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Expanding role of antibodies in kidney transplantation

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World Journal of transplantation 2025年第1期15卷 57-71页

作者： Khawar Abbas Muhammed Mubarak department of Transplant Immunology Sindh Institute of Urology&TransplantationKarachi 74200SindhPakistan Javed I.Kazi department of Histopathology Sindh Institute of Urology&TransplantationKarachi 74200SindhPakistan

The role of antibodies in kidney transplant(KT)has evolved significantly over the past few *** role of antibodies in KT is multifaceted,encompassing both the challenges they pose in terms of antibody-mediated rejection(AMR)and the opportunities for improving transplant outcomes through better detection,prevention,and treatment *** our understanding of the immunological mechanisms continues to evolve,so too will the approaches to managing and harnessing the power of antibodies in KT,ultimately leading to improved patient and graft *** narrative review explores the multifaceted roles of antibodies in KT,including their involvement in rejection mechanisms,advancements in desensitization protocols,AMR treatments,and their potential role in monitoring and improving graft survival.

关键词： Antibodies Humoral theory kidney transplantation Rejection

Predictive value of tacrolimus concentration/dose ratio in first posttransplant week for CYP3A5-polymorphism in kidney-transplant recipients

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World Journal of transplantation 2025年第2期15卷 197-204页

作者： Pham-Thai Dung Hoang-Xuan Su Nguyen-Chi Tue Nguyen-Huu Ben Nguyen-Minh Phuong Tuan-Ngoc Tran Phan-Ba Nghia Diem-Thi Van Nguyen Thi-Thuy Dung Hoang-Trung Vinh Lionel Rostaing Pham-Quoc Toan Center of Critical Care Medicine Emergency and Clinical ToxicologyMilitary HospitalHanoï100000Viet Nam Institute of Biomedicine and Pharmacy Vietnam Military Medical UniversityHanoï100000Viet Nam department of Post-Transplant Intensive Care and Treatment Center of Organ Transplantation-Military HospitalHanoï100000Viet Nam department of Occupational Medicine Vietnam Military Medical UniversityHanoï100000Viet Nam department of Military Medical Command and Organization Vietnam Military Medical UniversityHanoï100000Viet Nam department of nephrology and Dialysis Military HospitalHanoï100000Viet Nam department of nephrology HemodialysisApheresisand Kidney TransplantationGrenoble University HospitalGrenoble 38043Auvergne-Rhone-AlpesFrance

BACKGROUND Tacrolimus(TAC)is metabolized primarily by the CYP3A-encoded enzyme family(CYP3A4,CYP3A5,and CYP3A7).Individuals expressing the CYP3A51 allele are considered fast metabolizers and generally require higher TAC doses to reach therapeutic *** To evaluate the predictive value of the TAC concentration-to-dose(C0/D)ratio for identifying CYP3A5 poly-morphisms in renal transplant *** Eighty-six de novo kidney transplant recipients with TAC-based immunosuppression from the department of nephrology and Dialysis at Military Hospital 103(Hanoi,Vietnam)were included in this retrospective *** samples were collected within the first week post-transplantation to monitor TAC levels and to perform genotyping for CYP3A5 genetic *** The CYP3A53/3 genotype was identified in 37 patients(43%),CYP3A51/3 in 40 patients(46.5%),and CYP3A51/1 in 9 patients(10.5%).Patients carrying the CYP3A51/3 or CYP3A51/1 genotype,classified as fast metabolizers(CYP3A5 expressers),had significantly lower TAC C0 concentrations and C0/D ratios compared to slow meta-bolizers(CYP3A53/3 genotype)at multiple time points during follow-up(all P<0.001).Notably,the TAC C0/D ratio obtained on day 1(0.91)was shown to predict CYP3A5 polymorphism with a sensitivity of 84.6%and a specificity of 84.6%.CONCLUSION This study demonstrates that the TAC C0/D ratio provides a reliable predictive value for CYP3A5 polymorphisms,which can be used to individualize TAC dosing in renal transplant recipients in Vietnam and other low-income countries.

关键词： Tacrolimus CYP3A5 Renal transplant recipient Concentration-to-dose kidney transplant

Donor-specific antibodies against HLA-C,HLA-DP and HLA-DQ and their implications in kidney transplantation

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World Journal of transplantation 2025年第2期15卷 30-48页

作者： Muhammad Abdul Mabood Khalil Nihal Mohammed Sadagah Ishida Hediki Jackson Tan Salem H Al-Qurashi Center of Renal Diseases and transplantation King Fahad Armed Forces Hospital JeddahJeddah 23311Saudi Arabia department of Urology and transplantation Tokyo Women's Medical University HospitalTokyo 162-8666Japan department of nephrology RIPAS Hospital Brunei DarussalamBrunei Muara BA1710Brunei Darussalam

HLA-C,HLA-DP and HLA-DQ are thought to be benign due to low expression and few initial negative ***,most allocation programs used HLA-A,HLA-B and HLA-DR antigens for *** the advent and use of single-bead antigen assays,more was learned about donor-specific antibodies(DSAs)against these *** in these antigens and antibodies grew when cases of acute antibody-mediated rejection(AMR),mixed rejections,chronic AMR,and reduced graft survival were reported with DSAs against these *** the deleterious effects of these DSAs are more pronounced in retransplants,harmful effects have also been observed in first-time *** against each of these antigens can trigger rejection *** combination with DSAs against HLA-A,HLA-B and HLA-DR can cause more *** has been shown that strategies that reduce mismatches for these antigen lead to fewer rejections and better graft *** is a need for greater consensus on the universal typing of these antigens prior to transplantation for better patient and graft *** review focuses on the interaction of these antigens with lymphocytes and killer immunoglobulin receptors,arguments for not typing them,detailed analyses of the literature about their harmful effects,potential strategies moving forward,and recommendations for the future.

