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Fiorella Calabrese, Sandrine Hirschi, Desley Neil, Angeles Montero-Fernandez, Wim Timens, Erik Verbeken, Marie-Pierre Chenard, Marina Ivanovic, Jerome Le Pavec, Tahuanty Pena, Peter Dorfmüller, Antoine Roux, Alexandra Rice, Egle Perissinotto, Francesca Lunardi, Deborah J Levine, Emanuele Cozzi, Martin Goddard
BACKGROUND: Antibody mediated rejection (AMR) plays an important role in allograft dysfunction. Acute lung injury (ALI), endotheliitis, capillary inflammation and C4d positivity have been described as morphological features conventionally associated with lung AMR. A multidisciplinary, international task force reviewed AMR cases in the context of four face-to-face meetings. Septal widening was a frequent, striking histological feature recognized firstly and easily at low-power magnification...
March 1, 2019: Transplantation
Abdullah K Malik, Steven Masson, Elisa Allen, Murat Akyol, Andrew Bathgate, Mervyn Davies, Ernest Hidalgo, Mark Hudson, James Powell, Rhiannon Taylor, Agne Zarankaite, Derek M Manas
BACKGROUND: In the UK, Liver Transplantation (LT) is undertaken in 7 supra-regional centres. Until March 2018, liver grafts were offered to a centre and allocated to a patient on their elective waiting list (WL) based on unit prioritization. Patients in Newcastle, Leeds and Edinburgh with a UKELD score ≥62 were registered on a common WL and prioritised for deceased donor liver allocation. This was known as the Northern Liver Alliance (NLA) 'top-band scheme'. Organs were shared between the 3 centres, with a 'payback' scheme ensuring no patient in any centre was disadvantaged...
March 1, 2019: Transplantation
Nancy A Wilson, Natalie M Bath, Bret M Verhoven, Xiang Ding, Brittney A Boldt, Adarsh Sukhwal, Weixiong Zhong, Sarah E Panzer, Robert R Redfield
BACKGROUND: Highly sensitized candidates on the transplant waitlist remain a significant challenge as current desensitization protocols have variable success rates of donor specific antibody (DSA) reduction. Therefore, improved therapies are needed. APRIL (proliferation-inducing ligand) and BLyS (B-lymphocyte stimulator) are critical survival factors for B-lymphocytes and plasma cells, which are the primary sources of alloantibody production. We examined the effect of APRIL/BLyS blockade on DSA in a murine kidney transplant model as a possible novel desensitization strategy...
March 1, 2019: Transplantation
Jason M Zimmerer, Bryce A Ringwald, Steven M Elzein, Christina L Avila, Robert T Warren, Mahmoud Abdel-Rasoul, Ginny L Bumgardner
BACKGROUND: We previously reported the novel activity of alloprimed CD8 T cells that suppress post transplant alloantibody production. The purpose of the current study is to investigate the expression and role of CXCR5 on antibody-suppressor CD8 T cell function. METHODS: C57BL/6 mice were transplanted with FVB/N hepatocytes. Alloprimed CD8 T cells were retrieved on day 7 from hepatocyte transplant recipients. Unsorted or flow-sorted (CXCR5CXCR3 and CXCR3CXCR5) alloprimed CD8 T cell subsets were analyzed for in vitro cytotoxicity and capacity to inhibit in vivo alloantibody production following adoptive transfer into C57BL/6 or high alloantibody-producing CD8 KO hepatocyte transplant recipients...
March 1, 2019: Transplantation
Lianne Barnieh, Scott Klarenbach, Jennifer Arnold, Meaghan Cuerden, Greg Knoll, Charmaine Lok, Jessica M Sontrop, Matthew Miller, G V Ramesh Prasad, Sebastian Przech, Amit X Garg
BACKGROUND: Living donors may incur out-of-pocket costs during the donation process. While many jurisdictions have programs to reimburse living kidney donors for expenses, few programs have been evaluated. METHODS: The Program for Reimbursing Expenses of Living Organ Donors (PRELOD) was launched in the province of Ontario, Canada in 2008 and reimburses travel, parking, accommodation, meals, and loss of income; each category has a limit and the maximum total reimbursement is $5,500 CAD...
March 1, 2019: Transplantation
Jordan M Chiasson, Cory E Fominaya, Mulugeta Gebregziabher, David J Taber
BACKGROUND: NSAID use is recommended to be avoided in kidney transplantation (KTX), with a paucity of studies assessing their safety within this population. This study aims to use a large cohort of Veterans Affairs (VA) KTX recipients to assess the risk of acute kidney injury (AKI) with NSAID use. METHODS: This is a ten-year longitudinal cohort study of adult kidney transplant recipients retrospectively followed in the VA system from 2001-10 that assessed for risk of AKI with NSAID prescriptions...
