Article
Urology & Nephrology
Richard Danger, Ludmilla Le Berre, Marion Cadoux, Clarisse Kerleau, Emmanuell Papuchon, Hoa Le Mai, Thi-Van-Ha Nguyen, Pierrick Guerif, Emmanuel Morelon, Olivier Thaunat, Christophe Legendre, Dany Anglicheau, Carmen Lefaucheur, Lionel Couzi, Arnaud Del Bello, Nassim Kamar, Moglie Le Quintrec, Valenti Goutaudier, Karin Renaudin, Magal Giral, Sophi Brouard
Summary: We confirmed that a six-gene-based blood score associated with operational tolerance in kidney transplantation is also related to immunological events and rejection risk. The score was validated in a multicenter cohort and showed a significant decrease in patients with biopsy-proven subclinical rejection. A refined score using two genes and four clinical parameters had a high predictive value for identifying patients at low risk for developing rejection.
KIDNEY INTERNATIONAL
(2023)
Article
Immunology
Yongsheng Luo, Feifei Luo, Kuanxin Zhang, Shilei Wang, Haojie Zhang, Xianlei Yang, Wenjun Shang, Junxiang Wang, Zhigang Wang, Xinlu Pang, Yonghua Feng, Lei Liu, Hongchang Xie, Guiwen Feng, Jinfeng Li
Summary: Circulating IL-10(+) Breg levels are a more appropriate indicator for assessing resistance to AMR after kidney transplantation compared to Bregs. Kidney B cell and IL-10 infiltration, as well as high expression of CXCL13, were associated with AMR. Furthermore, circulating IL-10(+) Bregs remained elevated during the 90-day post-operation period, contributing to immune homeostasis.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Biotechnology & Applied Microbiology
Junpeng Wang, Xin Li, Xiaoqiang Wu, Zhiwei Wang, Chan Zhang, Guanghui Cao, Shun Liu, Tianzhong Yan
Summary: Antibody-mediated rejection (AMR) in kidney transplantation is associated with alterations in gut microbiota, with recipients experiencing decreased bacterial richness in the gut microbiota compared to controls. Specific taxa such as Clostridiales could potentially serve as biomarkers to distinguish recipients with AMR. Additionally, functional pathways in the gut microbiota differ significantly between AMR and control groups.
APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
(2021)
Article
Medicine, General & Internal
Hoa Le Mai, Nicolas Degauque, Sabine Le Bot, Marie Rimbert, Karine Renaudin, Richard Danger, Florent Le Borgne, Clarisse Kerleau, Gaelle Tilly, Anais Vivet, Florent Delbos, Alexandre Walencik, Magali Giral, Sophie Brouard
Summary: The study found that the percentage and absolute number of CD28-CD8+ T cells were significantly increased in kidney transplant patients with antibody-mediated rejection (ABMR). Moreover, CD28-CD8+ T cells from patients with ABMR showed a more rigorous response to stimulation compared to their CD28+ counterparts. These findings suggest that differentiated CD28-CD8+ T cells, with increased frequency, number, and function, may play a role in the pathobiology of ABMR.
Article
Urology & Nephrology
Brian J. Nankivell, Meena Shingde, Chow H. P'Ng, Ankit Sharma
Summary: This study suggests that arterial C4d (C4d(art)) immunoperoxidase deposition may serve as a suggestive biomarker for antibody-mediated vascular rejection. Inclusion of C4d(art) in the diagnostic schema improves the sensitivity and accuracy of diagnosis for antibody-mediated vascular rejection and aids in the etiologic classification of arteritis.
KIDNEY INTERNATIONAL REPORTS
(2022)
Article
Biochemistry & Molecular Biology
Bertrand Chauveau, Anne-Aurelie Raymond, Sylvaine Di Tommaso, Jonathan Visentin, Agathe Vermorel, Nathalie Dugot-Senant, Cyril Dourthe, Jean-William Dupuy, Julie Dechanet-Merville, Jean-Paul Duong Van Huyen, Marion Rabant, Lionel Couzi, Frederic Saltel, Pierre Merville
Summary: This study used proteomics to investigate the glomerular proteome modification in antibody-mediated rejection (ABMR) in kidney transplantation. It identified several proteins related to cellular stress, leukocyte activation, and tissue remodeling that were deregulated in ABMR. These findings may have implications for the diagnosis and treatment of ABMR.
