1
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Cseprekal O, Van Craenenbroeck AH, de Borst MH, Stevens KI, Ferreira AC, Molnar MZ, Pettinelli P, Wiecek A. The Young Nephrologists' Platform: the gateway to the future of nephrology. Clin Kidney J 2024; 17:sfae024. [PMID: 38464958 PMCID: PMC10921385 DOI: 10.1093/ckj/sfae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Orsolya Cseprekal
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
| | | | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kate I Stevens
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Ana Carina Ferreira
- Department of Nephrology – Hospital Curry Cabral – ULS São José, Lisbon, Portugal
- Nova Medical School, Lisbon, Portugal
| | - Miklos Z Molnar
- Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | | | - Andrzej Wiecek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
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2
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Ladányi Z, Bárczi A, Fabian A, Adrienn U, Cseprekal O, Kis É, Merkely B, Reusz GS, Kovács A, Lakatos BK. GET TO THE HEART OF PEDIATRIC RENAL TRANSPLANTATION: A THREE-DIMENSIONAL ECHOCARDIOGRAPHY STUDY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01959-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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3
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Mohamed K, Rzymski P, Islam MS, Makuku R, Mushtaq A, Khan A, Ivanovska M, Makka SA, Hashem F, Marquez L, Cseprekal O, Filgueiras IS, Fonseca DLM, Mickael E, Ling I, Arero AG, Cuschieri S, Minakova K, Rodríguez-Román E, Abarikwu SO, Faten AB, Grancini G, Cabral-Marques O, Rezaei N. COVID-19 vaccinations: The unknowns, challenges, and hopes. J Med Virol 2021; 94:1336-1349. [PMID: 34845731 PMCID: PMC9015467 DOI: 10.1002/jmv.27487] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 12/25/2022]
Abstract
The entire world has been suffering from the coronavirus disease 2019 (COVID‐19) pandemic since March 11, 2020. More than a year later, the COVID‐19 vaccination brought hope to control this viral pandemic. Here, we review the unknowns of the COVID‐19 vaccination, such as its longevity, asymptomatic spread, long‐term side effects, and its efficacy on immunocompromised patients. In addition, we discuss challenges associated with the COVID‐19 vaccination, such as the global access and distribution of vaccine doses, adherence to hygiene guidelines after vaccination, the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants, and vaccine resistance. Despite all these challenges and the fact that the end of the COVID‐19 pandemic is still unclear, vaccines have brought great hope for the world, with several reports indicating a significant decline in the risk of COVID19‐related infection and hospitalizations. Vaccination plays a pivotal role in reducing the death toll of the COVID‐19 infection. The immunity provided by vaccines is still disputable leading to some challenges like the asymptomatic spread; therefore, staying strict to hygiene guidelines is necessary. Hence, COVID‐19 vaccines' related long‐term side effects are still unknown; cautions should be taken when injected to various individuals of the community. COVID‐19 vaccines' effectiveness are strongly related to their effect on emergent COVID‐19 variants, but until now approved vaccines can still show some protective effects against new variants.
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Affiliation(s)
- Kawthar Mohamed
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Manama, Bahrain
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznań University of Medical Sciences, Poznań, Poland.,Universal Scientific Education and Research Network (USERN), Poznań, Poland
| | - Md Shahidul Islam
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Dhaka, Bangladesh
| | - Rangarirai Makuku
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Harare, Zimbabwe
| | - Ayesha Mushtaq
- International Higher School of Medicine, International University of Kyrgyzstan, Bishkek, Kyrgyzstan.,Universal Scientific Education and Research Network (USERN), Bishkek, Kyrgyzstan
| | - Amjad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan.,Universal Scientific Education and Research Network (USERN), Islamabad, Pakistan
| | - Mariya Ivanovska
- Department of Microbiology and Immunology, Research Center, Medical University, Plovdiv, Bulgaria.,Universal Scientific Education and Research Network (USERN), Plovdiv, Bulgaria
| | - Sara A Makka
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.,Universal Scientific Education and Research Network (USERN), Beirut, Lebanon
| | - Fareeda Hashem
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Manama, Bahrain
| | - Leander Marquez
- College of Social Sciences and Philosophy, University of the Philippines Diliman, Quezon City, Philippines.,Universal Scientific Education and Research Network (USERN), Quezon City, Philippines
| | - Orsolya Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.,Universal Scientific Education and Research Network (USERN), Budapest, Hungary
| | - Igor Salerno Filgueiras
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Universal Scientific Education and Research Network (USERN), São Paulo, Brazil
| | - Dennyson Leandro M Fonseca
- Universal Scientific Education and Research Network (USERN), São Paulo, Brazil.,Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Essouma Mickael
- Department of Rheumatology and Physical Medicine, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Universal Scientific Education and Research Network (USERN), Yaoundé, Cameroon
| | - Irene Ling
- School of Science, Monash University Malasia, Jalan Lagoon Selatan, Darul Ehsan, Selangor, Malaysia.,Universal Scientific Education and Research Network (USERN), Darul Ehsan, Selangor, Malaysia
| | - Amanuel Godana Arero
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Addis Ababa, Ethiopia
| | - Sarah Cuschieri
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Universal Scientific Education and Research Network (USERN), Valletta, Malta
| | - Kseniia Minakova
- National Technical University "Kharkiv Polytechnic Institute", Kharkiv, Ukraine.,Universal Scientific Education and Research Network (USERN), Kyiv, Ukraine
| | - Eduardo Rodríguez-Román
- Center for Microbiology and Cell Biology, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela.,Universal Scientific Education and Research Network (USERN), Caracas, Venezuela
| | - Sunny O Abarikwu
- Department of Biochemistry, University of Port Harcourt, Choba, Nigeria.,Universal Scientific Education and Research Network (USERN), Choba, Nigeria
| | - Attig-Bahar Faten
- Tunisia Polytechnic School, University of Carthage, Tunis, Tunisia.,Universal Scientific Education and Research Network (USERN), Tunis, Tunisia
| | - Giulia Grancini
- Department of Chemistry, Physical Chemistry Unit, University of Pavia, Pavia, Italy.,Universal Scientific Education and Research Network (USERN), Pavia, Italy
| | - Otavio Cabral-Marques
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Universal Scientific Education and Research Network (USERN), São Paulo, Brazil.,Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Nima Rezaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Agbim U, Cseprekal O, Yazawa M, Talwar M, Balaraman V, Bhalla A, Podila PSB, Maliakkal B, Nair S, Eason JD, Molnar MZ. Factors associated with hepatitis C antibody seroconversion after transplantation of kidneys from hepatitis C infected donors to hepatitis C naïve recipients. Ren Fail 2021; 42:767-775. [PMID: 32729359 PMCID: PMC7472509 DOI: 10.1080/0886022x.2020.1798784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background We aimed to assess the probability and factors associated with the presence of hepatitis C virus (HCV) antibody among HCV seronegative kidney transplant recipients receiving HCV-infected (nucleic acid testing positive) donor kidneys. Methods This is a retrospective review examining HCV antibody seroconversion of all kidney transplant recipients receiving an organ from an HCV-infected donor between 1 March 2018 and 2 December 2019 at a high-volume kidney transplant center in the southeast United States. Results Of 97 patients receiving HCV-infected kidneys, the final cohort consisted of 85 recipients with 5 (5.9%) recipients noted to have HCV antibody seroconversion in the setting of HCV viremia. The HCV RNA level at closest time of antibody measurement was higher in the seroconverted patients versus the ones who never converted [median and (interquartile range): 1,091,500 (345,000–8,360,000) vs 71,500 (73–313,000), p = 0.02]. No other significant differences including type of immunosuppression were noted between the HCV antibody positive group and HCV antibody negative group. Donor donation after cardiac death status [Odds Ratio (OR) and 95% Confidence Interval (CI) was: 8.22 (1.14–59.14)], donor age [OR (95% CI) (+5 years) was: 3.19 (1.39–7.29)] and Kidney Donor Profile Index [OR (95% CI) (+1) was:1.07 (1.01–1.15)] showed a statistically significant association with HCV seroconversion. Conclusions HCV antibody should not be considered routine screening for presence of infection in previously HCV naïve kidney transplant recipients receiving kidneys from HCV-infected donors, as only a modest percentage have antibody despite active viremia. The assessment of HCV viral load should be routine in all transplant recipients receiving organs from public health service increased risk donors.
