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985 results on '"Jordan, Stanley C"'

205. A Phase I/II Placebo-Controlled Trial of C1-Inhibitor for Prevention of Antibody-Mediated Rejection in HLA Sensitized Patients

Author

Vo, Ashley A., primary, Zeevi, Adriana, additional, Choi, Jua, additional, Cisneros, Kristen, additional, Toyoda, Mieko, additional, Kahwaji, Joseph, additional, Peng, Alice, additional, Villicana, Rafael, additional, Puliyanda, Dechu, additional, Reinsmoen, Nancy, additional, Haas, Mark, additional, and Jordan, Stanley C., additional

Published
2015
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206. Rituximab: An emerging therapeutic agent for kidney transplantation

Author

Kahwaji, J, Kahwaji,J, Tong,C, and Jordan,Stanley C.

Subjects
surgical procedures, operative, hemic and lymphatic diseases, Transplant Research and Risk Management
Abstract

Joseph Kahwaji, Chris Tong, Stanley C Jordan, Ashley A VoComprehensive Transplant Center, Transplant immunology Laboratory, HLA Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: Rituximab (anti-CD20, anti-B-cell) is now emerging as an important drug for modification of B-cell and antibody responses in solid-organ transplant recipients. Its uses are varied and range from facilitating desensitization and ABO blood group-incompatible transplantation to the treatment of antibody-mediated rejection (AMR), post-transplant lymphoproliferative disorder (PTLD), and recurrent glomerular diseases in the renal allograft. Despite these uses, prospective randomized trials are lacking. Only case reports exist in regards to its use in de novo and recurrent diseases in the renal allograft. Recent reports suggests that the addition of rituximab to intravenous immunoglobulin (IVIG) may have significant benefits for desensitization and treatment of AMR and chronic rejection. Current dosing recommendations are based on data from United States Food and Drug Administration-approved indications for treatment of B-cell lymphomas and rheumatoid arthritis. From the initial reported experience in solid organ transplant recipients, the drug is well tolerated and not associated with increased infectious risks. However, close monitoring for viral infections is recommended with rituximab use. The occurrence of progressive multifocal leukoencephalopathy (PML) has been reported with rituximab use. However, this is rare and not reported in the renal transplant population. Here we will review current information regarding the effectiveness of rituximab as an agent for desensitization of highly human leukocyte antigen-sensitized and ABO-incompatible transplant recipients and its use in treatment of AMR. In addition, the post-transplant use of rituximab for treatment of PTLD and for recurrent and de novo glomerulonephritis in the allograft will be discussed. In summary, we will make recommendations based on existing literature and our extensive experience at Cedars-Sinai Medical Center for using rituximab in renal transplantation.Keywords: kidney transplant, rituximab, desensitization, rejection, review

Published
2009

207. Risk factors for the development of antibody-mediated rejection in highly sensitized pediatric kidney transplant recipients.

Author

Kim, Irene K., Choi, Jua, Vo, Ashley, Kang, Alexis, Steggerda, Justin, Louie, Sabrina, Haas, Mark, Mirocha, James, Cohen, J. Louis, Pizzo, Helen, Kamil, Elaine S., Jordan, Stanley C., and Puliyanda, Dechu

Subjects
KIDNEY transplant patients, RITUXIMAB, BLOOD transfusion, LYMPHOCYTES, ALEMTUZUMAB, THERAPEUTICS
Abstract

ABMR remains a significant concern for early graft loss, especially for those who are HS against HLA antigens. We sought to determine the risk factors leading to ABMR in HS pediatric kidney transplant recipients. From January 2009 to December 2015, 16 HS pediatric kidney transplant patients at our center (age range 2-21) were retrospectively reviewed for outcomes and risk factors for ABMR. All HS patients received desensitization with high-dose IVIG/rituximab prior to transplant. Two groups were examined: ABMR+ (n = 7) and ABMR− (n = 9). Patient survival was 100%; however, one patient in the ABMR+ group suffered graft loss from ABMR 16 months post-transplant. ABMR+ patients had higher Class I PRA at the time of transplant (Class I: 73.1 ± 19.1 vs 49.1 ± 28.3, P = .075), although not statistically significant. ABMR+ patients were more likely to have a history of transplant nephrectomy ( P = .013). The characteristic that most strongly correlated with ABMR was the DSA- RIS ( P = .045), a scoring system used to quantify cumulative intensity of all DSA. In conclusion, DSA, as quantified by the RIS at the time of transplant, should be considered as part of the initial allocation strategy and patients with high RIS monitored closely for ABMR post-transplant. [ABSTRACT FROM AUTHOR]

