Association of post-transplantation anellovirus viral load with kidney transplant rejection in children

Introduction: Immunological monitoring could indirectly measure the suppressive effects of the drugs and provide early guidance on necessary preventive interventions in transplant recipients. Objectives: Our goal was to determine whether mycophenolic acid (MPA) modulates peripheral blood lymphocyte T in kidney transplant recipients. Patients and Methods: We assessed T lymphocytes CD3, CD4 and CD8 in peripheral blood in 30 donors and 35 recipients one day before and 10 days after transplantation using Becton Dickinson’s direct immune fluorescent light. Results: Comparisons showed that the number of T lymphocytes CD3+, CD4+, CD8+ in peripheral blood of transplant recipients were lower than donors (TCD3 was 1690.31±503.45 versus 2280.73± 522.48; TCD4 was 549.51 ±211.72 cell/µL versus 766.37± 341.72 cell/µL and CD8 was 1134.37 ±431.07 cell/µL versus 1523.4± 349.23 cell/µL with P<0.001; P=0.001 and P= 0.0002 respectively). Additionally, post-transplantation lymphocytes TCD4 decreased in 10/35 of recipients and increased in 22/35 of recipients (P=0.036). Conclusion: The T lymphocytes CD3, CD4 and CD8 in peripheral blood should be monitored at multiple post-transplant times to make early predictions of transplant rejection during follow-up treatment.

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Faculty Opinions recommendation of Antibodies against MICA antigens and kidney-transplant rejection.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1091288.545712 ◽

2007 ◽

Author(s):

Seiamak Bahram

Keyword(s):

Kidney Transplant ◽

Transplant Rejection

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BK Polyomavirus Micro-RNAs: Time Course and Clinical Relevance in Kidney Transplant Recipients

Viruses ◽

10.3390/v13020351 ◽

2021 ◽

Vol 13 (2) ◽

pp. 351

Author(s):

Baptiste Demey ◽

Véronique Descamps ◽

Claire Presne ◽

Francois Helle ◽

Catherine Francois ◽

...

Keyword(s):

Viral Replication ◽

Kidney Transplant ◽

Clinical Relevance ◽

Graft Loss ◽

First Year ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Post Transplantation ◽

Bk Polyomavirus ◽

Micro Rnas

Background: Kidney transplant recipients (KTRs) are exposed to a high risk of BK polyomavirus (BKPyV) replication, which in turn may lead to graft loss. Although the microRNAs (miRNAs) bkv-miR-B1-3p and bkv-miR-B1-5p are produced during the viral cycle, their putative value as markers of viral replication has yet to be established. In KTRs, the clinical relevance of the changes over time in BKPyV miRNA levels has not been determined. Methods: In a retrospective study, we analyzed 186 urine samples and 120 plasma samples collected from 67 KTRs during the first year post-transplantation. Using a reproducible, standardized, quantitative RT-PCR assay, we measured the levels of bkv-miR-B1-3p and bkv-miR-B1-5p (relative to the BKPyV DNA load). Results: Detection of the two miRNAs had low diagnostic value for identifying patients with DNAemia or for predicting DNAuria during follow-up. Seven of the 14 KTRs with a sustained BKPyV infection within the first year post-transplantation showed a progressive reduction in the DNA load and then a rapid disappearance of the miRNAs. DNA and miRNA loads were stable in the other seven KTRs. Conclusions: After the DNA-based diagnosis of BKPyV infection in KTRs, bkv-miR-B1-3p and bkv-miR-B1-5p levels in the urine might be valuable markers for viral replication monitoring and thus might help physicians to avoid an excessive reduction in the immunosuppressive regimen.

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Anti‐interleukin‐6 antibody clazakizumab in late antibody‐mediated kidney transplant rejection: effect on cytochrome P450 drug metabolism

Transplant International ◽

10.1111/tri.13954 ◽

2021 ◽

Author(s):

Jakob Mühlbacher ◽

Christian Schörgenhofer ◽

Konstantin Doberer ◽

Michael Dürr ◽

Klemens Budde ◽

...

