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Almeida ARF, Grincenkov FRS, Colugnati FAB, Medina-Pestana JO, De Geest S, Sanders-Pinheiro H. Quality of life of patients after kidney transplant: ADHERE Brazil multicenter cross-sectional study. Appl Nurs Res 2024; 78:151815. [PMID: 39053995 DOI: 10.1016/j.apnr.2024.151815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/16/2023] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Quality of life (QoL) is a measure to evaluate kidney transplant (KT) results. AIM To describe the QoL profile in a larger sample of Brazilian patients who underwent KT according to age, sex, and access to KT. METHODS We conducted a secondary data analysis of the ADHERE BRAZIL multicenter cross-sectional study including 1105 patients from 20 centers, considering KT access region and transplant activity. QoL was assessed by the WHOQOL-BREF. Data was compared using Generalized Estimating Equations. RESULTS Overall, 58.5 % of the patients were men, mean age of 47.6 ± 12.6 years. The general QoL score was 81 ± 15.1, 58.6 ± 11.6 for physical, 65.5 ± 11.4 for psychological, 68.3 ± 17.1 for social relationships, and 64.2 ± 13.3 for environmental domain. Higher QoL scores were observed in men compared to women in three WHOQOL-BREF domains: psychological (OR:2.62; CI, 1.29 ̶ 3.95, p < 0.0001), social relationships (OR:3.21; CI, 1.2 ̶ 5.23, p = 0.002) and environmental (OR:3.79; CI:2.23 ̶ 5.35, p < 0.0001). Younger patients (18-44 years) had higher scores in the psychological (OR:-2.69; CI, -4.13 ̶ -1.25; p < 0.001; OR:-3.52; CI, -5.39 ̶ -1.66; p < 0.001) and social (OR:-3.46; CI, -5.64 ̶ -1.27; p = 0.002; OR:-7.17; CI, -10 ̶ -4.35; p < 0.0001) domains than older ones (45-59 and > 60 years, respectively). Patients from higher KT access region had higher scores in environmental domain (OR:3.53; CI, 0.28 ̶ 6.78; p = 0.033). CONCLUSIONS Featuring the results of KT under patient view, the physical and social relationships domains were the most and least affected, respectively. Lower QoL subgroups (females and age > 45 years) should be targeted in future multi-professional interventions.
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Affiliation(s)
- Aline R F Almeida
- Renal Transplantation Unit, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil; Interdisciplinary Center for Studies and Research in Nephrology (NIEPEN), Faculty of Medicine, Federal University of Juiz de Fora. Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil.
| | - Fabiane R S Grincenkov
- Faculty of Psychology, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, S/N, São Pedro, Juiz de Fora, MG CEP: 36036-900, Brazil.
| | - Fernando A B Colugnati
- Renal Transplantation Unit, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil; Interdisciplinary Center for Studies and Research in Nephrology (NIEPEN), Faculty of Medicine, Federal University of Juiz de Fora. Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil.
| | - José O Medina-Pestana
- Hospital do Rim e Hipertensão, Oswaldo Ramos Foundation, Nephrology Discipline, Federal University of São Paulo, Rua Borges Lagoa, 960, Vila Clementino, São Paulo, SP CEP: 04038-002, Brazil.
| | - Sabina De Geest
- Institute of Nursing Science, Department Public Health, University of Basel, Peterspl. 1, 4001 Basel, Switzerland; Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Oude Markt 13, 3000 Leuven, Belgium.
| | - Helady Sanders-Pinheiro
- Renal Transplantation Unit, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil; Interdisciplinary Center for Studies and Research in Nephrology (NIEPEN), Faculty of Medicine, Federal University of Juiz de Fora. Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil.
