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Renal Transplantation

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176 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28535527/treatment-of-acute-antibody-mediated-rejection
#1
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/28535528/chronic-allograft-injury-an-overview-of-pathogenesis-and-treatment-strategies
#2
Hector M Madariaga, Leonardo V Riella
Chronic allograft injury (CAI) remains one of the biggest challenges in transplantation as it directly affects the long-term allograft survival, an area in which the scientific and transplantation communities have struggled to improve outcomes. Therefore, understanding the mechanisms of CAI is paramount to implement preventive measures and novel therapeutic options. In this review, we will address the latest evidence on CAI, potential etiologies and risk factors including non-adherence, antibody-mediated rejection, recurrence of glomerular disease, BK nephropathy, and calcineurin nephrotoxicity...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535529/looking-into-the-graft-without-a-biopsy-biomarkers-of-acute-rejection-in-renal-transplantation
#3
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/28515172/cross-sex-transplantation-alters-gene-expression-and-enhances-inflammatory-response-in-the-transplanted-kidneys
#4
Lei Wang, Jiangping Song, Shaohui Wang, Jacentha Buggs, Rongjun Chen, Jie Zhang, Liqing Wang, Song Rong, Wenbin Li, Jin Wei, Ruisheng Liu
Kidney transplantation (KTX) is a life-saving procedure for patients with end-stage renal disease. Expression levels of many genes in kidney vary between males and females which may play an essential role in the sex differences in graft function. However, whether these differences are affected after cross-sex-KTX is unknown. In the present study, we assessed post-operative changes in genotype, function and inflammatory responses of the grafts in same-sex and cross-sex-KTX. Single kidney transplants were performed between same and different sex C57BL/6 mice paired into 4 combination groups: female donor/female recipient (F/F); male donor/male recipient (M/M); female donor/male recipient (F/M); and male donor/female recipient (M/F)...
May 17, 2017: American Journal of Physiology. Renal Physiology
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
#5
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/28503746/application-of-ultrasound-elastography-for-chronic-allograft-dysfunction-in-kidney-transplantation
#6
REVIEW
Zijie Wang, Haiwei Yang, Chuanjian Suo, Jifu Wei, Ruoyun Tan, Min Gu
Interstitial fibrosis is the main characteristic of chronic allograft dysfunction, which remains the key factor affecting long-term allograft survival after kidney transplantation. Ultrasound elastography (UE), including real-time elastography, transient elastography, and acoustic radiation force impulse, has been applied widely in breast, thyroid, and liver diseases, especially in the assessment of liver fibrosis. Recently, numerous studies have reported the efficacy of UE methods in evaluating renal allograft fibrosis...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28504869/kidney-outcomes-in-patients-with-liver-cirrhosis-and-chronic-kidney-disease-receiving-an-orthotopic-liver-transplant-alone
#7
Neeraj Singh, Shahab Ahmadzadeh, Hosein Shokouh-Amiri, Yasir Qazi, Adrian Sequeira, Hrishikesh Samant, Robert McMillan, Gazi B Zibari
Kidney transplant in patients with liver cirrhosis and non-dialysis chronic kidney disease (CKD) is controversial. We report 14 liver cirrhotic patients who had persistently low MDRD-6 estimated-glomerular filtration rate (e-GFR) < 40 ml/min/1.73m2 for ≥ 3 months and underwent either liver transplant alone (LTA) (n=9) or simultaneous liver-kidney transplant (SLKT) (n=5). Pre-transplant, patients with LTA compared with SLKT had lower serum creatinine (2.5±0.73 vs. 4.6±0.52 mg/dl, P= 0.001), higher MDRD-6 e-GFR (21...
May 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28452165/cutaneous-toxicities-from-transplant-related-medications
#8
M Ilyas, O R Colegio, B Kaplan, A Sharma
Despite the abundance of information on cutaneous malignancies associated with solid organ transplantation in the transplant literature, there is limited information regarding non-malignant skin changes after transplantation. There are numerous skin toxicities secondary to immunosuppressive and other transplant-related medications that can vary in presentation, severity, and prognosis. In order to limit associated morbidity and mortality, SOTR care providers should effectively identify and manage cutaneous manifestations secondary to drug toxicity...
