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2. Anti-glutathione S-transferase theta 1 antibodies correlate with graft loss in non-sensitized pediatric kidney recipients

Author

Comoli, Patrizia, primary, Cioni, Michela, additional, Ray, Bryan, additional, Tagliamacco, Augusto, additional, Innocente, Annalisa, additional, Caridi, Gianluca, additional, Bruschi, Maurizio, additional, Hariharan, Jayasree, additional, Fontana, Iris, additional, Trivelli, Antonella, additional, Magnasco, Alberto, additional, Nocco, Angela, additional, Klersy, Catherine, additional, Muscianisi, Stella, additional, Ghiggeri, Gian Marco, additional, Cardillo, Massimo, additional, Verrina, Enrico, additional, Nocera, Arcangelo, additional, and Ginevri, Fabrizio, additional

Published
2022
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6. DQ molecules are the principal stimulators of de novo donor-specific antibodies in nonsensitized pediatric recipients receiving a first kidney transplant

Author

Tagliamacco, Augusto, Cioni, Michela, Comoli, Patrizia, Ramondetta, Miriam, Brambilla, Caterina, Trivelli, Antonella, Magnasco, Alberto, Biticchi, Roberta, Fontana, Iris, Dulbecco, Pietro, Palombo, Domenico, Klersy, Catherine, Ghiggeri, Gian Marco, Ginevri, Fabrizio, Cardillo, Massimo, and Nocera, Arcangelo

Published
2014
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7. Post-transplant de novo non donor-specific HLA antibodies are not associated with poor graft outcome in non-sensitized pediatric recipients of kidney transplantation

Author

Cioni, Michela, primary, Comoli, Patrizia, additional, Tagliamacco, Augusto, additional, Innocente, Annalisa, additional, Basso, Sabrina, additional, Fontana, Iris, additional, Magnasco, Alberto, additional, Trivelli, Antonella, additional, Nocco, Angela, additional, Macchiagodena, Mario, additional, Catenacci, Laura, additional, Klersy, Catherine, additional, Verrina, Enrico, additional, Garibotto, Giacomo, additional, Ghiggeri, Gian Marco, additional, Cardillo, Massimo, additional, Ginevri, Fabrizio, additional, and Nocera, Arcangelo, additional

Published
2021
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8. Effects of Late Conversion from Twice-Daily to Once-Daily Slow Release Tacrolimus on the Insulin Resistance Indexes in Kidney Transplant Patients

Author

Cademartori, Valeria, primary, Massarino, Fabio, additional, Parodi, Emanuele L., additional, Paoletti, Ernesto, additional, Russo, Rodolfo, additional, Sofia, Antonella, additional, Fontana, Iris, additional, Viazzi, Francesca, additional, Esposito, Pasquale, additional, and Garibotto, Giacomo, additional

Published
2021
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13. Everolimus for BKV nephropathy in kidney transplant recipients: a prospective, controlled study.

Author

Bussalino, Elisabetta, primary, Marsano, Luigina, additional, Parodi, Angelica, additional, Russo, Rodolfo, additional, Massarino, Fabio, additional, Ravera, Maura, additional, Gaggero, Gabriele, additional, Fontana, Iris, additional, Garibotto, Giacomo, additional, Zaza, Gianluigi, additional, Stallone, Giovanni, additional, and Paoletti, Ernesto, additional

Published
2020
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16. Longitudinal evaluation of mycophenolic acid pharmacokinetics in pediatric kidney transplant recipients. The role of post-transplant clinical and therapeutic variables

Author

Ghio, Luciana, Ferraresso, Mariano, Zacchello, Graziella, Murer, Luisa, Ginevri, Fabrizio, Belingheri, Mirco, Peruzzi, Licia, Zanon, Franco, Perfumo, Francesco, Berardinelli, Luisa, Tirelli, Silvia, Dello Strologo, Luca, Fontana, Iris, Valente, Umberto, Cardillo, Massimo, and Edefonti, Alberto

Published
2009
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17. The frequency of rare and monogenic diseases in pediatric organ transplant recipients in Italy.

