Association of Factor V Leiden Mutation with Delayed Graft Function, Acute Rejection Episodes and Long-term Graft Dysfunction in Kidney Transplant Recipients

2002 ◽  
Vol 87 (02) ◽  
pp. 194-198 ◽  
Author(s):  
Torsten Slowinski ◽  
Ingeborg Hauser ◽  
Birgit Vetter ◽  
Lutz Fritsche ◽  
Daniela Bachert ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Function ◽  
Factor V Leiden ◽  
Factor V ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients ◽  
Factor V Leiden Mutation

SummaryWe analysed whether the factor V Leiden mutation – the most common hereditary predisposing factor for venous thrombosis – is associated with early and long-term graft dysfunction after kidney transplantation in 394 Caucasian kidney transplant recipients. The presence of factor V Leiden mutation was identified by allele specific PCR. The prevalence of the factor V Leiden mutation was compared to 32216 unselected neonates. The prevalence of the factor V Leiden mutation (GA genotype) was similar in 394 kidney transplant recipients and 32216 neonates. The frequency of known factors predicting long-term graft function were similar in patients with the GA genotype and with the normal factor V gene (GG genotype). The GA genotype was associated with the occurrence of no primary graft function (risk: 2.87; 95% confidence interval: 1.01-8.26; p < 0.05), the number of dialysis after transplantation in patients with no primary graft function until graft function (7.5 ± 2.06 dialysis in GA patients; 4.2 ± 0.36 dialyses in GG patients; p < 0.05), and the risk for at least one acute rejection episode (risk: 3.83; 95% confidence interval: 1.38-10.59; p < 0.02). The slope of 1/creatinine per year was significantly lower in patients with the GA genotype (GA patients: – 0.0204 ± 0.008 dl/mg per year; GG patients: 0.0104 ± 0.004 dl/mg per year; p < 0.02). The annual enhancement of the daily protein excretion rate was elevated in patients with the GA genotype (GA patients: 38.5 ± 16.6 mg/24 h per year; GG patients: 4.9 ± 4.4 mg/24 h per year; p < 0.02). Our study showed that the factor V Leiden mutation is associated with the occurrence of delayed graft function, acute rejection episodes and chronic graft dysfunction after kidney transplantation.

scholarly journals Long-Term Outcomes after Acute Rejection in Kidney Transplant Recipients: An ANZDATA Analysis

2019 ◽  
Vol 30 (9) ◽  
pp. 1697-1707 ◽  
Author(s):  
Philip A. Clayton ◽  
Stephen P. McDonald ◽  
Graeme R. Russ ◽  
Steven J. Chadban
Keyword(s):  
Cardiovascular Disease ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Loss ◽  
Graft Function ◽  
High Rate ◽  
Sensitivity Analyses ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

BackgroundDeclining rates of acute rejection (AR) and the high rate of 1-year graft survival among patients with AR have prompted re-examination of AR as an outcome in the clinic and in trials. Yet AR and its treatment may directly or indirectly affect longer-term outcomes for kidney transplant recipients.MethodsTo understand the long-term effect of AR on outcomes, we analyzed data from the Australia and New Zealand Dialysis and Transplant Registry, including 13,614 recipients of a primary kidney-only transplant between 1997 and 2017 with at least 6 months of graft function. The associations between AR within 6 months post-transplant and subsequent cause-specific graft loss and death were determined using Cox models adjusted for baseline donor, recipient, and transplant characteristics.ResultsAR occurred in 2906 recipients (21.4%) and was associated with graft loss attributed to chronic allograft nephropathy (hazard ratio [HR], 1.39; 95% confidence interval [95% CI], 1.23 to 1.56) and recurrent AR beyond month 6 (HR, 1.85; 95% CI, 1.39 to 2.46). Early AR was also associated with death with a functioning graft (HR, 1.22; 95% CI, 1.08 to 1.36), and with death due to cardiovascular disease (HR, 1.30; 95% CI, 1.11 to 1.53) and cancer (HR, 1.35; 95% CI, 1.12 to 1.64). Sensitivity analyses restricted to subgroups with either biopsy-proven, antibody-mediated, or vascular rejection, or stratified by treatment response produced similar results.ConclusionsAR is associated with increased risks of longer-term graft failure and death, particularly death from cardiovascular disease and cancer. The results suggest AR remains an important short-term outcome to monitor in kidney transplantation and clinical trials.

