bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO949: Metabolic Syndrome and Longitudinal Risk of Renal and Cardiovascular Events in Renal Transplant Recipients: A Single Center Study in Japan
Authors: Naganuma Toshihide , Kabata Daijiro , Iwai Tomoaki , Takemoto Yoshiaki , Uchida Junji 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Metabolic syndrome (MetS) is a condition that promotes arteriosclerosis due to various arteriosclerosis risk factors such as impaired glucose tolerance, impaired lipid metabolism and hypertension, caused by insulin resistance as a result of visceral fat obesity. There have been several epidemiological studies on MetS after renal transplantation conducted in the U.S. and Europe, indicating that MetS is an accumulation of non-immunological risks of renal transplantation, which affects the patient's prognosis as well as that of the kidney. However, the incidence of MetS in Japanese renal transplant recipients is 20 to 30% and lower compared with that of American and European recipients, and its effects on cardiovascular complications and kidney prognosis are not clear. We report on the results of our long-term longitudinal study on MetS in renal transplant recipients.

METHOD
A total of 104 renal transplant outpatients, over 6 months after their transplants and in stable condition, were diagnosed with MetS from January 2006 and June 2007 and followed up until December 2020. The effects of MetS on outcomes including renal and cardiovascular events were studied using four diagnostic criteria [NCEP-ATP III (Japanese, original, Asian) and IDF criteria]. We performed multivariate Cox proportional hazards regression analysis to examine the association between the presence or absence of MetS and combined vascular events in renal transplant recipients. This study protocol was conducted in accordance with the Principles of the Declaration of Helsinki and the Declaration of Istanbul, and was approved by the ethics committee of Osaka City University (No. 2020–197). All analyses were performed using R ver. 4.0.3 (https://www.r-project.org/foundation/) with the ‘rms’ and ‘RcmdrPlugin.EZR’ packages.

RESULTS
The incidence of MetS among our renal transplant recipients in our baseline investigation was 24.0% by the NCEP-ATP III (Japanese) criteria, and our longitudinal study showed that MetS was a significant risk factor even after adjustment of background factors using the propensity score (HR: 2.82; 95% CI: 1.26–6.34, P = 0.012). In addition, the effects of MetS diagnosed using the NCEP (original), NCEP (Asian) and IDF criteria on cardiac composite events were HR: 2.39; 95% CI: 1.07–5.38, P = 0.035, HR: 2.35; 95% CI: 1.00–5.55, P = 0.051, and HR: 1.90; 95% CI: 0.84–4.31, P = 0.12, respectively.

CONCLUSION
Although the incidence of MetS in Japanese renal transplant recipients was lower compared to that of American and European renal transplant recipients, our results indicated that MetS also affected cardiovascular complications and kidney prognosis in Japanese renal transplant recipients. Moreover, depending on the diagnostic criteria for MetS, the HR was shown to be around 2.0–3.0.
MO953: Relevance of Proteinuria and Donor Specific Antibody in Kidney Transplanted Recipients and Allograft Outcomes
Authors: Hashmi Amna , Klenk Nora , Bidiga Laszlo , Kardos Laszlo , Áron Nemes Balázs , Balla Jozsef , P. Szabo Reka 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The onset of proteinuria in renal allograft recipients is a frequent complication that may be associated with an increased risk of graft failure and mortality. Our aim was to research if proteinuria effects is independent from donor specific antibody (DSA) for transplant graft survival and the changes of proteinuria response to therapy in ABMR group.

METHOD
85 transplanted patients were enrolled in our study and followed up till 31 October 2020 or till death, or date of return to dialysis. We created three groups: ABMR group (n = 19, biopsy proven antibody mediated rejection), ABMRDSApos positive group (n = 14) ABMRDSAneg (n = 5), DSA negative group with stabile kidney function without rejection as a reference (n = 52). Differences in patient, donor and transplant characteristics between DSA positive and negative groups were assessed by Fishers exact test for categorical variables. Death censored graft loss was assessed by Kaplan Meier analysis with log risk statistics.

RESULTS
Proteinuria decrease after treatment in ABMR group (P = 0.0009). Graft failure's frequency increase every 10 mg/mmol elevation of proteinuria means 7% elevation (hazard ratio: 1.07%). Before treatment nephrotic proteinuria was found in group AMBRDSApoz 21%, 14,29% in group ABMR DSAneg 1,92% in reference group. Estimated 3-year graft survival was 87, 5% in ABMR group, 93% in DSA pos group, and 100% in DSA negative group (log-rank probe P = 0.0666).

