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.
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
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
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)
Article
Immunology
Kritsada Pongsakornkullachart, Methee Chayakulkeeree, Attapong Vongwiwatana, Wannee Kantakamalakul, Peenida Skulratanasak, Pakpoom Phoompoung
Summary: This study found that single-timepoint pretransplant or 1-month posttransplant QF-CMV assays are not reliable predictors for posttransplant CMV viremia in CMV seropositive kidney transplant recipients.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Medicine, General & Internal
Karol Granak, Matej Vnucak, Monika Beliancinova, Patricia Kleinova, Margareta Pytliakova, Marian Mokan, Ivana Dedinska
Summary: Our study aimed to determine the risk of acute graft rejection in protocol biopsy based on the adiponectin/leptin (A/L) ratio in patients after kidney transplantation. We found that patients with A/L ratio < 0.5 before and 3 months after transplantation were independent risk factors for acute graft rejection.
FRONTIERS IN MEDICINE
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
P. Lovinfosse, L. Weekers, H. Pottel, A. Bouquegneau, C. Bonvoisin, C. Bovy, S. Grosch, R. Hustinx, Francois Jouret
Summary: The study suggests that [F-18]FDG PET/CT may be a helpful tool in predicting acute allograft rejection in kidney transplant recipients, potentially avoiding unnecessary transplant biopsies.
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
(2021)
Article
Immunology
Tingting Chen, Xiaoyu Li, Jina Wang, Xuanchuan Wang, Tongyu Zhu, Ruiming Rong, Cheng Yang
Summary: A 66-year-old Chinese man underwent deceased donor kidney transplantation and developed BKV nephropathy and acute TCMR post-transplant. Treatment with basiliximab improved the kidney graft status.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Urology & Nephrology
Marina Pontello Cristelli, Taina Veras de Sandes-Freitas, Laila Almeida Viana, Lucio R. Requiao-Moura, Luis Gustavo Modelli de Andrade, Helio Tedesco-Silva, Jose Medina-Pestana
Summary: This article describes the main outcomes of COVID-19 in kidney transplant recipients in different regions of Brazil. The study found that patients from different regions showed variations in clinical presentations and management, and COVID-19 in these recipients was associated with higher fatality rates.
JORNAL BRASILEIRO DE NEFROLOGIA
(2022)
Article
Urology & Nephrology
Rafael H. Astolfi, Wilson F. Aguiar, Laila Viana, Marina Cristelli, Helio T. S. Junior, Jose M. Pestana
Summary: The study compared the postoperative outcomes of patients undergoing stentless modified Lich-Gregoir technique with early bladder catheter removal to those undergoing traditional technique with routine removal of catheter. It found that patients in the modified technique group had a higher rate of early catheter removal and shorter hospital stay.
Article
Urology & Nephrology
Manoela Linhares Machado Barteczko, Henry Campos Orellana, Gustavo Rocha Feitosa Santos, Attilio Galhardo, Gabriel Kanhouche, Ana Carolina Buso Faccinetto, Helio Tedesco Junior, Jose Osmar Medina Pestana, Angelo Amato Vincenzo de Paola, Adriano Henrique Pereira Barbosa
Summary: This retrospective study analyzed the outcomes of kidney transplant recipients with less than 50% renal artery stenosis. The results showed that most patients had improved kidney function and quality of life, although there were cases of death and kidney loss.
Article
Urology & Nephrology
Jose Medina-Pestana, Mario Abbud-Filho, Valter Duro Garcia, Renato Demarchi Foresto, Lucio R. Requiao-Moura
Summary: The growing demand for transplant kidneys requires strategies to increase organ supply and avoid long waiting periods on the list. Increasing the number of transplants from living donors may face ethical and social challenges, especially in regions with socioeconomic limitations and disparities in healthcare access.
JORNAL BRASILEIRO DE NEFROLOGIA
(2022)
Article
Urology & Nephrology
Maria Bethania Peruzzo, Lucio Requiao-Moura, Monica Rica Nakamura, Laila Viana, Marina Cristelli, Helio Tedesco-Silva, Jose Medina-Pestana
Summary: This study evaluated the predictive ability of severity scores for mortality in kidney transplant patients with COVID-19. The results showed that the APACHE IV score was significantly associated with mortality, while other traditional severity scores were not able to accurately predict mortality.
