Friederike Bachmann's research while affiliated with Charité Universitätsmedizin Berlin and other places
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Publications (51)
Women of childbearing age show increased fertility after kidney transplantation. Of concern, preeclampsia, preterm delivery, and allograft dysfunction contribute to maternal and perinatal morbidity and mortality. We performed a retrospective single-center study, including 40 women with post-transplant pregnancies after single or combined pancreas–k...
Background
De novo donor-specific HLA antibodies (dnDSA) are key factors in the diagnosis of antibody-mediated rejection (ABMR) and related to graft loss.
Methods
This retrospective study was designed to evaluate the natural course of dnDSA in graft function and kidney allograft survival and to assess the impact of mean fluorescence intensity (MFI...
The immunogenicity of SARS-CoV-2 vaccines in kidney transplant recipients is limited, resulting in inadequately low serological response rates and low immunoglobulin (Ig) levels, correlating with reduced protection against death and hospitalization from COVID-19. We retrospectively examined the time course of anti-SARS-CoV-2 Ig antibody levels afte...
Mortality from COVID-19 among kidney transplant recipients (KTR) is high, and their response to three vaccinations against SARS-CoV-2 is strongly impaired. We retrospectively analyzed the serological response of up to five doses of the SARS-CoV-2 vaccine in KTR from 27 December 2020 until 31 December 2021. Particularly, the influence of the differe...
Background
Transplant glomerulopathy (TG) may indicate different disease entities including chronic AMR (antibody-mediated rejection). However, AMR criteria have been frequently changed, and long-term outcomes of allografts with AMR and TG according to Banff 2017 have rarely been investigated.
Methods
282 kidney allograft recipients with biopsy-pr...
Immunogenicity of SARS-CoV-2 vaccines in kidney transplant recipients is limited, resulting in inadequately low serological response rates and low immunoglobulin (Ig) levels, correlating with reduced protection against death and hospitalization from COVID-19. We retrospectively examined the time course of anti-SARS-CoV-2 Ig antibody levels after up...
Background: Antiviral drugs have shown little impact in patient infected with acute respiratory coronavirus 2 (SARS-CoV-2). Especially for immunocompromised persons positive for SARS-CoV-2, novel treatments are warranted. Recently, the U.S. FDA has granted an emergency use authorization (EUA) to two monoclonal antibodies (mAb) targeting the viral s...
Transplant recipients exhibit an impaired protective immunity after SARS-CoV-2 vaccination, potentially caused by mycophenolate (MPA) immunosuppression. Recent data from autoimmune patients suggest that temporary MPA hold might significantly improve booster vaccination outcomes. We applied a fourth dose of SARS-CoV-2 vaccine to 29 kidney transplant...
Mortality from COVID-19 among kidney transplant recipients (KTR) is high, and their response to three vaccinations against SARS-CoV-2 is strongly impaired.
We retrospectively analyzed serological response of up to five doses of SARS-CoV-2 vaccine in KTR from December 27, 2020, until December 31, 2021. Particularly, the influence of different dose a...
Immunosuppression increases the risk of severe coronavirus disease 2019 (COVID-19). Morbidity and mortality of this disease in kidney transplant patients are higher than in the general population. As the vaccination response of transplant patients is weak, serological monitoring was performed. In this cohort study, we analyzed the determinants of v...
Transplant recipients exhibit an impaired protective immunity after SARS-CoV-2 vaccination, potentially caused by mycophenolate (MPA) immunosuppression. Recent data from autoimmune patients suggest that temporary MPA hold might significantly improve booster vaccination outcomes. We applied a fourth dose of SARS-CoV-2 vaccine during temporary (5 wee...
The Banff 2017 report permits the diagnosis of pure chronic antibody-mediated rejection (cAMR) in absence of microcirculation inflammation. We retrospectively investigated renal allograft function and long-term outcomes of 67 patients with cAMR, and compared patients who received antihumoral therapy (cAMR-AHT, n = 21) with patients without treatmen...
West Nile Virus (WNV) infections are increasingly detected in birds and horses in central Europe, with a first mosquito-borne autochthonous human infection detected in Germany in 2019. Human infections are typically asymptomatic, with occasional severe neurological disease. Because of a low number of cases in central Europe, awareness regarding pot...
Background: Accumulating evidence suggests that solid organ transplant recipients, as opposed to the general population, show strongly impaired responsiveness towards standard SARS-CoV-2 mRNA-based vaccination, demanding alternative strategies for protection of this vulnerable group.
Methods: In line with recent recommendations, a third dose of eit...
Background: Accumulating evidence suggests that solid organ transplant recipients, as opposed to the general population, show strongly impaired responsiveness towards standard SARS-CoV-2 mRNA-based vaccination, demanding alternative strategies for protection of this vulnerable group.
