bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO952: Risk Factors of Post Transplantation Diabetes Mellitus After Kidney Transplantation
Authors: Carlsen Rasmus , Åsberg Anders , Birkeland Kåre , Svensson My , Bressendorff Iain , Gulseth Hanne , Midtvedt Karsten , G. Jenssen Trond 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Between 10 and 30% of kidney transplant recipients develop post-transplant diabetes mellitus (PTDM). PTDM is a major risk factor for cardiovascular events and death in kidney transplant recipients. At our center prednisolone doses are tapered to a low maintenance dose eight weeks after transplantation. In a retrospective single-center cohort study, we investigated risk factors for development of de novo PTDM from 8 weeks after kidney transplantation.

METHOD
Inclusion criteria were kidney transplantation, age &gt; 18 years, no known diabetes prior to, or at the 8-week control after transplantation and with at least one year of follow up. At the 8-week control an oral glucose tolerance test (OGTT) was performed for PTDM diagnosis. De novo PTDM was defined as fasting glucose ≥7 mmol/L, 2-h glucose ≥11.1 mmol/L at OGTT performed routinely at the one-year visit, or at least two registered dispensations of glucose lowering medication in the Norwegian Prescription Database (NorPD).

RESULTS
In total 632 patients (median age 53 years, 62% males) with a median follow-up of 2.7 years [1–4] were included of which 54 (8.5%) developed de novo PTDM (31 diagnosed by the OGTT at 1 year and 23 identified by glucose lowering dispensation). De novo PTDM patients were older than non-PTDM patients at transplantation (median age 63 versus 52 years), were more often males (81% versus 61%), and had higher fasting blood glucose (mean 5.8 versus 5.3 mmol/L), 2-h glucose (mean 8.3 versus 6.6 mmol/L) and HbA1c (median 38 versus 32 mmol/mol) at the 8-week post-transplantation control.
In a multiple logistic regression analysis, significant associated factors of PTDM were age (years), OR 1.04 (CI 95%: 1.01;1.06), triglycerides (mmol/L), OR 1.42 (CI 95%: 1.10;1.81) and tacrolimus (µg/L) OR 1.23 (CI 95%: 1.03;1.46) concentrations measured at the one-year control visits, and CMV serostatus (positive donor to negative recipient), OR 2.12 (CI 95%: 1.04;4.28). Plasma magnesium, gender, BMI and plasma creatinine were not associated with development of PTDM.

CONCLUSION
Development of de novo PTDM from 8 weeks after kidney transplantation was associated with increased age, higher triglycerides, higher tacrolimus concentrations and D+/R- CMV-serostatus.
MO963: Vitamin D Status and Sars-Cov-2 Infection in A Cohort of Renal Transplanted Patients
Authors: Regalia Anna , Maria Alfieri Carlo , Rosaria Campise Maria , Cresseri Donata , Teresa Gandolfo Maria , Castellano Giuseppe , Messa Piergiorgio 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Immunomodulatory and anti-inflammatory properties have been hypothesized for native vitamin D (nVD). Very little is reported about nVD and risk of Sars-CoV-2 infection (COV) in renal transplant (RTx). In a cohort of renal transplanted patients (RTxp) we retrospectively evaluated: (i) nVD status in patients with (COV+) and without (COV-) COV infection; (ii) the impact of nVD status on severity of COV.

METHOD
The study includes 61 COV + in whom nVD status was available in the year before the infection, and 122 COV- matched 1:2 for age (53[45–64]years), gender (M = 60.7%), RTx vintage (7[2–15] years), presence of diabetes (18%), arterial hypertension (85%) and cardiac symptomatic disease (3%). Renal function, 24-h proteinuria and mineral metabolism (MM) parameters were evaluated at 1, 6 and 12 months before COV whereas nVD status was considered as the mean 25-OH-VD levels at the same timepoints. Severity of COV was based on the need for hospitalization (HOSP+: 27/61, 44.3%) and death (D+: 6/61, 9.8%).