Author

Vaisitti, Tiziana, Peritore, Daniela, Magistroni, Paola, Ricci, Andrea, Lombardini, Letizia, Gringeri, Enrico, Catalano, Silvia, Spada, Marco, Sciveres, Marco, Di Giorgio, Angelo, Limongelli, Giuseppe, Varrenti, Marisa, Gerosa, Gino, Terzi, Amedeo, Pace Napoleone, Carlo, Amodeo, Antonio, Ragni, Luca, Dello Strologo, Luca, Benetti, Elisa, and Fontana, Iris

Subjects
TRANSPLANTATION of organs, tissues, etc., RARE diseases, LUNG transplantation, HEART transplantation, KIDNEY transplantation, LUNGS, HEART
Abstract

Background: Rare diseases are chronic and life-threatening disorders affecting < 1 person every 2,000. For most of them, clinical symptoms and signs can be observed at birth or childhood. Approximately 80% of all rare diseases have a genetic background and most of them are monogenic conditions. In addition, while the majority of these diseases is still incurable, early diagnosis and specific treatment can improve patients' quality of life. Transplantation is among the therapeutic options and represents the definitive treatment for end-stage organ failure, both in children and adults. The aim of this paper was to analyze, in a large cohort of Italian patients, the main rare genetic diseases that led to organ transplantation, specifically pointing the attention on the pediatric cohort. Results: To the purpose of our analysis, we considered heart, lung, liver and kidney transplants included in the Transplant Registry (TR) of the Italian National Transplantation Center in the 2002–2019 timeframe. Overall, 49,404 recipients were enrolled in the cohort, 5.1% of whom in the pediatric age. For 40,909 (82.8%) transplant recipients, a disease diagnosis was available, of which 38,615 in the adult cohort, while 8,495 patients (17.2%) were undiagnosed. There were 128 disease categories, and of these, 117 were listed in the main rare disease databases. In the pediatric cohort, 2,294 (5.6%) patients had a disease diagnosis: of the 2,126 (92.7%) patients affected by a rare disease, 1,402 (61.1%) presented with a monogenic condition. As expected, the frequencies of pathologies leading to organ failure were different between the pediatric and the adult cohort. Moreover, the pediatric group was characterized, compared to the adult one, by an overall better survival of the graft at ten years after transplant, with the only exception of lung transplants. When comparing survival considering rare vs non-rare diseases or rare and monogenic vs rare non-monogenic conditions, no differences were highlighted for kidney and lung transplants, while rare diseases had a better survival in liver as opposed to heart transplants. Conclusions: This work represents the first national survey analyzing the main genetic causes and frequencies of rare and/or monogenic diseases leading to organ failure and requiring transplantation both in adults and children. [ABSTRACT FROM AUTHOR]

Published
2021
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24. De novo post-transplant thrombotic microangiopathy localized only to the graft in autosomal dominant polycystic kidney disease with thrombophilia

Author

Rolla, Davide, Fontana, Iris, Ravetti, Jean Louis, Marsano, Luigina, Bellino, Diego, Panaro, Laura, Ansaldo, Francesca, Mathiasen, Lisa, Storace, Giulia, and Trezzi, Matteo

Subjects
Kidney transplantation, hemic and lymphatic diseases, Leiden factor V, Case Report, urologic and male genital diseases, female genital diseases and pregnancy complications, Protrombin gene, Thrombotic miocroangiopathy
Abstract

Introduction: Thrombotic microangiopathy (TMA) is a serious complication of renal transplantation and is mostly related to the prothrombotic effect of calcineurin inhibitors (CNIs). A subset of TMA (29%-38%) is localized only to the graft. Case 1: A young woman suffering from autosomal dominant polycystic kidney disease (ADPKD) underwent kidney transplant. After 2 months, she showed slow renal deterioration (serum creatinine from 1.9 to 3.1 mg/dl), without hematological signs of hemolytic-uremic syndrome (HUS); only LDH enzyme transient increase was detected. Renal biopsy showed TMA: temporary withdraw of tacrolimus and plasmapheresis was performed. The renal function recovered (serum creatinine 1.9 mg/dl). From screening for thrombophilia, we found a mutation of the Leiden factor V gene. Case 2: A man affected by ADPKD underwent kidney transplantation, with delay graft function; first biopsy showed acute tubular necrosis, but a second biopsy revealed TMA, while no altered hematological parameters of HUS was detected. We observed only a slight increase of lactate dehydrogenase (LDH) levels. The tacrolimus was halved and plasmapheresis was performed: LDH levels normalized within 10 days and renal function improved (serum creatinine from 9 to 2.9 mg/dl). We found a mutation of the prothrombin gene. Only a renal biopsy clarifies the diagnosis of TMA, but it is necessary to pay attention to light increasing level of LDH. Conclusion: Prothrombotic effect of CNIs and mTOR inhibitor, mutation of genes encoding factor H or I, anticardiolipin antibodies, vascular rejection, cytomegalovirus infection are proposed to trigger TMA; we detected mutations of factor II and Leiden factor V, as facilitating conditions for TMA in patients affected by ADPKD.

