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4. Chromosomal instability in a patient with ring chromosome 14 syndrome: a case report

Author

Meza-Espinoza, Juan Pablo, González-García, Juan Ramón, Nieto-Marín, Nayeli, Patrón-Baro, Liliana Itzel, González-Arreola, Rosa María, Arámbula-Meraz, Eliakym, Benítez-Pascual, Julio, De la Herrán-Arita, Alberto Kousuke, Norzagaray-Valenzuela, Claudia Desireé, Valdez-Flores, Marco Antonio, Carrillo-Cázares, Tomás Adrián, and Picos-Cárdenas, Verónica Judith

Published
2024
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9. Clinical and molecular spectrum of v-lesion

Author

Buxeda, Anna, Crespo, Marta, Chamoun, Betty, Gimeno, Javier, Torres, Irina B., Redondo-Pachón, Dolores, Riera, Marta, Burballa, Carla, Pascual, Julio, Mengel, Michael, Adam, Benjamin A., and Pérez-Sáez, María José

Published
2024
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22. Phosphorylation of S6RP in peritubular capillaries of kidney grafts and circulating HLA donor-specific antibodies.

Author

Raïch-Regué, Dalia, Gimeno, Javier, Llinàs-Mallol, Laura, Menéndez, Silvia, Benito, David, Redondo, Dolores, Pérez-Sáez, M, Riera, Marta, Reed, Elaine, Pascual, Julio, and Crespo, Marta

Subjects
antibody mediated allograft rejection, donor specific antibodies, mammalian target of rapamycin (mTOR), peritubular capillaries, phosphorylation, ribosomal protein S6 (S6RP), transplantation—kidney
Abstract

Antibody-mediated rejection (ABMR) caused by donor-specific HLA-antibodies (DSA) is a mediator of allograft loss after kidney transplantation (KT). DSA can activate microvascular endothelium damage through the mTOR pathway. In this study we assessed the mTOR pathway activation by DSA in KT with ABMR (ABMR + DSA+) compared to controls (ABMR-DSA-), biopsies with ABMR changes without DSA (ABMR + DSA-) and DSA without ABMR changes (ABMR-DSA+), and the potential modulation by mTOR inhibitors (mTORi). We evaluated 97 biopsies: 31 ABMR + DSA+, 33 controls ABMR-DSA-, 16 ABMR + DSA-, and 17 ABMR-DSA+ cases. Regarding immunosuppression of full ABMR + DSA+ and controls, 21 biopsies were performed under mTORi treatment (11 of them ABMR + DSA+ cases) and 43 without mTORi (20 of them ABMR + DSA+) so as to explore its effect on the mTOR pathway. Biopsies were stained for C4d, Ki67, and phosphorylated (p) S6RP, ERK, and mTOR by immunohistochemistry. Labeling was graded according to peritubular capillary staining. ABMR biopsies showed significantly higher C4d, p-S6RP, and Ki67 staining in peritubular capillaries (PTC) compared to controls, and light differences in p-ERK or p-mTOR. mTORi treatment did not modify p-S6RP, p-mTOR, and p-ERK staining. Diffuse p-S6RP in PTC in the biopsies significantly associated with circulating HLA-DSA independently of graft rejection, and with worse death-censored graft survival. These findings suggest that activation of endothelium through the mTOR pathway evidence different mechanisms of damage in ABMR + DSA+ and ABMR + DSA- despite similar histological injury.

Published
2022

25. Immunosuppression of HLA identical living-donor kidney transplant recipients: A systematic review

Author

Pérez-Sáez, María José, Montero, Núria, Oliveras, Laia, Redondo-Pachón, Dolores, Martínez-Simón, David, Abramovicz, Daniel, Maggiore, Umberto, Mariat, Christophe, Mjoen, Geir, Oniscu, Gabriel C., Peruzzi, Licia, Sever, Mehmet Sükrü, Watschinger, Bruno, Velioglu, Arzu, Demir, Erol, Gandolfini, Ilaria, Hellemans, Rachel, Hilbrands, Luuk, Pascual, Julio, and Crespo, Marta