RESULTS
(i) nVD levels were significantly lower in COV + than in COV- (19[12–26] ng/mL and 23[16–30] ng/mL, respectively, P = 0.01). No differences in the other biochemical parameters were found. The COV discriminative power of nVD status was evaluated by ROC curve (AUC 0.61, 95% CI: 0.54–0.68, P = 0.01), with a value of 25-OHVD 23.9 ng/mL showing the best discriminative power (sensibility 72%, specificity 47%). (ii) nVD levels showed a trend towards lower values in HOSP + COV + than HOSP-COV+ (17[8–25] ng/mL versus 20[14–26] ng/mL) and in D + COV + than D-COV+ (13[6–23] ng/mL versus 20[13–26] ng/mL), although these differences did not reach the statistical significance (P = 0.1 and P = 0.2, respectively).

CONCLUSION
With the limitations of the retrospective nature of the study and the small sample size, our data report that:
No association was found between nVD levels in the year preceding the infection and COV severity.
MO980: Metabolomics Approach and Acute Rejection in Kidney Transplant Recipients
Authors: Dedinska Ivana , Baranovičová Eva , Graňák Karol , Vnučák Matej , Beliančinová Monika , Mokáň Marián 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Non-invasive diagnosis of graft rejection after kidney transplantation is still an unresolved issue. Changes in serum metabolite concentrations reflect the various processes involved in the graft, and thus graft rejection. Metabolomics approach might help with non-invasive diagnosis of graft rejection based on identification of T-cell activation.

METHOD
In a group of 55 patients after primary kidney transplantation (average follow-up 68.4 months, median 59 months) we identified patients with cellular rejection (ACR), antibody mediated rejection (AMR) and control group (CG)—patients without history of graft rejection. We used NMR metabolomic approach to determine the relative levels of metabolites in blood plasma.

RESULTS
From 23 evaluated metabolites: lactate was significantly increased in CG and in ACR against AMR (P &lt; 0.05), whilst plasma glutamine decreased in CG against ACR (P &lt; 0.05) and AMR (P &lt; 0.05) groups. Further, tyrosine was significantly increased in CG against AMR (P &lt; 0.05). All three branched chain α-keto acids (BCKAs) behaved similarly. However, little over significance cut off were CG &gt;AMR. When discriminating CG and AMR, Random Forest discriminatory algorithm performed with AUC = 0.849 when included also evaluated plasma creatinine and with AUC = 0.83 when creatinine was excluded (other metabolites with the highest discriminatory power were glutamine, lactate, tyrosine and BCKAs).

CONCLUSION
Metabolomic approach to blood plasma in patients after kidney transplantation seems to be very promising when looking for non-invasive techniques assessing graft viability/survival. The observed metabolomic changes were able to very well discriminate between patients with AMR and control group. However, discrimination of ACR against CG and AMR was rather poor.
MO988: Malignancy After Kidney Transplantation: A Two-Center Experience
Authors: Demir Erol , Tamer Dincer Mevlut , Karaca Cebrail , Erel Cansu , Karahan Latif , Pekmezci Aslihan , Trabulus Sinan , Seyahi Nurhan , Turkmen Aydin 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Kidney transplantation (KT) is the preferred treatment option for patients with end-stage renal disease (ESRD) as it provides better patient survival and quality of life. While longer graft survival is maintained with potent immunosuppressive drugs used to prevent allograft rejection, de novo malignancy development after transplantation has become a substantial issue. In this study, we aimed to investigate the incidence and risk factors of post-transplant malignancy in kidney transplant recipients, including its demographic, clinical and laboratory features.

METHOD
A retrospective cohort study was conducted at two tertiary care kidney transplant centers in the same province. We recruited adult (&gt;18 years of age) kidney transplant recipients who underwent kidney transplantation between 1986 and 2020. We excluded KT recipients who lost to follow-up in the early post-transplant period and/or with incomplete records. Malignancies that occurred after graft failure were also excluded. Kidney transplant recipients with malignancy were matched to KT recipients without malignancy using a 1:1 ratio.

