bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO931PRETRANSPLANT ANGIOTENSIN II TYPE 1 RECEPTOR ANTIBODIES INFLUENCE GRAFT FUNCTION BUT NOT GRAFT SURVIVAL AT 1 YEAR AFTER KIDNEY TRANSPLANTATION IN A LOW IMMUNOLOGICAL RISK COHORT
Authors: Sorohan Bogdan Marian , Berechet Andreea Ioana , Obrisca Bogdan , Constantinescu Ileana , Maruntelu Ionut , Tacu Dorina , Baston Catalin , Sinescu Ioanel , Ismail Gener 
Published: May 2021

Abstract

Background and Aims
Angiotensin II type 1 receptor antibodies (AT1R-Ab) are associated with graft rejection and poor graft outcomes in kidney transplantation (KT). It has been shown that AT1R-Ab have a negative impact on both short-term and long-term graft function, even in the absence of rejection, but this has not been confirmed by other studies. Our aim was to assess the frequency of pretransplant AT1R-Ab and to determine their influence on graft function and survival at 1 year after KT.

Method
We performed a prospective, observational cohort study in 67 adult KT recipients, transplanted between October 2018 and October 2019. Clinical, biological and immunological data of the recipients, age, gender and type of donor, transplant and immunosuppression parameters were collected at the moment of transplantation. A cut-off &gt; 10 U/mL was used for AT1R-Ab detection.

Results
Among the 67 recipients mean age was 41.3 ± 10.3 years, male gender was predominant (59.7%) and the main known cause of end-stage renal disease was glomerular disease. Six patients out of 67 (9%) had a previous kidney transplant. The donor mean age was 50 ± 15.5 years and 65.7% of patients received the kidney graft from a cadaveric donor. Pretransplant AT1R-Ab were detected in 7 out of 67 patients (10.4%) and none of the patients had specific antibodies against human leucocyte antigen. After 1 year of follow-up, median estimated glomerular filtration rate (eGFR) of the recipients was 54 ml/min/1.73 m2 (40.6 – 65.9), 10.4% of patients developed delayed graft function, 7.5% had graft failure and no cases of biopsy proven graft rejection or death was reported. Patients with pretransplant AT1R-Ab had a significant reduced graft function at 1 year after KT compared to those without antibodies [35 (29.8- 55.2) vs 56.1 (41.3 – 66.5) ml/min, p=0.02]. After multivariate linear regression analysis, pretransplant AT1R-Ab were an independent determinant of eGFR at 1 year after KT (β: -14.066; 95% CI: -27.44 - -0.68; p=0.04). Cox regression analysis was used to assess the association of AT1R-Ab along with other clinical, biological and immunological parameters with graft failure. Neither the univariate (HR= 2.07, 95% CI: 0.23-18.52, p=0.51) nor the multivariate (HR= 1.36, 95% CI: 0.10-14.09, p=0.80) Cox regression models showed that pretransplant AT1R-Ab were an independent predictor for graft loss.

Conclusion
We showed that pretransplant AT1R-Ab are an independent determinant of graft function but do not influence the graft survival at 1 year after transplantation in a prospective low immunological risk cohort of kidney transplant recipients.
MO938PATIENT SURVIVAL AFTER LIVING DONOR KIDNEY DONATION
Authors: Naik Marcel , Sakurayama Kayo , Lehner Lukas , Budde Klemens , Halleck Fabian 
Published: May 2021

Abstract

Background and Aims
Living donor kidney transplantation [LDKT] is associated with best patient survival and life quality among kidney replacement therapies in case of chronic kidney disease. Yet, numerous previous studies have reported inconsistent results. The aim of this study was to investigate the influence of recipient and donor characteristics on LDKT recipients in our center.

Method
All LDKT recipients from 01.01.1997 to 18.03.2020 were analyzed retrospectively. Based on the biological relationship between recipient and donor, recipients were grouped into “related” (biologically related) and “unrelated” (not related). Endpoints of this study were patient survival, death-censored graft survival and graft survival including death analyzed by Kaplan-Meier method and log-rank test. Independent risk factors were estimated with Cox-regression.

