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rejection in kidney transplant

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https://www.readbyqxmd.com/read/28937266/statistical-analysis-of-adcs-and-clinical-biomarkers-in-detecting-acute-renal-transplant-rejection
#1
Elizabeth Hollis, Mohamed Shehata, Mohamed Abou El-Ghar, Mohammed Ghazal, Tarek Eldiasty, Michael Merchant, Andrew E Switala, Ayman El-Baz
OBJECTIVE: To determine which parameters are correlated with transplanted kidney status in patients who have undergone kidney transplantation and can be used for early assessment of acute renal rejection. METHODS: The study included 16 patients with stable renal allografts (Group 1) and 37 patients with rejected allografts (Group 2), determined by renal biopsy post transplantation. All patients' kidneys were evaluated using diffusion-weighted MRI (DW-MRI), in which both clincal and MRI-derived biomarkers were integrated...
September 13, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28937072/epidemiology-of-end-stage-renal-disease-in-dubai-single-center-data
#2
Fakhriya Alalawi, Maseer Ahmed, Hind AlNour, Malaz Noralla, Amna Alhadari
Hemodialysis (HD) was first established in Dubai in the year 1980 and was in its full capacity by the year 1983. Since then, the HD population has been growing rapidly. This report represents the demographic data and clinical characteristics of our HD patients during the period between January 2012 and October 2016. Diabetic nephropathy (57%) and hypertension (12.4%) are emerging as the most common causes of end-stage renal disease (ESRD) in our data, followed by undetermined causes in those who presented as ESRD (10...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28933341/c4d-expressing-glomerulopathy-and-proteinuria-post-transplantation-of-a-%C3%A2-too-big-for-size-mismatched-kidney-allograft-an-unusual-case-with-good-outcome%C3%A2
#3
Francois Gougeon, Alexei V Mikhailov, Keisha Gibson, Tomasz Kozlowski, Harsharan K Singh, Volker Nickeleit
A 5-year-old severely growth-retarded child with tubulointerstitial, oliguric end-stage renal disease received an adult-size kidney transplant. Three years post grafting under standard triple immunosuppression (mycophenolate mofetil, tacrolimus, and prednisone) de novo nephrotic range proteinuria without the nephrotic syndrome developed. Graft function was normal (serum creatinine: 0.2 - 0.3 mg/dL), there were no donor-specific HLA antibodies (DSA), and the urine sediment was inactive. Two biopsies collected 3 and 4 years post-transplantation showed severe glomerular capillary wall remodeling and associated pseudolinear C4d staining as morphologic correlates for the proteinuria...
September 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28933173/-cytomegalovirus-and-polyomavirus-infection-after-renal-transplantation
#4
Jana Machová, Tomáš Reischig
Viral infections are among the most common infectious complications affecting transplant recipients. Due to immunosuppressive therapy predominantly affecting cellular immunity and thus successfully reducing the incidence of acute rejection, there is a higher incidence of viral infections. Herpesviruses and polyomaviruses are ubiquitous pathogens which have the ability to persist in a state of latent infection. In addition to post-transplant reactivation, donor-induced primoinfection can also occur, leading to increased morbidity and contributing to decreased survival of patients...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28929636/risk-factors-for-the-development-of-antibody-mediated-rejection-in-highly-sensitized-pediatric-kidney-transplant-recipients
#5
Irene K Kim, Jua Choi, Ashley Vo, Alexis Kang, Justin Steggerda, Sabrina Louie, Mark Haas, James Mirocha, J Louis Cohen, Helen Pizzo, Elaine S Kamil, Stanley C Jordan, Dechu Puliyanda
ABMR remains a significant concern for early graft loss, especially for those who are HS against HLA antigens. We sought to determine the risk factors leading to ABMR in HS pediatric kidney transplant recipients. From January 2009 to December 2015, 16 HS pediatric kidney transplant patients at our center (age range 2-21) were retrospectively reviewed for outcomes and risk factors for ABMR. All HS patients received desensitization with high-dose IVIG/rituximab prior to transplant. Two groups were examined: ABMR(+) (n = 7) and ABMR(-) (n = 9)...
