scholarly journals HLA-G 14bp Ins/Del Polymorphism in the 3′UTR Region and Acute Rejection in Kidney Transplant Recipients: An Updated Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1007
Author(s):  
Sang Wook Kang ◽  
Eunkyung Oh ◽  
Wonwoo Cho ◽  
Minseok Kim ◽  
Eo Jin Park ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Meta Analysis ◽  
Human Leukocyte ◽  
Asian Population ◽  
Kidney Transplant Recipients ◽  
Deletion Polymorphism ◽  
Transplant Patients ◽  
G 14

Background and Objectives: Acute kidney injury (AKI) affects the survival rate of kidney transplant organs and patients. Acute rejection (AR) due to AKI may lead to kidney transplantation failure. It is known that there is a relationship between human leukocyte antigen-G (HLA-G), which is involved in immune regulation, and AR in transplant patients. Moreover, 14-bp insertion/deletion polymorphism in the 3′ untranslated region (UTR) region of the HLA-G gene is known to affect HLA-G expression. However, its relationship to AR is still controversial. The aim of this study was to investigate whether HLA-G 14-bp insertion/deletion polymorphism contributed to the development of AR in kidney transplant patients using a meta-analysis. Materials and Methods: To perform our meta-analysis, eligible studies about HLA-G 14-bp insertion/deletion polymorphism and AR were searched in electronic databases until 1 June 2021. Finally, a total of 336 patients with AR and 952 patients without AR in relation to kidney transplantation were analyzed from a total of nine studies. Results: In our results, the Del allele and Ins/Del+Del/Del and Del/Del genotypes significantly increased susceptibility of AR in Asian populations [odds ratio (OR) = 2.359, 95% confidence interval (CI) = 1.568–3.550, p = 3.8 × 10−5; OR = 3.357, 95% CI = 1.769–6.370, p = 0.002; OR = 2.750, 95% CI = 1.354–5.587, p = 0.0052 in each model, respectively]. Conclusions: Evidence of the present results indicate that HLA-G 14-bp insertion/deletion polymorphism is associated with susceptibility to AR in the Asian population.

scholarly journals Impact of HLA-G 14 bp polymorphism and soluble HLA-G level on kidney graft outcome

2016 ◽  
Vol 11 (1) ◽  
pp. 372-379
Author(s):  
Vladimira Durmanova ◽  
Helena Bandzuchova ◽  
Zuzana Zilinska ◽  
Jana Tirpakova ◽  
Daniel Kuba ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Human Leukocyte ◽  
Hla Class I ◽  
Kidney Graft ◽  
Kidney Transplant Recipients ◽  
Deletion Polymorphism ◽  
Graft Outcome ◽  
Allograft Function ◽  
Soluble Hla ◽  
G 14

AbstractHuman leukocyte antigen G (HLA-G) is a non-classical HLA class I protein with various immunosuppressive functions. Besides its profound effect to induce fetal tolerance, HLA-G has been also found to enhance graft acceptance. The aim of the study was to analyse the association between HLA-G 14 bp insertion/deletion polymorphism, soluble HLA-G level and kidney graft outcome in the Slovak population. We investigated 69 kidney transplant recipients aged 27–65 years. Out of this group, 37 recipients developed acute rejection, confirmed by biopsy, and 32 patients had stable allograft function. Plasma was obtained from recipients at 1 day before transplantation and analyzed by ELISA. Genotyping of HLA-G polymorphism was performed by PCR. Significantly higher pre-transplantation levels of sHLA-G were found in the group with stable allograft function in comparison to group with acute rejection (P = 0.0409). In the homozygous −14/−14 recipients with stable allograft function, significantly higher values of sHLA-G were determined in comparison to the recipients with acute rejection (P = 0.0052). The study revealed an association between 14 bp deletion polymorphism and soluble HLA-G level that is proportional to kidney graft acceptance. It is suggested that pre-transplantation levels of soluble HLA-G should be monitored as additional marker to predict kidney graft outcome.

scholarly journals La terapia immunosoppressiva nel trapianto di rene

2019 ◽  
Vol 31 (3) ◽  
pp. 192-196
Author(s):  
Aris Tsalouchos ◽  
Maurizio Salvadori
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Acute Rejection ◽  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Induction Therapy ◽  
Immunosuppressive Agents ◽  
Oral Prednisone ◽  
Kidney Transplant Recipients ◽  
Optimal Maintenance

