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https://www.readbyqxmd.com/read/29331505/successful-treatment-of-anti-angiotensin-ii-type-1-receptor-antibody-associated-rejection-in-kidney-transplantation-a-case-report
#1
P Wiwattanathum, A Ingsathit, D Thammanichanond, S Worawichawong
Angiotensin II type 1 receptor (AT1R) antibody, a non-HLA antibody, has been found to have a detrimental effect on kidney allografts. Similarly to HLA antibodies, recipients who have AT1R antibodies are at risk for allograft rejection and poor long-term graft outcome. Besides mediating allograft rejections via direct effects on endothelial and vascular smooth muscle without complement activation, AT1R antibodies may lead to accelerated hypertension via the renin-angiotensin pathway. There has been no definite level of AT1R antibody that predicts allograft rejection...
January 10, 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29319615/clinical-and-pathological-features-of-plasma-cell-rich-acute-rejection-after-kidney-transplantation
#2
Jumpei Hasegawa, Kazuho Honda, Kazuya Omoto, Sachiko Wakai, Hiroki Shirakawa, Masayoshi Okumi, Hideki Ishida, Shohei Fuchinoue, Motoshi Hattori, Kazunari Tanabe
BACKGROUND: Plasma cell-rich acute rejection (PCAR) is a rare type of allograft rejection characterized by the presence of mature plasma cells. In general the prognosis of PCAR is poor, and its clinical and pathological features remain unclear. METHODS: We performed a retrospective observational study and compared allograft survival between kidney transplant recipients who developed PCAR and those who did not develop PCAR. We further analyzed clinical and pathological risk factors for allograft failure in PCAR patients...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29317301/antibody-mediated-rejection-due-to-de-novo-dsa-causing-venous-thrombosis-of-pancreas-allograft-a-case-report
#3
Kunal Yadav, Adrian Cotterell, Pamela Kimball, Laura Warmke, Melissa Contos, Gaurav Gupta, Anne King, Dhiren Kumar, Marlon Levy
This case describes a 34year old female who underwent an HLA identical living donor kidney transplant with a positive flow cytometric crossmatch (FCXM), but without any donor specific antibody (DSA). Tests to detect non-HLA antibody and autoantibody were negative. Allograft functioned well without rejection. She later received a pancreas allograft, again with a weakly positive FCXM, without DSA. After good initial graft function, she developed hyperglycemia six weeks posttransplant. Cross-sectional imaging demonstrated non-enhancing pancreas allograft with new vein thrombosis...
January 6, 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29296167/renal-myxoma-in-a-pediatric-transplant-recipient
#4
Jeffrey J Tutman, Anil G Rao, Jeanne G Hill, Connor D Crowley
Renal myxoma is a very rare benign neoplasm seen almost exclusively in adults with only 16 reported cases in the literature. All of these cases have been reported in native kidneys with none being reported in a transplant kidney. We report the case of a renal myxoma in a 17-year-old boy's transplant kidney that was found as an incidental mass on ultrasonography and further evaluated with CT and PET scans. PET findings of a renal myxoma are reported here for the first time, and imaging findings from previous cases are briefly reviewed...
November 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29260318/the-utility-of-surveillance-biopsies-in-pediatric-kidney-transplantation
#5
Vikas R Dharnidharka, Neil Vyas, Joseph P Gaut, Leslie Walther, S Paul Hmiel
BACKGROUND: Surveillance biopsies (SBs) are performed in some pediatric kidney transplant programs, based on data obtained in earlier immunosuppressive eras that the treatment of subclinical acute rejection results in better graft survival. The benefit of SBs for patients on modern immunosuppression regimens is unclear. We have therefore evaluated the clinical utility of SBs in a population of children receiving a kidney transplant. METHODS: We have performed SBs at 3, 6 and 12 months post-transplantation as standard of care at our institution since 2013 in patients on a regimen of rabbit anti-thymocyte globulin, tacrolimus, mycophenolate and rapid steroid taper (RST; steroids maintained in some exceptions)...
December 19, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29258531/malignant-rhabdoid-tumor-in-the-renal-allograft-of-an-adult-transplant-recipient-a-unique-case-of-a-rare-tumor
#6
Jing Xiong, Tiefen Su, Pengcheng Zhu, Qilin Ao, Qiurong Ruan, Guoping Wang
BACKGROUND: Renal transplant recipients have increased risk for developing malignant diseases because of immunosuppression or donor-to-recipient transmission. Malignant rhabdoid tumor (MRT) is a rare, highly aggressive and lethal tumor primarily affecting the kidney of infants and young children. MRT has not been reported in the renal allograft of an adult recipient after kidney transplantation. CASE PRESENTATION: In this report, a 47-year-old woman who received a kidney transplantation from an infant donor and developed a mass in the transplanted kidney is presented...
