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Kidney transplantation

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21 papers 25 to 100 followers
By P O Pediatrics, Nephrology
Juhan Lee, Borae G Park, Hyang Sook Jeong, Youn Hee Park, Sinyoung Kim, Beom Seok Kim, Hye Jin Kim, Kyu Ha Huh, Hyeon Joo Jeong, Yu Seun Kim
RATIONALE: Human leukocyte antigen (HLA) is the major immunologic barrier in kidney transplantation (KT). Various desensitization protocols to overcome the HLA barrier have increased the opportunity for transplantation in sensitized patients. In addition, technological advances in solid-phase assays have permitted more comprehensive assessment of donor-specific antibodies. Although various desensitization therapies and immunologic techniques have been developed, the final transplantation decision is still based on the classic complement-dependent cytotoxicity (CDC) crossmatch (XM) technique...
September 2017: Medicine (Baltimore)
Paolo Malvezzi, Thomas Jouve, Johan Noble, Lionel Rostaing
The number of kidney transplant candidates is increasing sharply. Among them, at least 20% are HLA sensitized. For these patients, in the setting of both living- and deceased-donor kidney transplant, we may face donor-specific alloantibodies at pretransplant. In such cases, the microlymphocytotoxicity crossmatch may or may not be positive. Kidney transplant with donor-specific antibodies at pretransplant is known as HLA-incompatible transplant. At present, we can use many methods to ensure that the kidney transplant is successful, provided that the recipient is desensitized before or after transplant...
August 2018: Experimental and Clinical Transplantation
Gastón J Piñeiro, Erika De Sousa-Amorim, Manel Solé, José Ríos, Miguel Lozano, Frederic Cofán, Pedro Ventura-Aguiar, David Cucchiari, Ignacio Revuelta, Joan Cid, Eduard Palou, Josep M Campistol, Federico Oppenheimer, Jordi Rovira, Fritz Diekmann
BACKGROUND: Chronic active antibody-mediated rejection (c-aABMR) is an important cause of allograft failure and graft loss in long-term kidney transplants. METHODS: To determine the efficacy and safety of combined therapy with rituximab, plasma exchange (PE) and intravenous immunoglobulins (IVIG), a cohort of patients with transplant glomerulopathy (TG) that met criteria of active cABMR, according to BANFF'17 classification, was identified. RESULTS: We identified 62 patients with active c-aABMR and TG (cg ≥ 1)...
October 11, 2018: BMC Nephrology
R A Montgomery, A Loupy, D L Segev
Despite the success of desensitization protocols, antibody-mediated rejection (AMR) remains a significant contributor to renal allograft failure in patients with donor-specific antibodies. Plasmapheresis and high-dose intravenous immunoglobulin have proved to be effective treatments to prevent and treat AMR, but irreversible injury in the form of transplant glomerulopathy can commonly manifest months to years later. There is an unmet need to improve the outcomes for patients at risk for AMR. Updated Banff criteria now take into account the increasing understanding of the complex and heterogeneous nature of AMR phenotypes, including the timing of rejection, subclinical and chronic AMR, C4d-negative AMR, and antibody-mediated vascular rejection...
January 2018: American Journal of Transplantation
Christos Chatzikyrkou, Jenny Eichler, Annika Karch, Christian Clajus, Florian Gunnar Scurt, Wolf Ramackers, Frank Lehner, Jan Menne, Hermann Haller, Peter R Mertens, Mario Schiffer
BACKGROUND: The efficacy and safety of renin angiotensin aldosterone system blockers (RAASB's) if introduced immediately after renal transplantation have not been extensively investigated. METHODS: The medical charts of 142 kidney transplant recipients who received a RAASB in the early postoperative period and of 114 matched controls were analyzed. The RAASB was given primarily for blood pressure control. RESULTS: 117 patients continued to receive and 50 controls remained continuously free of the RAASB in the first year...
