Acute Page Kidney After a Kidney Allograft Biopsy: Successful Outcome From Observation and Medical Treatment

2009 ◽  
Vol 87 (3) ◽  
pp. 453-454 ◽  
Author(s):  
Nassim Kamar ◽  
Federico Sallusto ◽  
Lionel Rostaing
Keyword(s):  
Medical Treatment ◽  
Successful Outcome ◽  
Kidney Allograft ◽  
Allograft Biopsy ◽  
Page Kidney

scholarly journals Renal Mucormycosis: A Rare and Potentially Lethal Complication of Kidney Transplantation

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
SreyRam Kuy ◽  
Chun He ◽  
David C. Cronin
Keyword(s):  
Kidney Transplantation ◽  
Amphotericin B ◽  
Early Recognition ◽  
Deceased Donor ◽  
The United States ◽  
Successful Outcome ◽  
Early Presentation ◽  
First Case ◽  
Allograft Biopsy ◽  
Transplant Nephrectomy

Renal mucormycosis is a rare and potentially lethal complication of kidney transplantation. We describe two cases of renal mucormycosis following deceased donor kidney transplantation. This is the second report of renal mucormycosis following kidney transplantation in the United States, and the first case of renal mucormycosis infection presumed to be of recipient origin. Case A had an early presentation of mucormycosis isolated to the kidney allograft. He had an unexpected rise in serum creatinine and leukocytosis necessitating allograft biopsy which showed mucormycosis. He underwent transplant nephrectomy on posttransplant day 11, was treated with amphotericin B, and discharged home on posttransplant day 22. Case B had a late presentation of renal mucormycosis, preceded by a cutaneous manifestation. One year after kidney transplantation he had a nonhealing knee ulcer which on biopsy showed cutaneous mucormycosis. Treatment included aggressive debridement and amphotericin B. Allograft biopsy showed mucormycosis, necessitating transplant nephrectomy. He was discharged to a rehabilitation facility and died from noninfectious causes. Review of the published literature of renal mucormycosis cases following kidney transplantation reveals a mortality rate of more than 50%. The key to successful outcome is early recognition, prompt institution of surgical debridement of all infected tissue, and appropriate antifungal therapy.

scholarly journals Chemokine CXCL13 as a New Systemic Biomarker for B-Cell Involvement in Acute T Cell-Mediated Kidney Allograft Rejection

2019 ◽  
Vol 20 (10) ◽  
pp. 2552 ◽  
Author(s):  
Lena Schiffer ◽  
Flavia Wiehler ◽  
Jan Hinrich Bräsen ◽  
Wilfried Gwinner ◽  
Robert Greite ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
Severe Disease ◽  
Serum Levels ◽  
Clinical Findings ◽  
Blood Levels ◽  
Kidney Allograft ◽  
Cell Clusters ◽  
Allograft Biopsy ◽  
Patients At Risk

The presence of B-cell clusters in allogenic T cell-mediated rejection (TCMR) of kidney allografts is linked to more severe disease entities. In this study we characterized B-cell infiltrates in patients with TCMR and examined the role of serum CXCL-13 in these patients and experimentally. CXCL-13 serum levels were analyzed in 73 kidney allograft recipients at the time of allograft biopsy. In addition, four patients were evaluated for CXCL13 levels during the first week after transplantation. ELISA was done to measure CXCL-13 serum levels. For further mechanistic understanding, a translational allogenic kidney transplant (ktx) mouse model for TCMR was studied in BalbC recipients of fully mismatched transplants with C57BL/6 donor kidneys. CXCL-13 serum levels were measured longitudinally, CD20 and CD3 composition and CXCL13 mRNA in tissue were examined by flow cytometry and kidneys were examined by histology and immunohistochemistry. We found significantly higher serum levels of the B-cell chemoattractant CXCL13 in patients with TCMR compared to controls and patients with borderline TCMR. Moreover, in patients with acute rejection within the first week after ktx, a >5-fold CXCL13 increase was measured and correlated with B-cell infiltrates in the biopsies. In line with the clinical findings, TCMR in mice correlated with increased systemic serum-CXCL13 levels. Moreover, renal allografts had significantly higher CXCL13 mRNA expression than isogenic controls and showed interstitial CD20+ B-cell clusters and CD3+ cell infiltrates accumulating in the vicinity of renal vessels. CXCL13 blood levels correlate with B-cell involvement in TCMR and might help to identify patients at risk of a more severe clinical course of rejection.