Immunosuppressive therapy in renal transplantation Immunosuppressive therapy in renal transplantation can be distinguished in induction therapy and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, the induction immunosuppressive strategies used at kidney transplant centers fall into one of these two categories. One strategy relies upon high doses of conventional immunosuppressive agents, while the other utilizes antibodies directed against T-cell antigens in combination with lower doses of conventional agents. Maintenance immunosuppressive therapy is administered to almost all kidney transplant recipients to help prevent acute rejection and loss of the renal allograft. Although an adequate level of immunosuppression is required to dampen the immune response to the allograft, the level of chronic immunosuppression is decreased over time (as the risk of acute rejection decreases) to help lower the overall risk of infection and malignancy; these risks directly correlate with the degree of overall immunosuppression. The optimal maintenance immunosuppressive therapy in kidney transplantation is not established. The major immunosuppressive agents that are available in various combination regimens are glucocorticoids (primarily oral prednisone), azathioprine, mycophenolate mofetil (MMF), enteric-coated mycophenolate sodium (EC-MPS), cyclosporine (in non-modified or modified [microemulsion] form), Tacrolimus, everolimus, rapamycin (sirolimus), and Belatacept.

La terapia immunosoppressiva nel trapianto di rene

2019 ◽  
Vol 31 (3) ◽  
pp. 192-196
Author(s):  
Aris Tsalouchos ◽  
Maurizio Salvadori
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Induction Therapy ◽  
Immunosuppressive Agents ◽  
Oral Prednisone ◽  
Kidney Transplant Recipients ◽  
Optimal Maintenance ◽  
Almost All

Immunosuppressive therapy in renal transplantation can be distinguished in induction therapy and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, the induction immunosuppressive strategies used at kidney transplant centers fall into one of these two categories. One strategy relies upon high doses of conventional immunosuppressive agents, while the other utilizes antibodies directed against T-cell antigens in combination with lower doses of conventional agents. Maintenance immunosuppressive therapy is administered to almost all kidney transplant recipients to help prevent acute rejection and loss of the renal allograft. Although an adequate level of immunosuppression is required to dampen the immune response to the allograft, the level of chronic immunosuppression is decreased over time (as the risk of acute rejection decreases) to help lower the overall risk of infection and malignancy; these risks directly correlate with the degree of overall immunosuppression. The optimal maintenance immunosuppressive therapy in kidney transplantation is not established. The major immunosuppressive agents that are available in various combination regimens are glucocorticoids (primarily oral prednisone), azathioprine, mycophenolate mofetil (MMF), enteric-coated mycophenolate sodium (EC-MPS), cyclosporine (in non-modified or modified [microemulsion] form), Tacrolimus, everolimus, rapamycin (sirolimus), and Belatacept.

Increased circulating concentrations of interleukin 2 receptor during rejection episodes in heart- or kidney-transplant recipients

1990 ◽  
Vol 36 (12) ◽  
pp. 2106-2109 ◽  
Author(s):  
G C Zucchelli ◽  
A Clerico ◽  
R De Maria ◽  
M Carmellini ◽  
R Di Stefano ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Allograft Rejection ◽  
Interleukin 2 ◽  
Clinical Markers ◽  
Kidney Transplant Recipients ◽  
Interleukin 2 Receptor ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
The Mean

Abstract Concentrations of interleukin 2 receptor (sIL-2R) have been suggested as a marker of rejection episodes after organ transplantation. To evaluate the analytical performance of a "sandwich-type" enzyme immunoassay method for sIL-2R and to verify whether increased concentrations of sIL-2R might be a useful marker of allograft rejection, we quantified sIL-2R in serum samples from heart- or kidney-transplant patients. The mean (+/- SD) pre-transplant value of sIL-2R (592 +/- 209 kilo-units/L) in heart-transplant patients was significantly higher (P less than 0.01) than that observed in controls (350 +/- 101 kilo-units/L). After heart transplantation, the concentrations of sIL-2R slowly decreased to baseline in successfully treated patients but increased significantly (1129 +/- 215 kilo-units/L; P less than 0.01) during acute rejection crisis. However, severe infections were also associated with a significant increase of sIL-2R, so the sIL-2R test is not specific for allograft rejection. The mean pre-transplant concentration of sIL-2R was also increased (1943 +/- 878 kilo-units/L) in 26 renal-transplant patients; after transplantation, this value returned to normal, as did that for creatinine, but persisted steadily high in five patients who experienced acute tubular necrosis. In this group of patients, the sIL-2R concentration increased by 1.5- to fourfold, both during acute rejection episodes and in clinically evident infection; thus measurement of creatinine and sIL-2R concentrations can help to distinguish between rejection, infection, and cyclosporine toxicity. In two episodes of mild cyclosporine-induced nephrotoxicity, we observed slight increases in serum creatinine (which returned to baseline when the cyclosporine dose was decreased) not associated with an increase in sIL-2R. We conclude that systematic monitoring of sIL-2R together with other biochemical and clinical markers may be useful in the management of kidney-transplant patients.

