International Kidney Paired Donation

1 Division of Transplant Surgery Department of Surgery Johns Hopkins University School of Medicine Baltimore, MD 2 Multi-Organ Transplant Program McGill University Health Center Montreal, Quebec, Canada 3 Department of Epidemiology Johns Hopkins School of Public Health Baltimore, MD.
Transplantation (Impact Factor: 3.83). 10/2013; 96(7):e55-e56. DOI: 10.1097/TP.0b013e3182a68879
Source: PubMed
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    ABSTRACT: Sensitization to human leukocyte antigens (HLA) creates significant barriers for renal transplant candidates, reducing access to transplantation by limiting donor availability and increasing the risk of rejection. Sensitized patients also endure longer wait-times on dialysis. Desensitization protocols, kidney-paired donation, and a combination of both of these modalities have been used to remove or circumvent the clinically deleterious anti-HLA antibodies. Technical advances in antibody characterization methods and therapies targeting the humoral arm of the immune system have facilitated successful transplantation for these immunologically challenging patients. However, antibody-mediated rejection and transplant glomerulopathy resulting from injury to the vascular endothelium are major impediments to further improvement in outcomes. This review describes the assessment protocols, antibody monitoring techniques, and therapeutic strategies that have been used effectively to overcome HLA incompatibility.
    Full-text · Article · Jun 2014
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    ABSTRACT: Innovative and exciting advances in the clinical science in solid organ transplantation continuously realize as the results of studies, clinical trials, international conferences, consensus conferences, new technologies and discoveries. This review will address to the full spectrum of news in transplantation, that verified by 2013. The key areas covered are the transplantation activity, with particular regards to the donors, the news for solid organs such as kidney, pancreas, liver, heart and lung, the news in immunosuppressive therapies, the news in the field of tolerance and some of the main complications following transplantation as infections and cancers. The period of time covered by the study starts from the international meetings held in 2012, whose results were published in 2013, up to the 2013 meetings, conferences and consensus published in the first months of 2014. In particular for every organ, the trends in numbers and survival have been reviewed as well as the most relevant problems such as organ preservation, ischemia reperfusion injuries, and rejections with particular regards to the antibody mediated rejection that involves all solid organs. The new drugs and strategies applied in organ transplantation have been divided into new way of using old drugs or strategies and drugs new not yet on the market, but on phase Ito III of clinical studies and trials.
    Full-text · Article · Dec 2014
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    ABSTRACT: This study was designed to explore the clinical significance of dynamically monitoring the serum level of matrix metalloproteinase 9 (MMP-9) before and after renal transplantation. Before transplantation and 1, 3, 5, 7, 10, 15, and 20 days after transplantation, the peripheral blood was collected from 102 renal transplant recipients, including 8 with acute rejection (ARs) and 94 non-ARs. The serum MMP-9 level was detected by Luminex 200 analyzer (Luminex Corporation, Austin, TX, USA). By day 3 post-transplantation, the serum MMP-9 level in non-ARs had significantly reduced as compared to the pretransplantation level, and reached the lowest value on day 20 post-transplantation. In contrast, the serum MMP-9 level in ARs had significantly increased by day 3, reached the highest value on day 7, and remained significantly higher on day 20 as compared to the pretransplantation level. The receiver operating characteristic curve was plotted to evaluate the power of serum MMP-9 level on day 20 post-transplantation to differentiate the non-AR and AR groups. Our data revealed that with a threshold of 8473.26 pg/mL, the area under the curve was 0.758 (0.661, 0.856); the sensitivity and specificity of the diagnostic were 78.40% and 61.30%, respectively; the positive and the negative predictive values were 74.60% and 66.67%, respectively; and the accuracy rate was up to 71.57%. Taken together, the results indicated that dynamically monitoring serum MMP-9 levels in renal allograft recipients might be a convenient and safe method to diagnose ARs. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Mar 2015 · Transplantation Proceedings
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