Published
2015

26. Early interstitial macrophage infiltration with mild dysfunction is associated with subsequent kidney graft loss

Author

Paoletti, Ernesto, primary, Bussalino, Elisabetta, additional, Bellino, Diego, additional, Tagliamacco, Augusto, additional, Bruzzone, Marco, additional, Ravera, Maura, additional, Parodi, Angelica, additional, Fontana, Iris, additional, Gaggero, Gabriele, additional, Garibotto, Giacomo, additional, and Ravetti, Jean Louis, additional

Published
2019
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27. Failure to removede novodonor-specific HLA antibodies is influenced by antibody properties and identifies kidney recipients with late antibody-mediated rejection destined to graft loss - a retrospective study

Author

Cioni, Michela, primary, Nocera, Arcangelo, additional, Tagliamacco, Augusto, additional, Basso, Sabrina, additional, Innocente, Annalisa, additional, Fontana, Iris, additional, Magnasco, Alberto, additional, Trivelli, Antonella, additional, Klersy, Catherine, additional, Gurrado, Antonella, additional, Ramondetta, Miriam, additional, Boghen, Stella, additional, Catenacci, Laura, additional, Verrina, Enrico, additional, Garibotto, Giacomo, additional, Ghiggeri, Gian Marco, additional, Cardillo, Massimo, additional, Ginevri, Fabrizio, additional, and Comoli, Patrizia, additional

Published
2018
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28. Fatal Donor-Derived Carbapenem-Resistant Klebsiella pneumoniae Infection in a Combined Kidney-Pancreas Transplantation

Author

Varotti, Giovanni, Dodi, Ferdinando, Marchese, Anna, Terulla, Alessia, Bertocchi, Massimo, and Fontana, Iris

Subjects
Article Subject
Abstract

Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections in solid organ transplant recipients are associated with high morbidity and mortality. We report a case of a fatal donor-derived CR-KP infection in a combined kidney-pancreas transplant. Given the short interval of time between donor hospitalization and organ procurement, information concerning the donor CR-KP positivity arrived only 72 hours after transplant. Based on this experience, we believe that knowledge of the donor’s CR-KP status should be mandatory before procurement and, if positive, pancreas donation should be contraindicated.

Published
2016
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31. De Novo Donor-Specific HLA Antibodies Developing Early or Late after Transplant Are Associated with the Same Risk of Graft Damage and Loss in Nonsensitized Kidney Recipients

Author

Cioni, Michela, primary, Nocera, Arcangelo, additional, Innocente, Annalisa, additional, Tagliamacco, Augusto, additional, Trivelli, Antonella, additional, Basso, Sabrina, additional, Quartuccio, Giuseppe, additional, Fontana, Iris, additional, Magnasco, Alberto, additional, Drago, Francesca, additional, Gurrado, Antonella, additional, Guido, Ilaria, additional, Compagno, Francesca, additional, Garibotto, Giacomo, additional, Klersy, Catherine, additional, Verrina, Enrico, additional, Ghiggeri, Gian Marco, additional, Cardillo, Massimo, additional, Comoli, Patrizia, additional, and Ginevri, Fabrizio, additional

Published
2017
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32. Unusual Extrapulmonary Rhodococcus Equi Infection in a Kidney Transplant Patient

Author

Varotti, Giovanni, Barabani, Caterina, Dodi, Ferdinando, Bertocchi, Massimo, Mondello, Rosalia, Cupo, Pierpaolo, Santori, Gregorio, Palombo, Domenico, and Fontana, Iris

