scholarly journals Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
K. V. Shenoy ◽  
C. Solomides ◽  
F. Cordova ◽  
T. J. Rogers ◽  
D. Ciccolella ◽  
...  
Keyword(s):  
Acute Rejection ◽  
B Cell ◽  
Allograft Rejection ◽  
Lymphoid Tissue ◽  
Rejection Rate ◽  
First Year ◽  
Transplant Recipients ◽  
Clinically Significant ◽  
Cell Subpopulations ◽  
One Year

Background. Bronchus-associated lymphoid tissue (BALT) has been associated with lung allograft rejection in rat transplant models. In human transplant recipients, BALT has not been linked to clinically significant rejection. We hypothesize that the immunohistochemical composition of BALT varies with the presence of acute lung allograft rejection.Methods. We retrospectively examined 40 human lung allograft recipients transplanted from 3/1/1999 to 6/1/2008. Patients were grouped by frequency and severity of acute rejection based on International Society of Heart Lung Transplant (ISHLT) criteria. Transbronchial biopsies were reviewed for BALT by a blinded pathologist. BALT if present was immunohistochemically stained to determine T-and B-cell subpopulations.Results. BALT presence was associated with an increased frequency of acute rejection episodes in the first year after transplantation. Patients with a lower CD4/CD8 ratio had an increased rejection rate; however, BALT size or densities of T-cell and B-cell subpopulations did not correlate with rejection rate.Conclusion. The presence of BALT is associated with an increased frequency of rejection one year after transplant. The lower the CD4/CD8 ratio, the more acute rejection episodes occur in the first year after transplantation. The immunohistochemical composition of BALT may predict patients prone to frequent episodes of acute cellular rejection.

SO056THE CLINICAL AND IMMUNOLOGICAL IMPACT OF LOW DOSE RITUXIMAB IN CLINICAL NEPHROLOGY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sunu Alex
Keyword(s):  
B Cells ◽  
B Cell ◽  
Low Dose ◽  
Cost Effective ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cell Percentage ◽  
Steroid Dependent ◽  
One Year

Abstract Background and Aims Currently, the dose of rituximab used in nephrology practice is mostly extrapolated from the dose used in lymphoproliferative disorders. It is possible that a lesser dose may suffice when treating a non-neoplastic disorder. We conducted this study to study the clinical response and CD19 B cell suppression with a single dose of 100mg rituximab in nephrology practice Method This was a single center prospective study of role of 100mg rituximab as initial dose in steroid dependent (SDNS), frequently relapsing nephrotic syndrome (FRNS), idiopathic membranous nephropathy (MN) and high immunologic risk kidney transplantation with subsequent doses based on CD19 B cell reconstitution. Results Following 100mg rituximab in 42 patients, CD19 B cell percentage decreased from 16.3+7.6 to 0.3±0.3, 1.9±1.7 and 4.0±4.5 by 30, 90 and 180 days respectively. At 30th day, 40(95.2%) had CD19 B cell count <1%. Of the 30 patients with SDNS and FRNS followed up for one year, 29(96.7%) went into remission at day 30. Remission was sustained in 23(76.6%) at day 180 and 21(70%) at 1 year. There was significant decrease [P <0.001] in the dose of steroids needed to maintain remission at 180 days following rituximab (0.27±0.02mg/Kg to 0.02±0.00mg/Kg). Of the five patients with MN, four patients achieved remission by 6 months. Remission was sustained in three patients by 1 year. Of the 7 kidney transplant recipients, 2 had antibody mediated rejections though CD19 B cells were suppressed even at one year. Conclusion Low dose of 100 mg rituximab is sufficient to deplete CD19 B cells for up to 90days and is effective in inducing remission in SDNS and FRNS and MN. Targeting subsequent doses depending on CD19 B cell reconstitution may prevent relapses, limit toxicity and be cost effective.

Acute Rejection in the First Year in Heart Transplant Recipients in the United States.