Article
Urology & Nephrology
Brian J. Nankivell, Chow H. P'Ng, Meena Shingde
Summary: C4d(glom) is a promising diagnostic biomarker of endothelial interaction with antibody, which improves the immunologic classification of transplant glomerulopathy and enhances the accuracy of diagnosing late antibody-mediated rejection.
KIDNEY INTERNATIONAL REPORTS
(2022)
Article
Cardiac & Cardiovascular Systems
Moritz Benjamin Immohr, Payam Akhyari, Hug Aubin, Ralf Westenfeld, Arash Mehdiani, Raphael Romano Bruno, Nihat Firat Sipahi, Sophiko Erbel-Khurtsidze, Petra Reinecke, Igor Tudorache, Artur Lichtenberg, Udo Boeken
Summary: IGM-IVIG treatment is an effective method for addressing antibody-mediated graft rejection, showing significant results in restoring ventricular function and reducing malignant arrhythmias.
Article
Medicine, General & Internal
Johan Noble, Diane Giovannini, Reda Laamech, Farida Imerzoukene, Benedicte Janbon, Laura Marchesi, Paolo Malvezzi, Thomas Jouve, Lionel Rostaing
Summary: In this study, tocilizumab (TCZ) showed potential in preventing clinical and histological deterioration of chronic antibody-mediated rejection (cABMR) in kidney transplant recipients, but its effectiveness may be limited in patients with more severe conditions. Randomized studies are needed to further evaluate the risk/benefit profile of TCZ in cABMR.
FRONTIERS IN MEDICINE
(2021)
Review
Surgery
Massimiliano Bertacchi, Paloma Parvex, Jean Villard
Summary: Antibody-mediated rejection (AMR) is a critical issue in renal transplantation, with lack of FDA-approved treatment options and controversial studies due to the absence of a gold standard and challenges in conducting large multi-center studies. Pediatric transplantation is even more limited by the lack of studies and occasional use of therapies with unknown side effects, making management difficult for pediatric nephrologists.
CLINICAL TRANSPLANTATION
(2022)
Article
Medicine, General & Internal
Gaston J. Pineiro, Enrique Montagud-Marrahi, Jose Rios, Pedro Ventura-Aguiar, David Cucchiari, Ignacio Revuelta, Miquel Lozano, Joan Cid, Frederic Cofan, Nuria Esforzado, Eduard Palou, Federico Oppenheimer, Josep M. Campistol, Beatriu Bayes-Genis, Jordi Rovira, Fritz Diekmann
Summary: This retrospective study involving 116 patients with active ABMR after treatment found that persistent inflammation, especially in terms of MVI and tubulitis, significantly influenced graft survival rates, increasing the risk of graft failure even without meeting Banff rejection criteria.
FRONTIERS IN MEDICINE
(2021)
Article
Medicine, Research & Experimental
Xin Li, Ruoying Li, Bingqing Ji, Lili Zhao, Junpeng Wang, Tianzhong Yan
Summary: This study investigated the metagenomic and metabolic patterns of gut microbiota in patients with antibody-mediated rejection (AMR) after kidney transplantation. The findings provide a comprehensive understanding of the correlation between AMR and gut microbiota, which is important for the etiological and diagnostic study of AMR after kidney transplantation.