December 19, 2017: Diagnostic Pathology
https://www.readbyqxmd.com/read/29250696/nephrotic-syndrome-after-autologous-hematopoietic-stem-cell-transplantation-a-case-report
#7
Bogdan Obrişcă, Adriana Roxana JurubiŢă, Andreea Gabriella Andronesi, Mihaela Gherghiceanu, Gener Ismail, George Mitroi, Mihai Cristian Hârza
Nephrotic syndrome (NS) is a rare complication of hematopoietic cell transplantation (HCT) and is thought to represent a renal manifestation of chronic graft-versus-host disease (cGVHD). Glomerulopathies occur less often in recipients of autologous as compared to allogeneic HCT and, in this setting, renal pathology is less well characterized. This case report describes a 54-year-old man admitted for the evaluation of a nephrotic-range proteinuria. His past medical history included a ? light-chain secreting multiple myeloma (MM) for which he underwent autologous HCT...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29230343/unusual-pathology-in-a-kidney-from-a-heart-transplant-patient
#8
Marie Larcher, Audey Delas, Clément Delmas, Olivier Cointault, Camille Dambrin, Arnaud Del Bello, Nassim Kamar
Acute kidney injury (AKI) is often observed after heart transplantation. In this setting, acute tubular necrosis is the main histological finding on kidneys. We report the unusual pathology found in a kidney from a heart-transplant patient. The patient experienced several hemodynamic insults, massive transfusion, and implantation of a mechanical circulatory-support device before heart transplantation: there was prolonged AKI after transplantation. A kidney biopsy revealed acute tubular necrosis and renal hemosiderosis, which was probably related to the transfusion and to mechanical circulatory-support device-induced intravascular hemolysis...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/29224373/pharmacotherapy-and-treatment-options-for-hiv-associated-nephropathy
#9
Steven Menez, Mohamad Hanouneh, Blaithin A McMahon, Derek M Fine, Mohamed G Atta
Human immunodeficiency virus (HIV) remains a worldwide disease with significant mortality and morbidity. There are a multitude of HIV-related kidney diseases including HIV-associated nephropathy (HIVAN) most prominently. The risk of developing HIVAN increases with decreasing CD4 count, higher viral load, and based on genetic factors. The mortality rate for those with HIVAN-end stage renal disease (ESRD) remains 2.5-3 times higher than ESRD patients without HIVAN. Areas covered: The epidemiology of HIVAN, particularly risk assessment, will be explored in this review...
January 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29207754/clinicopathological-characteristics-and-outcomes-of-diffuse-crescentic-glomerulonephritis-a-single-center-experience-from-southern-india
#10
Shankar Prasad Nagaraju, Sindhura Lakshmi Koulmane Laxminarayana, Srinivas Kosuru, Rajeevalochana Parthasarathy, Ravindra Prabhu Attur, Dharshan Rangaswamy, Uday Venkat Matteti, Vasudeva Guddattu
Introduction: Diffuse Crescentic glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure and has grave prognosis. There is significant regional and temporal variation in aetiology, prevalence and prognosis of diffuse crescentic glomerulonephritis (CrGN) with limited data available in adult Indian population. Aim: This study aims to identify the aetiology, clinico-pathological features and outcomes of diffuse CrGN in south Indian population...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29199277/the-renaissance-of-complement-therapeutics
#11
REVIEW
Daniel Ricklin, Dimitrios C Mastellos, Edimara S Reis, John D Lambris
The increasing number of clinical conditions that involve a pathological contribution from the complement system - many of which affect the kidneys - has spurred a regained interest in therapeutic options to modulate this host defence pathway. Molecular insight, technological advances, and the first decade of clinical experience with the complement-specific drug eculizumab, have contributed to a growing confidence in therapeutic complement inhibition. More than 20 candidate drugs that target various stages of the complement cascade are currently being evaluated in clinical trials, and additional agents are in preclinical development...
December 4, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29198665/isolated-crystalloid-podocytopathy-with-focal-segmental-glomerulosclerosis-in-renal-allograft-an-unusual-presentation-of-post-transplant-monoclonal-gammopathy-of-renal-significance-a-case-report
#12
A-H Yang, C-C Loong, N-C Lin, C-Y Yang
BACKGROUND: Monoclonal gammopathy of renal significance denotes a spectrum of hematologic disorders that cause direct or indirect renal damage. CASE PRESENTATION: A 51-year-old man had received a living-donor kidney transplant from his wife in 2008. He had gradual increased proteinuria 4 years later. His renal biopsy results revealed cytoplasmic crystalloid inclusions in the podocytes. No crystalloid inclusion was found in other renal cells. Despite that immunofluorescent examination failed to show light-chain deposition, the serum immuno-electrophoresis revealed monoclonal immunoglobulin-Gκ...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198655/clinical-and-pathological-analyses-of-cases-of-acute-vascular-rejection-after-kidney-transplantation
#13
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/29198654/evaluation-of-frozen-and-paraffin-sections-using-the-maryland-aggregate-pathology-index-score-in-donor-kidney-biopsy-specimens-of-a-brazilian-cohort
#14
A C Teixeira, C C Freire de Carvalho, G P Mororó, L D M Pereira, V S Lacerda, R M Esmeraldo
The Maryland aggregate pathology index (MAPI) score is an important tool developed to help pathologists in evaluating potential organs for transplantation. It is based on analysis of five variables (present or absent): arteriolar hyalinosis (4 points), periglomerular fibrosis (2 points), arterial wall-lumen ratio superior to 0.5 (2 points), global glomerulosclerosis in more than 15% of glomeruli (2 points), and interstitial scar (3 points). Kidneys with a MAPI score >7 points are considered inadequate for donation...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29190645/cd105-mesenchymal-stem-cells-migrate-into-osteoarthritis-joint-an-animal-model
#15
Pablo Fernandez-Pernas, Iván Rodríguez-Lesende, Alexandre de la Fuente, Jesús Mateos, Isaac Fuentes, Javier De Toro, Fco J Blanco, M C Arufe
Mesenchymal stem cells are being the focus of connective tissue technology and regenerative medicine, presenting a good choice cell source for improving old and well recognized techniques of cartilage defect repair. For instance, the autologous chondrocyte transplantation using new concepts of regenerative medicine. The present study investigated the risk of xenogenicity of human synovial membrane-derived MSCs, injected into the monkeys using intravenous and intra-articular administration. The animal models used were adult monkeys Rhesus which had been injured into the left knee to create an Osteoarthritis (OA) animal model...
