201 results on '"Bemelman, F.J."'
Search Results
2. Antibody and T-Cell Responses 6 Months after Coronavirus Disease 2019 Messenger RNA-1273 Vaccination in Patients with Chronic Kidney Disease, on Dialysis, or Living with a Kidney Transplant
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Sanders, J.F., Messchendorp, A.L., Vries, R.D. de, Baan, C.C., Baarle, D. van, Binnendijk, R. van, Diavatopoulos, D.A., Geers, D., Schmitz, K.S., GeurtsvanKessel, C.H., Hartog, G. den, Kho, M.M., Koopmans, M.P., Molen, R.G. van der, Remmerswaal, E.B.M., Rots, N., Gansevoort, R.T., Bemelman, F.J., Hilbrands, L.B., Reinders, M.E., Virology, Internal Medicine, Experimental Immunology, AII - Inflammatory diseases, AII - Infectious diseases, and Nephrology
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Microbiology (medical) ,Infectious Diseases ,All institutes and research themes of the Radboud University Medical Center ,SDG 3 - Good Health and Well-being ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,COVID-19 ,dialysis ,kidney transplantation ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] ,chronic kidney disease ,mRNA-1273 vaccine - Abstract
Background The immune response to COVID-19 vaccination is inferior in kidney transplant recipients (KTRs) and to a lesser extent in patients on dialysis or with chronic kidney disease (CKD). We assessed the immune response 6 months after mRNA-1273 vaccination in kidney patients and compared this to controls. Methods A total of 152 participants with CKD stages G4/5 (eGFR Results At 6 months after vaccination, S1-specific antibodies were detected in 100% of controls, 98.7% of CKD G4/5 patients, 95.1% of dialysis patients, and 56.6% of KTRs. These figures were comparable to the response rates at 28 days, but antibody levels waned significantly. Neutralization of the ancestral and Delta variants was detected in most participants, whereas neutralization of Omicron was mostly absent. S-specific T-cell responses were detected at 6 months in 75.0% of controls, 69.4% of CKD G4/5 patients, 52.6% of dialysis patients, and 12.9% of KTRs. T-cell responses at 6 months were significantly lower than responses at 28 days. Conclusions Although seropositivity rates at 6 months were comparable to rates at 28 days after vaccination, significantly decreased antibody levels and T-cell responses were observed. The combination of low antibody levels, reduced T-cell responses, and absent neutralization of the newly emerging variants indicates the need for additional boosts or alternative vaccination strategies in KTRs. Clinical Trials Registration NCT04741386.
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- 2023
3. Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant
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Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., van der Meer, A., Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., van Reekum, F.E., van Zuilen, A.D., Verhaar, M.C., Bots, M.L., Drop, A.C.A.D., Plaisier, L., Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G.J., Voorter, C.E., Wieten, L., van Duijnhoven, E.M., Gelens, M., Christiaans, M.H.L., van Ittersum, F.J., Nurmohamed, S.A., Lardy, N.M., Swelsen, W., van der Pant, K.A., van der Weerd, N.C., ten Berge, I.J.M., Bemelman, F.J., Hoitsma, A., van der Boog, P.J.M., de Fijter, J.W., Betjes, M.G.H., Heidt, S., Roelen, D.L., Claas, F.H., and Otten, H.G.
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- 2018
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4. DCD donor hemodynamics as predictor of outcome after kidney transplantation
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Peters-Sengers, H., Houtzager, J.H.E., Heemskerk, M.B.A., Idu, M.M., Minnee, R.C., Klaasen, R.W., Joor, S.E., Hagenaars, J.A.M., Rebers, P.M., van der Heide, J.J. Homan, Roodnat, J.I., and Bemelman, F.J.
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- 2018
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5. Persistence of seroconversion at 6 months following primary immunisation in patients with immune-mediated inflammatory diseases
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Wieske, L., Stalman, E.W., Dam, P.J.K. van, Kummer, L.Y., Steenhuis, M., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Boekel, L., Wolbink, G., Kooi, A. van der, Raaphorst, J., Lowenberg, M., Takkenberg, B., D'Haens, G.R.A.M., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A., Broens, B., Sanchez, A.P., Els, C.A.C.M. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horvath, B., Verschuuren, J.J.G.M., Ruiter, A.M., Ouwerkerk, L. van, Woude, D. van der, Allaart, C.F., Teng, Y.K.O., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D., Schreurs, C.R.G., Pol, W.L. van der, Goedee, H.S., Keijzer, S., Keijser, J., Cristianawati, O., Brinke, A. ten, Verstegen, N.J.M., Zwinderman, K.A.H., Ham, S.M. van, Kuijpers, T.W., Rispens, T., Eftimov, F., T2B Immunity SARS CoV 2 Study Grp, Interne Geneeskunde, MUMC+: MA Nefrologie (9), MUMC+: MA Klinische Immunologie (9), RS: Carim - B02 Vascular aspects thrombosis and Haemostasis, Neurology, Amsterdam Neuroscience - Neuroinfection & -inflammation, AII - Inflammatory diseases, Rheumatology, Dermatology, Nephrology, and AII - Infectious diseases
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Rheumatology ,SDG 3 - Good Health and Well-being ,Immunology ,Vaccination ,Immunology and Allergy ,Tumor Necrosis Factor Inhibitors ,Covid-19 ,General Biochemistry, Genetics and Molecular Biology ,Autoimmune Diseases - Abstract
Patients with immune-mediated inflammatory diseases (IMIDs) may have impaired initial humoral responses after SARS-CoV-2 vaccination depending on the type of immunosuppression (ISP) used.1 It is largely unknown how antibody titres develop over time and whether it is needed to adjust timing of booster campaigns for patients with IMID.
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- 2023
6. 13 Orgaantransplantatie
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ten Berge, R.J.M., Huisman, C., Bemelman, F.J., Benner, R., editor, Kraal, G., editor, van Dissel, J.T., editor, and van Lier, R.A.W., editor
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- 2016
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7. Early Conversion From Calcineurin Inhibitor- to Everolimus-Based Therapy Following Kidney Transplantation: Results of the Randomized ELEVATE Trial
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de Fijter, J.W., Holdaas, H., Øyen, O., Sanders, J.-S., Sundar, S., Bemelman, F.J., Sommerer, C., Pascual, J., Avihingsanon, Y., Pongskul, C., Oppenheimer, F., Toselli, L., Russ, G., Wang, Z., Lopez, P., Kochuparampil, J., Cruzado, J.M., and van der Giet, M.
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- 2017
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8. Early Conversion to Prednisolone/Everolimus as an Alternative Weaning Regimen Associates With Beneficial Renal Transplant Histology and Function: The Randomized-Controlled MECANO Trial
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Bemelman, F.J., de Fijter, J.W., Kers, J., Meyer, C., Peters-Sengers, H., de Maar, E.F., van der Pant, K.A.M.I., de Vries, A.P.J., Sanders, J.-S., Zwinderman, A., Idu, M.M., Berger, S., Reinders, M.E.J., Krikke, C., Bajema, I.M., van Dijk, M.C., ten Berge, I.J.M., Ringers, J., Lardy, J., Roelen, D., Moes, D.-J., Florquin, S., and Homan van der Heide, J.J.
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- 2017
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9. Eculizumab Rescue Therapy in Patients With Recurrent Atypical Hemolytic Uremic Syndrome After Kidney Transplantation
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Duineveld, Caroline, primary, Bouwmeester, Romy N., additional, Wijnsma, Kioa L., additional, Bemelman, F.J., additional, van der Heijden, J.W., additional, Berger, S.P., additional, van den Heuvel, L.P.W.J., additional, van de Kar, Nicole C.A.J., additional, Wetzels, Jack F.M., additional, van Zuijlen, A.D., additional, Berger, Dr.SP., additional, van de Wetering, J., additional, de Vries, A.P.J., additional, Wetzels, J.F.M., additional, van Wijk, J.A.E., additional, Bouts, A.H.M., additional, Dorresteijn, E.M., additional, Gracchi, V., additional, Horuz-Engels, F.A.P.T., additional, Keijzer-Veen, M.G., additional, van Rooij, R.W.G., additional, van de Kar, N.C.A.J., additional, and van den Heuvel, L.P., additional
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- 2023
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10. Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy.
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Bouwmans, P., Messchendorp, A.L., Imhof, C., Sanders, J.F., Hilbrands, L.B., Reinders, M.E., Vart, P., Bemelman, F.J., Abrahams, A.C., Dorpel, R.M.A. van den, Dam, Marc Ten, Vries, A.P.J. de, Rispens, T., Steenhuis, M., Gansevoort, R.T., Hemmelder, M.H., Bouwmans, P., Messchendorp, A.L., Imhof, C., Sanders, J.F., Hilbrands, L.B., Reinders, M.E., Vart, P., Bemelman, F.J., Abrahams, A.C., Dorpel, R.M.A. van den, Dam, Marc Ten, Vries, A.P.J. de, Rispens, T., Steenhuis, M., Gansevoort, R.T., and Hemmelder, M.H.
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Item does not contain fulltext, BACKGROUND: Patients with chronic kidney disease (CKD) or kidney replacement therapy demonstrate lower antibody levels after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination compared with healthy controls. In a prospective cohort, we analysed the impact of immunosuppressive treatment and type of vaccine on antibody levels after three SARS-CoV-2 vaccinations. METHODS: Control subjects (n = 186), patients with CKD G4/5 (n = 400), dialysis patients (n = 480) and kidney transplant recipients (KTR) (n = 2468) were vaccinated with either mRNA-1273 (Moderna), BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford/AstraZeneca) in the Dutch SARS-CoV-2 vaccination programme. Third vaccination data were available in a subgroup of patients (n = 1829). Blood samples and questionnaires were obtained 1 month after the second and third vaccination. Primary endpoint was the antibody level in relation to immunosuppressive treatment and type of vaccine. Secondary endpoint was occurrence of adverse events after vaccination. RESULTS: Antibody levels after two and three vaccinations were lower in patients with CKD G4/5 and dialysis patients with immunosuppressive treatment compared with patients without immunosuppressive treatment. After two vaccinations, we observed lower antibody levels in KTR using mycophenolate mofetil (MMF) compared with KTR not using MMF [20 binding antibody unit (BAU)/mL (3-113) vs 340 BAU/mL (50-1492), P < .001]. Seroconversion was observed in 35% of KTR using MMF, compared with 75% of KTR not using MMF. Of the KTR who used MMF and did not seroconvert, eventually 46% seroconverted after a third vaccination. mRNA-1273 induces higher antibody levels as well as a higher frequency of adverse events compared with BNT162b2 in all patient groups. CONCLUSIONS: Immunosuppressive treatment adversely affects the antibody levels after SARS-CoV-2 vaccination in patients with CKD G4/5, dialysis patients and KTR. mRNA-1273 vaccine induces a higher antibody level
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- 2023
11. Eculizumab Rescue Therapy in Patients With Recurrent Atypical Hemolytic Uremic Syndrome After Kidney Transplantation
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Duineveld, C., Bouwmeester, R.N., Wijnsma, K.L., Bemelman, F.J., Heijden, J.W. van der, Berger, S.P., Heuvel, L.P.W.J. van den, Kar, N.C.A.J. van de, Wetzels, J.F.M., Grp, Dutch aHUS Working, Duineveld, C., Bouwmeester, R.N., Wijnsma, K.L., Bemelman, F.J., Heijden, J.W. van der, Berger, S.P., Heuvel, L.P.W.J. van den, Kar, N.C.A.J. van de, Wetzels, J.F.M., and Grp, Dutch aHUS Working
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Item does not contain fulltext
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- 2023
12. The role of interleukin-21 in COVID-19 vaccine-induced B cell-mediated immune responses in patients with kidney disease and kidney transplant recipients.