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Liu Y, Feng R, Chen J, Yan H, Liu X. The future of living organ donation: confronting the challenges and embracing the opportunities of an aging donor population. Int J Surg 2024; 110:5260-5261. [PMID: 38759690 PMCID: PMC11326022 DOI: 10.1097/js9.0000000000001562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Yongguang Liu
- Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University
| | - Runtao Feng
- Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University
| | - Jianrong Chen
- Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University
| | - Hongyan Yan
- Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University
| | - Xiaoyou Liu
- Department of Organ Transplantation, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
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Banno T, Hirai T, Oki R, Yagisawa T, Unagami K, Kanzawa T, Omoto K, Shimizu T, Ishida H, Takagi T. Higher Donor Age and Severe Microvascular Inflammation Are Risk Factors for Chronic Rejection After Treatment of Active Antibody-Mediated Rejection. Transpl Int 2024; 37:11960. [PMID: 38371907 PMCID: PMC10869508 DOI: 10.3389/ti.2024.11960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024]
Abstract
Recent developments in intensive desensitization protocols have enabled kidney transplantation in human leukocyte antigen (HLA)-sensitized recipients. However, cases of active antibody-mediated rejection (AABMR), when they occur, are difficult to manage, graft failure being the worst-case scenario. We aimed to assess the impact of our desensitization and AABMR treatment regimen and identify risk factors for disease progression. Among 849 patients who underwent living-donor kidney transplantation between 2014 and 2021 at our institution, 59 were diagnosed with AABMR within 1 year after transplantation. All patients received combination therapy consisting of steroid pulse therapy, intravenous immunoglobulin, rituximab, and plasmapheresis. Multivariable analysis revealed unrelated donors and preformed donor-specific antibodies as independent risk factors for AABMR. Five-year death-censored graft survival rate was not significantly different between patients with and without AABMR although 27 of 59 patients with AABMR developed chronic AABMR (CABMR) during the study period. Multivariate Cox proportional hazard regression analysis revealed that a donor age greater than 59 years and microvascular inflammation (MVI) score (g + ptc) ≥4 at AABMR diagnosis were independent risk factors for CABMR. Our combination therapy ameliorated AABMR; however, further treatment options should be considered to prevent CABMR, especially in patients with old donors and severe MVI.
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Affiliation(s)
- Taro Banno
- Department of Urology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Toshihito Hirai
- Department of Urology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Rikako Oki
- Department of Organ Transplant Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Takafumi Yagisawa
- Department of Urology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Kohei Unagami
- Department of Organ Transplant Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Taichi Kanzawa
- Department of Urology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Kazuya Omoto
- Department of Urology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Tomokazu Shimizu
- Department of Organ Transplant Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Hideki Ishida
- Department of Organ Transplant Medicine, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Toshio Takagi
- Department of Urology, Tokyo Women’s Medical University Hospital, Tokyo, Japan
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Lai GS, Li JR, Wang SS, Chen CS, Yang CK, Lin CY, Hung SC, Ho HC, Ou YC, Chiu KY, Yang SF. Influence of Surgical Complications on Outcomes in Kidney Transplantation Patients. In Vivo 2023; 37:2796-2802. [PMID: 37905612 PMCID: PMC10621446 DOI: 10.21873/invivo.13392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/27/2023] [Accepted: 09/01/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM With the increasing use of marginal donors, it is important to identify factors for outcomes in kidney transplantation. The aim of the present study was to evaluate the influence of surgical complications for graft survival after kidney transplantation and identify risk factors for surgical complications. PATIENTS AND METHODS We performed a retrospective cohort study by chart review of patients who underwent kidney transplantation at the Taichung Veterans General Hospital in the period from 2007 to 2018. RESULTS Of the 433 patients who underwent kidney transplantation, 57 experienced surgical complications with an occurrence rate of 13.2%. The most common complications were vascular complications (n=31; 7.2%), followed by urologic (n=9; 2%) and wound (n=9; 2%) complications. From univariate analyses, risk factors for surgical complications were cold ischemia time, blood loss, operation time, number of vascular anastomoses and year of operation. From univariate and multivariate analyses, operation time was associated to surgical complications. Patients with surgical complications experienced worse both one-year and five-year death-censored graft and patient survival. CONCLUSION Surgical complications were associated with higher risk of death-censored graft failure and mortality. Cold ischemia time, blood loss, operation time, number of vascular anastomoses and year of operation were risk factors for surgical complications. Efforts should aim to minimize surgical complications to improve both graft and patient survival.
