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  • 1
    Online-Ressource
    Online-Ressource
    Elevated ST 2 levels are associated with antibody‐mediated rejection in heart transplant recipients
    Wiley ; 2018
    In:  Clinical Transplantation Vol. 32, No. 9 ( 2018-09)
    Details
    In: Clinical Transplantation, Wiley, Vol. 32, No. 9 ( 2018-09)
    Kurzfassung: Soluble ST 2 ( sST 2) is a novel biomarker of inflammation and fibrosis. Elevated sST 2 levels (≥35 ng/mL) are associated with worse outcomes in patients with heart failure ( HF ). There are sparse data regarding the significance of sST 2 levels after heart transplantation ( HT x). The study aims were to evaluate trends in soluble ST 2 levels after the resolution of HF status with HT x and association between post‐ HT x sST 2 levels and outcomes. Plasma sST 2 levels were measured at baseline (median [ IQR ] of 118 days pre‐ HT x) and 12 months post‐ HT x in 62 subjects who were stratified into two groups by post‐ HT x sST 2 levels 〈 or ≥35 ng/mL: “Group 1” or “Group 2,” respectively. Plasma sST 2 levels were elevated in 58% of patients pre‐ HT x and in 50% of patients post‐ HT x. There was no association between elevated sST 2 levels before and after HT x, and no significant differences in baseline characteristics between Group 1 and Group 2 patients. Group 2 as compared to Group 1 HT x recipients had significantly higher incidence of antibody‐mediated rejection ( AMR ) for the entire post‐transplant follow‐up period (32% vs 4%, P  = 0.006). There was no association between post‐ HT x sST 2 level status and other post‐ HT x outcomes including survival. In conclusion, elevated plasma sST 2 levels after HT x are associated with increased risk for AMR.
    Materialart: Online-Ressource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.2018.32.issue-9
    DOI: 10.1111/ctr.13349
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2018
    ZDB Id: 2739458-X
    ZDB Id: 2004801-4
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 2
    Online-Ressource
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    Progression and new onset of nonalcoholic fatty liver disease in living kidney donors compared to healthy controls
    Wiley ; 2018
    In:  Clinical Transplantation Vol. 32, No. 5 ( 2018-05)
    Details
    In: Clinical Transplantation, Wiley, Vol. 32, No. 5 ( 2018-05)
    Kurzfassung: There is growing evidence linking nonalcoholic fatty liver disease ( NAFLD ) with reduced glomerular filtration rate ( GFR ). Living kidney donors do not have underlying kidney disease, but have reduced GFR as a result of nephrectomy. Whether kidney donation is associated with a higher risk for development or progression of NAFLD is currently unknown. Methods Retrospective evaluation of metabolic parameters and sonographic evidence of NAFLD were performed in 232 living kidney donors and 162 healthy controls. Results A total of 25 donors and 44 controls had NAFLD at baseline. During a mean follow‐up of 6.8 years, 6 donors (24%) and 17 controls (38.6%) ( P  = .29) had a remission of NAFLD , related with decreased body mass index ( BMI ). The progression of NAFLD fibrosis score was similar in both groups. New onset of NAFLD was observed in 14 (6.8%) donors and 13 (11.01%) controls ( P  = .211), and was related to increased BMI and a higher baseline Fatty Liver Index score. Neither eGFR nor urine albumin excretion in the donors were related to new onset or progression of NAFLD . Conclusions Reduced kidney function secondary to kidney donation is not associated with increased incidence or progression of NAFLD .