JORNAL BRASILEIRO DE NEFROLOGIA
(2022)
Article
Urology & Nephrology
Filipa Silva, Klaus Nunes Ficher, Laila Viana, Ines Coelho, JulianaToniato Rezende, Daniel Wagner, Maria Lucia Vaz, Renato Foresto, Helio Tedesco Silva Jr, Jose Medina Pestana
Summary: CMV retinitis is a rare manifestation of CMV invasive disease that poses a potential threat to vision in immunocompromised individuals. Early diagnosis and treatment are crucial for obtaining the best visual prognosis in affected patients.
JORNAL BRASILEIRO DE NEFROLOGIA
(2022)
Article
Urology & Nephrology
Melissa Gaspar Tavares, Marina Pontello Cristelli, Julia Taddeo, Helio Tedesco Silva Junior, Jose Medina Pestana
Summary: This retrospective study compared the early hospital readmission rate and one-year clinical outcomes of kidney transplant patients receiving different doses of anti-thymocyte globulin (rATG) induction therapy. The use of a single 3 mg/kg dose of rATG in the new era was associated with a decrease in early hospital readmission rate, as well as a reduction in the incidence of acute rejection and mortality.
JORNAL BRASILEIRO DE NEFROLOGIA
(2023)
Review
Immunology
Helio Tedesco Silva Junior, Yaman Tokat, Jinzhen Cai, Inderjeet Singh, Anudeep Sandhu, Dirk Demuth, Jongman Kim
Summary: This systematic review focuses on the epidemiology, management, and burden of cytomegalovirus (CMV) infection following solid organ transplantation (SOT) in selected countries outside of Europe and North America. The results show highly variable rates of CMV infection/disease post-SOT, frequent CMV recurrence, and limitations of conventional treatment.
TRANSPLANT INFECTIOUS DISEASE
(2023)
Editorial Material
Urology & Nephrology
Jose Medina Pestana
JORNAL BRASILEIRO DE NEFROLOGIA
(2023)
Article
Virology
Milena Karina Colo Brunialti, Giuseppe G. F. Leite, Gabriela Strafolino Eburneo, Orlei Ribeiro de Araujo, Paula M. Pecanha-Pietrobom, Paulo Roberto Abrao Ferreira, Nancy C. Junqueira Bellei, Jaquelina Sonoe Ota Arakaki, Jose Medina-Pestana, Lucio Requiao-Moura, Reinaldo Salomao
Summary: This study aimed to describe the patterns of cytokines and vascular mediators in COVID-19 patients and kidney transplant recipients (KTRs). The results showed that COVID-19 was associated with higher levels of cytokines and vascular mediators. Non-KTRs had a higher number of correlations and different cytokine and mediator patterns compared to KTRs.
Article
Urology & Nephrology
Marina Rezende de Fazio, Marina Pontello Cristelli, Jane Tomimori, Carlos Eiji Koga, Marilia Marufuji Ogawa, Giovannitani Beneventi, Helio Tedesco-Silva, Jose Medina-Pestana
Summary: This study suggests that sirolimus monotherapy may be useful as adjuvant therapy for high-risk cSCC in kidney transplant recipients. The conversion strategy used was well tolerated and safe regarding key mid-term transplant outcomes.
JORNAL BRASILEIRO DE NEFROLOGIA
(2023)
Article
Surgery
Thais Malta Romano, Marcelo Moura Linhares, Karin Romano Posegger, Erika Bevillaqua Rangel, Adriano Miziara Gonzalez, Alcides Augusto Salzedas-Netto, Samantha Mucci, Helio Tedesco Silva-Junior, Gaspar de Jesus Lopes Filho, Jose Osmar Medina-Pestana
Summary: Simultaneous pancreas-kidney transplantation (SPKT) has a positive impact on psychological aspects, specifically in reducing depression levels, for insulin-dependent type-1 diabetic patients with end-stage renal disease (ESRD). However, patients waiting for transplantation are more vulnerable to psychological disorders, and the stressors during the pretransplant stage significantly impact the psychosocial condition of the patient.
ACTA CIRURGICA BRASILEIRA
(2022)