Incidence of Cytomegalovirus and Acute Rejection in D+/R- Kidney Transplant Patients On Valganciclovir Prophylaxis After Medication Dose Adjustments.

Abstract Concentrations of interleukin 2 receptor (sIL-2R) have been suggested as a marker of rejection episodes after organ transplantation. To evaluate the analytical performance of a "sandwich-type" enzyme immunoassay method for sIL-2R and to verify whether increased concentrations of sIL-2R might be a useful marker of allograft rejection, we quantified sIL-2R in serum samples from heart- or kidney-transplant patients. The mean (+/- SD) pre-transplant value of sIL-2R (592 +/- 209 kilo-units/L) in heart-transplant patients was significantly higher (P less than 0.01) than that observed in controls (350 +/- 101 kilo-units/L). After heart transplantation, the concentrations of sIL-2R slowly decreased to baseline in successfully treated patients but increased significantly (1129 +/- 215 kilo-units/L; P less than 0.01) during acute rejection crisis. However, severe infections were also associated with a significant increase of sIL-2R, so the sIL-2R test is not specific for allograft rejection. The mean pre-transplant concentration of sIL-2R was also increased (1943 +/- 878 kilo-units/L) in 26 renal-transplant patients; after transplantation, this value returned to normal, as did that for creatinine, but persisted steadily high in five patients who experienced acute tubular necrosis. In this group of patients, the sIL-2R concentration increased by 1.5- to fourfold, both during acute rejection episodes and in clinically evident infection; thus measurement of creatinine and sIL-2R concentrations can help to distinguish between rejection, infection, and cyclosporine toxicity. In two episodes of mild cyclosporine-induced nephrotoxicity, we observed slight increases in serum creatinine (which returned to baseline when the cyclosporine dose was decreased) not associated with an increase in sIL-2R. We conclude that systematic monitoring of sIL-2R together with other biochemical and clinical markers may be useful in the management of kidney-transplant patients.

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Clinical course of kidney transplant patients with acute rejection and BK virus replication following Campath therapy

Clinical Transplantation ◽

10.1111/j.1399-0012.2008.00791.x ◽

2008 ◽

Vol 22 (3) ◽

pp. 348-353 ◽

Cited By ~ 5

Author(s):

Liise K. Kayler ◽

Ravi Mohanka ◽

Claire Morgan ◽

Amit Basu ◽

Ron Shapiro ◽

...

Keyword(s):

Acute Rejection ◽

Kidney Transplant ◽

Virus Replication ◽

Clinical Course ◽

Bk Virus ◽

Transplant Patients ◽

Kidney Transplant Patients

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Delayed Graft Function and Acute Rejection in Kidney Transplant Patients with Positive Panel-Reactive Antibody and Negative Donor-Specific Antibodies

Nephro-Urology Monthly ◽

10.5812/numonthly.107969 ◽

2020 ◽

Vol 12 (4) ◽

Author(s):

Ha Nguyen Thi Thu ◽

Manh Bui Van ◽

Dung Nguyen Thi Thuy ◽

Kien Truong Quy ◽

Duc Nguyen Van ◽

...

Keyword(s):

Acute Rejection ◽

Kidney Transplant ◽

Kidney Function ◽

Graft Function ◽

Post Transplantation ◽

Transplant Patients ◽

Kidney Transplant Patients ◽

Group 2 ◽

Reactive Antibody ◽

Group 1

Background: Delayed graft function (DGF) and acute rejection (AR) are common complications in kidney transplant patients. Objectives: The study evaluated DGF and AR in highly sensitized patients and their effects on kidney function for six months post-transplantation. Methods: We enrolled 95 patients with kidney transplants from living donors who were divided into two groups. Group 1 included 47 highly sensitized patients with panel reactive antibody (PRA) < 20.0% and negative donor-specific antigen, and group 2 included 48 patients with negative PRA. All patients were followed for the state of DGF, AR, and kidney function for six months. Results: Group 1 showed a significantly higher proportion of DGF and AR than group 2 (27.7% versus 2.1%, P < 0.001 and 14.9% versus 2.1%, P = 0.031, respectively). The rates of positive PRA in DGF and AR patients were significantly higher than those in non-DGF and non-AR patients (92.9% versus 42.0%, P < 0.001 and 87.5% versus 46.0%, P = 0.031, respectively). Transplanted kidney function was significantly worse in patients with PRA and DGF and/or AR than in patients with negative PRA and non-DGF and non-AR only in the seventh-day post-transplantation. Conclusions: Kidney transplant in highly sensitized patients with positive PRA was related to the increased ratio of DGF and AR.

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