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Affiliation(s)
- Uchenna Agbim
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
| | - Orsolya Cseprekal
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Masahiko Yazawa
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Division of Nephrology and Hypertension, St. Marianna University School of Medicine, Tokyo, Japan
| | - Manish Talwar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Vasanthi Balaraman
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anshul Bhalla
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Pradeep S B Podila
- Faith and Health Division, Methodist Le Bonheur Healthcare, Memphis, TN, USA.,Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Benedict Maliakkal
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Satheesh Nair
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - James D Eason
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Miklos Z Molnar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
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5
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Husen P, Boffa C, Jochmans I, Krikke C, Davies L, Mazilescu L, Brat A, Knight S, Wettstein D, Cseprekal O, Banga N, Bellini MI, Szabo L, Ablorsu E, Darius T, Quiroga I, Mourad M, Pratschke J, Papalois V, Mathe Z, Leuvenink HGD, Minor T, Pirenne J, Ploeg RJ, Paul A. Oxygenated End-Hypothermic Machine Perfusion in Expanded Criteria Donor Kidney Transplant: A Randomized Clinical Trial. JAMA Surg 2021; 156:517-525. [PMID: 33881456 DOI: 10.1001/jamasurg.2021.0949] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Importance Continuous hypothermic machine perfusion during organ preservation has a beneficial effect on graft function and survival in kidney transplant when compared with static cold storage (SCS). Objective To compare the effect of short-term oxygenated hypothermic machine perfusion preservation (end-HMPo2) after SCS vs SCS alone on 1-year graft survival in expanded criteria donor kidneys from donors who are brain dead. Design, Setting, and Participants In a prospective, randomized, multicenter trial, kidneys from expanded criteria donors were randomized to either SCS alone or SCS followed by end-HMPo2 prior to implantation with a minimum machine perfusion time of 120 minutes. Kidneys were randomized between January 2015 and May 2018, and analysis began May 2019. Analysis was intention to treat. Interventions On randomization and before implantation, deceased donor kidneys were either kept on SCS or placed on HMPo2. Main Outcome and Measures Primary end point was 1-year graft survival, with delayed graft function, primary nonfunction, acute rejection, estimated glomerular filtration rate, and patient survival as secondary end points. Results Centers in 5 European countries randomized 305 kidneys (median [range] donor age, 64 [50-84] years), of which 262 kidneys (127 [48.5%] in the end-HMPo2 group vs 135 [51.5%] in the SCS group) were successfully transplanted. Median (range) cold ischemia time was 13.2 (5.1-28.7) hours in the end-HMPo2 group and 12.9 (4-29.2) hours in the SCS group; median (range) duration in the end-HMPo2 group was 4.7 (0.8-17.1) hours. One-year graft survival was 92.1% (n = 117) in the end-HMPo2 group vs 93.3% (n = 126) in the SCS group (95% CI, -7.5 to 5.1; P = .71). The secondary end point analysis showed no significant between-group differences for delayed graft function, primary nonfunction, estimated glomerular filtration rate, and acute rejection. Conclusions and Relevance Reconditioning of expanded criteria donor kidneys from donors who are brain dead using end-HMPo2 after SCS does not improve graft survival or function compared with SCS alone. This study is underpowered owing to the high overall graft survival rate, limiting interpretation. Trial Registration isrctn.org Identifier: ISRCTN63852508.
