HCV-infected solid organ donors, direct-acting antivirals and the current challenges.

HCV-infected solid organ donors, direct-acting antivirals and the current challenges. Expert Rev Clin Pharmacol. 2019 Dec 02;: Authors: Fabrizi F, Cerutti R, Silva M Abstract Introduction: The introduction of direct-acting antiviral therapy has generated tremendous interest in transplanting organs from HCV-infected donors, an option which has the potential to lower waiting times for solid organ transplantation (including kidneys). Safe, effective and pangenotypic direct-acting antiviral agents are currently available.Areas covered: We have identified studies from PubMed, EMBASE, and the Cochrane database to review risks and benefits on solid organ transplantation from HCV exposed donors in uninfected recipients.Expert opinion: The transmission of HCV with transplantation from anti-HCV positive kidneys without viraemia is extremely uncommon whereas recent evidence (five clinical studies, n=94 patients) shows absence of HCV infection in HCV naïve recipients who received kidneys from HCV RNA positive donors and underwent early DAAs. The evidence regarding non-kidney solid organ transplantation from HCV infected donors is more limited. One report showed the occurrence of dialysis-dependent kidney failure due to glomerulonephritis induced by acute HCV after liver transplant from a NAT positive donor into an HCV-naïve recipient. Transplantation of kidneys and other solid organs from HCV viremic donors into uninfected recipients has the potential to be...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

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CONCLUSIONS: Plasma exchange was effective in patients with severe AKI secondary to vasculitis. Pulse cyclophosphamide may result in an increased risk of relapse when compared to continuous oral use but a reduced total dose. Whilst CPA is standard induction treatment, rituximab and MMF were also effective. AZA, methotrexate and leflunomide were effective as maintenance therapy. Further studies are required to more clearly delineate the appropriate place of newer agents within an evidence-based therapeutic strategy. PMID: 31927782 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract C1q is a key intermediary in the classical complement pathway. It is known to be activated by several factors including immunoglobulins and charged molecules and is an initiator of the complement cascade. C1q nephropathy (C1qN) is a rare idiopathic glomerulonephritis characterized by predominant presence of glomerular deposits of C1q fraction of complement. Although few uncommon associations of C1qN have been seen with various disorders, we present the first case of C1qN diagnosed in an elderly male with gastric adenocarcinoma. Few months after the onset of symptoms related to gastric-outlet obstruction, ...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
We report the first case of microbiologically proven tubercular interstitial nephritis and membranous nephropathy (MN) occurring concurrently in the same patient. The patient improved with the use of antitubercular therapy alone. TB should be recognized as a potentially treatable infectious cause of secondary MN. PMID: 31929294 [PubMed - in process]
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
In this report, we describe the successful use of eculizumab to treat a patient with recurrent post-transplant C3GN caused by a C3 gene gain-of-function mutation, and also review the published literature regarding the use of eculizumab for the treatment of recurrent C3 glomerulopathy.
. PMID: 31661064 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
CONCLUSIONS: Since the beginning of KRT programs reporting to the ERA-EDTA Registry since the 1960s, fewer women than men have received KRT. The relative difference between men and women initiating and undergoing KRT has remained consistent over the last five decades and in all studied countries. PMID: 31649071 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
AbstractBackgroundAlthough high-density lipoprotein (HDL) modulates many cell types in the cardiovascular system, little is known about HDL in the kidney. We assessed urinary excretion of apolipoprotein AI (apoAI), the main protein in HDL.MethodsWe enrolled 228 children with various kidney disorders and 40 controls. Urinary apoAI, albumin, and other markers of kidney damage were measured using ELISA, apoAI isoforms with Western blot, and renal biopsies stained for apoAI.ResultsPatients followed in nephrology clinic had elevated urinary apoAI vs. controls (median 0.074  μg/mg; interquartile range (IQR) 0.0160–...
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
Abstract Rapidly progressive glomerulonephritis (RPGN) is rare syndrome in children, characterized by clinical features of glomerulonephritis and rapid loss of renal function, and is associated with crescentic glomerulonephritis. Primary membranous nephropathy (MN) is an immune-complex-mediated cause of the adult nephrotic syndrome but occurs less frequently in children. RPGN is rarely observed in adults with primary MN. In this article, we report a case of MN, which developed during long-term follow-up of previously treated RPGN. Our case may be the first to demonstrate primary MN and crescentic glomerulonephriti...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Abstract The pattern of kidney diseases varies in different places due to differences in genetic status, socioeconomic status, access to health care, and presence of background infection. In spite of nephrology as a specialty since 1970s, there are still limited data regarding the spectrum of renal diseases in India. Our study was conducted in a tertiary care institute and referral center in northeast India. It provides insight into profile of renal diseases in hospitalized children. It is a cross-sectional study conducted in a government medical college in Assam. All children who were admitted in this department ...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
In conclusion, primary glomerular diseases were the predominant biopsy-proven kidney diseases, and FSGS and MN were the most common glomerular diseases. This pattern in South Punjab closely resembles that in southern and northern parts of the country. PMID: 31696854 [PubMed - in process]
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
CONCLUSIONS: In kidney transplant recipients, urinary tract infections are common complications and have negative outcomes on graft function. These infections remain an important disease that requires frequent investigations andnewwaysof approachforprevention. PMID: 31424358 [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
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