scholarly journals Negative Impact of CMV and BKV Infections on Kidney-Allograft Function at 1-Year Post-Transplantation: Can it Be Changed by Modifying Immunosuppression?

EBioMedicine ◽  
2018 ◽  
Vol 34 ◽  
pp. 2-3 ◽  
Author(s):  
Paolo Malvezzi ◽  
Thomas Jouve ◽  
Lionel Rostaing
Keyword(s):  
Negative Impact ◽  
Post Transplantation ◽  
Kidney Allograft ◽  
Allograft Function

scholarly journals Exome sequencing and prediction of long-term kidney allograft function

2015 ◽  
Author(s):  
Laurent Mesnard ◽  
Thangamani Muthukumar ◽  
Maren Burbach ◽  
Carol Li ◽  
Huimin Shang ◽  
...  
Keyword(s):  
Amino Acid ◽  
Exome Sequencing ◽  
Amino Acid Level ◽  
Graft Function ◽  
Kidney Graft ◽  
Donor Age ◽  
Post Transplantation ◽  
Kidney Allograft ◽  
Allograft Function

Current strategies to improve graft outcome following kidney transplantation consider information at the HLA loci. Here, we used exome sequencing of DNA from ABO compatible kidney graft recipients and their living donors to determine recipient and donor mismatches at the amino acid level over entire exomes. We estimated the number of amino acid mismatches in transmembrane proteins, more likely to be seen as foreign by the recipient’s immune system, and designated this tally as the allogenomics mismatch score (AMS). The AMS can be measured prior to transplantation with DNA for potential donor and recipient pairs. We examined the degree of relationship between the AMS and post-transplantation kidney allograft function by linear regression. In a discovery cohort, we found a significant inverse correlation between the AMS and kidney graft function at 36 months post-transplantation (n=10 recipient/donor pairs; 20 exomes) (r2>=0.57, P<0.05). The predictive ability of the AMS persists when the score is restricted to regions outside of the HLA loci. This relationship was validated using an independent cohort of 24 recipient donor pairs (n=48 exomes) (r2>=0.39, P<0.005). In an additional cohort of living and mostly intra-familial recipient/donor pairs (n=19, 38 exomes), we validated the association after controlling for donor age at time of transplantation. Finally, a model that controls for donor age, HLA mismatches and time post-transplantation yields a consistent AMS effect across these three independent cohorts (P<0.05). Taken together, these results show that the AMS is a strong predictor of long-term graft function in kidney transplant recipients.

scholarly journals Exome Sequencing and Prediction of Long-Term Kidney Allograft Function

2015 ◽  
Author(s):  
Laurent Mesnard ◽  
Thangamani Muthukumar ◽  
Maren Burbach ◽  
Carol Li ◽  
Huimin Shang ◽  
...  
Keyword(s):  
Amino Acid ◽  
Exome Sequencing ◽  
Amino Acid Level ◽  
Graft Function ◽  
Kidney Graft ◽  
Donor Age ◽  
Post Transplantation ◽  
Kidney Allograft ◽  
Allograft Function

Current strategies to improve graft outcome following kidney transplantation consider information at the HLA loci. Here, we used exome sequencing of DNA from ABO compatible kidney graft recipients and their living donors to determine recipient and donor mismatches at the amino acid level over entire exomes. We estimated the number of amino acid mismatches in transmembrane proteins, more likely to be seen as foreign by the recipient's immune system, and designated this tally as the allogenomics mismatch score (AMS). The AMS can be measured prior to transplantation with DNA for potential donor and recipient pairs. We examined the degree of relationship between the AMS and post-transplantation kidney allograft function by linear regression. In a discovery cohort, we found a significant inverse correlation between the AMS and kidney graft function at 36 months post-transplantation (n=10 recipient/donor pairs; 20 exomes) (r2>=0.57, P<0.05). The predictive ability of the AMS persists when the score is restricted to regions outside of the HLA loci. This relationship was validated using an independent cohort of 24 recipient donor pairs (n=48 exomes) (r2>=0.39, P<0.005). In an additional cohort of living and mostly intra-familial recipient/donor pairs (n=19, 38 exomes), we validated the association after controlling for donor age at time of transplantation. Finally, a model that controls for donor age, HLA mismatches and time post-transplantation yields a consistent AMS effect across these three independent cohorts (P<0.05). Taken together, these results show that the AMS is a strong predictor of long-term graft function in kidney transplant recipients.

