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rejection in kidney transplant

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https://www.readbyqxmd.com/read/29346260/race-risk-and-willingness-of-end-stage-renal-disease-patients-without-hepatitis-c-hcv-to-accept-an-hcv-infected-kidney-transplant
#1
Maureen McCauley, Adam Mussell, David Goldberg, Deirdre Sawinski, Rodolfo N Molina, Ricarda Tomlin, Sahil D Doshi, Peter Abt, Roy Bloom, Emily Blumberg, Sanjay Kulkarni, Gabriela Esnaola, Justine Shults, Carrie Thiessen, Peter P Reese
BACKGROUND: Despite effective antiviral treatment, hundreds of kidneys from deceased donors with hepatitis C virus (HCV) are discarded annually. Little is known about the determinants of willingness to accept HCV-infected kidneys among HCV-negative patients. METHODS: At 2 centers, 189 patients undergoing initial or reevaluation for transplant made 12 hypothetical decisions about accepting HCV-infected kidneys in which we systematically varied expected HCV cure rate, allograft quality and wait-time for an uninfected kidney...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29346257/association-of-cold-ischemia-time-with-acute-renal-transplant-rejection
#2
Merve Postalcioglu, Arnaud D Kaze, Benjamin C Byun, Andrew Siedlecki, Stefan G Tullius, Edgar L Milford, Julie M Paik, Reza Abdi
BACKGROUND: Kidney transplantation holds much promise as a treatment of choice for patients with end stage kidney disease. The impact of cold ischemia time (CIT) on acute renal transplant rejection (ARTR) remains to be fully studied in a large cohort of renal transplant patients. METHODS: From the Organ Procurement and Transplantation Network database, we analyzed 63,798 deceased donor renal transplants performed between 2000-2010. We assessed the association between CIT and ARTR...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29344912/capillary-leak-syndrome-as-a-complication-of-antibody-mediated-rejection-treatment-a-case-report
#3
Juan C Ramirez-Sandoval, Ricardo Varela-Jimenez, Luis E Morales-Buenrostro
We report a case of capillary leak that developed during treatment of antibody-mediated rejection in a kidney transplant recipient. A 53-year-old female transplant recipient experienced an increase in serum creatinine from 1.1 to 1.8 mg/dL. Antibody-mediated rejection was diagnosed by graft biopsy. She was treated with five plasmapheresis sessions (on alternate days with albumin replacement), five doses of immunoglobulin (5 g/dose at 100 mg/kg), a single dose of rituximab (500 mg), and four doses of bortezomib on days 1, 4, 7, and 10 (1...
January 17, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29343314/cell-free-dna-the-role-in-pathophysiology-and-as-a-biomarker-in-kidney-diseases
#4
Peter Celec, Barbora Vlková, Lucia Lauková, Janka Bábíčková, Peter Boor
Cell-free DNA (cfDNA) is present in various body fluids and originates mostly from blood cells. In specific conditions, circulating cfDNA might be derived from tumours, donor organs after transplantation or from the foetus during pregnancy. The analysis of cfDNA is mainly used for genetic analyses of the source tissue -tumour, foetus or for the early detection of graft rejection. It might serve also as a nonspecific biomarker of tissue damage in critical care medicine. In kidney diseases, cfDNA increases during haemodialysis and indicates cell damage...
January 18, 2018: Expert Reviews in Molecular Medicine
https://www.readbyqxmd.com/read/29343027/-using-creatinine-reduction-ratio-as-a-predictor-for-delayed-graft-function-of-kindey-transplant-recipients-from-donor-of-cardiac-death
#5
Z J Sun, X D Zhang, L Ren, X Y Yang, J F Cai, X Li, X Zheng, W Wang
Objective: To explore the relationship between creatinine reduction ratio (CRR) and delayed graft function among kidney transplant recipients from donor of cardiac death (DCD). To define the value of CRR to predict delayed graft function (DGF) in early post-transplant period. Method: 86 patients were included, who received renal transplantation from DCD during Jan 1(st) 2011 to Jun 30(th) 2016. We performed a retrospective study and collected creatinine data within 3 days post-operation and marked them with Cr1, Cr2 , Cr3, and then calculated creatinine reduction ratio day-2 (CRR 2) =(Cr1-Cr2)/Cr1×100% and creatinine reduction ratio day-3 (CRR 3)=[(Cr1-Cr2)/Cr1+ (Cr2-Cr3)/Cr2]/2×100%...
January 2, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29341290/early-failure-of-kidney-transplants-in-the-current-era-a-national-cohort-study
#6
Ilkka Helanterä, Juulia Räihä, Patrik Finne, Marko Lempinen
Although short-term outcome after kidney transplantation has improved, a small proportion of grafts are lost during the first year. We characterize in detail all early graft losses in the current era in a nationwide cohort of kidney transplant recipients. Altogether 2447 kidney transplantations, performed between June 2004 and October 2016, were included. All graft losses (return to dialysis or patient death) occurring during the first posttransplant year were characterized. During the first posttranplant year altogether 109 grafts were lost, 67 grafts failed, and 42 patients died...