Results
Among 946 LDKT recipients we identified n=548 related and n=398 unrelated recipients. Over a median observation time of 6.3 years 9.1% (86) of grafts failed and 10.8% (102) of recipients died. Rates of graft failure and deaths were 8.8% and 7.1% in related recipients and 9.5% and 15.8% in unrelated recipients, respectively. Kaplan-Meier-analysis showed 5, 10 and 15 year overall patient survival of 93.8%, 85.6% and 76.0%; death-censored graft survival of 94.7%, and 87.3% and 79.8%; graft survival including death were 89.8%, 76.3% and 62.7%. There was a significant difference between subgroups in patient survival (p&lt;0.001) and graft survival including death (p&lt;0.001) but not in death-censored graft survival (p=0.280). (figure 1, 2, 3) In the multivariate analysis we observed recipient age in years (Hazard Ratio [HR]:1.08; p&lt;0.001) and donor age in years (HR:0.97; p=0.008) to be independent risk factors for patient mortality. The occurrence of a delayed graft function (HR:2.52; p&lt;0.001) as well as recipient age in years (HR:1.04; p&lt;0.001) were risk factors for graft survival including death, while delayed graft function (HR:4.05; p&lt;0.001) was the only independent risk factor for death-censored graft survival.

Conclusion
LDKT recipients without a biological relationship to their donors have an inferior patient survival and graft survival including death. The donor relationship as well as delayed graft function, recipient age and donor age should be taken into account during patient evaluation. Recipients subjected to these characteristics should be informed about their individual risks and carefully monitored long term. Further evaluations are needed particularly including the effects of immunosuppressive medication.
MO939RECURRENCE AND OUTCOME OF ANTI-GLOMERULAR BASEMENT MEMBRANE GLOMERULONEPHRITIS AFTER KIDNEY TRANSPLANTATION: A BELGIAN MULTICENTER STUDY
Authors: Coche Sophie , Sprangers Ben , Van Laecke Steven , Weekers Laurent , De Meyer Vicky , Hellemans Rachel , Castanares Diego , Ameye Heleen , Goffin Eric Jean , Demoulin Nathalie , Gillion Valentine , Mourad Michel , Darius Tom , Antoine Buemi , Arnaud Devresse , Kanaan Nada 
Published: May 2021

Abstract

Background and Aims
Recurrence of anti-glomerular basement membrane (anti-GBM) glomerulonephritis in the kidney graft is a rare event, described in limited case reports and registry analysis. The aim of this study was to evaluate in a large cohort of patients with detailed data collection and long follow-up the risk of recurrence of anti-GBM disease and graft loss caused by recurrence, the risk factors associated with clinical recurrence and the long-term patient and graft survival.

Method
Multicenter retrospective study. Inclusion criteria: patients with anti-GBM glomerulonephritis transplanted with a kidney between 1977 and 2015. Exclusion criteria: systemic vasculitis (except ANCA), lupus erythematosus and cryoglobulinemia. Clinical recurrence was defined as reappearance of signs of glomerulonephritis along with histological signs of proliferative glomerulonephritis and linear IgG staining on kidney biopsy, with or without anti-GBM antibodies.

Results
Fifty-three patients were included. Clinical recurrence in a first kidney transplant occurred in only one patient five years after transplantation -a prevalence rate of 1.9%- in the context of cessation of immunosuppressive drugs. The graft was lost due to recurrence. Histological recurrence with linear IgG staining on kidney biopsy in the absence of histologic signs of proliferative glomerulonephritis was observed in four patients, in the context of cellular rejection. Two patients lost their kidney graft from severe acute rejection; the others fully recovered. Patient survival was 100%, 94% and 89% at 5, 10 and 15 years, respectively. Overall, death-censored first graft survival rates were 88%, 83% and 79% at 5, 10 and 15 years, respectively.

Conclusion
Recurrence rate of anti-GBM glomerulonephritis after transplantation is very low, and associated with graft loss. The long-term patient and graft survival rates are excellent.
MO923PREDICTING POST-TRANSPLANT HRQOL TO OPTIMIZE OUTCOMES IN OLDER KIDNEY TRANSPLANT RECIPIENTS
Authors: Tsarpali Vasiliki , Midtvedt Karsten , Lønning Kjersti , Bernklev Tomm , Von der Lippe Nanna , Reisater Anna Varberg , Heldal Kristian 
Published: May 2021

Abstract

Background and Aims
Kidney transplantation (KT) is the optimal treatment for older patients in need for kidney replacement therapy, with favorable outcomes both on survival, and health-related quality of life (HRQoL). Given the current organ scarcity, allocation of transplants should prioritize patients who are expected to benefit most from KT and identifying reliable predictors of post-transplant HRQoL outcomes is essential to optimize the selection process.