Subjects
Kidney transplantation, Rhodococcus Equi, Extrapulmonary infection, Extrapulmonary infection, Rhodococcus equi, Soft Tissue Infections, Graft Survival, Humans, Kidney Diseases, Immunotherapy, Middle Aged, Actinomycetales Infections, Kidney Transplantation, Abscess
Abstract

Rhodococcus equi is a well-recognized pathogen in veterinary medicine that can also affect immuno-compromised human subjects. The most common clinical features in humans include necrotizing pneumonia with subacute pulmonary disease, progressive cough, chest pain and fever. We report a case of a 49-year-old kidney transplant patient who developed a Rhodococcus equi infection characterized by multiple abscesses of the soft tissues and muscles without any respiratory manifestation. Combining specific antibiotic therapy and surgical management of the abscesses without immunosuppression discontinuation led to a complete recovery of both patient and graft.

Published
2015

33. Failure to remove de novo donor‐specific HLA antibodies is influenced by antibody properties and identifies kidney recipients with late antibody‐mediated rejection destined to graft loss – a retrospective study.

Author

Cioni, Michela, Nocera, Arcangelo, Tagliamacco, Augusto, Basso, Sabrina, Innocente, Annalisa, Fontana, Iris, Magnasco, Alberto, Trivelli, Antonella, Klersy, Catherine, Gurrado, Antonella, Ramondetta, Miriam, Boghen, Stella, Catenacci, Laura, Verrina, Enrico, Garibotto, Giacomo, Ghiggeri, Gian Marco, Cardillo, Massimo, Ginevri, Fabrizio, and Comoli, Patrizia

Subjects
IMMUNOGLOBULINS, KIDNEY transplantation, BLOOD proteins, TRANSPLANTATION of organs, tissues, etc., MEDICAL care
Abstract

Summary: Current research is focusing on identifying bioclinical parameters for risk stratification of renal allograft loss, largely due to antibody‐mediated rejection (AMR). We retrospectively investigated graft outcome predictors in 24 unsensitized pediatric kidney recipients developing HLA de novo donor‐specific antibodies (dnDSAs), and treated for late AMR with plasmapheresis + low‐dose IVIG + Rituximab or high‐dose IVIG + Rituximab. Renal function and DSA properties were assessed before and longitudinally post treatment. The estimated GFR (eGFR) decline after treatment was dependent on a negative % eGFR variation in the year preceding treatment (P = 0.021) but not on eGFR at treatment (P = 0.74). At a median follow‐up of 36 months from AMR diagnosis, 10 patients lost their graft. Altered eGFR (P < 0.001) and presence of C3d‐binding DSAs (P = 0.005) at treatment, and failure to remove DSAs (P = 0.01) were negatively associated with graft survival in the univariable analysis. Given the relevance of DSA removal for therapeutic success, we analyzed antibody properties dictating resistance to anti‐humoral treatment. In the multivariable analysis, C3d‐binding ability (P < 0.05), but not C1q‐binding, and high mean fluorescence intensity (P < 0.05) were independent factors characterizing DSAs scarcely susceptible to removal. The poor prognosis of late AMR is related to deterioration of graft function prior to treatment and failure to remove C3d binding and/or high‐MFI DSAs. [ABSTRACT FROM AUTHOR]

Published
2019
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35. Current preventive strategies and management of Epstein-Barr virus-related post-transplant lymphoproliferative disease in solid organ transplantation in Europe. Results of the ESGICH Questionnaire-based Cross-sectional Survey