2014 ◽  
Vol 98 ◽  
pp. 423
Author(s):  
A. Yoosabai ◽  
A. Mehrnia ◽  
W. Chaiwatcharayut ◽  
M. Sampaio ◽  
E. Huang ◽  
...  
Keyword(s):  
United States ◽  
Acute Rejection ◽  
Heart Transplant ◽  
The United States ◽  
First Year ◽  
Transplant Recipients ◽  
Heart Transplant Recipients

scholarly journals The Effect of Different Glycaemic States on Renal Transplant Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Sheu ◽  
Barbara Depczynski ◽  
Anthony J. O’Sullivan ◽  
Grant Luxton ◽  
George Mangos
Keyword(s):  
Acute Rejection ◽  
Graft Function ◽  
Cardiovascular Complications ◽  
Transplant Recipients ◽  
Glucose Levels ◽  
One Year ◽  
The Impact ◽  
Infective Complications ◽  
Improve Patient ◽  
Patient And Graft Survival

Background. Optimal glycaemic targets following transplantation are unknown. Understanding the impact of DM and posttransplant diabetes mellitus (PTDM) may improve patient and graft survival in transplant recipients. Aim. To determine the perioperative and one-year outcomes after renal transplantation and whether these outcomes are affected by preexisting DM, PTDM, or glycaemia during transplant admission. Method. Adult recipients of renal transplants from a single centre over 5.5 years were retrospectively reviewed. Measured outcomes during transplant admission included glycaemia and complications (infective complications, acute rejection, and return to dialysis) and, at 12 months, glycaemic control and complications (cardiovascular complication, graft failure). Results. Of 148 patients analysed, 29 (19.6%) had DM and 27 (18.2%) developed PTDM. Following transplantation, glucose levels were higher in patients with DM and PTDM. DM patients had a longer hospital stay, had more infections, and were more likely return to dialysis. PTDM patients had increased rates of acute rejection and return to dialysis. At 1 year after transplant, there were more cardiovascular complications in DM patients compared to those without DM. Conclusions. Compared to patients without DM, patients with DM or PTDM are more likely to suffer from complications perioperatively and at 12 months. Perioperative glycaemia is associated with graft function and may be a modifiable risk.

scholarly journals Importance of High-Risk Human Papillomavirus Infection Detection in Female Renal Transplant Recipients in the First Year after Transplantation

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Maksims Cistjakovs ◽  
Alina Sultanova ◽  
Olga Jermakova ◽  
Liba Sokolovska ◽  
Svetlana Chapenko ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Immune System ◽  
Renal Transplant ◽  
Immunosuppressive Therapy ◽  
Hpv Infection ◽  
Control Group ◽  
First Year ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
One Year

Objectives. Most of human papillomavirus (HPV) infections are “cleared” by the immune system; however, in cases of immune system suppression, infections could lead to development of malignancies. The aim of this study was to find out the frequency of HR-HPV infection in early period after renal transplantation in recipients receiving immunosuppressive therapy and to follow the progression of the infection up to one year. Methods. 43 female renal transplant recipients and 79 healthy female individuals as a control group were enrolled in this investigation. For the detection of HPV infection, patients’ samples (blood and vaginal swabs) were collected two weeks after transplantation with following collection of six months and one year. Different polymerase chain reactions for HR-HPV genomic sequences detection and ELISA kit for detection of anti-HPV IgG antibodies were used. Results. In this study, we show that frequency rate of HR-HPV infection has increased in the first year after transplantation from early stage of immunosuppressive therapy (from 24% to 36%). Also an increase of HR-HPV load was detected over time, showing the highest median viral load at sixth month after transplantation. Conclusions. From the obtained data, it follows that it is very important to carefully monitor patients receiving immunosuppression therapy on progression of HR-HPV.

