#11#
Revisiones-Ciencias
Básicas-Eventos celulares *** Reviews-Basic Sciences-Cellular events
TRASPLANTE
RENAL *** RENAL TRANSPLANTATION
(Conceptos
/ Keywords: Renal-Kidney transplantation; Kidney donation-procurement; etc).
Enero /
January 2001 --- Marzo / March 2004
La
biblioteca del conocimiento biomédico© es un servicio GRATUITO. Toda la
información ha sido obtenida de fuentes públicas, de portales de internet que
no requieren registro alguno para su uso, que no requieren estar de acuerdo con
sus Términos de uso, que son de libre acceso a todo el mundo, y son a su vez
gratuitos. La biblioteca (revisiones, guías, protocolos, medicina basada en la
evidencia, etc...) se recopila en base a una patente que permite a Effiloop la
catalogación de los artículos por campos de interés así como por el orden de su
importancia (se proveen las primeras 200 revisiones). Toda la informacion se
ampara en las leyes de libre pensamiento-expresión, y de uso justo. Este
documento sólo contiene artículos escritos en Castellano y/o Inglés.
The
biomedical library© is a FREE service. All the information has been obtained
from public sources, from web sites that do not require registration for their
use, that do not require an agreement with their Terms of use, that provide
free access for all, and are free of charge. The library (reviews, guides,
protocols, medicine based medicine, etc) is arranged according to a patent that
warrants Effiloop to catalogue the articles by fields of interest as well as to
sort articles by true relevance (the first 200 reviews are provided). All the
information is provided according to the freedom of speech and fair use laws.
Only articles written in Spanish and/or English are included.
[1]
TÍTULO / TITLE: - Interleukin-2 receptor
monoclonal antibodies in renal transplantation: meta-analysis of randomised
trials.
REVISTA
/ JOURNAL: - British Medical J (BMJ). Acceso gratuito
al texto completo.
●●
Enlace a la Editora de la Revista http://bmj.com/search.dtl
●●
Cita: British Medical J. (BMJ): <> 2003 Apr 12;326(7393):789.
●●
Enlace al texto completo (gratuito o de pago) 1136/bmj.326.7393.789
AUTORES
/ AUTHORS: - Adu D; Cockwell P; Ives NJ; Shaw J;
Wheatley K
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology, Queen Elizabeth
Hospital, Birmingham, B15 2TH. dwomoa.adu@uhb.nhs.uk
RESUMEN
/ SUMMARY: - OBJECTIVE: To study the effect of
interleukin-2 receptor monoclonal antibodies on acute rejection episodes, graft
loss, deaths, and rate of infection and malignancy in patients with renal
transplants. DESIGN: Meta-analysis of published data. DATA SOURCES: Medline,
Embase, and Cochrane library for years 1996-2003 plus search of medical
editors’ trial amnesty and contact with manufacturers of the antibodies.
SELECTION OF STUDIES: Randomised controlled trials comparing interleukin-2
receptor antibodies with placebo or no additional treatment in patients with
renal transplants receiving ciclosporin based immunosuppression. RESULTS: Eight
randomised controlled trials involving 1871 patients met the selection criteria
(although only 1858 patients were analysed). Interleukin-2 receptor antibodies
significantly reduced the risk of acute rejection (odds ratio 0.51, 95%
confidence interval 0.42 to 0.63). There were no significant differences in the
rate of graft loss (0.78, 0.58 to 1.04), mortality (0.75, 0.46 to 1.23),
overall incidence of infections (0.97, 0.77 to 1.24), incidence of
cytomegalovirus infections (0.81, 0.62 to 1.04), or risk of malignancies at one
year (0.82, 0.39 to 1.70). The different antibodies had a similar sized effect
on acute rejection (test for heterogeneity P=0.7): anti-Tac (0.37, 0.16 to
0.89), BT563 (0.37, 0.1 to 1.38), basiliximab (0.56, 0.44 to 0.72), and
daclizumab (0.46, 0.32 to 0.67). The reduction in acute rejections was similar
for all ciclosporin based immunosuppression regimens (test for heterogeneity
P=1.0). CONCLUSIONS: Adding interleukin-2 receptor antibodies to ciclosporin
based immunosuppression reduces episodes of acute rejection at six months by
49%. There is no evidence of an increased risk of infective complications.
Longer follow up studies are needed to confirm whether interleukin-2 receptor
antibodies improve long term graft and patient survival.
----------------------------------------------------
[2]
TÍTULO / TITLE: - Interleukin 2 receptor
antagonists for renal transplant recipients: a meta-analysis of randomized
trials.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 27;77(2):166-76.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000109643.32659.C4
AUTORES
/ AUTHORS: - Webster AC; Playford EG; Higgins G;
Chapman JR; Craig JC
INSTITUCIÓN
/ INSTITUTION: - Cochrane Renal Group, Centre for Kidney
Research, Children’s Hospital at Westmead, Westmead, NSW, Australia.