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Malahe, S.R.K., Hartog, Y.D., Rietdijk, W.J.R., Baarle, D. van, Kuiper, R. de, Reijerkerk, D., Ras, A.M., Geers, D., Diavatopoulos, D.A., Messchendorp, A.L., Molen, R.G. van der, Remmerswaal, E.B.M., Bemelman, F.J., Gansevoort, R.T., Hilbrands, L.B., Sanders, J.S., GeurtsvanKessel, C.H., Kho, M.M.L., Vries, R.D. de, Reinders, M.E.J., Baan, C.C., Malahe, S.R.K., Hartog, Y.D., Rietdijk, W.J.R., Baarle, D. van, Kuiper, R. de, Reijerkerk, D., Ras, A.M., Geers, D., Diavatopoulos, D.A., Messchendorp, A.L., Molen, R.G. van der, Remmerswaal, E.B.M., Bemelman, F.J., Gansevoort, R.T., Hilbrands, L.B., Sanders, J.S., GeurtsvanKessel, C.H., Kho, M.M.L., Vries, R.D. de, Reinders, M.E.J., and Baan, C.C.
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01 september 2023, Contains fulltext : 296138.pdf (Publisher’s version ) (Open Access), T-cell-mediated help to B cells is required for the development of humoral responses, in which the cytokine interleukin (IL)-21 is key. Here, we studied the mRNA-1273 vaccine-induced SARS-CoV-2-specific memory T-cell IL-21 response, memory B cell response, and immunoglobulin (Ig)G antibody levels in peripheral blood at 28 days after the second vaccination by ELISpot and the fluorescent bead-based multiplex immunoassay, respectively. We included 40 patients with chronic kidney disease (CKD), 34 patients on dialysis, 63 kidney transplant recipients (KTR), and 47 controls. We found that KTR, but not patients with CKD and those receiving dialysis, showed a significantly lower number of SARS-CoV-2-specific IL-21 producing T cells than controls (P < .001). KTR and patients with CKD showed lower numbers of SARS-CoV-2-specific IgG-producing memory B cells when compared with controls (P < .001 and P = .01, respectively). The T-cell IL-21 response was positively associated with the SARS-CoV-2-specific B cell response and the SARS-CoV-2 spike S1-specific IgG antibody levels (both Pearson r = 0.5; P < .001). In addition, SARS-CoV-2-specific B cell responses were shown to be IL-21 dependent. Taken together, we show that IL-21 signaling is important in eliciting robust B cell-mediated immune responses in patients with kidney disease and KTR.
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- 2023
13. Adherence to preventive measures after SARS-CoV-2 vaccination and after awareness of antibody response in kidney transplant recipients in the Netherlands: a nationwide questionnaire study.
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Frölke, S.C., Bouwmans, P., Messchendorp, A.L., Vervoort, J.P.M., Abrahams, A.C., Vries, Aiko P.J. de, Nieuwkerk, P.T., Hemmelder, M.H., Gansevoort, R.T., Hilbrands, L.B., Reinders, M.E., Sanders, J.F., Bemelman, F.J., Geerlings, S.E., Frölke, S.C., Bouwmans, P., Messchendorp, A.L., Vervoort, J.P.M., Abrahams, A.C., Vries, Aiko P.J. de, Nieuwkerk, P.T., Hemmelder, M.H., Gansevoort, R.T., Hilbrands, L.B., Reinders, M.E., Sanders, J.F., Bemelman, F.J., and Geerlings, S.E.
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01 augustus 2023, Item does not contain fulltext, BACKGROUND: Kidney transplant recipients (KTRs) were advised to tightly adhere to government recommendations to curb the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) because of a high risk of morbidity and mortality and decreased immunogenicity after vaccination. The aim of this study was to analyse the change in adherence to preventive measures after vaccination and awareness of antibody response, and to evaluate its effectiveness. METHODS: In this large-scale, national questionnaire study, questionnaires were sent to 3531 KTRs enrolled in the Dutch RECOVAC studies, retrospectively asking for adherence to nine preventive measures on a 5-point Likert scale before and after SARS-CoV-2 vaccination and after awareness of antibody response. Blood samples were collected 28 days after the second vaccination. Antibody response was categorised as non-responder (≤50 BAU/mL), low-responder (>50 ≤ 300 BAU/mL) or high-responder (>300 BAU/mL), and shared with participants as a correlate of protection. Participants of whom demographics on sex and age, blood samples and completed questionnaires were available, were included. Our study took place between February 2021 and January 2022. The primary outcome of adherence before and after vaccination was assessed between August and October 2021 and compared via the Wilcoxon signed rank sum test. Logistic regression analysis was performed to estimate the association between antibody response and non-adherence, and adherence on acquiring SARS-CoV-2 infection. This study is registered at ClinicalTrials.gov (NCT04841785). FINDINGS: In 2939 KTRs (83%) who completed the first questionnaire on adherence to preventive measures, adherence was higher before than after vaccination (4.56, IQR 4.11-4.78 and 4.22, IQR 3.67-4.67, p < 0.001). Adherence after awareness of antibody response was analysed in 2399 KTRs (82%) of whom also blood samples were available, containing 949 non-responders, 500 low-responders and 950 high-r
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- 2023
14. Considerable Variability Among Transplant Nephrologists in Judging Deceased Donor Kidney Offers.
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Schutter, R., Sanders, J.F., Ramspek, C.L., Crop, M.J., Bemelman, F.J., Christiaans, M.H., Hilbrands, L.B., Vries, A.P.J. de, Wetering, J. van de, Zuilen, A.D. van, Diepen, Merel van, Leuvenink, H.G., Dekker, F.W., Moers, C., Schutter, R., Sanders, J.F., Ramspek, C.L., Crop, M.J., Bemelman, F.J., Christiaans, M.H., Hilbrands, L.B., Vries, A.P.J. de, Wetering, J. van de, Zuilen, A.D. van, Diepen, Merel van, Leuvenink, H.G., Dekker, F.W., and Moers, C.
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Item does not contain fulltext, INTRODUCTION: Transplant clinicians may disagree on whether or not to accept a deceased donor kidney offer. We investigated the interobserver variability between transplant nephrologists regarding organ acceptance and whether the use of a prediction model impacted their decisions. METHODS: We developed an observational online survey with 6 real-life cases of deceased donor kidneys offered to a waitlisted recipient. Per case, nephrologists were asked to estimate the risk of adverse outcome and whether they would accept the offer for this patient, or for a patient of their own choice, and how certain they felt. These questions were repeated after revealing the risk of adverse outcome, calculated by a validated prediction model. RESULTS: Sixty Dutch nephrologists completed the survey. The intraclass correlation coefficient of their estimated risk of adverse outcome was poor (0.20, 95% confidence interval [CI] 0.08-0.62). Interobserver agreement of the decision on whether or not to accept the kidney offer was also poor (Fleiss kappa 0.13, 95% CI 0.129-0.130). The acceptance rate before and after providing the outcome of the prediction model was significantly influenced in 2 of 6 cases. Acceptance rates varied considerably among transplant centers. CONCLUSION: In this study, the estimated risk of adverse outcome and subsequent decision to accept a suboptimal donor kidney varied greatly among transplant nephrologists. The use of a prediction model could influence this decision and may enhance nephrologists' certainty about their decision.
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- 2023
15. Virus-Specific CD8+ T Cells Cross-Reactive to Donor-Alloantigen Are Transiently Present in the Circulation of Kidney Transplant Recipients Infected With CMV and/or EBV
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Heutinck, K.M., Yong, S.L., Tonneijck, L., van den Heuvel, H., van der Weerd, N.C., van der Pant, K.A.M.I., Bemelman, F.J., Claas, F.H.J., and ten Berge, I.J.M.
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- 2016
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16. Early eculizumab withdrawal in patients with atypical hemolytic uremic syndrome in native kidneys is safe and cost-effective
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Bouwmeester, R.N., Duineveld, C., Wijnsma, K.L., Bemelman, F.J., Heijden, J.W. van der, Wijk, J.A.E. van, Bouts, A.H.M., Wetering, J. van de, Dorresteijn, E., Berger, S.P., Gracchi, V., Zuilen, A.D. van, Keijzer-Veen, M.G., Vries, A.P.J. de, Rooij, R.W.G. van, Engels, F.A.P.T., Altena, W., Wildt, R. de, Kempen, E. van, Adang, E.M., Avest, M. ter, Heine, R. ter, Volokhina, E.B., Heuvel, L.P.W.J. van den, Wetzels, J.F.M., Kar, N.C.A.J. van de, Nephrology, Pediatrics, ACS - Microcirculation, Amsterdam Reproduction & Development (AR&D), Kindergeneeskunde, MUMC+: MA Medische Staf Kindergeneeskunde (9), RS: FHML non-thematic output, Internal Medicine, Paediatric Nephrology, ARD - Amsterdam Reproduction and Development, Groningen Kidney Center (GKC), and Groningen Institute for Organ Transplantation (GIOT)
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MUTATIONS ,atypical hemolytic uremic syndrome ,eculizu-mab ,DISCONTINUATION ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,thrombotic microangiopathy ,Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Nephrology ,complement inhibition ,eculizumab ,complement ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,COMPLEMENT ACTIVATION ,cost-effectiveness ,AHUS - Abstract
Introduction: The introduction of eculizumab has improved the outcome in patients with atypical hemo-lytic uremic syndrome (aHUS). The optimal treatment strategy is debated. Here, we report the results of the CUREiHUS study, a 4-year prospective, observational study monitoring unbiased eculizumab discontinuation in Dutch patients with aHUS after 3 months of therapy. Methods: All pediatric and adult patients with aHUS in native kidneys and a first-time eculizumab treat-ment were evaluated. In addition, an extensive cost-consequence analysis was conducted. Results: A total of 21 patients were included in the study from January 2016 to October 2020. In 17 patients (81%), a complement genetic variant or antibodies against factor H were identified. All patients showed full recovery of hematological thrombotic microangiopathy (TMA) parameters after the start of eculizumab. A renal response was noted in 18 patients. After a median treatment duration of 13.6 weeks (range 2.1-43.9), eculizumab was withdrawn in all patients. During follow-up (80.7 weeks [0.0-236.9]), relapses occurred in 4 patients. Median time to first relapse was 19.5 (14.3-53.6) weeks. Eculizumab was reinitiated within 24 hours in all relapsing patients. At last follow-up, there were no chronic sequelae, i.e., no clinically relevant increase in serum creatinine (sCr), proteinuria, and/or hypertension in relapsing patients. The low sample size and event rate did not allow to determine predictors of relapse. However, relapses only occurred in patients with a likely pathogenic variant. The cost-effectiveness analysis revealed that the total medical expenses of our population were only 30% of the fictive expenses that would have been made when patients received eculizumab every fortnight. Conclusion: It is safe and cost-effective to discontinue eculizumab after 3 months of therapy in patients with aHUS in native kidneys. Larger data registries are needed to determine factors associated with suboptimal kidney function recovery during eculizumab treatment, factors to predict relapses, and long-term outcomes of eculizumab discontinuation.
