Abstract:
PURPOSE OF REVIEW:Antibody-mediated rejection (ABMR) is the leading cause of allograft failure in kidney transplant recipients. This article provides a summary of the clinical research relating to donor-specific antibodies (DSA) and ABMR in kidney transplant recipients at the University of Wisconsin-Madison Transplant Center. RECENT FINDINGS:Over 40% of the kidney transplant candidates on the UNOS waitlist are sensitized, and both preformed and de novo DSA are associated with increased risk of rejection and graft loss. We have developed graded induction-desensitization treatment and monitoring protocols based on the degree of immunologic risk. We have also implemented standard treatment and surveillance strategies for patients with ABMR. Additional important observations from our studies include high rates of ABMR in patients with positive C4d staining in postreperfusion biopsies and rise in DSA at 1 week after transplant, and increased risk of kidney allograft failure in patients with de novo DSA and ABMR, as well as in patients with HLA-DSA undetectable ABMR. We also found worse outcomes with de novo DSA following simultaneous pancreas--kidney and liver--kidney transplantation. Notably, favorable long-term graft outcomes were observed in patients with DSA who do not present the classic histopathological findings of ABMR. SUMMARY:In order to improve long-term outcomes for kidney transplant recipients, further research focusing on the pathogenic mechanisms elicited by HLA and non-HLA DSA, and novel therapies targeting these pathways is needed.
journal_name
Curr Opin Organ Transplantjournal_title
Current opinion in organ transplantationauthors
Garg N,Parajuli S,Mandelbrot DA,Djamali Adoi
10.1097/MOT.0000000000000814subject
Has Abstractpub_date
2020-12-01 00:00:00pages
543-548issue
6eissn
1087-2418issn
1531-7013journal_volume
25pub_type
杂志文章abstract:PURPOSE OF REVIEW:In the current graft shortage, it is paramount to improve the quality of transplanted organs. Organ preservation represents an underused therapeutic window with great potential to reduce ischaemia-reperfusion injury (IRI) and improve graft quality. Herein, we review strategies using this window as wel...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283446b1d
更新日期:2011-04-01 00:00:00
abstract:PURPOSE OF REVIEW:B cells are known to play a central role in humoral immunity and to boost cellular immunity, however, in a variety of experimental models, B-cell subsets ameliorate inflammation and autoimmune disease, indicating that they can also play a regulatory role. Here, we highlight the advances in regulatory ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000204
更新日期:2015-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The immunomodulatory enzyme indoleamine 2,3-dioxygenase (IDO) is activated by interferon-gamma and via tryptophan depletion and the production of proapoptotic downstream metabolites IDO suppresses adaptive T-cell-mediated immunity in inflammation, host immune defence and maternal tolerance. In additio...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3282f3df26
更新日期:2008-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Maintenance of T-cell function and modulation of tolerance are critical issues in organ transplantation. The thymus is the primary organ for T-cell generation, and a preserved thymic function is essential for a self-tolerant diverse T-cell repertoire. Transplant procedures and related immunosuppressiv...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283615df9
更新日期:2013-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Pulmonary hypertension patients provide challenging issues to anesthesiology. The condition is more so when it is associated with liver transplant surgery. This situation is especially true when associated with portopulmonary hypertension (POPH), a subdivision of pulmonary hypertension. Understanding ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328346e138
更新日期:2011-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Blood loss in orthotopic liver transplantation has declined during the past decade. Recent papers addressed this issue and emphasized its importance, because there is a significant correlation between intraoperative blood transfusion requirements and postoperative morbidity. This review addresses chan...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章
doi:10.1097/MOT.0b013e32814e6bb0
更新日期:2007-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Xenotransplantation may become clinically feasible once the mechanisms of graft loss and rejection are better understood. Inflammatory reactions to vasculature of grafted pig organs and pancreatic islets have been linked to procoagulant activation and consumption with resulting thrombosis that preclud...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283373ccc
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This review emphasizes new information concerning the role of anaphylatoxins in the regulation of the immune response to allografts. Its timeliness relates the growing concept of the innate immune response as a regulator of the adaptive immune system and to how this concept lends itself to therapeutic...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e32831ec551
更新日期:2009-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indic...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000451
更新日期:2017-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Living donation has a tremendous impact in bridging the gap between the shortage of organs and the growing list of transplant candidates but remains underutilized as a percentage of total transplants performed. This review focuses on obesity and social determinants of health as potential barriers to t...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000779
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Recent studies on the directed differentiation of human pluripotent stem cells report tissue self-organization in vitro such that multiple component cell types arise in concert and arrange with respect to each, thereby recapitulating the morphogenetic events typical for that organ. Such self-organizat...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000174
更新日期:2015-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Several expanded criteria for liver transplantation for hepatocellular carcinoma (HCC) have been suggested out of concern that the Milan criteria may be too strict, and thereby exclude patients who could benefit from this surgical procedure. However, most expanded criteria were designed for deceased d...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000294
更新日期:2016-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Although the scarcity of clinical trials with de-novo immunosuppression has been typical over the last 2 years, several attempts have been made in drug conversion, dosing optimization, and bioequivalence. On the basis of recent clinical and animal studies, future directions of management and treatment...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000093
更新日期:2014-08-01 00:00:00
