Management of Renal Failure in the Liver Transplant Patient

AbstractPurpose of ReviewTo examine several current issues in the management of patients undergoing orthotopic liver transplantation (OLT) with significant renal injury.Recent FindingsReview of the recent literature suggests that the actual cause of acute kidney injury (AKI) in cirrhotic patients undergoing OLT may significantly influence outcomes. Strategies such a simultaneous liver-kidney transplant (SLK) and intraoperative renal replacement therapy have been employed to achieve comparable results to either single organ transplant or those without pre-OLT AKI.SummaryWith the dramatic rise in acuity at the time of transplant, several strategies have been employed to influence outcomes in OLT recipients with concomitant renal failure. Furthermore, shifts in organ allocation policy have resulted in significant changes in the management of this patient population. At present, the impact of these evolving strategies on long-term graft and patient survival is unknown.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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Conclusion: Longer hospitalization is significantly associated with the development of de novo DSA in SLKT. PMID: 31875761 [PubMed - in process]
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
In conclusion, high-dose NR induces the onset of WAT dysfunction, which may in part explain the deterioration of metabolic health. Towards a Rigorous Definition of Cellular Senescence https://www.fightaging.org/archives/2019/11/towards-a-rigorous-definition-of-cellular-senescence/ The accumulation of lingering senescent cells is a significant cause of aging, disrupting tissue function and generating chronic inflammation throughout the body. Even while the first senolytic drugs capable of selectively destroying these cells already exist, and while a number of biotech companies are working on the productio...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSIONS: Liver transplant can be considered a treatment for patients with primary hyperoxaluria type 1. Combined liver and kidney transplant and preemptive liver transplant could be proper options for these patients. PMID: 31580236 [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
ard E Abstract Primary hyperoxaluria type 1 (PH1) is an inherited metabolic disorder caused by a deficiency of the peroxisomal enzyme alanine-glyoxylate aminotransferase (AGT), which leads to overproduction of oxalate by the liver and results in urolithiasis, nephrocalcinosis and renal failure. The only curative treatment for PH1 is combined liver and kidney transplantation, which is limited by the lack of suitable organs, significant complications, and the life-long requirement for immunosuppressive agents to maintain organ tolerance. Hepatocyte-like cells (HLCs) generated from CRISPR/Cas9 genome-edited human-ind...
Source: Biochemical and Biophysical Research communications - Category: Biochemistry Authors: Tags: Biochem Biophys Res Commun Source Type: research
Crohn’s Disease in Clinical Remission Is Marked by Systemic Oxidative Stress Arno R. Bourgonje1, Julius Z. H. von Martels1, Marian L. C. Bulthuis2, Marco van Londen3, Klaas Nico Faber1, Gerard Dijkstra1† and Harry van Goor2*† 1Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 2Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 3Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Gro...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusions: We propose that epigenetics mechanisms involving microRNAs may integrate human transplantation tolerance mechanisms, and regulate key members of the cell death/survival signaling. miR-885-5p could favor cell survival in OT by diminishing the levels of CRADD/RAIDD and CASP3. Nonetheless, given the nature of any complex phenomenon in humans, only cumulative data will help to determine whether this microRNA differential profile may be related to the cause or consequence of operational tolerance. Introduction Despite its clinical success, allotransplantation still faces important challenges, such as preventi...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: Pre-transplantation plasmatic miR-155-5p expression may be useful for stratifying low-immunologic-risk patients, and post-transplantation miR-181a-5p and miR-155-5p may be candidates for inclusion in early, non-invasive prognostic biomarker panels to prevent TCMAR or SCR and better identify patient candidates for IS minimization. Large prospective randomized multicenter trials are needed to refine the cut-off values and algorithms and validate the clinical usefulness of these biomarkers. Introduction Despite great advances in immunosuppressive (IS) therapy, T cell-mediated rejection (TCMAR), which is the...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusion and Perspectives Collectively, previous studies showed that numerous types of TCMs protect against AKI via different mechanisms of action, including inhibiting inflammation, cell apoptosis, necroptosis, ferroptosis, and restraining oxidative stress etc. These data support the potential application of these TCMs as novel therapeutic agents in treating patients with AKI. Although some TCMs have entered preclinical trials, it is essential to initiate pre-clinical pharmacologic and toxicologic trials and clinical trials to evaluate the efficacy and safety of TCMs usage. Moreover, considering that some TCMs are dele...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions and Perspectives In this review, we have discussed important milestones from the early description of “Serum-sickness” as being due to antibodies directed against Neu5Gc epitopes all the way to the present-day therapeutic implications of these antibodies in cancer therapy. Some of these milestones have been represented in a concise timeline (Figure 6). While the “Xenosialitis” hypothesis is well-supported in the human-like mouse models, it has yet to be conclusively proven in humans. It remains to be seen if “Xenosialitis” plays a role in other uniquely-human diseases. FI...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusion As a critical regulator of inflammation and cell survival, the NFκB pathway is a promising target for diagnosing and treating kidney diseases. For modulation of the NFκB pathway in the clinic, a number of molecules can effectively inhibit NFκB signaling by targeting the receptors, associated adaptors, IKKs, IκBs and transcriptional regulators (144). There is further clinical evidence on small-molecule inhibitors of IKKα and NIK from recent trials on anti-cancer therapies (145). These clinical trials showed that the cancer-selective pharmacodynamic response of DTP3, the co-inhibitor...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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