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- 2022
17. The potential beneficial role of faecal microbiota transplantation in diseases other than Clostridium difficile infection
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Singh, R., Nieuwdorp, M., ten Berge, I.J.M., Bemelman, F.J., and Geerlings, S.E.
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- 2014
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18. Breakthrough infections with the SARS-CoV-2 omicron (B.1.1.529) variant in patients with immune-mediated inflammatory diseases
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Stalman, E.W., Wieske, L., Dam, K.P.J. van, Kummer, L.Y., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Boekel, L., Wolbink, G.J., Kooi, A.J. van der, Raaphorst, J., Lowenberg, M., Takkenberg, R.B., D'Haens, G.R.A.M., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A.E., Broens, B., Sanchez, A.P., Els, C.A.C.M. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horvath, B., Verschuuren, J.J.G.M., Ruiter, A.M., Ouwerkerk, L. van, Woude, D. van der, Allaart, C.F., Teng, O.Y.K., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D.J., Schreurs, C.R.G., Pol, W.L. van der, Goedee, H.S., Steenhuis, M., Keijzer, S., Keijser, J.B.D., Boogaard, A., Cristianawati, O., Brinke, A. ten, Verstegen, N.J.M., Zwinderman, K.A.H., Rispens, T., Ham, S.M. van, Kuijpers, T.W., Eftimov, F., T2B Immunity Against SARS Co, Neurology, Dermatology, Graduate School, Paediatrics, Gastroenterology and Hepatology, Experimental Immunology, Clinical Immunology and Rheumatology, AII - Inflammatory diseases, Landsteiner Laboratory, ANS - Neuroinfection & -inflammation, ANS - Neurodegeneration, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, APH - Methodology, APH - Quality of Care, AII - Cancer immunology, Nephrology, 01 Internal and external specialisms, ACS - Atherosclerosis & ischemic syndromes, Epidemiology and Data Science, Paediatric Infectious Diseases / Rheumatology / Immunology, ARD - Amsterdam Reproduction and Development, EURO-NMD, Translational Immunology Groningen (TRIGR), SILS Other Research (FNWI), Amsterdam Neuroscience - Neuroinfection & -inflammation, Rheumatology, Molecular cell biology and Immunology, Pediatrics, Interne Geneeskunde, MUMC+: MA Nefrologie (9), MUMC+: MA Klinische Immunologie (9), RS: Carim - B02 Vascular aspects thrombosis and Haemostasis, and MUMC+: MA Med Staf Artsass Interne Geneeskunde (9)
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COVID-19 Vaccines ,SARS-CoV-2 ,Immunology ,Vaccination ,Autoimmunity ,General Biochemistry, Genetics and Molecular Biology ,Autoimmune Diseases ,Cohort Studies ,Rheumatology ,SDG 3 - Good Health and Well-being ,Immunology and Allergy ,Humans ,Prospective Studies ,Covid-19 ,Immunosuppressive Agents - Abstract
ObjectivesTo compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections.MethodsData were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants.Results1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection.ConclusionsThe cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.
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- 2022
19. 1 Nieren en pyelum-ureter: anatomie en fysiologie
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de Reijke, Th., Bemelman, F.J., Bosch, J.L.H.R., editor, and Prins, A., editor
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- 2010
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20. Early eculizumab withdrawal in patients with atypical hemolytic uremic syndrome in native kidneys is safe and cost-effective: results of the CUREiHUS study
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Bouwmeester, R.N., Duineveld, C., Wijnsma, K.L., Bemelman, F.J., Heijden, J.W. van der, Wijk, J.A. van, Bouts, A.H., Wetering, J. van de, Dorresteijn, E., Berger, S.P., Adang, E.M., Avest, M. ter, Heine, R. ter, Volokhina, E.B., Heuvel, L.P.W.J. van den, Wetzels, J.F.M., Kar, N.C.A.J. van de, Bouwmeester, R.N., Duineveld, C., Wijnsma, K.L., Bemelman, F.J., Heijden, J.W. van der, Wijk, J.A. van, Bouts, A.H., Wetering, J. van de, Dorresteijn, E., Berger, S.P., Adang, E.M., Avest, M. ter, Heine, R. ter, Volokhina, E.B., Heuvel, L.P.W.J. van den, Wetzels, J.F.M., and Kar, N.C.A.J. van de
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Item does not contain fulltext
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- 2022
21. Breakthrough SARS-CoV-2 infections with the delta (B.1.617.2) variant in vaccinated patients with immune-mediated inflammatory diseases using immunosuppressants: a substudy of two prospective cohort studies
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Boekel, L., Stalman, E.W., Wieske, L., Hooijberg, F., Dam, K.P.J. van, Besten, Y.R., Kummer, L.Y., Steenhuis, M., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Kooi, A.J. van der, Raaphorst, J., Löwenberg, M., Takkenberg, R.B., d'Haens, G., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A.E., Broens, B., Sanchez, A., Els, C. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horváth, B., Verschuuren, J., Ruiter, A.M. de, Ouwerkerk, L., Woude, D. van der, Allaart, C.F., Teng, Y.K.O., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D.J., Schreurs, C.R.G., Pol, W.Ludo van der, Goedee, H.S., Vogelzang, E.H., Leeuw, M. de, Atiqi, S., Vollenhoven, R. van, Gerritsen, M, Horst-Bruinsma, I.E. van der, Lems, W.F., Nurmohamed, M.T., Boers, Maarten, Keijzer, Sofie, Keijser, J. de, Sandt, C., Boogaard, A., Cristianawati, O., Brinke, A. Ten, Verstegen, N.J., Zwinderman, K.A.H., Ham, S.M. van, Rispens, T., Kuijpers, T.W., Wolbink, G., Eftimov, F., Boekel, L., Stalman, E.W., Wieske, L., Hooijberg, F., Dam, K.P.J. van, Besten, Y.R., Kummer, L.Y., Steenhuis, M., Kempen, Z.L.E. van, Killestein, J., Volkers, A.G., Tas, S.W., Kooi, A.J. van der, Raaphorst, J., Löwenberg, M., Takkenberg, R.B., d'Haens, G., Spuls, P.I., Bekkenk, M.W., Musters, A.H., Post, N.F., Bosma, A.L., Hilhorst, M.L., Vegting, Y., Bemelman, F.J., Voskuyl, A.E., Broens, B., Sanchez, A., Els, C. van, Wit, J. de, Rutgers, A., Leeuw, K. de, Horváth, B., Verschuuren, J., Ruiter, A.M. de, Ouwerkerk, L., Woude, D. van der, Allaart, C.F., Teng, Y.K.O., Paassen, P. van, Busch, M.H., Jallah, P.B.P., Brusse, E., Doorn, P.A. van, Baars, A.E., Hijnen, D.J., Schreurs, C.R.G., Pol, W.Ludo van der, Goedee, H.S., Vogelzang, E.H., Leeuw, M. de, Atiqi, S., Vollenhoven, R. van, Gerritsen, M, Horst-Bruinsma, I.E. van der, Lems, W.F., Nurmohamed, M.T., Boers, Maarten, Keijzer, Sofie, Keijser, J. de, Sandt, C., Boogaard, A., Cristianawati, O., Brinke, A. Ten, Verstegen, N.J., Zwinderman, K.A.H., Ham, S.M. van, Rispens, T., Kuijpers, T.W., Wolbink, G., and Eftimov, F.
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Item does not contain fulltext, BACKGROUND: Concerns have been raised regarding the risks of SARS-CoV-2 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases treated with immunosuppressants, but clinical data on breakthrough infections are still scarce. The primary objective of this study was to compare the incidence and severity of SARS-CoV-2 breakthrough infections between patients with immune-mediated inflammatory diseases using immunosuppressants, and controls (patients with immune-mediated inflammatory diseases not taking immunosuppressants and healthy controls) who had received full COVID-19 vaccinations. The secondary objective was to explore determinants of breakthrough infections of the delta (B.1.617.2) variant of SARS-CoV-2, including humoral immune responses after vaccination. METHODS: In this substudy, we pooled data collected in two large ongoing prospective multicentre cohort studies conducted in the Netherlands (Target to-B! [T2B!] study and Amsterdam Rheumatology Center COVID [ARC-COVID] study). Both studies recruited adult patients (age ≥18 years) with immune-mediated inflammatory diseases and healthy controls. We sourced clinical data from standardised electronic case record forms, digital questionnaires, and medical files. We only included individuals who were vaccinated against SARS-CoV-2. For T2B!, participants were recruited between Feb 2 and Aug 1, 2021, and for ARC-COVID, participants were recruited between April 26, 2020, and March 1, 2021. In this study we assessed data on breakthrough infections collected between July 1 and Dec 15, 2021, a period in which the delta SARS-CoV-2 variant was the dominant variant in the Netherlands. We defined a SARS-CoV-2 breakthrough infection as a PCR-confirmed or antigen test-confirmed SARS-CoV-2 infection that occurred at least 14 days after vaccination. All breakthrough infections during this period were assumed to be due to the delta variant due to its dominance during the study period. We analysed
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- 2022
22. Employment and ability to work after kidney transplantation in the Netherlands: The impact of preemptive versus non-preemptive kidney transplantation
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Visser, Annemieke de, Alma, M.A., Bakker, S.J.L., Bemelman, F.J., Berger, S.P., Boog, P.J. van der, Brouwer, S., Hilbrands, L.B., Standaar, D.S.M., Stewart, R.E., Gansevoort, R.T., Visser, Annemieke de, Alma, M.A., Bakker, S.J.L., Bemelman, F.J., Berger, S.P., Boog, P.J. van der, Brouwer, S., Hilbrands, L.B., Standaar, D.S.M., Stewart, R.E., and Gansevoort, R.T.
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Contains fulltext : 283478.pdf (Publisher’s version ) (Open Access), BACKGROUND: Work can have a major positive impact on health and wellbeing. Employment of kidney transplant recipients (KTR) of working age is much lower than in the general population. The first aim of this study was to examine the impact of a preemptive kidney transplantation (PKT) on employment, in addition to other possible influencing factors. The second aim was to explore differences in work ability, absenteeism and work performance among employed KTR with different types of transplantations. METHODS: A cross-sectional survey study was conducted between 2018 and 2019 in nine Dutch hospitals. PKT as potential predictor of employment was examined. Furthermore, work ability, absenteeism and loss of work performance were compared between employed preemptive recipients with a living donor (L-PKT) and non-preemptive recipients with a living donor (L-nPKT) and with a deceased donor (D-nPKT). RESULTS: Two hundred and twenty four KTR participated; 71% reported having paid work. Paid work was more common among PKT recipients (82% vs. 65% in L-nPKT and 55% in D-nPKT) and recipients who were younger (OR .950, 95%CI .913-.989), had no comorbidities (1 comorbidity: OR .397, 95%CI .167-.942; 2 comorbidities: OR .347, 95%CI .142-.844), had less fatigue (OR .974, 95%CI .962-.987) and had mentally demanding work tasks (only in comparison with physically demanding tasks, OR .342, 95%CI .145-.806). If recipients were employed, D-nPKT recipients worked fewer hours (mean 24.6±11.3 vs. PKT 31.1±9.6, L-nPKT 30.1±9.5) and D-nPKT and L-nPKT recipients received more often supplemental disability benefits (32 and 33.3%, respectively) compared to PKT recipients (9.9%). No differences were found for self-reported ability to work, sick leave (absenteeism) and loss of work performance with the exception of limitations in functioning at work. CONCLUSIONS: Preemptive kidney transplantation recipients with a kidney from a living donor are employed more often, work more hours per week (only in co
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- 2022
23. The Natural History of Clinical Operational Tolerance After Kidney Transplantation Through Twenty-Seven Cases
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Brouard, S., Pallier, A., Renaudin, K., Foucher, Y., Danger, R., Devys, A., Cesbron, A., Guillot-Guegen, C., Ashton-Chess, J., Le Roux, S., Harb, J., Roussey, G., Subra, J.-F., Villemain, F., Legendre, C., Bemelman, F.J., Orlando, G., Garnier, A., Jambon, H., Le Monies De Sagazan, H., Braun, L., Noël, C., Pillebout, E., Moal, M.-C., Cantarell, C., Hoitsma, A., Ranbant, M., Testa, A., Soulillou, J.-P., and Giral, M.
