Pharmacokinetics and Pharmacodynamics of Immunosuppressive Drugs in Elderly Kidney Transplant Recipients
Elderly patients are a fast growing population among transplant recipients over the past decades. Both the innate and adaptive immune reactivity decrease with age, which is believed to contribute to the decreased incidence of acute rejection and increased infectious death rate in elderly transplant recipients. In contrast to recipient age, donor age is associated with a higher incidence of acute rejection.Pharmacokinetic studies in renal transplant recipients show that CNI troughs are >50% higher in elderly compared to younger patients given the same dose normalized by body weight. (Source: Transplantation Reviews)
Source: Transplantation Reviews - May 6, 2015 Category: Transplant Surgery Authors: Yun-Ying Shi, Dennis A. Hesselink, Teun van Gelder Source Type: research
Anti-human leukocyte antigen DQ antibodies in renal transplantation: Are we underestimating the most frequent donor specific alloantibodies?
The role of anti-human leukocyte antigens DQ region (HLA-DQ) in transplantation is historically less studied than HLA-DR and HLA class I regions, but several studies are demonstrating that anti HLA-DQ antibodies are among the most frequent anti HLA antibodies that develop after transplantation and can have great influence on the developing of humoral rejection and graft loss. In this article we review the gene structure and nomenclature of the HLA-DQ region, the role of anti HLA-DQ antibodies after and before transplantation and briefly the associations of particular HLA-DQ alleles and other diseases. (Source: Transplantation Reviews)
Source: Transplantation Reviews - April 30, 2015 Category: Transplant Surgery Authors: Paolo Carta, Lorenzo Di Maria, Leonardo Caroti, Elisa Buti, Giulia Antognoli, Enrico Eugenio Minetti Source Type: research
New Strategies for Evaluating the Quality of Kidney Grafts from Elderly Donors
The increased demand for kidney transplantation and organ shortage resulted in the increased use of kidneys from suboptimal donors. Therefore, identification of kidneys that can be accepted without significantly compromising the outcome of allograft or recipient has become critical. A robust assessment of organ quality is of particular importance especially in kidneys from elderly donors in whom morphological and functional changes associated with aging and diseases are obvious. A number of predictive tools have been developed to help with evaluating the suitability of a deceased-donor kidney for transplantation. (Source: ...
Source: Transplantation Reviews - April 30, 2015 Category: Transplant Surgery Authors: Mariana Wohlfahrtova, Ondrej Viklicky Source Type: research
Anti-Human Leukocyte Antigen DQ antibodies in renal transplantation. Are we underestimating the most frequent donor specific alloantibodies?
The role of anti-human leukocyte antigens DQ region (HLA-DQ) in transplantation is historically less studied than HLA-DR and HLA class I regions, but several studies are demonstrating that anti HLA-DQ antibodies are among the most frequent anti HLA antibodies that develop after transplantation and can have great influence on the developing of humoral rejection and graft loss. In this article we review the gene structure and nomenclature of the HLA-DQ region, the role of anti HLA-DQ antibodies after and before transplantation and briefly the associations of particular HLA-DQ alleles and other diseases. (Source: Transplantation Reviews)
Source: Transplantation Reviews - April 30, 2015 Category: Transplant Surgery Authors: Paolo Carta, Lorenzo Di Maria, Leonardo Caroti, Elisa Buti, Giulia Antognoli, Enrico Eugenio Minetti Source Type: research
The diverging roles of dendritic cells in kidney allotransplantation
Dendritic cells (DCs) are a family of antigen presenting cells which play a paramount role in bridging innate and adaptive immunity. In murine models several subtypes of DCs have been identified, including classical DCs, monocyte-derived DCs, and plasmacytoid DCs. Quiescent, immature DCs and some subtypes of plasmacytoid cells favor the expression of regulatory T cells, but in an inflammatory milieu DCs become mature and after intercepting the antigen migrate to lymphatic system where they present the antigen to naïve T cells. (Source: Transplantation Reviews)
Source: Transplantation Reviews - April 15, 2015 Category: Transplant Surgery Authors: Manuel Alfredo Podestà, David Cucchiari, Claudio Ponticelli Source Type: research
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Source: Transplantation Reviews - April 1, 2015 Category: Transplant Surgery Source Type: research