    Materialart: Online-Ressource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.2018.32.issue-5
    DOI: 10.1111/ctr.13240
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2018
    ZDB Id: 2739458-X
    ZDB Id: 2004801-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    In sickness and in health: Living HIV positive kidney donation from a wife to her husband, with 7 years' post‐transplant follow‐up
    Wiley ; 2019
    In:  Transplant Infectious Disease Vol. 21, No. 6 ( 2019-12)
    Details
    In: Transplant Infectious Disease, Wiley, Vol. 21, No. 6 ( 2019-12)
    Kurzfassung: Human immunodeficiency virus (HIV) infection was traditionally considered an absolute contraindication for kidney transplantation. After the introduction of ART, several studies have demonstrated comparable patient and graft outcomes between HIV‐negative and HIV‐positive kidney recipients. The US Congress passed the HIV Organ Policy Equity (HOPE) Act in 2013, which permits research in the area of HIV‐positive to HIV‐positive transplantation. HIV‐infected living donation is also permitted under the HOPE Act. However, there is a concern regarding the safety of kidney donation in an HIV‐infected person, given the risk of renal disease associated with HIV infection. We report here the case of successful kidney transplantation from HIV‐positive living donor to HIV‐positive recipient performed in our center on July 2012. To the best of our knowledge, this is the earliest case done in this medical context to be reported in the literature, therefore, potentially carrying several important messages to the transplantation community. In the present case, the living‐donor kidney transplant was performed between a married couple infected with same strain of HIV‐1, both on effective ART with efficiently suppressed viral replication and satisfactory pre‐transplantation immune status.
    Materialart: Online-Ressource
    ISSN: 1398-2273 , 1399-3062
    URL: Issue
    URL: Article
    DOI: 10.1111/tid.v21.6
    DOI: 10.1111/tid.13171
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2019
    ZDB Id: 2010983-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Kidney transplant recipients vaccinated before transplantation maintain superior humoral response to SARS‐CoV‐2 vaccine
    Wiley ; 2021
    In:  Clinical Transplantation Vol. 35, No. 12 ( 2021-12)
    Details
    In: Clinical Transplantation, Wiley, Vol. 35, No. 12 ( 2021-12)
    Kurzfassung: Majority of transplant recipients did not develop an appreciable humoral response following SARS‐CoV‐2 vaccine, in contrast to dialysis patients and healthy individuals. We analyzed the serologic response to BNT162b2 (Pfizer‐BioNTech) vaccine in a cohort of 19 kidney transplant recipients, vaccinated prior to transplantation, compare to 109 recipients vaccinated after transplantation, and to 39 healthcare workers, by determining the level of anti‐spike antibodies after transplantation. All controls and 17 of 19 (90%) of recipients vaccinated before transplant were seropositive, while only 49 of 109 (45%) recipients vaccinated post‐transplant had positive serology ( P   〈  .001). Median anti‐spike IgG in the group of kidney transplant recipients vaccinated after transplantation (10.7 AU/ml, [IQR 0–62.5]) was lower than the patients vaccinated before transplantation (66.2 AU/ml [21.6–138] ), which was significantly lower than in the controls (156 AU/ml [99.7–215.5]). Negative humoral response was associated with vaccination post transplantation (odds ratio 22.4), older age (OR = 1.04), and longer time on dialysis (OR = 1.02), while higher lymphocyte count at time of vaccination was protective (OR = .52). Our findings of sustained superior humoral response to SARS‐CoV‐2 vaccine in kidney transplant recipients vaccinated prior to transplantation strongly support the recommendations of SARS‐CoV‐2 vaccination of transplant candidates, especially those younger than 60 years.