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- 2012
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24. Long-term efficacy and safety of SARS-CoV-2 vaccination in patients with chronic kidney disease, on dialysis or after kidney transplantation: a national prospective observational cohort study
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Bouwmans, P., Messchendorp, A.L., Sanders, J.S., Hilbrands, L., Reinders, M.E.J., Vart, P., Bemelman, F.J., Abrahams, A.C., Dorpel, M.A. van den, Dam, M.A. ten, Vries, A.P.J. de, Rispens, T., Steenhuis, M., Gansevoort, R.T., Hemmelder, M.H., RECOVAC Collaborators, Internal Medicine, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Groningen Institute for Organ Transplantation (GIOT), Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Nephrology, AII - Infectious diseases, APH - Aging & Later Life, and Landsteiner Laboratory
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COVID-19 Vaccines ,Time Factors ,Efficacy ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Cohort Studies ,Kidney transplantation ,Study Protocol ,All institutes and research themes of the Radboud University Medical Center ,SDG 3 - Good Health and Well-being ,Renal Dialysis ,Chronic kidney disease ,Humans ,Prospective Studies ,Renal Insufficiency, Chronic ,Netherlands ,SARS-CoV-2 ,MORTALITY ,COVID-19 ,Diseases of the genitourinary system. Urology ,Observational Studies as Topic ,Nephrology ,Antibody response ,RC870-923 ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,Safety ,Dialysis ,Vaccine ,Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] - Abstract
Background COVID-19 is associated with increased morbidity and mortality in patients with chronic kidney disease (CKD) stages G4-G5, on dialysis or after kidney transplantation (kidney replacement therapy, KRT). SARS-CoV-2 vaccine trials do not elucidate if SARS-CoV-2 vaccination is effective in these patients. Vaccination against other viruses is known to be less effective in kidney patients. Our objective is to assess the efficacy and safety of various types of SARS-CoV-2 vaccinations in patients with CKD stages G4-G5 or on KRT. Methods In this national prospective observational cohort study we will follow patients with CKD stages G4-G5 or on KRT (n = 12,000) after SARS-CoV-2 vaccination according to the Dutch vaccination program. Blood will be drawn for antibody response measurements at day 28 and month 6 after completion of vaccination. Patient characteristics and outcomes will be extracted from registration data and questionnaires during 2 years of follow-up. Results will be compared with a control group of non-vaccinated patients. The level of antibody response to vaccination will be assessed in subgroups to predict protection against COVID-19 breakthrough infection. Results The primary endpoint is efficacy of SARS-CoV-2 vaccination determined as the incidence of COVID-19 after vaccination. Secondary endpoints are the antibody based immune response at 28 days after vaccination, the durability of this response at 6 months after vaccination, mortality and (serious) adverse events. Conclusion This study will fulfil the lack of knowledge on efficacy and safety of SARS-CoV-2 vaccination in patients with CKD stages G4-G5 or on KRT. Trial registration The study protocol has been registered in clinicaltrials.gov(NCT04841785). Current knowledge about this subject COVID-19 has devastating impact on patients with CKD stages G4-G5, on dialysis or after kidney transplantation. Effective SARS-CoV-2 vaccination is very important in these vulnerable patient groups. Recent studies on vaccination in these patient groups are small short-term studies with surrogate endpoints. Contribution of this study Assessment of incidence and course of COVID-19 after various types of SARS-CoV-2 vaccination during a two-year follow-up period in not only patients on dialysis or kidney transplant recipients, but also in patients with CKD stages G4-G5. Quantitative analysis of antibody response after SARS-CoV-2 vaccination and its relationship with incidence and course of COVID-19 in patients with CKD stages G4-G5, on dialysis or after kidney transplantation compared with a control group. Monitoring of (serious) adverse events and development of anti-HLA antibodies. Impact on practice or policy Publication of the study design contributes to harmonization of SARS-CoV-2 vaccine study methodology in kidney patients at high-risk for severe COVID-19. Data on efficacy of SARS-CoV-2 vaccination in patients with CKD will provide guidance for future vaccination policy.
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- 2022
25. T-Cell Epitopes Shared Between Immunizing HLA and Donor HLA Associate With Graft Failure After Kidney Transplantation
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Peereboom, E.T.M., Matern, B.M., Tomosugi, T., Niemann, M., Drylewicz, J., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Reekum, F.E. van, Verhaar, M.C., Kamburova, E.G., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, A., Lardy, N.M., Swelsen, W., Pant, Karlijn A.M.I. van der, Weerd, N.C. van der, Berge, I.J. Ten, Bemelman, F.J., Vries, A.P.J de, Fijter, J.W. de, Betjes, M. G. H., Roelen, D.L., Claas, F.H.J., Otten, H.G., Heidt, S., Zuilen, A.D. van, Kobayashi, T., Geneugelijk, K., Spierings, E, Peereboom, E.T.M., Matern, B.M., Tomosugi, T., Niemann, M., Drylewicz, J., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Reekum, F.E. van, Verhaar, M.C., Kamburova, E.G., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, A., Lardy, N.M., Swelsen, W., Pant, Karlijn A.M.I. van der, Weerd, N.C. van der, Berge, I.J. Ten, Bemelman, F.J., Vries, A.P.J de, Fijter, J.W. de, Betjes, M. G. H., Roelen, D.L., Claas, F.H.J., Otten, H.G., Heidt, S., Zuilen, A.D. van, Kobayashi, T., Geneugelijk, K., and Spierings, E
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Contains fulltext : 241482.pdf (Publisher’s version ) (Open Access), CD4(+) T-helper cells play an important role in alloimmune reactions following transplantation by stimulating humoral as well as cellular responses, which might lead to failure of the allograft. CD4(+) memory T-helper cells from a previous immunizing event can potentially be reactivated by exposure to HLA mismatches that share T-cell epitopes with the initial immunizing HLA. Consequently, reactivity of CD4(+) memory T-helper cells toward T-cell epitopes that are shared between immunizing HLA and donor HLA could increase the risk of alloimmunity following transplantation, thus affecting transplant outcome. In this study, the amount of T-cell epitopes shared between immunizing and donor HLA was used as a surrogate marker to evaluate the effect of donor-reactive CD4(+) memory T-helper cells on the 10-year risk of death-censored kidney graft failure in 190 donor/recipient combinations using the PIRCHE-II algorithm. The T-cell epitopes of the initial theoretical immunizing HLA and the donor HLA were estimated and the number of shared PIRCHE-II epitopes was calculated. We show that the natural logarithm-transformed PIRCHE-II overlap score, or Shared T-cell EPitopes (STEP) score, significantly associates with the 10-year risk of death-censored kidney graft failure, suggesting that the presence of pre-transplant donor-reactive CD4(+) memory T-helper cells might be a strong indicator for the risk of graft failure following kidney transplantation.
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- 2021
26. The RECOVAC IR study: the immune response and safety of the mRNA-1273 COVID-19 vaccine in patients with chronic kidney disease, on dialysis or living with a kidney transplant
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Kho, M.M., Reinders, M.E., Baan, C.C., Baarle, D. van, Bemelman, F.J., Diavatopoulos, D.A., Gansevoort, R.T., Klis, F.R. van der, Koopmans, M.P., Messchendorp, A.L., Molen, R.G. van der, Remmerswaal, E.B.M., Rots, N., Vart, P., Vries, R.D. de, Hilbrands, L.B., Sanders, J.F., Kho, M.M., Reinders, M.E., Baan, C.C., Baarle, D. van, Bemelman, F.J., Diavatopoulos, D.A., Gansevoort, R.T., Klis, F.R. van der, Koopmans, M.P., Messchendorp, A.L., Molen, R.G. van der, Remmerswaal, E.B.M., Rots, N., Vart, P., Vries, R.D. de, Hilbrands, L.B., and Sanders, J.F.
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Item does not contain fulltext
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- 2021
27. Rationale and design of the OPTIMIZE trial: OPen label multicenter randomized trial comparing standard IMmunosuppression with tacrolimus and mycophenolate mofetil with a low exposure tacrolimus regimen In combination with everolimus in de novo renal transplantation in Elderly patients
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Boer, S de, Sanders, J.S., Bemelman, F.J., Betjes, M. G. H., Burgerhof, J.G.M., Hilbrands, L.B., Hesselink, D.A., Berger, S.P., Boer, S de, Sanders, J.S., Bemelman, F.J., Betjes, M. G. H., Burgerhof, J.G.M., Hilbrands, L.B., Hesselink, D.A., and Berger, S.P.
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Contains fulltext : 245104.pdf (Publisher’s version ) (Open Access)
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- 2021
28. ABO-incompatible kidney transplantation in perspective of deceased donor transplantation and induction strategies: a propensity-matched analysis
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Weerd, A.E. de, Brand, J. van den, Bouwsma, H., Vries, A.P.J de, Dooper, I.M.M., Sanders, J.F., Christiaans, M.H., Reekum, F.E. van, Zuilen, A.D. van, Bemelman, F.J., Nurmohamed, A.S., Agteren, M. van, Betjes, M. G. H., Jong, M.F.C. de, Baas, M.C., Weerd, A.E. de, Brand, J. van den, Bouwsma, H., Vries, A.P.J de, Dooper, I.M.M., Sanders, J.F., Christiaans, M.H., Reekum, F.E. van, Zuilen, A.D. van, Bemelman, F.J., Nurmohamed, A.S., Agteren, M. van, Betjes, M. G. H., Jong, M.F.C. de, and Baas, M.C.
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Contains fulltext : 245148.pdf (Publisher’s version ) (Open Access), Kidney transplant candidates are blood group incompatible with roughly one out of three potential living donors. We compared outcomes after ABO-incompatible (ABOi) kidney transplantation with matched ABO-compatible (ABOc) living and deceased donor transplantation and analyzed different induction regimens. We performed a retrospective study with propensity matching and compared patient and death-censored graft survival after ABOi versus ABOc living donor and deceased donor kidney transplantation in a nationwide registry from 2006 till 2019. 296 ABOi were compared with 1184 center and propensity-matched ABOc living donor and 1184 deceased donor recipients (matching: recipient age, sex, blood group, and PRA). Patient survival was better compared with deceased donor [hazard ratio (HR) for death of HR 0.69 (0.49-0.96)] and non-significantly different from ABOc living donor recipients [HR 1.28 (0.90-1.81)]. Rate of graft failure was higher compared with ABOc living donor transplantation [HR 2.63 (1.72-4.01)]. Rejection occurred in 47% of 140 rituximab versus 22% of 50 rituximab/basiliximab, and 4% of 92 alemtuzumab-treated recipients (P < 0.001). ABOi kidney transplantation is superior to deceased donor transplantation. Rejection rate and graft failure are higher compared with matched ABOc living donor transplantation, underscoring the need for further studies into risk stratification and induction therapy [NTR7587, www.trialregister.nl].