April 27, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28446536/donor-specific-antibodies-in-kidney-transplant-recipients
#9
REVIEW
Rubin Zhang
Donor-specific antibodies have become an established biomarker predicting antibody-mediated rejection. Antibody-mediated rejection is the leading cause of graft loss after kidney transplant. There are several phenotypes of antibody-mediated rejection along post-transplant course that are determined by the timing and extent of humoral response and the various characteristics of donor-specific antibodies, such as antigen classes, specificity, antibody strength, IgG subclasses, and complement binding capacity...
April 26, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28445619/mtor-inhibitors-and-risk-for-chronic-antibody-mediated-rejection-after-kidney-transplantation-where-are-we-now
#10
REVIEW
Philippe Grimbert, Olivier Thaunat
Antibody-mediated rejection (AMR) usually starts with generation of donor-specific anti-HLA antibodies (DSA), arising from a B-cell response to antigen recognition. In vitro and preclinical data demonstrate that mammalian target of rapamycin (mTOR) inhibition attenuates the mTOR-mediated intracellular signaling pathway involved in AMR-related kidney damage. The limited available data from immunological studies in kidney transplant patients, however, have not shown such effects in vivo. In terms of clinical immunosuppression, the overriding influence on rates of de novo DSA (dnDSA) or AMR - regardless of the type of regimen - is patient adherence...
April 26, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28437390/hepatitis-c-positive-kidney-transplant-recipients-when-is-the-best-time-to-treat-with-direct-acting-antiviral-agents
#11
Neeraj Singh, David Dies, Hrishikesh Samant
No abstract text is available yet for this article.
May 2017: Transplantation
https://www.readbyqxmd.com/read/28380212/upregulation-of-microrna-142-3p-in-the-peripheral-blood-and-urinary-cells-of-kidney-transplant-recipients-with-post-transplant-graft-dysfunction
#12
T D Domenico, G Joelsons, R M Montenegro, R C Manfro
We analyzed microRNA (miR)-142-3p expression in leucocytes of the peripheral blood and urinary sediment cell samples obtained from kidney transplant recipients who developed graft dysfunction. Forty-one kidney transplant recipients with kidney graft dysfunction and 8 stable patients were included in the study. The groups were divided according to histological analysis into acute rejection group (n=23), acute tubular necrosis group (n=18) and stable patients group used as a control for gene expression (n=8)...
April 3, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28366228/albuminuria-and-posttransplant-chronic-kidney-disease-stage-predict-transplant-outcomes
#13
Ngan N Lam, Marcello Tonelli, Krista L Lentine, Brenda Hemmelgarn, Feng Ye, Kevin Wen, Scott Klarenbach
In 2012, the KDIGO guidelines updated the classification system for chronic kidney disease to include albuminuria. Whether this classification system predicts adverse clinical outcomes among kidney transplant recipients is unclear. To evaluate this, we conducted a retrospective study using linked databases in Alberta, Canada to follow kidney transplant recipients from 2002-2011. We examined the association between an estimated glomerular filtration rate (eGFR of 60 or more, 45-59, 30-44, 15-29 mL/min/1.73 m(2)) and albuminuria (normal, mild, heavy) at one year post-transplant and subsequent mortality and graft loss...
March 30, 2017: Kidney International
https://www.readbyqxmd.com/read/28366944/transplantation-a-new-biomarker-for-transplant-rejection
#14
Shimona Starling
No abstract text is available yet for this article.
May 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28371433/urinary-markers-of-fibrosis-and-risk-of-cardiovascular-events-and-death-in-kidney-transplant-recipients-the-favorit-trial
#15
M Park, R Katz, M G Shlipak, D Weiner, R Tracy, V Jotwani, J Hughes-Austin, F Gabbai, C Y Hsu, M Pfeffer, N Bansal, A Bostom, O Gutierrez, M Sarnak, A Levey, J H Ix
Cardiovascular risk remains high in kidney transplant recipients (KTRs) despite improved kidney function after transplant. Urinary markers of kidney fibrosis and injury may help to reveal mechanisms of this risk. In a case-cohort study among stable KTRs who participated in the FAVORIT trial, we measured four urinary proteins known to correlate with kidney tubulointerstitial fibrosis on biopsy (urine alpha 1 microglobulin [α1m], monocyte chemoattractant protein-1 [MCP-1], procollagen type I [PINP] and type III [PIIINP] N-terminal amino peptide) and evaluated associations with cardiovascular disease (CVD) events (n = 300) and death (n = 371)...
