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rejection transplantation

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https://www.readbyqxmd.com/read/28647502/alternative-complement-pathway-hemolytic-assays-reveal-incomplete-complement-blockade-in-patients-treated-with-eculizumab
#1
Bénédicte Puissant-Lubrano, Sylvain Puissochet, Nicolas Congy-Jolivet, Dominique Chauveau, Stéphane Decramer, Arnaud Garnier, Antoine Huart, Nassim Kamar, David Ribes, Antoine Blancher
Eculizumab is a monoclonal anti-C5 antibody used in the treatment of atypical hemolytic uremic syndrome (aHUS). We monitored complement inhibition in 16 eculizumab-treated patients suffering from HUS or transplant rejection (not aHUS patients). Blood samples were obtained one to four weeks after the last eculizumab injection. We observed that eculizumab efficiently blocked the terminal pathway (TP) through classical pathway (CP) activation measured by kinetic hemolytic assay (HA) (<10%) but incompletely blocked the TP through alternative pathway (AP) activation measured by rabbit (APH50>23%) or chicken erythrocytes HA (AP100>15%)...
June 21, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28647182/preoperative-application-of-combination-of-portal-venous-injection-of-donor-spleen-cells-and-intraperitoneal-injection-of-rapamycin-prolongs-the-survival-of-cardiac-allografts-in-mice
#2
Wen-Lin Gong, Chuang Sha, Gang Du, Zhong-Gui Shan, Zhong-Quan Qi, Su-Fang Zhou, Nuo Yang, Yong-Xiang Zhao
OBJECTIVE: To investigate the effects of preoperative portal venous injection of donor spleen cells (PVIDSC) and intraperitoneal injection of rapamycin in the acute rejection of cardiac allograft in mice and the underlying mechanisms. METHODS: Homogenous female B6 mice and BALB/c mice were used as recipients and donors of heart transplantation. These mice were randomly divided into different groups and received PVIDSC alone, rapamycin alone, or PVIDSC and rapamycin combined therapy...
May 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28643821/non-invasive-approaches-in-the-diagnosis-of-acute-rejection-in-kidney-transplant-recipients-part-i-in-vivo-imaging-methods
#3
REVIEW
Oriane Hanssen, Pauline Erpicum, Pierre Lovinfosse, Paul Meunier, Laurent Weekers, Luaba Tshibanda, Jean-Marie Krzesinski, Roland Hustinx, François Jouret
Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ultimately relies on transplant needle biopsy. However, such an invasive procedure is associated with a significant risk of complications and is limited by sampling error and interobserver variability. In the present review, we summarize the current literature about non-invasive approaches for the diagnosis of AR in kidney transplant recipients (KTRs), including in vivo imaging, gene expression profiling and omics analyses of blood and urine samples...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28643819/non-invasive-approaches-in-the-diagnosis-of-acute-rejection-in-kidney-transplant-recipients-part-ii-omics-analyses-of-urine-and-blood-samples
#4
REVIEW
Pauline Erpicum, Oriane Hanssen, Laurent Weekers, Pierre Lovinfosse, Paul Meunier, Luaba Tshibanda, Jean-Marie Krzesinski, Roland Hustinx, François Jouret
Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, the full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ultimately relies on transplant needle biopsy. However, such an invasive procedure is associated with a significant risk of complications and is limited by sampling error and interobserver variability. In the present review, we summarize the current literature about non-invasive approaches for the diagnosis of AR in kidney transplant recipients (KTRs), including in vivo imaging, gene-expression profiling and omics analyses of blood and urine samples...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28643491/association-of-foxp3-polymorphism-with-allograft-outcome-in-kidney-transplantation
#5
Hyewon Park, Nuri Lee, Ji Won In, Eun Youn Roh, Kyoung Un Park, Sue Shin, Jaeseok Yang, Eun Young Song
BACKGROUND: Forkhead box P3 (Foxp3) is the most reliable marker for regulatory T cells, which play an important role in maintaining renal allograft tolerance. Recently, Foxp3 polymorphisms have been reported to be associated with graft outcome in kidney transplantation. We analyzed the association of Foxp3 polymorphisms with renal allograft outcome. METHODS: Foxp3 polymorphisms (rs3761548 A/C, rs2280883 C/T, rs5902434 del/ATT, and rs2232365 A/G) were tested by PCR with sequence-specific primers (PCR-SSP) in 231 adult kidney transplantation recipients from 1996-2004 at Seoul National University Hospital...