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- 2021
29. Improving outcomes for donation after circulatory death kidney transplantation: Science of the times
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de Kok, M.J.C. (Michèle J C), Schaapherder, A.F.M. (Alexander), Alwayn, I.P.J. (Ian), Bemelman, F.J. (Fréderike), Wetering, J. (Jacqueline) van de, van Zuilen, A.D. (Arjan D.), Christiaans, M.H. (Maarten), Baas, M.C. (Marije), Nurmohamed, A.S. (Azam S.), Berger, S.P. (Stefan P.), Bastiaannet, E. (Esther), Ploeg, R.J. (Rutger), de Vries, A.P.J. (Aiko P J), Lindeman, J. (J.), de Kok, M.J.C. (Michèle J C), Schaapherder, A.F.M. (Alexander), Alwayn, I.P.J. (Ian), Bemelman, F.J. (Fréderike), Wetering, J. (Jacqueline) van de, van Zuilen, A.D. (Arjan D.), Christiaans, M.H. (Maarten), Baas, M.C. (Marije), Nurmohamed, A.S. (Azam S.), Berger, S.P. (Stefan P.), Bastiaannet, E. (Esther), Ploeg, R.J. (Rutger), de Vries, A.P.J. (Aiko P J), and Lindeman, J. (J.)
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The use of kidneys donated after circulatory death (DCD) remains controversial due to concerns with regard to high incidences of early graft loss, delayed graft function (DGF), and impaired graft survival. As these concerns are mainly based on data from historical cohorts, they are prone to time-related effects and may therefore not apply to the current timeframe. To assess the impact of time on outcomes, we performed a time-dependent comparative analysis of outcomes of DCD and donation after brain death (DBD) kidney transplantations. Data of all 11,415 deceased-donor kidney transplantations performed in The Netherlands between 1990-2018 were collected. Based on the incidences of early graft loss, two eras were defined (1998-2008 [n = 3,499] and 2008-2018 [n = 3,781]), and potential time-related effects on outcomes evaluated. Multivariate analyses were applied to examine associations between donor type and outcomes. Interaction tests were used to explore presence of effect modification. Results show clear time-related effects on posttransplant outcomes. The 1998-2008 interval showed compromised outcomes for DCD procedures (higher incidences of DGF and early graft loss, impaired 1-year renal function, and inferior graft survival), whereas DBD and DCD outcome equivalence was observed for the 2008-2018 interval. This occurred despite persistently high incidences of DGF in DCD grafts, and more adverse recipient and donor risk profiles (recipients were 6 years older and the KDRI increased from 1.23 to 1.39 and from 1.35 to 1.49 for DBD and DCD donors). In contrast, the median cold ischaemic period dec
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- 2020
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30. Toward a Sensible Single-antigen Bead Cutoff Based on Kidney Graft Survival
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Wisse, B.W., Kamburova, E.G., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A., Plaisier, L., Seelen, M.A., Stephan Sanders, J., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., van Duijnhoven, E.M., Gelens, M., Christiaans, M.H., van Ittersum, F.J., Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K. van der, Weerd, N.C. van der, Berge, I.J. ten, Bemelman, F.J., Hoitsma, A.J., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., Otten, H.G., Wisse, B.W., Kamburova, E.G., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A., Plaisier, L., Seelen, M.A., Stephan Sanders, J., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., van Duijnhoven, E.M., Gelens, M., Christiaans, M.H., van Ittersum, F.J., Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K. van der, Weerd, N.C. van der, Berge, I.J. ten, Bemelman, F.J., Hoitsma, A.J., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., and Otten, H.G.
- Abstract
Contains fulltext : 204258.pdf (publisher's version ) (Open Access), BACKGROUND: There is no consensus in the literature on the interpretation of single-antigen bead positive for a specific HLA antibody. METHODS: To inform the debate, we studied the relationship between various single-antigen bead positivity algorithms and the impact of resulting donor-specific HLA antibody (DSA) positivity on long-term kidney graft survival in 3237 deceased-donor transplants. RESULTS: First, we showed that the interassay variability can be greatly reduced when working with signal-to-background ratios instead of absolute median fluorescence intensities (MFIs). Next, we determined pretransplant DSA using various MFI cutoffs, signal-to-background ratios, and combinations thereof. The impact of the various cutoffs was studied by comparing the graft survival between the DSA-positive and DSA-negative groups. We did not observe a strong impact of various cutoff levels on 10-year graft survival. A stronger relationship between the cutoff level and 1-year graft survival for DSA-positive transplants was found when using signal-to-background ratios, most pronounced for the bead of the same HLA locus with lowest MFI taken as background. CONCLUSIONS: With respect to pretransplant risk stratification, we propose a signal-to-background ratio-6 (using the bead of the same HLA-locus with lowest MFI as background) cutoff of 15 combined with an MFI cutoff of 500, resulting in 8% and 21% lower 1- and 10-year graft survivals, respectively, for 8% DSA-positive transplants.
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- 2019
31. Allocation to highly sensitized patients based on acceptable mismatches results in low rejection rates comparable to nonsensitized patients
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Heidt, S., Haasnoot, G.W., Witvliet, M.D., Linden-van Oevelen, M.J.H. van der, Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A., Plaisier, L., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K. van der, Weerd, N.C. van der, Berge, I.J. Ten, Bemelman, F.J., Hoitsma, A., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Otten, H.G., Roelen, D.L., Claas, F.H., Heidt, S., Haasnoot, G.W., Witvliet, M.D., Linden-van Oevelen, M.J.H. van der, Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A., Plaisier, L., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K. van der, Weerd, N.C. van der, Berge, I.J. Ten, Bemelman, F.J., Hoitsma, A., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Otten, H.G., Roelen, D.L., and Claas, F.H.
- Abstract
Contains fulltext : 208426.pdf (publisher's version ) (Open Access), Whereas regular allocation avoids unacceptable mismatches on the donor organ, allocation to highly sensitized patients within the Eurotransplant Acceptable Mismatch (AM) program is based on the patient's HLA phenotype plus acceptable antigens. These are HLA antigens to which the patient never made antibodies, as determined by extensive laboratory testing. AM patients have superior long-term graft survival compared with highly sensitized patients in regular allocation. Here, we questioned whether the AM program also results in lower rejection rates. From the PROCARE cohort, consisting of all Dutch kidney transplants in 1995-2005, we selected deceased donor single transplants with a minimum of 1 HLA mismatch and determined the cumulative 6-month rejection incidence for patients in AM or regular allocation. Additionally, we determined the effect of minimal matching criteria of 1 HLA-B plus 1 HLA-DR, or 2 HLA-DR antigens on rejection incidence. AM patients showed significantly lower rejection rates than highly immunized patients in regular allocation, comparable to nonsensitized patients, independent of other risk factors for rejection. In contrast to highly sensitized patients in regular allocation, minimal matching criteria did not affect rejection rates in AM patients. Allocation based on acceptable antigens leads to relatively low-risk transplants for highly sensitized patients with rejection rates similar to those of nonimmunized individuals.
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- 2019
32. A paired kidney analysis on the impact of pre-transplant anti-HLA antibodies on graft survival
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Michielsen, L.A., Wisse, B.W., Kamburova, E.G., Verhaar, M.C., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E, Hack, C.E., Reekum, F.E. van, Bots, M.L., Drop, A., Plaisier, L., Seelen, M.A., Sanders, J.F., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K.A. van der, Weerd, N.C. van der, Berge, I.J. ten, Bemelman, F.J., Hoitsma, A.J., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., Otten, H.G., Zuilen, A.D. van, Michielsen, L.A., Wisse, B.W., Kamburova, E.G., Verhaar, M.C., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E, Hack, C.E., Reekum, F.E. van, Bots, M.L., Drop, A., Plaisier, L., Seelen, M.A., Sanders, J.F., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K.A. van der, Weerd, N.C. van der, Berge, I.J. ten, Bemelman, F.J., Hoitsma, A.J., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., Otten, H.G., and Zuilen, A.D. van
- Abstract
Item does not contain fulltext, BACKGROUND: Pre-transplant donor-specific anti-human leucocyte antigen (HLA) antibodies (DSAs) are associated with impaired kidney graft survival while the clinical relevance of non-donor-specific anti-HLA antibodies (nDSAs) is more controversial. The aim of the present paired kidney graft study was to compare the clinical relevance of DSAs and nDSAs. METHODS: To eliminate donor and era-dependent factors, a post hoc paired kidney graft analysis was performed as part of a Dutch multicentre study evaluating all transplantations between 1995 and 2005 with available pre-transplant serum samples. Anti-HLA antibodies were detected with a Luminex single-antigen bead assay. RESULTS: Among 3237 deceased donor transplantations, we identified 115 recipient pairs receiving a kidney from the same donor with one recipient being DSA positive and the other without anti-HLA antibodies. Patients with pre-transplant DSAs had a significantly lower 10-year death-censored graft survival (55% versus 82%, P=0.0001). We identified 192 pairs with one recipient as nDSA positive (against Class I and/or II) and the other without anti-HLA antibodies. For the patients with nDSAs against either Class I or II, graft survival did not significantly differ compared with patients without anti-HLA antibodies (74% versus 77%, P = 0.79). Only in patients with both nDSAs Class I and II was there a trend towards a lower graft survival (58%, P = 0.06). Lastly, in a small group of 42 recipient pairs, 10-year graft survival in recipients with DSAs was 49% compared with 68% in recipients with nDSAs (P=0.11). CONCLUSION: This paired kidney analysis confirms that the presence of pre-transplant DSAs in deceased donor transplantations is a risk marker for graft loss, whereas nDSAs in general are not associated with a lower graft survival. Subgroup analysis indicated that only in broadly sensitized patients with nDSAs against Class I and II, nDSAs may be a risk marker for graft loss in the long term.
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- 2019
33. Antibodies against ARHGDIB are associated with long-term kidney graft loss
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Kamburova, E.G., Gruijters, M.L., Kardol-Hoefnagel, T., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A., Plaisier, L., Melchers, R.C., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K. van der, Weerd, N.C. van der, Berge, I.J. Ten, Hoitsma, A., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., Bemelman, F.J., Otten, H.G., Kamburova, E.G., Gruijters, M.L., Kardol-Hoefnagel, T., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A., Plaisier, L., Melchers, R.C., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, K. van der, Weerd, N.C. van der, Berge, I.J. Ten, Hoitsma, A., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., Bemelman, F.J., and Otten, H.G.
