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Control of BKPyV-DNAemia by a Tailored Viro-Immunologic Approach Does Not Lead to BKPyV-Nephropathy Progression and Development of Donor-Specific Antibodies in Pediatric Kidney Transplantation.
Microorganisms
December 2024
Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy.
Polyomavirus BK (BKPyV)-associated nephropathy (BKPyV-nephropathy) remains a significant cause of premature kidney allograft failure. In the absence of effective antiviral treatments, current therapeutic approaches rely on immunosuppression (IS) reduction, possibly at the risk of inducing alloimmunity. Therefore, we sought to explore the long-term effects of a tailored viro-immunologic surveillance and treatment program for BKPyV on the development of alloimmunity and kidney graft outcome.
View Article and Find Full Text PDFImpact of repeat human leukocyte antigen mismatches on kidney graft survival: A contemporary Collaborative Transplant Study analysis.
Am J Transplant
December 2024
Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
Repeat human leukocyte antigen (HLA) mismatches (RMM) have been historically associated with an increased risk of graft loss after repeat kidney transplantation, in particular HLA-DR RMM in sensitized recipients. As routine use of sensitive assays can at present prevent the transplantation of RMM in hosts with donor-specific antibodies, we hypothesized that RMM would no longer be associated with graft loss. We performed a registry analysis of the Collaborative Transplant Study database including 6711 patients who received a second kidney transplant (KT) between 2010 and 2021, with at least 1 HLA-A, HLA-B, or HLA-DR mismatch.
View Article and Find Full Text PDFNK Cells: Not Just Followers But Also Initiators of Chronic Vascular Rejection.
Transpl Int
October 2024
CIRI, INSERM U1111, Université Claude Bernard Lyon I, CNRS UMR5308, Ecole Normale Supérieure de Lyon, University of Lyon, Lyon, France.
Chronic graft rejection represents a significant threat to long-term graft survival. Early diagnosis, understanding of the immunological mechanisms and appropriate therapeutic management are essential to improve graft survival and quality of life for transplant patients. Knowing which immune cells are responsible for chronic vascular rejection would allow us to provide effective and appropriate treatment for these patients.
View Article and Find Full Text PDFImlifidase in Highly Sensitized Kidney Transplant Recipients With a Positive Crossmatch Against a Deceased Donor.
Kidney Int Rep
October 2024
Bordeaux University Hospital, Department of Nephrology, Transplantation, Dialysis and Apheresis, UMR-CNRS5164 Immunoconcept, University of Bordeaux, Bordeaux, France.
Article Synopsis
- Imlifidase is used for desensitizing highly sensitized adult kidney transplant candidates with a positive crossmatch against deceased donors, and results from the first 9 patients are reported after at least 3 months of follow-up.
- All 9 patients had been on dialysis for an average of over 10 years, and after treatment with imlifidase, all patients showed negative results for donor-specific antibodies (DSAs) that could have restricted their transplant eligibility.
- The study concludes that imlifidase appears to be effective and safe for desensitization in these patients, with no graft losses or deaths reported, although some patients did experience infections and DSA rebounds.
Terminally differentiated effector memory T cells in kidney transplant recipients: New crossroads.
Am J Transplant
February 2025
Renal Division, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.
Immunosenescence, the age-related dysregulation of innate and adaptive immunity, impairs immune response and increases inflammation, leading to higher infection and cardiovascular risks, particularly outside the field of transplantation. In kidney transplant recipients (KTRs), conditions like cytomegalovirus infection, old age, uremia, smoking, and diabetes, linked to poor outcomes, are associated with enhanced immunosenescence. Recent studies highlight the pathogenic role of cytotoxic T cells, particularly terminally differentiated effector memory T cells that reexpress CD45RA (T), in graft dysfunction.
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