Method
Patients ≥ 65 years, who were enlisted for KT between January 2013 and November 2016 at the Norwegian national transplant center, were asked to participate. Self-reported HRQoL was assessed using the Kidney-Disease Quality of Life Short Form version 1.3 (KDQOL-SF) survey. Pre-transplant comorbidity was assessed by the Liu comorbidity index (LCI). Linear mixed-effect models were used to detect HRQoL changes over time (pre-KT, at -6, -12 and -36 months post-KT), and to identify pre-transplant predictors of post-transplant outcomes.

Results
By November 2020, 220 (76%) out of 289 enrolled participants, were transplanted. The mean age at KT was 71.8 (4.1) years, 154 (70%) were males, 57 (26%) were transplanted pre-emptively and 30 (13.6%) received a transplant from a living donor.
Longer dialysis vintage was independently associated with impaired physical function post-transplantion (Figure 1). Pre-transplant LCI score ≥ 7 consistently predicted poorer HRQoL outcomes at baseline and after 3-years, compared with LCI score &lt; 7 (Figure 2). At 3- years post-transplant, increasing LCI score was lineary associated with decreasing SF-36 scores. Recipients on dialysis for ≥ 1 year with LCI ≥ 7 experienced the worst outcomes, with a marked and sustained post-transplant physical deterioration (Figure 3).

Conclusion
Older wait-listed candidates either on dialysis for &gt;1 year or with elevated pre-transplant LCI are at high risk for impaired HRQoL post-transplant outcomes and should be re-evaluated with respect to transplantability on a regular basis. The identification of criteria to optimize the selection of older transplant candidates should be the scope of future studies
MO943IMPACT OF NON-ACTIVE HEPATITIS B ON PATIENT SURVIVAL AFTER RENAL TRANSPLANTATION
Authors: Paschereit Anissa , Budde Klemens , Dürr Michael , Naik Marcel 
Published: May 2021

Abstract

Background and Aims
Dialysis patients (pts) have an increased risk for hepatitis B (HB) infection and impaired response to HB vaccine compared to the general population. As shown in other studies, patient and graft survival in pts with chronic HB is worse. This study assesses the outcome of HBc-positive patients after kidney transplantation (KTx).

Method
In our retrospective analysis we included all patients &gt;18 years old, who underwent kidney transplantation from 01.01.1990 to 31.08.2019 in our center. Patients were grouped by their serostatus prior to kidney transplantation into “A: naïve” (HB negative), “B: HBc-positive” (non-active HB) and “C: HBsAg-positive” (chronic HB). Primary endpoints included patient and graft survival analyzed with Kaplan-Meier and log-rank test. Regression analysis was applied to determine independent risk factors for the occurrence of primary endpoints.

Results
In 2487 kidney transplant patients, serologic markers were retrievable. We identified n=2198 HB naïve, n=218 non-active HB and n=75 chronic HB pts. Overall 29.1% (A:27.7%, B:37.6%, C:45.3%) pts died and 20.3% (A:19.1%, B:27.5%, C:37.3%) pts suffered from graft failure. The 5-year pts survival (Fig. 1) was A: 87.0%, B: 82.8%, C: 82.2%. The 10-year pts survival was A: 71.7%, B: 61.1%, C: 64.5% and the 20-year pts survival was A: 43.1%, B: 26.1%, C: 40.9% (p=0.01). Kaplan-Meier-analysis showed a 5-year graft survival (Fig. 2) of 87.7% in the naïve, 86.1% in non-active HB and 84.3% in chronic HB group. The 10-year graft survival was A: 77.3%, B: 64.9%, C: 76% and the 20-year graft survival was A: 59.7%, B: 52.2%, C: 33.4% (p&lt;0.001). The overall 5-year pts and graft survival (Fig. 3) was A: 78.7%, B: 74.2%, C: 68.6%. The 10-year pts and graft survival was A: 59.8%, B: 46.4%, C: 51.8%. The 20-year overall rate was A: 30.8%, B: 26.4%, C: 14.9% (p&lt;0.001).
Regression analysis (Table 1) showed that anti-HBs positivity (≥100 IE/l) was a protective factor for graft failure and death (p&lt;0.001).