- Abstract
Contains fulltext : 215571.pdf (publisher's version ) (Open Access), The clinical significance of non-HLA antibodies on renal allograft survival is a matter of debate, due to differences in reported results and lack of large-scale studies incorporating analysis of multiple non-HLA antibodies simultaneously. We developed a multiplex non-HLA antibody assay against 14 proteins highly expressed in the kidney. In this study, the presence of pretransplant non-HLA antibodies was correlated to renal allograft survival in a nationwide cohort of 4770 recipients transplanted between 1995 and 2006. Autoantibodies against Rho GDP-dissociation inhibitor 2 (ARHGDIB) were significantly associated with graft loss in recipients transplanted with a deceased-donor kidney (N = 3276) but not in recipients of a living-donor kidney (N = 1496). At 10 years after deceased-donor transplantation, recipients with anti-ARHGDIB antibodies (94/3276 = 2.9%) had a 13% lower death-censored covariate-adjusted graft survival compared to the anti-ARHGDIB-negative (3182/3276 = 97.1%) population (hazard ratio 1.82; 95% confidence interval, 1.32-2.53; P = .0003). These antibodies occur independently from donor-specific anti-HLA antibodies (DSA) or other non-HLA antibodies investigated. No significant relations with graft loss were found for the other 13 non-HLA antibodies. We suggest that pretransplant risk assessment can be improved by measuring anti-ARHGDIB antibodies in all patients awaiting deceased-donor transplantation.
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- 2019
34. Antibodies against ARHGDIB are associated with long-term kidney graft loss
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Kamburova, E. G., Gruijters, M.L., Kardol-Hoefnagel, T., Wisse, B. W., Joosten, I. (Irma), Allebes, W.A. (Wil), Meer, A.J.G.M. (Astrid) van der, Hilbrands, L.B., Baas, M. C., Spierings, E. (E.), Hack, C.E. (Erik), van Reekum, F. E., Zuilen, A.D. (Arjan) van, Verhaar, M.C. (Marianne), Bots, M.L. (Michiel), Drop, A., Plaisier, L., Melchers, R.C.A., Seelen, MAJ, Sanders, J.-S. (Jan-Stephan), Hepkema, B.G. (Bouke), Lambeck, AJA, Bungener, LB, Roozendaal, C, Tilanus, M.G.J., Voorter, CE, Wieten, L, van Duijnhoven, E. M., Gelens, M., Christiaans, M.H. (Maarten), Ittersum, F.J. (Frans) van, Nurmohamed, S.A. (Shaikh Azam), Lardy, N.M. (Neubury), Swelsen, W., van der Pant, K., van der Weerd, NC, Berge, I.J.M. (Ineke) ten, Hoitsma, A., van der Boog, P. J. M., Fijter, J.W. (Johan) de, Betjes, M.G.H. (Michiel), Heidt, P.J. (Peter), Roelen, D.L., Claas, FH, Bemelman, F.J. (Fréderike), Otten, H.G. (Henderikus), Kamburova, E. G., Gruijters, M.L., Kardol-Hoefnagel, T., Wisse, B. W., Joosten, I. (Irma), Allebes, W.A. (Wil), Meer, A.J.G.M. (Astrid) van der, Hilbrands, L.B., Baas, M. C., Spierings, E. (E.), Hack, C.E. (Erik), van Reekum, F. E., Zuilen, A.D. (Arjan) van, Verhaar, M.C. (Marianne), Bots, M.L. (Michiel), Drop, A., Plaisier, L., Melchers, R.C.A., Seelen, MAJ, Sanders, J.-S. (Jan-Stephan), Hepkema, B.G. (Bouke), Lambeck, AJA, Bungener, LB, Roozendaal, C, Tilanus, M.G.J., Voorter, CE, Wieten, L, van Duijnhoven, E. M., Gelens, M., Christiaans, M.H. (Maarten), Ittersum, F.J. (Frans) van, Nurmohamed, S.A. (Shaikh Azam), Lardy, N.M. (Neubury), Swelsen, W., van der Pant, K., van der Weerd, NC, Berge, I.J.M. (Ineke) ten, Hoitsma, A., van der Boog, P. J. M., Fijter, J.W. (Johan) de, Betjes, M.G.H. (Michiel), Heidt, P.J. (Peter), Roelen, D.L., Claas, FH, Bemelman, F.J. (Fréderike), and Otten, H.G. (Henderikus)
- Abstract
The clinical significance of non‐HLA antibodies on renal allograft survival is a matter of debate, due to differences in reported results and lack of large‐scale studies incorporating analysis of multiple non‐HLA antibodies simultaneously. We developed a multiplex non‐HLA antibody assay against 14 proteins highly expressed in the kidney. In this study, the presence of pretransplant non‐HLA antibodies was correl
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- 2019
- Full Text
- View/download PDF
35. Allocation to highly sensitized patients based on acceptable mismatches results in low rejection rates comparable to nonsensitized patients
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Heidt, P.J. (Peter), Haasnoot, G.W. (Geert), Witvliet, M.D. (Marian), van der Linden-van Oevelen, M.J.H. (Marissa J. H.), Kamburova, E.G., Wisse, B.W., Joosten, I. (Irma), Allebes, W.A. (Wil), van der Meer, A., Hilbrands, L.B. (Luuk), Baas, M.C. (Marije), Spierings, E. (E.), Hack, C.E. (Erik), van Reekum, F., van Zuilen, A.D. (Arjan D.), Verhaar, M.C. (Marianne), Bots, M.L. (Michiel), Drop, A.C.A.D., Plaisier, L., Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G. (Bouke), Lambeck, A.J.A. (Annechien J.A.), Bungener, L.B., Roozendaal, C., Tilanus, M.G.J. (Marcel), Voorter, C.E.M. (C. E M), Wieten, L., van Duijnhoven, E., Gelens, M., Christiaans, M.H. (Maarten), van Ittersum, F., Nurmohamed, S.A. (Shaikh Azam), Lardy, N.M. (Neubury), Swelsen, W.T., van der Pant, K.A., Weerd, N.C. (Neelke) van der, Berge, I.J.M. (Ineke) ten, Bemelman, F.J. (Fréderike), Hoitsma, A.J. (Andries), van der Boog, P.J.M., Fijter, J.W. (Johan) de, Betjes, M.G.H. (Michiel), Otten, H.G. (Henderikus), Roelen, D.L. (Dave), Claas, F.H.J. (Frans), Heidt, P.J. (Peter), Haasnoot, G.W. (Geert), Witvliet, M.D. (Marian), van der Linden-van Oevelen, M.J.H. (Marissa J. H.), Kamburova, E.G., Wisse, B.W., Joosten, I. (Irma), Allebes, W.A. (Wil), van der Meer, A., Hilbrands, L.B. (Luuk), Baas, M.C. (Marije), Spierings, E. (E.), Hack, C.E. (Erik), van Reekum, F., van Zuilen, A.D. (Arjan D.), Verhaar, M.C. (Marianne), Bots, M.L. (Michiel), Drop, A.C.A.D., Plaisier, L., Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G. (Bouke), Lambeck, A.J.A. (Annechien J.A.), Bungener, L.B., Roozendaal, C., Tilanus, M.G.J. (Marcel), Voorter, C.E.M. (C. E M), Wieten, L., van Duijnhoven, E., Gelens, M., Christiaans, M.H. (Maarten), van Ittersum, F., Nurmohamed, S.A. (Shaikh Azam), Lardy, N.M. (Neubury), Swelsen, W.T., van der Pant, K.A., Weerd, N.C. (Neelke) van der, Berge, I.J.M. (Ineke) ten, Bemelman, F.J. (Fréderike), Hoitsma, A.J. (Andries), van der Boog, P.J.M., Fijter, J.W. (Johan) de, Betjes, M.G.H. (Michiel), Otten, H.G. (Henderikus), Roelen, D.L. (Dave), and Claas, F.H.J. (Frans)
- Abstract
Whereas regular allocation avoids unacceptable mismatches on the donor organ, allocation to highly sensitized patients within the Eurotransplant Acceptable Mismatch (AM) program is based on the patient's HLA phenotype plus acceptable antigens. These are HLA antigens to which the patient never made antibodies, as determined by extensive laboratory testing. AM patients have superior long-term graft survival compared with highly sensitized patients in regular allocation. Here, we questioned whether the AM program also results in lower rejection rates. From the PROCARE cohort, consisting of all Dutch kidney transplants in 1995-2005, we selected deceased donor single transplants with a minimum of 1 HLA mismatch and determined the cumulative 6-month rejection incidence for patients in AM or regular allocation. Additionally, we determined the effect of minimal matching criteria of 1 HLA-B plus 1 HLA-DR, or 2 HLA-DR antigens on rejection incidence. AM patients showed significantly lower rejection rates than highly immunized patients in regular allocation, comparable to nonsensitized patients, independent of other risk factors for rejection. In contrast to highly sensitized patients in regular allocation, minimal matching criteria did not affect rejection rates in AM patients. Allocation based on acceptable antigens leads to relatively low-risk transplants for highly sensitized patients with rejection rates similar to those of nonimmunized individuals.
- Published
- 2019
- Full Text
- View/download PDF
36. No long-term benefit of low-dose OKT3 induction therapy in non to moderately immunized renal allograft recipients
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Bemelman, F.J, Yong, S, Parlevliet, K.J, Surachno, S, Schellekens, P.T.A, and ten Berge, R.J.M
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- 2002
- Full Text
- View/download PDF
37. Predicition models for delayed graft function: external validation on The Dutch Prospective Renal Transplantation Registry
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Kers, J., Peters-Sengers, H., Heemskerk, M.B., Berger, S.P., Betjes, M.G., Zuilen, A.D. van, Hilbrands, L.B., Debray, Thomas P.A., Bemelman, F.J., Kers, J., Peters-Sengers, H., Heemskerk, M.B., Berger, S.P., Betjes, M.G., Zuilen, A.D. van, Hilbrands, L.B., Debray, Thomas P.A., and Bemelman, F.J.
