Article
Infectious Diseases
Elizabeth R. Wan, Sophie A. Elands, Stephen B. Walsh
Summary: A 68-year-old renal transplant recipient experienced multiple complications after a deceased donor transplant, including graft failure, hematoma, recurrent bleeding, and skin infection caused by Aspergillus flavus. Systemic aspergillosis is rare but recognized in immunocompromised patients, and diagnosis requires histology or culture confirmation. Treatment involves systemic antifungals and involvement of microbiology services, but the prognosis is poor.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2023)
Article
Hematology
Su Han Lum, Sinead Greener, Inigo Perez-Heras, Daniel Drozdov, Rebecca P. Payne, Helen Watson, Kay Carruthers, Robert January, Zohreh Nademi, Stephen Owens, Eleri Williams, Sheila Waugh, Shirelle Burton-Fanning, Timmothy Ronan Leahy, Andrew Cant, Mario Abinun, Terry Flood, Sophie Hambleton, Andrew R. Gennery, Mary Slatter
Summary: This study compared the outcomes of hematopoietic cell transplantation using alemtuzumab and TCR alpha beta/CD19 depletion. The results showed that in younger patients, both methods had comparable survival rates, while in older patients, the use of alemtuzumab had higher survival rates. Additionally, transplantation with TCR alpha beta/CD19 depletion led to a higher incidence of viremia and delayed CD3 reconstitution.
Article
Biochemistry & Molecular Biology
Ruonan Xu, Ji-Yuan Zhang, Bo Tu, Zhe Xu, Hui-Huang Huang, Lei Huang, Yan-Mei Jiao, Tao Yang, Chao Zhang, En-Qiang Qin, Tian-Jun Jiang, Yun-Bo Xie, Yuan-Yuan Li, Lei Jin, Chun-Bao Zhou, Ming Shi, Mei Guo, Hui-Sheng Ai, Linqi Zhang, Fu-Sheng Wang
Summary: This study reports the development of an allogeneic adaptive immune therapy for severely immunosuppressed AIDS patients, showing safety and efficacy in combination with antiretroviral therapy. The therapy involved transfusing peripheral blood mononuclear cells from qualified donors into patients, leading to improvements in immune function and clinical symptoms. Further clinical trials with control groups are needed to confirm the efficacy of this medication.
SIGNAL TRANSDUCTION AND TARGETED THERAPY
(2021)
Review
Biochemistry & Molecular Biology
Kathleen M. Job, Jessica K. Roberts, Elena Y. Enioutina, Silvia M. IIIamola, Shaun S. Kumar, Jahidur Rashid, Robert M. Ward, Tsuyoshi Fukuda, Joseph Sherbotie, Catherine M. Sherwin
Summary: This review examines the impact of pharmacokinetic variability on renal transplantation and its association with various factors. Pharmacodynamics are outlined for each immunosuppressant, along with potential adverse effects and the utility of pharmacodynamic biomarkers. Acquiring a better quantitative understanding of immunosuppressant pharmacokinetics and pharmacodynamics can help clinicians maintain the balance between therapeutic efficacy and drug-related toxicity.
EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY
(2021)
Article
Urology & Nephrology
Klemens Budde, Rohini Prashar, Hermann Haller, Maria C. Rial, Nassim Kamar, Avinash Agarwal, Johan W. de Fijter, Lionel Rostaing, Stefan P. Berger, Arjang Djamali, Nicolae Leca, Lisa Allamassey, Sheng Gao, Martin Polinsky, Flavio Vincenti
Summary: This study demonstrates that converting stable renal transplant recipients from CNI-based to belatacept-based maintenance immunosuppression improves renal function and reduces the risk of acute rejection, making it a suitable alternative for patients intolerant to CNIs.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2021)
Article
Medicine, General & Internal
Dominic Stringer, Leanne Gardner, Olivia Shaw, Brendan Clarke, David Briggs, Judith Worthington, Matthew Buckland, Guilherme Danzi, Rachel Hilton, Michael Picton, Raj Thuraisingham, Richard Borrows, Richard Baker, Keith McCullough, John Stoves, Mysore Phanish, Sapna Shah, Kin Yee Shiu, Stephen B. Walsh, Aimun Ahmed, Waqar Ayub, Janet Hegarty, Rose Tinch-Taylor, Evangelos Georgiou, Natalie Bidad, Aysenur Kilic, Zoe Moon, Robert Horne, Paul McCrone, Joanna Kelly, Caroline Murphy, Janet Peacock, Anthony Dorling
Summary: This study aimed to investigate whether screening for antibodies against human leukocyte antigens (HLA) and interventions to improve medication adherence and optimize immunosuppression could prevent kidney transplant failure. The results showed that the development of antibodies against HLA predicted an increased risk of graft failure, but interventions to improve medication adherence and optimize immunosuppression did not delay transplant failure. Novel interventions are needed before screening can be used to guide transplantation therapy.