RESUMEN
/ SUMMARY: - BACKGROUND: Interleukin 2 receptor
antagonists (IL-2Ra) are increasingly used to treat renal transplant
recipients. This study aims to systematically identify and summarize the
effects of using IL-2Ra as induction immunosuppression, as an addition to
standard therapy, or as an alternative to other antibody therapy. METHODS:
Databases, reference lists, and abstracts of conference proceedings were
searched extensively to identify relevant randomized controlled trials in all
languages. Data were synthesized using the random effects model. Results are
expressed as relative risk (RR), with 95% confidence intervals (CI). RESULTS: A
total of 117 reports from 38 trials involving 4,893 participants were included.
When IL-2Ra were compared with placebo (17 trials; 2,786 patients), graft loss
was not significantly different at 1 year (14 trials: RR 0.84; CI 0.64-1.10) or
3 years (4 trials: RR 1.08; CI 0.71-1.64). Acute rejection was significantly
reduced at 6 months (12 trials: RR 0.66; CI 0.59-0.74) and at 1 year (10
trials: RR 0.67; CI 0.60-0.75). At 1 year, cytomegalovirus infection (7 trials:
RR 0.82; CI 0.65-1.03) and malignancy (9 trials: RR 0.67; CI 0.33-1.36) were
not significantly different. When IL-2Ra were compared with other antibody
therapy, no significant differences in treatment effects were demonstrated, but
IL-2Ra had significantly fewer side effects. CONCLUSIONS: Given a 40% risk of
rejection, seven patients would need treatment with IL-2Ra in addition to
standard therapy, to prevent one patient from undergoing rejection, with no
definite improvement in graft or patient survival. There is no apparent
difference between basiliximab and daclizumab.
----------------------------------------------------
[3]
TÍTULO / TITLE: - Routes to allograft
survival.
REVISTA
/ JOURNAL: - J Clin Invest. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.jci.org/
●●
Cita: J Clinical Investigation: <> 2001 Apr;107(7):797-8.
AUTORES
/ AUTHORS: - Bromberg JS; Murphy B
INSTITUCIÓN
/ INSTITUTION: - Recanati/Miller Transplant Institute,
Mount Sinai School of Medicine, New York, New York 10029, USA. jon.bromberg@mountsinai.org N. Ref:: 21
----------------------------------------------------
[4]
TÍTULO / TITLE: - Treatment of hepatitis
B in special patient groups: hemodialysis, heart and renal transplant,
fulminant hepatitis, hepatitis B virus reactivation.
REVISTA
/ JOURNAL: - J Hepatol 2003;39 Suppl 1:S206-11.
AUTORES
/ AUTHORS: - Tillmann HL; Wedemeyer H; Manns MP
INSTITUCIÓN
/ INSTITUTION: - Department of Gastroenterology, Hepatology
and Endocrinology, Medizinische Hochschule Hannover, Carl-Neuberg-Strassel,
30623 Hannover, Germany. N.
Ref:: 81
----------------------------------------------------
[5]
TÍTULO / TITLE: - 4D imaging to assay
complex dynamics in live specimens.
REVISTA
/ JOURNAL: - Nat Cell Biol 2003 Sep;Suppl:S14-9.
AUTORES
/ AUTHORS: - Gerlich D; Ellenberg J
INSTITUCIÓN
/ INSTITUTION: - Gene Expression and Cell
Biology/Biophysics Programmes, European Molecular Biology Laboratory,
Heidelberg, Germany.
RESUMEN
/ SUMMARY: - A full understanding of cellular dynamics
is often difficult to obtain from time-lapse microscopy of single optical
sections. New microscopes and image-processing software are now making it
possible to rapidly record three-dimensional images over time. This
four-dimensional imaging allows precise quantitative analysis and enhances
visual exploration of data by allowing cellular structures to be interactively
displayed from many angles. It has become a key tool for understanding the
complex organization of biological processes in live specimens. N. Ref:: 55
----------------------------------------------------
[6]
TÍTULO / TITLE: - Pretransplant blood
transfusions revisited: a role for CD(4+) regulatory T cells?
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S26-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106469.12073.01
AUTORES
/ AUTHORS: - Roelen D; Brand A; Claas FH
INSTITUCIÓN
/ INSTITUTION: - Department of Immunohematology and
Bloodtransfusion, Leiden University Medical Center, Leiden, The Netherlands. d.l.roelen@lumc.nl.
RESUMEN
/ SUMMARY: - Pretransplant blood transfusions have been
shown to improve organ allograft survival. However, the immunologic mechanism
leading to this beneficial effect of blood transfusions is still unknown. The
observation that transfusions sharing at least one HLA-DR antigen (human
leukocyte antigen) with the recipient are more effective than HLA-mismatched
transfusions has led to the hypothesis that CD(4+) regulatory T cells are
induced that recognize allopeptides of the blood transfusion donor in the
context of the self-HLA-DR molecule on the donor cells. In vitro studies showed
that CD(4+) T cells recognizing an allopeptide in the context of self-HLA-DR
are indeed able to decrease the alloimmune response of autologous T cells by
affecting the activated T cells directly or indirectly by their modulatory
effect on dendritic cells. The first studies in a patient with a
well-functioning kidney graft after receiving an HLA-DR-matched pretransplant
blood transfusion showed that the low organ donor-specific cytotoxic
T-lymphocyte response after transplantation was indeed attributable to the
activity of regulatory CD(4+) T cells. N.