RESULTS
In this study, 2750 eligible patients were reviewed for the development of malignancy after kidney transplantation. A total of 278 KT recipients (10.1%) had biopsy confirmed malignancies during the follow-up period. The median post-transplant follow-up time was 217 months (IQR: 148–290 months). The most common malignancies were nonmelanoma skin cancer (28.8%), urinary tract cancer (16.5%), Kaposi's sarcoma (9.7%), gastrointestinal tract cancer (6.5%) and post-transplant lymphoproliferative disease (6.5%). The median time from kidney transplantation to the diagnosis of malignancy was 127 months (IQR: 62–198 months).
In comparison to the control group, patients with malignancy were older (P ≤ 0.001), had a higher family history of malignancy (P ≤ 0.001), had a greater history of smoking (P = 0.005), and usage of erythropoietin in the pre-transplant period was higher (P ≤ 0.001). There was no significant difference between the two groups in terms of gender and the type of induction therapy. Overall mortality was higher in patients with malignancy (OR: 2.491 [CI: 1.586–3.912], P &lt; 0.001).

CONCLUSION
The most common malignancy in kidney transplant recipients was found to be non-melanoma skin cancer. Elderly recipients, patients with a family history of malignancy and patients using erythropoietin in the pre-transplant period should be closely monitored for the development of malignancy.
MO991: Covid-19 Infection After Kidney Transplantation in Spain: Comparable Impact Throughout Six Epidemic Waves
Authors: Llinàs-Mallol Laura , Burballa Carla , Redondo Pachon Dolores , Solà Eulàlia , Arias-Cabrales Carlos , Buxeda Anna , Martinez Saez Aida , Bach Anna , Pascual Julio , José Pérez-Saéz María , Crespo Marta 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The successive COVID-19 epidemic waves have significantly influenced kidney transplantation (KT) programs. Contact protection together with vaccination are the principal protective tools for KT recipients. We reviewed the impact of COVID-19 infection in KT recipients throughout the different epidemic waves.

METHOD
Of 900 active KT recipients in our program, 160 (17.8%) have suffered COVID-19 infection during the six epidemic waves: first (March–August 2020), second (September–December2020), third (January–March 2021), fourth (April–May 2021), fifth (June–September 2021) and sixth (October–December 2021, preliminary data). We compared the clinical evolution and the impact of vaccination.

RESULTS
Infected KT recipients were younger in the third and fourth waves (P &lt; 0.001). We observed a higher percentage of pneumonia and hospital admission in the first and fifth waves (P = 0.045, P = 0.016) (Table 1), without differences in ICU admission, and with the disappearance of asymptomatic cases after the third wave. The highest mortality was observed in KT recipients &gt;65 years old infected within the first 6 months after KT (P = 0.006) and overall mortality was higher in the first wave (P = 0.033). Mortality in hospitalized KT recipients and those admitted in the ICU were similar along the 5 waves, without clear impact of vaccination (P = 0.251). On the 5 January 2022, we have already accumulated an incidence of COVID in KT of 3.1% (sixth wave, 77% with booster vaccination), similar to the first wave (3.8%), with 12.5% mortality, similar to second, third and fifth waves, in patients with outcome (53.3%).

CONCLUSION
The incidence of COVID-19 in KT recipients has been high in all the waves of the pandemic in Spain. Global mortality has diminished after the first wave, and the time until outcome has increased. The highest mortality occurs in the subgroup of old KT recipients early after KT. Vaccination has not significantly reduced the mortality in KT with Covid who require hospital or ICU admission.
MO1001: Tocilizumab in the Treatment of Chronic Antibody-Mediated Rejection Post Kidney Transplantation: Clinical and Histological Monitoring
Authors: Noble Johan , Giovannini Diane , Laamech Reda , Imerzoukene Farida , Janbon Benedicte , Marchesi Laura , Malvezzi Paolo , Jouve Thomas , Rostaing Lionel 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Chronic antibody-mediated rejection (cAMR) has very few effective therapeutic options. Interleukin-6 is an attractive target because it is involved in inflammation and humoral immunity. Therefore, the use of tocilizumab (anti-IL6 receptor, TCZ) is a potential valuable therapeutic option to treat cABMR in kidney-transplant (KT) recipients

METHOD
This single-centre retrospective study included all KT recipients that received monthly TCZ infusions in the setting of cABMR, between August 2018 and July 2021. We assessed 12-month renal function and KT histology during follow-up.