September 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28643391/fatal-orthotopic-liver-transplant-organ-rejection-induced-by-a-checkpoint-inhibitor-in-two-patients-with-refractory-metastatic-hepatocellular-carcinoma
#6
Brian D Friend, Robert S Venick, Sue V McDiarmid, Xiaoyan Zhou, Bita Naini, Hanlin Wang, Douglas G Farmer, Ronald W Busuttil, Noah Federman
Although checkpoint inhibitor therapies have demonstrated significant efficacy in many malignancies, they have not been well studied in patients with a history of solid organ transplant. We describe two patients with recurrent, refractory, and progressive advanced fibrolamellar hepatocellular carcinoma (HCC) following orthotopic liver transplantation who received programmed cell death protein 1 (PD-1) inhibitor, nivolumab, on a patient access, off-label basis. Both rapidly developed irreversible acute liver rejection shortly after starting therapy, and ultimately died...
June 23, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28642816/safe-and-effective-administration-of-t-vec-in-a-patient-with-heart-transplantation-and-recurrent-locally-advanced-melanoma
#7
Gustavo Schvartsman, Kristen Perez, Jill E Flynn, Jeffrey N Myers, Hussein Tawbi
BACKGROUND: Immunotherapy plays a key role in the treatment of metastatic melanoma. Patients with autoimmune conditions and/or on immunosuppressive therapy due to orthotropic transplants, however, are systematically excluded from clinical trials. Talimogene laherparepvec (T-VEC) is the first oncolytic virus to be approved by the FDA for cancer therapy. To our knowledge, this is the first report of T-VEC being administered in the setting of an organ transplant recipient. CASE PRESENTATION: Here we present the case of a patient with recurrent locally advanced cutaneous melanoma receiving salvage T-VEC therapy in the setting of orthotropic heart transplantation...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28642710/tacrolimus-updated-guidelines-through-poppk-modeling-how-to-benefit-more-from-cyp3a-pre-emptive-genotyping-prior-to-kidney-transplantation
#8
Jean-Baptiste Woillard, Michel Mourad, Michael Neely, Arnaud Capron, Ron H van Schaik, Teun van Gelder, Nuria Lloberas, Dennis A Hesselink, Pierre Marquet, Vincent Haufroid, Laure Elens
Tacrolimus (Tac) is a profoundly effective immunosuppressant that reduces the risk of rejection after solid organ transplantation. However, its use is hampered by its narrow therapeutic window along with its highly variable pharmacological (pharmacokinetic [PK] and pharmacodynamic [PD]) profile. Part of this variability is explained by genetic polymorphisms affecting the metabolic pathway. The integration of CYP3A4 and CY3A5 genotype in tacrolimus population-based PK (PopPK) modeling approaches has been proven to accurately predict the dose requirement to reach the therapeutic window...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28641881/peripheral-blood-regulatory-t-cell-counts-as-a-predictive-biomarker-for-the-outcome-of-kidney-transplant-a-systematic-review
#9
Francisco Herrera-Gómez, Mónica Vásquez-Seoane, Waldo Del Aguila, Débora Martín-García, Álvaro Maurtua-Briseño Meiggs, Anunciación González-López, Beatriz Andrés-Martín, Álvaro Nava-Rebollo, Fernando Casquero-Fernández, Pilar Pascual-Núñez, Jesús Grande-Villoria, Jesús Bustamante-Bustamante, Carlos Ochoa-Sangrador, Claude Lambert, Alicia Mendiluce-Herrero
BACKGROUND AND OBJECTIVE: Circulating regulatory T cells could become a suitable biomarker for kidney recipients. The objective of this study was to evaluate the effect of mammalian target of rapamycin (mTOR) inhibitors on regulatory T cell numbers, and the clinical interest of this effect. MATERIAL AND METHODS: Systematic review of published and unpublished studies. Worldwide databases or repositories. Randomised controlled trials and cohort studies comparing regulatory T cell counts and rejection episodes between patients with and without mTOR inhibitors were searched...
