scholarly journals SP792DE NOVO DONOR-SPECIFIC HLA ANTIBODIES AFTER STEROID WITHDRAWAL IN KIDNEY TRANSPLANT RECIPIENTS: A PROSPECTIVE, RANDOMIZED, CONTROLLED, PARALLEL GROUP STUDY. PRELIMINARY RESULTS

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii410-iii410
Author(s):  
Juana Alonso-Titos ◽  
Pedro Ruiz-Esteban ◽  
Eulalia Palma ◽  
Veronica Lopez ◽  
Abelardo Caballero ◽  
...  
2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii390-iii390
Author(s):  
Juana Alonso-Titos ◽  
Pedro Ruiz-Esteban ◽  
Eulalia Palma ◽  
Abelardo Caballero ◽  
Veronica Lopez ◽  
...  

Author(s):  
José Côté ◽  
Marie-Chantal Fortin ◽  
Patricia Auger ◽  
Geneviève Rouleau ◽  
Sylvie Dubois ◽  
...  

BACKGROUND Optimal immunosuppressive medication adherence is essential to graft survival. Transplant-TAVIE is a Web-based tailored intervention developed to promote this adherence. OBJECTIVE The objective of our study was to evaluate the Transplant-TAVIE intervention’s acceptability, feasibility, and preliminary efficacy. METHODS In a pilot, parallel-group, randomized controlled trial, we randomly assigned a convenience sample of 70 kidney transplant patients on immunosuppressive medication either to an experimental group (Transplant-TAVIE) or to a control group (existing websites). Kidney transplant recipients had to be older than 18 years, be taking immunosuppressant medication, and have access to the internet to participate in this study. Transplant-TAVIE was composed of three interactive Web-based sessions hosted by a virtual nurse. We documented user appreciation of and exposure to the intervention. Furthermore, we assessed medication adherence, medication self-efficacy, intake-related skills, and medication side effects at baseline and 3 and 6 months later. Analyses of variance were used to assess intergroup differences over time. RESULTS After baseline questionnaire completion, participants were randomly assigned either to Transplant-TAVIE (n=35) or to the websites (n=35) group. All participants had received their kidney graft <1 year to 32 years earlier (mean 6.8 years). Of the experimental group, 54% (19/35) completed the sessions of Transplant-TAVIE. Users found the intervention to be acceptable—33% were extremely satisfied (6/18), 39% were very satisfied (7/18), and 28% were satisfied (5/18). At baseline and over time, both experimental and control groups reported high medication adherence, high medication self-efficacy, and frequent use of skills related to medication intake. No intergroup differences emerged over time. CONCLUSIONS The results of this study support the feasibility and acceptability of Transplant-TAVIE. It could constitute an accessible adjunct in support of existing specialized services.


2018 ◽  
Vol 102 ◽  
pp. S203
Author(s):  
Teresa Vazquez ◽  
Juana Alonso-Titos ◽  
Juan Pablo Gamez ◽  
Pedro Ruiz Esteban ◽  
Abelardo Caballero ◽  
...  

2017 ◽  
Vol 78 ◽  
pp. 127
Author(s):  
Adriana I. Colovai ◽  
Christina Savchik ◽  
Dianne Ramkishun ◽  
Sonia Solomon ◽  
Enver Akalin ◽  
...  

2019 ◽  
Vol 316 (1) ◽  
pp. F9-F19 ◽  
Author(s):  
Alice Doreille ◽  
Mélanie Dieudé ◽  
Heloise Cardinal

Independent of the initial cause of kidney disease, microvascular injury to the peritubular capillary network appears to play a central role in the development of interstitial fibrosis in both native and transplanted kidney disease. This association is explained by mechanisms such as the upregulation of profibrotic genes and epigenetic changes induced by hypoxia, capillary leakage, endothelial and pericyte transition to interstitial fibroblasts, as well as modifications in the secretome of endothelial cells. Alloimmune injury due to antibody-mediated rejection and ischemia-reperfusion injury are the two main etiologies of microvascular damage in kidney transplant recipients. The presence of circulating donor-specific anti-human leukocyte antigen (HLA) antibodies, histological findings, such as diffuse C4d staining in peritubular capillaries, and the extent and severity of peritubular capillaritis, are commonly used clinically to provide both diagnostic and prognostic information. Complement-dependent assays, circulating non-HLA antibodies, or evaluation of the microvasculature with novel imaging techniques are the subject of ongoing studies.


2020 ◽  
Vol 104 (S3) ◽  
pp. S122-S123
Author(s):  
Idalia Parra-Avila ◽  
Abraham Cohen-Bucay ◽  
Rogelio E. Castillo-Ramirez ◽  
Silvia E. Ramirez-Andrade ◽  
Luis E. Morales-Buenrostro

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