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Affiliation(s)
- Gu-Shun Lai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Jian-Ri Li
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
- Department of Medicine and Nursing, Hungkuang University, Taichung, Taiwan, R.O.C
| | - Shian-Shiang Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
- Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan, R.O.C
| | - Chuan-Shu Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Chun-Kuang Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Yen Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Sheng-Chun Hung
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Hao-Chung Ho
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Yen-Chuan Ou
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Department of Urology, Tung's Taichung MetroHarbor Hospital, Taichung, Taiwan, R.O.C
| | - Kun-Yuan Chiu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
- Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan, R.O.C
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.;
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C
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Nasic S, Peters B, Stegmayr B, Kenne Sarenmalm E, Afghahi H, Eriksson M. Sex-specific time trends of long-term graft survival after kidney transplantation - a registry-based study. Ren Fail 2023; 45:2270078. [PMID: 37882045 PMCID: PMC11001319 DOI: 10.1080/0886022x.2023.2270078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/08/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Sex-specific trends over time with respect to kidney graft survival have scarcely been described in earlier studies. The present study aimed to examine whether kidney graft survival differs between women and men over time. METHODS This study was based on prospectively collected data extracted from a quality registry including all kidney transplant patients between January 1965 and September 2017 at the transplantation center of a university hospital in Sweden. The transplantation center serves a population of approximately 3.5 million inhabitants. Only the first graft for each patient was included in the study resulting in 4698 transplantations from unique patients (37% women, 63% men). Patients were followed-up until graft failure, death, or the end of the study. Death-censored graft survival analysis after kidney transplantation (KT) was performed using Kaplan-Meier analysis with log-rank test, and analysis adjusted for confounders was performed using multivariable Cox regression analysis. RESULTS Median age at transplantation was 48 years (quartiles 36-57 years) and was similar for women and men. Graft survival was analyzed separately in four transplantation periods that represented various immunosuppressive regimes (1965-1985, 1986-1995, 1996-2005, and 2006-2017). Sex differences in graft survival varied over time (sex-by-period interaction, p = 0.026). During the three first periods, there were no significant sex differences in graft survival. However, during the last period, women had shorter graft survival (p = 0.022, hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.1-2.7, adjusted for covariates). Biopsy-proven rejections were more common in women. CONCLUSIONS In this registry-based study, women had shorter graft survival than men during the last observation period (years 2006-2017).
