scholarly journals Diabetes and Cardiovascular Risk in Renal Transplant Patients

2021 ◽  
Vol 22 (7) ◽  
pp. 3422
Author(s):  
Jacek Rysz ◽  
Beata Franczyk ◽  
Maciej Radek ◽  
Aleksandra Ciałkowska-Rysz ◽  
Anna Gluba-Brzózka
Keyword(s):  
Mammalian Target Of Rapamycin ◽  
Survival Rates ◽  
Public Health Problem ◽  
Post Transplant ◽  
Transplant Patients ◽  
Renal Replacement Therapies ◽  
Strict Glycemic Control ◽  
Risk Patients ◽  
Kidney Transplant Patients ◽  
End Stage

End-stage kidney disease (ESKD) is a main public health problem, the prevalence of which is continuously increasing worldwide. Due to adverse effects of renal replacement therapies, kidney transplantation seems to be the optimal form of therapy with significantly improved survival, quality of life and diminished overall costs compared with dialysis. However, post-transplant patients frequently suffer from post-transplant diabetes mellitus (PTDM) which an important risk factor for cardiovascular and cardiovascular-related deaths after transplantation. The management of post-transplant diabetes resembles that of diabetes in the general population as it is based on strict glycemic control as well as screening and treatment of common complications. Lifestyle interventions accompanied by the tailoring of immunosuppressive regimen may be of key importance to mitigate PTDM-associated complications in kidney transplant patients. More transplant-specific approach can include the exchange of tacrolimus with an alternative immunosuppressant (cyclosporine or mammalian target of rapamycin (mTOR) inhibitor), the decrease or cessation of corticosteroid therapy and caution in the prescribing of diuretics since they are independently connected with post-transplant diabetes. Early identification of high-risk patients for cardiovascular diseases enables timely introduction of appropriate therapeutic strategy and results in higher survival rates for patients with a transplanted kidney.

Comparison Of Mycophenolic Acid Pharmaco-kinetic Parameters In Kidney Transplant Patients Within The First 3 Months Post-transplant

2005 ◽  
Vol 27 (2) ◽  
pp. 238
Author(s):  
Tomasz Pawinski ◽  
Iwona Szlaska ◽  
Magdalena Durlik ◽  
Jadwiga Majchrzak ◽  
Artur Urbanowicz ◽  
...  
Keyword(s):  
Kinetic Parameters ◽  
Kidney Transplant ◽  
Mycophenolic Acid ◽  
Post Transplant ◽  
Transplant Patients ◽  
Kidney Transplant Patients

The Effect of Individual HLA Antigens on Graft Survival Rates in Kidney Transplant Patients

1984 ◽  
Vol 8 (3-4) ◽  
pp. 237-243
Author(s):  
Darlene V. Katz ◽  
Max R. Mickey ◽  
Michael Cecka ◽  
James Cicciarelli ◽  
Paul I. Terasaki
Keyword(s):  
Kidney Transplant ◽  
Graft Survival ◽  
Survival Rates ◽  
Hla Antigens ◽  
Transplant Patients ◽  
Kidney Transplant Patients

scholarly journals Treatment of Post-Transplant Recurrent FSGS in Children Using Plasmapheresis and Augmentation of Immunosuppression

2021 ◽  
Author(s):  
Jaime Restrepo-Tovar ◽  
Laura Torres-Canchala ◽  
Hernando Londoño ◽  
Michael Somers ◽  
Eliana Manzi ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Calcineurin Inhibitors ◽  
Renal Transplant Recipients ◽  
Post Transplant ◽  
Transplant Patients ◽  
Single Center Experience ◽  
Pediatric Renal Transplant ◽  
Remission Rates ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Up to 60% of pediatric renal transplant recipients with end-stage renal disease due to primary focal and segmental glomerulosclerosis (FSGS) may develop recurrent disease. Such recurrence is associated with poor prognosis if no remission is achieved. We report a single center experience with a protocol based on plasmaphereis and increased immunosuppression that resulted in a high long-lived remission rates.Methods: This retrospective cohort study included consecutive pediatric renal transplant patients with recurrent FSGS treated with a standardized protocol using plasmapheresis and cyclophosphamide to supplement usual post-transplant immunosuppression with calcineurin inhibitors and steroids. Relapse was defined as urinary protein/creatinine ratio >1.0g/g and remission as <0.5g/g. Results: 15 patients with FSGS recurrence post-transplant were treated. All had therapy-resistant FSGS in native kidneys and had been on dialysis from 4-10 years. Of the 15, one died perioperatively from a pulmonary thromboembolism. 13 others achieved a complete remission within 3 months of treatment for FSGS recurrence. After a median follow-up period of 4 years, there were no recurrences of significant proteinuria. Conclusion: The addition of plasmapheresis and cyclophosphamide to a calcineurin- and steroid-based immunosuppression regime was highy successful in inducing high remission rates with recurrent FSGS. Prospective trials are needed to evaluate further the efficacy of increased immunosuppression along with plasmapheresis in this setting.