Ref:: 24
----------------------------------------------------
[7]
TÍTULO / TITLE: - Dendritic cells and the
mode of action of anticalcineurinic drugs: an integrating hypothesis.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2003 Mar;18(3):467-8;
discussion 469-70.
AUTORES
/ AUTHORS: - Fierro A; Mora JR; Bono MR; Morales J;
Buckel E; Sauma D; Rosemblatt M
INSTITUCIÓN
/ INSTITUTION: - Clinica las Condes, Transplantation Unit,
Santiago, Chile. afierro@vtr.net N. Ref:: 16
----------------------------------------------------
[8]
TÍTULO / TITLE: - Regulatory T cells in
kidney transplant recipients: active players but to what extent?
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Jun;14(6):1706-8.
AUTORES
/ AUTHORS: - Zhai Y; Kupiec-Weglinski JW N. Ref:: 20
----------------------------------------------------
[9]
TÍTULO / TITLE: - Potential role of major
histocompatibility complex class II peptides in regulatory tolerance to
vascularized grafts.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S35-7.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106472.91343.8D
AUTORES
/ AUTHORS: - LeGuern C
INSTITUCIÓN
/ INSTITUTION: - Transplantation Biology Research Center,
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA. leguern@helix.mgh.harvard.edu
RESUMEN
/ SUMMARY: - The inactivation of persisting T
lymphocytes reactive to self- and non-self-antigens is a major arm of
operational immune tolerance in mammals. Silencing of such T cells proceeds
mostly by means of suppression, a process that is mediated by regulatory T-cell
subsets and especially by CD4(+)CD(25high) regulatory T cells (Treg). Although
Treg activation and ensuing suppressive activity appear to be major
histocompatibility complex class II dependent, the fine specificity of Treg
T-cell receptors has not yet been elucidated. Recent data from the author’s
laboratory on a class II gene therapy induction of tolerance to allogeneic
kidney grafts suggest that class II peptides are involved as generic signals
for Treg activation. A brief compilation of results that would support this
hypothesis is discussed in the present article. N. Ref:: 31
----------------------------------------------------
[10]
TÍTULO / TITLE: - Transcriptional
regulation of inflammatory genes before transplantation: a role for hypoxia
inducible factor-1alpha?
REVISTA
/ JOURNAL: - Transplantation 2003 Feb 27;75(4):437-8.
AUTORES
/ AUTHORS: - Koo DD; Fuggle SV
INSTITUCIÓN
/ INSTITUTION: - Nuffield Department of Surgery, University
of Oxford, Oxford Transplant Centre, United Kingdom. N. Ref:: 5
----------------------------------------------------
[11]
TÍTULO / TITLE: - Complement and the
kidney.
REVISTA
/ JOURNAL: - J Immunol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jimmunol.org/
●●
Cita: J. of Immunology: <> 2003 Oct 1;171(7):3319-24.
AUTORES
/ AUTHORS: - Quigg RJ
INSTITUCIÓN
/ INSTITUTION: - Section of Nephrology, University of
Chicago, Chicago, IL 60637, USA. rqigg@medicine.uchicago.edu N. Ref:: 94
----------------------------------------------------
[12]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.3.2. Long-term immunosuppression. Therapy conversion.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002;17 Suppl 4:20-1.
RESUMEN
/ SUMMARY: - GUIDELINE: Conversion of immunosuppressive
drug therapy is recommended to avoid or reduce drug-specific adverse effects,
and is generally safe for long-term graft outcome.
----------------------------------------------------
[13]
TÍTULO / TITLE: - A benefit-risk
assessment of basiliximab in renal transplantation.
REVISTA
/ JOURNAL: - Drug Saf. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.csmwm.org/
●●
Cita: Drug Safety: <> 2004;27(2):91-106.