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Affiliation(s)
- Salmir Nasic
- Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation Department, Skaraborg Hospital, Skövde, Sweden
| | - Björn Peters
- Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Nephrology, Skaraborg Hospital, Skövde, Sweden
| | - Bernd Stegmayr
- Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Elisabeth Kenne Sarenmalm
- Research, Education, Development and Innovation Department, Skaraborg Hospital, Skövde, Sweden
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Henri Afghahi
- Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Nephrology, Skaraborg Hospital, Skövde, Sweden
| | - Marie Eriksson
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
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Malapure SS, Oommen S, Bhushan S, Bhojaraja MV, Nagaraju SP, Attur RP, Suresh S, Rangaswamy D. Predictive Value of Camera-based Donor Glomerular Filtration Rate Estimation on the Immediate Renal Allograft Outcome Following Live-related Renal Transplant: A Single-center Retrospective Study. Indian J Nucl Med 2023; 38:320-327. [PMID: 38390542 PMCID: PMC10880840 DOI: 10.4103/ijnm.ijnm_33_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/30/2023] [Indexed: 02/24/2024] Open
Abstract
Purpose of the Study The purpose of this study was to assess the association of measured glomerular filtration rate (mGFR) using camera-based method with early transplant outcomes. Methodology Diethylenetriamine pentaacetate renograms of all voluntary kidney donors between January 2016 and December 2022 at Kasturba Hospital, Manipal, India, were retrieved for the study. Recipients' posttransplant biochemical parameters were collected and compared against donors with scaled mGFR >80 ml/min/1.73 m2 (Group 1) and with mGFR between 60 and 80 ml/min/1.73 m2 (Group 2). Donor-recipient pair age, anthropometric parameters, and their differences were also assessed against the immediate transplant outcome. Posttransplant immediate graft function was assessed by posttransplant nadir serum creatinine, day to achieve nadir serum creatinine, the incidence of slow graft or delayed graft function, and serum creatinine at 1-month posttransplantation. Recipients with serum creatinine of >2.5 mg/dl on posttransplant day 7 were taken as slow graft function. Results A total of 161 donor-recipient pairs were analyzed in the study. In recipients who showed persistently high serum creatinine posttransplant, older donor age(p < 0.001), higher difference in body mass index among the donor-recipient pair (p= 0.03), and mGFR <80ml/min (p < 0.001) were significantly associated. Slow graft function was significantly more in Group II recipients, with donors having mGFR <80ml/min as compared to Group I with mGFR >80 ml/min (37.3% vs. 10.6%) (P < 0.001). Conclusions Camera-based mGFR using Gates' formula is a reliable tool to predict inferior graft outcomes in the immediate posttransplant period. Kidneys from donors with mGFR of 60-80 mL/min/1.73 m2 are likely to experience slow graft function in the immediate posttransplant period.
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Affiliation(s)
- Sumeet Suresh Malapure
- Department of Nuclear Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sibi Oommen
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shivanand Bhushan
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Shankar Prasad Nagaraju
- Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ravindra Prabhu Attur
- Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sucharitha Suresh
- Department of Community Medicine, Father Muller Medical College, Mangalore, Karnataka, India
| | - Dharshan Rangaswamy
- Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Matsunaga T, Roesel MJ, Schroeter A, Xiao Y, Zhou H, Tullius SG. Preserving and rejuvenating old organs for transplantation: novel treatments including the potential of senolytics. Curr Opin Organ Transplant 2022; 27:481-487. [PMID: 35950886 PMCID: PMC9490781 DOI: 10.1097/mot.0000000000001019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Older donors have the potential to close the gap between demand and supply in solid organs transplantation. Utilizing older organs, at the same time, has been associated with worse short- and long-term outcomes. Here, we introduce potential mechanisms on how treatments during machine perfusion (MP) may safely improve the utilization of older organs. RECENT FINDINGS Consequences of ischemia reperfusion injury (IRI), a process of acute, sterile inflammation leading to organ injury are more prominent in older organs. Of relevance, organ age and IRI seem to act synergistically, leading to an increase of damage associated molecular patterns that trigger innate and adaptive immune responses. While cold storage has traditionally been considered the standard of care in organ preservation, accumulating data support that both hypothermic and normothermic MP improve organ quality, particularly in older organs. Furthermore, MP provides the opportunity to assess the quality of organs while adding therapeutic agents. Experimental data have already demonstrated the potential of applying treatments during MP. New experimental show that the depletion of senescent cells that accumulate in old organs improves organ quality and transplant outcomes. SUMMARY As the importance of expanding the donor pool is increasing, MP and novel treatments bear the potential to assess and regenerate older organs, narrowing the gap between demand and supply.