Conclusion
HB leads to earlier graft loss and inferior patient survival. Beside the already known negative effect of chronic HB infection, also in patients with non-active HB infection overall survival was significant worse to HB naïve patients. Thus, non-active HB status is an important risk factor for overall transplant outcome. Next, influence of antiviral and immunosuppressive regimens and incidence of HB-reactivation are to be analyzed.
MO944BONE DISEASE AFTER KIDNEY TRANSPLANTATION - (SUBTOTAL) PARATHYROIDECTOMY REDUCES FRACTURE RISK
Authors: Jehn Ulrich , Kortenhorn Anja , Schütte-Nütgen Katharina , Strauss Markus , Pavenstädt Hermann Josef , Suwelack Barbara , Reuter Stefan 
Published: May 2021

Abstract

Background and Aims
Kidney transplant recipients can be considered as high-risk collective for pathological fractures, since diverse risk factors leading to mineral bone disorder (MBD) and osteoporosis accumulate in this setting.
(Subtotal) parathyroidectomy (PTX) is indicated for ESRD patients with secondary hyperparathyroidism (sHPT) who do not respond to drug therapy adequately.
This study aims to identify influencable factors that are associated with pathological fractures and bone disease in KTX recipients.

Method
We conducted a retrospective study involving 722 adult patients with a total of 4686 patient-years who were transplanted at our center between January 2007 and June 2015. The clinical patient data was extracted from the patients’ electronic files.
Different laboratory and clinical parameters for mineral bone disorder and osteoporosis including medication were evaluated. As primary endpoint we chose fracture events that were not related to malignancies or adequate trauma.

Results
47 (6,5%) of the patients suffered from pathologic fracture events during the follow-up period. 124 of the patients (17.2%) underwent PTX. In 112 of these patients (90.3%), PTX was performed prior to kidney transplantation (KTx), in 12 patients PTX took place after KTx. Median time for PTX in relation to KTx was 3.7 years prior to KTx (IQR 5.43).
Only 1 (2,2%) of the patients with fracture events has received PTX beforehand compared to 124 (19,2%) of the patients without fractures.
Adjusted for the well-known fracture risk factors for mineral bone disease and osteoporosis which include female sex, age and dialysis vintage, PTX remains a significant protective factor against fractures after KTx in multivariable Cox regression analysis (HR 0.124, p=0.041) and in Kaplan-Meier analysis (Figure 1).
Serum calcium levels were significantly lower in patients after PTX (p&lt;0.001).
Active Vitamin D was applicated in patients after PTX more frequently (40.0% vs. 22.7%, p&lt;0.001)

Conclusion
Our study reveals PTX as a protective factor regarding pathological fractures after KTx. As these patients show lower serum calcium levels, one explanation for this finding could be a more generous supplementation of these patients with active vitamin D, which is known to increase bone mineral density and to reduce fracture risk. Therefore, considering that hypoprathyroidism following PTX after KTx and low plasma-PTH levels correlate with significant decrease of renal function, patients on conservative sHPT therapy should be treated with active vitamin D preparations more generously and special attention should be paid on bone metabolism.
MO945SERUM AND URINE LEUCINE RICH ALPHA-2-GLYCOPROTEIN-1 IS ASSOCIATED WITH KIDNEY TRANSPLANT INJURY AND FAILURE
Authors: Vasiļvolfa Aiga , Kroiča Juta , Popova Anna , Rācenis Kārlis , Šlisere Baiba , Ziedina Ieva , Folkmane Inese , Lejnieks Aivars , Cernevskis Harijs , Petersons Aivars , Kuzema Viktorija 
Published: May 2021

Abstract

Background and Aims
Kidney transplantation is the treatment of choice for most of the patients with end stage chronic kidney disease. To improve patient and graft survival, early diagnostics and discovery of specific biomarkers is important. Leucine rich alpha-2-glycoprotein-1 (LRG-1) is an innovative, non-invasive biomarker that is elevated in case of angiogenesis, inflammation and kidney injury. Aim was to evaluate biomarker LRG-1 level in serum and urine in kidney transplant recipients in accordance with kidney injury markers and time period after kidney transplantation.

Method
In the study 35 patients were enrolled. Patients had functioning kidney grafts and they were more than one year post transplant. We detected patient serum and urine LRG-1 levels, using ELISA. Correlation between serum LRG-1, urine LRG-1 and kidney graft structural and functional damage markers was performed. Also, we compared serum LRG-1 levels between subgroups (patients &gt;5 years post transplant and ≤ 5 years post transplant).