Author

San-Juan, R., Manuel, O., Hirsch, H.H., Fernández-Ruiz, M., López-Medrano, F., Comoli, P., Caillard, S., Grossi, P., Aguado, J.M., Alamo-Martinez, Jose Maria, Anaya, Fernando, Anttila, Veli-Jukka, Arnol, Miha, Avolio, Alfonso W., Baccarani, Umberto, Castello, Isabel Beneyto, Boletis, Ioannis, Bonofiglio, Renzo, Bressollette, Celine, Brockmann, Jens, Caillard, Sophie, Pulido, Jorge Calvo, Catalan, Pilar, Christiansen, Claus, Cofan, Frederic, Cordero, Elisa, Leiro, Marisa Crespo, Dantal, Jacques, D'armini, Andrea, Delgado, Juan F., Strologo, Luca Dello, Raimondo, Francesco Di, Dierickx, Daan, Eis-Hübinger, Anna, Kremer, Samira Faf, Faggian, Giuseppe, Farinas, Maria Carmen, Folgueira, Maria Dolores, Fontana, Iris, Franco, Antonio, Furian, Lucrezia, Garzoni, Christian, Ghirardo, Giulia, Ginevri, Fabrizio, Grinyo, Josep, Grossi, Paolo Antonio, Gupte, Girish, Hansson, Lennart, Helantera, Ilkka, Herrero, Jose Ignacio, Hirsch, Hans H., Hobin, David, Hoffmann, Dieter, Jan, Lerut, Jarque, Isidro, Jespersen, Bente, Kaczmarek, Ingo, Kevin, Pilarczyk, Koneth, Irene, Kovac, Damjan, Lacaille, Florence, Lautenschlager, Irmeli, Len, Oscar, Llado, Laura, Loy, Monica, Manuel, Oriol, Marcos Maeso, Maria Angeles, Marianne, Leruez-Ville, Marsh, James, Meylan, Pascal, Minambres, Eduardo, Montejo, Miguel, Mueller, Nicolas, Munoz, Patricia, Nadalin, Silvio, Kamar, Nassim, Nicolas, Blin, Olivier, Detry, Palomo, Jesus, Pascual, Manuel, Peter, Jaksch, Pierre, Frange, Francisca Portero, M., Provot, Francois, Boluda, Esther Ramos, Regalia, Enrico, Reina, Gabriel, Reuter, Stefan, Ricart, Jose, Garcia, Minerva Rodriguez, Rollag, Halvor, Russo, Francesco Paolo, Sabe, Nuria, Salcedo, Magdalena, Santambrogio, Luigi, Seeman, Tomas, Serra, Nuria, Sgarabotto, Dino, Simonek, Jan, Thierry, Yandza, Thomsen, Marianne Kragh, Tihic, Nijaz, Torre-Cisneros, Julian, Travi, Giovanna, Tulissi, Patrizia, Moal, Valerie, Veroux, Massimiliano, Santandreu, Ana Vila, Vizzini, Giovanni, Zibar, Lada, San-Juan, R., Manuel, O., Hirsch, H.H., Fernández-Ruiz, M., López-Medrano, F., Comoli, P., Caillard, S., Grossi, P., Aguado, J.M., Alamo-Martinez, Jose Maria, Anaya, Fernando, Anttila, Veli-Jukka, Arnol, Miha, Avolio, Alfonso W., Baccarani, Umberto, Castello, Isabel Beneyto, Boletis, Ioannis, Bonofiglio, Renzo, Bressollette, Celine, Brockmann, Jens, Caillard, Sophie, Pulido, Jorge Calvo, Catalan, Pilar, Christiansen, Claus, Cofan, Frederic, Cordero, Elisa, Leiro, Marisa Crespo, Dantal, Jacques, D'armini, Andrea, Delgado, Juan F., Strologo, Luca Dello, Raimondo, Francesco Di, Dierickx, Daan, Eis-Hübinger, Anna, Kremer, Samira Faf, Faggian, Giuseppe, Farinas, Maria Carmen, Folgueira, Maria Dolores, Fontana, Iris, Franco, Antonio, Furian, Lucrezia, Garzoni, Christian, Ghirardo, Giulia, Ginevri, Fabrizio, Grinyo, Josep, Grossi, Paolo Antonio, Gupte, Girish, Hansson, Lennart, Helantera, Ilkka, Herrero, Jose Ignacio, Hirsch, Hans H., Hobin, David, Hoffmann, Dieter, Jan, Lerut, Jarque, Isidro, Jespersen, Bente, Kaczmarek, Ingo, Kevin, Pilarczyk, Koneth, Irene, Kovac, Damjan, Lacaille, Florence, Lautenschlager, Irmeli, Len, Oscar, Llado, Laura, Loy, Monica, Manuel, Oriol, Marcos Maeso, Maria Angeles, Marianne, Leruez-Ville, Marsh, James, Meylan, Pascal, Minambres, Eduardo, Montejo, Miguel, Mueller, Nicolas, Munoz, Patricia, Nadalin, Silvio, Kamar, Nassim, Nicolas, Blin, Olivier, Detry, Palomo, Jesus, Pascual, Manuel, Peter, Jaksch, Pierre, Frange, Francisca Portero, M., Provot, Francois, Boluda, Esther Ramos, Regalia, Enrico, Reina, Gabriel, Reuter, Stefan, Ricart, Jose, Garcia, Minerva Rodriguez, Rollag, Halvor, Russo, Francesco Paolo, Sabe, Nuria, Salcedo, Magdalena, Santambrogio, Luigi, Seeman, Tomas, Serra, Nuria, Sgarabotto, Dino, Simonek, Jan, Thierry, Yandza, Thomsen, Marianne Kragh, Tihic, Nijaz, Torre-Cisneros, Julian, Travi, Giovanna, Tulissi, Patrizia, Moal, Valerie, Veroux, Massimiliano, Santandreu, Ana Vila, Vizzini, Giovanni, and Zibar, Lada