January 16, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29341061/pericardial-effusion-unrelated-to-surgery-is-a-predictor-of-mortality-in-heart-transplant-patients
#7
Simon F Stämpfli, Tardu Özkartal, Niels Hagenbuch, Stephan Bernhart, Andreas J Flammer, Alessandra Vecchiati, Georg M Fröhlich, Frank Ruschitzka, Leonhard Held, Felix C Tanner
BACKGROUND: Hemodynamically irrelevant pericardial effusion (PeEf) is a predictor of adverse outcome in heart failure patients. The clinical relevance of a PeEf unrelated to surgery in heart transplant patients remains unknown. This study assesses the prognostic value of PeEf occurring later than one year after transplantation. METHODS: All patients undergoing heart transplantation in Zurich between 1989 and 2012 were screened. Cox proportional hazard models were used to analyse mortality (primary) and hospitalization (secondary endpoint)...
January 17, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29335397/pediatric-renal-transplantation-focus-on-current-transition-care-and-proposal-of-the-rise-to-transition-protocol
#8
Rupesh Raina, Joseph Wang, Vinod Krishnappa, Maria Ferris
The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care...
January 16, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29334529/midterm-outcome-of-kidney-transplantation-from-donors-with-thin-basement-membrane-nephropathy
#9
Chanjoong Choi, Sanghyun Ahn, Seung-Kee Min, Jongwon Ha, Curie Ahn, Yonsu Kim, Hajeong Lee, Sang-Il Min
BACKGROUND: Thin basement membrane nephropathy (TBMN) is the most common cause of persistent glomerular hematuria. Most individuals with TBMN show a benign course, although it can be difficult to distinguish it from early stages of progressive renal diseases. However, only limited studies address the prognosis of donors with TBMN and their recipients. METHODS: From 2007 to 2016, 11 recipients received kidney grafts from donors with TBMN, and their clinical data were analyzed retrospectively...
January 12, 2018: Transplantation
https://www.readbyqxmd.com/read/29334522/themes-in-literature-related-to-incidence-risk-and-prevention-of-cancer-in-solid-organ-transplantation-recipients-on-immunosuppressive-therapy
#10
Stefanie L Rashti
BACKGROUND: Solid-organ transplants provide a second chance to thousands of critically ill patients with end-organ failure each year. Immunosuppressants are administered to patients to prevent graft rejection of a transplanted organ, such as a heart, kidney, or liver, while placing the recipient at greater risk for infection and cancer. OBJECTIVE: The literature provides evidence of various cancers that have been found to develop in patients' posttransplantation...
January 12, 2018: Cancer Nursing
https://www.readbyqxmd.com/read/29332627/pre-transplant-history-of-mental-health-concerns-non-adherence-and-post-transplant-outcomes-in-kidney-transplant-recipients
#11
Franz Marie Gumabay, Marta Novak, Aarushi Bansal, Margot Mitchell, Olusegun Famure, S Joseph Kim, Istvan Mucsi
OBJECTIVE: The association between pre-transplant mental health concerns and non-adherence and post-transplant outcomes after kidney transplantation is not fully established. We examined the relationship between a pre-transplant history of mental health concerns and non-adherence and post-transplant outcomes among kidney transplant recipients. METHODS: In this retrospective single center cohort study of adult kidney transplant recipients (n=955) the associations between the history of mental health concerns or non-adherence and the time from kidney transplant to biopsy proven acute rejection; death-censored graft failure and total graft failure were examined using Cox proportional hazards models...
February 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29331505/successful-treatment-of-anti-angiotensin-ii-type-1-receptor-antibody-associated-rejection-in-kidney-transplantation-a-case-report
#12
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/29331397/persistent-hyperparathyroidism-as-a-risk-factor-for-long-term-graft-failure-the-need-to-discuss-indication-for-parathyroidectomy
#13
Maria Júlia Correia Lima Nepomuceno Araujo, Janaina Almeida Mota Ramalho, Rosilene Motta Elias, Vanda Jorgetti, William Nahas, Melani Custodio, Rosa M A Moysés, Elias David-Neto
BACKGROUND: Although a successful kidney transplant (KTx) improves most of the mineral and bone disorders (MBD) produced by chronic kidney disease (CKD), hyperparathyroidism may persist (pHPT). Current guidelines recommend parathyroidectomy if serum parathormone is persistently elevated 1 year after KTx, because pHPT has been recently associated with poor graft outcomes. However, whether patients with pHPT and adequate renal function are at risk for long-term graft failure is unknown...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29329489/mycophenolic-acid-and-its-metabolites-in-kidney-transplant-recipients-a-semimechanistic-enterohepatic-circulation-model-to-improve-estimating-exposure
#14
Malek Okour, Pamala A Jacobson, Mariam A Ahmed, Ajay K Israni, Richard C Brundage
Mycophenolic acid (MPA) is an approved immunosuppressive agent widely prescribed to prevent rejection after kidney transplantation. Wide between-subject variability (BSV) in MPA exposure exists which in part may be due to variability in enterohepatic recirculation (EHC). Several modeling strategies were developed to evaluate EHC as part of MPA pharmacokinetics, however mechanistic representation of EHC is limited. These models have not provided a satisfactory representation of the physiology of EHC in their modeling assumptions...