CONCLUSION
The presence of DSA increases graft loss but it is independent to proteinuria. Therapy refractory proteinuria state represents worse graft survival.
MO958: Hyperleptinemia as A Risk Factor for Post-Transplant Diabetes Mellitus Development After Kidney Transplantation
Authors: Graňák Karol , Vnučák Matej , Beliančinová Monika , Pytliaková Margaréta , Dedinska Ivana 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Adipose tissue, as an endocrine organ, is involved in the synthesis of hormones that are involved in several processes, including the regulation of food intake, the control of insulin sensitivity or as mediators of inflammatory processes. The aim of this study was to determine the importance of leptin, adiponectin, interleukin 6 and interleukin 10 levels for the development of post-transplant diabetes mellitus (PTDM) 1 year after kidney transplantation (KT).

METHOD
In the prospective analysis, the studied sample (n = 104) was divided into three groups: (1) control group, (2) patients who developed a pre-diabetic condition after KT (impaired glucose tolerance, fasting hyperglycemia) and (3) patients who developed de novo PTDM. Pre-transplantation and subsequently at 3, 6 and 12 months after KT, we recorded the basic characteristics of the donor and recipient, including parameters reflecting graft function, metabolic (lipid profile, glucose metabolism parameters) and anthropometric parameters. At the same time, we monitored the levels of adipocytokines (adiponectin, leptin) and interleukins (IL-6, IL-10) during the monitored period (Table 1).

RESULTS
The level of leptin in the post-transplant period had a continuously decreasing tendency in the control group with a significantly lower level 12 months after KT (P = 0.0078). On the other hand, after transient decrease, leptin level remained high in 12 months after KT in the group with prediabetes (P = 0.0343) and PTDM (insignificant). In contrast, adiponectin levels showed a significant decrease after 12 months in the group with prediabetes (P = 0.0009) and PTDM (P &lt;0.0001), while it increased in the control group. IL-6 decreased significantly in the control group (P = 0.0023), with prediabetes (P = 0.0061) and PTDM (P = 0.0499). After adjusting for differences in the baseline donor and recipient characteristics, we found risk factors for PTDM 12 months after KT in a univariate analysis: baseline hyperleptinemia (P = 0.0458) and at 12 months (P = 0.0464), low adiponectin levels at 12 months (P = 0.0108), low IL-6 baseline (P = 0.0180), IL10 at 6 months (P = 0.0271) and 12 months (P = 0.0397). Using multivariate analysis, we identified hyperleptinemia 12 months after KT as an independent risk factor for PTDM development 1 year after KT [OR: 1.0320; 95% Cl: 0.9785–1.0884 (P = 0.0038)] (Table 2).

CONCLUSION
We confirmed that elevated leptin level 12 months after KT is associated with the development of PTDM. Levels of inflammatory process mediators (IL-6 and IL-10) did not correlate with an increased incidence of metabolic complications. Their importance seems to apply in the event of acute rejection, which requires further investigation.
MO962: C-Peptide and Epicardial Adipose Tissue in Chronic Kidney Disease
Authors: D'marco Luis , Bermudez Valmore , Raggi Paolo 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Recent studies suggest that C-peptide (CP) may exhibit characteristics of a hormone and show physiological functions in various tissues. Moreover, it has been proposed that CP could be involved in the regulation of lipolysis, adiponectin release and function of mesenchymal stem cells in adipose tissue. However, there is a certain controversy regarding reported effects of the CP. Its beneficial effects have been demonstrated in long-term complication in type 1 diabetes mellitus (T1DM). Substitution of CP in T1DM improves glomerular hyperfiltration, hypertrophy and proteinuria. In contrast to this, CP in T2DM shows proinflammatory and proatherogenic effects. The aim of this study was to find the association between CP, epicardial adipose tissue (EAT) and vascular calcifications in diabetic subjects under insulin treatment on dialysis.