Methods: In line with recent recommendations, a third dose of eit...
Background:
Post-transplantation diabetes mellitus (PTDM) might be preventable.
Methods:
This open-label, multicenter randomized trial compared 133 kidney transplant recipients given intermediate-acting insulin isophane for postoperative afternoon glucose ≥140 mg/dl with 130 patients given short-acting insulin for fasting glucose ≥200 mg/dl (con...
Novel mRNA-based vaccines have been proven powerful tools to combat the global pandemic caused by SARS-CoV2 with BNT162b2 (trade name: Comirnaty) efficiently protecting individuals from COVID-19 across a broad age range. Still, it remains largely unknown how renal insufficiency and immunosuppressive medication affect development of vaccine induced...
Background and Aims
Patients with chronic kidney disease suffer often from cardiovascular diseases, especially high blood pressure and its complications such as stroke and heart attack. After kidney transplantation, this condition persists and can in addition harm the graft. However, outpatient care surveillance is not ideal to treat high blood pre...
The MACCS (Medical Assistant for Chronic Care Service) platform enables secure sharing of key medical information between patients after kidney transplantation and physicians. Patients provide information such as vital signs, well-being, and medication intake via smartphone apps. The information is transferred directly into a database and electroni...
Novel mRNA-based vaccines have been proven powerful tools to combat the global pandemic caused by SARS-CoV2 with BNT162b2 efficiently protecting individuals from COVID-19 across a broad age range. Still, it remains largely unknown how renal insufficiency and immunosuppressive medication affect development of vaccine induced immunity. We therefore c...
Background:
Preservation of kidney function in newly diagnosed (ND) multiple myeloma (MM) helps to prevent excess toxicity. Patients (pts) from two prospective trials were analyzed, provided postinduction (PInd) restaging was performed. Pts received three cycles with bortezomib (btz), cyclophosphamide, and dexamethasone (dex; VCD) or btz, lenalido...
Background:
Hepatitis E virus (HEV) infection especially in immunocompromised individuals can lead to chronic hepatitis. Aggressive courses of chronic hepatitis E leading to liver cirrhosis in a short period of time have been described, but evidence on the degree of liver involvement in chronic hepatitis E is rare. We therefore aimed to quantify l...
Background: Preservation of kidney function in newly diagnosed (ND) multiple myeloma (MM) helps to prevent excess toxicity. Patients (pts) from two prospective trials were analyzed, provided postinduction (PInd) restaging was performed. Pts received three cycles with bortezomib (btz), cyclophosphamide, and dexamethasone (dex; VCD) or btz, lenalidom...
Background
Transplant recipients are prone to develop severe infections due to immunosuppression. Therefore, studying the manifestation of SARS-CoV-2-infection in transplant patients is of special importance.
Methods
112 transplant patients consecutively visiting the outpatient-department of two German transplant-centers were included after writte...
Proteinuria and transplant glomerulopathy (TG) are common in kidney transplantation. To date, there is limited knowledge regarding proteinuria in different types of TG and its relationship to allograft survival. A retrospective cohort analysis of TG patients from indication biopsies was performed to investigate the relationship of proteinuria, hist...
eHealth (“electronic” Health) is a new field in medicine that has the potential to change medical care, increase efficiency, and reduce costs. In this review, we analyzed the current status of eHealth in transplantation by performing a PubMed search over the last 5 years with a focus on clinical studies for post‐transplant care. We retrieved 463 ma...
The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 denotes a global health issue. Data regarding COVID-19 incidence in kidney transplant recipients (KTR) are sparse. From 19 March to 19 May 2020, we performed a systematic screening for COVID-19 in KTR. Tests included serum analysis for SARS-CoV-2 antibodies using S protein-based...
Abstract Background In de novo kidney transplant recipients (KTR) treatment with belatacept has been established as a comparable option as maintenance immunosuppression, preferably as a strategy to convert from calcineurin inhibitor (CNI)- to belatacept-based immunosuppression. Switch to belatacept demonstrated improved renal function in patients w...
Background:
Mycophenolic acid (MPA) is a standard immunosuppressant in organ transplantation. A simple monitoring biomarker for MPA treatment has not been established so far. Here, we describe inosine 5'-monophosphate dehydrogenase (IMPDH) monitoring in erythrocytes and its application to kidney allograft recipients.
Methods:
IMPDH activity meas...
Introduction The kidney is an important target organ in plasma cell dyscrasias, subjected to various mechanisms of injury such as tubular obstruction, hypercalcemia, and pre-existing disease. Preservation of kidney function in newly diagnosed (ND) multiple myeloma (MM) is of concern as treatment-related toxicity (for instance infections and mucosit...