RESULTS
Forty patients were included. At 12-months, eGFR was not significantly different, 41.6 ± 17 versus 43 ± 17 mL/min/1.73 m2 (P = .102) in patients with functional graft. Six patients (15%) lost their grafts: Their condition was clinically more severe at the time of the first TCZ infusion. Histological follow-up showed no statistical difference in the scores of glomerulitis, peritubular capillaritis, and interstitial fibrosis/tubular atrophy (IFTA). However, the chronic glomerulopathy score, increased significantly over time, and conversely, arteritis and inflammation in IFTA ares improved in follow-up biopsies.

CONCLUSION
In our study, the addition of TCZ prevented clinical and histological worsening of cABMR in KT recipients, except for more severely ill patients. Randomized studies are needed to clarify the risk/benefit of TCZ in cABMR.
MO1002: Two-Step Desensitization Protocol Consisting of High-Dose Intravenous Immunoglobulin, Plasmapheresis and Rituximab in Highly Sensitized Kidney Transplantation
Authors: Okada Manabu , Hiramitsu Takahisa , Futamura Kenta , Norihiko Goto , Narumi Shunji , Watarai Yoshihiko , Ichimori Toshihiro 
Published: May 2022

Abstract

BACKGROUND AND AIMS
High-dose intravenous immunoglobulin (IVIG) therapy has not only immediate effects but also gradual effects via Fc receptors. To optimize IVIG therapy, we adopted a two-step desensitization protocol in kidney transplantation (KTx) with positive flow cytometry crossmatch (FCXM).

METHOD
In the first step, rituximab 200 mg and IVIG 2 g/kg were administered 2 months before KTx. In the second step, patients received additional rituximab 200 mg and IVIG 2g/kg for 2 weeks prior to transplantation in combination with plasmapheresis.

RESULTS
Of the six KTx with positive FCXM, there was no rejection except one (16.7%) subclinical antibody-mediated rejection within 1 month after transplantation. Average graft function was acceptable (serum creatinine level of 1.17 mg/dL).

CONCLUSION
The two-step desensitization protocol is an effective option for achieving successful transplant outcomes in KTx with positive FCXM, which can spare more aggressive and expensive treatments, such as C5 inhibitors, proteasome inhibitors and imlifidase.
MO1003: Role of Tacrolimus Trough Levels on Intra-Abdominal Pressure After Kidney Transplantation
Authors: Martínez Manrique María , Ardura Paula , Lorenzo Arturo , Acosta-Ochoa Isabel , Lucía Valencia Ana , Sanz-Ballesteros Sandra , Mendiluce Alicia , Reinaldo Sanchez Gil Jimmy , Fidalgo Veronica , Coca Armando 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Increased intra-abdominal pressure (IAP) is common after kidney transplantation (KT). However, the role of potential transplant-specific predictors of this complication, such as tacrolimus-associated endothelial dysfunction, remains unclear. We aimed to describe the relationship between tacrolimus trough levels and IAP in a sample of incident KT patients.

METHOD
Single-centre prospective cohort of deceased-donor KTs. Anesthesia, surgical technique and immunosuppression induction therapy were the same in all cases. IAP monitoring was performed according to WSACS guidelines using the urinary bladder technique (UnoMeter Abdo-Pressure kit). IAP values were registered every 8h during the first 72 h after surgery or until reoperation. Mean IAP values during the first 7 2h (72 h-IAP) were used in this analysis. The first measured tacrolimus trough levels after transplantation were included as a potential predictor of IAP. Patients without recorded tacrolimus trough levels during the first 7 days after surgery were excluded. The study was approved by the local ethics committee.

RESULTS
A total of 192 patients were enrolled in the study. Table 1A summarizes relevant patient and haemodynamic variables. Subjects with more severe intra-abdominal hypertension were more commonly males, with longer dialysis vintage, higher BMI and suffered diabetes more frequently. Multivariate linear regression analysis was used to examine potential predictors of 72 h-IAP, including male sex, months on dialysis, body mass index (BMI) (Table 1B), 72 h-fluid balance and tacrolimus trough levels. Recipient age, months on dialysis, BMI and tacrolimus trough levels were independent predictors of 72 h-IAP.