Published
2017
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211. Transplantation in highly HLA-sensitized patients: challenges and solutions

Author

Kim,Irene K, Vo,Ashley, Jordan,Stanley C, Kim,Irene K, Vo,Ashley, and Jordan,Stanley C

Abstract

Irene K Kim, Ashley Vo, Stanley C Jordan Transplant Immunotherapy Program, Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA Abstract: Despite better understanding of the impact of development of the human leukocyte antigen (HLA) antibody and numerous advancements in immunosuppressive therapy, the ability to successfully transplant highly sensitized patients remains a significant challenge. As the percentage of the waiting list becomes increasingly populated with highly sensitized patients, there is a growing demand for effective strategies to manage these patients. Over the past 20 years, desensitization therapies have been modified and developed, and are mainly utilized at transplant centers that have developed expertise. In addition, recognition that the highly sensitized patient population is disadvantaged on the transplant waiting list has led to recent changes in national kidney allocation policy. Furthermore, creative strategies, such as enrollment of sensitized patients into paired kidney exchange programs, have been developed to find compatible matches for these patients. The goal of this article is to address some of the specific challenges related to transplanting the highly sensitized patient at a high-volume transplant center with experience in desensitization and to review established and emerging solutions to help this patient population. Keywords: human leukocyte antigen, antibodies, desensitization, high-dose intravenous immunoglobulin, rituximab

Published
2014

217. Hospital readmissions following HLA‐incompatible live donor kidney transplantation: A multi‐center study

Author

Orandi, Babak J., Luo, Xun, King, Elizabeth A., Garonzik‐Wang, Jacqueline M., Bae, Sunjae, Montgomery, Robert A., Stegall, Mark D., Jordan, Stanley C., Oberholzer, Jose, Dunn, Ty B., Ratner, Lloyd E., Kapur, Sandip, Pelletier, Ronald P., Roberts, John P., Melcher, Marc L., Singh, Pooja, Sudan, Debra L., Posner, Marc P., El‐Amm, Jose M., Shapiro, Ron, Cooper, Matthew, Lipkowitz, George S., Rees, Michael A., Marsh, Christopher L., Sankari, Bashir R., Gerber, David A., Nelson, Paul W., Wellen, Jason, Bozorgzadeh, Adel, Osama Gaber, A., and Segev, Dorry L.

Abstract

Thirty percent of kidney transplant recipients are readmitted in the first month posttransplantation. Those with donor‐specific antibody requiring desensitization and incompatible live donor kidney transplantation (ILDKT) constitute a unique subpopulation that might be at higher readmission risk. Drawing on a 22‐center cohort, 379 ILDKTs with Medicare primary insurance were matched to compatible transplant‐matched controls and to waitlist‐only matched controls on panel reactive antibody, age, blood group, renal replacement time, prior kidney transplantation, race, gender, diabetes, and transplant date/waitlisting date. Readmission risk was determined using multilevel, mixed‐effects Poisson regression. In the first month, ILDKTs had a 1.28‐fold higher readmission risk than compatible controls (95% confidence interval [CI] 1.13‐1.46; P< .001). Risk peaked at 6‐12 months (relative risk [RR] 1.67, 95% CI 1.49‐1.87; P< .001), attenuating by 24‐36 months (RR 1.24, 95% CI 1.10‐1.40; P< .001). ILDKTs had a 5.86‐fold higher readmission risk (95% CI 4.96‐6.92; P< .001) in the first month compared to waitlist‐only controls. At 12‐24 (RR 0.85, 95% CI 0.77‐0.95; P= .002) and 24‐36 months (RR 0.74, 95% CI 0.66‐0.84; P< .001), ILDKTs had a lower risk than waitlist‐only controls. These findings of ILDKTs having a higher readmission risk than compatible controls, but a lower readmission risk after the first year than waitlist‐only controls should be considered in regulatory/payment schemas and planning clinical care. In this multi‐center cohort study, the authors examine the risk of hospital readmission for live donor kidney transplant recipients requiring peritransplant desensitization compared to compatible live donor kidney transplant recipients and waitlist‐matched controls.