abstract:PURPOSE OF REVIEW:A significant shift in our understanding of the molecular and cellular basis for inflammatory bowel disease (IBD) mirrors research that has been ongoing in intestinal transplantation. The blurring of lines between these two disease states creates an avenue into potential therapeutic interventions whic...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000615
更新日期:2019-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Vascular injury is a complex process that is central to the rejection of solid-organ xenografts in the preclinical pig-to-primate model of xenotransplantation. This review summarizes recent work that provides insights into the mechanisms of vascular injury in GalT KO pig xenografts. RECENT FINDINGS:S...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/mot.0b013e3283279591
更新日期:2009-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Because the gap between liver organ supply and demand continues to increase, adult living-donor liver transplantation continues to represent a significant pool of organs. RECENT FINDINGS:With this in mind, we discuss recent issues in adult living-donor liver transplantation, including issues with don...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328300a352
更新日期:2008-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Re-transplantation of the lung has come of age. Here, we wish to review the recent literature on the topic and discuss clinical implications. RECENT FINDINGS:Many large volume transplant centres routinely perform lung re-transplantation with satisfactory outcomes. The main indication is bronchiolitis...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328357d8ba
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Donor-derived disease with Mycobacterium tuberculosis (MTB) is likely to become more common as donor pools expand due to increasing transplant volume coupled with patterns of migration and global mobility. Our article reviews the current literature and provides a rational approach for clinicians manag...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000787
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Lungs are extremely susceptible to injury, and despite advances in surgical management and immunosuppression, outcomes for lung transplantation are the worst of any solid organ transplant. The success of lung transplantation is limited by high rates of primary graft dysfunction because of ischemia-rep...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000304
更新日期:2016-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this chapter is to review the literature published in the past 10 years with focus to the best literatures published since 2015 regarding chronic hepatitis E virus (HEV) infection in patients who received solid organ transplantation. RECENT FINDINGS:Diagnosis of this disease relies pri...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000432
更新日期:2017-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Xenotransplantation of tissues from swine into humans poses the threat of bidirectional transfer of porcine or human microorganisms to the recipient or to the xenograft, respectively. This review focuses on recipient-derived infection. Recent data are reviewed that assess the susceptibility of porcine...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328336b8f9
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The number of patients listed for lung transplantation largely exceeds the number of available transplantable organs because of both a shortage of organ donors and a low utilization rate of lungs from those donors. Two major innovations in recent years include the use of lungs from donations after car...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328365191b
更新日期:2013-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To outline recent studies describing the mechanisms of antibody-mediated rejection (AMR) and new clinical protocols aimed at prevention and/or treatment of this difficult clinical entity. RECENT FINDINGS:The natural history of acute AMR after positive cross-match kidney transplantation involves an ac...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283342712
更新日期:2010-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The first generation of implantable pulsatile ventricular assist devices (VADs) has proven to be successful as bridge to transplantation. Adverse events such as mechanical failure and infections, however, limit their use for long-term support (>1 year) or as alternative for heart transplantation. Newe...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283303750
更新日期:2009-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Accurate measurement of human leukocyte antigen antibodies is critical for making clinical decisions treating patients awaiting transplantation or monitoring them post transplantation. Single antigen bead assay results are given as Mean Fluorescence Intensity, falling short of providing the required q...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章
doi:10.1097/MOT.0000000000000822
更新日期:2020-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Adoptive cell therapy using CD4FOXP3 regulatory T cells (Treg) has emerged as a promising therapeutic strategy to treat autoimmunity and alloimmunity. Preclinical studies suggest that the efficacy of Treg therapy can be improved by modifying the antigen specificity, stability and function of therapeut...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000566
更新日期:2018-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights current outcomes in intestinal transplantation and summarizes advances that have recently occurred in five interrelated areas: progress in intestinal rehabilitation, immunologic and technical modifications, awareness of opportunities for improved allograft monitoring, and better...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328330680d
更新日期:2009-10-01 00:00:00
abstract:PURPOSE OF REVIEW:In the past few years, there has been an increasing interest in nonhuman histocompatibility antigens as targets of injury in organ-transplant recipients. This increased interest has been spurred by the fact that human-histocompatibility-antigen-identical kidney transplants also undergo immunological r...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e328307ebd7
更新日期:2008-08-01 00:00:00
abstract:PURPOSE OF REVIEW:High infectious risk donors (HRDs) fall into a behavioral category thought to increase risk of infectious transmission through transplantation; despite controversy surrounding their use, they comprise almost 9% of donors in which at least one organ is recovered. This review seeks to describe national ...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0b013e3283449dd3
更新日期:2011-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Type 1 and type 2 diabetes mellitus represent a widespread metabolic disorder, related to autoimmune β-cell destruction and insulin resistance, leading to β-cell dysfunction, respectively, that are associated with severe chronic complications with irreversible multiorgan morphological and functional d...
journal_title:Current opinion in organ transplantation
pub_type: 杂志文章,评审
doi:10.1097/MOT.0000000000000055
更新日期:2014-04-01 00:00:00