Editorial Material
Biochemistry & Molecular Biology
Nissrin Alachkar, Nada Alachkar
Summary: Diagnosing kidney allograft rejection is complex and subjective, but an automated Banff classification could make assessment easier and improve accuracy.
Article
Transplantation
Yasar Caliskan, Gonca Karahan, Sebahat Usta Akgul, Safak Mirioglu, Yasemin Ozluk, Halil Yazici, Erol Demir, Ahmet B. Dirim, Aydin Turkmen, John Edwards, Fatma Oguz Savran, Mehmet S. Sever, Krzysztof Kiryluk, Ali Gharavi, Krista L. Lentine
Summary: The study revealed that recipients with the GG genotype of LIMS1 have a higher risk of TCMR after kidney transplantation, suggesting the importance of LIMS1 in allograft rejection. However, the GG genotype was not significantly associated with allograft loss.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2021)
Review
Immunology
Martin Tepel, Subagini Nagarajah, Qais Saleh, Olivier Thaunat, Stephan J. L. Bakker, Jacob van den Born, Morten A. Karsdal, Federica Genovese, Daniel G. K. Rasmussen
Summary: The characterization of potential kidney transplant recipients using novel biomarkers can lead to improved outcomes after transplantation. This mini-review focuses on the current understanding of pretransplant recipients' characteristics, biomarkers, and immunology. Clinical characteristics and immunological risk assessment, such as histocompatibility leukocyte antigens (HLAs) and non-HLA antibodies, have been used to predict recipient and allograft survival. Recent studies have shown that pretransplant markers, such as plasma endotrophin levels and non-synonymous single-nucleotide polymorphism mismatch, are associated with posttransplant complications and allograft loss. Integrating clinical characteristics and novel markers is important for making better diagnostic decisions tailored to individual patients.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Pediatrics
Abigail Atlas-Lazar, Daniella Levy-Erez
Summary: In a child with acute kidney injury (AKI) after renal transplantation, it is crucial to diagnose the cause quickly and accurately in order to initiate timely treatment. This article provides a systematic review on the differential diagnosis of acute graft dysfunction in pediatric kidney transplant recipients, including rejection, infections, medication toxicity, and other potential causes. It also discusses current advancements in noninvasive methods of diagnosing rejection.
CURRENT OPINION IN PEDIATRICS
(2023)
Review
Medicine, General & Internal
Sami Alasfar, Lavanya Kodali, Carrie A. Schinstock
Summary: Despite advancements in immunosuppressive therapies, kidney transplant rejection remains a challenge. This article provides an overview of the diagnosis, current therapies, and management strategies for acute T-cell-mediated rejection (TCMR) and antibody-mediated rejection (ABMR). Corticosteroids are the primary treatment for TCMR, while plasmapheresis is commonly used for ABMR, although its efficacy is still debated. Optimizing immunosuppression and addressing adherence are crucial for managing both types of rejection, but further research is needed to explore newer therapeutics and evaluate their effectiveness.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Biochemistry & Molecular Biology
Torsten R. Goesch, Nancy A. Wilson, Weifeng Zeng, Bret M. Verhoven, Weixiong Zhong, Maya M. Coumbe Gitter, William E. Fahl
Summary: PrC-210 has shown potential to suppress kidney damage and inflammation caused by allograft kidney transplantation, reducing histologic damage, improving kidney function metrics, and decreasing levels of inflammatory cytokines and activated caspase.
Article
Immunology
Emilie Gaiffe, Mathilde Colladant, Maxime Desmaret, Jamal Bamoulid, Franck Leroux, Caroline Laheurte, Sophie Brouard, Magali Giral, Philippe Saas, Cecile Courivaud, Nicolas Degauque, Didier Ducloux
Summary: Unsupervised hierarchical clustering analysis was performed on pre-transplant immunological phenotype in 1113 renal transplant recipients, identifying three immune profiles correlated with clinical phenotypes. The memory immune cluster was associated with older age and diabetes, while the activated immune cluster was associated with younger age and previous exposure to CMV. Both were associated with an increased risk of acute rejection.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Medicine, General & Internal
Sebastian Sallaberger, Lukas Buchwinkler, Susanne Eder, Stefan Schneeberger, Gert Mayer, Markus Pirklbauer
Summary: Kidney transplantation is the preferred method for treating kidney failure, but there is still a significant proportion of graft losses. This study provides information on kidney graft and patient survival rates, eGFR trajectories, and rejection rates, and also establishes a valuable biobank for the future discovery and validation of prognostic methods.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Immunology
Jung-Woo Seo, Yu Ho Lee, Dong Hyun Tae, Yang Gyun Kim, Ju-Young Moon, Su Woong Jung, Jin Sug Kim, Hyeon Seok Hwang, Kyung-Hwan Jeong, Hye Yun Jeong, So-Young Lee, Byung Ha Chung, Chan-Duck Kim, Jae Berm Park, Junhee Seok, Yeong Hoon Kim, Sang-Ho Lee
Summary: This study aimed to identify novel biomarkers for the diagnosis of acute rejection (AR) in kidney transplant recipients by examining urinary exosomal microRNAs. Candidate microRNAs were selected through urinary exosomal microRNA profiling, meta-analysis, and literature review. A three-microRNA AR signature, consisting of hsa-miR-21-5p, hsa-miR-31-5p, and hsa-miR-4532, showed promising diagnostic power in discriminating recipients with AR from those with stable graft function.