Published
2018
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218. Rituximab: An emerging therapeutic agent for kidney transplantation

Author

Kahwaji,Joseph, Tong,Chris, Jordan,Stanley C, Vo,Ashley, Kahwaji,Joseph, Tong,Chris, Jordan,Stanley C, and Vo,Ashley

Abstract

Joseph Kahwaji, Chris Tong, Stanley C Jordan, Ashley A VoComprehensive Transplant Center, Transplant immunology Laboratory, HLA Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: Rituximab (anti-CD20, anti-B-cell) is now emerging as an important drug for modification of B-cell and antibody responses in solid-organ transplant recipients. Its uses are varied and range from facilitating desensitization and ABO blood group-incompatible transplantation to the treatment of antibody-mediated rejection (AMR), post-transplant lymphoproliferative disorder (PTLD), and recurrent glomerular diseases in the renal allograft. Despite these uses, prospective randomized trials are lacking. Only case reports exist in regards to its use in de novo and recurrent diseases in the renal allograft. Recent reports suggests that the addition of rituximab to intravenous immunoglobulin (IVIG) may have significant benefits for desensitization and treatment of AMR and chronic rejection. Current dosing recommendations are based on data from United States Food and Drug Administration-approved indications for treatment of B-cell lymphomas and rheumatoid arthritis. From the initial reported experience in solid organ transplant recipients, the drug is well tolerated and not associated with increased infectious risks. However, close monitoring for viral infections is recommended with rituximab use. The occurrence of progressive multifocal leukoencephalopathy (PML) has been reported with rituximab use. However, this is rare and not reported in the renal transplant population. Here we will review current information regarding the effectiveness of rituximab as an agent for desensitization of highly human leukocyte antigen-sensitized and ABO-incompatible transplant recipients and its use in treatment of AMR. In addition, the post-transplant use of rituximab for treatment of PTLD and for recurrent and de novo glomerulonephritis in the allograft will be discussed. In summary, we will make

Published
2009

224. Significant Reduction of ATP Production in PHA-Activated CD4+ Cells in 1-Day-Old Blood from Transplant Patients

Author

Suviolahti, Elina, primary, Petrosyan, Anna, additional, Mirocha, James, additional, Ge, Shili, additional, Karasyov, Artur, additional, Thomas, David, additional, Galera, Odette, additional, Lim, Washington, additional, Jimenez, Anne Maria, additional, Czer, Lawrence S.C., additional, Chaux, George, additional, De Leon, Jeffrey, additional, Pao, Andy, additional, Jordan, Stanley C., additional, and Toyoda, Mieko, additional

Published
2012
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226. Plasma Exosomes From HLA-Sensitized Kidney Transplant Recipients Contain mRNA Transcripts Which Predict Development of Antibody-Mediated Rejection

Author

Zhang, Hao, Huang, Edmund, Kahwaji, Joseph, Nast, Cynthia C., Li, Ping, Mirocha, James, Thomas, David L., Ge, Shili, Vo, Ashley A., Jordan, Stanley C., and Toyoda, Mieko

Abstract

In 152 kidney transplant recipients with or without antibody-mediated rejection (AMR), the authors study mRNA transcripts for 21 candidate genes in plasma exosomes and find a significant increase in patients with AMR. A score involving 4 specific genes may help AMR occurrence prediction. Supplemental digital content is available in the text.