September 19, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28927645/angiotensin-ii-type-1-receptor-antibodies-are-associated%C3%A2-with-inflammatory-cytokines-and-poor-clinical-outcomes-in-pediatric-kidney-transplantation
#6
Meghan H Pearl, Qiuheng Zhang, Miguel Fernando Palma Diaz, Jonathan Grotts, Maura Rossetti, David Elashoff, David W Gjertson, Patricia Weng, Elaine F Reed, Eileen Tsai Chambers
Angiotensin II type 1 receptor (AT1R) antibody has been linked to poor allograft outcomes in adult kidney transplantation. However, its clinical consequences in children are unknown. To study this, we examined the relationship of AT1R antibody with clinical outcomes, biopsy findings, inflammatory cytokines, and HLA donor-specific antibodies (DSA) in a cohort of pediatric renal transplant recipients. Sixty-five patients were longitudinally monitored for AT1R antibody, HLA DSA, IL-8, TNF-α, IL-1β, IFN-γ, IL-17, and IL-6, renal dysfunction, hypertension, rejection, and allograft loss during the first two years post transplantation...
September 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28925597/lower-tacrolimus-exposure-and-time-in-therapeutic-range-increase-the-risk-of-de-novo-donor-specific-antibodies-in-the-first-year-of-kidney-transplantation
#7
Scott Davis, Jane Gralla, Patrick Klem, Suhong Tong, Gina Wedermyer, Brian Freed, Alexander Wiseman, James E Cooper
De novo donor-specific antibodies (dnDSA) have been associated with reduced graft survival. Tacrolimus (TAC)-based regimens are the most common immunosuppression used in in clinical practice today, yet an optimal therapeutic dose to prevent dnDSA has not been established. We evaluated mean TAC C0 and TAC time in therapeutic range for the risk of dnDSA in a cohort of 538 patients in the first year of kidney transplant. A mean TAC C0 < 8 ng/ml was associated with dnDSA by 6 months (OR 2.51, 95% CI 1.32-4.79, p=0...
September 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28924461/do-the-benefits-of-transplant-tourism-amongst-nigerian-patients-outweigh-the-risks-a-single-center-experience
#8
C O Amira, B T Bello
BACKGROUND: Transplant tourism (TT) is the term used to describe travel outside one's country of abode for the sole purpose of obtaining organ transplantation services. OBJECTIVE: This study describes the characteristics and outcomes of kidney transplant tourists who were followed up in our institution. METHODS: A retrospective study was conducted on patients who underwent kidney transplantation outside the country and were followed up in our institution from 2007 to 2015...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28923621/extended-spectrum-beta-lactamase-producing-enterobacteriaceae-related-urinary-tract-infection-in-kidney-transplant-recipients-risk-factors-treatment-and-long-term-outcome
#9
S Brakemeier, S I Taxeidi, B Zukunft, D Schmidt, J Gaedeke, M Dürr, S Hansen, K Budde
BACKGROUND: Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) has risen in kidney transplant (KT) patients, with no long-term data so far on graft function or survival. METHODS: KT patients with ESBL-E-positive urine culture were retrospectively analyzed regarding initial adequate antimicrobial therapy, recurrent infection, transplant function, and survival compared with an ESBL-E-negative KT control cohort. RESULTS: ESBL-E-positive KT patients (n = 93) were older (55...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28923620/late-conversion-to-belatacept-after-kidney-transplantation-outcome-and-prognostic-factors
#10
M Dürr, N Lachmann, B Zukunft, D Schmidt, K Budde, S Brakemeier
BACKGROUND: Conversion to belatacept at a later point after kidney transplantation (KT) as a rescue therapy has been shown to be beneficiary in an increasing number of patients, but prognostic factors for a favorable outcome have never been investigated. METHODS: The present study analyzed all KT patients after late conversion to belatacept in a single center regarding graft survival and changes in estimated glomerular filtration rate (eGFR), proteinuria, and mean fluorescence intensity (MFI) of donor-specific antibodies (DSA)...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28923618/impact-of-induction-therapy-on-delayed-graft-function-following-kidney-transplantation-in-mated-kidneys
#11
T Butler, N Hayde
BACKGROUND: Delayed graft function (DGF) is defined as the need for dialysis within 1 week of transplantation and occurs in 20%-50% of deceased-donor kidney transplant recipients. Although recovery from DGF often occurs within a few days, many cases may take weeks to months before the transplant function begins. The delay in function increases the complexity of recipient care, makes the diagnosis of acute rejection more difficult, prolongs length of stay, and increases hospital costs...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28923615/effective-and-safe-reduction-of-conventional-immunosuppressants-using-everolimus-in-maintenance-kidney-transplant-recipients