JOURNAL OF TRANSLATIONAL MEDICINE
(2022)
Article
Pharmacology & Pharmacy
Zhou Hang, Jintao Wei, Ming Zheng, Zeping Gui, Hao Chen, Li Sun, Shuang Fei, Zhijian Han, Jun Tao, Zijie Wang, Ruoyun Tan, Min Gu
Summary: This study found that IGT can inhibit the polarization of M1 macrophages, alleviate the pathological changes in ABMR, reduce DSA titers, and mitigate the pathogenesis of ABMR by targeting KLF4.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Immunology
Lara Cabezas, Thomas Jouve, Paolo Malvezzi, Benedicte Janbon, Diane Giovannini, Lionel Rostaing, Johan Noble
Summary: Chronic kidney disease is a significant public-health problem, and kidney transplantation is a better alternative to dialysis. Antibody-mediated rejection is a major complication following kidney transplantation. TCZ appears to be a safe and effective treatment for managing antibody-mediated rejection and reducing injury.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Surgery
Maeva Massat, Nicolas Congy-Jolivet, Anne-Laure Hebral, Laure Esposito, Olivier Marion, Audrey Delas, Magali Colombat, Stanislas Faguer, Nassim Kamar, Arnaud Del Bello
Summary: This study found that monthly infusions of tocilizumab did not alter the progression of antibodies in patients with antibody-mediated rejection resistant to standard of care therapy. There were no significant differences in graft survival and decline in renal function between patients who received tocilizumab and those who did not. Despite a decrease in inflammation and tubulitis scores, the course of antibody-mediated lesions and chronic glomerulopathy were similar in both groups.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Article
Surgery
Isabel Breyer, Brad C. Astor, Aniruddha Srivastava, Fahad Aziz, Neetika Garg, Maha A. Mohamed, Margaret R. Jorgenson, Didier A. Mandelbrot, Sandesh Parajuli
Summary: Pre-transplant hypoalbuminemia is not significantly associated with early post-transplant outcomes.
CLINICAL TRANSPLANTATION
(2023)
Article
Immunology
Sandesh Parajuli, Didier Mandelbrot, David Aufhauser, Dixon Kaufman, Jon Odorico
Summary: This study reviewed the outcomes of simultaneous pancreas and kidney (SPK) transplantation in patients with type 2 diabetes mellitus (T2DM). The results showed excellent overall outcomes in T2DM SPK recipients. However, higher levels of pretransplant C-peptide may be associated with inferior posttransplant outcomes, including graft dysfunction.
Article
Surgery
Angelie Santos, Margaret R. Jorgenson, Fauzia Osman, Aniruddha Srivastava, Elizabeth Ann Misch, Neetika Garg, Fahad Aziz, Kurtis J. Swanson, Maha Mohamed, Arjang Djamali, Didier Mandelbrot, Sandesh Parajuli
Summary: Hypoalbuminemia is a risk factor for invasive fungal infections in kidney transplant recipients and is associated with poor outcomes.
CLINICAL TRANSPLANTATION
(2023)
Article
Surgery
Emily Zona, Margaret Jorgenson, Sonam Dolma, Angelie Santos, Neetika Garg, Fahad Aziz, Maha Mohamed, Christopher M. M. Saddler, Jeannina A. A. Smith, Didier Mandelbrot, Sandesh Parajuli
Summary: The impact of concordance versus discordance in cytomegalovirus (CMV) between two different recipients of kidneys from the same donor is largely unknown. This study found that CMV discordance was associated with increased risk of death-censored graft failure (DCGF) in kidney transplant recipients (KTR), while CMV concordance did not have a significant impact on outcomes.
CLINICAL TRANSPLANTATION
(2023)
Review
Immunology
Katya Loban, Anna Horton, Jorane-Tiana Robert, Lindsay Hales, Sandesh Parajuli, Mara McAdams-DeMarco, Shaifali Sandal
Summary: This study conducted a systematic literature review to explore the personal experiences of kidney transplant recipients with graft failure. The findings revealed that graft failure has a significant impact on patients' lives and requires multidisciplinary teamwork, social support, and individual-level factors to cope. Additionally, there were identified gaps in the provision of information and psychosocial support. The results of this review can inform research and guideline development to improve care for patients with graft failure.
TRANSPLANTATION REVIEWS
(2023)
Article
Transplantation
Sandesh Parajuli, Weixiong Zhong, Monika Pantha, Megan Sokup, Fahad Aziz, Neetika Garg, Maha Mohamed, Didier Mandelbrot
Summary: This study investigated the trend of serum creatinine levels after treatment of antibody-mediated rejection (AMR) in kidney transplant recipients and found that creatinine level is not a good predictor of the resolution of rejection, highlighting the importance of follow-up biopsies after treatment.
