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rejection in kidney transplant

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https://www.readbyqxmd.com/read/28544604/thymic-peripheral-crosstalk-in-lymphodepletion-therapy
#1
EDITORIAL
M E Snyder, D L Farber
T cell depletion is widely used as induction therapy in solid organ transplants and particularly in kidney transplantation, to reduce the episodes of acute cellular rejection. The resultant reduction in T cell numbers is usually temporary, as T cells are actively replenished due to thymic output and/or lymphopenia-induced proliferation of remaining, depletion-resistant T cells. However, the extent of T cell replenishment and the persistence of lymphopenia varies between individuals, with potential impacts on protective or pathogenic immune responses...
May 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28543378/renal-transplantation-in-patients-with-pre-existing-hypogammaglobulinemia
#2
K P Lund, H Bruunsgaard, H V Marquart, S S Sørensen
Hypogammaglobulinemia is well-characterized as a common phenomenon after kidney transplantation. However, no reports of pre-existing hypogammaglobulinemia from kidney transplantation seem to be available. We have reviewed three patients who developed hypogammaglobulinemia prior to kidney transplantation, and all three were treated successfully with immunoglobulin-replacement therapy before and after kidney transplantation. The kidney grafts were functioning at follow-up 1.5 to 8 years (mean: 3.6 years) after transplantation, and there were no diagnosed episodes of clinical rejections and no severe infection complications post-transplantation...
May 22, 2017: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/28542109/application-and-interpretation-of-histocompatibility-data-in-pediatric-kidney-transplantation
#3
Hilda E Fernandez
PURPOSE OF REVIEW: Advances in technology to assess immunologic risk in solid organ transplant offer an opportunity to optimize the approach to pediatric deceased donor kidney transplant in the setting of a new allocation system in the United States. RECENT FINDINGS: Degree of human leukocyte antigen (HLA) mismatch, class II HLA mismatch, unacceptable antigens and donor-specific antibody (DSA) detected by solid-phase assays, and epitope matching pretransplant affect pediatric kidney transplant outcomes...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28540908/two-unusual-cases-of-microvascular-thrombosis-in-the-immediate-posttransplant-period
#4
Swarnalata Gowrishankar, Srinivasan Krishnan, M S Ravishankar, Swapna Nuguri
We present two unusual cases of microvascular thrombosis in the immediate posttransplant period resulting in graft loss. The first was a 20-year-old female with a cadaveric renal transplant with immediate graft dysfunction due to microthrombi of probable donor origin, with nonrecovery of renal function nine months' posttransplant. The second was a 23-year-old male with unrelated live kidney transplant with hyperacute rejection due to anti-endothelial antibodies.
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540902/primary-focal-segmental-glomerulosclerosis-recurring-rapidly-as-collapsing-glomerulopathy-in-a-renal-allograft-recipient
#5
Vinita Agrawal, Narayan Prasad, Pritpal Singh
Recurrent focal segmental glomerulosclerosis (FSGS) develops in about 30%-40% of patients of FSGS undergoing renal transplantation. We report a patient who received a live- related renal transplant for end-stage renal disease due to a primary FSGS (not otherwise specified) in the native kidney and presented with graft dysfunction in the immediate posttransplant period. The first and the second biopsy showed no evidence of rejection or glomerular lesion. A repeat biopsy done on the 30th day revealed recurrent FSGS morphologically presenting as collapsing variant...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540896/postrenal-transplant-malignancy-incidence-risk-factors-and-prognosis
#6
Nabil Abdelfadil Elserwy, Esam Elden Lotfy, Mohamad Ashraf Fouda, Medhat Ibrahim Mahmoud, Ahmed Farouk Donia, Mohamed Elsayed Mashaly, Mohamed Hamed Abbas, Mohamed Megahed Abuelmagd, Rasha Kamal Abouelenein, Mabrouk Ibrahim Ismail, Mohamed Adel Bakr