- Abstract
Item does not contain fulltext
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- 2018
38. Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation
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Schaapherder, A., Wijermars, L.G.M., Vries, D.K. (Dorottya) de, de Vries, A. P. J., Bemelman, F.J. (Fréderike), Wetering, J. (Jacqueline) van de, Zuilen, A.D. (Arjan) van, Christiaans, M.H. (Maarten), Hilbrands, L.H., Baas, M. C., Nurmohamed, A.S., Berger, SP, Alwayn, I.P.J. (Ian), Bastiaannet, E. (Esther), Lindeman, JHN, Schaapherder, A., Wijermars, L.G.M., Vries, D.K. (Dorottya) de, de Vries, A. P. J., Bemelman, F.J. (Fréderike), Wetering, J. (Jacqueline) van de, Zuilen, A.D. (Arjan) van, Christiaans, M.H. (Maarten), Hilbrands, L.H., Baas, M. C., Nurmohamed, A.S., Berger, SP, Alwayn, I.P.J. (Ian), Bastiaannet, E. (Esther), and Lindeman, JHN
- Abstract
Background: Despite growing waiting lists for renal transplants, hesitations persist with regard to the use of deceased after cardiac death (DCD) renal grafts. We evaluated the outcomes of DCD donations in The Netherlands, the country with the highest proportion of DCD procedures (42.9%) to test whether these hesitations are justified. Methods: This study included all procedures with grafts donated after brain death (DBD) (n = 3611) and cardiac death (n= 2711) performed between 2000 and 2017. Transplant outcomes were compared by Kaplan Meier and Cox regression analysis, and factors associated with short (within 90 days of transplantation) and long-term graft loss evaluated in multi-variable analyses. Findings: Despite higher incidences of early graft loss (+50%) and delayed graft function (+250%) in DCD grafts, 10-year graft and recipient survival were similar for the two graft types (Combined 10-year graft survival: 73.9% (95% CI: 72.5–75.2), combined recipient survival: 64.5% (95 CI: 63.0–66.0%)). Long-term outcome equivalence was explained by a reduced impact of delayed graft function on DCD graft survival (RR: 0.69 (95% CI: 0.55–0.87), p b 0.001). Mid and long-term graft function (eGFR), and the impact of incident delayed graft function on eGFR were similar for DBD and DCD grafts. Interpretation: Mid and long term outcomes for DCD grafts are equivalent to DBD kidneys. Poorer short term outcomes are offset by a lesser impact of delayed graft function on DCD graft survival. This nation-wide evaluation does not justify the reluctance to use of DCD renal grafts. A strong focus on short-term outcome neglects the superior recovery potential of DCD grafts
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- 2018
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39. PIRCHE-II is related to graft failure after kidney transplantation
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Geneugelijk, K. (Kirsten), Niemann, M. (Matthias), Drylewicz, J. (Julia), van Zuilen, A.D. (Arjan D.), Joosten, I. (Irma), Allebes, W.A. (Wil), van der Meer, A., Hilbrands, L.B. (Luuk), Baas, M.C. (Marije), Hack, C.E. (Erik), van Reekum, F., Verhaar, M.C. (Marianne), Kamburova, E.G., Bots, M.L. (Michiel L.), Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G. (Bouke), Lambeck, A.J.A. (Annechien J.A.), Bungener, L.B., Roozendaal, C., Tilanus, M.G.J. (Marcel), Vanderlocht, J. (Joris), Voorter, C.E.M. (C. E M), Wieten, L., van Duijnhoven, E., Gelens, M., Christiaans, M.H. (Maarten), van Ittersum, F., Nurmohamed, A., Lardy, J.N.M. (Junior N.M.), Swelsen, W.T., van der Pant, K.A., Weerd, N.C. (Neelke) van der, Berge, I.J.M. (Ineke) ten, Bemelman, F.J. (Fréderike), Hoitsma, A.J. (Andries), van der Boog, P.J.M., Fijter, J.W. (Johan) de, Betjes, M.G.H. (Michiel), Heidt, P.J. (Peter), Roelen, D.L. (Dave), Claas, F.H.J. (Frans), Otten, H.G. (Henderikus), Spierings, E. (E.), Geneugelijk, K. (Kirsten), Niemann, M. (Matthias), Drylewicz, J. (Julia), van Zuilen, A.D. (Arjan D.), Joosten, I. (Irma), Allebes, W.A. (Wil), van der Meer, A., Hilbrands, L.B. (Luuk), Baas, M.C. (Marije), Hack, C.E. (Erik), van Reekum, F., Verhaar, M.C. (Marianne), Kamburova, E.G., Bots, M.L. (Michiel L.), Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G. (Bouke), Lambeck, A.J.A. (Annechien J.A.), Bungener, L.B., Roozendaal, C., Tilanus, M.G.J. (Marcel), Vanderlocht, J. (Joris), Voorter, C.E.M. (C. E M), Wieten, L., van Duijnhoven, E., Gelens, M., Christiaans, M.H. (Maarten), van Ittersum, F., Nurmohamed, A., Lardy, J.N.M. (Junior N.M.), Swelsen, W.T., van der Pant, K.A., Weerd, N.C. (Neelke) van der, Berge, I.J.M. (Ineke) ten, Bemelman, F.J. (Fréderike), Hoitsma, A.J. (Andries), van der Boog, P.J.M., Fijter, J.W. (Johan) de, Betjes, M.G.H. (Michiel), Heidt, P.J. (Peter), Roelen, D.L. (Dave), Claas, F.H.J. (Frans), Otten, H.G. (Henderikus), and Spierings, E. (E.)
- Abstract
Individual HLA mismatches may differentially impact graft survival after kidney transplantation. Therefore, there is a need for a reliable tool to define permissible HLA mismatches in kidney transplantation. We previously demonstrated that donor-derived Predicted Indirectly ReCognizable HLA Epitopes presented by recipient HLA class II (PIRCHE-II) play a role in de novo donor-specific HLA antibodies formation after kidney transplantation. In the present Dutch multi-center study, we evaluated the possible association between PIRCHE-II and kidney graft failure in 2,918 donor-recipient couples that were transplanted between 1995 and 2005. For these donors-recipients couples, PIRCHE-II numbers were related to graft survival in univariate and multivariable analyses. Adjusted for confounders, the natural logarithm of PIRCHE-II was associated with a higher risk for graft failure [hazard ratio (HR): 1.13, 95% CI: 1.04-1.23, p = 0.003]. When analyzing a subgroup of patients who had their first transplantation, the HR of graft failure for ln(PIRCHE-II) was higher compared with the overall cohort (HR: 1.22, 95% CI: 1.10-1.34, p < 0.001). PIRCHE-II demonstrated both early and late effects on graft failure in this subgroup. These data suggest that the PIRCHE-II may impact graft survival after kidney transplantation. Inclusion of PIRCHE-II in donor-selection criteria may eventually lead to an improved kidney graft survival.
- Published
- 2018
- Full Text
- View/download PDF
40. Pretransplant C3d-Fixing Donor-Specific Anti-HLA Antibodies Are Not Associated with Increased Risk for Kidney Graft Failure
- Author
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Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A.C., Plaisier, L., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M.A., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, Karlijn A.M.I. van der, Weerd, N.C. van der, Berge, I.J. Ten, Bemelman, F.J., Hoitsma, A.J., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., Otten, H.G., Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A.C., Plaisier, L., Seelen, M.A., Sanders, J.S., Hepkema, B.G., Lambeck, A.J.A., Bungener, L.B., Roozendaal, C., Tilanus, M.G., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M.A., Christiaans, M.H., Ittersum, F.J. van, Nurmohamed, S.A., Lardy, N.M., Swelsen, W., Pant, Karlijn A.M.I. van der, Weerd, N.C. van der, Berge, I.J. Ten, Bemelman, F.J., Hoitsma, A.J., Boog, P.J. van der, Fijter, J.W. de, Betjes, M.G., Heidt, S., Roelen, D.L., Claas, F.H., and Otten, H.G.
- Abstract
Item does not contain fulltext
- Published
- 2018
41. DIFFERENTIAL EFFECT OF DONOR-SPECIFIC HLA ANTIBODIES IN LIVING VERSUS DECEASED DONOR KIDNEY TRANSPLANTATION
- Author
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Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F. van, Zuilen, A. van, Verhaar, M.C., Bots, M.L., Drop, A.C.A.D., Plaisier, L., Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G., Lambeck, A.J., Bungener, L.B., Roozendaal, C., Tilanus, M.G.J., Voorter, C.E.M., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H.L., Ittersum, F.J. van, Nurmohamed, A., Lardy, N.M., Swelsen, W., Pant, K.A. van der, Weerd, N.C. van der, Berge, I.J.M. ten, Bemelman, F.J., Hoitsma, A., Boog, P.J.M. van der, Fijter, H. de, Betjes, M.G.H., Heidt, S., Roelen, D.L., Claas, F.H.J., and Otten, H.G.
- Published
- 2017
42. Treatment efficacy of hypertension in kidney transplant recipients in the Netherlands
- Author
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Dobrowolski, L.C., Bemelman, F.J., Donselaar-van der Pant, K.A. van, Hoitsma, A.J., Berge, I.J. Ten, and Krediet, C.T.
- Subjects
surgical procedures, operative ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] - Abstract
Item does not contain fulltext Background: Hypertension in kidney transplant recipients jeopardises graft and patient survival. Guidelines suggest blood pressure targets of ≤130/80 mmHg and sodium intake.
- Published
- 2014
43. Stretching the Limits of Renal Transplantation in Elderly Recipients of Grafts from Elderly Deceased Donors
- Author
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Peters-Sengers, H., Berger, S.P., Heemskerk, M.B., Arashi, D. Al, Heide, J.J. van der, Hemke, A.C., Berge, I.J. Ten, Idu, M.M., Betjes, M.G., Zuilen, A.D. van, Hilbrands, L.B., Vries, A.P.J de, Nurmohamed, A.S., Christiaans, M.H., Heurn, L.W. van, Fijter, J.W. de, Bemelman, F.J., Peters-Sengers, H., Berger, S.P., Heemskerk, M.B., Arashi, D. Al, Heide, J.J. van der, Hemke, A.C., Berge, I.J. Ten, Idu, M.M., Betjes, M.G., Zuilen, A.D. van, Hilbrands, L.B., Vries, A.P.J de, Nurmohamed, A.S., Christiaans, M.H., Heurn, L.W. van, Fijter, J.W. de, and Bemelman, F.J.
- Abstract
Item does not contain fulltext, An increasing number of elderly patients (>/=65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation Registry, we selected 3597 recipients (>/=18 years) who received a first DBD or DCD kidney during 2002-2012, and categorized them as young or elderly recipients receiving a graft from either a young or elderly donor, stratified by donor type. In multiple logistic regression analysis, elderly recipients of elderly DCD kidneys experienced more delayed graft function and acute rejection than did elderly recipients of young DBD kidneys (odds ratios 10.43 [95% confidence interval (95% CI), 5.75 to 18.91] and 2.78 [95% CI, 1.35 to 5.73], respectively). In Cox regression analysis, elderly recipients of elderly DCD kidneys had a 5-year mortality risk higher than that of elderly recipients of young DBD kidneys (hazard ratio, 1.86; 95% CI, 1.15 to 3.02). Elderly recipients of elderly kidneys had a 5-year mortality rate comparable to that of waitlisted elderly patients remaining on dialysis. Among elderly recipients, 63.8% of those who received elderly DCD kidneys, 45.5% of those who received elderly DBD kidneys, and approximately 26% of those who received young DBD or DCD kidneys had an eGFR<30 ml/min per 1.73 m2 (including primary nonfunction) after 1 year. In conclusion, improving donor selection and preservation is warranted if the allocation of elderly DCD grafts to elderly recipients is to be expanded.
- Published
- 2017
44. Similar 5-Year Estimated Glomerular Filtration Rate Between Kidney Transplants From Uncontrolled and Controlled Donors After Circulatory Death-A Dutch Cohort Study
- Author
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Peters-Sengers, H., Heide, J.J. van der, Heemskerk, M.B., Berge, I.J. Ten, Ultee, F.C.W., Idu, M.M., Betjes, M.G., Zuilen, A.D. van, Christiaans, M.H., Hilbrands, L.B., Nurmohamed, A.S., Berger, S.P., Bemelman, F.J., Peters-Sengers, H., Heide, J.J. van der, Heemskerk, M.B., Berge, I.J. Ten, Ultee, F.C.W., Idu, M.M., Betjes, M.G., Zuilen, A.D. van, Christiaans, M.H., Hilbrands, L.B., Nurmohamed, A.S., Berger, S.P., and Bemelman, F.J.