March 1, 2019: Transplantation
Sulemon Chaudhry, Jean Emond, Adam Griesemer
The human liver is an organ with a diverse array of immunologic functions. Its unique anatomic position that leads to it receiving all the mesenteric venous blood, combined with its unique micro anatomy, allows it to serve as a sentinel for the body's immune system. Hepatocytes, biliary epithelial cells, Kupffer cells, stellate cells, and liver sinusoidal endothelial cells express key molecules that recruit and activate innate and adaptive immunity. Additionally, a diverse array of lymphoid and myeloid immune cells resides within and traffics to the liver in specific circumstances...
February 25, 2019: Transplantation
Sebastian Dolff, Benjamin Wilde, Bastian Tebbe
No abstract text is available yet for this article.
February 25, 2019: Transplantation
Erik Berglund, Mette Andersen Ljungdahl, Darko Bogdanović, David Berglund, Jonas Wadström, Jan Kowalski, Gerald Brandacher, Dorota Kamińska, Christina L Kaufman, Simon G Talbot, Kodi Azari, Luis Landin, Christoph Höhnke, Karen M Dwyer, Pedro C Cavadas, Alessandro Thione, Brendan Clarke, Simon Kay, Dan Wilks, Subramania Iyer, Martin Iglesias, Ömer Özkan, Özlenen Özkan, Johanna Krapf, Annemarie Weissenbacher, Palmina Petruzzo, Stefan Schneeberger
BACKGROUND: Donor-specific antibodies (DSA) have a strong negative correlation with long-term survival in solid organ transplantation. Although the clinical significance of DSA and antibody-mediated rejection (AMR) in upper extremity transplantation (UET) remains to be established, a growing number of single-center reports indicate their presence and potential clinical impact. METHODS: We present a multicenter study assessing the occurrence and significance of alloantibodies in UET in reference to immunological parameters and functional outcome...
February 22, 2019: Transplantation
William S Oetting, Baolin Wu, David P Schladt, Weihua Guan, Jessica van Setten, Brendan J Keating, David Iklé, Rory P Remmel, Casey R Dorr, Roslyn B Mannon, Arthur J Matas, Ajay K Israni, Pamala A Jacobson
BACKGROUND: The immunosuppressants tacrolimus and mycophenolate are important components to the success of organ transplantation, but are also associated with adverse effects such as nephrotoxicity, anemia, leukopenia and new onset diabetes after transplant (NODAT). In this report, we attempted to identify genetic variants which are associated with these adverse outcomes. METHODS: We performed a genome-wide association study (GWAS), using a genotyping array tailored specifically for transplantation outcomes containing 722,147 SNPs, and two cohorts of kidney allograft recipients, a discovery cohort and a confirmation cohort, to identify and then confirm genetic variants associated with immunosuppressant pharmacokinetics and adverse outcomes...
February 19, 2019: Transplantation
Ling Gao, Mark Hicks, Jeanette E Villanueva, Aoife Doyle, Hong C Chew, Min Ru Qui, Andrew Jabbour, Kumud K Dhital, Peter S Macdonald
BACKGROUND: Storage of donor hearts in cardioplegic solutions supplemented with conditioning agents activating endogenous mitochondrial protective signaling enhanced their post-reperfusion recovery. The present study investigates the role of timing and duration of cardiac exposure to cyclosporine A, another putative mitochondrial protectant, on cardiac functional recovery and potential mechanisms of CsA action in an isolated working rat heart model of donor heart retrieval and storage...
February 19, 2019: Transplantation
Christian Heim, Mohammad Afzal Khan, Benjamin von Silva-Tarouca, Annika Kuckhahn, Thomas Stamminger, Martina Ramsperger-Gleixner, Mark R Nicolls, Michael Weyand, Stephan M Ensminger
BACKGROUND: Survival after lung transplantation is mainly limited by the development of chronic lung allograft dysfunction (CLAD). The aim of this study was to investigate if platelet inhibition by clopidogrel has a functionally relevant influence on the microvascular integrity of orthotopic tracheal allografts as an anatomic basis for the development of CLAD. METHODS: We orthotopically transplanted C57Bl/6 (H-2) tracheas into CBA.J (H-2) recipients which afterwards received clopidogrel (1mg/kg)...
February 19, 2019: Transplantation
Ek Khoon Tan, Andrew J Bentall, Patrick G Dean, Mohammed F Shaheen, Mark D Stegall, Carrie A Schinstock
BACKGROUND: Active antibody-mediated rejection (AMR) that occurs during the amnestic response within the first month post-transplant is a rare but devastating cause of early allograft loss after kidney transplant. Prior reports of eculizumab treatment for AMR have been in heterogeneous patient groups needing salvage therapy or presenting at varied time points. We investigated the role of Eculizumab as primary therapy for active AMR early post-transplant. METHODS: We performed a retrospective observational study of a consecutive cohort of solitary kidney transplant recipients who were transplanted between January 1, 2014 and January 31, 2018 and had AMR within the first 30 days post-transplant and treated with eculizumab ± plasmapheresis...
