Elevated Blood IFNg, IL-6, IL-10 and IL-17A Levels Are Associated With Allograft Rejection (AR) in HLA-Sensitized (HS) Kidney Transplant Recipients (Tx Pts).

2014 ◽  
Vol 98 ◽  
pp. 323-324
Author(s):  
J. Watanabe ◽  
C. Nast ◽  
S. Ge ◽  
A. Vo ◽  
A. Peng ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Allograft Rejection ◽  
Elevated Blood ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals Outcomes of Kidney Transplantation in Fabry Disease: A Meta-Analysis

Diseases ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 2
Author(s):  
Maria L. Gonzalez Suarez ◽  
Charat Thongprayoon ◽  
Panupong Hansrivijit ◽  
Juan Medaura ◽  
Pradeep Vaitla ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Fabry Disease ◽  
Kidney Transplant ◽  
Allograft Rejection ◽  
Graft Failure ◽  
Current Therapy ◽  
Transplant Recipients ◽  
Lysosomal Storage ◽  
Kidney Transplant Recipients ◽  
Enzyme Replacement

Background: Fabry disease (FD) is a rare X-linked lysosomal storage disorder with progressive systemic deposition of globotriaosylceramide, leading to life-threatening cardiac, central nervous system, and kidney disease. Current therapy involves symptomatic medical management, enzyme replacement therapy (ERT), dialysis, kidney transplantation, and, more recently, gene therapy. The aim of this systematic review was to assess outcomes of kidney transplantation among patients with FD. Methods: A comprehensive literature review was conducted utilizing MEDLINE, EMBASE, and Cochrane Database, from inception through to 28 February 2020, to identify studies that evaluate outcomes of kidney transplantation including patient and allograft survival among kidney transplant patients with FD. Effect estimates from each study were extracted and combined using the random-effects generic inverse variance method of DerSimonian and Laird. Results: In total, 11 studies, including 424 kidney transplant recipients with FD, were enrolled. The post-transplant median follow-up time ranged from 3 to 11.5 years. Overall, the pooled estimated rates of all-cause graft failure, graft failure before death, and allograft rejection were 32.5% (95%CI: 23.9%–42.5%), 14.5% (95%CI: 8.4%–23.7%), and 20.2% (95%CI: 15.4%–25.9%), respectively. In the sensitivity analysis, limited only to the recent studies (year 2001 or newer when ERT became available), the pooled estimated rates of all-cause graft failure, graft failure before death, and allograft rejection were 28.1% (95%CI: 20.5%–37.3%), 11.7% (95%CI: 8.4%–16.0%), and 20.2% (95%CI: 15.5%–26.0%), respectively. The pooled estimated rate of biopsy proven FD recurrence was 11.1% (95%CI: 3.6%–29.4%), respectively. There are no significant differences in the risks of all-cause graft failure (p = 0.10) or mortality (0.48) among recipients with vs. without FD. Conclusions: Despite possible FD recurrence after transplantation of 11.1%, allograft and patient survival are comparable among kidney transplant recipients with vs. without FD.

scholarly journals Comparison of clinical outcome of induction immunosuppressive therapy with thymoglobulin and standard therapy in kidney transplantation; a randomized double-blind clinical trial

2019 ◽  
Vol 9 (1) ◽  
pp. e08-e08
Author(s):  
Heshmatollah Shahbazian ◽  
Ali Ghorbani ◽  
Fatemeh Hayati ◽  
Seyed Seifollah Beladi Mousavi ◽  
Leila Sabetnia ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Induction Therapy ◽  
Allograft Rejection ◽  
Control Group ◽  
Case Group ◽  
Transplant Recipients ◽  
Acute Allograft Rejection ◽  
Kidney Transplant Recipients

