scholarly journals CD8+ T CELL SENESCENCE IS A DISTINCT IMMUNOLOGICAL STATE THAT IDENTIFIES LONG-TERM RENAL TRANSPLANT RECIPIENTS AT INCREASED RISK OF FUTURE MALIGNANCY

2020 ◽  
Vol 104 (S3) ◽  
pp. S106-S106
Author(s):  
Matthew J. Bottomley ◽  
Suzanne Bezstarosti ◽  
Eleni Ieremiah ◽  
Joanna Hester ◽  
Fadi Issa ◽  
...  
Keyword(s):  
T Cell ◽  
Renal Transplant ◽  
Cd8 T Cell ◽  
Cell Senescence ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk ◽  
T Cell Senescence

scholarly journals Initial mycophenolate dose in tacrolimus treated renal transplant recipients, a cohort study comparing leukopaenia, rejection and long-term graft function

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Vatsa Dave ◽  
Kevan R. Polkinghorne ◽  
Khai Gene Leong ◽  
John Kanellis ◽  
William R. Mulley
Keyword(s):  
Renal Function ◽  
Cohort Study ◽  
Renal Transplant ◽  
Graft Function ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplantation ◽  
Post Transplant ◽  
Increased Risk

Abstract The evidence supporting an initial mycophenolate mofetil (MMF) dose of 2 g daily in tacrolimus-treated renal transplant recipients is limited. In a non-contemporaneous single-centre cohort study we compared the incidence of leukopaenia, rejection and graft dysfunction in patients initiated on MMF 1.5 g and 2 g daily. Baseline characteristics and tacrolimus trough levels were similar by MMF group. MMF doses became equivalent between groups by 12-months post-transplant, driven by dose reductions in the 2 g group. Leukopaenia occurred in 42.4% of patients by 12-months post-transplant. MMF 2 g was associated with a 1.80-fold increased risk of leukopaenia compared to 1.5 g. Rejection occurred in 44.8% of patients by 12-months post-transplantation. MMF 2 g was associated with half the risk of rejection relative to MMF 1.5 g. Over the first 7-years post-transplantation there was no difference in renal function between groups. Additionally, the development of leukopaenia or rejection did not result in reduced renal function at 7-years post-transplant. Leukopaenia was not associated with an increased incidence of serious infections or rejection. This study demonstrates the initial MMF dose has implications for the incidence of leukopaenia and rejection. Since neither dose produced superior long-term graft function, clinical equipoise remains regarding the optimal initial mycophenolate dose in tacrolimus-treated renal transplant recipients.

Everolimus-Treated Renal Transplant Recipients Have a More Robust CMV-Specific CD8+ T-Cell Response Compared With Cyclosporine- or Mycophenolate-Treated Patients

2013 ◽  
Vol 95 (1) ◽  
pp. 184-191 ◽  
Author(s):  
Simone H.C. Havenith ◽  
Si La Yong ◽  
Karlijn A.M.I. van Donselaar-van der Pant ◽  
René A.W. van Lier ◽  
Ineke J.M. ten Berge ◽  
...  
Keyword(s):  
T Cell ◽  
Renal Transplant ◽  
Cell Response ◽  
Cd8 T Cell ◽  
T Cell Response ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

Monitoring of Cytomegalovirus-Specific CD4+ and CD8+ T Cell Responses by Cytokine Flow Cytometry in Renal Transplant Recipients

2016 ◽  
Vol 50 (2) ◽  
pp. 224-235 ◽  
Author(s):  
Hafize KILINÇKAYA DOĞAN ◽  
Esvet MUTLU ◽  
Sadi KÖKSOY ◽  
Vural T. YILMAZ ◽  
Hüseyin KOÇAK ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
T Cell ◽  
Renal Transplant ◽  
T Cell Responses ◽  
Cd8 T Cell ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cell Responses ◽  
Cytokine Flow Cytometry

scholarly journals Flow Cytometric Crossmatching in Primary Renal Transplant Recipients with a Negative Anti-Human Globulin Enhanced Cytotoxicity Crossmatch

2001 ◽  
Vol 12 (12) ◽  
pp. 2807-2814 ◽  
Author(s):  
Martin Karpinski ◽  
David Rush ◽  
John Jeffery ◽  
Markus Exner ◽  
Heinz Regele ◽  
...  
Keyword(s):  
T Cell ◽  
Renal Transplant ◽  
Graft Loss ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Hla Antibodies ◽  
Antibody Mediated Rejection ◽  
Flow Cytometric ◽  
Increased Risk ◽  
Early Graft

