Impact of low tacrolimus exposure and high tacrolimus intra-patient variability on the development of de novo anti-HLA donor-specific antibodies in kidney transplant recipients.

This article provides an overview of current findings published in the recent five years regarding the relationship between tacrolimus exposure and variation therein and the development of dnDSA.Expert opinion: In this review we describe how combining data on tacrolimus intra-patient variability and mean pre-dose concentration may be an effective tool to identify kidney transplant recipients who are at higher risk of developing dnDSA. PMID: 31721605 [PubMed - as supplied by publisher]
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research

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ConclusionThe combination of donor sCr and Δγ-H2AX from 0 to 1 h after reperfusion may predict severe DGF and PNF in the early phase.
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
This study aimed to define the ultrastructural changes of the endothelium in lung allografts in the setting of AMR and determine its specificity for AMR.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
Contributors : Nissim Ben-Haim ; Tomer KaliskySeries Type : Expression profiling by high throughput sequencingOrganism : Homo sapiensEnd-stage renal disease is a worldwide epidemic requiring renal replacement therapy. Harvesting tissue from failing kidneys and autotransplantation of expanded committed progenitors giving rise to renal parenchyma could theoretically allow for the restoration of kidney function delaying or preventing the need for dialysis or a renal allograft. Here we utilized healthy and end-stage human adult kidneys to robustly expand proliferative kidney epithelial cells and establish 3D-kidney epithelial ...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by high throughput sequencing Homo sapiens Source Type: research
AbstractBackgroundTo improve the long-term outcomes following renal transplantation, prevention of renal-allograft interstitial fibrosis (IF), mainly due to calcineurin inhibitors, is an important therapeutic target. Everolimus (EVR) was reported to have antifibrotic effects. We aimed to investigate the safety, efficacy, and IF of our modified immunosuppressive regimen, which includes early introduction of EVR and reduced-exposure tacrolimus (Tac) (EVR group), and compare it with the standard-exposure tacrolimus-based regimen (Tac group) in de novo living-donor renal recipients.MethodsIn this retrospective, single-center c...
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
This study evaluated the analytical performance of a massively multiplexed polymerase chain reaction assay that targets 13 962 single-nucleotide polymorphisms, characterized and validated using 66 unique samples with 1064 replicates, including cell line-derived reference samples, plasma-derived mixtures, and transplant patient samples. The dd-cfDNA fraction was quantified in both related and unrelated donor-recipient pairs. Results. The dd-cfDNA assay showed a limit of blank of 0.11%, a limit of detection and limit of quantitation of 0.15% for unrelated donors, and limit of blank of 0.23%, a limit of detection an...
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research
Authors: Yao J, Jiang L, Xue D, Sun Y Abstract The present study was designed to determine the potential role of circulating procalcitonin (PCT) in predicting chronic allograft dysfunction (CAD) in kidney transplant recipients (KTRs). A total of 87 KTRs were retrospectively analyzed and divided into a CAD and a non-CAD (normal renal function) group. Clinical features and inflammatory markers were compared between the groups, including PCT, white blood cell count, C-reactive protein, neutrophil percentage (N%) and lipoprotein(a) [Lp(a)], and the receiver operating characteristic (ROC) curve for CAD prediction was pl...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Purpose of review Despite improvement in short-term renal allograft survival in recent years, renal transplant recipients (RTR) have poorer long-term allograft outcomes. Allograft function slowly declines with periods of stable function similar to natural progression of chronic kidney disease in nontransplant population. Nearly all RTR transitions to failing renal allograft (FRG) period and require transition to dialysis. Conservative chronic kidney disease management before transition to end-stage renal disease is an increasingly important topic; however, there is limited data in RTR regarding how to delay dialysis init...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Kamyar Kalantar-Zadeh and Ekamol Tantisattamo Source Type: research
CONCLUSIONS: Although screening for BK polyomavirus in urine did detect viralreactivation earlier,there were no differences in graft or clinical outcomes when either the urine or blood screening method was used. PMID: 31801449 [PubMed - as supplied by publisher]
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
There is a growing shortage of kidney donors leading to extended transplant waiting times associated with increased mortality. To expand the donor pool, clinicians nowadays regularly accept organs from elderly donors, including those aged ≥70 years. There is only limited and conflicting data whether kidneys from these elderly donors allow for satisfactory allograft outcome rates. To asses this question, the 5-year death censored graft survival of 116,870 adult first deceased donor kidney allograft recipients that were transplanted at European centers between 1997 and 2016 and reported to the “Collaborative Transpl...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Activation of host T cells that mediate allograft rejection is a 2-step process. The first occurs in secondary lymphoid organs where T cells encounter alloantigens presented by host DCs and differentiate to effectors. Antigen presentation at these sites occurs principally via transfer of intact, donor MHC-peptide complexes from graft cells to host DCs (cross-dressing) or by uptake and processing of donor antigens into allopeptides bound to self-MHC molecules (indirect presentation). The second step takes place in the graft, where effector T cells reengage with host DCs before causing rejection. How host DCs present alloant...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
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