Simultaneous blockade of the CD40 and CD28 costimulatory pathways is an effective treatment strategy to promote allograft acceptance but does not lead indefinite survival. The immune mechanisms responsible for costimulation-independent rejection are defined. Here we have studied responses murine C57BL/6 recipients, which show be relatively resistant inhibition by combined CD40/CD28 blockade. We demonstrate that asialo GM1+ CD8+ cells play a critical role in this costimulation...

Organ transplant recipients currently require lifetime immunosuppressive therapy, with its accompanying side effects. Biological agents that block T-cell costimulatory pathways are important components of strategies being developed to induce transplantation tolerance. The aim this study was test the effect a novel chimeric anti-human CD40 monoclonal antibody (Chi 220), either alone or in combination CTLA4-Ig, on survival renal allografts nonhuman primate model.Captive-bred adolescent male...

Abstract The aim of this study was to assess the long‐term safety and clinical outcomes associated with utilization highly steatotic donor livers utilizing a specific donor/recipient matching algorithm. This prospective, observational, single‐center, 10‐yr follow‐up study. Highly were utilized according algorithm that guided surgeon use organs judiciously in low‐risk recipients. initially compared fat assessment based on frozen‐section Ehrlich's hematoxylin eosin (H&E) reperfusion biopsy...

Outcomes from intensive glycemic control postrenal transplant have not been studied. Our objective was to observe the optimal management of hyperglycemia in patients with diabetes or impaired glucose tolerance receiving renal transplantation. We conducted a randomized controlled trial undergoing transplantation either iv insulin therapy (intensive) standard sc while were admitted hospital. The study consisted 3-day group treated [blood (BG) = 70–110 mg/dl] (BG 70–180 mg/dl). primary endpoint...

Neoral was replaced with a generic cyclosporine formulation on our hospital formulary. We compared outcomes for de novo kidney transplant recipients who either received Gengraf (n=88) or (n=100) in single-center, retrospective review. As to patients Neoral, were significantly more likely have an acute rejection episode (39% vs. 25%, P=0.04), second (13% 4%; P=0.03), antibody preparation treat (19% 8%; P=0.02). Patients treated had higher degree of intrapatient variability trough...

Abstract: Background. Despite advances in antiviral therapies, cytomegalovirus (CMV) remains the leading opportunistic infection transplant population. Valganciclovir (VGC), l ‐valyl ester prodrug of ganciclovir (GCV), provides an excellent oral alternative to GCV for prevention CMV recipients. We investigated use VGC high‐risk renal and pancreas Methods. Patients at high risk development disease were defined as either those who had donor positive, recipient‐negative serostatus (D+/R−), or...

Background. This study examined the potential therapeutic effects of a combination therapy consisting 5-aminoimidazole-4-carboxamide-1-β-d-ribonucleoside (AICAR) and N-acetyl cysteine (NAC) to attenuate ischemia-reperfusion (I/R) injury in canine model autologous renal transplantation. Methods. Male mongrel dogs (15–20 kg) underwent left nephrectomy followed by flushing static preservation kidney University Wisconsin (UW) solution for 48 hr. The treatment group received AICAR (50 mg/kg) plus...

Background. It has been hypothesized that regimens to induce transplantation tolerance and long-term hematopoietic chimerism require recipient conditioning with whole body irradiation or a cytoablative regimen create space within the marrow microenvironment permit pluripotent stem cell engraftment.Thepurpose of this study was determine if an intact bone in form graft would stable engraftment, shape repertoire developing T cells, donor-specific unresponsiveness absence regimen. Methods....

Heparin-induced thrombocytopenia (HIT) type II is an immunologically mediated reduction in platelets that increases the risk of arterial or venous thrombosis. It has been reported up to 5% patients receiving unfractionated heparin. Unlike other thrombocytopenic coagulopathies, HIT associated with a high thromboembolic events if not treated appropriate anticoagulant alternative. Diagnosis dependent on assessment platelet reduction, identification previous heparin exposure, detection...

The laparoscopic donor nephrectomy has revolutionized the living donation process for kidney transplantation. Because this surgery is elective and altruistic smoking been associated with greater technical difficulty increased risk postoperative complications other types of surgeries, potential must be addressed regard to surgical complications. We reviewed 221 donors known status. Forty-two (19%) were smokers, 39 (18%) former 140 (63%) nonsmokers. Important demographics similar between...

Hammond EB, Taber DJ, Weimert NA, Egidi MF, Bratton CF, Lin A, McGillicuddy JW, Chavin KD, Baliga PK. Efficacy of induction therapy on acute rejection and graft outcomes in African American kidney transplantation. Clin Transplant 2010: 24: 40–47. © 2009 John Wiley & Sons A/S. Abstract: Background: Americans (AA) have higher rates poorer compared to non‐AAs. Induction is yet unproven this high risk population. Methods: This retrospective study the efficacy [IL‐2 receptor antibodies...

We previously reported that compared to standard glycemic control [blood glucose (BG): 70-180 mg/dL], patients randomized intensive (BG: 70-110 mg/dL) were at increased risk of graft rejection in renal transplantation. However, the underlying mechanisms associate effect with transplant outcomes have not been identified.A secondary data analysis 93 participants (n=44 intensive, n=49 control) was conducted using from a previous controlled clinical trial. examined inflammatory biomarkers,...

The influence of ethnicity on outcome simultaneous pancreas-kidney transplantation (SPK) is poorly defined. After excluding technical failures, we retrospectively reviewed 96 consecutive SPKs (63 Caucasians [C], 33 African-Americans [AA]). All patients received antibody induction, tacrolimus, mycophenolate mofetil, and steroids. One-, 3-, 5-year actuarial patient survival was similar between C (98%, 95%, 87%) AA (90%, 90%, 81%), p=NS. kidney graft 86%, 81%) (85%, 85%, 78%), p =NS. pancreas...

Sirolimus (SRL) rescue in kidney-pancreas transplantation has not been well described. We reviewed 112 KPTxs performed at our institution between December 3, 1995 and June 27, 2002. All patients received antibody induction, tacrolimus (TAC), mycophenolate mofetil (MMF), steroids. In 35 patients, SRL was substituted for MMF the following reasons: acute rejection (AR) of kidney or pancreas despite adequate TAC levels, intolerance, increasing creatinine TAC-induced hyperglycemia. Three-year...

BACKGROUND: Maintaining access to kidney transplantation during a pandemic is challenge, particularly for centers that serve large rural and minority patient population with an additional burden of travel. The aim this article was describe our experience the rollout use virtual pretransplantation evaluation platform facilitate ongoing transplant waitlisting early peak COVID-19 pandemic. STUDY DESIGN: This retrospective analysis process improvement project implemented continue potential...

Abstract: Pelvic kidneys are uncommon anomalies rarely utilized in kidney transplantation. We describe a successful case of living‐donor transplantation using pelvic 17‐month‐old infant with congenital renal dysplasia. The recipient had exhausted all options for replacement therapy, and urgent was considered life saving treatment.