Abstract

There is limited clinical evidence on the utility of the monitoring of Epstein-Barr virus (EBV) DNAemia in the pre-emptive management of post-transplant lymphoproliferative disease (PTLD) in solid organ transplant (SOT) recipients. We investigated current preventive measures against EBV-related PTLD through a web-based questionnaire sent to 669 SOT programmes in 35 European countries. This study was performed on behalf of the ESGICH study group from the European Society of Clinical Microbiology and Infectious Diseases. A total of 71 SOT programmes from 15 European countries participated in the study. EBV serostatus of the recipient is routinely obtained in 69/71 centres (97%) and 64 (90%) have access to EBV DNAemia assays. EBV monitoring is routinely used in 85.9% of the programmes and 77.4% reported performing pre-emptive treatment for patients with significant EBV DNAemia levels. Pre-emptive treatment for EBV DNAemia included reduction of immunosuppression in 50.9%, switch to mammalian target of rapamycin inhibitors in 30.9%, and use of rituximab in 14.5% of programmes. Imaging by whole-body 18-fluoro-deoxyglucose positron emission tomography (FDG-PET) is used in 60.9% of centres to rule out PTLD and complemented computer tomography is used in 50%. In 10.9% of centres, FDG-PET is included in the first-line diagnostic workup in patients with high-risk EBV DNAemia. Despite the lack of definitive evidence, EBV load measurements are frequently used in Europe to guide diagnostic workup and pre-emptive reduction of immunosuppression. We need prospective and controlled studies to define the impact of EBV monitoring in reducing the risk of PTLD in SOT recipients.

Published
2015

36. Optimising utilisation of kidneys from deceased donors over 60 years: Five–year outcomes after implementation of a combined clinical and histological allocation algorithm

Author

Pierobon Elisa Sefora, Sandrini Silvio, De Fazio Nicola, Rossini Giuseppe, Fontana Iris, Boschiero Luigino, Gropuzzo Maria, Gotti Eliana Donati Donato, Minetti Enrico, Gandolfo Maria Teresa, Brunello Anna, Libetta Carmelo, Secchi A, Chiaramonte Stefano, Rigotti Paolo, Pierobon Elisa, Sefora, Sandrini, Silvio, De Fazio, Nicola, Rossini, Giuseppe, Fontana, Iri, Boschiero, Luigino, Gropuzzo, Maria, Gotti Eliana Donati, Donato, Minetti, Enrico, Gandolfo Maria, Teresa, Brunello, Anna, Libetta, Carmelo, Secchi, A, Chiaramonte, Stefano, and Rigotti, Paolo

Published
2013

37. Optimizing utilization of kidneys from deceased donors over 60 years: Five-year outcomes after implementation of a combined clinical and histological allocation algorithm

Author

Elisa Sefora, Pierobon, Pierobon Elisa, Sefora, Silvio, Sandrini, Sandrini, Silvio, Nicola, De Fazio, De Fazio, Nicola, Giuseppe, Rossini, Rossini, Giuseppe, Iris, Fontana, Fontana, Iris, Luigino, Boschiero, Boschiero, Luigino, Maria, Gropuzzo, Gropuzzo, Maria, Eliana, Gotti, Gotti, Eliana, Donato, Donati, Donati, Donato, Enrico, Minetti, Minetti, Enrico, Maria Teresa, Gandolfo, Gandolfo Maria, Teresa, Anna, Brunello, Brunello, Anna, Carmelo, Libetta, Libetta, Carmelo, Antonio, Secchi, Secchi, Antonio, Stefano, Chiaramonte, Chiaramonte, Stefano, Paolo, Rigotti, and Rigotti, Paolo