    Materialart: Online-Ressource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.v35.12
    DOI: 10.1111/ctr.14478
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2739458-X
    ZDB Id: 2004801-4
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 5
    Online-Ressource
    Online-Ressource
    Hypertension is associated with increased post‐exercise albuminuria, which may be attenuated by an active lifestyle
    Wiley ; 2019
    In:  The Journal of Clinical Hypertension Vol. 21, No. 8 ( 2019-08), p. 1171-1179
    Details
    In: The Journal of Clinical Hypertension, Wiley, Vol. 21, No. 8 ( 2019-08), p. 1171-1179
    Kurzfassung: Albuminuria is a known marker for endothelial dysfunction and cardiovascular events, even below the threshold of moderately increased albuminuria (MIA). Post‐exercise increased albuminuria may precede the appearance of rest MIA, enabling detection of early injury. Modifying lifestyle for a population at risk for MIA is therefore of interest. Our aim was to evaluate post‐exercise albuminuria in hypertensive compared with normotensive individuals and to analyze the effect of an active lifestyle on rest and post‐exercise albumin excretion. The study cohort consisted of 3931 adults who participated in a health‐screening program. Albuminuria was measured as urine albumin‐to‐creatinine ratio (ACR). Lifestyle was divided into three groups: non‐active, less‐active, and active according to regular sport activity, categorized as follows: none, 〈 2.5 and ≥2.5 hours per week. Mean age was 47.7 years, and 31.2% (n = 1228) were diagnosed with hypertension. Both rest and post‐exercise ACR were higher in hypertensive compared to normotensive participants. Rest ACR was higher in non‐active compared to less‐active and active hypertensive participants. Hypertensive participants with an active lifestyle had significantly lower post‐exercise and delta ACR compared to less‐active and non‐active hypertensive participants. Parameters related to delta ACR in hypertensive participants were increased age, BMI, and diabetes, while active lifestyle and fitness (measured as METS achieved by a stress test) were protective. In conclusion, there is an association between hypertension and increased albumin excretion post‐exercise, which can be attenuated with an active lifestyle.
    Materialart: Online-Ressource
    ISSN: 1524-6175 , 1751-7176
    URL: Issue
    URL: Article
    DOI: 10.1111/jch.v21.8
    DOI: 10.1111/jch.13624
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2019
    ZDB Id: 2058690-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    Online-Ressource
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    Dialysis modality, humoral response to vaccine, and SARS‐CoV‐2 infection risk: Comparative prospective evaluation
    Wiley ; 2023
    In:  Seminars in Dialysis Vol. 36, No. 5 ( 2023-09), p. 382-389
    Details
    In: Seminars in Dialysis, Wiley, Vol. 36, No. 5 ( 2023-09), p. 382-389
    Kurzfassung: COVID‐19 vaccinations have a central role in decreasing severe SARS‐CoV‐2 disease complications. This study investigated the long‐term humoral immune response to BNT162b2 vaccine among hemodialysis (HD) versus peritoneal dialysis (PD) patients, and their relative risk for COVID‐19 infection. Methods This prospective, observational study included maintenance HD and PD patients who had received at least two BNT162b2 vaccine doses. Levels of antibodies targeting SARS‐CoV‐2 spike protein were measured 6 and 12 months after the first vaccine dose, and 2–3 weeks after the third and fourth vaccine doses. Patients were divided according to dialysis modality (HD or PD). Humoral response was evaluated at different time points among different vaccine regimens (two vs. three vs. four doses of vaccine). An adjusted multivariate model was used to assess cumulative risk for SARS‐CoV‐2 infection. Results Eighty‐seven HD and 36 PD patients were included. Among them, 106 (86%) received at least three vaccine doses. Both HD and PD patients demonstrated marked increases in humoral response 2–3 weeks after the third dose (mean anti‐S antibody increased from 452 ± 501 AU/mL to 19,556 ± 14,949 AU/mL, p  〈  0.001). By 6 months after the third dose, antibody titers had declined significantly (mean anti‐S antibody 9841 ± 10,493 AU/mL, p  〈  0.001). HD patients had higher risk for SARS‐CoV‐2 infection than PD patients (OR 4.4 [95% CI 1.4–13.6], p = 0.006). In multivariate analysis, the most important predictor for SARS‐CoV‐2 infection was dialysis modality. Conclusion This study found a high antibody response rate after the third and fourth doses of BNT162b2 vaccine among dialysis patients. Hemodialysis as dialysis modality is an important predictor of COVID‐19 infection, despite similar humoral responses to vaccine in peritoneal dialysis.
    Materialart: Online-Ressource
    ISSN: 0894-0959 , 1525-139X
    URL: Issue
    URL: Article
    DOI: 10.1111/sdi.v36.5
    DOI: 10.1111/sdi.13155
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2023
    ZDB Id: 2010756-0
    Standort Signatur Einschränkungen Verfügbarkeit
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