March 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28360198/donor-recipient-weight-and-sex-mismatch-and-the-risk-of-graft-loss-in-renal-transplantation
#16
Amanda J Miller, Bryce A Kiberd, Ian P Alwayn, Ayo Odutayo, Karthik K Tennankore
BACKGROUND AND OBJECTIVES: Relatively smaller kidney donor to recipient size is proposed to result in higher graft loss due to nephron underdosing and hyperfiltration injury, but the potentially additive effect of sex and weight mismatch has not been explored in detail. The purpose of this study was to determine if concurrent donor and recipient absolute weight and sex mismatch was associated with graft loss in a cohort of deceased donor kidney transplant recipients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The association of kidney donor and recipient absolute weight and sex difference with death-censored graft loss was explored using a cohort of United States deceased donor recipients between 2000 and 2014 through the Scientific Registry of Transplants Recipients...
April 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28359537/macrophage-density-in-early-surveillance-biopsies-predicts-future-renal-transplant-function
#17
Jan Hinrich Bräsen, Abedalrazag Khalifa, Jessica Schmitz, Wei Dai, Gunilla Einecke, Anke Schwarz, Michael Hallensleben, Bernhard M W Schmidt, Hans H Kreipe, Hermann Haller, Sibylle von Vietinghoff
Inflammation impairs renal allograft survival but is difficult to quantify by eye at low densities. Here we measured leukocyte abundance in early surveillance biopsies by digital image analysis to test for a role of chemokine receptor genotypes and analyze the predictive value of leukocyte subsets to allograft function. In six-week surveillance biopsies, T-cell (CD3), B-cell (CD20), macrophage (CD68), and dendritic cell (CD209) densities were assessed in whole slide scans. Renal cortical CD3, CD20, and CD68 were significantly higher in histologic rejection...
March 27, 2017: Kidney International
https://www.readbyqxmd.com/read/28353491/nonprogrammed-vascular-access-is-associated-with-greater-mortality-in-patients-who-return-to-hemodialysis-with-a-failing-renal-graft
#18
Gustavo Laham, Gervasio Soler Pujol, Antonio Vilches, Ana Cusumano, Carlos Diaz
BACKGROUND: In incident hemodialysis (HD) patients the use of catheters is associated with a worse prognosis when compared to those with an arteriovenous fistula (AVF), but the role of vascular access (VA) type in the morbidity and mortality of patients returning to HD with a failing renal allograft is unknown. We aimed to determine the associations between the type of vascular access and mortality in this population. METHODS: This was a retrospective observational cohort study of 138 patients who initiated dialysis after kidney transplant failure between 1995 and 2014...
March 28, 2017: Transplantation
https://www.readbyqxmd.com/read/28346297/exposure-to-mycophenolate-and-fatherhood
#19
Karsten Midtvedt, Stein Bergan, Anna Varberg Reisæter, Bjørn Egil Vikse, Anders Åsberg
BACKGROUND: Mycophenolic acid (MPA) is the active immunosuppressive substance in both mycophenolate mofetil and mycophenolate sodium and it is widely used after organ transplantation. In females taking MPA is teratogenic and may also influence spermatogenesis. There is a lack of knowledge regarding outcome of pregnancies fathered by males exposed to MPA. METHODS: We compared outcomes in pregnancies fathered by renal transplant males per whether they had been exposed to MPA or not at time of conception...
March 22, 2017: Transplantation
https://www.readbyqxmd.com/read/28320531/global-trends-and-challenges-in-deceased-donor-kidney-allocation
#20
REVIEW
Diana A Wu, Christopher J Watson, J Andrew Bradley, Rachel J Johnson, John L Forsythe, Gabriel C Oniscu
Worldwide, the number of patients able to benefit from kidney transplantation is greatly restricted by the severe shortage of deceased donor organs. Allocation of this scarce resource is increasingly challenging and complex. Striking an acceptable balance between efficient use of (utility) and fair access to (equity) the limited supply of donated kidneys raises controversial but important debates at ethical, medical, and social levels. There is no international consensus on the recipient and donor factors that should be considered in the kidney allocation process...
June 2017: Kidney International
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