Published
2023
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26. Challenges in the management of the kidney allograft: from decline to failure: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Ahn, Curie, Alberú, Josefina, Baliker, Mary, Bamgboye, Ebun L., Barber, Thelma, Bensouda, Melissa, Chadban, Steve J., Dadhania, Darshana M., Dębska-Ślizień, Alicja, Devresse, Arnaud, Ditzen, Beate, Fowler, Kevin, Gill, John S., Jha, Vivekanand, Khairallah, Pascale, Knoll, Greg A., Korst, Uwe, Lee, Austin, Legendre, Christophe, Lentine, Krista L., Lerma, Edgar V., Lorenz, Elizabeth C., Matas, Arthur J., Mohan, Sumit, Nazarewski, Sławomir, Noronha, Irene L., Obrador, Gregorio T., Parekh, Rulan S., Pavlakis, Martha, Pascual, Julio, Pilmore, Helen L., Rosenkranz, Alexander R., Rozen-Zvi, Benaya, Roy-Chaudhury, Prabir, Tanabe, Kazunari, Wanner, Christoph, Wasse, Haimanot, Yang, Chul-Woo, Josephson, Michelle A., Becker, Yolanda, Budde, Klemens, Kasiske, Bertram L., Kiberd, Bryce A., Loupy, Alexandre, Małyszko, Jolanta, Mannon, Roslyn B., Tönshoff, Burkhard, Cheung, Michael, Jadoul, Michel, Winkelmayer, Wolfgang C., and Zeier, Martin

Published
2023
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27. New perspectives on frailty in light of the Global Leadership Initiative on Malnutrition, the Global Leadership Initiative on Sarcopenia, and the WHO's concept of intrinsic capacity: A narrative review

Author

Muñoz-Redondo, Elena, Morgado-Pérez, Andrea, Pérez-Sáez, María José, Pascual, Julio, Tejero-Sánchez, Marta, Curbelo, Yulibeth G., Terradellas-Fernández, Marc, Meza-Valderrama, Delky, Vázquez-Ibar, Olga, Annweiler, Cédric, Sánchez-Rodríguez, Dolores, and Marco, Ester

Published
2023
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28. Non-HLA Antibodies and Epitope Mismatches in Kidney Transplant Recipients With Histological Antibody-Mediated Rejection

Author

Crespo, Marta, Llinàs-Mallol, Laura, Redondo-Pachón, Dolores, Butler, Carrie, Gimeno, Javier, Pérez-Sáez, María José, Burballa, Carla, Buxeda, Anna, Arias-Cabrales, Carlos, Folgueiras, Montserrat, Sanz-Ureña, Sara, Valenzuela, Nicole M, Reed, Elaine F, and Pascual, Julio

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Immunology, Prevention, Organ Transplantation, Transplantation, Clinical Research, Renal and urogenital, Adult, Antibody Specificity, Epitopes, Female, Graft Rejection, HLA Antigens, Humans, Isoantibodies, Kidney Transplantation, Male, Middle Aged, kidney transplantation, antibody-mediated rejection, HLA antibodies, non-HLA antibodies, HLA epitope mismatch, AT(1)R antibodies, AT1R antibodies, Medical Microbiology, Biochemistry and cell biology, Genetics
Abstract