AUTORES
/ AUTHORS: - Boggi U; Danesi R; Vistoli F; Del Chiaro
M; Signori S; Marchetti P; Del Tacca M; Mosca F
INSTITUCIÓN
/ INSTITUTION: - Division of General Surgery and
Transplants, Department of Oncology, Transplants and Advanced Technologies in
Medicine, University of Pisa, Pisa, Italy. uboggi@med.unipi.it
RESUMEN
/ SUMMARY: - Interleukin-2 (IL-2) and its receptor
(IL-2R) play a central role in T lymphocyte activation and immune response
after transplantation. Research on the biology of IL-2R allowed the
identification of key signal transduction pathways involved in the generation
of proliferative and antiapoptotic signals in T cells. The alpha-chain of the
IL-2R is a specific peptide against which monoclonal antibodies have been
raised, with the aim of blunting the immune response by means of inhibiting
proliferation and inducing apoptosis in primed lymphocytes. Indeed,
basiliximab, one of such antibodies, has proved to be effective in reducing the
episodes of acute rejection after kidney and pancreas transplantation. The use
of basiliximab was associated with a significant reduction in the incidence of
any treated rejection episodes after kidney transplantation in the two major
randomised studies (placebo 52.2% vs basiliximab 34.2% at 6 months, European
study; placebo 54.9% vs basiliximab 37.6% at 1 year, US trial). Basiliximab and
equine antithymocyte globulin (ATG) administration resulted in a similar rate
of biopsy-proven acute rejection at 6 months (19% for both) and at 12 months
(19% and 20%, respectively). The use of basiliximab appears not to be
associated with an increased incidence of adverse events as compared with
placebo in immunosuppressive regimens, including calcineurin inhibitors,
mycophenolate mofetil or azathioprine and corticosteroids, and its safety
profile is superior to ATG. Moreover, a similar occurrence of infections is
noted in selected studies (65.5% after basiliximab vs 65.7% of controls),
including cytomegalovirus infection (17.3% vs 14.5%), and cytokine-release
syndrome is not observed. Finally, economic analysis demonstrated lower costs of
overall treatment in patients treated with basiliximab. Therefore, the use of
basiliximab entails a very low risk, allows safe reduction of corticosteroid
dosage and reduces the short- and mid-term rejection rates. However, the
improvement in the long-term survival of kidney grafts in patients treated
according to modern immunosuppressive protocols is still to be demonstrated.
These conclusions are based on a systematic review of the scientific
literature, indexed on Medline database, concerning the mechanism of action,
therapeutic activity, safety and pharmacoeconomic evaluation of basiliximab in
renal transplantation. N.
Ref:: 62
----------------------------------------------------
[14]
TÍTULO / TITLE: - Renal transplantation
in HBsAg+ patients: is lamivudine your “final answer”?
REVISTA
/ JOURNAL: - J Clin Gastroenterol 2003 Jul;37(1):9-11.
AUTORES
/ AUTHORS: - Fontana RJ N. Ref:: 30
----------------------------------------------------
[15]
TÍTULO / TITLE: - Renal dopaminergic
mechanisms in renal parenchymal diseases and hypertension.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2001;16 Suppl 1:53-9.
AUTORES
/ AUTHORS: - Pestana M; Jardim H; Correia F;
Vieira-Coelho MA; Soares-da-Silva P
INSTITUCIÓN
/ INSTITUTION: - Departments of Nephrology, and Institute
of Pharmacology and Therapeutics, Faculty of Medicine, 4200 Porto, Portugal.
RESUMEN
/ SUMMARY: - The present report addresses the status of
the renal dopaminergic system activity in patients afflicted with different
renal disorders and in the remnant kidney of uninephrectomized (UNX) rats,
based on the urinary excretion of L-DOPA, dopamine and amine metabolites. In
renal transplant recipients with good recovery of graft function (group 1,
n=11), the daily urinary excretion of DOPAC, but not that of HVA, was found to
increase progressively throughout the first 12 days post-transplantation from
698+/-57 nmol in the first day to 3498+/-414 nmol on day 9, and then remained
constant until day 12. This resulted in a 6-fold increase in the urinary
DOPAC/dopamine ratios. In renal transplant recipients with acute tubular
necrosis (group 2, n=8), the urinary levels of dopamine, DOPAC and HVA were
approximately 30% of those in group 1. In a group of 28 patients with chronic
renal parenchymal disorders, the daily urinary excretion of L-DOPA, free
dopamine and dopamine metabolites (DOPAC and HVA) correlated positively with
the degree of deterioration of renal function (P<0.01). However, the
U(Dopamine/(L)-DOPA) and U(DOPAC/Dopamine) ratios in patients with chronic renal
insufficiency were found to be similar to those observed in patients with
normal renal function. In 14 IgA nephropathy (IgA-N) patients with near normal
renal function, the changes in 24 h mean blood pressure when going from 20 to
350 mmol/day sodium intake correlated negatively with the daily urinary
excretion of dopamine (r(2)=0.597, P<0.01). The urinary excretion of L-DOPA
and dopamine in IgA-N patients with salt-sensitive (SS) blood pressure was
lower than in salt-resistant (SR) patients (P<0.05), irrespective of their
daily sodium intake. However, the rise in urinary dopamine output during salt
loading (from 20 to 350 mmol/day) was greater (P<0.05) in IgA-N SS patients
(21.2+/-2.5% increase) than in SR patients (6.3+/-1.4% increase). Fifteen days
after the surgery, uninephrectomy (UNX) in the rat was accompanied by an
enhanced (P<0.05) urinary excretion of dopamine (36+/-3 vs 26+/-2), DOPAC
(124+/-11 vs 69+/-6) and HVA (611+/-42 vs 354+/-7) (nmol/g kidney/kg body
weight). This was accompanied by an increase in V(max) values for renal
aromatic L-amino acid decarboxylase in the remnant kidney of UNX rats
(P<0.05). Sch 23390, a D1 dopamine receptor antagonist, produced a marked
reduction in the urinary excretion of sodium in UNX rats, whereas in sham-operated
rats the decrease in urinary sodium did not attain a significant difference. It
is concluded that the study of the renal dopaminergic system in patients
afflicted with renal parenchymal disorders should address parameters other than
free urinary dopamine, namely the urinary excretion of L-DOPA and dopamine
metabolites (DOPAC and HVA). It is also suggested that in SS hypertension of
chronic renal parenchymal diseases, renal dopamine produced in the residual
tubular units may be enhanced during a sodium challenge, thus behaving
appropriately as a compensatory natriuretic hormone. N. Ref:: 25
----------------------------------------------------
[16]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.3.4. Long-term immunosuppression. Non-compliance.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002;17 Suppl 4:23-4.
