July 12: Recent Transplant News

Monday, July 15, 2013

Gene test may ID kidney rejection
MedPage Today (login required)
A urine-derived three-gene signature showed potential for noninvasive discrimination of kidney grafts that are being rejected from those that are not, a study of almost 500 kidney recipients showed. Read more. 

Donor-specific antibodies: Can they predict C4d deposition in pediatric heart recipients?
Pediatric Transplantation (login required)
There is limited evidence regarding the utility of circulating DSA in surveillance for AMR of pediatric heart recipients. It has been hypothesized that quantitation of DSA improves their power for predicting a C4d+, an integral component in the current diagnostic criteria of AMR. Read more. 

Early pancreas allograft thrombosis
Clinical Transplantation (login required)
To determine factors associated with early pancreatic allograft thrombosis (EPAT). Thrombosis is the leading non-immunological cause of early pancreatic allograft failure. Multiple risk factors have been postulated. Researchers hypothesized that recipient perioperative hypotension was a major risk factor and evaluated the correlation of this and other parameters with EPAT. Read more.

Dialysis patient coronary artery disease burden rising, mortality declining
Renal & Urology News 
Coronary artery disease (CAD) is on the rise among U.S. dialysis patients, but mortality rates are declining, new findings show. Dr. Austin G. Stack of the University of Limerick in Limerick, Ireland, and colleagues analyzed data from 823,753 incident dialysis patients and found that the annual prevalence of CAD at dialysis initiation increased significantly from 23.7 percent in 1995 to 27.6 percent in 2004, according to a report in the American Journal of Nephrology. Read more.

Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent
In renal allograft recipients presenting with graft dysfunction, it is critical to determine the patency of the transplant vasculature to guide clinical management. Conventional modalities such as Doppler ultrasound, contrast-enhanced computed tomography, magnetic resonance angiography (MRA), and noncontrast MRA are each of limited use because of technical factors and toxicity of standard contrast agents. The purpose of this study was to retrospectively review institutional experience with renal transplant MRA using ferumoxytol (a nonnephrotoxic medication) as a contrast agent and evaluate its use in the assessment of allograft vascular patency in patients with graft dysfunction, either delayed or slow graft function within hours to days after kidney transplantation or acute kidney injury weeks to months after kidney transplantation. Read more. 

Obesity and its impact on transplantation and alloimmunity
Transplantation (login required)
Obesity has become an increasing problem in healthcare worldwide with far-reaching consequences. More obese patients with irreversible end-stage organ failure undergo organ transplantation, and organs from obese donors are more frequently used. A growing body of evidence suggests more frequent postoperative complications and inferior patient and graft survival linked to obesity. More recently, adipose tissue has been linked to chronic inflammatory processes potentially impacting alloimmune responses and graft quality. Read more.