Prevention of Post Transplantation Lymphoproliferative Disorders by Adapted Management of EBV Reactivations. A Monocentric Prospective Study on 101 Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2932-2932
Author(s):  
Sylvain Choquet ◽  
Shaida Varnous ◽  
Claire Deback ◽  
Corinne Amiel ◽  
Jean Louis Golmar ◽  
...  
Keyword(s):  
Viral Load ◽  
Prospective Study ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Rejection Rate ◽  
First Year ◽  
Solid Organ ◽  
Post Transplantation ◽  
Ebv Reactivation ◽  
One Year

Abstract Background: Post-transplantation lymphoproliferative diseases (PTLD) represent a rare but aggressive graft complication. Patients who have received a solid organ transplantation have a 20 to 120 fold higher incidence of non-Hodgkin’s lymphoma. EBV reactivation represents a major predictive factor for PTLD, especially during the first year after transplantation, but there is no consensual attitude in this situation Aim: We conducted a monocentric prospective study in the Hospital of Pitie Salpêtriere, Paris, France, on all new heart or lung-heart transplanted patients. EBV viral load was systematically followed and confirmed reactivations were treated or surveyed, depending on viral load. Methods: 101 patients were included between January 2004 and December 2006. Twelve to 15 blood samples per year were analysed. If the viral load was more than 50N, patients were treated by diminution of the immunosupression and one injection of rituximab (375 mg/m2), between 10N and 50N, only the immunosupression was modified, and rituximab was used in case of failure, and below 10N, a simple survey was decided. Correlation with CMV reactivation has been analysed. Results: 45 (44%) patients presented an EBV reactivation. A simple survey has been sufficient in 29 cases, immunosupression decrease was the only treatment in 8 cases, 2 patients had to be treated in a second step by rituximab, because of stability or increase of the viral load beside the immnosupression modification, and 6 patients have been treated by rituximab as first treatment. All EBV reactivations have been controlled by this attitude, no PTLD has been diagnosed during this period and graft rejection rate did not change. From 1987 to December 2003, 24 PTLD have been treated in the same unit (18 EBV positive, 1 unknown), of which 13 were early PTLD (all EBV positive) with a diagnosis of less than one year after transplantation. We did not find any correlation between EBV and CMV reactivations. Conclusion: EBV reactivation after organ transplantation can be managed by diminution of immunosupression and/or rituximab, depending on viral load, without serious complication. A prolongation of this study and a longer follow-up are necessary to know if this attitude decreases the incidence of early EBV positive PTLD.

scholarly journals INFECTIONS DURING FIRST YEAR OF RENAL TRANSPLANTATION: ETIOLOGY, RISK FACTORS AND OUTCOME

2020 ◽  
pp. 1-3
Author(s):  
Amit Katyal ◽  
M.M. Bahadur
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Graft Function ◽  
Western World ◽  
First Year ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Major Infection ◽  
One Year

Background: Renal transplantation is the best treatment in managing end stage renal disease patients.However infections in these patients remain the leading cause of morbidity and mortality[1].Various factors like age, co-morbid infections like Hepatitis C infection and presence of Diabetes Mellitus,play a role in development of these infections.In developing country like ours, the spectrum of infection is likely to be different from the western world[2]. There is paucity of data on this aspect.There exists a conflict in literature regarding the predisposition to these infections and their impact on graft outcome. Aims & Objectives : This study proposes to analyse the predisposing factors,spectrum of infections in renal transplant recipients and their impact on graft function. Materials & Methods : Hundred renal transplant patients who received transplant between 01 Jan 2015 to Dec 2015 were prospectively followed for a period of one year for development of a major infection. All patients underwent thorough evaluation with complete blood count, urine and blood cultures, Radiological investigations and invasive investigations were done on case to case basis to achieve an etiological diagnosis. Special investigations were done when clinically indicated and infections were diagnosed based on established criteria. Those patients who had evidence of graft dysfunction were subjected to kidney biopsy.Descriptive analysis was done for all variables statistical analysis was done using paired/unpaired T test.A p value of < o.o5 was considered significant. Results: 68 patients (68%) had 138 episodes of infection (i.e. 2.02/patient)[3]. There were 42%episodes of bacterial infections,29% of viral infections,8.7% of fungal,7.1% tubercular and 14.4% had miscellaneous infection.There was no significant correlation between development of infection and variables like Diabetes Mellitus, age and HCV infection. There was significant increase in creatinine value at the end of one year,in the patients of infection(p value0.003),which on comparison with the non infected group was not significant(p >0.05). Conclusion: Nearly 68% of transplant recipients had an episode of major infection in the first year of transplantation.The majority of infection were bacterial(42%); and the dominant amongst them, was UTI. Graft survival was not inferior in these patients,at the end of one year.

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