Post-transplant Alternative Complement Pathway Activation Influences Kidney Allograft Function

AbstractThe complement system is one of the crucial pathophysiological mechanisms that directly influence the function of a transplanted kidney. Since the complement pathways ’ activation potential can be easily determined via their functional activity measurement, we focused on fluctuation in the cascade activity in the early post-transplant period. The aim of the study was to relate the kidney transplantation-induced complement system response to allograft outcome. F orty-two kidney recipients (aged: 53.5 [37–52], 17 females/25 males) and 24 healthy controls (aged: 40.5 [34–51], 13 females/11 males) were enrolled in the study. The functional activities of alternative, classical, and lectin pathways were determined before and in the first week after transplan tation using Wielisa®-kit. We observed that the baseline functional activity of the alternative pathway (AP) was higher in chronic kidney disease patients awaiting transplantation compared to healthy controls and that its level depended on the type of dialysis. AP-functional activity was decreased following transplantation procedure and its post-transplant level was related to allograft function. The baseline and transplantation-induced functional activities of the classical and lectin pathways were not influenced by dialysis type and were not associated with transplant outcome. Moreover, our study showed that intraoperative graft surface cooling had a protective effect on AP activation. Our study ...
Source: Archivum Immunologiae et Therapiae Experimentalis - Category: Allergy & Immunology Source Type: research

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Sonia Mehrotra, Raj Kumar Sharma, Manas R PatelIndian Journal of Nephrology 2019 29(4):242-247 Vitamin-D has immuno-modulatory properties besides its role in mineral and bone disorder (MBD) and could have a role in allograft outcome. Fifty-two chronic kidney disease patients on dialysis going for transplantation were prospectively studied before and after renal transplantation. FGF23, 25(OH) vitamin D, 1,25-Dihydroxyvitamin D, PTH, serum Ca, serum PO4, and e-GFR status were evaluated. Vitamin D deficiency was seen in 25.0% of recipients before transplant (26.09 ± 12.19 ng/mL) and in 48.1% at 6 months post-tra...
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
Purpose of review The population of kidney transplant recipients with advanced chronic kidney disease is growing but their outcomes are poor and care is not standardized. There has been wide variety of research in recent years on different aspects of care in failing allografts, and these research findings may help the providers in optimizing care. The purpose of the review is to outline the challenges and opportunities in management of failing allograft, and provide tools for improvement. Recent findings This review summarizes the recent research in field of failing allograft including outcomes, immunosuppression, ris...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: KIDNEY PANCREAS: Edited by Matthew Cooper Source Type: research
Kidney transplantation (KT) is the treatment of choice for end stage kidney disease , offering the highest survival benefit amongst all the different renal replacement therapies1. Long term renal allograft and patient survival have shown substantial improvements over time: however, death with a functioning allograft remains the leading cause of late allograft loss with cardiovascular disease (CVD) related deaths representing a major cause of mortality2. While recipients of kidney transplants have lower risk for CVD when compared to the 10-20 fold increased risk in patients with dialysis, their risk of CVD is substantially ...
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Policy Forum Source Type: research
Abstract BACKGROUND: In chronic kidney disease (CKD), intensive systolic blood pressure (SBP) control reduces mortality at a cost of greater acute kidney injury (AKI) risk. Kidney transplantation involves implantation of denervated kidneys and immunosuppressive medications that increase AKI risk. The optimal blood pressure (BP) target in kidney transplant recipients (KTRs) is uncertain. Prior observational studies from the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) trial demonstrate associations of lower SBP levels and reduced mortality risk, but the relationship of BP with kidney allog...
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research
AbstractDespite the advances in renal transplantation over the last decades, chronic allograft dysfunction remains the largest concern for patients, their families, clinicians and other members of the multi-disciplinary team. Although we have made progress in improving patient and renal allograft survival within the first year after transplantation, the rate of transplant failure with requirement for commencement of dialysis or re-transplantation has essentially remained unchanged. It is important that paediatric and adult nephrologists and transplant surgeons, not only manage their patients and their renal transplants but...
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
Publication date: Available online 20 December 2018Source: American Journal of Kidney DiseasesAuthor(s): Wouter R. Verberne, Zofia Das-Gupta, Andrew S. Allegretti, Hans A.J. Bart, Wim van Biesen, Guillermo García-García, Elizabeth Gibbons, Eduardo Parra, Marc H. Hemmelder, Kitty J. Jager, Markus Ketteler, Charlotte Roberts, Muhamed Al Rohani, Matthew J. Salt, Andrea Stopper, Türkan Terkivatan, Katherine R. Tuttle, Chih-Wei Yang, David C. Wheeler, Willem Jan W. BosValue-based health care is increasingly promoted as a strategy for improving care quality by benchmarking outcomes that matter to patients rela...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
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Source: Iranian Journal of Kidney Diseases - Category: Urology & Nephrology Tags: Iran J Kidney Dis Source Type: research
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Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Perspective Source Type: research
Purpose of review With improving short-term kidney transplant outcomes, recurrent glomerular disease is being increasingly recognized as an important cause of chronic allograft failure. Further understanding of the risks and pathogenesis of recurrent glomerular disease enable informed transplant decisions, along with the development of preventive and treatment strategies. Recent findings Multiple observational studies have highlighted differences in rates and outcomes for various recurrent glomerular diseases, although these rates have not markedly improved over the last decade. Emerging evidence supports use of ritux...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by J. Kevin Tucker and Anil Chandraker Source Type: research
Chronic kidney disease frequently accompanies end-stage heart failure, and may result in consideration of simultaneous heart and kidney transplantation (SHKT). In recent years there has been a significant increase SHKT. This single center cohort consisted of 35 patients who underwent SHKT during 1996 - 2015. The aim of this study was to review factors that may predict better long-term outcome following SKHT. Thirteen patients (37%) had delayed graft function (DGF) post-transplant (defined as the need for dialysis during the first 7 days post- transplant), which was significantly associated with mechanical circulatory suppo...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
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