RESUMEN
/ SUMMARY: - GUIDELINES: A. The detection of
non-compliers should be a permanent concern of the transplant team (doctors,
nurses and others). B. Because non-compliance is associated with late graft
dysfunction and graft loss, it is important to reduce the proportion of
non-compliers by implementing specific educational programmes addressing this
problem and the importance of immunosuppressive medications. C. Non-compliance
starts during the first year and may increase thereafter. Therefore, the
specific educational programme should be repeated and adapted to the need of
the transplant recipient, with delivery of few but clear messages.
----------------------------------------------------
[17]
TÍTULO / TITLE: - Angiopoietin growth
factors and Tie receptor tyrosine kinases in renal vascular development.
REVISTA
/ JOURNAL: - Pediatr Nephrol 2001 Feb;16(2):177-84.
AUTORES
/ AUTHORS: - Woolf AS; Yuan HT
INSTITUCIÓN
/ INSTITUTION: - Nephro-Urology Unit, Institute of Child
Health, University College London, UK. a.woolf@ich.ucl.ac.uk
RESUMEN
/ SUMMARY: - Angiopoietin-1 (Ang-1) is a secreted
growth factor which binds to and activates the Tie-2 receptor tyrosine kinase.
The factor enhances endothelial cell survival and capillary morphogenesis, and
also limits capillary permeability. Ang-2 binds the same receptor but fails to
activate it: hence, it is a natural inhibitor of Ang-1. Ang-2 destabilises
capillary integrity, facilitating sprouting when ambient vascular endothelial
growth factor (VEGF) levels are high, but causing vessel regression when VEGF
levels are low. Tie-1 is a Tie-2 homologue but its ligands are unknown.
Angiopoietin and Tie genes are expressed in the mammalian metanephros, the
precursor of the adult kidney, where they may play a role in endothelial
precursor growth. Tie-1-expressing cells can be detected in the metanephros
when it first forms and, based on transplantation experiments, these precursors
contribute to the generation of glomerular capillaries. During glomerular
maturation, podocyte-derived Ang-1 and mesangial-cell-derived Ang-2 may affect
growth of nascent capillaries. After birth, vasa rectae acquire their mature
configuration and Ang-2 expressed by descending limbs of loops of Henle would
be well placed to affect the growth of this medullary microcirculation.
Finally, preliminary data implicate angiopoietins in deregulated vessel growth
in Wilms’ kidney tumours and in vascular remodelling after nephrotoxicity. N. Ref:: 64
----------------------------------------------------
[18]
TÍTULO / TITLE: - Vitamin D as
immunomodulatory therapy for kidney transplantation.
REVISTA
/ JOURNAL: - Transplantation 2002 Oct 27;74(8):1204-6.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000031949.70610.BB
AUTORES
/ AUTHORS: - Becker BN; Hullett DA; O’Herrin JK; Malin
G; Sollinger HW; DeLuca H
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, B-3063 UW
Nephrology, University of Wisconsin, 2500 Overlook Terrace, Madison, WI 53705, USA.
bnb@medicine.wisc.edu
RESUMEN
/ SUMMARY: - Vitamin D (1alpha,25-dihydroxyvitamin D(3)
[1alpha,25-(OH)(2)D(3)]) has been studied in the past for its immunosuppressive
properties, and, in that context, it may also have potential utility as an
immunomodulatory agent for transplantation. A number of studies have
demonstrated that 1alpha,25-(OH)(2)D(3) or its analogs regulate immune cell
proliferation, differentiation, and responsiveness. A burgeoning number of
studies have also explored using 1alpha,25-(OH)(2)D(3) and its analogs directly
as therapy in animal models of kidney transplantation with success in
prolonging allograft function and preventing acute rejection. Some of these in
vivo effects may well be caused by alterations in immune cell function, but it
is also possible that exogenous 1alpha,25-(OH)(2)D(3) and its analogs are
altering the intragraft milieu as well, specifically through changes in the
TGF-beta signaling cascade. Such provocative data and the availability of newer
1alpha,25-(OH)(2)D(3) analogs that may limit side effects (e.g. hypercalcemia)
have created interest in examining this secosteroid clinically in kidney
transplantation. N.
