Renal transplantation using kidneys from hepatitis C-infected donors: A review of 30-years' experience.

Kidney transplantation is the optimal therapy for end-stage kidney disease but limited by the available number of organs. Using HCV+ donors, both in HCV+ and HCV- recipients, is a rational response to the organ shortage. We review the historic experience using HCV+ donors in HCV+ recipients and assess long-term results.

The IgA Isotype of Anti-β2 Glycoprotein I Antibodies Recognizes Epitopes in Domains 3, 4, and 5 That Are Located in a Lateral Zone of the Molecule (L-Shaped).

Antiphospholipid syndrome (APS) is characterized by thrombosis and/or pregnancy morbidity with presence of anti-phospholipid antibodies (aPL). The APS classification criteria only consider the aPL of IgG/IgM isotype, however testing of aPL of IgA isotype is recommended when APS is suspected and consensus aPL are negative. IgA anti-βeta-2 glycoprotein-I (B2GP1) has been clearly related with occurrence of thrombotic events.

Hepatitis C and kidney transplant: The eradication time of the virus has arrived.

Hepatitis C virus (HCV) infection is a factor that reduces the survival of the patient and the graft in renal transplant (RT). The availability of directly acting antivirals agents (DAAs), very effective and with an excellent safety profile, it allows eradicate HCV from patients with kidney disease, and this is a revolutionary radical change in the natural evolution of this infection, until now without effective and safe treatment for the contraindication use of interferon in kidney transplant patients. The efficiency of some DAAs for all genotypes, even in patients with renal insufficiency constitutes a huge contribution to eradicate HCV in the RT population independently the genotype, severity of kidney failure, progression of liver disease and previous anti HCV therapy.

Antiphospholipid Syndrome and Renal Allograft Thrombosis.

Renal allograft thrombosis is the most frequent and devastating complication in the early postrenal transplantation period. Several risk factors to develop graft thrombosis depending on donors and recipients are well known. Antiphospholipid syndrome (APS) is well recognized as an important cause of kidney injury, with specific clinical and histological features that may lead to renal injury caused by thrombosis at any location within the renal vasculature.

The Presence of Pretransplant Antiphospholipid Antibodies IgA Anti-β-2-Glycoprotein I as a Predictor of Graft Thrombosis After Renal Transplantation.

Background: Vessel thrombosis is a severe complication after renal transplantation. Antibodies anti-β-2 glycoprotein-I of IgA isotype (IgA-aB2GP1) have been linked to thrombotic events and mortality in hemodialysis patients.

Methods: All kidney transplanted patients from 2000 to 2011 (n = 1375) in our hospital were followed up for 2 years, evaluating 3 time periods.

Early renal graft function deterioration in recipients with preformed anti-MICA antibodies: partial contribution of complement-dependent cytotoxicity.

Background: We previously reported that preformed anti-MHC class I-related chain A (MICA) antibodies increase the risk for renal graft rejection and enhance the deleterious effect of PRA(+) status early after transplantation.

Methods: We studied 727 kidney recipients. Days to reach optimal serum creatinine level, estimated glomerular filtration rate (eGFR) at Month 3 and chronic kidney disease (CKD) stages were recorded.

High proportion of pretransplantation activated regulatory T cells (CD4+CD25highCD62L+CD45RO+) predicts acute rejection in kidney transplantation: results of a multicenter study.

Background: Prognostic biomarkers of acute rejection (AR) in solid organ transplantation have been addressed in multiple small retrospective studies, and there is a critical need for multicenter studies. Because of their tolerogenic properties, regulatory T cells (Tregs) play an important role in transplant outcome.

Methods: In the present multicenter study, we have retrospectively examined different Treg subpopulations in an independent cohort of kidney transplant patients within first year after kidney transplantation.

Pretransplant identification of acute rejection risk following kidney transplantation.

Lack of an accepted definition for 'high immunological risk' hampers individualization of immunosuppressive therapy after kidney transplantation. For recipient-related risk factors for acute rejection, the most compelling evidence points to younger age and African American ethnicity. Recipient gender, body mass, previous transplantation, and concomitant infection or disease do not appear to be influential.

Depth of origin of magma in eruptions.

Many volcanic hazard factors--such as the likelihood and duration of an eruption, the eruption style, and the probability of its triggering large landslides or caldera collapses--relate to the depth of the magma source. Yet, the magma source depths are commonly poorly known, even in frequently erupting volcanoes such as Hekla in Iceland and Etna in Italy. Here we show how the length-thickness ratios of feeder dykes can be used to estimate the depth to the source magma chamber.

Risk factors for graft loss and mortality after renal transplantation according to recipient age: a prospective multicentre study.

Background: To describe the causes of graft loss, patient death and survival figures in kidney transplant patients in Spain based on the recipient's age.

Methods: The results at 5 years of post-transplant cardiovascular disease (CVD) patients, taken from a database on CVD, were prospectively analysed, i.e.

Epstein-Barr virus DNAemia is an early surrogate marker of the net state of immunosuppresion in solid organ transplant recipients.

Background: Epstein-Barr virus (EBV) DNAemia (EBVd) may be a surrogate marker of the net state of immunosuppression after solid organ transplantation (SOT).

Methods: A sample of 81 SOT recipients (53 renal, 21 liver, and 7 cardiac) from our institution (2003-2004) surviving more than 180 days was analyzed. EBVd was monitored in whole blood within the first 6 months using a real-time polymerase chain reaction assay.

Comparison of the long-term outcomes of kidney transplantation: USA versus Spain.