METHOD
This is a retrospective study of 62 consecutive chronic kidney disease (CKD) stages 5D patients awaiting kidney transplantation referred for risk stratification. Computer tomography (CT) was used to assess quantify coronary artery calcium (CAC) and to measure EAT volume. CAC was considered present if a minimum of three contiguous pixels with an attenuation of ≥130 Hounsfield Units (HU) were detected along the course of a coronary artery. CAC scores were calculated using the method described by Agatston. EAT was identified as a hypodense area surrounding the myocardium and limited by pericardium. The pericardium was traced manually from the mid-left atrium to the left ventricular apex interpolating slices of 10 mm thickness; the application of an attenuation threshold in the range of -250 to -30 HU effectively excluded myocardium, coronary arteries, coronary calcium, aorta and blood pool, leaving in evidence the EAT alone. Demographic and anthropometrics data were collected on all patients through record review.

RESULTS
Demographic, clinical and laboratorial characteristics of patients enrolled in the study are resume in the Table 1. Young women and smoking were more prevalent; none of the analytical parameters were correlated with CP. Subjects with higher BMI exhibited higher levels of CP (P 0.03). EAT was strongly correlated with higher levels of CP (P 0.03). EAT was significantly correlated with severity of CAC scores (P 0.01). No correlation was found between CP and CAC.

CONCLUSION
As a marker of insulin reserve, CP can be used to evaluate insulin needs and overdose in dialysis patients and to avoid its lipogenic effects. New and novel hypoglycemic therapies may help in this issue. While EAT was correlated to CP, this was not associated with vascular calcification (CAC); this final observation may be related to the lower levels of vascular damage observed in CKD patients from kidney transplantation waiting list. More studies are needed to explore this association and utility.
MO968: Vascular Complications of Renal Transplantation: Risk Factors and Impact on Graft Survival
Authors: Zaghbib Selim , Chakroun Marouene , Saadi Ahmed , Boussaffa Hamza , Bouzouita Abderazzak , Derouiche Amine , Ben Slama Riadh , Bacha Mongi , Abdallah Taieb Ben , Ayed Haroun , Chebil Mohamed 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Despite the progress made in renal transplantation, vascular complications can occur, jeopardizing the prognosis of the transplant.
This study aims to investigate the risk factors of vascular complications and their impact on transplant survival.

METHOD
We performed a retrospective longitudinal descriptive study including all patients who had a kidney transplant in a Urology department from 1986 to 2017. Transplant Vascular complications included: Arterial thrombosis (AT), Venous thrombosis (VT), hemorrhagic complications (hemorrhage and hematoma) and arterial stenosis (AS). The potential risk factors for vascular complications that were investigated included characteristics related to the recipient, the donor, the transplant and the procedure. The impact of vascular complications on transplant survival was then studied.

RESULTS
A total of 720 patients were included with a mean age of 32.7 years. The transplant was from a living donor in 79% and a brain-dead donor in 21%.
AT occurred in 15 patients (2.1%) and VT occurred in 10 patients (1.4%). Risk factors for vascular thrombosis were recipient age &gt;35 years (P = 0.001; OR = 10.78), recipient smoking (P = 0.005; OR = 1.8), multiple arteries (P &lt; 0.001; OR = 1.45) and prolonged warm ischemia (P = 0.02). Perirenal hematoma occurred in 11 patients (1.5%) and hemorrhage occurred in six patients (0.8%). The risk factors for bleeding complications were a prolonged pre-transplantation dialysis time (P = 0.03; OR = 1.35), and prolonged warm ischemia (P = 0.02; OR = 1.26). AS was the most frequent vascular complication, occurring in 20 cases (2.8%) and no risk factors were identified.
Transplant survival was 77.9% at 5 years, with a median survival of 15.9 years. Vascular thrombosis led to the loss of the transplant in all cases, and externalized hemorrhage significantly reduced transplant survival (P &lt; 0.001). Perirenal hematoma (P = 0.42) and transplant artery stenosis (P = 0.25) had no impact on transplant survival (Figure 1).

CONCLUSION
Our study showed that the vascular complications impacted the survival of the transplant and that they were related to factors related to the recipient, the transplant and the procedure insisting on a multidisciplinary and personalized management for each case.
MO972: Impact of Inhibition of Pcsk-9 Among Renal Transplant Recipients with High Cardiovascular Risk
Authors: Alotaibi Torki , Ashry Ahmed Gheith Osama , Maher Nagib Ayman , Hasaneen Ahmed Aboatya Aboatya Hasaneen , MA Halim Medhat , S.H. Mahmoud Tarek , Emam Mohamed , Mostafa Mohamed , Elsayed Zakaria , Nair Prasad 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Monoclonal antibodies inhibiting proprotein convertase subtilisin/Kexin type A(PCSK-9) have emerged as one of the new cholesterol-lowering agents. It is not evaluated among renal transplant recipients despite its favorable safety profile. We aimed to evaluate the safety and efficacy of evolocumab in reducing lipids and cardiovascular events among risky renal transplant recipients.