- Abstract
Item does not contain fulltext, BACKGROUND: Organ shortage persists despite a high rate of donation after circulatory death (DCD) in the Netherlands. The median waiting time for a deceased donor kidney in 2013 was 3.5 years. Most DCD kidneys are from controlled DCD (cDCD; Maastricht category III). Experience with uncontrolled donors after cardiac death (uDCD), that is, donors with an unexpected and irreversible cardiac arrest (Maastricht categories I and II), is increasing; and its effect on transplant outcomes needs evaluation. METHODS: We used the Dutch Organ Transplantation Registry to include recipients (>/=18 years old) from all Dutch centers who received transplants from 2002 to 2012 with a first DCD kidney. We compared transplant outcome in uDCD (n = 97) and cDCD (n = 1441). RESULTS: Primary nonfunction in uDCD was higher than in the cDCD (19.6% vs 9.6%, P < 0.001, respectively). Delayed graft function was also higher in uDCD than in cDCD, but not significantly (73.7% vs 63.3%, P = .074, respectively). If censored for primary nonfunction, estimated glomerular filtration rates after 1 year and 5 years were comparable between uDCD and cDCD (1 year: uDCD, 44.3 (23.4) mL/min/m and cDCD, 45.8 (24.1) mL/min/m; P = 0.621; 5 years: uDCD, 49.1 (25.6) mL/min/m and cDCD, 47.7 (21.7) mL/min/m; P = 0.686). The differences in primary nonfunction between kidneys from uDCD and cDCD were explained by differences in the first warm ischemic period, cold ischemic time, and donor age. CONCLUSIONS: We conclude that uDCD kidneys have potential for excellent function and can constitute a valuable extension of the donor pool. However, further efforts are necessary to address the high rate of primary nonfunction.
- Published
- 2017
45. Vesicoureteral reflux in kidney transplantation
- Author
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Molenaar, N.M. (Nina), Minnee, R.C., Bemelman, F.J. (Fréderike), Idu, M.M. (Mirza), Molenaar, N.M. (Nina), Minnee, R.C., Bemelman, F.J. (Fréderike), and Idu, M.M. (Mirza)
- Abstract
Background: Vesicoureteral reflux (VUR) is frequently found after transplantation, but its impact on graft function, urine tract infection, and graft loss remains uncertain. Therefore our objective was to evaluate the effects of VUR on the outcome of renal transplantation. Material and Methods: We included 1008 adult renal transplant recipients of whom a 1-week posttransplant voiding cystourethrogram was available. Study end points included occurrence of bacteriuria, renal function, and graft survival. Results: In total, 106 (10.5%) of 1008 graft recipients had a diagnosis of VUR on voiding cystography. The incidence of bacteriuria was comparable in the reflux and nonreflux group (17% vs 17.4%, P = .91). There was no significant difference in renal function at 3 months and 1 year in patients with and without VUR. One- and 5-year graft survival in patients with VUR was 85.8% and 82.1% compared to 87.3% and 83.0% in patients without VUR (P = .68 and P = .80). Conclusion: Posttransplant VUR has no correlations with early bacteriuria, renal function, and graft survival.
- Published
- 2017
- Full Text
- View/download PDF
46. Exploring genetic and non-genetic risk factors for delayed graft function, acute and subclinical rejection in renal transplant recipients
- Author
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Moes, D.J.A.R., Press, R.R., Ackaert, O., Ploeger, B.A., Bemelman, F.J., Diack, C., Wessels, J.A.M., Straaten, T. van der, Danhof, M., Sanders, J.S.F., Heide, J.J.H. van der, Guchelaar, H.J., and Fijter, J.W. de
- Subjects
Subclinical rejection ,Pharmacometrics ,Pharmacogenetics ,Acute rejection ,Delayed graft function ,Renal transplantation - Published
- 2016
47. How can we reduce costs of solid-phase multiplex-bead assays used to determine anti-HLA antibodies?
- Author
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Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F.E. van, Zuilen, A.D. van, Verhaar, M., Bots, M.L., Drop, A.C.A.D., Plaisier, L., Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G., Lambeck, A.J., Bungener, L.B., Roozendaal, C., Tilanus, M.G.J., Vanderlocht, J., Voorter, C.E., Wieten, L., Duijnhoven, E.M. van, Gelens, M., Christiaans, M.H.L., Ittersum, F.J. van, Nurmohamed, A., Lardy, N.M., Swelsen, W., Pant, K.A. van der, Weerd, N.C. van der, Berge, I.J.M. ten, Bemelman, F.J., Hoitsma, A., Boog, P.J.M. van der, Fijter, J.W. de, Betjes, M.G.H., Heidt, S., Roelen, D.L., Claas, F.H., Otten, H.G., RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Interne Geneeskunde, MUMC+: DA Transplantatie Immunologie (5), MUMC+: DA TI Staf (9), MUMC+: DA TI Laboratorium (9), MUMC+: MA Nefrologie (9), RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, Internal medicine, Nephrology, ICaR - Ischemia and repair, Internal Medicine, Other departments, AII - Amsterdam institute for Infection and Immunity, Groningen Institute for Organ Transplantation (GIOT), and Groningen Kidney Center (GKC)
- Subjects
CLINICAL-RELEVANCE ,KIDNEY-TRANSPLANTATION ,Immunology ,Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0] ,Sensitivity and Specificity ,HLA Antigens ,Isoantibodies ,Genetics ,Journal Article ,Immunology and Allergy ,Humans ,Alleles ,Automation, Laboratory ,Immunoassay ,Observer Variation ,ALLOANTIBODIES ,Histocompatibility Testing ,Immune Sera ,Reproducibility of Results ,human leukocyte antigen antibodies ,Kidney Transplantation ,single antigen ,solid-phase multiplex-bead assays ,luminex ,Reagent Kits, Diagnostic ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] - Abstract
Item does not contain fulltext Solid-phase multiplex-bead assays are widely used in transplantation to detect anti-human leukocyte antigen (HLA) antibodies. These assays enable high resolution detection of low levels of HLA antibodies. However, multiplex-bead assays are costly and yield variable measurements that limit the comparison of results between laboratories. In the context of a Dutch national Consortium study we aimed to determine the inter-assay and inter-machine variability of multiplex-bead assays, and we assessed how to reduce the assay reagents costs. Fifteen sera containing a variety of HLA antibodies were used yielding in total 7092 median fluorescence intensities (MFI) values. The inter-assay and inter-machine mean absolute relative differences (MARD) of the screening assay were 12% and 13%, respectively. The single antigen bead (SAB) inter-assay MARD was comparable, but showed a higher lot-to-lot variability. Reduction of screening assay reagents to 50% or 40% of manufacturers' recommendations resulted in MFI values comparable to 100% of the reagents, with an MARD of 12% or 14%, respectively. The MARD of the 50% and 40% SAB assay reagent reductions were 11% and 22%, respectively. From this study, we conclude that the reagents can be reliably reduced at least to 50% of manufacturers' recommendations with virtually no differences in HLA antibody assignments.
- Published
- 2016
48. PRE-TRANSPLANT DONOR SPECIFIC HLA ANTIBODIES IN 4386 RENAL TRANSPLANT RECIPIENTS: A PRELIMINARY ANALYSIS OF THE PROCARE COHORT
- Author
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Kamburova, E.G., Wisse, B.W., Joosten, I., Allebes, W.A., Meer, A. van der, Hilbrands, L.B., Baas, M.C., Spierings, E., Hack, C.E., Reekum, F. van, Zuilen, A.D. van, Verhaar, M.C., Bots, M.L., Drop, A.C.A.D., Plaisier, L., Seelen, M.A.J., Sanders, J.S.F., Hepkema, B.G., Lambeck, A.J., Bungener, L.B., Roozendaal, C., Tilanus, M.G.J., Vanderlocht, J., Voorter, C.E., Wieten, L., Duijnhoven, E. van, Gelens, M., Christiaans, M., Ittersum, F. van, Nurmohamed, A., Lardy, N.M., Swelsen, W.T., Pant, K.A.M.I. van der, Weerd, N.C. van der, Berge, I.J.M. ten, Bemelman, F.J., Hoitsma, A.J., Fijter, J.W. de, Betjes, M.G.H., Roelen, D.L., Claas, F.H.J., and Otten, H.G.
- Published
- 2016
49. Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands: Nephrology Dialysis Transplantation
- Author
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Dobrowolski, L. C., van Huis, A.M., van der Lee, J. H., Sengers, H. P., Lilien, M.R., Cransberg, K., Cornelissen, M., Bouts, A.H., de Fijter, Johan W., Berger, S.P., van Zuilen, Arjan, Nurmohamed, S. A., Betjes, M.G.H., Hilbrands, Luuk, Hoitsma, A.J., Bemelman, F.J., Krediet, C. T. P., Groothoff, J. W., Nephrology, and AII - Infectious diseases
- Abstract
Hypertension in kidney transplant recipients (KTRs) is a risk factor for cardiovascular mortality and graft loss. Data on the prevalence of hypertension and uncontrolled hypertension (uHT) in paediatric and young adult KTRs are scarce. Also, it is unknown whether 'transition' (the transfer from paediatric to adult care) influences control of hypertension. We assessed the prevalence of hypertension and uHT among Dutch paediatric and young adult KTRs and analysed the effects of transition. Additionally, we made an inventory of variations in treatment policies in Dutch transplant centres. Cross-sectional and longitudinal national data from living KTRs a parts per thousand currency sign30 years of age (a parts per thousand yen1-year post-transplant, eGFR > 20 mL/min) were extracted from the 'RICH Q' database, which comprises information about all Dutch KTRs
- Published
- 2016
50. Circulating lymphocyte subsets in different clinical situations after renal transplantation
- Author
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Berg, P.J. van den, Hoevenaars, E.C., Yong, S.L., Donselaar-van der Pant, K.A. van, Tellingen, A. van, Florquin, S., Lier, R.A.W. van, Bemelman, F.J., and Berge, I.J. Ten
- Subjects
Translational research [ONCOL 3] ,hemic and immune systems ,chemical and pharmacologic phenomena - Abstract
Item does not contain fulltext Phenotypic characterization of T and B lymphocytes allows the discrimination of functionally different subsets. Here, we questioned whether changes in peripheral lymphocyte subset distribution reflect specific clinical and histopathological entities after renal transplantation. Sixty-five renal transplant recipients with either histologically proven (sub)clinical acute rejection or chronic allograft dysfunction, or without abnormalities were studied for their peripheral lymphocyte subset composition and compared with 15 healthy control individuals. Naive, memory and effector CD8(+) T-cell counts were measured by staining for CD27, CD28 and CD45RO/RA. In addition, we studied the CD25(+) CD4(+) T-cell population for its composition regarding regulatory Foxp3(+) CD45RO(+) CD127(-) cells and activated CD45RO(+) CD127(+) cells. Naive, non-switched and switched memory B cells were defined by staining for IgD and CD27. We found a severe decrease in circulating effector-type CD8(+) T cells in recipients with chronic allograft dysfunction at 5 years after transplantation. Percentages of circulating CD25(+) CD127(low) CD4(+) regulatory T cells after transplantation were reduced, but we could not detect any change in the percentage of CD127(+) CD45RO(+) CD4(+) activated T cells in patients at any time or condition after renal transplantation. Regardless of clinical events, all renal transplant recipients showed decreased total B-cell counts and a more differentiated circulating B-cell pool than healthy individuals. The changes in lymphocyte subset distribution probably reflect the chronic antigenic stimulation that occurs in these transplant recipients. To determine the usefulness of lymphocyte subset-typing in clinical practice, large cohort studies are necessary. 01 juni 2012 10 p.
- Published
- 2012
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