Ref:: 34
----------------------------------------------------
[19]
TÍTULO / TITLE: - Kidney and liver
transplantation in HIV-infected patients: case presentations and review.
REVISTA
/ JOURNAL: - AIDS Patient Care STDS 2003
Oct;17(10):501-7.
●●
Enlace al texto completo (gratuito o de pago) 1089/108729103322494294
AUTORES
/ AUTHORS: - Roland ME; Adey D; Carlson LL; Terrault NA
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, University of
California, San Francisco, San Francisco, California, USA. mroland@php.ucsf.edu
RESUMEN
/ SUMMARY: - Until recently, HIV-infected patients have
been excluded from consideration for solid organ transplantation. The
relatively high mortality rates among HIV-infected transplant recipients
observed in the era prior to the use of highly active antiretroviral therapy
(HAART), coupled with long waiting times for cadaveric organs, made it
difficult to support organ transplantation in this patient group. However, in
response to the marked reductions in morbidity and mortality associated with
HIV infection, several transplant centers have developed pilot studies or
revised their clinical criteria to allow transplantation in this group of
patients. We describe two cases, one kidney and one liver transplant recipient,
and review the major clinical and research issues related to this topic.
Reports of transplantations in the pre-HAART era highlight two important
findings. First, some HIV-infected transplant recipients did very well with
long survival periods. However, overall progression to AIDS and death appeared
accelerated. We recently reported on our preliminary experience with 45
selected transplant recipients in the HAART era. One-year patient survival
rates were similar to unmatched survival data from the United Network for Organ
Sharing (UNOS) database. Median CD4+ T-cell counts remained stable in the
follow-up period compared to pretransplant. HIV-1 RNA nearly uniformly
continued to be suppressed below the limits of detection. Preliminary data are
promising and support the current efforts to evaluate patient and graft
survival among HIV-infected transplant recipients and to explore the mechanisms
underlying the many potential complications of transplantation in this population. N. Ref:: 21
----------------------------------------------------
[20]
TÍTULO / TITLE: - Transplant Mac attack:
humor the macrophages.
REVISTA
/ JOURNAL: - Kidney Int 2003 May;63(5):1953-4.
AUTORES
/ AUTHORS: - Colvin RB
N. Ref:: 10
----------------------------------------------------
[21]
TÍTULO / TITLE: - Basiliximab: a review
of its use as induction therapy in renal transplantation.
REVISTA
/ JOURNAL: - Drugs 2003;63(24):2803-35.
AUTORES
/ AUTHORS: - Chapman TM; Keating GM
INSTITUCIÓN
/ INSTITUTION: - Adis International Limited, Auckland, New
Zealand. demail@adis.co.nz
RESUMEN
/ SUMMARY: - Basiliximab (Simulect), a chimeric
(human/murine) monoclonal antibody, is indicated for the prevention of acute
organ rejection in adult and paediatric renal transplant recipients in
combination with other immunosuppressive agents.Basiliximab significantly
reduced acute rejection compared with placebo in renal transplant recipients
receiving dual- (cyclosporin microemulsion and corticosteroids) or
triple-immunotherapy (azathioprine- or mycophenolate mofetil-based); graft and
patient survival rates at 12 months were similar. Significantly more
basiliximab than placebo recipients were free from the combined endpoint of
death, graft loss or acute rejection 3 years, but not 5 years, after
transplantation.The incidence of adverse events was similar in basiliximab and
placebo recipients, with no increase in the incidence of infection, including
cytomegalovirus (CMV) infection. Malignancies or post-transplant
lymphoproliferative disorders after treatment with basiliximab were rare, with
a similar incidence to that seen with placebo at 12 months or 5 years
post-transplantation. Rare cases of hypersensitivity reactions to basiliximab
have been reported.The efficacy of basiliximab was similar to that of equine
antithymocyte globulin (ATG) and daclizumab, and similar to or greater than
that of muromonab CD3. Basiliximab was as effective as rabbit antithymocyte
globulin (RATG) in patients at relatively low risk of acute rejection, but less
effective in high-risk patients. Numerically or significantly fewer patients
receiving basiliximab experienced adverse events considered to be related to
the study drug than ATG or RATG recipients. The incidence of infection,
including CMV infection, was similar with basiliximab and ATG or
RATG.Basiliximab plus baseline immunosuppression resulted in no significant
differences in acute rejection rates compared with baseline immunosuppression
with or without ATG or antilymphocyte globulin in retrospective analyses
conducted for small numbers of paediatric patients. Limited data from
paediatric renal transplant recipients suggest a similar tolerability profile
to that in adults. Basiliximab appears to allow the withdrawal of
corticosteroids or the use of corticosteroid-free or calcineurin
inhibitor-sparing regimens in renal transplant recipients.Basiliximab did not
increase the overall costs of therapy in pharmacoeconomic studies.CONCLUSION:
Basiliximab reduces acute rejection without increasing the incidence of adverse
events, including infection and malignancy, in renal transplant recipients when
combined with standard dual- or triple-immunotherapy. The overall incidence of
death, graft loss or acute rejection was significantly reduced at 3 years;
there was no significant difference for this endpoint 5 years after
transplantation. Malignancy was not increased at 5 years. The overall efficacy,
tolerability, ease of administration and cost effectiveness of basiliximab make
it an attractive option for the prophylaxis of acute renal transplant
rejection. N. Ref:: 85
----------------------------------------------------
[22]
TÍTULO / TITLE: - Hepatitis B and renal
transplantation: securing the sword of damocles.