Comparison of FOXP3 and Interleukin 35 Expression Profiles in Kidney Transplant Recipients With Excellent Long-Term Graft Function and Acute Rejection

2021 ◽  
Vol 19 (11) ◽  
pp. 1142-1148
Author(s):  
Mahsa Torabijahromi ◽  
Jamshid Roozbeh ◽  
GhanbarAli Raeesjalali ◽  
Maryam Shafiee ◽  
Nakisa Rasaei ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Expression Profiles ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals Long-Term Care of the Pediatric Kidney Transplant Recipient

2021 ◽  
pp. CJN.16891020
Author(s):  
Hilda E. Fernandez ◽  
Bethany J. Foster
Keyword(s):  
Transplant Recipient ◽  
Kidney Transplant ◽  
Graft Failure ◽  
Graft Function ◽  
Failure Rates ◽  
Care Providers ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Term Care

Pediatric kidney transplant recipients are distinguished from adult recipients by the need for many decades of graft function, the potential effect of CKD on neurodevelopment, and the changing immune environment of a developing human. The entire life of an individual who receives a transplant as a child is colored by their status as a transplant recipient. Not only must these young recipients negotiate all of the usual challenges of emerging adulthood (transition from school to work, romantic relationships, achieving independence from parents), but they must learn to manage a life-threatening medical condition independently. Regardless of the age at transplantation, graft failure rates are higher during adolescence and young adulthood than at any other age. All pediatric transplant recipients must pass through this high-risk period. Factors contributing to the high graft failure rates in this period include poor adherence to treatment, potentially exacerbated by the transfer of care from pediatric- to adult-oriented care providers, and perhaps an increased potency of the immune response. We describe the characteristics of pediatric kidney transplant recipients, particularly those factors that may influence their care throughout their lives. We also discuss the risks associated with the transition from pediatric- to adult-oriented care and provide some suggestions to optimize transition to adult-oriented transplant care and long-term outcomes.

Long-term protein intake control in kidney transplant recipients: Effect in kidney graft function and in nutritional status

2003 ◽  
Vol 41 (3) ◽  
pp. S146-S152 ◽  
Author(s):  
Annamaria Bernardi ◽  
Franco Biasia ◽  
Tecla Pati ◽  
Michele Piva ◽  
Angela D'Angelo ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Kidney Transplant ◽  
Protein Intake ◽  
Graft Function ◽  
Kidney Graft ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Intake Control

scholarly journals Long-term graft function changes in kidney transplant recipients

2010 ◽  
Vol 3 (suppl 2) ◽  
pp. ii2-ii8 ◽  
Author(s):  
R. Marcen ◽  
J. M. Morales ◽  
A. Fernandez-Rodriguez ◽  
L. Capdevila ◽  
L. Pallardo ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

173: Delayed Graft Function (DGF) in HIV+ Kidney Transplant Recipients Predicts Worse Long-Term Renal Function

2010 ◽  
Vol 55 (4) ◽  
pp. B75
Author(s):  
Lissa Levin ◽  
Gregory Malat ◽  
Mohit Gupta ◽  
Muhammad Saeed ◽  
Snehankita Kulkarni ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplant ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals Association of Slow Graft Function with Long-Term Outcomes in Kidney Transplant Recipients

2018 ◽  
Vol 23 ◽  
pp. 224-231 ◽  
Author(s):  
Connie J. Wang ◽  
Ahmad Tuffaha ◽  
Milind A. Phadnis ◽  
Jonathan D. Mahnken ◽  
James B. Wetmore
Keyword(s):  
Kidney Transplant ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Long Term Outcomes

scholarly journals A Peripheral Blood Gene Expression Signature to Diagnose Subclinical Acute Rejection