scholarly journals Prognostic value of myocardial perfusion imaging in kidney transplant recipients: a systematic review and meta-analysis

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
FEJ Jolink ◽  
JR Kelderman ◽  
AG Monroy Gonzalez ◽  
S Benjamens ◽  
RHJA Slart ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Kidney Transplant ◽  
Cardiovascular Mortality ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Kidney transplant recipients are at risk for major adverse cardiac events (MACE) and cardiovascular mortality. We aimed to assess the prognostic value of myocardial perfusion imaging (MPI) single-photon emission computed tomography (SPECT), in patients evaluated for transplantation, for MACE and cardiovascular mortality after kidney transplantation. Methods We performed a systematic literature search in PubMed, EMBASE, Web of Science, OvidSP, The Cochrane Library and Google Scholar. We retrieved studies investigating the prognostic value of MPI for MACE and mortality in kidney transplant recipients. After risk of bias assessment using QUIPS, a meta-analysis was conducted. Results Out of 1379 records, 14 studies (7 prospective and 7 retrospective) using MPI SPECT were included in the meta-analysis with a total of 4643 MPI procedures. No studies were excluded after QUIPS assessment. Median follow-up duration of patients ranged from 1 to 8 years. Kidney transplant recipients with perfusion defects on MPI showed an increased risk for MACE (RR 2.76, 95%-CI 1.73-4.42), cardiovascular mortality (RR 3.15, 95%-CI 1.94-5.13) and all-cause mortality (RR 2.12, 95%-CI 1.76-2.54) compared to recipients with normal MPI findings. Significant heterogeneity existed across the included studies investigating MACE. Conclusions Our results showed that MPI SPECT may identify patients at increased risk for MACE and mortality after kidney transplantation.

scholarly journals Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis

2021 ◽  
Vol 1 (2) ◽  
pp. 100-120
Author(s):  
Ellen M. Castle ◽  
Emily McBride ◽  
James Greenwood ◽  
Kate Bramham ◽  
Joseph Chilcot ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Meta Analysis ◽  
First Year ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Intervention ◽  
Combined Interventions

Weight gain within the first year of kidney transplantation is associated with adverse outcomes. This narrative systematic review and meta-analysis examines the effect of exercise, physical activity, dietary, and/or combined interventions on body weight and body mass index (BMI) within the first year of kidney transplantation. Seven databases were searched from January 1985 to April 2021 (Prospero ID: CRD42019140865), using a ‘Population, Intervention, Controls, Outcome’ (PICO) framework. The risk-of-bias was assessed by two reviewers. A random-effects meta-analysis was conducted on randomized controlled trials (RCTs) that included post-intervention body weight or BMI values. Of the 1197 articles screened, sixteen met the search criteria. Ten were RCTs, and six were quasi-experimental studies, including a total of 1821 new kidney transplant recipients. The sample sizes ranged from 8 to 452. Interventions (duration and type) were variable. Random-effects meta-analysis revealed no significant difference in post-intervention body weight (−2.5 kg, 95% CI −5.22 to 0.22) or BMI (−0.4 kg/m2, 95% CI −1.33 to 0.54). Despite methodological variance, statistical heterogeneity was not significant. Sensitivity analysis suggests combined interventions warrant further investigation. Five RCTs were classified as ‘high-risk’, one as ‘some-concerns’, and four as ‘low-risk’ for bias. We did not find evidence that dietary, exercise, or combined interventions led to significant changes in body weight or BMI post kidney transplantation. The number and quality of intervention studies are low. Higher quality RCTs are needed to evaluate the immediate and longer-term effects of combined interventions on body weight in new kidney transplant recipients.

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