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Affiliation(s)
- Peri Husen
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Catherine Boffa
- Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom
| | - Ina Jochmans
- Transplant Research Group, Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Christina Krikke
- Department of Surgery, University Medical Center Groningen, the Netherlands
| | - Lucy Davies
- Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom
| | - Laura Mazilescu
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Aukje Brat
- Department of Surgery, University Medical Center Groningen, the Netherlands
| | - Simon Knight
- Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom
| | - Daniel Wettstein
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Orsolya Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.,International Nephrology Research and Training Center (INRTC), Budapest, Hungary
| | - Neal Banga
- Department of General Surgery, Royal Free Hospital, London, United Kingdom
| | | | - Laszlo Szabo
- Nephrology and Transplant Directorate, University Hospital of Wales, Cardiff, United Kingdom
| | - Elijah Ablorsu
- Nephrology and Transplant Directorate, University Hospital of Wales, Cardiff, United Kingdom
| | - Tom Darius
- Surgery and Abdominal Transplant Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Isabel Quiroga
- Oxford University Hospitals, NHS Foundation Trust, Oxford, United Kingdom
| | - Michel Mourad
- Surgery and Abdominal Transplant Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | | | - Zoltan Mathe
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.,Department of Transplantation and Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Thomas Minor
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jacques Pirenne
- Transplant Research Group, Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Rutger J Ploeg
- Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom
| | - Andreas Paul
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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6
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Yazawa M, Fülöp T, Cseprekal O, Talwar M, Balaraman V, Bhalla A, Azhar A, Kovesdy CP, Eason JD, Molnar MZ. The incidence of cytomegalovirus infection after deceased-donor kidney transplantation from hepatitis-C antibody positive donors to hepatitis-C antibody negative recipients. Ren Fail 2020; 42:1083-1092. [PMID: 33100098 PMCID: PMC7594852 DOI: 10.1080/0886022x.2020.1835675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Deceased-donor kidney transplantation (KT) from hepatitis C (HCV)-infected donors into HCV-uninfected recipients (HCV D+/R-) could become standard care in the near future. However, HCV viral replication by viral transmission might lead to a higher incidence of cytomegalovirus (CMV) infection in these recipients. METHODS A national-registry-based retrospective cohort study was conducted using the Scientific Registry of Transplant Recipients (SRTR) data set. We assessed the incidence of CMV infection in HCV antibody (Ab) negative recipients receiving kidneys from HCV Ab positive (HCVAb D+/R-) and negative (HCVAb D-/R-) donors. The risk of CMV infection was analyzed by Cox regression analysis in a propensity score (PS) matched-cohort of HCVAb D+/R- (n = 950) versus HCVAb D-/R- (n = 950). Sensitivity analysis was also conducted in the entire cohort (n = 181 082). RESULTS The mean age at baseline was 54 years, 75% were male, and 55% of the patients were African American in PS-matched cohort. Compared to the HCVAb D-/R - patients, recipients with HCVAb D+/R - showed identical probability for the incidence of CMV infection (Hazard Ratio (HR) = 1.00, 95% Confidence Interval (CI): 0.82-1.22). In the sensitivity analysis, compared to the HCVAb D-/R - patients, the HCVAb D+/R - group had a significantly lower risk of CMV infection in the unadjusted analysis (HR = 0.75, 95%CI: 0.65-0.85), while this risk difference disappeared after the adjusted analysis (HR = 0.99, 95%CI: 0.87-1.14). CONCLUSION The incidence of CMV infection was similar in recipients who received HCVAb D + and HCVAb D - KT. Further studies are needed to assess this association in KT from HCV nucleic acid positive donors.
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Affiliation(s)
- Masahiko Yazawa
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tibor Fülöp
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
- Medicine Service, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Orsolya Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Manish Talwar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Vasanthi Balaraman
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anshul Bhalla
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ambreen Azhar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Csaba P. Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, TN, USA
| | - James D. Eason
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Miklos Z. Molnar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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7
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Yazawa M, Cseprekal O, Helmick RA, Talwar M, Balaraman V, Podila PSB, Fossey S, Satapathy SK, Eason JD, Molnar MZ. Association between longer hospitalization and development of de novo donor specific antibodies in simultaneous liver-kidney transplant recipients. Ren Fail 2020; 42:40-47. [PMID: 31875761 PMCID: PMC6968335 DOI: 10.1080/0886022x.2019.1705338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: De novo Donor Specific Antibodies (DSA) are considered as a risk factor for the kidney allograft outcomes in recipients after simultaneous liver-kidney transplantation (SLKT). We hypothesized that length of hospital stay (LOS) might be associated with de novo DSA development of due to the increased likelihood of receiving blood transfusions with reduced immunosuppressive regimens.Methods: This study is a single-center, retrospective cohort study consisting of 85 recipients who underwent SLKT from 2009 to 2018 in our hospital. We divided the patients into two groups according to LOS [long hospital stay (L) group (LOS >14 days) and short hospital stay (S) group (LOS ≤14 days)]. Propensity score (PS) has been created using logistic regression to predict LOS greater than median of 14 days. The association between the presence of de novo DSA and LOS was assessed by logistic regression models adjusted for PS.Results: The mean age at transplantation of the entire cohort was 55.5 ± 10.1 years. Sixty percent of the recipients were male and Caucasian. Median LOS in (L) group was three-fold longer than (S) group [L: median 30 days (IQR: 21-52), S: median 8.5 days (IQR: 7-11)]. Eight patients developed de novo DSA after SLKT (9.4%), all of them were in (L) group. Longer LOS was significantly associated with higher risk of development of de novo DSA in unadjusted (OR+ each 5 days: 1.09, 95% CI:1.02-1.16) and PS adjusted (OR+ each 5 days: 1.11, 95% CI:1.02-1.21) analysis.Conclusion: Longer hospitalization is significantly associated with the development of de novo DSA in SLKT.
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Affiliation(s)
- Masahiko Yazawa
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Orsolya Cseprekal
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Ryan A Helmick
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Manish Talwar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Vasanthi Balaraman
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Pradeep S B Podila
- Faith and Health Division, Methodist Le Bonheur Healthcare, Memphis, TN, USA.,Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | - Sanjaya K Satapathy
- Sandra Atlas Bass Center for Liver Diseases and Transplantation, Department of Medicine, Northshore University Hospital/Northwell Health, Manhasset, NY, USA
| | - James D Eason
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Miklos Z Molnar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.,Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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8
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Cseprekal O, Marton A, Molnar S, Patonai A, Fintha A, Micsik T, Török S, Mathe Z, Wagner L, Kobori L, Remport A. P1758TOCILIZUMAB TREATMENT IN DSA POSITIVE ANTIBODY MEDIATED REJECTION AMONG KIDNEY TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Pretransplant or de novo donor specific antibodies (DSA) may lead to active or chronic active antibody mediated rejection (a and cABMR) as leading cause of graft loss after kidney transplantation. There is no treatment protocol approved for ABMR. Anti Il-6 tocilizumab (TCZ), inhibitor of DSA production, is a potential approach to stabilize kidney allograft function, however, evidence based results are not available.
In our retrospective case series analysis, we assessed the changes in DSA and eGFR during and at the end of treatment with TCZ.
Method
In our single center case series analysis, 10 kidney transplant patients with biopsy proven ABMR (aABMR 6, cABMR 4, age 43±10.5ys, 6 males, time since transplantation 18(2-119)months, 7 first transplant, serum creatinine 224±80 umol/L at baseline) were studied between January 2017 – June 2019. Total plasma exchange (PE) (5x) was followed by TCZ (8 mg/kg, 1x monthly for 6 months) in case of a and cABMR. Intravenous immunoglobulin (IVIG, 1gr/kg) was added in case of aABMR. Routine laboratory parameters and DSA were reported retrospectively.
Results
6 aABMR patients completed the treatment protocol. Class I DSA decreased significantly (MFI 4457(635-14084) vs. 877(595-5678); p=0.007), but Class II DSA remained the same during the treatment (MFI 4725 (586-17615) vs. 8097 (671-14636) p=NS). eGFR of aABMR patients and 1 cABMR patient were stabilized. 3 cABMR patients returned to dialysis. Reversible elevation of liver transaminases were detected in three patients. There was no any serious adverse event recorded.
Conclusion
The opportunely timed TCZ seems to be effective in reducing Class I DSA and stabilize graft function in patients with aABMR. Further studies are needed to prove the long-term efficacy and the exact role of TCZ in cABMR among kidney transplant patients.