The newer and potent immunosuppressive agents have successfully reduced the risk of rejection after kidney transplantation, but the development of cardiovascular diseases, infections, and malignancy is major factors limiting their success. Posttransplantation malignancy is the second most common cause of death in renal transplant recipients after cardiovascular disease; it is expected that mortality due to malignancy may become the most common cause of death within the next two decades. This study is designed to evaluate the incidence, risk factors, and types of malignancies occurring after renal transplantation and their impact on patient and graft survival...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540885/outcome-of-recipients-of-human-leukocyte-antigen-incompatible-kidney-transplants-who-underwent-desensitization-at-king-fahad-specialist-hospital-dammam-saudi-arabia
#7
Mohammed Abdulrahim Idris, Akhtar Hossain, Mohammed Abdulrahman Muntasir, Adnan Marmi, Ahmed Abdulfattah Aldajani, Yousef Mohammed Aljamaan, Mahmood Akhtar, Abdulrahman Housawi
In patients whom are highly sensitized immunologically, the benefit of kidney transplantation can be extended to this population through the utilization of organs from human leukocyte antigen incompatible (HLAi) donors. This retrospective observational study was designed to identify the incidence and predictors of acute antibody-mediated rejection/acute cellular rejection (AMR/ACR) in our kidney recipients from living kidney donors (sensitized and those with low immunologic risk). This single-center study has been conducted at King Fahad Specialist Hospital, Dammam (KFSH-D), Saudi Arabia; during the period of September 2008- August 2013...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540837/enterovesical-fistula-after-enteric-conversion-of-a-bladder-drained-pancreatic-allograft-a-case-report
#8
Clifford Akateh, Amer Rajab, Mitchell Henry, Ashraf El-Hinnawi
Since the inception of pancreas transplant as a treatment for type 1 diabetes mellitus, there has been considerable debate about the best way to manage exocrine secretions and monitor patients for graft rejection. For patients who undergo bladder exocrine drainage of a pancreatic allograft, a bladder-to-enteric drainage conversion can serve as a rescue procedure in case of anastomotic leaks or other complications. However, this procedure is associated with its own complications, including a rarely described enterovesical fistula...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28540602/late-conversion-from-tacrolimus-to-a-belatacept-based-immuno-suppression-regime-in-kidney-transplant-recipients-improves-renal-function-acid-base-derangement-and-mineral-bone-metabolism
#9
Kevin Schulte, Clara Vollmer, Vera Klasen, Jan Hinrich Bräsen, Jodok Püchel, Christoph Borzikowsky, Ulrich Kunzendorf, Thorsten Feldkamp
BACKGROUND: Calcineurin inhibitor (CNI)-induced nephrotoxicity and chronic graft dysfunction with deteriorating glomerular filtration rate (GFR) are common problems of kidney transplant recipients. The aim of this study was to analyze the role of belatacept as a rescue therapy in these patients. METHODS: In this retrospective, observational study we investigated 20 patients (10 females, 10 males) who were switched from a CNI (tacrolimus) to a belatacept-based immunosuppression because of CNI intolerance or marginal transplant function...
May 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28538652/association-between-delayed-graft-function-and-graft-loss-in-donation-after-cardiac-death-kidney-transplants-a-paired-kidney-registry-analysis
#10
Wai H Lim, Stephen P McDonald, Graeme R Russ, Jeremy R Chapman, Maggie Km Ma, Henry Pleass, Bryon Jaques, Germaine Wong
BACKGROUND: Delayed graft function (DGF) is an established complication after donation after cardiac death (DCD) kidney transplants, but the impact of DGF on graft outcomes is uncertain. To minimize donor variability and bias, a paired donor kidney analysis was undertaken where 1 kidney developed DGF and the other did not develop DGF using data from the Australia and New Zealand Dialysis and Transplant Registry. METHODS: Using paired DCD kidney data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between DGF, graft and patient outcomes between 1994 and 2012 using adjusted Cox regression models...