REVISTA
/ JOURNAL: - Hepatology 2002 Nov;36(5):1041-5.
●●
Enlace al texto completo (gratuito o de pago) 1053/jhep.2002.36805
AUTORES
/ AUTHORS: - Perrillo RP N. Ref:: 37
----------------------------------------------------
[23]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.2.2 Chronic graft dysfunction. Immunological factors
(alloimmunity).
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002;17 Suppl 4:8-11.
RESUMEN
/ SUMMARY: - GUIDELINE: All recipients of an allogeneic
kidney graft should take life-long maintenance immunosuppressive medication.
Whereas there is no immunological test to diagnose chronic allograft
dysfunction, circumstantial evidence suggests that immunological factors play
an important role in its pathogenesis. This evidence is based on experimental
data, the beneficial effect of sharing HLA antigens between donor and recipient
and post-transplantation immunological monitoring studies.
----------------------------------------------------
[24]
TÍTULO / TITLE: - Capillary C4d
deposition as a marker of humoral immunity in renal allograft rejection.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2002
Sep;13(9):2420-3.
AUTORES
/ AUTHORS: - Watschinger B; Pascual M N. Ref:: 38
----------------------------------------------------
[25]
TÍTULO / TITLE: - Primary intestinal
posttransplant T-cell lymphoma.
REVISTA
/ JOURNAL: - Transplantation 2003 Jun 27;75(12):2131-2.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000060253.54333.F3
AUTORES
/ AUTHORS: - Michael J; Greenstein S; Schechner R;
Tellis V; Vasovic LV; Ratech H; Glicklich D
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, Albert Einstein
College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.
RESUMEN
/ SUMMARY: - There have been only five reported cases
of primary posttransplant T-cell lymphoma. We report the first case associated
with the use of sirolimus (Rapamycin, Wyeth-Ayerst, Philadelphia, PA). The
patient, receiving prednisone, cyclosporine, and sirolimus treatment, developed
ascites, diarrhea, and weight loss 7 months after his second renal transplant.
Tissue obtained at laparotomy established the diagnosis of primary T-cell
lymphoma. Latent membrane protein-1 for Epstein-Barr virus was negative, but
in-site hybridization test for Epstein-Barr-encoded RNA was positive. Despite
aggressive chemotherapy, the patient died 8 months posttransplant. This is the
sixth reported case of primary intestinal posttransplant T-cell lymphoma, but
it is the first case associated with the use of sirolimus. The incidence of
posttransplant lymphoproliferative disease in patients receiving sirolimus
should be studied. N.
Ref:: 6
----------------------------------------------------
[26]
TÍTULO / TITLE: - The impact of
cytomegalovirus infections and acute rejection episodes on the development of
vascular changes in 6-month protocol biopsy specimens of cadaveric kidney
allograft recipients.
REVISTA
/ JOURNAL: - Transplantation 2003 Jun 15;75(11):1858-64.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000064709.20841.E1
AUTORES
/ AUTHORS: - Helantera I; Koskinen P; Tornroth T;
Loginov R; Gronhagen-Riska C; Lautenschlager I
INSTITUCIÓN
/ INSTITUTION: - Department of Virology, Helsinki
University Central Hospital and University of Helsinki, Helsinki, Finland.
RESUMEN
/ SUMMARY: - BACKGROUND: The role of cytomegalovirus
(CMV) in chronic kidney allograft rejection remains controversial. The purpose
of this study was to examine the impact of CMV infection on histopathologic
changes in 6-month protocol biopsy specimens of kidney allografts. METHODS:
Altogether, 52 renal allograft recipients were studied. CMV infection was
diagnosed by CMV antigenemia test, viral cultures from blood and urine, or
both. CMV was demonstrated in the biopsy specimens by antigen detection and
hybridization in situ. Acute rejections were diagnosed by biopsy histology, and
biopsy specimens were graded according to the Banff ‘97 classification.
RESULTS: CMV infection was diagnosed in 41 patients. The 11 patients in whom
CMV infection was not detected were used as controls. Acute rejection was
diagnosed in 22 of 41 CMV patients and in 6 of 11 control patients. CMV was
demonstrated in the biopsy specimens of 19 of 41 CMV patients. CMV was not
associated with increased glomerular, tubular, or interstitial changes.