February 2017: Blood Pressure
Akinori Miyazono, Yasuhiro Okamoto, Hironobu Nagasako, Yuko Hamasaki, Seiichiro Shishido, Takako Yoshioka, Yoshifumi Kawano
Posttransplantation lymphoproliferative disorder (PTLD) is associated with significant mortality in kidney transplant recipients. PTLD cases associated with poor prognostic factors that are refractory to reduction of immunosuppression generally require chemotherapy and immunotherapy. We present a patient with PTLD who achieved complete remission after reduction of immunosuppression alone despite having a poor prognosis. A boy with a mutation in the WT1 gene developed bilateral Wilms tumor at 15 months and received a kidney transplant at the age of 4 years...
September 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Rishi Pruthi, Mark McClure, Anna Casula, Paul J Roderick, Damian Fogarty, Mark Harber, Rommel Ravanan
Glomerulonephritis (GN) is the primary diagnosis in 20% to 40% of patients receiving a renal transplant. Here we studied patient survival and graft outcomes in patients with GN transplanted in the UK. UK Renal Registry data were used to analyze patient survival and graft failure in incident transplant patients between 1997 to 2009 who had a diagnosis of primary GN, in comparison to patients transplanted with adult polycystic kidney disease (APKD) or diabetes. Multivariable regression analysis adjusted for age, sex, donor type, ethnicity, donor age, time on dialysis, human leukocyte antigen mismatch, cold ischemic time, and graft failure (for patient survival)...
April 2016: Kidney International
Hoon Young Choi, Dong Jin Joo, Mi Kyung Song, Myoung Soo Kim, Hyeong Cheon Park, Yu Seun Kim, Beom Seok Kim
Evaluation of renal function using an accurate estimation equation is important for predicting long-term graft survival. We designed this retrospective cohort study to evaluate the predictive power of renal function estimation by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) study equations for graft survival. We reviewed data of 3290 adult kidney transplant recipients who underwent transplantation at a single center between April 1979 and September 2012...
February 2016: Medicine (Baltimore)
Véronique Sébille, Jean-Benoit Hardouin, Magali Giral, Angélique Bonnaud-Antignac, Philippe Tessier, Emmanuelle Papuchon, Alexandra Jobert, Elodie Faurel-Paul, Stéphanie Gentile, Elisabeth Cassuto, Emmanuel Morélon, Lionel Rostaing, Denis Glotz, Rebecca Sberro-Soussan, Yohann Foucher, Aurélie Meurette
BACKGROUND: Treatment of end stage renal disease has an impact on patients' physical and psychological health, including quality of life (QoL). Nowadays, it is known that reducing the dialysis period has many advantages regarding QoL and medical outcomes. Although preemptive transplantation is the preferred strategy to prevent patients undergoing dialysis, its psychological impact is unknown. Moreover, transplantation can be experienced in a completely different manner among patients who were on dialysis and those who still had a functioning kidney at the time of surgery...
January 19, 2016: BMC Nephrology
Pietro E Cippà, Marc Schiesser, Henrik Ekberg, Teun van Gelder, Nicolas J Mueller, Claude A Cao, Thomas Fehr, Corrado Bernasconi
BACKGROUND AND OBJECTIVES: Definition of individual risk profile is the first step to implement strategies to keep the delicate balance between under- and overimmunosuppression after kidney transplantation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used data from the Efficacy Limiting Toxicity Elimination Symphony Study (1190 patients between 2002 and 2004) to model risk of rejection and infection in the first year after kidney transplantation. External validation was performed in a study population from the Fixed-Dose Concentration-Controlled Trial (630 patients between 2003 and 2006)...
December 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
V Saxena, N A Terrault
No abstract text is available yet for this article.
May 2016: American Journal of Transplantation
D Kamińska, K Kościelska-Kasprzak, P Chudoba, M Klinger
No abstract text is available yet for this article.
May 2016: American Journal of Transplantation
K C Gurudev, Sonika Puri, Mahesha Vankalakunti
No abstract text is available yet for this article.
