Delayed Gastric Emptying in Prelung Transplant Patients Is Associated With Posttransplant Acute Cellular Rejection Independent of Reflux

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Taylor Derousseau ◽  
Walter W. Chan ◽  
David Cangemi ◽  
Vaidehi Kaza ◽  
Wai-Kit Lo ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Acute Cellular Rejection ◽  
Transplant Patients ◽  
Cellular Rejection

scholarly journals Usefulness of Speckle Tracking Echocardiography and Biomarkers for Detecting Acute Cellular Rejection After Heart Transplantation

2020 ◽  
Author(s):  
Cecília Beatriz Bittencourt Viana Cruz ◽  
Ludhmila A. Hajjar ◽  
Fernando Bacal ◽  
Marco S. Lofrano-Alves ◽  
Márcio S.M. Lima ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Troponin I ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Acute Cellular Rejection ◽  
Control Group ◽  
Transplant Patients ◽  
Cellular Rejection

Abstract Background: Acute cellular rejection (ACR) is a major complication after heart transplantation. Endomyocardial biopsy (EMB) remains the gold standard for its diagnosis, but it has concerning complications. We evaluated the usefulness of speckle tracking echocardiography (STE) and biomarkers for detecting ACR after heart transplantation.Methods: We prospectively studied 60 transplant patients with normal left and right ventricular systolic function who underwent EMB for surveillance six months after transplantation. Sixty age- and sex-matched healthy individuals constituted the control group. Conventional echocardiographic parameters, left ventricular global longitudinal, radial and circumferential strain (LV-GLS, LV-GRS and LV-GCS, respectively), left ventricular systolic twist (LV-twist) and right ventricular free wall longitudinal strain (RV-FWLS) were analyzed just before the procedure. We also measured biomarkers at the same moment. Results: Among the included 60 patients, 17 (28%) had severe ACR (grade ≥ 2R), and 43 (72%) had no significant ACR (grade 0 – 1R). The absolute values of LV-GLS, LV-twist and RV-FWLS were lower in transplant patients with ACR degree ≥ 2 R than in those without ACR (12.5% ± 2.9% vs 14.8% ± 2.3%, p=0.002; 13.9° ± 4.8° vs 17.1° ± 3.2°, p=0.048; 21.4%± 3.2% vs 16.6% ± 2.9%, p<0.001; respectively), while no differences were observed between the LV-GRS or LV-GCS. All of these parameters were lower in the transplant group without ACR than in the nontransplant control group, except for the LV-twist. Cardiac troponin I levels were significantly higher in patients with significant ACR than in patients without significant ACR [0.19 ng/mL (0.09–1.31) vs. 0.05 ng/mL (0.01–0.18), p=0.007]. The combination of troponin with LV-GLS, RV FWLS and LV-Twist had an AUC (area under curve) for the detection of ACR of 0.80 (0.68 – 0.92), 0.89 (0.81 – 0.93) and 0.79 (0.66 – 0.92), respectively. Conclusion: Heart transplant patients have altered left ventricular dynamics compared with control individuals. The combination of troponin with strain parameters had higher accuracy for the detection of ACR than the isolated variables and this association might select patients with a higher risk for ACR who will benefit from an EMB procedure in the first year after heart transplantation.

scholarly journals CD4+CD25+CD127-Foxp3+ and CD8+CD28- Tregs in Renal Transplant Recipients: Phenotypic Patterns, Association With Immunosuppressive Drugs, and Interaction With Effector CD8+ T Cells and CD19+IL-10+ Bregs

2021 ◽  
Vol 12 ◽  
Author(s):  
Mostafa G. Aly ◽  
Eman H. Ibrahim ◽  
Hristos Karakizlis ◽  
Rolf Weimer ◽  
Gerhard Opelz ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Negative Impact ◽  
Immunosuppressive Drugs ◽  
Acute Cellular Rejection ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Regulatory Cells ◽  
Transplant Patients ◽  
Antibody Induction ◽  
Cellular Rejection