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Source: Transplantation Reviews - April 1, 2015 Category: Transplant Surgery Source Type: research
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Source: Transplantation Reviews - April 1, 2015 Category: Transplant Surgery Source Type: research
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Source: Transplantation Reviews - April 1, 2015 Category: Transplant Surgery Source Type: research
Immunosuppressive therapies after heart transplantation — The balance between under- and over-immunosuppression
Since the first heart transplantation (HT) in 1967, survival has steadily improved. Issues related to over- and under-immunosuppression are, however, still common following HT. Whereas under-immunosuppression may result in rejection, over-immunosuppression may render other medical problems, including infections, malignancies and chronic kidney disease (CKD). As such complications constitute major limiting factors for long-term survival following HT, identifying improved diagnostic and preventive methods has been the focus of many studies. (Source: Transplantation Reviews)
Source: Transplantation Reviews - February 28, 2015 Category: Transplant Surgery Authors: Carl Söderlund, Göran Rådegran Source Type: research
Immunosuppressive therapies after heart transplantation - the balance between under- and over-immunosuppression
Since the first heart transplantation (HT) in 1967, survival has steadily improved. Issues related to over- and under-immunosuppression are, however, still common following HT. Whereas under-immunosuppression may result in rejection, over-immunosuppression may render other medical problems, including infections, malignancies and chronic kidney disease (CKD). As such complications constitute major limiting factors for long-term survival following HT, identifying improved diagnostic and preventive methods has been the focus of many studies. (Source: Transplantation Reviews)
Source: Transplantation Reviews - February 28, 2015 Category: Transplant Surgery Authors: Carl Söderlund, Göran Rådegran Source Type: research
mTOR inhibitor therapy: Does it prevent HCC recurrence after liver transplantation?
Prevention of hepatocellular carcinoma (HCC) recurrence after liver transplantation is a clinical priority. The importance of the mammalian target of rapamycin (mTOR) pathway in cell growth and survival makes it a logical target for antitumor strategies, as borne out by clinical data in various types of malignancy. A number of studies have indicated that the mTOR inhibitors everolimus and sirolimus suppress cell proliferation and tumor growth in animal models of HCC. Coadministration of an mTOR inhibitor could permit lower dosing of chemotherapeutic agents in HCC management, and trials in non-transplant HCC population are ...
Source: Transplantation Reviews - February 24, 2015 Category: Transplant Surgery Authors: Christophe Duvoux, Christian Toso Source Type: research
The prevalence and implications of BK virus replication in non-renal solid organ transplant recipients: a systematic review
The significance of BK viruria and viremia in non-renal solid organ transplants is poorly understood. A systematic review was performed reviewing the incidence and implications of BK virus replication in non-renal solid organ transplants. 97 studies were identified, of which 18 including lung, heart, liver and pancreas transplants were included. The overall incidence of BK viruria and viremia were 20% and 3% respectively and 17 cases of BK nephropathy were identified. Heart transplant recipients had a higher overall incidence of BK viremia than other non-renal organ types, and the majority of cases of BK virus-associated n...
Source: Transplantation Reviews - February 23, 2015 Category: Transplant Surgery Authors: Velliyur Viswesh, Sarah E. Yost, Bruce Kaplan Source Type: research
Monitoring B cell subsets and alloreactivity in kidney transplantation
B cells are the precursors of antibody producing plasma cells that can give rise to the formation of donor-specific antibodies. However, recent data suggest that besides their role in antibody production, B cells participate in antibody-independent responses, potentially leading to allograft rejection or allograft tolerance. The presence of CD20+ B cells in kidney graft biopsies has been shown during severe acute rejection episodes and during chronic rejection. Furthermore, operationally tolerant kidney transplant recipients showed a clear B cell dominated fingerprint of tolerance. (Source: Transplantation Reviews)
Source: Transplantation Reviews - February 21, 2015 Category: Transplant Surgery Authors: Marta Crespo, Sebastiaan Heidt, Dolores Redondo, Julio Pascual Source Type: research