Introduction: Thymoglobulin is a lymphocyte-depleting polyclonal antibody, administered for induction therapy at the time of kidney transplantation to reduce the risk of acute allograft rejection. The appropriate dosage and duration of therapy is controversial. The higher dosages are associated with infection and malignancy. Objectives: In this study efficacy and safety of lower dosage (in comparison with previous studies) of thymoglobulin in kidney transplant recipients was evaluated. Patients and Methods: In this clinical trial, 106 adult kidney transplant recipients, were randomized before transplantation in two groups (case and control). The case group (53 patients) were received induction therapy with thymoglobulin (1.5 mg/kg/d for 3 days) and the control group (53 patients) were received non-induction regiment. Delayed graft function (DGF), glomerular filtration rate (GFR), acute allograft rejection and thymoglobulin complications were evaluated during the first post-transplantation year. Results: Around 106 kidney transplant recipients were enrolled (71 or 66.98% deceased donor) to the study. No significant statistical differences were found in GFR at the time of discharge from hospital (P=0.399) and at 1 year (P=0.851) and acute allograft rejection (P= 0.304) between two groups. Graft survival (73.5% in case group versus 81.1% in control group, P=0.392) at month 12th was similar among groups. Additionally, no significant differences of acute allograft rejection in recipient from deceased or living donor between two groups were detected. There was a higher incidence of DGF in the control group (26.4%) than the thymoglobulin group (5.8%) and the difference was statistically significant (P= 0.004). Thrombocytopenia (17% versus 49.1%, P<0.001) and leukopenia (11.3% versus 50.9%, P<0.001) were also significantly higher in the case group. Conclusion: While the incidence of DGF was reduced in thymoglobulin group, the short-term acute allograft rejection rate was not reduced compared to the control group. However, our results require further consideration with larger samples

scholarly journals Collateral effects and mortality of kidney transplant recipients during the COVID-19 pandemic

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0006472021
Author(s):  
Christian Schmidt-Lauber ◽  
Christian Günster ◽  
Tobias B. Huber ◽  
Melissa Spoden ◽  
Florian Grahammer
Keyword(s):  
Kidney Transplant ◽  
Allograft Rejection ◽  
Rate Ratio ◽  
Final Analysis ◽  
Intensive Care Treatment ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Admission Rates ◽  
Urogenital Infections ◽  
Collateral Effects

Background: Collateral effects and consequences of the coronavirus disease 19 (COVID-19) pandemic on kidney transplant recipients remain widely unknown. Methods: This retrospective cohort study examines changes in admission rates, incidences of diseases leading to hospitalization, in-patient procedures, and maintenance medication in long-term kidney transplant recipients with functioning graft during the early COVID-19 pandemic in Germany. Data derived from a nationwide health insurance database. Analysis was performed from March 15th to September 30th and compared the years 2019 and 2020. Effects on mortality and adverse allograft events were compared to COVID-19 attributed effects. Results: 7,725 patients were included in the final analysis. Admissions declined in 2020 by 17% with a main dip during a 3-month lockdown (-31%) but without a subsequent rebound. Incidences for hospitalization did not increase for any investigated disease entities, while decreasing trends were noted for non-COVID-19 pulmonary and urogenital infections (incidence rate ratio 0.8, 95%-CI 0.62-1.03, and 0.82, 95%-CI 0.65-1.04, respectively). Non-COVID-19 hospital stays were 0.6 days shorter (p = 0.034) and not complicated by increased dialysis, ventilation, or intensive care treatment rates. In-hospital and 90-day mortality remained stable. Incidence of severe COVID-19 requiring hospitalization was 0.09 per 1,000 patient-days and in-hospital mortality was 9.2%. 31% of patients with calcineurin-inhibitor medication and without being hospitalized for COVID-19 reduced doses by at least 25%, which was associated with an increased allograft rejection risk (adjusted hazard ratios 1.29, 95%-CI 1.02-1.63). COVID-19 caused 16.9% of all deaths but had no significant association with allograft rejections. All-cause mortality remained stable (rate ratio 1.15, 95%-CI 0.91-1.46), also when restricting analysis to patients with no or outpatient-treated COVID-19 (0.97, 95%-CI 0.76-1.25). Conclusion: Despite significant collateral effects, mortality remained unchanged during the early COVID-19 pandemic. Considerable temporary reductions in admissions are safe whereas reducing immunosuppression results in increased allograft rejection risk.

OKT3 monoclonal antibody in pediatric kidney transplant recipients with recurrent and resistant allograft rejection

1987 ◽  
Vol 111 (1) ◽  
pp. 45-50 ◽  
Author(s):  
M.R. Leone ◽  
S.R. Alexander ◽  
J.M. Barry ◽  
K. Henell ◽  
M.B. Funnell ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Kidney Transplant ◽  
Allograft Rejection ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients
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