Subjects
Male, medicine.medical_specialty, Biopsy, graft survival, Delayed Graft Function, kidney transplantation, Kidney, Kidney transplant, Single kidney, allocation algorithm, Risk Factors, Internal medicine, Daily practice, Cadaver, medicine, Humans, In patient, ECD, Kidney transplantation, Aged, Retrospective Studies, Aged, 80 and over, DKT, Transplantation, medicine.diagnostic_test, business.industry, Allocation algorithm, Middle Aged, medicine.disease, Tissue Donors, Surgery, Treatment Outcome, Italy, Kidney Failure, Chronic, Female, Observational study, business, Algorithms
Abstract

This 5 year observational multicentre study conducted in the Nord Italian Transplant programme area evaluated outcomes in patients receiving kidneys from donors over 60 years allocated according to a combined clinical and histological algorithm. Low-risk donors 60-69 years without risk factors were allocated to single kidney transplant (LR-SKT) based on clinical criteria. Biopsy was performed in donors over 70 years or 60-69 years with risk factors, allocated to Single (HR-SKT) or Dual kidney transplant (HR-DKT) according to the severity of histological damage. Forty HR-DKTs, 41 HR-SKTs and 234 LR-SKTs were evaluated. Baseline differences generally reflected stratification and allocation criteria. Patient and graft (death censored) survival were 90% and 92% for HR-DKT, 85% and 89% for HR-SKT, 88% and 87% for LR-SKT. The algorithm appeared user-friendly in daily practice and was safe and efficient, as demonstrated by satisfactory outcomes in all groups at 5 years. Clinical criteria performed well in low-risk donors. The excellent outcomes observed in DKTs call for fine-tuning of cut-off scores for allocation to DKT or SKT in high-risk patients.

Published
2013

38. CEUS Retrograde Cystography Is Helpful in Percutaneous Drainage of Complex Posttransplant Lymphocele

Author

Di Domenico, Stefano, Patti, Valentina, Fazio, Federico, Moggia, Elisabetta, Fontana, Iris, and Valente, Umberto

Subjects
Article Subject
Abstract

After monolateral dual kidney transplantation, a 69 years old male patient developed symptomatic lymphocele with mild hydroureteronephrosis, impaired renal function, and right inferior limb oedema. A percutaneous ultrasound-guided drainage of the fluid collection was planned, but the complex mutual relations between the collection and the renal hilus did not allow to identify a suitable route for a safe drainage insertion during conventional ultrasound examination. A retrograde cystography using echographic contrast agent was, therefore, performed, and it clarified the position of both ureters and the renal vessels, permitting an harmless ultrasound-guided percutaneous lymphocele drainage. In conclusion contrast-enhanced ultrasound retrograde cystography may be helpful in percutaneous drainage of complex posttransplant lymphocele.

Published
2012
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39. Regression of asymptomatic cardiomyopathy and clinical outcome of renal transplant recipients: a long-term prospective cohort study

Author

Paoletti, Ernesto, primary, Bellino, Diego, additional, Signori, Alessio, additional, Pieracci, Laura, additional, Marsano, Luigina, additional, Russo, Rodolfo, additional, Massarino, Fabio, additional, Ravera, Maura, additional, Fontana, Iris, additional, Carta, Annalisa, additional, Cassottana, Paolo, additional, and Garibotto, Giacomo, additional

Published
2015
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40. Posttransplant Soluble B-Cell Activating Factor Kinetics in Pediatric Recipients of First Kidney Allograft

Author

Comoli, Patrizia, primary, Quartuccio, Giuseppe, additional, Cioni, Michela, additional, Parodi, Angelica, additional, Nocera, Arcangelo, additional, Basso, Sabrina, additional, Fontana, Iris, additional, Magnasco, Alberto, additional, Sioli, Viviana, additional, Guido, Ilaria, additional, Klersy, Catherine, additional, Zecca, Marco, additional, Cardillo, Massimo, additional, Ghiggeri, Gian Marco, additional, and Ginevri, Fabrizio, additional