June 2017: Transplantation
https://www.readbyqxmd.com/read/28536887/ficolin-2-gene-rs7851696-polymorphism-is-associated-with-delayed-graft-function-and-acute-rejection-in-kidney-allograft-recipients
#11
Ewa Dabrowska-Zamojcin, Michal Czerewaty, Damian Malinowski, Maciej Tarnowski, Sylwia Słuczanowska-Głabowska, Leszek Domanski, Krzysztof Safranow, Andrzej Pawlik
Ficolin-2 is an activator of the complement system that acts via the lectin pathway. Complement activation plays a substantial role in the renal injury inherent to kidney transplantation. In this study, we examined the associations between ficolin-2 gene polymorphisms in exon 8 and kidney allograft function. This study comprised 270 Caucasian deceased-donor renal transplant recipients. The following parameters were recorded in each case: delayed graft function (DGF), acute rejection (AR), and chronic allograft dysfunction...
May 23, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/28535529/looking-into-the-graft-without-a-biopsy-biomarkers-of-acute-rejection-in-renal-transplantation
#12
Andrea Angeletti, Paolo Cravedi
Immunosuppression in kidney transplantation is still largely driven by center-specific protocols and adjusted according to the presence of graft dysfunction, drug toxicity or infection. Due to the current inability to titrate immunosuppression to the needs of every single patient, this approach is burdened by an increased risk of under or over-immunosuppression. To extend allograft survival, immunosuppression should be decided based on reliable biomarkers capable of quantifying the alloimmune response and/or noninvasively diagnosing acute rejection...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535527/treatment-of-acute-antibody-mediated-rejection
#13
Giorgia Comai, Matteo Ravaioli, Olga Baraldi, Vania Cuna, Lorenzo Gasperoni, Giovanni Liviano D''Arcangelo, Maria Cappuccilli, Antonio D Pinna, Claudio Ronco, Gaetano La Manna
Acute antibody-mediated rejection (AMR) remains an important challenge in the field of kidney transplantation despite the advances in immunosuppressive strategies, and has been recognized as an important cause of allograft dysfunction and graft loss. The treatments of acute AMR are not standardized and poor evidence is currently available on the effectiveness of therapy regimens with combinations of drugs. Standard treatment for acute AMR is based on 3 cornerstones: removal of donor-specific antibodies (DSAs) from the bloodstream, reduction of DSAs synthesis, and inhibition of the interaction between DSAs and human leukocyte antigen antigens on donor's cells...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28533501/post-transplant-diabetes-mellitus-after-kidney-transplant-in-hispanics-and-caucasians-treated-with-tacrolimus-based-immunosuppression
#14
Pedro W Baron, Sergio Infante, Regina Peters, Jerusalem Tilahun, Jill Weissman, Lauren Delgado, Arputharaj Higgins Kore, W Lawrence Beeson, Michael E de Vera
BACKGROUND Development of post-transplant diabetes mellitus after kidney transplant (PTDM) significantly increases kidney graft loss and mortality. Several risk factors for PTDM have been reported, including Hispanic ethnicity and the use of calcineurin inhibitors and corticosteroids. The incidence and impact of PTDM in the Hispanic kidney transplant population is unknown. MATERIAL AND METHODS We retrospectively reviewed the medical records of 155 Hispanic and 124 Caucasian patients, who were not diabetics and underwent kidney transplant between January 2006 and December 2011...
May 23, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28524801/association-of-ugt2b7-ugt1a9-abcg2-and-il23r-polymorphisms-with-rejection-risk-in-kidney-transplant-patients
#15
Heloísa Lizotti Cilião, Rossana Batista Oliveira Camargo-Godoy, Marilesia Ferreira de Souza, Mariana Bisarro Dos Reis, Lorena Iastrenski, Vinicius Daher Alvares Delfino, Silvia Regina Rogatto, Ilce Mara de Syllos Cólus
Despite advances in testing compatibility between donor and recipient, graft rejection remains a current concern. Single-nucleotide polymorphisms (SNPs) that codify altered enzymes of metabolism, drug transport, and the immune system may contribute to graft rejection in transplant patients. This study examined the association between SNPs present in genes of these processes and occurrence of graft rejection episodes in 246 kidney transplant patients, 35% of which were diagnosed with rejection. Genotype-gene expression associations were also assessed...
