scholarly journals The role of soluble mediators in the clinical course of EBV infection and B cell homeostasis after kidney transplantation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sharon Bajda ◽  
Arturo Blazquez-Navarro ◽  
Björn Samans ◽  
Patrizia Wehler ◽  
Sviatlana Kaliszczyk ◽  
...  
Keyword(s):  
B Cell ◽  
Kidney Transplant ◽  
Cell Expansion ◽  
Soluble Factors ◽  
Post Transplant ◽  
Transplant Patients ◽  
Proliferative Effect ◽  
Kidney Transplant Patients ◽  
B Cell Homeostasis

Abstract Epstein-Barr virus (EBV) reactivation can lead to serious complications in kidney transplant patients, including post-transplant lymphoproliferative disorder (PTLD). Here, we have assessed the impact of EBV on B cell homeostasis at cellular and humoral level. In a multicenter study monitoring 540 kidney transplant patients during the first post-transplant year, EBV reactivation was detected in 109 patients. Thirteen soluble factors and B cell counts were analyzed in an EBV+ sub-cohort (N = 54) before, at peak and after EBV clearance and compared to a control group (N = 50). The B cell activating factor (BAFF) was significantly elevated among EBV+ patients. No additional soluble factors were associated with EBV. Importantly, in vitro experiments confirmed the proliferative effect of BAFF on EBV-infected B cells, simultaneously promoting EBV production. In contrast, elevated levels of BAFF in EBV+ patients did not lead to B cell expansion in vivo. Moreover, diminished positive inter-correlations of soluble factors and alterations of the bi-directional interplay between B cell and soluble factors were observed in EBV+ patients at peak and after clearance. Our data suggest that such alterations may counteract the proliferative effect of BAFF, preventing B cell expansion. The role of these alterations in lymphoma development should be analyzed in future studies.

Comparison Of Mycophenolic Acid Pharmaco-kinetic Parameters In Kidney Transplant Patients Within The First 3 Months Post-transplant

2005 ◽  
Vol 27 (2) ◽  
pp. 238
Author(s):  
Tomasz Pawinski ◽  
Iwona Szlaska ◽  
Magdalena Durlik ◽  
Jadwiga Majchrzak ◽  
Artur Urbanowicz ◽  
...  
Keyword(s):  
Kinetic Parameters ◽  
Kidney Transplant ◽  
Mycophenolic Acid ◽  
Post Transplant ◽  
Transplant Patients ◽  
Kidney Transplant Patients

scholarly journals Fibroblast Growth Factor and Mineral Metabolism Parameters among Prevalent Kidney Transplant Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Madhumathi Rao ◽  
Priyanka Jain ◽  
Temitope Ojo ◽  
Gautam Surya ◽  
Vaidyanathapuram Balakrishnan
Keyword(s):  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Kidney Transplant ◽  
Mineral Metabolism ◽  
Serum Phosphate ◽  
Fibroblast Growth ◽  
Post Transplant ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Fgf 23

Background. Chronic kidney disease (CKD) related mineral bone disorders persist after kidney transplantation, but little is known about the relationship between fibroblast growth factor-23 (FGF-23) and mineral metabolism in prevalent post-transplant patients.Objectives. To examine mineral metabolism parameters and their relationship to FGF-23 and parathyroid hormone (PTH) in prevalent kidney transplant patients.Methods. Cross-sectional study of 106 kidney transplant patients enrolled November 2005–October 2009 at Tufts Medical Center (TMC), Boston.Results. The prevalence of hypophosphatemia was 34%, hypercalcemia 3%, and elevated PTH levels 66%, at a median (25th–75th percentile) duration of 12.8 (7.5–30.9) months post-transplant. Males had significantly higher levels of PTH (P=0.04) and lower levels of serum phosphate (P=0.002). Serum PTH levels did not relate to eGFR, corrected calcium levels or serum phosphate. FGF-23 levels were above the reference limits in 7% of patients; higher levels were associated with higher serum phosphate and PTH levels after adjustment for transplant kidney function.Conclusion. FGF-23 is an important driver of mineral metabolism in prevalent transplant patients. Its modulatory role in mineral metabolism homeostasis may be heightened as feedback suppression of PTH is disturbed. Its role in long term cardiovascular and graft outcomes needs further study.

scholarly journals Outcomes at 3 years post‐transplant in imlifidase‐desensitized kidney transplant patients

2021 ◽  
Author(s):  
Christian Kjellman ◽  
Angela Q Maldonado ◽  
Kristoffer Sjöholm ◽  
Bonnie E Lonze ◽  
Robert A Montgomery ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Post Transplant ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Use of Nurse Practitioners in Pediatric Kidney Transplant: A Model for Providing Comprehensive Care to Children and Families

2011 ◽  
Vol 21 (4) ◽  
pp. 306-311
Author(s):  
Jessica Brennan ◽  
Marilyn McEnhill
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Comprehensive Care ◽  
Pediatric Nurse ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Pediatric Nurse Practitioners

It is well documented that kidney transplantation is the treatment of choice for children with end-stage renal disease. Pediatric kidney transplant patients are a complex population because of their need for lifelong immunosuppression, potential for delayed growth and development, and increased risk of heart disease and cancer. Although many large pediatric kidney transplant programs use nurse practitioners, the role of the nurse practitioner is still emerging in relation to the transplant coordinator role. This article describes the practice of pediatric nurse practitioners caring for children who require a kidney transplant and why nurse practitioners are ideal for providing comprehensive care to this population. Transplant programs are regulated by the United Network for Organ Sharing and the Centers for Medicare and Medicaid Services. Both organizations require transplant programs to designate a transplant coordinator with the primary responsibility of coordinating clinical aspects of transplant care. Incorporating transplant coordinator activities into the role of the pediatric nurse practitioner is discussed as a model for providing care throughout the process of kidney transplantation. Transplant pediatric nurse practitioners are in a unique position to expand the care for pediatric kidney transplant patients by assuming the role of clinician, educator, administrator, and coordinator.

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