June 19, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28640530/how-does-age-affect-the-outcome-of-kidney-transplantation-in-elderly-recipients
#10
Flavia Neri, Lucrezia Furian, Francesco Cavallin, Matteo Ravaioli, Cristina Silvestre, Paola Donato, Gaetano La Manna, Antonio Daniele Pinna, Paolo Rigotti
The aging of the on-dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aims to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all patients over 60 years, receiving a deceased-donor kidney transplantation from January 2004 to December 2014 in two north Italian Centers. We analyzed the correlation of recipient age with graft's and patient's survival, delayed graft function (DGF), acute cellular rejection (ACR), surgical complications, infections and glomerular filtration rate (GFR)...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28640529/effect-of-everolimus-versus-calcineurin-inhibitors-on-quality-of-life-in-heart-transplant-recipients-during-a-3-year-follow-up-results-of-a-randomized-controlled-trial-schedule
#11
A Relbo Authen, I Grov, K Karason, F Gustafsson, H Eiskjaer, G Rådegran, E Gude, K Jansson, G Dellgren, D Solbu, S Arora, A K Andreassen, L Gullestad
The SCHEDULE trial was a 12-month, randomized, open-label, parallel-group trial that compared everolimus (EVR; n=56) to conventional CsA (n=59) immunosuppression. Previously, we reported that EVR outperformed CsA in improving renal function and coronary artery vasculopathy, despite a higher rejection rate with EVR. The present study aimed to compare the effects of these treatments on quality of life (QoL). Within 5 postoperative days, patients (mean age 50±13 years, 27% women) were randomized to EVR or a standard CsA dosage (CsA group)...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28640063/pharmacodynamic-monitoring-of-tacrolimus-based-immunosuppression-in-cd14-monocytes-after-kidney-transplantation
#12
Nynke M Kannegieter, Dennis A Hesselink, Marjolein Dieterich, Gretchen N De Graav, Rens Kraaijeveld, Ajda T Rowshani, Pieter Jm Leenen, Carla C Baan
BACKGROUND: Monocytes significantly contribute to ischemia reperfusion injury and allograft rejection after kidney transplantation. However, the knowledge about the effects of immunosuppressive drugs on monocyte activation is limited. Conventional pharmacokinetic methods for immunosuppressive drug monitoring are not cell type-specific. In this study, phosphorylation of three signaling proteins was measured to determine the pharmacodynamic effects of immunosuppression on monocyte activation in kidney transplant patients...
June 19, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28639599/comparative-analysis-of-luminex-based-donor-specific-antibody-mean-fluorescence-intensity-values-with-complement-dependent-cytotoxicity-flow-crossmatch-results-in-live-donor-renal-transplantation
#13
Ajay Kumar Baranwal, Deepali Krishan Bhat, Sanjeev Goswami, Sanjay Kumar Agarwal, Gurvinder Kaur, Jasmeet Kaur, Narinder Mehra
BACKGROUND & OBJECTIVES: Antibodies specific to donor human leucocyte antigen (HLA) play a critical role in graft rejection and graft loss. In recent years, techniques for their detection have evolved significantly providing an ever-increasing degree of sensitivity and specificity, from the conventional cell-based assays to the advanced solid-phase system based on the Luminex platform. Consensus is still evolving on the routine employment of all these methods, either stand alone or in combination...
February 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28639386/development-of-immune-response-to-tissue-restricted-self-antigens-in-simultaneous-kidney-pancreas-transplant-recipients-with-acute-rejection
#14
Muthukumar Gunasekaran, Neeta Vachharajani, Joseph P Gaut, Thin Thin Maw, Rowena Delos Santos, Surendra Shenoy, William C Chapman, Jason Wellen, Thalachallour Mohanakumar
Simultaneous kidney-pancreas transplantation (SKP Tx) is a treatment for end-stage kidney disease secondary to diabetes mellitus. We investigated the role of immune responses to donor human leukocyte antigens (HLA) and tissue-restricted kidney and pancreas self-antigens (KSAgs and PSAgs, respectively) in SKP Tx recipients (SKP TxRs). Sera collected from 39 SKP TxRs were used to determine de novo Abs specific for KSAgs (collagen-IV, Col-IV; fibronectin, FN) and PSAgs (insulin, islet cells, glutamic acid decarboxylase, and pancreas-associated protein-1) by ELISA...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28638610/looking-for-the-needle-in-the-kidney-transplantation-haystack
#15
Josep M Cruzado, Edoardo Melilli
The diagnosis of acute rejection still relies on renal allograft biopsy. In fact, histological features including C4d staining can be useful to differentiate cellular and antibody-mediated acute rejection. However, the pathogenic mechanism to define the type of rejection is usually assessed by anti-HLA donor specific antibodies (DSA) monitoring. Suspicion of acute rejection is usually based on renal function deterioration. This method has low sensitivity. Moreover, creatinine increase follows graft injury and therefore the diagnosis is performed when there is an ongoing acute rejection...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28638110/a-novel-and-effective-method-to-generate-human-porcine-specific-regulatory-t-cells-with-high-expression-of-il-10-tgf-%C3%AE-1-and-il-35
#16
Mingqian Li, Judith Eckl, Christiane Geiger, Dolores J Schendel, Heike Pohla
Organ transplantation remains the most effective treatment for patients with late stage organ failure. Transgenic pigs provide an alternative organ donor source to the limited availability of human organs. However, cellular rejection still remains to be the obstacle for xenotransplantation. Superior to other methods, antigen-specific regulatory T cells (Treg) alleviate cellular rejection with fewer side effects. Here we demonstrate the use of a fast method to provide tolerogenic dendritic cells (tolDC) that can be used to generate effective porcine-specific Treg cells (PSTreg)...