IntroductionGaps still exist regarding knowledge on regulatory cells in transplant recipients. We studied the phenotypic patterns of CD4+, CD8+CD28- Tregs, and CD19+IL-10+ Bregs in the blood of healthy controls (HC), end-stage kidney disease patients (ESKD), early and late stable renal transplant recipients (Tx), and transplant recipients with steroid-treated acute cellular rejection 1 week–3 months after successful treatment. We also investigated the relationship between immunosuppressive drugs and the aforementioned regulatory cells in transplant recipients.MethodsWe recruited 32 HC, 83 ESKD, 51 early Tx, 95 late Tx, and 9 transplant patients with a recent steroid-treated acute cellular rejection. Besides CD19+IL-10+ Bregs, we analyzed absolute and relative frequencies of CD4+CD25+CD127-Foxp3+ Tregs and CD8+CD28- Tregs and their expression of IL-10, TGF-ß, IFN-g, and Helios.ResultsWe found a negative correlation between absolute CD4+CD25+CD127-Foxp3+ Treg and relative CD19+IL-10+ Breg frequencies in early Tx recipients (r=-0.433, p=0.015, n=31). In that group, absolute CD4+CD25+CD127-Foxp3+ Tregs were negatively associated with steroid dose and tacrolimus trough levels (r=-0.377, p = 0.021, n=37; r=-0.43, p=0.033, n=25, respectively), opposite to IL-10+ Bregs, whose frequency apparently was not negatively affected by potent immunosuppression early posttransplant. We found also lower CD4+CD25+CD127-Foxp3+ Tregs in patients treated with basiliximab or rATG as compared with ESKD patients (p=0.001 and p &lt;0.001, respectively). No difference in absolute IL-10+ Bregs could be detected among these 3 patient groups. Early Tx recipients showed lower CD4+CD25+CD127-Foxp3+ Tregs within 3 months of antibody induction than after 3 months (p = 0.034), whereas IL-10+ Bregs showed higher relative counts during the first 3 months post antibody induction than after 3 months (p = 0.022). Our findings suggest that IL-10+ Bregs decrease with time posttransplantation independent of the effect of antibody induction and dose of other immunosuppressive drugs.ConclusionThese findings suggest that CD19+IL-10+ Bregs and CD4+CD25+CD127-Foxp3+ Tregs behave in opposite ways during the early posttransplant period, possibly due to a predominant negative impact of high doses of immunosuppressants on Tregs. CD19+IL-10+Bregs do not seem to be suppressed by antibody induction and early potent immunosuppression with chemical drugs.

Inadequate Immune Regulatory Function of CD4+CD25bright+FoxP3+ T Cells in Heart Transplant Patients who Experience Acute Cellular Rejection

2009 ◽  
Vol 87 (8) ◽  
pp. 1191-1200 ◽  
Author(s):  
I Esmé Dijke ◽  
Sander S. Korevaar ◽  
Kadir Caliskan ◽  
Aggie H.M.M. Balk ◽  
Alex P.W.M. Maat ◽  
...  
Keyword(s):  
T Cells ◽  
Heart Transplant ◽  
Acute Cellular Rejection ◽  
Regulatory Function ◽  
Transplant Patients ◽  
Cellular Rejection

scholarly journals Using an immune functional assay to differentiate acute cellular rejection from recurrent hepatitis C in liver transplant patients

2009 ◽  
Vol 15 (2) ◽  
pp. 216-222 ◽  
Author(s):  
Roniel Cabrera ◽  
Miguel Ararat ◽  
Consuelo Soldevila-Pico ◽  
Lisa Dixon ◽  
Jen-Jung Pan ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Acute Cellular Rejection ◽  
Functional Assay ◽  
Recurrent Hepatitis ◽  
Transplant Patients ◽  
Recurrent Hepatitis C ◽  
Cellular Rejection

scholarly journals Sarcomere ACTC1 and MYO18A serum expression levels detect acute cellular rejection in cardiac transplant patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L Perez Carrillo ◽  
J C Trivino ◽  
I Sanchez Lazaro ◽  
L Martinez Dolz ◽  
M Portoles ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Acute Cellular Rejection ◽  
Cardiac Transplant ◽  
Sequencing Analysis ◽  
Development Fund ◽  
Expression Levels ◽  
Non Invasive ◽  
Transplant Patients ◽  
Good Ability ◽  
Cellular Rejection

Abstract Introduction and purpose The development of non-invasive approaches for the early diagnosis of cardiac allograft rejection is necessary. Given the central role of sarcomeric dysfunction in cardiomyocyte biology and sarcomere alterations, described in endomyocardial biopsies of transplant patients with rejection, we hypothesized that the serum expression levels of genes encoding sarcomeric proteins were altered in acute cellular rejection (ACR). Methods Forty consecutive serum samples from transplant recipients undergoing routine endomyocardial biopsies were included in an RNA sequencing analysis. Results We identified 61 sarcomeric genes, 19 of which were differentially expressed in patients with clinically relevant rejection (ACR grade ≥2R). A receiver operating characteristic curve was done to assess their accuracy for ACR detection, and found that 8 relevant actins, myosins, and other sarcomere-related genes showed great diagnostic capacity (AUC≥0.800); ACTC1 (AUC=1.000, p&lt;0.0001) and MYO18A (AUC=1.000, p&lt;0.0001) showed the best results. MYO18A had a good ability to detect mild rejection (AUC=0.789, p&lt;0.05). We found a relationship between MYO18A and the left ventricular end-systolic (p&lt;0.01) and end-diastolic (p&lt;0.05) diameters. Conclusions ACTC1 and MYO18A also showed a significant correlation with the NT-proBNP levels (p&lt;0.05). Because of their precision to detect ACR, we propose sarcomere ACTC1 and MYO18A serum expression levels as potential candidates for non-invasive ACR detection. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Carlos IIIEuropean Regional Development Fund (ERDF)

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