关键词： kidney transplantation HLA-C HLA-DP HLA-DQ Donor specific antibodies Review

Role of variation coefficient of stone density in determining success of shock wave lithotripsy in urinary calculi

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World Journal of nephrology 2025年第1期14卷 110-118页

作者： Nadeem Iqbal Aisha Hasan Sajid Iqbal Sadaf Noureen Saeed Akhter department of Urology and kidney Transplant Shifa Intl HospitalsIslamabad 44790Pakistan department of Urology Pakistan Kidney and Liver InstituteLahore 54000PunjabPakistan department of Biochemistry Riphah International UniversityRawalpindi 44000PunjabPakistan department of Rehabilitation PNS KarachiKarachi 75950SindhPakistan department of Medicine Groves Medical CenterNew MaldenLondon KT33PBUnited Kingdom department Urology Shifa International Hospital IslamabadIslamabad 44000Pakistan

BACKGROUND Various stone factors can affect the net results of shock wave lithotripsy(SWL).Recently a new factor called variation coefficient of stone density(VCSD)is being considered to have an impact on stone free *** To assess the role of VCSD in determining success of SWL in urinary *** Charts review was utilized for collection of data *** patients were subjected to SWL,using an electromagnetic *** stone density(MSD),stone heterogeneity index(SHI),and VCSD were calculated by generating regions of interest on computed tomography(CT)*** of these factors were determined by applying the relevant statistical tests for continuous and categorical variables and a P value of<0.05 was gauged to be statistically *** There were a total of 407 patients included in the *** mean age of the subjects in this study was 38.89±14.61 *** total,165 out of the 407 patients could not achieve stone free *** successful group had a significantly lower stone volume as compared to the unsuccessful group(P<0.0001).Skin to stone distance was not dissimilar among the two groups(P=0.47).MSD was significantly lower in the successful group(P<0.0001).SHI and VCSD were both significantly higher in the successful group(P<0.0001).CONCLUSION VCSD,a useful CT based parameter,can be utilized to gauge stone fragility and hence the prediction of SWL outcomes.

关键词： Computed tomography Shock wave lithotripsy Stone heterogeneity Variation coefficient of stone density kidney stones

Basiliximab is superior to low dose rabbit anti-thymocyte globulin in pediatric kidney transplant recipients: The younger, the better

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中华医学杂志(英文版) 2025年第2期138卷 225-227页

作者： Zhu Lan Zhang Lei Shang Wenjun Liu Wenhua Sa Rula Guo Zhiliang Liu Longshan Tan Jinghong Zhang Hengxi Feng Yonghua Zhao Wenyu Cong Wenqi Wu Jianyong Wang Changxi Chen Gang Institute of Organ transplantation Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Key Laboratory of Organ Transplantation Ministry of Education NHC Key Laboratory of Organ Transplantation Key Laboratory of Organ Transplantation Chinese Academy of Medical Sciences Wuhan Hubei China department of Organ transplantation First Affiliated Hospital Naval Medical University Shanghai China department of Renal transplantation First Affiliated Hospital Zhengzhou University Zhengzhou Henan China Clinical Research Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China Organ Transplant Center The First Affiliated Hospital Sun Yat-sen University Guangzhou Guangdong China Center of nephrology First Affiliated Hospital College of Medicine Zhejiang University Hangzhou Zhejiang China

Endothelial dysfunction in the kidney transplant population:Current evidence and management strategies

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World Journal of transplantation 2025年第1期15卷 24-43页

作者： Arun Prabhahar Akshey Batta Juniali Hatwal Vivek Kumar Raja Ramachandran Akash Batta department of Telemedicine(Internal Medicine and nephrology) Post Graduate Institute of Medical Education and ResearchChandigarh 160012India department of Urology and Renal Transplant Neelam HospitalRajpura 140401PunjabIndia department of Internal Medicine Post Graduate Institute of Medical Education and ResearchChandigarh 160012India department of nephrology Post Graduate Institute of Medical Education and ResearchChandigarh 160012India department of Cardiology Dayanand Medical College and HospitalLudhiana 141001PunjabIndia

The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and *** dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)*** kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the *** is also associated with a decline in estimated glomerular filtration *** kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV ***,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft *** in kidney transplant recipients is an underrecognized and poorly studied *** diseases are the leading cause of death among kidney transplant candidates with functioning *** contributes to the pathogenesis of many of the CV *** biomarkers and vasoreactivity tests are available to study endothelial *** an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.