Background:
Pregnancy after kidney transplantation has been considered as high risk for maternal and fetal complications. After careful patient selection successful pregnancies are described. Little is known about fetal outcomes and data is particularly scarce on childrens´ early development up to two years when born to kidney/-pancreas transplant...
Antibody‐mediated rejection (ABMR) is a major cause of graft loss in renal transplantation. We assessed the predictive value of clinical, pathological and immunological parameters at diagnosis for graft survival. We investigated 54 consecutive patients with biopsy‐proven ABMR. Patients were treated according to our current standard regimen followed...
Background
Perioperative antibiotic prophylaxis (PAP) is an integral part of kidney transplantation to prevent surgical site infections (SSI). In July 2015, we changed our standard from a multiple-dose to a single-dose (SD) prophylaxis. Here, we report on results with both regimens and a related survey among Eurotransplant renal transplantation cen...
Background:
Current evidence on steroid withdrawal following AB0-incompatible (AB0i) renal transplantation is low. We compared clinical outcomes of patients who agreed to late steroid withdrawal and patients who remained on steroid treatment.
Methods:
Steroid withdrawal was carried out in 11 patients at ≥12 months after transplantation (group W)...
Objective:
Ovarian cysts are a common finding in reproductive-aged females. Most of them are functional cysts that typically resolve spontaneously and require no treatment. However, ovarian cysts may also be adverse events associated with inhibitors of the mammalian target of rapamycin (mTOR). Both approved mTOR inhibitors everolimus and sirolimus...
Background:
Antibody-mediated rejection (ABMR) is a major risk for renal allograft survival. Throughout decades, cyclophosphamide treatment has been proven to be effective in patients with antibody-associated autoimmune diseases. We investigated, whether cyclophosphamide combined with plasmapheresis (PPH) and intravenous immunoglobulins (IVIG) is...
Pneumocystis jirovecii pneumonia (PJP) affects immunocompromised patients. As a result of effective prophylaxis in the 1st months after kidney transplantation, PJP is increasingly diagnosed in the long term after transplantation. The present study evaluates course and outcome of PJP in a single transplant center from 2010 to 2015. Twenty-three pati...
Recurrence of hepatitis C virus (HCV)-associated membranoproliferative glomerulonephritis (MPGN) in the kidney transplant may lead to continuous graft deterioration and the need for further renal replacement therapy. The novel direct acting antiviral agents (DAAs) allow a highly effective and interferon-free treatment option for chronic HCV infecte...
LAM ist eine seltene Multisystemerkrankung, die nahezu ausschlieslich Frauen im gebarfahigen Alter betrifft. LAM kann in zwei verschiedenen Formen auftreten: erstens als nicht vererbbare sporadische LAM (sLAM) und zweitens als autosomal dominant vererbbare Erkrankung im Rahmen des Tuberose-Sklerose-Komplexes (TSC). Bei bis zu 50 % der weiblichen TS...
In adult tuberous sclerosis complex (TSC) patients, renal complications are the leading cause of death. Beginning in childhood, up to 80 % of patients develop renal angiomyolipoma characterized by a size-dependent risk of life-threatening bleeding. After discovery of the two causative genes, TSC1 and TSC2, and the role of mammalian target of rapamy...
Lymphangioleiomyomatosis (LAM) is a rare multi-system disorder affecting predominantly women of childbearing age. The disease entity is divided in sporadic LAM (sLAM) and LAM associated with tuberous sclerosis complex (TSC). In up to 50 % of female TSC-patients pulmonary involvement (TSC-LAM) can be found, with first clinical symptoms usually start...
In kidney transplant recipients with chronic graft dysfunction, long-term immunosuppression with calcineurin inhibitors (CNIs) or mTOR inhibitors (mTORi) can be challenging due to adverse effects, such as nephrotoxicity and proteinuria. Seventy-nine kidney transplant recipients treated with CNI-based or mTORi-based maintenance immunosuppression who...
Transplant patients are at increased risk for developing severe norovirus (NoV) infections with secondary complications such as rejection episodes and acute transplant failure.
This single‐center retrospective study included all kidney transplant patients tested positive for NoV RNA between January 2007 and December 2011. Data were compared to a co...
Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults, and one-third of patients develop end-stage renal disease (ESRD). Circulating autoantibodies against the podocyte surface antigens phospholipase A2 receptor 1 (PLA2R1) and the recently identified thrombospondin type 1 domain-containing 7A (THSD7A) are assumed to c...
Background
Current immunosuppressive protocols effectively prevent acute rejection of renal allografts. Extensive drug toxicity and the deleterious effects of long-term immunosuppression are associated with significant morbidity and mortality.
Objectives
The purpose of this article is to provide an overview over modern immunosuppressants and their...