February 19, 2019: Transplantation
Helio Tedesco-Silva, Julio Pascual, Ondrej Viklicky, Nikolina Basic-Jukic, Elisabeth Cassuto, Dean Y Kim, Josep M Cruzado, Claudia Sommerer, Mohamed Adel Bakr, Valter D Garcia, Huynh-Do Uyen, Graeme Russ, Myoung Soo Kim, Dirk Kuypers, Matthias Buchler, Franco Citterio, Maria Pilar Hernandez Gutierrez, Peter Bernhardt, Steve Chadban
BACKGROUND: The safety profiles of standard therapy versus everolimus with reduced-exposure calcineurin inhibitor (CNI) therapy using contemporary protocols in de novo kidney transplant recipients have not been compared in detail. METHODS: TRANSFORM was a randomized, international trial in which de novo kidney transplant patients were randomized to everolimus with reduced-exposure CNI (N=1014) or mycophenolic acid (MPA) with standard-exposure CNI (N=1012), both with induction and corticosteroids...
February 19, 2019: Transplantation
Janet Delgado, Alberto Molina-Pérez, David Shaw, David Rodríguez-Arias
Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person's donation wishes...
February 19, 2019: Transplantation
Aaltje A Rijkse, Hendrikus J A N Kimenai, Joke I Roodnat, Sander Ten Raa, Diederik C Bijdevaate, Jacob L van Dam, Kelly Muller, Jan N M IJzermans, Marcus A van der Zijden, Robert C Minnee
BACKGROUND: Patients with end-stage renal disease (ESRD) and aorto-iliac stenosis are often considered ineligible for kidney transplantation, even though kidney transplantation has been acknowledged as the best therapy for ESRD. The clinical outcomes of kidney transplantation in patients with aorto-iliac stenosis are not well-studied. This study aimed to assess the impact of aorto-iliac stenosis on graft and patient survival. METHODS: This retrospective, single-center study included kidney transplant recipients transplanted between January 1, 2000 and December 31, 2016 who received contrast-enhanced imaging...
February 19, 2019: Transplantation
Mary G Bowring, Sheng Zhou, Eric K H Chow, Allan B Massie, Dorry L Segev, Sommer E Gentry
BACKGROUND: The OPTN implemented Share35 on 6/18/2013 to broaden deceased-donor liver sharing within regional boundaries. We investigated whether increased sharing under Share35 impacted geographic disparity in deceased-donor liver transplantation (DDLT) across Donation Service Areas (DSAs). METHODS: Using SRTR 6/2009-6/2017, we identified 86,083 adult LT candidates and retrospectively estimated MELD-adjusted DDLT rates using nested multilevel Poisson regression with random intercepts for DSA and transplant program...
February 19, 2019: Transplantation
Mary M Flynn, Anjali N Parekh, Mehul R Parikh, Akhil Sood, Katherine M Shaffer, Thomas M Runge, Anna M Lipowska, Sebastian D Perez, Sonali S Sakaria, Ram M Subramanian
BACKGROUND: Intravenous contrast enhanced imaging is invaluable in diagnosing pathology following liver transplantation. Given the potential risk of contrast nephropathy associated with iodinated CT contrast, alternate contrast modalities need to be examined, especially in the setting of renal insufficiency. The purpose of this study was to examine the renal safety of MRI with gadolinium following liver transplantation. METHODS: The study involved a retrospective analysis of 549 cases of abdominal MRI with low dose gadobenate dimeglumine in liver transplant recipients at a single center...
February 19, 2019: Transplantation
Xian C Li
No abstract text is available yet for this article.
February 19, 2019: Transplantation
Zahraa Mohammed Ali, Tomas Tokar, Ihor Batruch, Shelby Reid, Alexandre Tavares-Brum, Paul Yip, Héloïse Cardinal, Marie Josée Hébert, Yanhong Li, S Joseph Kim, Igor Jurisica, Rohan John, Ana Konvalinka
BACKGROUND: Interstitial fibrosis/tubular atrophy (IFTA) is an important cause of kidney allograft loss; however, noninvasive markers to identify IFTA or guide anti-fibrotic therapy are lacking. Using angiotensin-II (AngII) as the prototypical inducer of IFTA, we previously identified 83 AngII-regulated proteins in vitro. We developed mass spectrometry-based assays for quantification of 6 AngII signature proteins (BST1, GLNA, LAMB2, LYPLA1, RHOB and TSP1) and hypothesized that their urine excretion will correlate with IFTA in kidney transplant patients...
February 19, 2019: Transplantation
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