June 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28637827/islet-encapsulation-physiological-possibilities-and-limitations
#17
Olle Korsgren
A logical cure for type 1 diabetes (T1D) involves replacing the lost insulin-producing cells with new ones, preferably cells from a well-characterized and unlimited source of human insulin-producing cells. This straightforward and simple solution to provide a cure for T1D is immensely attractive but entails at least two inherent and thus far unresolved hurdles: 1) provision of an unlimited source of functional human insulin-producing cells and 2) prevention of rejection without the side effects of systemic immunosuppression...
July 2017: Diabetes
https://www.readbyqxmd.com/read/28637080/the-prognostic-importance-of-bronchoalveolar-lavage-fluid-cxcl9-during-minimal-acute-rejection-on-the-risk-of-chronic-lung-allograft-dysfunction
#18
M Y Shino, S S Weigt, N Li, A Derhovanessian, D M Sayah, R Saggar, Richard H Huynh, A L Gregson, A Ardehali, D J Ross, J P Lynch, R M Elashoff, J A Belperio
The clinical significance and treatment strategies for minimal acute rejection (grade A1), the most common form of acute rejection (AR), remains controversial. In this retrospective single-center cohort study of 441 lung transplant recipients, we formally evaluate the association between minimal AR and chronic lung allograft dysfunction (CLAD) and test a novel hypothesis using BAL CXCL9 concentration during minimal AR as a biomarker of subsequent CLAD development. In univariable and multivariable models adjusted for all histopathologic injury patterns, minimal AR was not associated with CLAD development...
June 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28636627/plasma-cell-neoplasia-after-kidney-transplantation-french-cohort-series-and-review-of-the-literature
#19
Raphaël Kormann, Hélène François, Thibault Moles, Jacques Dantal, Nassim Kamar, Karine Moreau, Thomas Bachelet, Anne-Elisabeth Heng, Antoine Garstka, Charlotte Colosio, Didier Ducloux, Johnny Sayegh, Benjamin Savenkoff, Denis Viglietti, Rebecca Sberro, Eric Rondeau, Julie Peltier
Although post-transplant lymphoproliferative disorder (PTLD) is the second most common type of cancer in kidney transplantation (KT), plasma cell neoplasia (PCN) occurs only rarely after KT, and little is known about its characteristics and evolution. We included twenty-two cases of post-transplant PCN occurring between 1991 and 2013. These included 12 symptomatic multiple myeloma, eight indolent myeloma and two plasmacytomas. The median age at diagnosis was 56.5 years and the median onset after transplantation was 66...
2017: PloS One
https://www.readbyqxmd.com/read/28635677/t-cell-manipulation-strategies-to-prevent-graft-versus-host-disease-in-haploidentical-stem-cell-transplantation
#20
REVIEW
Jayakumar Vadakekolathu, Sergio Rutella
Allogeneic haematopoietic stem cell transplantation (HSCT) from an human leukocyte antigen (HLA)-identical donor can be curative for eligible patients with non-malignant and malignant haematological disorders. HSCT from alternative donor sources, such as HLA-mismatched haploidentical donors, is increasingly considered as a viable therapeutic option for patients lacking HLA-matched donors. Initial attempts at haploidentical HSCT were associated with vigorous bidirectional alloreactivity, leading to unacceptably high rates of graft rejection and graft-versus-host disease (GVHD)...
June 21, 2017: Biomedicines
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