METHOD
About 195 kidney transplant recipients—with high cardiovascular risk (&gt;20)—were enrolled in this randomized controlled study during the period between 6.2017 and 6.2018. Patients who received statin and evolocumab (140 mg/2 weeks, group 1, n = 97) while those who were maintained on statin alone comprised group 2 (n = 98). They were followed up for 24 months.

RESULTS
The two groups were comparable regarding their demographics (P &gt; 0.05). Before enrollment in the study, post-transplant complications were comparable apart from a higher prevalence of NODAT in group 2 (P = 0.033). Smokers were significantly more prevalent in group 1. Basal graft function was significantly higher in group 1 despite equivalent regimen of immunosuppression in both groups (P &gt; 0.05). Clinically two groups were comparable concerning cardiovascular events and both graft and patient outcomes (P &gt; 0.05). Basal cholesterol was significantly higher in group 1 (5.5 versus 4.7, P &lt; 0.001) which dropped significantly after 3 months (versus12 months in group 2) and thereafter (P = 0.031). We observed that triglycerides in the two groups were comparable (P &gt; 0.05) till the end of the study.

CONCLUSION
Evolocumab is a promising add on lipid-lowering agent. In high risk renal transplant, earlier reduction of cholesterol was observed in the add-on evolocumab group but without significant positive cardiovascular impact.
MO985: Physical Function Trajectories Predict Patient Survival in Older Recipients of Deceased Donor Kidneys
Authors: Tsarpali Vasiliki , Midtvedt Karsten , Lønning Kjersti , Bernklev Tomm , Åsberg Anders , Von der Lippe Nanna , Varberg Reisater Anna , Heldal Kristian 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Health-related quality of life (HRQOL) outcomes have been positively associated with patient survival after kidney transplantation (KT). In older recipients, poor HRQOL may indicate risk for clinical deterioration. We aimed to prospectively evaluate if, in older recipients of deceased brain-dead donor (DBD) kidneys, changes in HRQOL during the first year post-transplantation differed between survivor and non-survivors.

METHOD
KT candidates aged ≥65 years who were enlisted between January 2013 and November 2016 at the Norwegian national transplant center and received a deceased brain-dead donor (DBD) kidney were included. HRQOL was assessed using the Kidney Disease Quality of Life Short Form, version 1.3. HRQOL outcomes were collected prior to KT, at 10 weeks, 6 months and 12 months post-KT. A mixed-effect linear regression model was used to examine the development of HRQOL during the first year post-KT in survivors versus non-survivors. Longitudinal HRQOL trajectories were identified using a group-based trajectory modelling. A Cox proportional hazard regression was used to investigate the association of longitudinal HRQOL trajectories for each domain with patient survival.

RESULTS
We included 289 waitlisted candidates, of whom 192 received a DBD kidney. Mean age at KT was 72 (4.1) years, 133 (69%) were males, 47 (24%) were transplanted preemptively and 80% received an expanded criteria donor organ. During a median observation time of 4.6 (3.2, 6.3) years post-KT, 66 recipients died. In survivors, all the generic and kidney-specific HRQOL domains substantially improved during the first year post-KT, whereas HRQOL deteriorated in non-survivors (Figure 1). Three developmental trajectories, describing poor, fair and good outcomes were identified for most of the HRQOL domains. Recipients perceiving poor physical development during the first post-transplant year had a 2.5 higher mortality risk, while recipients with fair physical development had 1.4 increased mortality risk, compared with recipients with good physically development (Figure 2).

CONCLUSION
In elderly kidney transplant recipients, poor post-transplant physical function trajectory may indicate impaired survival. The systematic HRQOL monitoring following KT is warranted to identify high-risk patients and guide therapeutic decisions.
MO996: Immunogenicity Rates After Sars-Cov-2 Vaccination Among Kidney Transplant Recipients: A Meta-Analysis
Authors: Jay Robles Mark , Coronel Marichel 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Various COVID-19 vaccines have been developed across a range of platforms and have been deployed among immunocompetent individuals, but data have been lacking regarding the effects of these vaccines among kidney transplant recipients. While it is true that there is high immunogenicity after COVID vaccination among immunocompetent individuals, disappointing results in the humoral response were seen among kidney transplant recipients. There are studies that undermine the over-all immunogenicity among end-stage renal disease on renal replacement therapy, but little is known regarding data among kidney transplant recipients. Hence, this meta-analysis would like to investigate the over-all immunogenicity rate among kidney transplant recipient after COVID vaccination.