Published
2017
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227. Differences in pathologic features and graft outcomes in antibody-mediated rejection of renal allografts due to persistent/recurrent versus de novodonor-specific antibodies

Author

Haas, Mark, Mirocha, James, Reinsmoen, Nancy L., Vo, Ashley A., Choi, Jua, Kahwaji, Joseph M., Peng, Alice, Villicana, Rafael, and Jordan, Stanley C.

Abstract

Antibody-mediated rejection (ABMR) of renal allografts occurs in two forms. Type 1 ABMR results from persistence and/or a rebound of preexisting donor-specific antibodies in sensitized patients and usually occurs early post-transplantation. Type 2 ABMR is associated with de novodonor-specific antibodies and usually occurs over one year post-transplantation. It is generally accepted that types 1 and 2 also differ with regard to certain pathologic features including the frequencies of C4d positivity and concurrent cell-mediated rejection. However, direct comparison of pathologic, serologic, and clinical features of types 1 and 2 ABMR is lacking. Here we compared these features in 80 cases of ABMR (37 type 1, 43 type 2) diagnosed at our center. Compared with type 1, type 2 ABMR occurred later post-transplantation, was more often associated with donor-specific antibodies against Class II HLA, and was associated with more interstitial fibrosis/tubular atrophy and more frequent cell-mediated rejection, although these did not differ with respect to C4d positivity. By univariate analysis, graft survival was lower with type 2 than type 1 ABMR with borderline significance. Still, among these 80 patients, all but one treated for ABMR following diagnosis, the only two independent predictors of graft failure were at least moderate interstitial fibrosis/tubular atrophy and failure of the donor-specific antibody relative intensity scale score, a measure of the combined strength of all donor-specific antibodies present, to decrease in response to therapy.

Published
2017
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230. Immunologic parameters and viral infections in patients desensitized with intravenous immunoglobulin and rituximab

Author

Ge, Shili, primary, Pao, Andy, additional, Vo, Ashley, additional, Deer, Nathan, additional, Karasyov, Artur, additional, Petrosyan, Anna, additional, Kahwaji, Joseph, additional, Lukovsky, Marina, additional, Chai, Ning-Ning, additional, Aguiluz, Angela, additional, Mirocha, James, additional, Jordan, Stanley C., additional, and Toyoda, Mieko, additional

Published
2011
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231. Anti-Angiotensin Type 1 Receptor Antibodies Associated With Antibody Mediated Rejection in Donor HLA Antibody Negative Patients

Author

Reinsmoen, Nancy L., primary, Lai, Chih-Hung, additional, Heidecke, Harald, additional, Haas, Mark, additional, Cao, Kai, additional, Ong, Geraldine, additional, Naim, Mehrnoush, additional, Wang, Qi, additional, Mirocha, James, additional, Kahwaji, Joseph, additional, Vo, Ashley A., additional, Jordan, Stanley C., additional, and Dragun, Duska, additional

Published
2010
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239. Intracellular IFNγ production in CD3 negative cells exposed to allo-antigens is an indicator of prior sensitization

Author

Toyoda, Mieko, primary, Pao, Andy, additional, Vo, Ashley, additional, Lukovsky, Marina, additional, Radha, Raju, additional, Sado, Tetsu, additional, Ge, Shili, additional, Reinsmoen, Nancy, additional, Chai, Ning Ning, additional, Baden, Lara, additional, Petrosyan, Anna, additional, Skinner, Edwina, additional, Mirocha, James, additional, and Jordan, Stanley C., additional

Published
2010
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249. 58-P

Author

Toyoda, Mieko, primary, Vo, Ashley, additional, Puliyanda, Dechu, additional, Pao, Andy, additional, Petrosyan, Anna, additional, Peng, Alice, additional, Bunnapradist, Mike, additional, and Jordan, Stanley C., additional

Published
2006
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250. 69-P

Author

Toyoda, Mieko, primary, Vo, Ashley, additional, Puliyanda, Dechu, additional, Pao, Andy, additional, Petrosyan, Anna, additional, Peng, Alice, additional, Bunnapradist, Mike, additional, and Jordan, Stanley C., additional

Published
2006
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