term graft loss is chronic allograft nephropathy (CAN). Therefore, elucidating and understanding the mechanisms involved in CAN is crucial for achieving better post-transplant outcomes...
June 15, 2016: American Journal of Physiology. Renal Physiology
Fruzsina Tóth, Gergely Zádori, Roland Fedor, Dávid Ágoston Kovács, Zsolt Kanyári, Zsolt Kincses, Csaba Ötvös, László Damjanovich, László Asztalos, Balázs Nemes
INTRODUCTION: Indication and timing of allograft nephrectomy is still uncertain in some cases. AIM: The aim of the authors was to summarize their experience with graftectomies. METHOD: Data from patients who underwent kidney transplantation between January 1, 2004 and December 31, 2015 were retrospectively analyzed. Frequency, indications, timing, complications as well as early and late allograft nephrectomies were reviewed. RESULTS: From 480 renal transplants, 55 graftectomies were performed (11%)...
June 12, 2016: Orvosi Hetilap
Roland Fedor, Dávid Ágoston Kovács, Lajos Lőcsey, Miklós Fagyas, László Asztalos, Attila Tóth
INTRODUCTION: Renal transplantation provides longer life expectancy in patients with renal failure. Nonetheless, this improved life expectancy is still shorter than that for the general population. The main couse of death in renal transplant patients is cardiovascular disease, and chronic allograft nephropathy is the most significant cause of graft loss. Genetic polymorphisms of the renin angiotensin system have been implicated in both chronic allograft nephropathy and fatal cardiovascular diseases...
June 12, 2016: Orvosi Hetilap
R Carpio, G E Pamugas, R Danguilan, E Que
BACKGROUND: Studies on the effect of hepatitis C virus (HCV) infection showed decreased graft survival compared to HCV-negative matched patients. It was also identified as an independent risk factor for graft loss and mortality in kidney transplantation patients. OBJECTIVE: This study was designed to evaluate the 10-year graft and patient outcomes of renal allograft recipients with HCV infection at the National Kidney and Transplant Institute. METHODS: This is a retrospective study of patients who underwent renal transplantation with HCV infection and a group who were HCV-negative in the same post-transplantation period...
April 2016: Transplantation Proceedings
Zoltan H Endre, Mangalee Fernando
Diagnosis of transplant dysfunction usually requires kidney biopsy. Sidgel et al. compared urinary proteomics with matched kidney biopsies to develop a biomarker panel to differentiate acute rejection, BK viral nephropathy, and chronic allograft nephropathy. The results suggest that monitoring a panel of urinary peptides may ultimately facilitate noninvasive diagnosis and management of common transplant complications.
June 2016: Kidney International
Tara K Sigdel, Yuqian Gao, Jintang He, Anyou Wang, Carrie D Nicora, Thomas L Fillmore, Tujin Shi, Bobbie-Jo Webb-Robertson, Richard D Smith, Wei-Jun Qian, Oscar Salvatierra, David G Camp, Minnie M Sarwal
The human urinary proteome provides an assessment of kidney injury with specific biomarkers for different kidney injury phenotypes. In an effort to fully map and decipher changes in the urine proteome and peptidome after kidney transplantation, renal allograft biopsy matched urine samples were collected from 396 kidney transplant recipients. Centralized and blinded histology data from paired graft biopsies was used to classify urine samples into diagnostic categories of acute rejection, chronic allograft nephropathy, BK virus nephritis, and stable graft...
June 2016: Kidney International
Ryan J Goldberg, Francis L Weng, Praveen Kandula
Allograft dysfunction after a kidney transplant is often clinically asymptomatic and is usually detected as an increase in serum creatinine level with corresponding decrease in glomerular filtration rate. The diagnostic evaluation may include blood tests, urinalysis, transplant ultrasonography, radionuclide imaging, and allograft biopsy. Whether it occurs early or later after transplant, allograft dysfunction requires prompt evaluation to determine its cause and subsequent management. Acute rejection, medication toxicity from calcineurin inhibitors, and BK virus nephropathy can occur early or later...
May 2016: Medical Clinics of North America
Qiang Zhang, Zexing Yu, Yue Xu, Song Zeng, Zijian Zhang, Wenrui Xue, Wei Wang, Xiaodong Zhang, Xiaopeng Hu
This study quantitatively analyzed changes in the hemodynamic characteristics of renal allografts at different stages in a rat chronic allograft nephropathy (CAN) model as well as the relationship between hemodynamic parameters and renal allograft fibrosis using contrast-enhanced ultrasonography (CEUS). The experimental group used a CAN rat model (n = 30), and the control group used an orthotopic syngeneic renal transplant model (n = 30). After surgery, creatinine clearance rates were regularly monitored every 2 wk...
April 5, 2016: Ultrasound in Medicine & Biology
Siham El Houssni, Siham Sabri, Loubna Benamar, Naima Ouzeddoun, Rabia Bayahia, Hakima Rhou
The aim of this study was to report our experience of pregnancy in renal transplant (RT) patients and its medium and long-term effects on the renal graft as well as the maternal fetal complications. We studied 21 pregnancies in 12 RT patients with mean age of 29.9 ± 5.3 years. The mean duration of RT to 1 st pregnancy was 42 (21-68.5) months and the median follow-up period was 112.5 (138-165) months. The pregnancy was planned in 28.6% of the cases. At the time of the diagnosis of the pregnancy, all the patients were maintained on corticosteroids and cyclosporine, 14...
March 2016: Saudi Journal of Kidney Diseases and Transplantation
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