January 12, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29326157/targeting-b-cells-and-plasma-cells-in-glomerular-diseases-translational-perspectives
#15
Eva Schrezenmeier, David Jayne, Thomas Dörner
The unique contributions of memory B cells and plasma cells in kidney diseases remain unclear. In this review, we evaluate the clinical experience with treatments directed at B cells, such as rituximab, and at plasma cells, such as proteasome inhibition, to shed light on the role of these two B lineage compartments in glomerular diseases. Specifically, analysis of these targeted interventions in diseases such as ANCA-associated vasculitis, SLE, and antibody-mediated transplant rejection permits insight into the pathogenetic effect of these cells...
January 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29325996/direct-acting-antiviral-therapy-for-hepatitis-c-virus-infection-in-the-kidney-transplant-recipient
#16
REVIEW
Donald F Chute, Raymond T Chung, Meghan E Sise
Hepatitis C virus infection (HCV) is a common comorbidity in patients who have undergone kidney transplantation and is associated with increased morbidity and mortality compared with recipients who do not have chronic HCV infection. Because interferon-α-based therapies can precipitate acute rejection, they are relatively contraindicated after kidney transplantation. Thus, the majority of kidney transplant recipients with HCV remain untreated. There are now all-oral, interferon-free direct-acting antiviral therapies for HCV infection that are extremely effective and well tolerated in the general population...
January 9, 2018: Kidney International
https://www.readbyqxmd.com/read/29323755/direct-acting-antiviral-regimens-are-safe-and-effective-in-the-treatment-of-hepatitis-c-in-simultaneous-liver-kidney-transplant-recipients
#17
Anupama U Nookala, James Crismale, Thomas Schiano, Helen Te, Joseph Ahn, Suzanne Robertazzi, Colleen Rodigas, Rohit Satoskar, Mandip Kc, Mohamed Hassan, Coleman Smith
Hepatitis C (HCV) remains the single most common etiology of end-stage liver disease leading to simultaneous liver/kidney transplant (SLKT) and has worse post transplant survival compared to non-HCV patients. We aim to assess the effectiveness and tolerance of the all-oral direct acting antiviral (DAA) agents with or without ribavirin (RBV) in the treatment of HCV recurrence post SLKT. 34 patients were studied retrospectively, composed predominantly of treatment-naïve (73.5%) non-Caucasian (61.8%) males (82...
January 11, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29323725/serum-igg-antibodies-from-healthy-subjects-up-to-100-years-old-react-to-jc-polyomavirus
#18
Ilaria Bononi, Elisa Mazzoni, Silvia Pietrobon, Marco Manfredini, Elena Trregiani, Marika Rossini, Francesca Lotito, Giovanni Guerra, Paola Rizzo, Fernanda Martini, Mauro Tognon
JC polyomavirus (JCPyV) was identified in 1971 in the brain tissue of a patient (J.C.) affected by the progressive multifocal leukoencephalopathy (PML). JCPyV encodes for the oncoproteins large T antigen (Tag) and small t-antigen (tag). These oncoproteins are responsible of the cell transformation and tumorigenesis in experimental animals. JCPyV is ubiquitous in human populations. After the primary infection, which is usually asymptomatic, JCPyV remains lifelong in the host in a latent phase. Its reactivation may occur in heathy subjects and immunocompromised patients...
January 11, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29322327/combined-and-sequential-liver-kidney-transplantation-in-children
#19
Ryszard Grenda, Piotr Kaliciński
Combined and sequential liver-kidney transplantation (CLKT and SLKT) is a definitive treatment in children with end-stage organ failure. There are two major indications: - terminal insufficiency of both organs, or - need for transplanting new liver as a source of lacking enzyme or specific regulator of the immune system in a patient with renal failure. A third (uncommon) option is secondary end-stage renal failure in liver transplant recipients. These three clinical settings use distinct qualification algorithms...
January 10, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29320806/experiences-of-living-kidney-donors-during-the-donation-process
#20
Hanne Agerskov, Claus Bistrup, Mette S Ludvigsen, Birthe D Pedersen
BACKGROUND: The shortage of organs from deceased donors has led to more living donation. Furthermore, immunological developments have made it possible to perform kidney transplantation despite preformed antibodies against the donor organ. This has led to a broader recruitment base of living donors. OBJECTIVE: The objective was to investigate experiences and considerations on becoming, and during the process of being, a living kidney donor. MATERIALS AND METHODS: Interviews and participant observation were conducted before, during and after the donation...
January 10, 2018: Journal of Renal Care
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