2019 ◽  
Vol 30 (8) ◽  
pp. 1481-1494 ◽  
Author(s):  
Weijia Zhang ◽  
Zhengzi Yi ◽  
Karen L. Keung ◽  
Huimin Shang ◽  
Chengguo Wei ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Peripheral Blood ◽  
Expression Profiles ◽  
Graft Function ◽  
Gene Signature ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Targeted Expression ◽  
Independent Cohort

BackgroundIn kidney transplant recipients, surveillance biopsies can reveal, despite stable graft function, histologic features of acute rejection and borderline changes that are associated with undesirable graft outcomes. Noninvasive biomarkers of subclinical acute rejection are needed to avoid the risks and costs associated with repeated biopsies.MethodsWe examined subclinical histologic and functional changes in kidney transplant recipients from the prospective Genomics of Chronic Allograft Rejection (GoCAR) study who underwent surveillance biopsies over 2 years, identifying those with subclinical or borderline acute cellular rejection (ACR) at 3 months (ACR-3) post-transplant. We performed RNA sequencing on whole blood collected from 88 individuals at the time of 3-month surveillance biopsy to identify transcripts associated with ACR-3, developed a novel sequencing-based targeted expression assay, and validated this gene signature in an independent cohort.ResultsStudy participants with ACR-3 had significantly higher risk than those without ACR-3 of subsequent clinical acute rejection at 12 and 24 months, faster decline in graft function, and decreased graft survival in adjusted Cox analysis. We identified a 17-gene signature in peripheral blood that accurately diagnosed ACR-3, and validated it using microarray expression profiles of blood samples from 65 transplant recipients in the GoCAR cohort and three public microarray datasets. In an independent cohort of 110 transplant recipients, tests of the targeted expression assay on the basis of the 17-gene set showed that it identified individuals at higher risk of ongoing acute rejection and future graft loss.ConclusionsOur targeted expression assay enabled noninvasive diagnosis of subclinical acute rejection and inflammation in the graft and may represent a useful tool to risk-stratify kidney transplant recipients.

Kidney graft function before pregnancy as a predictor of graft, maternal and fetal outcomes in pregnant renal transplant recipients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Filipe S. Mira ◽  
Joana Oliveira ◽  
Filipa Sousa ◽  
Dora Antunes ◽  
Ana Carolina Figueiredo ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Function ◽  
Adverse Outcomes ◽  
Hypertensive Disorder ◽  
Renal Transplant Recipients ◽  
Kidney Graft ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients

Abstract Objectives Maternal and fetal complications can occur in pregnant kidney transplant recipients. Since these are high-risk pregnancies, they require a multidisciplinary follow-up to prematurely detect adverse events. Identifying factors that would affect fetal, maternal and graft outcomes is essential to further stratify the risk of pregnant kidney transplant recipients. Methods All pregnancies in kidney transplant recipients followed in a single center for 30 years were included. Data included previous transplant information and blood and urine tests performed before pregnancy. Impact of graft function on fetal, maternal and graft outcomes was evaluated. Results There were 41 pregnancies among 34 patients. Mean gestational age of 35 ± 3 weeks. Caesarean section was performed in 69.4% of patients. Five pregnancies were unsuccessful (12.2%). Four patients suffered an acute graft dysfunction (9.8%) and 12 (29.3%) had a serious maternal hypertensive disorder (preeclampsia, eclampsia or HELLP syndrome). Graft function before pregnancy showed significant correlation with adverse outcomes. Conclusions A proteinuria >669 mg/g, serum creatinine >1.75 mg/dL and glomerular filtration rate <36.2 mL/min/1.73 m2 before pregnancy were correlated to graft dysfunction during pregnancy. Similar values of proteinuria were also associated with a risk of maternal hypertensive disorders and pregnancy failure. Therefore, in patients with proteinuria and graft dysfunction, follow-up should be stricter to quickly detect complications.

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