Published
2015
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41. DQ molecules are the principal stimulators ofde novodonor-specific antibodies in nonsensitized pediatric recipients receiving a first kidney transplant

Author

Tagliamacco, Augusto, primary, Cioni, Michela, additional, Comoli, Patrizia, additional, Ramondetta, Miriam, additional, Brambilla, Caterina, additional, Trivelli, Antonella, additional, Magnasco, Alberto, additional, Biticchi, Roberta, additional, Fontana, Iris, additional, Dulbecco, Pietro, additional, Palombo, Domenico, additional, Klersy, Catherine, additional, Ghiggeri, Gian Marco, additional, Ginevri, Fabrizio, additional, Cardillo, Massimo, additional, and Nocera, Arcangelo, additional

Published
2014
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42. Regression of asymptomatic cardiomyopathy and clinical outcome of renal transplant recipients: a long-term prospective cohort study.

Author

Paoletti, Ernesto, Bellino, Diego, Signori, Alessio, Pieracci, Laura, Marsano, Luigina, Russo, Rodolfo, Massarino, Fabio, Ravera, Maura, Fontana, Iris, Carta, Annalisa, Cassottana, Paolo, and Garibotto, Giacomo

Subjects
LEFT ventricular hypertrophy, KIDNEY transplantation, CARDIOVASCULAR diseases, DISEASE prevalence, RANDOMIZED controlled trials, FOLLOW-up studies (Medicine)
Abstract

Background. Asymptomatic left ventricular hypertrophy (LVH) is highly prevalent and associated with an adverse outcome in renal transplant recipients (RTRs). Nonetheless, there are currently no available studies analyzing the effect of LVH regression on solid clinical endpoints in these patients. Methods. This study is the prospective observational extension of two randomized controlled trials aimed at assessing the effect of active intervention on post-transplant LVH in RTRs. We evaluated the incidence of a composite of death and any cardiovascular (CV) or renal event in 60 RTRs in whom LVH regression was observed and in 40 whose LVH remained unchanged or worsened. Results. During an 8.4 ± 3.5-year follow-up, 8 deaths, 18 CV events and 6 renal events occurred in the entire cohort. Multivariable analysis showed that age [hazard ratio (HR) 1.07, 95% confidence interval (CI) 1.03-1.12 each 1 year, P = 0.002] and LVH regression (HR 0.42, 95% CI 0.22-0.87, P = 0.019) were significant predictors of the composite endpoint. Kaplan- Meier estimates showed better survival rates in patients in whom actual LVH regression was achieved (P < 0.001, logrank test). Age (HR 1.09, 95% CI 1.03-1.15 each 1 year, P = 0.004), better graft function (HR 0.95, 95% CI 0.91-0.99 each 1 mL/min/1.73 m² increase in estimated glomerular filtration rate, P = 0.03) and LVH regression (HR 0.41, 95% CI 0.22-0.79, P = 0.01) were significant predictors of the CV endpoint. Patients with a left ventricular mass index decrease also showed better cardiac event-free survival (P = 0.0022, log-rank test). Conclusions. This is the first study to demonstrate that LVH regression, regardless of the therapeutic strategy adopted to achieve it, portends better long-term clinical outcome in RTRs. [ABSTRACT FROM AUTHOR]

Published
2016
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44. Polyomavirus BK-Specific Immunity after Kidney Transplantation

Author

Comoli, Patrizia, primary, Azzi, Alberta, additional, Maccario, Rita, additional, Basso, Sabrina, additional, Botti, Gerardo, additional, Basile, Giancarlo, additional, Fontana, Iris, additional, Labirio, Massimo, additional, Cometa, Angela, additional, Poli, Francesca, additional, Perfumo, Francesco, additional, Locatelli, Franco, additional, and Ginevri, Fabrizio, additional

Published
2004
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48. HLA MATCHING IN PEDIATRIC RECIPIENTS OF A FIRST KIDNEY GRAFT

Author

Barocci, Sergio, primary, Valente, Umberto, additional, Gusmano, Rosanna, additional, Torre, Francesca, additional, Basile, Gianfranco, additional, Fontana, Iris, additional, Arcuri, Valentino, additional, Olmi, Fabrizio, additional, Angelini, Gerardo, additional, and Nocera, Arcangelo, additional

Published
1996
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