BackgroundCorrelation between antibody-mediated rejection (ABMR) and circulating HLA donor-specific antibodies (HLA-DSA) is strong but imperfect in kidney transplant (KT) recipients, raising the possibility of undetected HLA-DSA or non-HLA antibodies contributing to ABMR. Detailed evaluation of the degree of HLA matching together with the identification of non-HLA antibodies in KT may help to decipher the antibody involved.MethodsWe retrospectively assessed patients with transplant biopsies scored following Banff'15 classification. Pre- and post-transplant serum samples were checked for HLA and non-HLA antibodies [MICA-Ab, angiotensin-II type-1-receptor (AT1R)-Ab, endothelin-1 type-A-receptor (ETAR)-Ab and crossmatches with primary aortic endothelial cells (EC-XM)]. We also analyzed HLA epitope mismatches (HLA-EM) between donors and recipients to explore their role in ABMR histology (ABMRh) with and without HLA-DSA.ResultsOne-hundred eighteen patients with normal histology (n = 19), ABMRh (n = 52) or IFTA (n = 47) were studied. ABMRh patients were HLA-DSApos (n = 38, 73%) or HLA-DSAneg (n = 14, 27%). Pre-transplant HLA-DSA and AT1R-Ab were more frequent in ABMRh compared with IFTA and normal histology cases (p = 0.006 and 0.003), without differences in other non-HLA antibodies. Only three ABMRhDSAneg cases showed non-HLA antibodies. ABMRhDSAneg and ABMRhDSApos cases showed similar biopsy changes and graft-survival. Both total class II and DRB1 HLA-EM were associated with ABMRhDSApos but not with ABMRhDSAneg. Multivariate analysis showed that pre-transplant HLA-DSA (OR: 3.69 [1.31-10.37], p = 0.013) and AT1R-Ab (OR: 5.47 [1.78-16.76], p = 0.003) were independent predictors of ABMRhDSApos.ConclusionsIn conclusion, pre-transplant AT1R-Ab is frequently found in ABMRhDSApos patients. However, AT1R-Ab, MICA-Ab, ETAR-Ab or EC-XM+ are rarely found among ABMRhDSAneg patients. Pre-transplant AT1R-Ab may act synergistically with preformed or de novo HLA-DSA to produce ABMRhDSApos but not ABMRhDSAneg. HLA epitope mismatch associates with ABMRhDSApos compared with ABMRhDSAneg, suggesting factors other than HLA are responsible for the damage.

Published
2021

33. Microvascular inflammation in the absence of human leukocyte antigen-donor-specific antibody and C4d: An orphan category in Banff classification with cytotoxic T and natural killer cell infiltration

Author

Buxeda, Anna, Llinàs-Mallol, Laura, Gimeno, Javier, Redondo-Pachón, Dolores, Arias-Cabrales, Carlos, Burballa, Carla, Puche, Adrián, López-Botet, Miguel, Yélamos, José, Vilches, Carlos, Naesens, Maarten, Pérez-Sáez, María José, Pascual, Julio, and Crespo, Marta

Published
2023
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36. Recommendations for living donor kidney transplantation

Author

Frutos, Miguel Ángel, Crespo, Marta, Valentín, María de la Oliva, Alonso-Melgar, Ángel, Alonso, Juana, Fernández, Constantino, García-Erauzkin, Gorka, González, Esther, González–Rinne, Ana M., Guirado, Lluis, Gutiérrez-Dalmau, Alex, Huguet, Jorge, Moral, José Luis López del, Musquera, Mireia, Paredes, David, Redondo, Dolores, Revuelta, Ignacio, Hofstadt, Carlos J Van-der, Alcaraz, Antonio, Alonso-Hernández, Ángel, Alonso, Manuel, Bernabeu, Purificación, Bernal, Gabriel, Breda, Alberto, Cabello, Mercedes, Caro-Oleas, José Luis, Cid, Joan, Diekmann, Fritz, Espinosa, Laura, Facundo, Carme, García, Marta, Gil-Vernet, Salvador, Lozano, Miquel, Mahillo, Beatriz, Martínez, María José, Miranda, Blanca, Oppenheimer, Federico, Palou, Eduard, Pérez-Saez, María José, Peri, Lluis, Rodríguez, Oscar, Santiago, Carlos, Tabernero, Guadalupe, Hernández, Domingo, Domínguez-Gil, Beatriz, and Pascual, Julio

Published
2022
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39. Migraine treatment consensus document of the Spanish Society of Neurology (SEN), Spanish Society of Family and Community Medicine (SEMFYC), Society of Primary Care Medicine (SEMERGEN) and Spanish Association of Migraine and Headache (AEMICE) on migraine treatment