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Affiliation(s)
- Orsolya Cseprekal
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Adrienn Marton
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Sara Molnar
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Attila Patonai
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Attila Fintha
- Semmelweis University, Ist. Department of Pathology, Budapest, Hungary
| | - Tamás Micsik
- Semmelweis University, Ist. Department of Pathology, Budapest, Hungary
| | - Szilárd Török
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Zsolt Mathe
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Laszlo Wagner
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Laszlo Kobori
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Adam Remport
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
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9
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Cseprekal O, Marton A, Török S, Mucsi I, Wagner L, Remport A, Molnar MZ. P1666ASSOCIATION OF TACROLIMUS TROUGH LEVEL AND DAILY DOSE RATIO WITH OUTCOMES IN A PROSPECTIVE PREVALENT COHORT OF KIDNEY TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Tacrolimus is an integral part of the immunosuppressive regimen after solid organ transplantation. Due to its narrow therapeutic window, it requires frequent serum trough level (C0) monitoring and dose adjustment. Both over-and under treatment may have harmful effects regarding overall mortality and graft survival due to increased risk of cardiovascular diseases, malignancies, new onset diabetes and rejection. C0 and total daily dose ratio (CD) has recently been suggested as a potential predictor of worse graft outcome in the early period after transplantation, however, long term prospective studies are lacking. We hypothesized the association between lower CD ratio and increased risk of death with functioning graft (DWFG), graft loss (GL) and overall death (D) in our prospective cohort study.
Method
Our study included 386 prevalent kidney transplant recipients (205(53%) males, median and IQR age of 47.5 (13.2) years, eGFR 53.5 (22.5) ml/min/1.73m2, time since last transplant 51 (26-79) months) out of a total of 993 enrolled between 2006-2007. Sociodemographic, past medical history, clinical and laboratory data were collected and CD was recorded at baseline and 1 year after the enrollment. The associations between CD and CD2 ratios and above mentioned outcomes were examined using survival models..
Results
The median and IQR of CD was 2.1(1.4-3.2) at baseline and 2.0 (1.3-3.0) 1 year later (CD2). There was 46 (11.9%) DWFG, 79 (20.5%) GL and 68 (17.6%) D, respectively. After adjustment for important confounders (age, gender, eGFR, Charlson score, dialysis duration, donor age, rejection), neither CD (DWGL: HR 0.56(0.30-1.03) p=0.06; GL: HR 0.82(0.50-1.36) p=0.46; D: HR 0.79(0.48-1.32) p=0.38) nor CD2 (DWGL: HR 1.12(0.54-2.31) p=0.74; GL: HR 0.76(0.61-1.97) p=0.78; D: HR 1.19(0.64-2.20) p=0.59) found to be predictors of the outcomes.
Conclusion
CD ratio was not associated with increased risk of death with functioning graft, graft loss or overall death in our prevalent kidney transplant recipients.
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Affiliation(s)
- Orsolya Cseprekal
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Adrienn Marton
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Szilárd Török
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Istvan Mucsi
- University Health Network, Kidney Transplant Program Toronto General Hospital, Toronto, Canada
| | - Laszlo Wagner
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Adam Remport
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Miklos Zsolt Molnar
- James D Eason Transplant Institute, Methodist University Hospital, Memphis, United States of America
- University of Tennessee Health Science Center, Department of Surgery, Memphis, United Kingdom
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10
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Cseprekal O, Marton A, Török S, Patonai A, Földes K, Wagner L, Molnar MZ, Mathe Z, Kobori L, Remport A. P1774CONVERSION FROM TWICE-DAILY TACROLIMUS (TAC-IR) TO ONCE-DAILY EXTENDED RELEASE TACROLIMUS (LCPT) IN EVEROLIMUS TREATED STABLE KIDNEY TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Stable kidney transplant patients (KTX) treated according to TRANSFORM study protocol (TAC-IR + everolimus (EVR) + corticosteroid) were converted from twice daily TAC-IR to novel (MELT-dose) once-daily tacrolimus formulation (LCPT) on a 1:0.7 total daily dose (TDD) basis. Tolerability, safety, and trough level (Co) – TDD characteristics of the conversion (CV) was analyzed in a single center retrospective observational study.
Method
Between Sep. 2017 and Aug. 2018 38 KTX recipients were included. Pre- and post-CV TAC TDD, Co and TAC Co/D as well as EVR TDD and Co data were evaluated 4, 2 weeks before and 4 consecutive times after CV (94 (74-112 median IQR) post-transplant days). Pre- and post-CV eGFR, routine lab parameters and occurrence of adverse events were also investigated.
Results
In one patient 2 weeks after CV EVR was stopped due to infection, 37 KTX (males 22 (58%), age 54 (42-63) years) finished the entire observational period. According to CV protocol the median TDD of LCPT was lower than pre-CV TAC-IR at each visit: 4.5(3.5-7) mg/day pre-CV versus 3.5 (2.5-5), 3.6 (2.5-5), 3.5 (2.5-5) and 3.5 (2-5) (p<0.001) post-CV. Mean TAC Co decreased from pre-CV Co 7.8 (6.4-9.5) ng/ml to 6.7 (4.8, 8.6), 7.0 (5.2, 9.6), 6.5 (5.7, 8.4) and 7.2 (5.4, 8.7) (p<0.001). LCPT Co /TDD did not change: 1.6 (1.1-2.5) pre- and 2.1 (1.1- 2.9), 2.1 (1.1- 4.1), 1.6 (1.3- 3.5), 2.0 (1.4-4.1) (p = 0.18) post-CV. EVR Co /TDD (1.6 (1.3-2.1), 1.6 (1.3; 2.3), 1.6 (1.3-2.0), 1.6 (1.2-2.2)) remained similar to pre-CV: 1.6 (1.4- 2.4) (p = 0.65). There was no change in eGFR, hemoglobin levels and no drug related adverse event was observed during the study period.
Conclusion
Conversion from TAC-IR to LCPT in everolimus treated stable KTX recipients resulted in a significant post-CV decrease in TAC- Co, whilst Co/TDD remained unchanged. The conversion was safe and had no effect on EVR Co and TDD. Further investigations are needed to define optimal TAC-IR to LCPT conversion dose rate.