CONCLUSION
Tacrolimus-associated endothelial dysfunction may play a role in the increase of IAP after transplantation. In contrast, accumulated fluid balance, one of the strongest predictors of IAP in the ICU setting, failed to predict IAP values in our sample. These results offer new insight both into the pathophysiology of increased IAP and into the complex mechanisms of tacrolimus-associated nephrotoxicity in the early post-transplant period.
MO1008: The Role of IL-27/IL-27R in BKPYV Reactivation and Graft Rejection in Kidney Transplant Recipients
Authors: Afshari Afsoon , Roozbeh Jamshid , Yaghobi Ramin 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Kidney transplantation is the only cure for patients with end-stage renal disorders. Therefore, protecting these patients from transplant rejection is a critical lifesaving project after transplantation. Graft rejection and BK polyoma virus (BKPyV) associated nephropathy (BKVAN) is one of the common causes of graft loss among kidney transplant recipients (KTRs) through activating innate and adaptive immunity. In between, the role of cytokines is very perilous in handling the immune responses against rejection, such as IL-27, and in this study, it is tried to investigate the role of IL-27 and its receptor (IL-27R; WSX-1) in KTRs.

METHOD
EDTA-treated blood samples were collected from 90 KTRs that were divided into three equal groups of BKV-inactive/non-reject (G1), BKV-active/non-reject (G2) and BKV-inactive/reject (G3), after being monitored by real-time PCR (Taq-Man) in plasma. A total of 30 normal individuals were considered as healthy control group (G0). A real-time PCR (SYBR Green) technique is used to determine the expression level of studied genes.

RESULTS
The results of gene expression comparisons showed that the expression level of IL-27 was significantly higher in G1 compared with the G2 group. Analysis also showed that the difference in the expression level of genes between the G3 and G0 groups was statistically significant. Also, the same comparison between the G1 and G0 groups showed a significant difference.
The area under the ROC curve (AUC) showed that IL-27 is a significant discriminating molecule between all three studied groups of patients. The analyses revealed that the expression level of studied genes has a significant correlation with viral load. Finally, the ROC analysis showed that IL-27 and IL-27R seem to be important molecules for discrimination between G2 and G3 patient groups.

CONCLUSION
It is not easy to determine the IL-27 pro-inflammatory function as an endogenous regulatory mechanism, which might be one of the reasons for the immune system’s inability to inhibit the BKPyV reactivation in KTRs. Therefore, knowing the fact that in vivo loss of IL-27 signalling would not make drastic defects in immune development, turns IL-27 an attractive candidate for therapeutic research. It is important to consider the role of cytokines in different rejection conditions and the role of some cytokines should be more studied, such as IL-27 and IL-27R in course of kidney rejections, which happens especially between 2 weeks and 2 months after transplantation.
MO1010: Seroconversion Rate After Primary Vaccination with Two Doses of BNT162B2 versus MRNA-1273 in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
Authors: Verleye Arno , Wijtvliet Veerle , Abramowicz Daniel , Ledeganck Kristien 
Published: May 2022

Abstract

BACKGROUND AND AIMS
In the general population, the seroconversion rate after primary vaccination with two doses of anti-SARS-CoV-2 mRNA vaccine reaches nearly 100%, with significantly higher antibody titers after mRNA-1273 vaccination compared with BNT162b2 vaccination. Here, we performed a systematic review and meta-analysis to compare the antibody response after two-dose mRNA-1273 versus BNT162b2 vaccination in solid organ transplant (SOT) recipients.

METHOD
A systematic literature research was performed in PubMed, the Web of Science and the Cochrane library, and original research papers were included for a meta-analysis to calculate vaccine-specific seroconversion rates for each of the mRNA vaccines. Next, the pooled relative seroconversion rate was estimated.

RESULTS
Six studies that described the development of antibodies against receptor-binding domain (RBD) and/or S1 subunit of the spike protein were eligible for meta-analysis. Two of them also reported antibody titers. The meta-analysis revealed lower seroconversion rates in SOT recipients vaccinated with two doses of BNT162b2 {45.2%; [95% confidence interval (95% CI) 32.5%–58.3%]} than patients vaccinated with two doses of mRNA-1273 (60.4%; 95% CI 47.4%–72.7%). The relative seroconversion rate amounted 0.79 (95% CI 0.71–0.88).

CONCLUSION
This systematic review and meta-analysis indicates that, in SOT recipients, higher seroconversion rates were observed after vaccination with mRNA-1273 compared with BNT162b2.