Background: MicroRNAs (miRNAs, miR) hold important roles in the post-transcriptional regulation of gene expression. Their function has been correlated with kidney disease, and they might represent a new class of biomarkers for frequent evaluation of renal graft status. We analyzed their potential in identifying severe T cell-mediated vascular rejec...
Citations
... Except for the deterioration in eGFR before pregnancy, we did not find any other predictors for adverse pregnancy outcomes. The strength of this study is the comparison with a matched control cohort with detailed information regarding baseline characteristics, allograft function parameters with the emphasis on dynamic changes, and a detailed long-term mean follow-up time in both cohorts including regular determinations of HLA antibodies [60]. Since common clinical indicators were not helpful for risk prediction, the use of current biomarkers such as sFlt-1 and PlGF and the detection and validation of new biomarkers derived from multiple organ and cellular sources need to be explored in future studies [61]. ...
... También se ha encontrado que los niveles de protección humoral disminuyen rápidamente también en los trasplantados renales que inicialmente respondieron a la vacunación, independientemente del tipo de inmunoglobulina y del ensayo utilizado. La pérdida de anticuerpos a los dos y cuatro meses después de la vacunación ocurre en un número sustancial de individuos que responden inicialmente, lo que puede resultar en una pérdida de protección contra COVID-19 [49]. ...
Reference: revCN-649-22December
... The velocity of shear waves (SW) in tissue increases with increasing tissue stiffness (9). Previous studies have reported wide use of SWE to assess liver stiffness (10,11). After allo-HSCT, elastography has been demonstrated to improve the accuracy of early diagnosis of hepatobiliary complications (12). ...
... We demonstrated that antibody acquisition rates and antibody levels were low after two SARS-CoV-2 vaccinations in Japanese KT patients, consistent with previous reports from other countries and Japanese institutes [10,[15][16][17][18][19]. In our study, factors associated with antibody acquisition after the second vaccination were time since KT, ABO-I KT, and MMF use. ...
... Our data are in line with prior studies. Meanwhile, the therapy with mAbs in early-stage SARS-CoV-2 infections in high-risk groups is widely accepted, and clinical trials with mAbs have reported overall lower hospitalization rates in patients with mild-to-moderate COVID-19 [41][42][43]. However, previous studies have demonstrated that not all approved mAbs are suitable for treating the different variants of SARS-CoV-2 such as Omicron [44,45]. ...
... Eine Studie an 29 nierentransplantierten Patienten mit schlechten SARS-CoV-2-Antikörpertitern nach einer 1. Impfung zeigte, dass die Immunantwort auf eine 4. Dosis der COVID-19-Impfung durch eine Unterbrechung der Antimetabolitentherapie (z. B. MMF, Azathioprin) verbessert werden konnte[77].Bevor jedoch Empfehlungen zu diesem Ansatz abgegeben werden können, sind größere kontrollierte Studien erforderlich.Kalzineurininhibitoren (z. B. Cyclosporin A, Tacrolimus) haben in vitro antivirale Eigenschaften gegen mehrere Coronaviren gezeigt, darunter SARS-CoV und "middle east respiratory syndrome coronavirus" (MERS-CoV;[78,79]). ...
... REVIEW 3 authors concluded that further studies are needed to verify whether this difference remains after a third dose of vaccination. A study by Liefeldt [11] examined the predictors of the serological response to SARS-CoV-2 vaccination in kidney transplant patients. The study found that predictors of a weak response were the age at vaccination, time after kidney transplantation, immunosuppression, estimated glomerular filtration rate (eGFR) at vaccination and lymphocyte count at vaccination (Table 1a). ...
... However, the present results show that serologic testing of the vaccination response in immunocompromised KTR makes sense defining cohorts with either successful seroconversion as well as non-responding patients with better or worse chances for a successful booster vaccination. In this sub-cohort of non-responding KTR with better chances for successful booster vaccination, no potentially risky reductions in immunosuppressive therapy, as already proposed by others (25), may be necessary to achieve high seroconversion rates as shown here. Hereby it also can be considered that successful seroconversion is accompanied by, albeit relative (depending on the variants of the virus), protection from severe or fatal infections. ...
... Moreover, there is no consensus regarding the management of renal transplant recipients without allograft dysfunction with circulating de novo DSAs [16]. The impact of de novo anti-HLA DSAs on the development of ABMR is under investigation, as not all DSA-positive patients develop ABMR [17,18]. ...
... Although WNV was not detected in the Netherlands in the summer of 2021, in mid-September of 2022 a grey heron (Ardea cinerea) tested positive for the presence of WNV RNA in the province of North Holland, the Netherlands [9]. In other European countries, such as Germany and Hungary, WNV has been detected during summers of consecutive years, suggesting local persistence of the virus [10,11]. The first recorded finding of USUV in Europe occurred in 2001, in-and nearby Vienna, Austria [12]. ...