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Affiliation(s)
- Orsolya Cseprekal
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Adrienn Marton
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Szilárd Török
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Attila Patonai
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Katalin Földes
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Laszlo Wagner
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Miklos Zsolt Molnar
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
- James D Eason Transplant Institute, Methodist University Hospital, Memphis, United States of America
- University of Tennessee Health Science Center, Department of Surgery, Memphis, United States of America
| | - Zoltan Mathe
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Laszlo Kobori
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
| | - Adam Remport
- Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary
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11
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Talwar M, Balaraman V, Bhalla A, Cseprekal O, Yazawa M, Podila PSB, Azhar A, Cossey LN, Eason JD, Molnar MZ. Validation of Prognostic Index for Allograft Outcome in Kidney Transplant Recipients With Transplant Glomerulopathy. Kidney Int Rep 2020; 5:915-920. [PMID: 32518874 PMCID: PMC7271004 DOI: 10.1016/j.ekir.2020.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/02/2020] [Accepted: 03/30/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Manish Talwar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Vasanthi Balaraman
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Anshul Bhalla
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Orsolya Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Masahiko Yazawa
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Divison of Nephrology and Hypertension, St. Marianna University School of Medicine, Tokyo, Japan
| | - Pradeep S B Podila
- Faith & Health Division, Methodist Le Bonheur Healthcare, Memphis, Tennessee, USA.,Division of Health Systems Management & Policy, School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Ambreen Azhar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | - James D Eason
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Miklos Z Molnar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.,Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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12
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Yazawa M, Cseprekal O, Helmick RA, Talwar M, Balaraman V, Podila PS, Agbim UA, Maliakkal B, Fossey S, Satapathy SK, Sumida K, Kovesdy CP, Nair S, Eason JD, Molnar MZ. Lack of Association between Pretransplant Donor-Specific Antibodies and Posttransplant Kidney Outcomes in Simultaneous Liver-Kidney Transplant Recipients with Rabbit Anti-Thymocyte Globulin Induction and Steroid-Free Protocol. Nephron Clin Pract 2020; 144:126-137. [DOI: 10.1159/000505460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/15/2019] [Indexed: 11/19/2022] Open
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13
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Yazawa M, Cseprekal O, Helmick RA, Talwar M, Balaraman V, Podila PSB, Agbim UA, Maliakkal B, Fossey S, Satapathy SK, Sumida K, Kovesdy CP, Nair S, Eason JD, Molnar MZ. Association between post‐transplant donor‐specific antibodies and recipient outcomes in simultaneous liver–kidney transplant recipients: single‐center, cohort study. Transpl Int 2019; 33:202-215. [DOI: 10.1111/tri.13543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/25/2019] [Accepted: 10/18/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Masahiko Yazawa
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
- Division of Nephrology and Hypertension Department of Internal Medicine St. Marianna University School of Medicine Kawasaki Japan
| | - Orsolya Cseprekal
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
- Department of Transplantation and Surgery Semmelweis University Budapest Hungary
| | - Ryan A. Helmick
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
| | - Manish Talwar
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
| | - Vasanthi Balaraman
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
| | - Pradeep S. B. Podila
- Faith & Health Division Methodist Le Bonheur Healthcare Memphis TN USA
- Division of Health Systems Management & Policy School of Public Health The University of Memphis Memphis TN USA
| | - Uchenna A. Agbim
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
| | - Benedict Maliakkal
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
| | | | - Sanjaya K. Satapathy
- Department of Medicine Sandra Atlas Bass Center for Liver Diseases & Transplantation Northshore University Hospital/Northwell Health Manhasset NY USA
| | - Keiichi Sumida
- Division of Nephrology Department of Medicine University of Tennessee Health Science Center Memphis TN USA
| | - Csaba P. Kovesdy
- Division of Nephrology Department of Medicine University of Tennessee Health Science Center Memphis TN USA
- Nephrology Section Memphis Veterans Affairs Medical Center Memphis TN USA
| | - Satheesh Nair
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
| | - James D. Eason
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
| | - Miklos Z. Molnar
- James D. Eason Transplant Institute Methodist University Hospital Memphis TN USA
- Division of Transplant Surgery Department of Surgery University of Tennessee Health Science Center Memphis TN USA
- Department of Transplantation and Surgery Semmelweis University Budapest Hungary
- Division of Nephrology Department of Medicine University of Tennessee Health Science Center Memphis TN USA
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14
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Molnar MZ, Nair S, Cseprekal O, Yazawa M, Talwar M, Balaraman V, Podila PSB, Mas V, Maluf D, Helmick RA, Campos L, Nezakatgoo N, Eymard C, Horton P, Verma R, Jenkins AH, Handley CR, Snyder HS, Cummings C, Agbim UA, Maliakkal B, Satapathy SK, Eason JD. Transplantation of kidneys from hepatitis C-infected donors to hepatitis C-negative recipients: Single center experience. Am J Transplant 2019; 19:3046-3057. [PMID: 31306549 DOI: 10.1111/ajt.15530] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 01/25/2023]
Abstract
Our aim was to evaluate the safety of transplanting kidneys from HCV-infected donors in HCV-uninfected recipients. Data collected from 53 recipients in a single center, observational study included donor and recipient characteristics, liver and kidney graft function, new infections and de novo donor-specific antibodies and renal histology. Treatment with a direct-acting antiviral regimen was initiated when HCV RNA was detected. The mean ± SD age of recipients was 53 ± 11 years, 34% were female, 19% and 79% of recipients were white and African American, respectively. The median and interquartile range (IQR) time between transplant and treatment initiation was 76 (IQR: 68-88) days. All 53 recipients became viremic (genotype: 1a [N = 34], 1b [N = 1], 2 [N = 3], and 3 [N = 15]). The majority (81%) of recipients did not experience clinically significant increases (>3 times higher than upper limit of the normal value) in aminotransferase levels and their HCV RNA levels were in the 5 to 6 log range. One patient developed fibrosing cholestatic hepatitis with complete resolution. All recipients completed antiviral treatment and 100% were HCV RNA-negative and achieved 12-week sustained virologic response. The estimated GFRs at end of treatment and 12-week posttreatment were 67 ± 21 mL/min/1.73 m2 and 67 ± 17 mL/min/1.73 m2 , respectively. Four recipients developed acute rejection. Kidney transplantation from HCV-infected donors to HCV-negative recipients should be considered in all eligible patients.