#12
K Nanmoku, A Kurosawa, T Kubo, T Shinzato, T Shimizu, T Kimura, T Yagisawa
BACKGROUND: Adverse events due to conventional immunosuppressive therapy decrease both graft and patient survival. We aimed to establish a new protocol using everolimus (EVR) to safely minimize conventional immunosuppressants in maintenance kidney transplant recipients. METHODS: A total of 86 consecutive kidney transplant recipients with no complications were maintained with triple-drug combination therapy (conventional group). In case of complications, the administration of very low-dose tacrolimus (C0: 5...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28923614/flow-cytometry-panel-reactive-antibody-screening-of-anti-hla-antibodies-in-the-waiting-list-significantly-reduces-the-occurrence-of-acute-rejection-after-kidney-transplantation
#13
I Dedinská, N Mäčková, K Macháleková, J Miklušica, B Palkoci, J Fialová, M Čellár, P Galajda, M Mokáň
INTRODUCTION: The presence of preformed HLA-reactive antibodies in recipient serum before transplantation has long been recognized as a prominent risk factor for a generally worse graft outcome. Screening and identification of HLA antibodies can be used to stratify patients into high- and low-risk categories. MATERIALS AND METHODS: We determined patients' anti-HLA antibodies using flow cytometry panel-reactive antibody (flowPRA) screening, specifying more than 5% after positive screening...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28921709/kidney-allograft-failure-in-the-steroid-free-immunosuppression-era-a-matched-case-control-study
#14
Mohamad M Alkadi, Jim Kim, Meredith J Aull, Joseph E Schwartz, John R Lee, Anthony Watkins, Jun B Lee, Darshana M Dadhania, Surya V Seshan, David Serur, Sandip Kapur, Manikkam Suthanthiran, Choli Hartono, Thangamani Muthukumar
We studied the causes and predictors of death-censored kidney allograft failure among 1670 kidney recipients transplanted at our center in the corticosteroid-free maintenance immunosuppression era. As of January 1, 2012, we identified 137 recipients with allograft failure; 130 of them (cases) were matched 1-1 for recipient age, calendar year of transplant and donor type with 130 recipients with functioning grafts (controls). Median time to allograft failure was 29 months (interquartile range 18-51). Physician validated and biopsy confirmed categories of allograft failure were: acute rejection (21%), glomerular disease (19%), transplant glomerulopathy (13%), interstitial fibrosis tubular atrophy (10%), and polyomavirus-associated nephropathy (7%)...
September 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28918589/isolated-pancreas-rejections-do-not-have-an-adverse-impact-on-kidney-graft-survival-whereas-kidney-rejections-are-associated-with-adverse-pancreas-graft-survival%C3%A2-in-simultaneous-pancreas-kidney-transplantation
#15
Irfan Moinuddin, Muhammad Sohail Yaqub, Tim Taber, John Powelson, Jonathan Fridell, Asif Sharfuddin
BACKGROUND AND OBJECTIVES: Diabetic Kidney Disease is associated with excessive mortality and morbidity. Simultaneous pancreas kidney transplantation (SPK) significantly improves quality of life and increases life expectancy of uremic diabetic patients. It is not known whether pancreas and kidney rejections in these transplant patients is concordant or discordant. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We analyzed clinical data on all SPK transplants performed between 2003 and 2014 at Indiana University to assess the impact of isolated or combined pancreas and kidney rejections on patient and allograft outcomes...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28913939/elderly-living-donor-kidney-transplantation-allows-worthwhile-outcomes-the-japan-academic-consortium-of-kidney-transplantation-study
#16
Masayoshi Okumi, Kohei Unagami, Yoichi Kakuta, Atsuhiko Ochi, Toshio Takagi, Hideki Ishida, Kazunari Tanabe
OBJECTIVE: To compare transplant outcomes among elderly (aged ≥60 years) and non-elderly recipients, and to evaluate the acceptability of elderly living donor kidney transplantation in practice after consideration of living donor type. METHODS: We included 830 adult patients with living donor kidney transplantation between 2000 and 2011 in this retrospective cohort study. We compared death-censored graft survival, patient survival, biopsy-proven rejection, complications, and renal function in elderly (n = 119) and non-elderly recipients (n = 278)...