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Affiliation(s)
- Tomohisa Matsunaga
- Division of Transplant Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Maximilian J Roesel
- Division of Transplant Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Institute of Medical Immunology, Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Schroeter
- Division of Transplant Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Regenerative Medicine and Experimental Surgery, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Lower Saxony, Germany
| | - Yao Xiao
- Division of Transplant Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Hao Zhou
- Division of Transplant Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Stefan G Tullius
- Division of Transplant Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Baboudjian M, Gondran-Tellier B, Boissier R, Ancel P, Marjollet J, Lyonnet L, François P, Sabatier F, Lechevallier E, Dutour A, Paul P. An enhanced level of VCAM in transplant preservation fluid is an independent predictor of early kidney allograft dysfunction. Front Immunol 2022; 13:966951. [PMID: 36032101 PMCID: PMC9403542 DOI: 10.3389/fimmu.2022.966951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background We aimed to evaluate whether donor-related inflammatory markers found in kidney transplant preservation fluid can associate with early development of kidney allograft dysfunction. Methods Our prospective study enrolled 74 consecutive donated organs who underwent kidney transplantation in our center between September 2020 and June 2021. Kidneys from 27 standard criteria donors were allocated to static cold storage and kidneys from 47 extended criteria donors to hypothermic machine perfusion. ELISA assessment of inflammatory biomarkers (IL-6, IL6-R, ICAM, VCAM, TNFα, IFN-g, CXCL1 and Fractalkine) was analyzed in view of a primary endpoint defined as the occurrence of delayed graft function or slow graft function during the first week following transplantation. Results Soluble VCAM levels measured in transplant conservation fluid were significantly associated with recipient serum creatinine on day 7. Multivariate stepwise logistic regression analysis identified VCAM as an independent non-invasive predictor of early graft dysfunction, both at 1 week (OR: 3.57, p = .04, 95% CI: 1.06-12.03) and 3 Months (OR: 4.039, p = .034, 95% CI: 1.11-14.73) after transplant surgery. Conclusions This prospective pilot study suggests that pre-transplant evaluation of VCAM levels could constitute a valuable indicator of transplant health and identify the VCAM-CD49d pathway as a target to limit donor-related vascular injury of marginal transplants.
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Affiliation(s)
- Michael Baboudjian
- Department of Urology and Transplantation, La Conception Hospital, Assistance Publique-Hôpitaux Marseille, Marseille, France
- Department of Urology, Assistance Publique-Hôpitaux de Marseille, Hopital Nord, Aix-Marseille University, Marseille, France
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
| | - Bastien Gondran-Tellier
- Department of Urology and Transplantation, La Conception Hospital, Assistance Publique-Hôpitaux Marseille, Marseille, France
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
| | - Romain Boissier
- Department of Urology and Transplantation, La Conception Hospital, Assistance Publique-Hôpitaux Marseille, Marseille, France
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
| | - Patricia Ancel
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
| | - Juline Marjollet
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
| | - Luc Lyonnet
- Department of Hematology, Hopital de la Conception, Assistance Publique-Hôpitaux Marseille, Marseille, France
| | - Pauline François
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
| | - Florence Sabatier
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
- Cell Therapy Laboratory, Centre d'Investigation Clinique (CIC)-149, La Conception Hospital, Assistance Publique-Hôpitaux Marseille, Marseille, France
| | - Eric Lechevallier
- Department of Urology and Transplantation, La Conception Hospital, Assistance Publique-Hôpitaux Marseille, Marseille, France
| | - Anne Dutour
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pascale Paul
- Institut national de la santé et de la recherche médicale (INSERM) 1263, Aix Marseille University, French national research institute for agriculture, food and the environment (INRAE), Centre de recherche en CardioVasculaire et Nutrition (C2VN), Marseille, France
- Department of Hematology, Hopital de la Conception, Assistance Publique-Hôpitaux Marseille, Marseille, France
- Institut national de la santé et de la recherche médicale (INSERM) unité mixte de recherche (UMR)_1090, Aix Marseille University, TAGC Theories and Approaches of Genomic Complexity, Parc Scientifique de Luminy Case 928, Marseille, France
- *Correspondence: Pascale Paul,
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9
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Espitia D, García-López A, Patino-Jaramillo N, Girón-Luque F. Desenlaces a largo plazo en pacientes trasplantados renales con donantes de criterios expandidos: experiencia de 10 años. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El trasplante renal es el tratamiento de elección para la enfermedad renal crónica. Debido a la brecha con la disponibilidad de donantes, el uso de criterios expandidos es una opción que busca mejorar la tasa de donación mundial. El objetivo de este estudio fue comparar la sobrevida del injerto y del paciente trasplantado con donante de criterios expandidos versus el donante estándar.