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Affiliation(s)
- Miklos Z Molnar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.,Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Satheesh Nair
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Orsolya Cseprekal
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Masahiko Yazawa
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.,Divison of Nephrology and Hypertension, St. Marianna University School of Medicine, Tokyo, Japan
| | - Manish Talwar
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Vasanthi Balaraman
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Pradeep S B Podila
- Faith & Health Division, Methodist Le Bonheur Healthcare, Memphis, Tennessee.,Division of Health Systems Management & Policy, School of Public Health, The University of Memphis, Memphis, Tennessee
| | - Valeria Mas
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Daniel Maluf
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Ryan A Helmick
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Luis Campos
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Nosratollah Nezakatgoo
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Corey Eymard
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Peter Horton
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Rajanshu Verma
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Ann Holbrook Jenkins
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee
| | - Charlotte R Handley
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee
| | - Heather S Snyder
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee
| | - Carolyn Cummings
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee
| | - Uchenna A Agbim
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Benedict Maliakkal
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Sanjaya K Satapathy
- Sandra Atlas Bass Center for Liver Diseases & Transplantation, Zucker School of Medicine at Hofstra, Department of Medicine, Northshore University Hospital/Northwell Health, Manhasset, New York
| | - James D Eason
- James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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15
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Siwakoti A, Potukuchi PK, Thomas F, Gaipov A, Talwar M, Balaraman V, Cseprekal O, Yazawa M, Streja E, Eason JD, Kalantar-Zadeh K, Kovesdy CP, Molnar MZ. History of posttraumatic stress disorder and outcomes after kidney transplantation. Am J Transplant 2019; 19:2294-2305. [PMID: 30672107 PMCID: PMC6650381 DOI: 10.1111/ajt.15268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 01/25/2023]
Abstract
A history of posttraumatic stress disorder (PTSD), if uncontrolled, represents a contraindication for kidney transplantation. However, no previous large study has assessed the association between pretransplant history of PTSD and posttransplantation outcomes. We examined 4479 US veterans who had undergone transplantation. The diagnosis of history of PTSD was based on a validated algorithm. Measured covariates were used to create a matched cohort (n = 560). Associations between pretransplant PTSD and death with functioning graft, all-cause death, and graft loss were examined in survival models. Posttransplant medication nonadherence was assessed using proportion of days covered (PDC). From among 4479 veterans, 282 (6.3%) had a history of PTSD. The mean age ± standard deviation (SD) of the cohort at baseline was 61 ± 11 years, 91% were male, and 66% and 28% of patients were white and African American, respectively. Compared to patients without a history of PTSD, patients with a history of PTSD had a similar risk of death with a functioning graft (subhazard ratio [SHR] 0.97, 95% confidence interval [CI] 0.61-1.54), all-cause death (1.05, 0.69-1.58), and graft loss (1.09, 0.53-2.26). Moreover, there was no difference in immunosuppressive drug PDC in patients with and without a history of PTSD (PDC: 98 ± 4% vs 99 ± 3%, P = .733 for tacrolimus; PDC: 99 ± 4% vs 98 ± 7%, P = .369 for mycophenolic acid). A history of PTSD in US veterans with end-stage renal disease should not on its own preclude a veteran from being considered for transplantation.
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Affiliation(s)
- Ashmita Siwakoti
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Praveen K. Potukuchi
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee,IHOP, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Fridtjof Thomas
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Abduzhappar Gaipov
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Manish Talwar
- Methodist University Hospital Transplant Institute, Memphis, Tennessee,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Vasanthi Balaraman
- Methodist University Hospital Transplant Institute, Memphis, Tennessee,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Orsolya Cseprekal
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Masahiko Yazawa
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Elani Streja
- Division of Nephrology, University of California, Irvine, California
| | - James D. Eason
- Methodist University Hospital Transplant Institute, Memphis, Tennessee,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Csaba P. Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee,Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee
| | - Miklos Z. Molnar
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee,Methodist University Hospital Transplant Institute, Memphis, Tennessee,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
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16
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Gaipov A, Cseprekal O, Potukuchi PK, Kabulbayev K, Remport A, Mathe Z, Talwar M, Balaraman V, Fülöp T, Eason JD, Mucsi I, Kovesdy CP, Molnar MZ. Association between malnutrition-inflammation score and risk of subsequent self-reported bone fractures in prevalent kidney transplant recipients. Osteoporos Int 2019; 30:611-620. [PMID: 30456573 DOI: 10.1007/s00198-018-4774-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/11/2018] [Indexed: 12/19/2022]
Abstract
UNLABELLED Chronic inflammation and protein energy wasting (PEW) syndrome are common in kidney transplant recipients (KTR). The presence of inflammation and PEW syndrome can directly affect bone resorption and bone formation, leading to bone loss and fractures. We showed PEW is independently associated with new clinically detected bone fractures in prevalent KTR. INTRODUCTION Kidney transplant recipients (KTR) have a 4-fold higher risk of fracture compared to the general population. Chronic inflammation and PEW syndrome are common in KTR and are associated with poor outcomes. We hypothesized that the Malnutrition-Inflammation Score (MIS), a validated measure of PEW, is associated with higher risk of bone fractures in KTR. METHODS This prospective cohort study included 839 prevalent KTR from a Central European academic center. MIS, a semiquantitative instrument of PEW, was calculated at the study entry. Self-reported history of fractures was recorded during the 2-year follow-up period. The association between MIS and bone fractures was examined in logistic regression analyses with adjustment for age, gender, eGFR, smoking habits, history of pre-transplant bone fractures, and acute rejection. RESULTS Mean age was 51 ± 13 years, and 56% of patients were males with median (interquartile range) transplant vintage 69 (38-112) months, estimated glomerular filtration rate 55 ± 21 ml/min/1.73 m2, and calculated MIS 3 (2-4) at enrollment. Fifty-five (7%) patients experienced self-reported bone fractures during the 2-year follow-up period. Higher MIS score showed linear association with increased risk of fracture. Each one-point higher MIS was associated with 23% higher risk of bone fractures (odds ratio (OR) and 95% CI 1.23, 1.12-1.34), which remained significant after multivariable adjustments (OR 1.17, 95% CI 1.06-1.29). CONCLUSION The MIS is independently associated with new clinically detected bone fractures in prevalent KTR.
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Affiliation(s)
- A Gaipov
- Department of Medicine, Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Extracorporeal Hemocorrection, National Scientific Medical Center, Astana, Kazakhstan
| | - O Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - P K Potukuchi
- Department of Medicine, Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - K Kabulbayev
- Department of Nephrology, Kazakh National Medical University, Almaty, Kazakhstan
| | - A Remport
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Z Mathe
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - M Talwar
- Methodist Transplant Epidemiology Research Group, Methodist University Hospital Transplant Institute, 1211 Union Ave., Memphis, TN, 38104, USA
- Department of Surgery, Division of Transplant Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - V Balaraman
- Methodist Transplant Epidemiology Research Group, Methodist University Hospital Transplant Institute, 1211 Union Ave., Memphis, TN, 38104, USA
- Department of Surgery, Division of Transplant Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - T Fülöp
- Medical Services, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - J D Eason
- Methodist Transplant Epidemiology Research Group, Methodist University Hospital Transplant Institute, 1211 Union Ave., Memphis, TN, 38104, USA
- Department of Surgery, Division of Transplant Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - I Mucsi
- Department of Medicine, Division of Nephrology and Multiorgan Transplant Program, University Health Network, University of Toronto, Toronto, Canada
| | - C P Kovesdy
- Department of Medicine, Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, TN, USA
| | - M Z Molnar
- Department of Medicine, Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA.