Concurrent cytomegalovirus glomerulitis and BK polyomavirus-associated nephropathy in a kidney allograft biopsy

2016 ◽  
Vol 18 (2) ◽  
pp. 247-250 ◽  
Author(s):  
I.O. Chikeka ◽  
A. Paulk ◽  
A. Haririan ◽  
J.C. Papadimitriou ◽  
C.B. Drachenberg
Keyword(s):  
Kidney Allograft ◽  
Allograft Biopsy ◽  
Bk Polyomavirus

scholarly journals Safety And Efficacy Of Vaginal Misoprostol In Treatment Of First Trimester Miscarriage

2020 ◽  
Vol 7 (3) ◽  
pp. 138-144
Author(s):  
Mohamed S. A. Emarah
Keyword(s):  
Medical Treatment ◽  
Initial Dose ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Successful Outcome ◽  
Controlled Study ◽  
Gestational Sac ◽  
Vaginal Misoprostol ◽  
Median Interval

Objective: This study was conducted to determine the outcome of medical treatment with vaginal misoprostol in missed miscarriage.          Methods: A randomized controlled study was performed in Benha Teaching Hospital between April 2016 and June 2017. Eighty patients diagnosed with miscarriage before 13 weeks of gestation and wanted to try medical treatment were included. A detailed ultrasound scan was performed to confirm the diagnosis. Patients took 400 microgram (mcg) of misoprostol  vaginal as an initial dose, and repeated the same dose 4-6 hours apart. Successful medical abortion was defined as spontaneous expulsion of gestational products (including gestational sac, embryo, fetus, and placenta). Ultrasonography at least 24 hours later from the initial dose to assess the uterine cavity if gestational products were not expelled, surgical evacuation was performed. Results:  About two-thirds of patients (77.5%) had a successful outcome. The median interval time from pill to expulsion was 18 hours in the successful medical treatment group. Conclusion: Medical treatment with vaginal misoprostol should be a proper option for the first trimester miscarriage, especially for the patient who want to avoid surgical procedure. We can reduce the unnecessary sedation or surgical intervention in the patients with the first trimester miscarriage.

Kidney allograft biopsy: timing to complications

2010 ◽  
Vol 74 (07) ◽  
pp. 39-45 ◽  
Author(s):  
Z. Yablon ◽  
P. Recupero ◽  
J. McKenna ◽  
J. Vella ◽  
M.G. Parker
Keyword(s):  
Kidney Allograft ◽  
Allograft Biopsy

Acute page kidney phenomenon following renal allograft biopsy

2018 ◽  
Vol 94 (6) ◽  
pp. 1241 ◽  
Author(s):  
Krishnaswamy Sampathkumar ◽  
Thangaraj Mukuntharajan ◽  
Andrew Rajiv ◽  
Sivaraj Anandan
Keyword(s):  
Renal Allograft ◽  
Allograft Biopsy ◽  
Page Kidney

scholarly journals Unusual Case of Lipoprotein Glomerulopathy First Diagnosed in a Protocol Kidney Allograft Biopsy

2019 ◽  
Vol 4 (2) ◽  
pp. 350-354 ◽  
Author(s):  
Ibrahim Batal ◽  
Gaia Fakhoury ◽  
Emily Groopman ◽  
Vivette D. D’Agati ◽  
Heather Morris
Keyword(s):  
Unusual Case ◽  
Lipoprotein Glomerulopathy ◽  
Kidney Allograft ◽  
Allograft Biopsy

scholarly journals Liver Function Enzymes are Potential Predictive Markers for Kidney Allograft Dysfunction

2020 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Liver Function ◽  
Estimated Glomerular Filtration Rate ◽  
Serum Alkaline Phosphatase ◽  
Serum Biomarkers ◽  
Kidney Allograft ◽  
Individual Level ◽  
Allograft Dysfunction ◽  
Allograft Biopsy ◽  
Allograft Function ◽  
Pearson Correlations

Introduction: Biopsy of the allograft is the gold standard for assessing kidney allograft dysfunction. The aim of our pilot study was to identify serum biomarkers that could obviate the need for biopsy. Materials and Methods: We conducted a study to identify the biomarkers in the serum from different groups of chronic kidney disease (CKD) patients and kidney transplanted patients vs. healthy individuals. The four groups (n=25 in each group) were as follows: 1) Patients with unstable kidney allograft transplants requiring biopsy for cause, 2) Patients with stable kidney allograft transplants, 3) Patients with CKD not on immunosuppressive therapy and, 4) healthy subjects. We measured the activity and level of serum alkaline phosphatase (ALP) and other liver enzymes (alanine transaminase (ALT) and aspartate transaminase (AST)) as potential serum biomarkers in acute allograft dysfunction. Results: We found that ALP correlated with allograft biopsy findings, liver function, and clinical outcomes and possibly graft survival. Additionally, AST and ALT were higher in patients with graft rejection compared to non-rejected and stable kidney transplants. Moreover, the low Pearson correlations (r- values) between ALP level with age (r=0.179), gender, body mass index (r=0.236), creatinine (r=0.044) or estimated glomerular filtration rate (r=0.048) suggest that ALP may be an independent biomarker which is relatively unaffected by other individual-level variables. Conclusion: ALP may be a putative biomarker to predict kidney allograft function and rejection. Data also indicated that liver function plays an important role for the overall success of kidney transplantation.

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