关键词： Endothelial dysfunction Endothelium Cardiovascular disease kidney transplantation Chronic kidney disease Nitric oxide Flow-mediated dilatation Nitro-glycerine-mediated dilatation Biomarkers

Transient elastography(Fibro Scan~?) with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease- Where do we stand?

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World Journal of Gastroenterology 2016年第32期22卷 7236-7251页

作者： Ivana Mikolasevic Lidija Orlic Neven Franjic Goran Hauser Davor Stimac Sandra Milic department of Gastroenterology UHC Rijeka department of nephrology Dialysis and Kidney Transplantation UHC Rijeka

Non-alcoholic fatty liver disease(NAFLD) is the most common cause of chronic liver disease worldwide. Currently, the routinely used modalities are unable to adequately determine the levels of steatosis and fibrosis(laboratory tests and ultrasonography) or cannot be applied as a screening procedure(liver biopsy). Among the non-invasive tests, transient elastography(Fibro Scan?, TE) with controlled attenuation parameter(CAP) has demonstrated good accuracy in quantifying the levels of liver steatosis and fibrosis in patients with NAFLD, the factors associated with the diagnosis and NAFLD progression. The method is fast, reliable and reproducible, with good intra- and interobserver levels of agreement, thus allowing for population-wide screening and disease follow-up. The initial inability of the procedure to accurately determine fibrosis and steatosis in obese patients has been addressed with the development of the obese-specific XL probe. TE with CAP is a viable alternative to ultrasonography, both as an initial assessment and during follow-up of patients with NAFLD. Its ability to exclude patients with advanced fibrosis may be used to identify low-risk NAFLD patients in whom liver biopsy is not needed, therefore reducing the risk of complications and the financial costs.

关键词： Non-alcoholic fatty liver disease Transient elastography Controlled attenuation parameter

Comparative study of living donor kidney transplants:Right vs left

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World Journal of transplantation 2025年第1期15卷 115-123页

作者： Taqi Khan Nadeem Ahmad Qaisar Iqbal Muneeb Hassan Lajward Asnath Naveed Khan Sajid Shakeel kidney Transplant Unit Rehman Medical InstitutePeshawar 25100Khyber PakhtunkhwaPakistan department of Surgery Princess Noura Binti AbdulRehman UniversityRiyadh 84428Saudi Arabia

BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft ***,circumstances may arise where selecting the RK over the left kidney(LK)is ***,it is crucial to thoroughly examine the implications of such a choice on the overall transplant *** To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these *** We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December *** included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based *** variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)*** used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney *** Of the 250 transplants performed during the period,56(22%)were *** recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for *** and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being *** complications,however,were not related to the venous *** RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical *** post-transplant SC trend and mean SC at the last follow-up were similar across both kidney *** The donor kidney side has little impact on post-transplant

关键词： Living donor Right kidney Right renal vein Venous anastomosis Technical graft loss Early graft function

Protective Effect of Liraglutide on Early Renal Fibrosis in Diabetes Mice

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Journal of Biosciences and Medicines 2025年第1期13卷 84-91页

作者： Xiaolan Ke Te’an Ma department of nephrology The First Affiliated Hospital of Yangtze University Jingzhou China

Background: In recent years, studies have shown that liraglutide may delay the progression of renal fibrosis by inhibiting renal fibrosis signaling pathways and reducing collagen deposition. TGF-β1 and E-Cadherin play crucial roles in renal fibrosis. Objective: To explore the protective effect of liraglutide on early renal fibrosis in diabetes mice. Methods: Twenty-four 8-week-old healthy male C57BL/6J mice were randomly divided into a normal diet feeding group (NG, n = 8) and a high-fat diet feeding group (HG, n = 16) using a simple random sampling method. Four weeks later, the high-fat diet feeding group received a one-time intraperitoneal injection of STZ diluted with 0.1 mol/L sodium citrate buffer (50 mg/Kg). The diabetes model was established after 7 days of continuous injection. The diabetes model mice were randomly divided into 2 groups, each containing 8 mice. One group received liraglutide (400 ug per kilogram per day, subcutaneous injection), named Liraglutide Intervention Group (LDG);the other group received an equal dose of saline subcutaneously, named the Diabetes Model Non-intervention Group (NDG). NG also received an equal dose of saline subcutaneously, named Normal Control Group (NCG). Renal tissue pathological changes were observed by HE and Masson staining;TGF-βl and E-Cadherin protein expressions were detected by immunohistochemistry;E-Cadherin protein expression was detected by Western blotting. Results: The degree of kidney tissue damage and fibrosis in liraglutide intervention group was milder than that in non-intervention group, and the expression of TGF-β1 and E-Cadherin protein tended to be similar to that in normal control group. Conclusion: Liraglutide can significantly reduce early renal fibrosis in diabetes mice, and its mechanism may be related to the reduction of TGF-β1 expression to induce EMT changes in epithelial cells (for example, up regulation of E-Cadherin).

关键词： Liraglutide Diabetes Renal fibrosis TGF-β1 E-Cadherin