Author

Belvís, Robert, Irimia, Pablo, González, Nuria, García-Ull, Jésica, Pozo-Rosich, Patricia, López-Bravo, Alba, Morollón, Noemí, Quintas, Sonia, Plana, Antoni, Baz, Pablo Gregorio, Tentor, Ana, Gallego Artiles, Natalia, León, Francisco Javier, Pérez Martín, Miguel, Rivera, Inés, Ramírez, Raquel, Colomina, Isabel, Lainez, José Miguel, and Pascual, Julio

Published
2024
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40. Documento de consenso de la Sociedad Española de Neurología (SEN), Sociedad Española de Medicina de Familia y Comunitaria (SEMFYC), Sociedad de Medicina de Atención Primaria (SEMERGEN) y Asociación Española de Migraña y Cefalea (AEMICE) sobre el tratamiento de la migraña

Author

Belvís, Robert, Irimia, Pablo, González, Nuria, García-Ull, Jésica, Pozo-Rosich, Patricia, López-Bravo, Alba, Morollón, Noemí, Quintas, Sonia, Plana, Antoni, Baz, Pablo Gregorio, Tentor, Ana, Gallego Artiles, Natalia, León, Francisco Javier, Pérez Martín, Miguel, Rivera, Inés, Ramírez, Raquel, Colomina, Isabel, Lainez, José Miguel, and Pascual, Julio

Published
2024
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44. Recomendaciones para el trasplante renal de donante vivo

Author

Frutos, Miguel Ángel, Crespo, Marta, Valentín, María de la Oliva, Alonso-Melgar, Ángel, Alonso, Juana, Fernández, Constantino, García-Erauzkin, Gorka, González, Esther, González-Rinne, Ana M., Guirado, Lluis, Gutiérrez-Dalmau, Alex, Huguet, Jorge, López del Moral, José Luis, Musquera, Mireia, Paredes, David, Redondo, Dolores, Revuelta, Ignacio, Van-der Hofstadt, Carlos J., Alcaraz, Antonio, Alonso-Hernández, Ángel, Alonso, Manuel, Bernabeu, Purificación, Bernal, Gabriel, Breda, Alberto, Cabello, Mercedes, Caro-Oleas, José Luis, Cid, Joan, Diekmann, Fritz, Espinosa, Laura, Facundo, Carme, García, Marta, Gil-Vernet, Salvador, Lozano, Miquel, Mahillo, Beatriz, Martínez, María José, Miranda, Blanca, Oppenheimer, Federico, Palou, Eduard, Pérez-Saez, María José, Peri, Lluis, Rodríguez, Oscar, Santiago, Carlos, Tabernero, Guadalupe, Hernández, Domingo, Domínguez-Gil, Beatriz, and Pascual, Julio

Published
2022
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46. Negative immune responses to two-dose mRNA COVID-19 vaccines in renal allograft recipients assessed with simple antibody and interferon gamma release assay cellular monitoring

Author

Crespo, Marta, Barrilado-Jackson, Antoni, Padilla, Eduardo, Eguía, Jorge, Echeverria-Esnal, Daniel, Cao, Higini, Faura, Anna, Folgueiras, Montserrat, Solà-Porta, Eulàlia, Pascual, Sergi, Barbosa, Francesc, Hurtado, Sara, Ribera, Laura, Río-No, Laura, Pérez-Sáez, María José, Redondo-Pachón, Dolores, and Pascual, Julio

Published
2022
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47. Post-transplant renal anemia: a call to action from a national study in routine clinical practice.

Author

Portoles, Jose, Crespo, Marta, Belotto, Miguel Martínez, Morales, Eduardo Martínez, Aristoy, Emma Calatayud, Lopez, Paula Mora, Garcia, Sthefanny Carolina González, Oliveras, Laia, Colina, Julio, Singh, Arhsdeep, Calabuig, Asunción Sancho, Calabia, Emilio Rodrigo, Montero, Nuria, Gutierrez-Dalmau, Alex, Mazuecos, Auxiliadora, and Pascual, Julio

Subjects
IRON deficiency anemia, IRON supplements, ELECTRONIC health records, GLOMERULAR filtration rate, BRAIN death
Abstract