2017: PloS One
https://www.readbyqxmd.com/read/29187134/correlation-between-renal-cortical-stiffness-and-histological-determinants-by-point-shear-wave-elastography-in-patients-with-kidney-transplantation
#16
A L Croci Chiocchini, C Sportoletti, G Comai, S Brocchi, I Capelli, O Baraldi, P Bruno, F Conti, C Serra, M Meola, M Zompatori, G La Manna
INTRODUCTION: Renal allograft biopsy is the gold standard for the detection of histological lesions of chronic allograft dysfunction. The identification of a noninvasive routine test would be desirable. Elastosonography is used to assess tissue stiffness according to viscosity, and no data are available on the use of point quantification shear-wave elastography (ElastPQ) for the evaluation of renal chronic lesions. RESEARCH QUESTION: To evaluate the feasibility of ElastPQ to assess cortical allograft stiffness and to determine the correlation of clinical, biological, and pathological factors with the diagnostic accuracy of kidney stiffness values in patients with histological lesions...
December 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29159992/clinical-and-histopathologic-features-of-antibody-mediated-rejection-among-pediatric-renal-transplant-recipients-with-preformed-vs-de-novo-donor-specific-antibodies
#17
Justin A Steggerda, Irene K Kim, Mark Haas, Xiaohai Zhang, Alexis Kang, Helen Pizzo, Elaine Kamil, Stanley Jordan, Dechu Puliyanda
Preformed and de novo donor specific antibodies (pDSA and dnDSA) are risk factors for ABMR. This study compares the effects of pDSA vs dnDSA in pediatric kidney transplant recipients. Sixteen pediatric patients with biopsy-proven ABMR were evaluated. Strong DSA (MFI >10 000) was recorded at transplant, rejection, and follow-up. DSAs with the highest MFI were termed iDSAs. Allograft biopsies were scored according to Banff 2013 criteria. Seven of 16 (44%) patients had pDSA at transplant; 9 (56%) developed dnDSA...
December 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29155318/kidney-pathology-after-hematologic-cell-transplantation-a-single-center-observation-study-of-indication-biopsies-and-autopsies
#18
Michael Girsberger, Jörg P Halter, Helmut Hopfer, Michael Dickenmann, Thomas Menter
Hematopoietic cell transplantation (HCT) is an increasingly used treatment for hematologic malignancies as well as for non-malignant diseases. Kidney impairment remains an important early and late posttransplant complication. Numerous histopathologic changes have been reported but the pathophysiology is still incompletely understood. Furthermore, correlations between clinical findings and morphologic changes are not well studied. Between 2000 and 2016, 17 patients after allogeneic (n=12) or autologous (n=5) HCT underwent kidney biopsy for either proteinuria or deterioration of kidney function at our center...
November 16, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29141316/-a-clinical-analysis-of-micafungin-treatment-of-pulmonary-invasive-fungal-infection-in-pediatric-patients-with-acute-leukemia-or-post-hematopoietic-stem-cells-transplantation
#19
K Huang, K Y Qiu, L L Deng, J P Fang, Y Li, H X Guo, D H Zhou
Objective: To investigate the efficacy and safety of micafungin (MCF) for pulmonary invasive fungal disease (PIFD) in pediatric patients with acute leukemia or post hematopoietic stem cells transplantation. Method: Twenty-five neutropenic PIFD children with acute leukemia or post hematopoietic stem cells transplantation in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were selected from January 2012 to June 2015, including 12 males and 13 females, age range 2-15 (average 6.2±2.0) years. There were 12 cases of acute leukemia (AL) after chemotherapy, 4 cases of acute leukemia (AL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and 9 cases of β-thalassemia major after allo-HSCT...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#20
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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