Humoral Immunity in Kidney Transplantation: What Clinicians by G. Remuzzi, S. Chiaramonte, N. Perico, C. Ronco

By G. Remuzzi, S. Chiaramonte, N. Perico, C. Ronco

As contemporary advances in immunosuppression and apheresis suggestions have opened new avenues for the administration of humoral immunity, curiosity in ABO-incompatible kidney transplantation has been renewed. in addition, new screening thoughts - corresponding to the only antigen bead assay - permit for the detection and definition of very low degrees of alloantibody, which has had a favorable impression at the remedy percentages in hugely sensitized grownup sufferers with end-stage renal affliction. yet regardless of those advances, a theoretical cause remains to be lacking for either the choice to transplant a sensitized sufferer and the class of the transplant as low, medium or excessive chance. there's additionally no uniform technique with reference to pre-transplant desensitization protocols, and it's doubtful no matter if specific post-transplant immunosuppression might be required and what could be the top blend therapy. final yet no longer least, the frequency and genuine medical influence of alloantibodies constructed after transplantation on brief- and long term graft survival must be ascertained. Aimed specially on the clinician, this ebook provides contemporary insights within the characterization and pathogenetic function of humoral immunity in continual allograft damage and investigates the views for novel immunosuppressive remedies to regulate antibody construction after transplantation.

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Extra resources for Humoral Immunity in Kidney Transplantation: What Clinicians Need to Know (Contributions to Nephrology)

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These findings have implications for the management of ABOi Rapid Accomodation of an A1 Renal Allograft after Preconditioning for ABOi Transplantation 41 renal allograft recipients in the postoperative period and provide guidance for future investigations of mechanistic aspects of this phenomenon.

IVIG can inhibit the activation of Jordan/Peng/Vo 22 endothelial cells in in vitro models of inflammation. Data by Bayry et al. [55] suggest that IVIG inhibits the maturation and function of dendritic cells, impairing their APC activity and inducing IL-10 production. These data are in concert with data from our laboratory demonstrating similar effects on B cells [51]. Recently, Abe et al. [62] examined gene expression in patients with Kawasaki disease before and after high-dose IVIG infusion. Here, the immunomodulatory effects of IVIG were likely mediated by suppression of an array of immune activation genes in monocytes and macrophages.

Brennan DC, Daller JA, Lake KD, Cibrik D, Del Castillo D. Rabbit antithymocyte globulin versus basiliximab in renal transplantation. N Engl J Med 2006;355:1967–1977. Zand MS. B-cell activity of polyclonal antithymocyte globulins. Transplantation 2006;82: 1387–1395. Posttransplant Immunosuppression in Highly Sensitized Patients 33 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Montgomery RA, Zachary AA: Transplanting patients with a positive donor-specific crossmatch: a single center’s perspective.

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