Review
Microbiology
Liyanage Shamithra Madhumali Sigera, David W. Denning
Summary: Over 95,000 renal transplantation procedures were completed in 2021. Invasive aspergillosis (IA) affects about 1 in 250 to 1 in 43 renal transplant recipients. Major risk factors for IA include old age, diabetes mellitus, delayed graft function, acute graft rejection, chronic obstructive pulmonary disease, cytomegalovirus disease, and neutropenia. Typical pulmonary features of IA include fever, dyspnea, cough, and hemoptysis. The fastest means of establishing the diagnosis is bronchoscopy for direct microscopy, fungal culture, and Aspergillus antigen testing.
Article
Hematology
Antonio Jimenez Jimenez, Krishna Komanduri, Samantha Brown, Trent Wang, Denise Pereira, Mark Goodman, Amer Beitinjaneh, Lazaros Lekakis, Stephanie Chinapen, Sean Devlin, Doris Ponce, Craig Sauter, Miguel-Angel Perales, Brian C. Shaffer
Summary: This study compared the graft-versus-host disease-free, relapse-free survival (GRFS) in patients who underwent allogeneic hematopoietic cell transplantation from an HLA-mismatched unrelated donor using different prophylactic measures. The results showed that the use of posttransplant cyclophosphamide resulted in superior GRFS and overall survival after one year.
Article
Immunology
Matthew J. Bottomley, Paul N. Harden, Kathryn J. Wood, Joanna Hester, Fadi Issa
Summary: The monocytic HLA-DR density remains stable in long-term renal transplant recipients and is associated with myeloid-derived suppressor-like cells accumulation. Decreased HLA-DR density is linked to a higher risk of subsequent malignancy, indicating a potential novel marker for excess immunosuppression. Further research is needed to understand the underlying mechanism behind this association.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Urology & Nephrology
Anas Elgenidy, Rasha Samir Shemies, Mostafa Atef, Ahmed K. Awad, Hatem H. El-Leithy, Mohamed Helmy, Mostafa G. Aly
Summary: Prolonged maintenance immunosuppression after kidney transplant failure is not associated with increased risk of mortality, infection, or malignancy, or reduced risk of sensitization or allograft nephrectomy compared with early withdrawal.
JOURNAL OF NEPHROLOGY
(2023)
Article
Cell & Tissue Engineering
Amir H. Kashani, Jane S. Lebkowski, David R. Hinton, Danhong Zhu, Mohamed A. Faynus, Sanford Chen, Firas M. Rahhal, Robert L. Avery, Hani Salehi-Had, Clement Chan, Neal Palejwala, April Ingram, Wei Dang, Chih-Min Lin, Debbie Mitra, Juan Carlos Martinez-Camarillo, Jeff Bailey, Cassidy Arnold, Britney O. Pennington, Narsing Rao, Lincoln Johnson, Dennis O. Clegg, Mark S. Humayun
Summary: A clinical trial was conducted to assess the safety and efficacy of subretinal implantation of polarized monolayer of allogeneic human embryonic stem cell-derived retinal pigmented epithelium (RPE) cells in patients with geographic atrophy secondary to dry age-related macular degeneration. The results showed that the implanted cells survived, expressed functional markers, and did not elicit intraocular inflammation or immune responses.
Article
Urology & Nephrology
Sunjae Bae, JiYoon B. Ahn, Corey Joseph, Ryan Whisler, Mark A. Schnitzler, Krista L. Lentine, Bernard S. Kadosh, Dorry L. Segev, Mara A. McAdams-DeMarco
Summary: This study analyzed a national cohort to assess the real-world effectiveness of statins in reducing all-cause mortality in kidney transplant recipients. The study found that statin use was significantly associated with lower mortality, and this protective effect might be greater when combined with mTOR inhibitors.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2023)
Article
Medicine, General & Internal
Maya Gibson, Nianlan Yang, Jennifer L. Waller, Lufei Young, Wendy B. Bollag, Mufaddal Kheda, Azeem Mohammed, Stephanie L. Baer
Summary: Renal transplant patients are at increased risk of Nocardia infection, but information on its incidence and risk factors is limited. Factors associated with increased Nocardia infection include age, history of transplant failure or rejection. Early recognition and targeted treatment of nocardiosis in renal transplant patients need to be enhanced based on the study findings.
JOURNAL OF INVESTIGATIVE MEDICINE
(2022)
Article
Immunology
Paula Muniz, Mi Kwon, Diego Carbonell, Maria Chicano, Rebeca Bailen, Gillen Oarbeascoa, Julia Suarez-Gonzalez, Cristina Andres-Zayas, Javier Menarguez, Nieves Dorado, Ignacio Gomez-Centurion, Javier Anguita, Jose Luis Diez-Martin, Carolina Martinez-Laperche, Ismael Buno
Summary: HLA loss may be a mechanism of relapse after Haplo-HSCT, more common in female patients. Relapse with HLA loss occurs later, with more active disease and treatment history, requiring different treatment strategies.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Immunology
Hongfeng Huang, Qixia Shen, Jingyi Zhou, Xiuyan Yang, Qiuqin Cai, Jia Shen, Shi Feng, Wenqing Xie, Hong Jiang, Jianghua Chen
Summary: The clinical experience demonstrates the efficacy of non-myeloablative conditioning protocol in inducing tolerance in HLA identical patients, and complete chimerism may be a risk factor for GVHD.
FRONTIERS IN IMMUNOLOGY
(2022)