scholarly journals The role of soluble mediators in the clinical course of EBV infection and B cell homeostasis after kidney transplantation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sharon Bajda ◽  
Arturo Blazquez-Navarro ◽  
Björn Samans ◽  
Patrizia Wehler ◽  
Sviatlana Kaliszczyk ◽  
...  
Keyword(s):  
B Cell ◽  
Kidney Transplant ◽  
Cell Expansion ◽  
Soluble Factors ◽  
Post Transplant ◽  
Transplant Patients ◽  
Proliferative Effect ◽  
Kidney Transplant Patients ◽  
B Cell Homeostasis

Abstract Epstein-Barr virus (EBV) reactivation can lead to serious complications in kidney transplant patients, including post-transplant lymphoproliferative disorder (PTLD). Here, we have assessed the impact of EBV on B cell homeostasis at cellular and humoral level. In a multicenter study monitoring 540 kidney transplant patients during the first post-transplant year, EBV reactivation was detected in 109 patients. Thirteen soluble factors and B cell counts were analyzed in an EBV+ sub-cohort (N = 54) before, at peak and after EBV clearance and compared to a control group (N = 50). The B cell activating factor (BAFF) was significantly elevated among EBV+ patients. No additional soluble factors were associated with EBV. Importantly, in vitro experiments confirmed the proliferative effect of BAFF on EBV-infected B cells, simultaneously promoting EBV production. In contrast, elevated levels of BAFF in EBV+ patients did not lead to B cell expansion in vivo. Moreover, diminished positive inter-correlations of soluble factors and alterations of the bi-directional interplay between B cell and soluble factors were observed in EBV+ patients at peak and after clearance. Our data suggest that such alterations may counteract the proliferative effect of BAFF, preventing B cell expansion. The role of these alterations in lymphoma development should be analyzed in future studies.

scholarly journals Fibroblast Growth Factor and Mineral Metabolism Parameters among Prevalent Kidney Transplant Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Madhumathi Rao ◽  
Priyanka Jain ◽  
Temitope Ojo ◽  
Gautam Surya ◽  
Vaidyanathapuram Balakrishnan
Keyword(s):  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Kidney Transplant ◽  
Mineral Metabolism ◽  
Serum Phosphate ◽  
Fibroblast Growth ◽  
Post Transplant ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Fgf 23

Background. Chronic kidney disease (CKD) related mineral bone disorders persist after kidney transplantation, but little is known about the relationship between fibroblast growth factor-23 (FGF-23) and mineral metabolism in prevalent post-transplant patients.Objectives. To examine mineral metabolism parameters and their relationship to FGF-23 and parathyroid hormone (PTH) in prevalent kidney transplant patients.Methods. Cross-sectional study of 106 kidney transplant patients enrolled November 2005–October 2009 at Tufts Medical Center (TMC), Boston.Results. The prevalence of hypophosphatemia was 34%, hypercalcemia 3%, and elevated PTH levels 66%, at a median (25th–75th percentile) duration of 12.8 (7.5–30.9) months post-transplant. Males had significantly higher levels of PTH (P=0.04) and lower levels of serum phosphate (P=0.002). Serum PTH levels did not relate to eGFR, corrected calcium levels or serum phosphate. FGF-23 levels were above the reference limits in 7% of patients; higher levels were associated with higher serum phosphate and PTH levels after adjustment for transplant kidney function.Conclusion. FGF-23 is an important driver of mineral metabolism in prevalent transplant patients. Its modulatory role in mineral metabolism homeostasis may be heightened as feedback suppression of PTH is disturbed. Its role in long term cardiovascular and graft outcomes needs further study.

scholarly journals Outcomes at 3 years post‐transplant in imlifidase‐desensitized kidney transplant patients

2021 ◽  
Author(s):  
Christian Kjellman ◽  
Angela Q Maldonado ◽  
Kristoffer Sjöholm ◽  
Bonnie E Lonze ◽  
Robert A Montgomery ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Post Transplant ◽  
Transplant Patients ◽  
Kidney Transplant Patients
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