FRONTIERS IN IMMUNOLOGY
(2023)
Review
Biochemistry & Molecular Biology
Israa Sharaby, Ahmed Alksas, Mohamed Abou El-Ghar, Mona Eldeeb, Mohammed Ghazal, Dibson Gondim, Ayman El-Baz
Summary: Kidney transplantation is the preferred treatment for end-stage renal failure, but the limited availability of donors and the risk of immune rejection pose significant challenges. Early detection of acute renal rejection is crucial for the lifespan of the transplanted kidney. This review summarizes recent studies investigating various markers for differentiating between different types of acute kidney rejection, aiming to aid in the early detection and treatment of acute renal rejection for better outcomes in renal-transplant patients.
Review
Medicine, General & Internal
Yao-Yu Tsai, Lee-Moay Lim, Hung-Tien Kuo, Yi-Chun Tsai
Summary: Plasma cell-rich acute rejection (PCAR) is a rare type of acute allograft rejection that is often associated with a higher rate of graft failure. However, accurately diagnosing PCAR can be difficult. This case study reports on a 45-year-old woman who experienced acute kidney injury and uremic symptoms approximately 1 year after receiving a kidney transplant. The patient was diagnosed with PCAR and chronic active T cell-mediated rejection. Aggressive immunosuppressive therapy may be the remaining choice for PCAR treatment.
Review
Medicine, General & Internal
Hani Oweira, Ali Ramouz, Omid Ghamarnejad, Elias Khajeh, Sadeq Ali-Hasan-Al-Saegh, Rajan Nikbakhsh, Christoph Reissfelder, Nuh Rahbari, Arianeb Mehrabi, Mahmoud Sadeghi
Summary: Multiple factors influence graft rejection after kidney transplantation, including donor and recipient characteristics, as well as pre- and post-operative parameters. Identifying these risk factors helps reduce the risk of rejection and improve graft survival.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Immunology
Xingqiang Lai, Xin Zheng, James M. Mathew, Lorenzo Gallon, Joseph R. Leventhal, Zheng Jenny Zhang
Summary: Despite advances in post-transplant management, the long-term survival rate of kidney grafts and patients has not improved significantly, as around four in ten transplants fail within ten years due to CKTR. Early detection and effective treatments for CKTR remain challenges, while the development of high throughput biotechnologies offers potential for rapid identification of new biomarkers for diagnosis. Emerging novel therapeutic strategies hold promise for improving long-term graft and patient survival.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Urology & Nephrology
Aleksandar Senev, Elisabet Van Loon, Evelyne Lerut, Jasper Callemeyn, Maarten Coemans, Vicky Van Sandt, Dirk Kuypers, Marie-Paule Emonds, Maarten Naesens
Summary: Transplant glomerulopathy can occur independently of HLA-DSA, with less inflammation and better graft survival compared to cases with HLA-DSA. The presence of HLA-DSA was identified as a risk factor for glomerulopathy development, and HLA-DSA negative cases had a lower risk of graft failure compared to HLA-DSA positive cases. Landmark analysis showed that HLA-DSA negative patients with glomerulopathy still had a significant increased risk of graft failure, indicating the importance of monitoring and managing transplant glomerulopathy even in the absence of HLA-DSA.
KIDNEY INTERNATIONAL
(2021)
Article
Multidisciplinary Sciences
Aleixandra Mendoza Rojas, Teun van Gelder, Ronella de Kuiper, Derek Reijerkerk, Marian C. Clahsen-van Groningen, Dennis A. Hesselink, Carla C. Baan, Nicole M. van Besouw
Summary: Pre-transplant donor-reactive IL-21 producing cells are associated with an increased risk of acute rejection after kidney transplantation, along with advanced donor age and pre-transplant donor specific antibodies.
SCIENTIFIC REPORTS
(2021)
