A5020532221- Renal Transplantation Outcomes and Treatments
- Organ Transplantation Techniques and Outcomes
- Transplantation: Methods and Outcomes
- T-cell and B-cell Immunology
- Renal Diseases and Glomerulopathies
- Redox biology and oxidative stress
- Blood groups and transfusion
- Organ Donation and Transplantation
- Selenium in Biological Systems
- Hemoglobin structure and function
- Complement system in diseases
- Cytomegalovirus and herpesvirus research
- Organ and Tissue Transplantation Research
- Immune Cell Function and Interaction
- Monoclonal and Polyclonal Antibodies Research
- Pregnancy and Medication Impact
- Systemic Lupus Erythematosus Research
- Immunotherapy and Immune Responses
- Pharmacological Effects and Toxicity Studies
- Renal and Vascular Pathologies
- Advanced Biosensing Techniques and Applications
- Neurological Complications and Syndromes
- Liver Disease and Transplantation
- Hematopoietic Stem Cell Transplantation
- Blood transfusion and management
Guy's and St Thomas' NHS Foundation Trust
2008-2024
NHS Blood and Transplant
2024
Society of Analytical Psychology
2018-2023
Guy's Hospital
2013-2023
Virginia Tech
2023
St Thomas' Hospital
2009-2022
May Institute
2017
Centre for Addiction and Mental Health
2017
King's College London
2009-2014
Metabolism and Renal Physiology
2014
The development of donor-specific HLA antibodies (DSA) is associated with worse renal allograft survival in adult patients. This study assessed the natural history de novo DSA, and its impact on function pediatric transplant recipients (RTR). were measured prospectively using single-antigen-bead assays at 1, 3, 6 12 months posttransplant followed by 12-monthly intervals during episodes dysfunction. Of 215 patients antibody monitoring, 75 (35%) developed DSA median 0.25 years a high...
3% of kidney transplant recipients return to dialysis annually upon allograft failure. Development antibodies (Ab) against human leukocyte antigens (HLA) is a validated prognostic biomarker We tested whether screening for HLA Ab, combined with an intervention improve adherence and optimization immunosuppression could prevent failure.Prospective, open-labelled randomised biomarker-based strategy (hybrid) trial in 13 UK centres [EudraCT (2012-004308-36) ISRCTN (46157828)]. Patients were...
ABO and HLA antibody incompatible (HLAi) renal transplants (AIT) now comprise around 10% of living donor kidney transplants. However, the relationship between pretransplant factors medium-term outcomes are not fully understood, especially in relation to that may vary centers.
RituxiCAN-C4 combined an open-labelled randomised controlled trial (RCT) in 7 UK centres to assess whether rituximab could stabilise kidney function patients with chronic rejection, exploratory analysis of how B cell-depletion influenced T cell anti-donor responses relative outcome. Between January 2007 and March 2015, 59 recruits were enrolled after screening, 23 whom consented the embedded RCT. Recruitment was halted when a pre-specified per protocol interim analysis, RCT discovered be...
We have previously shown that children who developed de novo donor-specific human leukocyte antigen (HLA) antibodies (DSA) had greater decline in allograft function. hypothesised patients with complement-activating DSA would poorer renal outcomes. A total of 75 the original study. The first positive sample was subsequently tested for C1q and C3d fixing. primary event defined as 50% reduction from baseline estimated glomerular filtration rate analysed using Kaplan–Meier estimator. Of 65...
Abstract Background Kidney transplantation is the gold-standard treatment for patients with kidney failure. However, one-third of awaiting a transplant are highly sensitized to human leukocyte antigens (HLA), resulting in an increased waiting time suitable kidney, more acute and chronic rejection, shorter graft survival compared non-highly sensitised patients. Current standard immunosuppression protocols do not adequately suppress memory responses, so alternative strategies needed....
Background. An increasing number of patients are requiring multiple retransplants. We assessed outcomes third and fourth kidney transplants, to aid decision making on the most suitable donor type. Methods. Data were collected retrospectively for 2561 including 69 8 fourth, performed from 2000 2017. Demographics combined third/fourth group compared first second transplants. Within transplant group, comparisons made between deceased donors (n = 39), live HLA-compatible 23) -incompatible 13) as...
In Brief Background The last Banff 2013 report recognizes acute/active antibody-mediated rejection (ABMR) and C4d staining without evidence of rejection. goal our study was to analyze the incidence deposition after ABO-incompatible transplantation assess outcomes in patients with ABMR, (all acute scores = 0), tubulointerstitial inflammation (i > 0 or tubulitis). Methods Three-months 'For cause' protocol biopsies 50 were rescored correlated clinical antibody titres. Results Active/acute ABMR...
Abstract Solid organ transplantation represents the best (and in many cases only) treatment option for patients with end‐stage failure. The effectiveness and functioning life of these transplants has improved each decade due to surgical clinical advances, accurate histocompatibility assessment. Patient exposure alloantigen from another individual is a common occurrence takes place through pregnancies, blood transfusions or previous transplantation. Such alloantigen's can lead formation...
Antibody incompatible transplantation (AIT) may be an only option for highly sensitized patients. Severe form of early antibody mediated rejection (AMR) adversely affects graft survival after AIT. The aim this study was to identify individuals at risk AMR. We analyzed 213 living donor AITs performed our center. Among 120 ABOi, 58 HLAi and 35 DSA + FCXM-negative cases, the rates AMR were 6%, 31%, 9%, respectively ( p < 0.001). On multivariate analysis loss, had a HR 3.28 group worse...
Renal transplantation improves quality of life (QoL) and survival in children requiring renal replacement therapy (RRT). Sensitization with development a broad-spectrum anti-HLA antibodies as result previous or after receiving blood products is an increasing problem. There are no published reports desensitization protocols allowing from HLA-antibody-incompatible living donors.We adopted our well-established adult protocol for this purpose undertook HLA antibody-incompatible donor transplants...
Background. Because of the presence confounding antigens, assignment HLA antibody specificity is difficult in highly sensitized patients, and definition an acceptable mismatch requires a significant workload per patient. We describe new ELISA method, monoLISA, for detection immunoglobulin (Ig)G using single recombinant class I monomers bound to microtiter plates. Methods. HLA-A2 -B8 were synthesized used as screening targets 85 sera from renal patients. The contained various IgG IgM...
B cells play crucial roles in cell-mediated alloimmune responses. In vitro, can support or regulate indirect T-cell alloreactivity response to donor antigens on ELISpot and these patterns associate with clinical outcome. Previous reports of associations between B-cell phenotype function have examined global phenotypes responses polyclonal stimuli. We hypothesized that studying antigen-specific cells, using samples from sensitized patients, would inform further study identify novel targets...
Anti-HLA-antibody characteristics aid to risk-stratify patients and improve long-term renal graft outcomes. Complement activation by donor-specific antibody (DSA) is an important characteristic that may determine allograft outcome. There heterogeneity in outcomes within the moderate high immunological risk cases (cross-match-positive). We explored role of C3d-positive DSAs sub-stratification cross-match-positive relate investigated 139 living-donor transplant recipients from four centres...
Donor-specific antibodies are reported to increase the risk of rejection and reduce allograft survival following simultaneous liver-kidney transplantation. Optimal immunosuppression regimens this treat episodes underinvestigated.Cohort analysis first 27 transplant recipients, between 2014 2018 at our unit, is performed under a new stratification policy. Those with donor-specific class II HLA mean fluorescence intensity >10 000 considered high for antibody-mediated (AMR). These patients...