September 14, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28911876/immunoglobulin-isotype-switching-of-antibodies-to-vimentin-is-associated-with-development-of-transplant-glomerulopathy-following-human-renal-transplantation
#17
Muthukumar Gunasekaran, Thin Thin Maw, Rowena Delos Santos, Surendra Shenoy, Jason Wellen, T Mohanakumar
BACKGROUND: Immune responses to tissue-restricted self-antigens are thought to play a role in chronic rejection after solid organ transplantation. De novo development of antibodies (Abs) to vimentin have been reported to be associated with interstitial fibrosis/tubular atrophy after kidney transplant, and it has been suggested that immunoglobulin isotype switching of Abs to vimentin may occur during this process. We aimed to determine the correlation between immunoglobulin isotype switching of Abs to vimentin and development of transplant glomerulopathy (TG) after kidney transplant, and to determine whether citrullinated modification of vimentin is required for de novo anti-vimentin development...
September 11, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28906028/graft-outcomes-following-diagnosis-of-posttransplant-lymphoproliferative-disease-in-pediatric-kidney-recipients-a-retrospective-study
#18
Nele K Kanzelmeyer, Britta Maecker-Kolhoff, Henriette Zierhut, Christian Lerch, Murielle Verboom, Dieter Haffner, Lars Pape
Data related to graft outcomes following posttransplant lymphoproliferative disease (PTLD) in pediatric kidney transplantation are scarce. Data were analyzed retrospectively from 12 children (8 boys) for three years after diagnosis of PTLD, with a loss of follow-up after 2 years in 2/12. In all cases, intensity of immunosuppressive therapy was reduced, with switch from calcineurin inhibitor to a mammalian target of rapamcyin (mTOR) inhibitor in 6 cases. Nine children were treated with 6 doses of rituximab according to the PED-PTLD-2005 protocol, with additional treatment in one child as per protocol...
September 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28904428/collapsing-glomerulopathy-a-troublemaker-for-the-renal-allograft-lessons-learnt
#19
K V Kanodia, A V Vanikar, L K Nigam, R D Patel, K S Suthar, H V Patel, H L Trivedi
Collapsing glomerulopathy (CG) is a well-recognized distinct morphological pattern of proliferative parenchymal injury leading to rapid graft failure. We conducted a single-center retrospective study to evaluate the prevalence, clinicopathological features, and prognosis of CG in renal transplant recepient. We analyzed 2518 renal allograft biopsies performed from 2007 to 2015 and correlated their clinicopathological features. The prevalence of CG was 0.83% (21 out of 2518) of allograft biopsies with a higher prevalence of 1...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28902773/reduced-tcr-signalling-contributes-to-impaired-th17-responses-in-tolerant-kidney-transplant-recipients
#20
Estefania Nova-Lamperti, Marco Romano, Sofia Christakoudi, Manohursingh Runglall, Reuben McGregor, Paula Mobillo, Yogesh Kamra, Tjir-Li Tsui, Sonia Norris, Susan John, Dominic A Boardman, Robert I Lechler, Giovanna Lombardi, Maria P Hernandez-Fuentes
BACKGROUND: The development of spontaneous kidney transplant tolerance has been associated with numerous B cell-related immune alterations. We have previously shown that tolerant recipients exhibit reduced B cell receptor (BCR) signalling and higher IL-10 production than healthy volunteers. However, it is unclear whether CD4T cells from tolerant recipients also display an antiinflammatory profile that could contribute to graft maintenance. METHODS: CD4T cells were isolated from kidney transplant recipients who were identified as being tolerant recipients, patients with chronic-rejection or healthy volunteers...
September 12, 2017: Transplantation
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