scholarly journals Exome sequencing and prediction of long-term kidney allograft function

2015 ◽  
Author(s):  
Laurent Mesnard ◽  
Thangamani Muthukumar ◽  
Maren Burbach ◽  
Carol Li ◽  
Huimin Shang ◽  
...  
Keyword(s):  
Amino Acid ◽  
Exome Sequencing ◽  
Amino Acid Level ◽  
Graft Function ◽  
Kidney Graft ◽  
Donor Age ◽  
Post Transplantation ◽  
Kidney Allograft ◽  
Allograft Function

Current strategies to improve graft outcome following kidney transplantation consider information at the HLA loci. Here, we used exome sequencing of DNA from ABO compatible kidney graft recipients and their living donors to determine recipient and donor mismatches at the amino acid level over entire exomes. We estimated the number of amino acid mismatches in transmembrane proteins, more likely to be seen as foreign by the recipient’s immune system, and designated this tally as the allogenomics mismatch score (AMS). The AMS can be measured prior to transplantation with DNA for potential donor and recipient pairs. We examined the degree of relationship between the AMS and post-transplantation kidney allograft function by linear regression. In a discovery cohort, we found a significant inverse correlation between the AMS and kidney graft function at 36 months post-transplantation (n=10 recipient/donor pairs; 20 exomes) (r2>=0.57, P<0.05). The predictive ability of the AMS persists when the score is restricted to regions outside of the HLA loci. This relationship was validated using an independent cohort of 24 recipient donor pairs (n=48 exomes) (r2>=0.39, P<0.005). In an additional cohort of living and mostly intra-familial recipient/donor pairs (n=19, 38 exomes), we validated the association after controlling for donor age at time of transplantation. Finally, a model that controls for donor age, HLA mismatches and time post-transplantation yields a consistent AMS effect across these three independent cohorts (P<0.05). Taken together, these results show that the AMS is a strong predictor of long-term graft function in kidney transplant recipients.

Fibrous Intimal Thickening at Implantation Adversely Affects Long-Term Kidney Allograft Function

2009 ◽  
Vol 87 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Annemie T. Woestenburg ◽  
Gert A. Verpooten ◽  
Dirk K. Ysebaert ◽  
Eric A. Van Marck ◽  
Dierik Verbeelen ◽  
...  
Keyword(s):  
Intimal Thickening ◽  
Kidney Allograft ◽  
Allograft Function

scholarly journals What is known about palliative care in adult patients with allogeneic stem cell transplantation (allo-SCT)?

2021 ◽  
Author(s):  
Steffen T. Simon ◽  
Anne Pralong ◽  
Michael Hallek ◽  
Christoph Scheid ◽  
Udo Holtick ◽  
...  
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Negative Impact ◽  
Chronic Gvhd ◽  
Care Needs ◽  
Post Transplantation

AbstractPatients undergoing allogeneic stem cell transplantation (allo-SCT) are given a real chance of cure, but at the same time are confronted with a considerable risk of mortality and of severe long-term impediments. This narrative, non-systematic literature review aims to describe the supportive and palliative care needs of allo-SCT recipients, including long-term survivors or those relapsing or dying after transplantation. It also evaluates the feasibility and effectivity of integrating palliative care early in transplant procedures. In this appraisal of available literature, the main findings relate to symptoms like fatigue and psychological distress, which appear to be very common in the whole allo-SCT trajectory and might even persist many years post-transplantation. Chronic GvHD has a major negative impact on quality of life. Overall, there is a paucity of research on further issues in the context of allo-SCT, like the distress related to the frequently unpredictable post-transplant trajectory and prognosis, as well as the end-of-life phase. First randomized controlled results support the effectiveness of early integration of specialized palliative care expertise into transplant algorithms. Barriers to this implementation are discussed.

scholarly journals High urinary interleukin-2 in late post-transplant period portends a risk of decline in kidney allograft function: a preliminary study

2017 ◽  
Vol 10 (1) ◽  
Author(s):  
Andriy V. Trailin ◽  
Marina V. Pleten ◽  
Tetyana I. Ostapenko ◽  
Nadiia F. Iefimenko ◽  
Olexandr S. Nykonenko
Keyword(s):  
Interleukin 2 ◽  
Kidney Allograft ◽  
Post Transplant ◽  
Allograft Function ◽  
Preliminary Study

Adverse effect of donor vasopressor support on immediate and one-year kidney allograft function