December 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Paolo Malvezzi, Thomas Jouve, Lionel Rostaing
CONTEXT: Preventing acute rejection (AR) after kidney transplantation is of utmost importance because an AR can have a negative impact on long-term allograft survival. EVIDENCE ACQUISITION: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO, and Web of Science have been searched. RESULTS: At the moment this can be done by using rabbit anti-thymocyte globulins (rATGs) as an induction therapy. However, because rATGs are associated with some deleterious side-effects, such as the opportunistic infections cytomegalovirus (CMV) and de novo post-transplant cancer, it is very important they are used optimally, i...
October 2015: Journal of Nephropathology
Daniel Abramowicz, Marc Hazzan, Umberto Maggiore, Licia Peruzzi, Pierre Cochat, Rainer Oberbauer, Maria C Haller, Wim Van Biesen
This position statement brings up guidance on pre-emptive kidney transplantation from living donors. The provided guidance is based on a systematic review of the literature.
May 2016: Nephrology, Dialysis, Transplantation
Lara Danziger-Isakov, Upton Allen, Janet Englund, Betsy Herold, Jill Hoffman, Michael Green, Soren Gantt, Deepali Kumar, Marian G Michaels
A working group representing the American Society of Transplantation, Pediatric Infectious Diseases Society, and International Pediatric Transplant Association has developed a collaborative effort to identify and develop core knowledge in pediatric transplant infectious diseases. Guidance for patient care environments for training and core competencies is included to help facilitate training directed at improving the experience for pediatric infectious diseases trainees and practitioners in the area of pediatric transplant infectious diseases...
March 2015: Journal of the Pediatric Infectious Diseases Society
Umasankar Mathuram Thiyagarajan, Amirthavarshini Ponnuswamy, Atul Bagul
Thymoglobulin (Thymoglobulin®; Genzyme, Cambridge, Mass., USA) is a polyclonal antibody which has been used in the field of transplantation over the last four decades. With an initial hesitancy, it is widely used now in the prevention and treatment of rejection following renal transplantation. Thymoglobulin's lack of nephrotoxic properties (unlike calcineurin inhibitors) may potentiate it to be a very useful induction therapy during the early days following transplantation, particularly in a donation after circulatory death programme...
2013: American Journal of Nephrology
Abimereki D Muzaale, Allan B Massie, Mei-Cheng Wang, Robert A Montgomery, Maureen A McBride, Jennifer L Wainright, Dorry L Segev
IMPORTANCE: Risk of end-stage renal disease (ESRD) in kidney donors has been compared with risk faced by the general population, but the general population represents an unscreened, high-risk comparator. A comparison to similarly screened healthy nondonors would more properly estimate the sequelae of kidney donation. OBJECTIVES: To compare the risk of ESRD in kidney donors with that of a healthy cohort of nondonors who are at equally low risk of renal disease and free of contraindications to live donation and to stratify these comparisons by patient demographics...
February 12, 2014: JAMA: the Journal of the American Medical Association
Rebecca A Spicer, Philip A Clayton, Steven J McTaggart, Geoff Y Zhang, Stephen I Alexander
No abstract text is available yet for this article.
January 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Rukshana C Shroff, Mignon McCulloch, Vas Novelli, Delane Shingadia, Suzanne Bradley, Margaret Clapson, Nizam Mamode, Stephen D Marks
Classical HIV-associated nephropathy (HIVAN) was first described before the advent of highly active antiretroviral therapy in late stages of HIV disease with high viral load and low CD4 cell count. Renal transplantation has been successful in a large series of carefully selected HIV-infected adults, with patient and renal allograft survival approaching those of non-HIV-infected patients. We report the successful outcome of living related renal transplantation in a vertically transmitted HIV-infected 8-year-old girl with end-stage kidney disease on haemodialysis due to HIVAN...
November 2014: Archives of Disease in Childhood
2014-09-27 08:41:56
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