Métodos. Cohorte retrospectiva de 1002 pacientes con trasplante renal donde se determinó la sobrevida del injerto renal y del receptor a 10 años después del trasplante. La sobrevida del injerto renal y el receptor fueron estimadas por el método de Kaplan-Meier. Una regresión de Cox fue realizada ajustando el modelo multivariado.
Resultados. El análisis incluyó 1002 receptores, con un 18,8 % (n=189) que correspondían al uso de donante de criterios expandidos. El grupo de trasplante renal con donante de criterios expandidos tuvo menor sobrevida del paciente (48,1 % versus 63,8 %) y del injerto (63,3 % versus 74,7 %) en comparación con el grupo de trasplante renal con donantes con criterios estándar a los 10 años después del trasplante. La asociación de trasplante renal con donante de criterios expandidos y muerte o pérdida del injerto renal no fueron significativas cuando se ajustaron las variables en el modelo multivariado.
Conclusión. El trasplante renal con donante de criterios expandidos tiene menor sobrevida del receptor y del injerto frente al grupo de trasplante renal con donante estándar. No hubo diferencias estadísticamente significativas en cuanto al trasplante renal con donante de criterios expandidos frente a la pérdida del injerto renal o muerte.
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Mine KL, de Marco R, Raimundo TRF, Ernesto JV, Medina-Pestana JO, Tedesco-Silva H, Gerbase-DeLima M. High soluble HLA-DQB2 levels in posttransplant serum are associated with kidney graft dysfunction. Int J Immunogenet 2022; 49:63-69. [PMID: 35083872 DOI: 10.1111/iji.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/20/2021] [Accepted: 01/08/2022] [Indexed: 11/27/2022]
Abstract
HLA-DQB2 is a gene of limited polymorphism, with unknown function that presents at least two transcript variants: v1, which encodes the full-length beta-chain, and v2, which lacks exon 4 and could give rise to a soluble protein. We previously showed a strong correlation between high v2 expression in preimplantation biopsies (PIB) of kidneys from young (18- to 49-year olds) but not from old, deceased donors and 1-year posttransplant low (estimated glomerular filtration rate < 45 ml/min/1.73 m2 ) graft function (GF). In this study, we aimed to investigate the impact of posttransplant soluble HLA-DQB2 (sDQB2) serum levels, v1 expression in PIB, and recipient HLA-DQB2 rs7453920 A/G polymorphism on GF. sDQB2 was evaluated by enzyme-linked immunosorbent assay in sera from 114 recipients, collected at least 1 year (median 2.1 years) after transplantation. Higher sDQB2 levels were observed in recipients of kidneys from young, but not from old, donors that had a ≥30% decline in GF within 1 year after blood collection for sDQB2 determination. Among the 15 recipients of kidneys from young donors with sDQB2 ≥ 1.52 ng/ml, 40% presented a ≥30% decline in GF, whereas this occurred in none of the 43 recipients with lower sDQB2 levels (p = 0.007; OR: 36.5). Expression of HLA-DQB2 variant 1, measured by reverse transcription-polymerase chain reaction (RT-PCR) in 92 PIB from young or old donors, did not significantly differ between transplants with high or low 4-year GF. HLA-DQB2 rs7453920 single nucleotide polymorphism (SNP) frequencies did not significantly differ between recipients with low or high 4-year GF. We conclude that HLA-DQB2 variant 1 expression in PIB and recipient rs7453920 SNP polymorphism are not associated with graft outcome. On the other hand, the association, in transplants of kidneys from young donors, between high posttransplant serum sDQB2 levels and decline in GF is a very interesting finding that deserves a validation study in a larger cohort.