ABSTRACT. Flow cytometric crossmatching (FCXM) and panel reactive antibody (PRA) screening techniques are more sensitive than anti-human globulin enhanced cytotoxicity (AHG-CDC) techniques at detecting anti-HLA antibodies. The clinical significance of a positive FCXM in primary renal transplant recipients with a negative AHG-CDC crossmatch is unclear. We performed retrospective FCXM and flow cytometric panel reactive antibody (FlowPRA) determinations in primary renal transplant recipients with a negative T cell AHG-CDC crossmatch and a negative B cell CDC crossmatch pretransplant. Eighteen (13%) of 143 patients exhibited a positive retrospective T cell FCXM. Of these patients, six (33%) experienced early graft loss with explant histology, demonstrating antibody-mediated rejection in five of six cases. The 12 patients with positive T cell FCXM who maintained their grafts experienced more adverse events posttransplant, including more early, steroid-resistant, and recurrent rejection. Furthermore, in a subgroup of patients undergoing protocol biopsies, those with a positive T cell FCXM exhibited more subclinical rejection. Anti-HLA antibodies were detected by FlowPRA in all 18 patients with a positive T cell FCXM, whereas AHG-CDC PRA detected antibodies in only 8 of 18 patients. Therefore, flow cytometric techniques identify sensitized primary renal transplant recipients undetected by AHG-CDC techniques. In those patients, a positive T cell FCXM is associated with an increased risk of early graft loss due to antibody-mediated rejection and may represent a relative contraindication to transplantation. Moreover, those patients are also at increased risk of severe and recurrent rejection, which may carry implications for long-term graft outcomes.

scholarly journals Torquetenovirus Serum Load and Long-Term Outcomes in Renal Transplant Recipients

2020 ◽  
Vol 9 (2) ◽  
pp. 440 ◽  
Author(s):  
Edmund J. Gore ◽  
António W. Gomes-Neto ◽  
Lei Wang ◽  
Stephan J. L. Bakker ◽  
Hubert G. M. Niesters ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Long Term Outcomes ◽  
Post Transplantation ◽  
Increased Risk ◽  
All Cause Mortality ◽  
One Year

Following transplantation, patients must take immunosuppressive medication for life. Torquetenovirus (TTV) is thought to be marker for immunosuppression, and TTV–DNA levels after organ transplantation have been investigated, showing high TTV levels, associated with increased risk of infections, and low TTV levels associated with increased risk of rejection. However, this has been investigated in studies with relatively short follow-up periods. We hypothesized that TTV levels can be used to assess long term outcomes after renal transplantation. Serum samples of 666 renal transplant recipients were tested for TTV DNA. Samples were taken at least one year after renal transplantation, when TTV levels are thought to be relatively stable. Patient data was reviewed for graft failure, all-cause mortality and death due to infectious causes. Our data indicates that high TTV levels, sampled more than one year post-transplantation, are associated with all-cause mortality with a hazard ratio (HR) of 1.12 (95% CI, 1.02–1.23) per log10 increase in TTV viral load, (p = 0.02). Additionally, high TTV levels were also associated with death due to infectious causes (HR 1.20 (95% CI 1.01–1.43), p = 0.04). TTV levels decrease in the years following renal transplantation, but remain elevated longer than previously thought. This study shows that TTV level may aid in predicting long-term outcomes, all-cause mortality and death due to an infectious cause in renal transplant patients sampled over one year post-transplantation.

scholarly journals Impact of hyperuricemia on long-term clinical outcomes of renal transplant recipients: a systematic review and meta-analysis

2021 ◽  
Vol 24 ◽  
pp. 292-307
Author(s):  
Hui Yang ◽  
Qing Chen ◽  
Aiwen Huang ◽  
Xiaojia Yu ◽  
Gang Chen ◽  
...  
Keyword(s):  
Uric Acid ◽  
Renal Transplant ◽  
Clinical Outcomes ◽  
Cardiovascular Event ◽  
Graft Loss ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Significant Difference

Purpose: To evaluate the effect of hyperuricemia on clinical outcomes of renal transplant recipients (RTRs). Methods: A literature search of PubMed, Cochrane, Embase was conducted up to March 20, 2020. The primary outcome was the estimated glomerular filtration rate (eGFR). The second outcomes were the risk of graft loss, death, cardiovascular event and the level of triglyceride. The following search terms were utilized: ((Hyperuricemic group) OR (Hyperuricaemia) OR (Hyperuric) OR (Urea acid) OR (Uric acid) OR (Acid urate) OR (Urate) OR (Gout)) and ((Transplantation) OR (Transplantations) OR (Transplant) OR (Transplants) OR (Graft)). Results: 28 studies with 18224 patients were eligible for inclusion. There was no significant difference in eGFR (<12 months, p=0.07), the risk of graft loss (<60 months, p=0.07) and death (<60months, p=0.19) between the hyperuricemic and normouricemic group in the early post-transplantation period. But increased uric acid levels contributed to the long-term decline of eGFR, the risk of graft loss and death increased after transplantation. Hyperuricemia increased the risk of cardiovascular event with no significant difference in the level of triglyceride between the two groups. Conclusions: Increased uric acid levels contributed to the long-term decline of eGFR, increased risk of graft loss and death after transplantation. Although there was no significant effect on triglyceride, hyperuricemia increased the risk of cardiovascular event.

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