Surgery ◽  
1996 ◽  
Vol 120 (4) ◽  
pp. 663-666 ◽  
Author(s):  
Renee marshall ◽  
Nasimul Ahsan ◽  
Saleena Dhillon ◽  
Michael Holman ◽  
Harold C. Yang
Keyword(s):  
Adverse Effect ◽  
Kidney Allograft ◽  
Vasopressor Support ◽  
Allograft Function ◽  
One Year

scholarly journals Pre-Transplant Histological Assessment Provides a Useful Predictor of Subsequent Kidney Allograft Function

2018 ◽  
Vol 102 ◽  
pp. S340-S341
Author(s):  
Adam Brayne ◽  
Patrick Trotter ◽  
Daniel Hart ◽  
Gavin Pettigrew ◽  
Menna Clatworthy
Keyword(s):  
Kidney Allograft ◽  
Histological Assessment ◽  
Allograft Function

scholarly journals P1639DEVELOPMENT OF SELF-LIMITED LOW-LEVEL BK VIREMIA/VIRURIA SUGGESTS IDEAL IMMUNOSUPPRESSION TO SUPPRESS T-CELL AND ANTIBODY-MEDIATED REJECTION AND PRESERVE KIDNEY ALLOGRAFT FUNCTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bettina Näf ◽  
Thomas Müller ◽  
Rudolf Peter Wuthrich ◽  
Thomas Schachtner
Keyword(s):  
Lower Incidence ◽  
De Novo ◽  
Allograft Survival ◽  
Kidney Allograft ◽  
Low Level ◽  
Antibody Mediated Rejection ◽  
Maintenance Immunosuppression ◽  
Allograft Function ◽  
High Level ◽  
Egfr Slope

Abstract Background and Aims Polyomavirus BK (BKV) viremia has been suggested as a surrogate marker of overimmunosuppression. Due to recent advances in monitoring strategies and pre-emptive therapy, progression to BKV-associated nephropathy (BKVN) has been reduced. Reduction of maintenance immunosuppression during BKVN, however, has been associated with both T-cell mediated rejection (TCMR), antibody-mediated rejection (ABMR), and inferior kidney allograft outcomes. Although the administration of intravenous immunoglobulins (IVIG) failed to treat BKVN, IVIG may have properties to reduce allosensitization. Method We studied 860 kidney transplant recipients (KTRs) predominantly under tacrolimus-based triple-drug maintenance immunosuppression from 2009 to 2018. We identified 130 KTRs (15.1%) with high-level BK viremia &gt;10,000 copies/mL (presumptive BKVN), 180 KTRs (20.9%) with low-level BK viremia &lt;10,000 copies/mL, 85 KTRs (9.9%) with isolated BK viruria, and 465 KTRs (54.1%) with no BK viruria/viremia. Kidney allograft outcomes with respect to TCMR, ABMR, development of de novo donor-specific antibodies (DSA), kidney allograft survival, and estimated glomerular filtration rate (eGFR) slope were analysed. Due to the increased incidence of TCMR and ABMR among KTRs with presumptive BKVN, 48 of 130 KTRs (36.9%) with high-level BK viremia starting from 2015 received IVIG (0.5 g/kg of body weight) on a biweekly basis during BKV replication. Results Very interestingly, KTRs with low-level BK viremia/viruria showed a significantly lower incidence of TCMR compared to KTRs with no BK viremia/viruria and KTRs with high-level BK viremia (p&lt;0.05). In addition, KTRs with low-level BK viremia/viruria showed a significantly lower incidence of ABMR compared to KTRs with high-level BK viremia (p&lt;0.05). No differences were observed with respect to the development of de novo DSA (MFI&gt;5000) between KTRs with low-level BK viremia/viruria, KTRs with no BK viremia/viruria, and KTRs with high-level BK viremia (p&gt;0.05). KTRs with low-level BK viremia/viruria showed superior kidney allograft survival and lower eGFR slope compared to KTRs with no BK viremia/viruria and KTRs with high-level BK viremia (p&lt;0.05). The administration of IVIG during high-level BK viremia didn’t impact the development of TCMR, ABMR, development of de novo DSA, eGFR slope, and kidney allograft survival (p&lt;0.05). Conclusion Our results show that low-level BK viremia/viruria is associated with suppression of TCMR and ABMR in the early period posttransplantation, and preservation of kidney allograft function in the long-term. The administration of IVIG didn’t prove beneficial to reduce allosensitization among KTRs with high-level BK viremia.

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