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
- Methodist Transplant Epidemiology Research Group, Methodist University Hospital Transplant Institute, 1211 Union Ave., Memphis, TN, 38104, USA.
- Department of Surgery, Division of Transplant Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
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Gaipov A, Jackson CD, Talwar M, Balaraman V, Chakravarty A, Cseprekal O, Mathe Z, Remport A, Kovesdy CP, Eason JD, Mucsi I, Molnar MZ. Association Between Serum Prealbumin Level and Outcomes in Prevalent Kidney Transplant Recipients. J Ren Nutr 2019; 29:188-195. [PMID: 30819599 DOI: 10.1053/j.jrn.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/07/2018] [Accepted: 01/07/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE(S) Prealbumin, a transport protein mostly synthesized in the liver, is a marker of nutrition. Although decreased prealbumin levels are associated with increased mortality in end-stage kidney disease patients, its association with mortality in kidney transplant recipients remains unknown. We evaluated the association between prealbumin levels and outcomes in kidney transplant recipients. DESIGN This was a prospective prevalent cohort study. This study included 991 kidney transplant recipients enrolled from December 31, 2006, to December 31, 2007, and followed over a 6-year period. Sociodemographic, past medical history, clinical, and laboratory data were collected at the study entry. Associations between prealbumin levels and death with functioning graft, all-cause mortality, and graft loss were examined using survival models. RESULTS Serum prealbumin levels showed significant negative correlation with estimated glomerular filtration rate (R = -0.28; P < .001) and high-sensitive C-reactive protein (R = -0.24; P < .001). Each 5 mg/dL lower serum prealbumin level was associated with 20% higher risk of death with functioning graft (subdistribution hazard ratio [95% confidence interval]: 1.20 [1.08-1.35]; P = .001), which persisted after multivariable adjustments (subdistribution hazard ratio [95% confidence interval]: 1.13 [1.00-1.28]; P = .039). Qualitatively similar trend was observed in all-cause mortality; however, there was no association between prealbumin levels and graft loss. CONCLUSION(S) Lower serum prealbumin level is associated with increased risk of death with functioning graft in prevalent kidney transplant recipients.
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Affiliation(s)
- Abduzhappar Gaipov
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Christopher D Jackson
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Manish Talwar
- James D Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Vasanthi Balaraman
- James D Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Arijit Chakravarty
- James D Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Orsolya Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Zoltan Mathe
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Adam Remport
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Csaba P Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee
| | - James D Eason
- James D Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Istvan Mucsi
- Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Canada
| | - Miklos Z Molnar
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; James D Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
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Barczi A, Degi A, Cseprekal O, Fekete A, Reusz G. FP765CARDIOVASCULAR RISK FACTORS IN LONGTERM FOLLOW-UP AFTER PEDIATRIC KIDNEY TRANSPLANTATION. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Adrienn Barczi
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Arianna Degi
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Orsolya Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Andrea Fekete
- "Lendület" Diabetes Research Group, MTA-SE, Budapest, Hungary
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Gyorgy Reusz
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
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Korosi B, Laszlo A, Tabak A, Batta D, Lenart L, Fekete A, Eorsi D, Cseprekal O, Tisler A, Nemcsik-Bencze Z, Gonda X, Rihmer Z, Nemcsik J. The impact of currently recommended antihypertensive therapy on depression and other psychometric parameters: preliminary communication. Neuropsychopharmacol Hung 2017; 19:11-22. [PMID: 28467955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIMS Current evidence on the psychological effects of antihypertensive medications is controversial. The aim of this study was to evaluate the effect of current antihypertensive medication on different psychometric parameters and on serum brain-derived neurotrophic factor (BDNF) level. METHODS Psychometric, haemodynamic, arterial stiffness and laboratory parameters were evaluated before and 3 months after the initiation of antihypertensive medication in untreated hypertensive patients (HT, n=31), and once in healthy controls (CONT, n=22). Subjects completed the following psychometric tests: Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAM-A), Symptom Checklist 90 Revised (SCL-90), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire, Big Five Inventory, Pain Vigilance and Awareness Questionnaire and Berkeley Expressivity Questionnaire. Amlodipine and/or perindopril compounds were preferred medications. Serum BDNF was measured with ELISA. RESULTS Brachial systolic blood pressure, as well as pulse wave velocity were significantly improved in the HT group over the 3-month follow-up (153.3±15.9 mmHg vs. 129.5±10.0 mmHg and 8.2±1.4 m/s vs 7.5±1.6 m/s, respectively). Similarly, we found improvements in BDI (0.73 points) and in several Scl-90 subscales. Serum BDNF was not different between CONT and HT and did not change for therapy. CONCLUSIONS Our results indicate that initiation of currently recommended antihypertensive medications in newly diagnosed patients may have a significant impact on psychological well-being of patients and could influence quality of life as well.
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Affiliation(s)
- Beata Korosi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary.
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20
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Affiliation(s)
- George Reusz
- Ist Department of Paediatrics, Semmelweis University Budapest, Budapest, Hungary.