METHOD
A systematic search of relevant articles was performed on two English databases (Pubmed, Cochrane Library) published between January 2020 to November 2021 and we included studies on kidney transplant recipient who reported on antibody response rate after COVID vaccination.

RESULTS
Thirteen studies were included in this meta-analysis with a total of 2231 participants, analyzing immunogenicity rates among kidney transplant recipients towards the following vaccines: [mRNA-1273 SARS-CoV-2 Vaccine (Moderna), Inactivated whole-virus SARS-CoV-2 vaccine, CoronaVac® (Sinovac), mRNA BNT162b2 vaccine (Pfizer-BioNTech), and Oxford–AstraZeneca COVID-19]. The over-all immunogenicity rate among kidney transplant recipient was 43% (95% CI: 36–52%) with I2 = 80%. Compared with controls, kidney transplant recipient had a 53% reduced likelihood of attaining seroconversion after a standard 2 doses of COVID vaccine (RR: 0.47, 95% CI: 0.34–0.65).

CONCLUSION
The overall immunogenicity among Kidney Transplant (KT) recipient was 43% and compared with transplant-naïve group, KT recipients have a 53% reduced likelihood of attaining seroconversion. Moreover, KT recipients whom had prior COVID-19 infection, and received mRNA-1273 COVID-19 Vaccine (Moderna) as their COVID vaccine has higher antibody response rate. The addition of booster dose of vaccine showed a slight increase in immunogenicity compared with those whom had two doses only. Lastly, old age and high levels of anti-metabolite might have cause low level of immunogenicity among kidney transplant recipient after COVID vaccination.
MO1004: Non-Antibiotic Prophylaxis with D-MANOSE for Uti in DE-NOVO Kidney Transplant Recipients: The Manotras Study
Authors: Melissa Rau Lertora Ana , Santelli Adrián , Fiol Maria , Riera Luis , Etcheverry Begoña , Ardanuy Tisaire Carmen , Marti Sara , Cruzado Josep , Melilli Edoardo 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Urinary tract infections (UTIs) are one of the most frequent complications in the first 6 months after kidney transplantation. (1) D-Mannose, a simple sugar, could play a very important role in the prevention of urinary infections, inhibiting the attachment of bacterial type one fimbriae to the urothelium, reducing their ability to infect de host. Proanthocyanides (PAC) have also been shown in vitro activity to inhibit the adherence of Escherichia coli by a similar mechanism. Both have shown promising results in reducing the risk of UTI in healthy women, but its efficacy has not been evaluated in kidney transplant population yet. (2) In this single-cantre, double-blind, prospective, randomized clinical trial, we aimed to evaluate the impact and security of a 24-h prolonged release formulation of D-Mannose in de-novo kidney transplantation UTI's.

METHOD
Between April 2019 and September 2020, 60 patients were recruited and randomized in 1:1 ratio according to treatment arm. Control group was treated with PAC, while the study group received PAC plus Mannose. Treatments were given as a prophylaxis strategy immediate after renal transplantation and during the first 3 months. All patients were followed for 6 months.

RESULTS
No statistically differences were observed in the baseline characteristics among study groups (Table 1). During the follow up; 61% of patients had at least one UTI episode (asymptomatic bacteriuria 56%, cystitis 6% and acute graft pyelonephritis 17%). Escherichia coli accounted for 28% of all UTI episodes, followed by Enterococcus faecalis (15%), Enterobacter cloacae (13%) and Klebsiella pneumoniae (13%). The main renal outcomes (eGFR at 6 months, acute rejection and DGF) did not differ among study groups.
We found no statistically differences recording in the incidence of UTI between groups (Fig. 1). At univariate analysis the surgical complications, and female gender were independently associated with UTI. {OR 5.92, [95% confidence interval (95% CI) 1.021–34.36]; P = .041 and OR 3.59 95% CI 1.051–12.27; P = .047} with no effect of treatment with D-mannose.

CONCLUSION
In this study, a prophylaxis strategy based on Mannose + PAC did not show a significant impact compared with PAC alone on UTI in the de-novo kidney transplant population.