scholarly journals Late acute cellular rejection after switch to everolimus monotherapy at 11 months following liver transplantation

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Chantelli Iamblaudiot Razafindrazoto ◽  
Noémie Trystram ◽  
Gustavo Miranda Martins ◽  
Christiane Stern ◽  
Frédéric Charlotte ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Risk Factor ◽  
Mycophenolate Mofetil ◽  
Biological Evolution ◽  
Immunosuppressive Drugs ◽  
Acute Cellular Rejection ◽  
First Year ◽  
Main Risk Factor ◽  
Cellular Rejection ◽  
Uncommon Complication

Abstract Background Acute cellular rejection beyond the 6th month posttransplant is an uncommon complication after liver transplantation. The inadequate immunosuppression (IS) remains the main risk factor. We report a case of acute cellular rejection after a switch to everolimus monotherapy at 11 months following liver transplantation. Case presentation This was a 69-year-old man who underwent liver transplantation after hepatocellular carcinoma. The initial immunosuppression was a combination of three immunosuppressive drugs (corticosteroids + tacrolimus + mycophenolate mofetil). The corticosteroid therapy was stopped at the 4th month posttransplant. Serious side effects of the immunosuppressive drugs (agranulocytosis and renal dysfunction), which occurred 4 months after transplantation, required a reduction and then a discontinuation of tacrolimus and mycophenolate mofetil. Everolimus was introduced as a replacement. The patient was consulted at 11 months after liver transplantation, 1 month after stopping the two immunosuppressive drugs, for liver function test abnormalities such as cytolysis and anicteric cholestasis. A moderate late acute cellular rejection was confirmed by a liver biopsy. A satisfactory biological evolution was observed following corticosteroid boluses and optimization of basic immunosuppressive drugs. Conclusion Late acute cellular rejection remains an uncommon complication, observed mostly in the first year after liver transplantation. The main risk factor is usually the decrease of immunosuppression.

scholarly journals Applications and Limitations of Blood Eosinophilia for the Diagnosis of Acute Cellular Rejection in Liver Transplantation

2003 ◽  
Vol 3 (4) ◽  
pp. 432-438 ◽  
Author(s):  
Eleanor J. Barnes ◽  
Marwa M. Abdel-Rehim ◽  
Yiannis Goulis ◽  
Mona Abou Ragab ◽  
Susane Davies ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Acute Cellular Rejection ◽  
Blood Eosinophilia ◽  
Cellular Rejection

scholarly journals Peritoneal dialysis - associated peritonitis during treatment with continuous ambulatory peritoneal dialysis

2019 ◽  
pp. 47-52
Author(s):  
M. Malasaiev ◽  
I. Dudar ◽  
A. Shymova
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
First Year ◽  
Significant Progress ◽  
Main Risk Factor ◽  
Common Cause ◽  
Hemodialysis Treatment ◽  
Methodological Approaches ◽  
Peritoneal Function

 Infections associated with peritoneal dialysis (infection of the catheter, tunnel infection and peritonitis) are the most common complications of this method. Despite significant progress in the methodological approaches to the prevention, diagnosis and treatment of PD associated infections, peritonitis remains the main risk factor for mortality in PD patients (up to 6%) and plays a significant role in more than 1/6 of the deaths associated with non-infectious complications such as cardiovascular and / or cerebrovascular disease. Besides, PD-associated infections are the most common cause of loss of peritoneal function and the patients’ transition to hemodialysis treatment. About 5% of PD patients are converted to hemodialysis treatment in the first year after postponed peritonitis.

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 <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.

Evaluation of Longitudinal Exposure to Tacrolimus as a Risk Factor of Chronic Kidney Disease Occurrence Within the First Year Post-Liver Transplantation

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Pauline Maurel ◽  
Aurélie Prémaud ◽  
Paul Carrier ◽  
Marie Essig ◽  
Louise Barbier ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Liver Transplantation ◽  
Risk Factor ◽  
Kidney Disease ◽  
First Year ◽  
Disease Occurrence
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