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Affiliation(s)
- Karina L Mine
- Instituto de Imunogenética, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - Renato de Marco
- Instituto de Imunogenética, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - Tamiris R F Raimundo
- Instituto de Imunogenética, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - Julia V Ernesto
- Instituto de Imunogenética, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - José O Medina-Pestana
- Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Hélio Tedesco-Silva
- Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria Gerbase-DeLima
- Instituto de Imunogenética, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
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Tsatsakis A, Vakonaki E, Tzatzarakis M, Flamourakis M, Nikolouzakis TK, Poulas K, Papazoglou G, Hatzidaki E, Papanikolaou NC, Drakoulis N, Iliaki E, Goulielmos GN, Kallionakis M, Lazopoulos G, Kteniadakis S, Alegkakis A, Farsalinos K, Spandidos DA. Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals. Int J Mol Med 2021; 48:200. [PMID: 34515322 PMCID: PMC8448546 DOI: 10.3892/ijmm.2021.5033] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
Soon after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in December, 2019, numerous research teams, assisted by vast capital investments, achieved vaccine development in a fraction of time. However, almost 8 months following the initiation of the European vaccination programme, the need for prospective monitoring of the vaccine-induced immune response, its determinants and related side-effects remains a priority. The present study aimed to quantify the immune response following full vaccination with the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine by measuring the levels of immunoglobulin G (IgG) titers in healthcare professionals. Moreover, common side-effects and factors associated with IgG titers were identified. For this purpose, blood samples from 517 individuals were obtained and analysed. Blood sampling was performed at a mean period of 69.0±23.5 days following the second dose of the vaccine. SARS-CoV-2 IgG titers had an overall mean value of 4.23±2.76. Females had higher titers than males (4.44±2.70 and 3.89 ±2.84, respectively; P=0.007), while non-smokers had higher titers than smokers (4.48±2.79 and 3.80±2.64, respectively; P=0.003). An older age was also associated with lower antibody titers (P<0.001). Moreover, the six most prevalent adverse effects were pain at the injection site (72.1%), generalized fatigue (40.5%), malaise (36.3%), myalgia (31,0%), headache (25.8%) and dizziness/weakness (21.6%). The present study demonstrated that the immune response after receiving the BNT162b2 COVID-19 mRNA vaccine is dependent on various modifiable and non-modifiable factors. Overall, the findings of the present study highlight two key aspects of the vaccination programs: First, the need for prospective immunosurveillance studies in order to estimate the duration of immunity, and second, the need to identify those individuals who are at a greater risk of developing low IgG titers in order to evaluate the need for a third dose of the vaccine.
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Affiliation(s)
- Aristidis Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Elena Vakonaki
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Manolis Tzatzarakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Matthaios Flamourakis
- Department of General Surgery, Venizeleion General Hospital, 71409 Heraklion, Greece
| | | | - Konstantinos Poulas
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500 Rio‑Patras, Greece
| | - Georgios Papazoglou
- Department of Emergency Medicine, Venizeleion General Hospital, 71409 Heraklion, Greece
| | - Eleftheria Hatzidaki
- Department of Neonatology and Neonatal Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
| | | | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Evangelia Iliaki
- Department of Internal Medicine, Venizeleion General Hospital, 71409 Heraklion, Greece
| | - Georgios N Goulielmos
- Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Manolis Kallionakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Georgios Lazopoulos
- Department of Cardiothoracic Surgery, University Hospital of Heraklion, 71500 Heraklion, Greece
| | | | - Athanasios Alegkakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Konstantinos Farsalinos
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500 Rio‑Patras, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
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