Results
Serum LRG-1 had positive correlation with serum cystatin-C (r=0,46, p&lt;0,01), serum urea (r=0,53, p&lt;0,01) and negative correlation with eGFR (r= -0,39, p=0,02). Patients with &gt;5 years post transplant had higher serum LRG-1 level compared with patients ≤5 years post transplant (p&lt;0,01). Serum LRG-1 had positive correlation with a longer time period after transplantation (r=0,53, p=0,01). Urine LRG-1 had correlation with proteinuria (r=0,58, p&lt;0,01) and NGAL level in urine (r=0,44, p&lt;0,01). The most common maintenance immunosuppressive regimen was therapy with tacrolimus, mycophenolate and prednisolone (48,6%).

Conclusion
Higher serum LRG-1 level correlates with decreased kidney transplant function and with longer time period after transplantation. Higher LRG-1 level in serum and urine is related to kidney transplant injury and failure. Urine LRG-1 can be a useful biomarker for tubular dysfunction in kidney transplant recipients.
MO947KILLER CELL IMMUNOGLOBULIN LIKE RECEPTOR (KIR) GENE DISTRIBUTION AND ALLOGRAFT KIDNEY FUNCTION
Authors: Erken Ertugrul , Senel Mahmut Egemen , Dinkci Suzan , Goruroglu Ozturk Ozlem , Altunoren Orcun , Gungor Ozkan , Erken Eren 
Published: May 2021

Abstract

Background and Aims
There is increasing evidence about the alloreactivity of natural killer (NK) cells after kidney transplantation. The inhibition and activation cycles of the NK cells are mainly regulated by killer cell immunoglobulin-like receptors (KIRs) which may have extensive allelic polymorphisms within the population. In this study, we examined KIR genes/genotypes in kidney transplant recipients and healthy subjects. We aimed to determine if there are relations between certain KIR genes and graft function in kidney transplant patients.

Method
Renal transplant patients (n=131) and healthy controls (n=183) from the same ethnic background with similar demographics were included. Transplant patients with an obvious cause of graft dysfunction and presensitized patients were excluded. Recruited patients were classified as graft dysfunction (GD) (n=38) or functioning graft (FG) (n=93) on the basis of allograft rejection and dysfunction. Isolated DNA of all participants were typed for 16 KIR genes with specific primers using PCR. Patient groups were compared for KIR genes/genotypes and clinical features.

Results
Significant differences were observed for KIR2DL3 and KIR3DL1 genes that were presented with higher frequencies in healthy controls than in kidney transplant recipients (p=0.001 & p=0.006). Comparison between GD and FG groups revealed a protective association for the inhibitor gene KIR2DL1 (p=0.003, OR=0.148). Distribution of the remaining 15 KIR genes and the rates of KIR genotype patterns were not different among these patient groups.

Conclusion
KIR2DL3 and KIR3DL1 genes were more common in healthy subjects. KIR2DL1 gene was significantly more frequent in patients with FG. We suggest that the presence of KIR2DL1, which is an inhibitor gene for NK cell functions, might be associated with favorable graft function in kidney transplant recipients.
MO949APPRAISAL OF PSYCHO-SOCIAL BURDEN AND QUALITY OF LIFE OF KIDNEY DONORS- IS THERE A DEEP ROOTED APPREHENSION
Authors: Kaul Anupma 
Published: May 2021

Abstract

Background and Aims
Living kidney donation is a very complex psychological experience for donor candidates as well as the recipients improving self-esteem and donor-recipient relationships on one hand while may add on to emotional stresses increasing psychic vulnerability and predisposition to the development of mental disorder. The present study aimed to look into psychosocial outcome among donor characteristics and quantification of the psychological impact of kidney donation.

Method
This was a retrospective random study conducted among 506 renal transplant donors from 2010 till 2018 at Department of nephrology and transplantation at a tertiary care centre in northern part of India.

Results
Majority of donors were females ie mothers (38.1%) and wife (35.5%). A total of 18.6% developed one or more co morbid illness following transplantation. Most of the donors ( 98.9%) were motivated by affection and love for the recipient and out of them (89.1%) felt that there were the first choice among the available donors. A majority of them (94.5%) felt that donation had positively affected their relationship and were respected. These donors showed lesser degree of both depressive and anxiety (HAD score 3.5) and depressive score (BDI II 4.8). Donation had upgraded the stature of the donor in the family and recipient which proved statically significant predictor on donor related outcome. Donors well being was dependant on recepients wellbeing and 20% of the donors felt or were made to feel the guilt of the graft failure or a poor outcome.

Conclusion
The study showed a positive acknowledgement for the donors from the recipients and society thus giving a meaning to life Need of the hours is greater post donation monitoring as well as due recognition among donors which can improve long term donor outcomes.