TRANSPLANTATION DIRECT
(2023)
Article
Surgery
William Shockey, Joshua J. Wiegel, Sandesh Parajuli, Neetika Garg, Kurtis J. Swanson, Didier A. Mandelbrot
Summary: This study is the largest investigation on the use of SZC in transplant recipients, and the results show that a single 10-g dose of SZC reduced serum K+ levels in all subgroups, while adjunctive K+-lowering therapies did not provide additional reduction beyond the effects of SZC. SZC may be a safe and promising therapeutic option for managing hyperkalemia following solid organ transplantation.
CLINICAL TRANSPLANTATION
(2023)
Review
Immunology
Uyi Jefferson Imasuen, Kurtis J. Swanson, Sandesh Parajuli
Summary: This literature review presents an analysis of multiple studies exploring the relationship between serum uric acid levels and kidney transplant outcomes. It found that elevated serum uric acid levels may contribute to CKD progression in kidney transplant recipients. The review also highlights the need for further investigation to monitor and manage hyperuricemia in kidney transplant recipients.
TRANSPLANTATION REVIEWS
(2023)
Article
Transplantation
Sandesh Parajuli, Jon Odorico, Isabel Breyer, Emily Zona, Fahad Aziz, Heather Lorden, Jacqueline Garonzik-Wang, Dixon Kaufman, Didier Mandelbrot
Summary: This study investigated the association between pretransplant overall frailty and individual frailty components, with posttransplant outcomes among SPK and SPT recipients. Results showed that slow walk time was associated with an increased risk of mortality in SPK recipients. In SPT recipients, higher sum frailty scores and weight loss were associated with prolonged length of stay, and weight loss was associated with an increased risk of pancreas death-censored graft failure (DCGF). Low grip strength was strongly associated with an increased risk of early readmission. These findings have important implications for improving posttransplant outcomes.
TRANSPLANTATION DIRECT
(2023)
Article
Transplantation
Eman A. Alshaikh, Brad C. Astor, Brenda Muth, Margaret Jorgenson, Kurt Swanson, Neetika Garg, Fahad Aziz, Maha Mohamed, Didier Mandelbrot, Sandesh Parajuli
Summary: Delayed graft function (DGF) is associated with an increased risk of early infectious complications, mainly urinary tract infection (UTI) and BK viremia, but not cytomegalovirus viremia or pneumonia.
TRANSPLANTATION DIRECT
(2023)
Article
Urology & Nephrology
Nancy Wilson, Shannon Reese, Lucy Ptak, Fahad Aziz, Sandesh Parajuli, Vadim Jucaud, Shari Denham, Ameet Mishra, Marilia Cascalho, Jeffrey L. Platt, Peiman Hematti, Arjang Djamali
Summary: This study tested the safety and efficacy of ixazomib treatment in highly sensitized kidney transplant candidates. However, the treatment did not show a significant impact on the levels and diversity of anti-HLA antibodies in this small cohort. Combining ixazomib with other immunosuppressive agents may be a more effective approach in addressing antibody-mediated processes in kidney transplantation.
Article
Surgery
Tarek Alhamad, Haris Murad, Darshana M. Dadhania, Martha Pavlakis, Sandesh Parajuli, Beatrice P. Concepcion, Neeraj Singh, Naoka Murakami, Michael J. Casey, Mengmeng Ji, Michelle Lubetzky, Ekamol Tantisattamo, Omar Alomar, Arman Faravardeh, Christopher D. Blosser, Arpita Basu, Gaurav Gupta, Joel T. Adler, Deborah Adey, Kenneth J. Woodside, Song C. Ong, Ronald F. Parsons, Krista L. Lentine
Summary: The management of failing kidney allograft and transition of care to general nephrologists remain complex processes. A survey was conducted by the Kidney Pancreas Community of Practice (KPCOP) Failing Allograft Workgroup to investigate current practices and concerns among general nephrologists. The survey revealed heterogeneous approaches to care and the need for improved transitions and practical guidelines for this vulnerable population.
TRANSPLANT INTERNATIONAL
(2023)
Meeting Abstract
Surgery
Colin Snook, Sandesh Parajuli, Dixon Kaufman, Jon Odorico, David Aufhauser
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Meeting Abstract
Surgery
Juan Danobeitia, Brad Astor, Jeannina Smith, Jennifer Philip, Didier Mandelbrot, Jon Odorico, Sandesh Parajuli, Jacqueline Garonzik-Wang
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