Background Post-transplant anemia is a prevalent yet often overlooked condition that poses significant risks. Current guidelines consider the same treatment recommendations and goals for these patients as for chronic kidney disease patients not on dialysis. Previous reports demonstrated a lack of awareness and suboptimal management, indicating a pressing need for improvement. We therefore wanted to update the information on post-transplant anemia. We aimed to describe the present state of anemia management, goals and adherence to guidelines within a representative sample of the kidney transplant (KTx) population. Methods We designed a retrospective nationwide multicenter study including outpatients from eight KTx hospitals. Nephrologists gathered data from electronic medical records encompassing demographics, comorbidities, KTx characteristics and immunosuppressive therapy, and information pertaining to anemia management (laboratory values, previously prescribed treatments and subsequent adjustments). The European statement on the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines was the reference for definitions, drug prescriptions and targets. Anemia occurring within the initial 6 months post-transplantation was classified as early onset. Results We included 297 patients with post-transplant anemia aged 62.8 years (standard deviation 13.6), 60% of whom were male. They had received a graft from cardiac death or brain death donors (61.6% and 31.1%, respectively) a median of 2.5 years (0.5–8.7) before. Among them 77% (n  = 228) were classified as having late post-transplant anemia, characterized by a higher prevalence of microcytic and iron deficiency anemia. A total of 158 patients were on erythropoietic-stimulating agents (ESAs) treatment, yet surprisingly 110 of them lacked iron supplementation. Notably, 44 patients had an indication for iron supplementation and among them, 30 exhibited absolute iron deficiency. Out of the 158 patients receiving ESAs, only 39 surpassed the limit for the ESA resistance index, indicating poor response. This resistance was more frequent among patients with early post-transplant anemia (26.1% vs 9.2%). We have identified iron profile, early post-transplant anemia and estimated glomerular filtration rate as factors associated with the highest risk of resistance Conclusion We found that hemoglobin targets are individualized upwards in post-transplant anemia. In this setting, iron therapy continues to be underutilized, especially intravenous, and iron deficiency and prior events (blood transfusion or hospital admission) explain most of the hyporesponsiveness to ESA. This highlights missed opportunities for precise prescription targeting and adherence to established guidelines, suggesting a need for improved management strategies in post-transplant anemia patients. [ABSTRACT FROM AUTHOR]

Published
2024
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48. Guía de unidades de hemodiálisis 2020

Author

Pérez García, Rafael, Maduell, Francisco, del Pino Pino, María Dolores, Quereda Rodríguez-Navarro, Carlos, Alcalde Bezhold, Guillermo, Alcázar Arroyo, Roberto, Angoso de Guzmán, Manuel, Del Pino y Pino, Mª Dolores, Hernández Marrero, Domingo, Otero González, Alfonso, Arenas Jiménez, Dolores, Arias-Guillén, Marta, de Francisco Hernández, Ángel Martín, Martín Malo, Alejandro, Muñoz González, Rosa Inés, Díaz-Tejeiro Izquierdo, Rafael, Fernández Lucas, Milagros, Gutiérrez Martínez, Eduardo, Ojeda López, Raquel, Prieto Velasco, Mario, Rodríguez Benítez, Patrocinio, Sáenz Santolaya, Alfredo José, Slon Roblero, María Fernanda, Teruel Briones, José Luis, Tornero Molina, Fernando, Alcalde-Bezhold, Guillermo, Alcázar-Arroyo, Roberto, Angoso-de-Guzmán, Manuel, Arenas, María Dolores, Arribas-Cobo, Patricia, Díaz-Gómez, Juan Manuel, García-Maset, Rafael, González-Parra, Emilio, Hernández-Marrero, Domingo, Herrero-Calvo, José Antonio, Molina, Pablo, Molina-Núñez, Manuel, Otero-González, Alfonso, Pascual, Julio, Pereira-García, Mónica, Pérez-García, Rafael, del Pino y Pino, María Dolores, Prieto-Velasco, Mario, Pulido Pulido, Juan Francisco, Sánchez-Álvarez, José Emilio, Sánchez-Hernández, Rosa, and de Sequera-Ortiz, Patricia

Published
2021
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