However, the arteriosclerotic changes in small arterioles were significantly
increased in the subgroup of patients where CMV was demonstrated in the graft
as compared with controls (P<0.01). Analysis of the impact of acute
rejection on arteriolar thickening showed that only a positive history of both
acute rejection and CMV found in the graft was associated with significantly
increased vascular changes compared with CMV-free recipients (P<0.05).
CONCLUSIONS: Neither CMV nor acute rejection alone was associated with
increased vascular or other histopathologic changes in 6-month protocol biopsy
specimens of kidney allografts, but a previous history of both acute rejection
and the presence of CMV in the graft was associated with increased vascular
changes.
----------------------------------------------------
[27]
TÍTULO / TITLE: - Transplant
capillaropathy and transplant glomerulopathy: ultrastructural markers of
chronic renal allograft rejection.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2003 Apr;18(4):655-60.
AUTORES
/ AUTHORS: - Ivanyi B
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology, University of
Szeged, Szeged, Hungary. ivanyi@patho.szote.u-szeged.hu N. Ref:: 21
----------------------------------------------------
[28]
TÍTULO / TITLE: - Adenovirus
pyelonephritis in a pediatric renal transplant patient.
REVISTA
/ JOURNAL: - Pediatr Nephrol 2003 May;18(5):457-61.
Epub 2003 Mar 18.
●●
Enlace al texto completo (gratuito o de pago) 1007/s00467-003-1080-x
AUTORES
/ AUTHORS: - Kim SS; Hicks J; Goldstein SL
INSTITUCIÓN
/ INSTITUTION: - Baylor College of Medicine, Texas, USA.
RESUMEN
/ SUMMARY: - Gross hematuria, graft pain, and rising
serum creatinine are classic signs of acute rejection, obstruction, or
bacterial pyelonephritis for patients with renal transplants. This presentation
often prompts percutaneous renal allograft biopsy. If subsequent evaluation
fails to show evidence of acute rejection, obstruction, or bacterial infection,
viral etiologies should be considered. We report a 14-year-old Hispanic female
with a living-related renal transplant who had gross hematuria, graft
tenderness, and increased serum creatinine, but did not have evidence of acute
rejection, obstruction, or bacterial pyelonephritis. To our knowledge, this is
the first report of adenovirus pyelonephritis in a transplanted kidney of a
pediatric patient, with isolation of adenovirus in the urine and in the
allograft using immunocytochemical techniques.
N. Ref:: 26
----------------------------------------------------
[29]
TÍTULO / TITLE: - Interleukin 18 and
interleukin 18 binding protein: possible role in immunosuppression of chronic
renal failure.
REVISTA
/ JOURNAL: - Blood Purif 2003;21(3):258-70.
●●
Enlace al texto completo (gratuito o de pago) 1159/000070699
AUTORES
/ AUTHORS: - Dinarello CA; Novick D; Rubinstein M;
Lonnemann G
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, University of
Colorado Health Sciences Center, Denver, Colo 80262, USA.
RESUMEN
/ SUMMARY: - Although interleukin (IL)-18 is a member
of the IL-1 family of ligands, IL-18 appears to have unique characteristics,
particularly in the regulation of the T helper type 1 (Th1) response. Th1
responses are required for tumor surveillance, killing intracellular organisms,
and to provide help for antibody production. In patients with chronic renal
failure, the well-known immunosuppression contributes to a failure to respond
to infectious challenges and vaccinations. The most salient biological property
of IL-18, linking this cytokine to the Th1 response, is its ability to induce
interferon gamma (IFN-gamma). In fact, IL-18 was originally identified as an
IFN-gamma-inducing factor, and IFN-gamma production is the hallmark of the Th1
response. Dysregulation of IFN-gamma production resulting from reduced activity
of IL-18 would explain one of the mechanisms of immunosuppression in patients
with chronic renal failure. The activity of IL-18 can be regulated by the
IL-18-binding protein (IL-18BP), a glycoprotein of 40,000 daltons, which is
constitutively expressed and appears to be the natural inhibitor of IL-18
activity. Unlike soluble receptors for IL-18, IL-18BP does not have a
transmembrane domain; IL-18BP is a secreted protein possessing a high-affinity
binding and ability to neutralize IL-18. IL-18BP was discovered in human urine
and is excreted in health following glomerular filtration. With decreasing
renal function, the concentrations of IL-18BP in the circulation are elevated
as compared with subjects with a normal renal function, and these elevated
levels may result in a decreased IL-18 activity. Because of the importance of
IL-18 and IFN-gamma in the Th1 response, the biology of IL-18 and IL-18BP is
reviewed here in the context of the immunosuppression of chronic renal
failure. N. Ref:: 81
----------------------------------------------------
[30]
TÍTULO / TITLE: - C4d and the fate of
organ allografts.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2002
Sep;13(9):2417-9.
AUTORES
/ AUTHORS: - Platt JL
N. Ref:: 16