Keyword(s):

Cytochrome P450 ◽

Drug Metabolism ◽

Kidney Transplant ◽

Interleukin 6 ◽

Transplant Rejection

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Clinical Relevance of Corticosteroid Withdrawal on Graft Histological Lesions in Low-Immunological-Risk Kidney Transplant Patients

Journal of Clinical Medicine ◽

10.3390/jcm10092005 ◽

2021 ◽

Vol 10 (9) ◽

pp. 2005

Author(s):

Domingo Hernández ◽

Juana Alonso-Titos ◽

Teresa Vázquez ◽

Myriam León ◽

Abelardo Caballero ◽

...

Keyword(s):

Kidney Transplant ◽

Rejection Rate ◽

Open Label ◽

Post Transplantation ◽

Protocol Biopsy ◽

Corticosteroid Withdrawal ◽

Transplant Patients ◽

Prospective Phase ◽

Kidney Transplant Patients ◽

The Impact

The impact of corticosteroid withdrawal on medium-term graft histological changes in kidney transplant (KT) recipients under standard immunosuppression is uncertain. As part of an open-label, multicenter, prospective, phase IV, 24-month clinical trial (ClinicalTrials.gov, NCT02284464) in low-immunological-risk KT recipients, 105 patients were randomized, after a protocol-biopsy at 3 months, to corticosteroid continuation (CSC, n = 52) or corticosteroid withdrawal (CSW, n = 53). Both groups received tacrolimus and MMF and had another protocol-biopsy at 24 months. The acute rejection rate, including subclinical inflammation (SCI), was comparable between groups (21.2 vs. 24.5%). No patients developed dnDSA. Inflammatory and chronicity scores increased from 3 to 24 months in patients with, at baseline, no inflammation (NI) or SCI, regardless of treatment. CSW patients with SCI at 3 months had a significantly increased chronicity score at 24 months. HbA1c levels were lower in CSW patients (6.4 ± 1.2 vs. 5.7 ± 0.6%; p = 0.013) at 24 months, as was systolic blood pressure (134.2 ± 14.9 vs. 125.7 ± 15.3 mmHg; p = 0.016). Allograft function was comparable between groups and no patients died or lost their graft. An increase in chronicity scores at 2-years post-transplantation was observed in low-immunological-risk KT recipients with initial NI or SCI, but CSW may accelerate chronicity changes, especially in patients with early SCI. This strategy did, however, improve the cardiovascular profiles of patients.

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Clinical impact of serum bilirubin levels on kidney transplant outcomes

Scientific Reports ◽

10.1038/s41598-021-86330-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Juhan Lee ◽

Eun Jin Kim ◽

Jae Geun Lee ◽

Beom Seok Kim ◽

Kyu Ha Huh ◽

...

Keyword(s):

Kidney Transplant ◽

Graft Failure ◽

Serum Bilirubin ◽

Graft Loss ◽

Multivariable Analysis ◽

Post Transplantation ◽

Transplant Outcomes ◽

Increased Risk ◽

All Cause Mortality ◽

Kidney Transplantations

AbstractSerum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantations between 2003 and 2017. Patients were grouped into sex-specific quartiles according to mean serum bilirubin levels, 3–12 months post-transplantation. Median bilirubin levels were 0.66 mg/dL in males and 0.60 mg/dL in females. The intra-individual variability of serum bilirubin levels was low (9%). Serum bilirubin levels were inversely associated with graft loss, death-censored graft failure, and all-cause mortality, independent of renal function, donor status, and transplant characteristics. Multivariable analysis revealed that the lowest serum bilirubin quartile was associated with increased risk of graft loss (HR 2.64, 95% CI 1.67–4.18, P < 0.001), death-censored graft failure (HR 2.97, 95% CI 1.63–5.42, P < 0.001), and all-cause mortality (HR 2.07, 95% CI 1.01–4.22, P = 0.046). Patients with lower serum bilirubin were also at greater risk of rejection and exhibited consistently lower glomerular filtration rates than those with higher serum bilirubin. Serum bilirubin levels were significantly associated with transplantation outcomes, suggesting that bilirubin could represent a therapeutic target for improving long-term transplant outcomes.

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