May 19, 2017: Journal of Toxicology and Environmental Health. Part A
https://www.readbyqxmd.com/read/28518214/immune-monitoring-as-prerequisite-for-transplantation-tolerance-trials
#16
REVIEW
Katayoun Behnam Sani, Birgit Sawitzki
Ever since its first application in clinical medicine, scientists have urged to induce tolerance towards foreign allogeneic transplants and thus avoid rejection by the recipient's immune system. This would circumvent chronic use of immunosuppressive drugs (IS) and thus avoid development of IS-induced side effects, which are contributing to the still unsatisfactory long-term graft and patient survival after solid organ transplantation. Although manifold strategies of tolerance induction have been described in preclinical models, only three therapeutic approaches have been successfully utilized in a still small number of patients...
May 18, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28511172/donor-specific-anti-human-leukocyte-antigens-antibodies-acute-rejection-renal-function-and-histology-in-kidney-transplant-recipients-receiving-tacrolimus-and-everolimus
#17
Alexandra Ferreira, Claudia Felipe, Marina Cristelli, Laila Viana, Geovana Basso, Suelen Stopa, Juliana Mansur, Mayara Ivani, Adrieli Bessa, Priscila Ruppel, Wilson Aguiar, Erika Campos, Maria Gerbase-DeLima, Henrique Proença, Helio Tedesco-Silva, José Medina-Pestana
BACKGROUND: This analysis compared efficacy, renal function, and histology in kidney transplant recipients receiving tacrolimus (TAC) combined with everolimus (EVR) or mycophenolate (MPS). METHODS: This was a retrospective analysis from a randomized trial in kidney transplant recipients who received a single 3 mg/kg dose of rabbit antithymocyte globulin (r-ATG), TAC, EVR, and prednisone (PRED; r-ATG/EVR, n = 85), basiliximab (BAS), TAC, EVR, and PRED (BAS/EVR, n = 102) or BAS, TAC, MPS, and PRED (BAS/MPS, n = 101)...
May 17, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28510740/propofol-based-anaesthesia-versus-sevoflurane-based-anaesthesia-for-living-donor-kidney-transplantation-results-of-the-vapor-1-randomized-controlled-trial
#18
G J Nieuwenhuijs-Moeke, V B Nieuwenhuijs, M A J Seelen, S P Berger, M C van den Heuvel, J G M Burgerhof, P J Ottens, R J Ploeg, H G D Leuvenink, M M R F Struys
Background: Kidney transplantation is associated with harmful processes affecting the viability of the graft. One of these processes is associated with the phenomenon of ischaemia-reperfusion injury. Anaesthetic conditioning is a widely described strategy to attenuate ischaemia-reperfusion injury. We therefore conducted the Volatile Anaesthetic Protection of Renal Transplants-1 trial, a pilot project evaluating the influence of two anaesthetic regimens, propofol- vs sevoflurane-based anaesthesia, on biochemical and clinical outcomes in living donor kidney transplantation...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28510327/pre-existing-diabetes-is-a-risk-factor-for-increased-rates-of-cellular-rejection-after-kidney-transplantation-an-observational-cohort-study
#19
S Johal, F Jackson-Spence, H Gillott, S Tahir, J Mytton, F Evison, B Stephenson, J Nath, A Sharif
AIM: To investigate whether people with diabetes have an elevated risk of kidney allograft rejection in a well characterized clinical cohort in the setting of contemporary immunosuppression. METHODS: We conducted a retrospective cohort study including all kidney allograft recipients at a single centre between 2007 and 2015, linking clinical, biochemical and histopathological data from electronic patient records. RESULTS: Data were analysed for 1140 kidney transplant recipients...
May 16, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#20
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction of immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a five year period following the initiation of a serum BKV screening protocol...
May 16, 2017: Clinical Transplantation
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