| | - Orsolya Cseprekal
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Arianna Degi
- Ist Department of Paediatrics, Semmelweis University Budapest, Budapest, Hungary
| | - Eva Kis
- Gottsegen György National Institute of Cardiology, Budapest, Hungary
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21
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Nemcsik J, Cseprekal O, Egresits J, Járai Z, Farkas K, Fodor E, Kerkovits L, Babos L, Zs N, Marton A, Godina G, Sallai L, Kiss I, Tislér A. P1.26 MICROVASCULAR REACTIVITY PARAMETERS FAIL TO PREDICT CARDIOVASCULAR EVENTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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22
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Cseprekal O, Zs N, Marton A, Vámos E, Nemcsik J, Egresits J, El Hajd Othmane T, Fekete B, Gy D, Kiss I, Tislér A. P4.26 ASSOCIATIONS BETWEEN FGF23-LEVEL AND ARTERIAL DISTENSIBILITY IN CHRONIC KIDNEY DISEASE. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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23
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Shi H, Wen J, LI Z, Elsayed M, Kamal K, LI Z, Wen J, Shi H, El Shal A, Youssef D, Caubet C, Lacroix C, Benjamin B, Bandin F, Bascands JL, Monsarrat B, Decramer S, Schanstra J, Laetitia DB, Ulinski T, Aoun B, Ozdemir K, Dincel N, Sozeri B, Mir S, Dincel N, Berdeli A, Mir S, Akyigit F, Mizerska-Wasiak M, Panczyk-Tomaszewska M, Szymanik-Grzelak H, Roszkowska-Blaim M, Jamin A, Dehoux L, Monteiro RC, Deschenes G, Bouts A, Davin JC, Dorresteijn E, Schreuder M, Lilien M, Oosterveld M, Kramer S, Gruppen M, Pintos-Morell G, Ramaswami U, Parini R, Rohrbach M, Kalkum G, Beck M, Carter M, Antwi S, Callegari J, Kotanko P, Levin NW, Rumjon A, Macdougall IC, Turner C, Booth CJ, Goldsmith D, Sinha MD, Camilla R, Camilla R, Loiacono E, Donadio ME, Conrieri M, Bianciotto M, Bosetti FM, Peruzzi L, Conti G, Bitto A, Amore A, Coppo R, Mizerska-Wasiak M, Roszkowska-Blaim M, Maldyk J, Chou HH, Chiou YY, Bochniewska V, Jobs K, Jung A, Fallahzadeh Abarghooei MH, Zare J, Sedighi Goorabi V, Derakhshan A, Basiratnia M, Fallahzadeh Abarghooei MA, Hosseini Al-Hashemi G, Fallahzadeh Abarghooei F, Kluska-Jozwiak A, Soltysiak J, Lipkowska K, Silska M, Fichna P, Skowronska B, Stankiewicz W, Ostalska-Nowicka D, Zachwieja J, Girisgen L, Sonmez F, Yenisey C, Kis E, Cseprekal O, Kerti A, Szabo A, Salvi P, Benetos A, Tulassay T, Reusz G, Makulska I, Szczepanska M, Drozdz D, Zwolnska D, Sozeri B, Berdeli A, Mir S, Tolstova E, Anis L, Ulinski T, Alber B, Edouard B, Gerard C, Seni K, Dunia Julienne Hadiza T, Christian S, Benoit T, Francois B, Adama L, Rosenberg A, Munro J, Murray K, Wainstein B, Ziegler J, Singh-Grewal D, Boros C, Adib N, Elliot E, Fahy R, Mackie F, Kainer G, Polak-Jonkisz D, Zwolinska D, Laszki-Szczachor K, Zwolinska D, Janocha A, Rusiecki L, Sobieszczanska M, Garzotto F, Ricci Z, Clementi A, Cena R, Kim JC, Zanella M, Ronco C, Polak-Jonkisz D, Zwolinska D, Purzyc L, Zwolinska D, Makulska I, Szczepanska M, Peco-Antic A, Kotur-Stevuljevic J, Paripovic D, Scekic G, Milosevski-Lomic G, Bogicevic D, Spasojevic-Dimitrijeva B, Hassan R, El-Husseini A, Sobh M, Ghoneim M, Harambat J, Bonthuis M, Van Stralen KJ, Ariceta G, Battelino N, Jahnukainen T, Sandes AR, Combe C, Jager KJ, Verrina E, Schaefer F, Espindola R, Bacchetta J, Cochat P, Stefanis C, Leroy S, Leroy S, Fernandez-Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, Gurgoze M, Bressan S, Smolkin V, Tuerlinkx D, Stefanidis C, Vaos G, Leblond P, Gungor F, Gendrel D, Chalumeau M, Rumjon A, Macdougall IC, Turner C, Rawlins D, Booth CJ, Simpson JM, Sinha MD, Arnaud G, Arnaud G, Anne M, Stephanie T, Flavio B, Veronique FB, Stephane D, Mumford L, Marks S, Ahmad N, Maxwell H, Tizard J, Vidal E, Amigoni A, Varagnolo M, Benetti E, Ghirardo G, Brugnolaro V, Murer L, Aoun B, Christine G, Alber B, Ulinski T, Aoun B, Decramer S, Bandin F, Ulinski T, Degi A, Degi A, Kerti A, Kis E, Cseprekal O, Szabo AJ, Reusz GS, Ghirardo G, Vidoni A, Vidal E, Benetti E, Ramondo G, Miotto D, Murer L. Paediatric nephrology. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kis E, Cseprekal O, Degi A, Kerti A, Sallay P, Szabo A, Reusz G. P4.40 CARDIOVASCULAR DISEASE AFTER PEDIATRIC RENAL TRANSPLANTATION. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Reusz GS, Cseprekal O, Temmar M, Kis E, Cherif AB, Thaleb A, Fekete A, Szabó AJ, Benetos A, Salvi P. Reference Values of Pulse Wave Velocity in Healthy Children and Teenagers. Hypertension 2010; 56:217-24. [PMID: 20566959 DOI: 10.1161/hypertensionaha.110.152686] [Citation(s) in RCA: 204] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Carotid-femoral pulse wave velocity is an established method for characterizing aortic stiffness, an individual predictor of cardiovascular mortality in adults. Normal pulse wave velocity values for the pediatric population derived from a large data collection have yet to be available. The aim of this study was to create a reference database and to characterize the factors determining pulse wave velocity in children and teenagers. Carotid-femoral pulse wave velocity was measured by applanation tonometry. Reference tables from pulse wave velocities obtained in 1008 healthy subjects (aged between 6 and 20 years; 495 males) were generated using a maximum-likelihood curve-fitting technique for calculating SD scores in accordance with the skewed distribution of the raw data. Effects of sex, age, height, weight, blood pressure, and heart rate on pulse wave velocity were assessed. Sex-specific reference tables and curves for age and height are presented. Pulse wave velocity correlated positively (
P
<0.001) with age, height, weight, and blood pressure while correlating negatively with heart rate. After multiple regression analysis, age, height, and blood pressure remained major predictors of pulse wave velocity. This study, involving >1000 children, is the first to provide reference values for pulse wave velocity in children and teenagers, thereby constituting a suitable tool for longitudinal clinical studies assessing subgroups of children who are at long-term risk of cardiovascular disease.
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Affiliation(s)
- George S. Reusz
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Orsolya Cseprekal
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Mohamed Temmar
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Éva Kis
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Abdelghani Bachir Cherif
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Abddelhalim Thaleb
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Andrea Fekete
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Attila J. Szabó
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Athanase Benetos
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
| | - Paolo Salvi
- From the First Department of Pediatrics (G.S.R., O.C., E.K., A.F., A.J.S.), Semmelweis University, Budapest, Hungary; Telomere Cardiology Centre (M.T.), Ghardaia, Algeria; Department of Internal Medicine (A.B.C., A.T.), University of Blida, Blida, Algeria; Department of Internal Medicine and Geriatrics (A.B., P.S.), Institut National de la Santé et de la Recherche Médicale U961, University of Nancy, Nancy, France; Department of Internal Medicine (P.S.), University of Bologna, Bologna, Italy
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Cseprekal O, Kis E, Schaffer P, Othmane TEH, Fekete BC, Vannay A, Szabo AJ, Remport A, Szabo A, Tulassay T, Reusz GS. Pulse wave velocity in children following renal transplantation. Nephrol Dial Transplant 2008; 24:309-15. [DOI: 10.1093/ndt/gfn494] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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