Background: The long-term outcomes of kidney transplantation are suboptimal because many patients lose their allografts or experience premature death. Cross-country comparisons of long-term outcomes of kidney transplantation may provide insight into factors contributing to premature graft failure and death. We evaluated the rates of late graft failure and death among US and Spanish kidney recipients.

Impact of hepatitis C virus infection on the risk of infectious complications after kidney transplantation: data from the RESITRA/REIPI cohort.

Background: There is scarce information regarding the role of hepatitis C virus (HCV) infection in the development of infectious complications after kidney transplantation (KT).

Methods: We prospectively analyzed all KT recipients included in the Spanish Network for the Research of Infection in Transplantation cohort from September 2003 to February 2005 with a posttransplant follow-up of 3 years and compared the incidence of both overall and specific infections according to the pretransplant anti-HCV antibody status.

Results: Of 1302 analyzed recipients, 105 (8.

Gastrointestinal quality of life improvement of renal transplant recipients converted from mycophenolate mofetil to enteric-coated mycophenolate sodium drugs or agents: mycophenolate mofetil and enteric-coated mycophenolate sodium.

Background: In renal transplant (RT) recipients, treatment with enteric-coated mycophenolate sodium (EC-MPS) improves gastrointestinal (GI) tolerability compared with mycophenolate mofetil (MMF). The impact of conversion from MMF to EC-MPS on patient's health-related quality of life (HRQoL) using GI-specific instruments has been scarcely evaluated in randomized trials.

Methods: The present randomized, multicenter, open-labeled, 12-week study included RT recipients experiencing GI adverse events due to MMF treatment.

Acute graft pyelonephritis in renal transplant recipients: incidence, risk factors and long-term outcome.

Background: The influence of acute graft pyelonephritis (AGPN) on graft outcome in renal transplant recipients still remains controversial.

Methods: We retrospectively analysed 189 patients (113 males; mean age: 49.7 ± 13.

Renal transplantation in patients with hepatitis C virus antibody. A long national experience.

Background. Renal transplantation is the best therapy for patients with hepatitis C virus (HCV) infection with end-stage renal disease. Patient and graft survival are lower in the long term compared with HCV-negative patients.

Results of renal re-transplant in Spain (1990-2002).

Background. Renal re-transplants are increasing in number, due to many first renal transplant patients coming back to dialysis treatment. There are controversial opinions about the evolution of these re-transplanted patients.

Long-term graft function changes in kidney transplant recipients.

Background. Monitoring changes in glomerular filtration rate (GFR) is the recommended method for assessing the progression of kidney disease. The aim of this study was to assess the decline of graft function defined by the annualized change in GFR and the factors which affect it.

[Chronic nephropathy in non-kidney transplantation: [prevention, early diagnosis and management].

Transplant from solid nonrenal organ has experienced an important increase in the last decades. It is due to the increasing improvement of the results obtained with the above mentioned transplants. Parallel, many nonrenal transplanted patients have developed a chronic renal failure that has determined, in some cases, the need of beginning the substitution of renal function by means of dialysis and/or transplant.

A novel risk score for mortality in renal transplant recipients beyond the first posttransplant year.

Background: All-cause mortality is high after kidney transplantation (KT), but no prognostic index has focused on predicting mortality in KT using baseline and emergent comorbidity after KT.

Methods: A total of 4928 KT recipients were used to derive a risk score predicting mortality. Patients were randomly assigned to two groups: a modeling population (n=2452), used to create a new index, and a testing population (n=2476), used to test this index.

Hepatitis C virus, an important risk factor for tuberculosis in immunocompromised: experience with kidney transplantation.

Little is known about the role of hepatitis C virus (HCV) infection in the development of tuberculosis (TB) in patients with immunosuppression. We performed a retrospective case-control study (1:4) to investigate by univariate and multivariate logistic regression analysis the importance of HCV infection in the development of TB in a cohort of kidney transplant recipients (KTR). TB was diagnosed in 16 out of 2012 (0.

Impact of tacrolimus and mycophenolate mofetil combination on cardiovascular risk profile after kidney transplantation.

Cardiovascular risk factors after kidney transplantation are enhanced as a result of the chronic use of immunosuppressants. Tacrolimus with mycophenolate mofetil has become the most commonly used combination after kidney transplantation. Cardiovascular risk factors that are related to the use of this combined therapy have been analyzed in various clinical trials in comparison with other immunosuppressive therapies.

Ischemic heart disease after renal transplantation in patients on cyclosporine in Spain.

Ischemic heart disease (IHD), more common among transplant recipients than in the general population, accounts for approximately 50% of cardiovascular deaths. Despite its importance, only a few publications have addressed the prevalence of and risk factors for this complication. This was a retrospective cohort study in 2382 cadaver renal transplant recipients who were treated with cyclosporine as initial immunosuppression.

Valganciclovir preemptive therapy for the prevention of cytomegalovirus disease in high-risk seropositive solid-organ transplant recipients.

Background: The role of valganciclovir in the prevention of cytomegalovirus (CMV) disease in high-risk seropositive transplant patients is not known.

Methods: We prospectively followed 301 seropositive solid organ transplant recipients to assess the efficacy and safety of valganciclovir (VGCV) in the prevention of CMV disease in high-risk patients. Asymptomatic patients with an antigenemia test >or=25 positive cells/2x10(5) polymorphonuclear cells received valganciclovir 900 mg twice a day as preemptive therapy until resolution of antigenemia (minimum 14 days).