Pregnant patients had a higher survival rate (97%) compared to non-pregnant controls (79%) at 10 years post-transplant, with similar graft loss rates (74% vs 66%). 56% of pregnancies were successful, indicating favorable outcomes for women who became pregnant after transplantation.
Only 26 out of 241 kidney transplant recipients (10.8%) had a positive serological response at 28 days post-injection, with a median IgG titer of 224 AU/mL. This low seroconversion rate highlights the limited effectiveness of the vaccine in this population compared to immunocompetent individuals, who typically show a strong response.
The study found that over 50% of kidney transplant recipients lacked an Omicron-specific neutralization response one month after the third vaccine dose. However, among those who did respond, binding and neutralizing antibody responses were well-preserved at three months. Additionally, anti-RBD antibody titres may help identify patients with detectable Omicron neutralizing antibody responses.
The 60-day incidence of breakthrough infection was 1.8% in the treatment group compared to 4.7% in the control group, indicating a significant reduction in infection risk.
Despite receiving Evusheld™, 39 out of 416 kidney transplant recipients developed COVID-19, indicating insufficient protection against the Omicron variant.
Vaccine effectiveness against any SARS-CoV-2 infection was estimated at 46.6% after 14 days, increasing to 73.9% after 56 days. Effectiveness against severe, critical, or fatal COVID-19 was 72.3% after 14 days, reaching 83.8% after 56 days.
Despite the initial response, there was a significant decline in anti-SARS-CoV-2 Ig levels over time, indicating a need for ongoing monitoring and potentially shorter vaccination intervals.
The administration of a third dose of the mRNA vaccine significantly increases anti-RBD IgG titers in kidney transplant recipients, particularly in those with low titers and the presence of spike-specific CD4+ T cells after the second dose.
The positive outcomes include a more efficient organ matching process, reduced organ wastage, improved pre-transplant screening accuracy, and ultimately, increased patient access to life-saving kidney transplants, which could prevent transplant failures and save lives.
Patients receiving tixagevimab-cilgavimab had significantly lower rates of COVID-19-related hospitalizations (3.8% vs 34%) and oxygen needs (3.8% vs 23%). There were also trends towards fewer ICU admissions and deaths in the treated group.
Recipients with matching MYH9 genotypes (AA) had significantly worse long-term graft survival outcomes, indicating the importance of genetic matching in transplantation.
The study found that prioritizing eplet mismatch significantly decreases racial disparities in donor matching, increasing the percentage of well-matched donors for minority candidates compared to traditional antigen matching methods.
Stable monocytic HLA-DR density in long-term renal transplant recipients was similar to non-immunosuppressed controls, but decreased levels were linked to higher malignancy risk during follow-up.
The study found that after receiving a third dose of the COVID-19 mRNA vaccine, solid organ transplant recipients showed a significant increase in anti-SARS-CoV-2 antibody titers and neutralizing activity against the alpha, beta, and delta variants. However, the response to the omicron variant was notably reduced compared to other variants.
Intra-operative perfusion strategies, particularly distal aortic perfusion (DAP) with LHB or pCPB, are associated with lower rates of dialysis and operative mortality compared to simple aortic cross clamping. Adjunctive SRP with cold blood or crystalloid fluids enhances kidney protection during DAP.
Healthy individuals showed robust germinal center responses, leading to the production of neutralizing antibodies and memory B cells, while kidney transplant recipients exhibited significantly blunted responses.
The study aims to assess the efficacy, outcomes, and safety of NIDUS, with pilot data suggesting it may contribute significant benefits to the health of small babies needing renal replacement therapy.
Higher concentrations of sDNA in the perfusate were associated with reduced graft function in the early post-transplant period, indicating its potential as a predictive biomarker for transplant outcomes.
The cumulative serological response rate increased significantly with repeated vaccinations, reaching 88.7% after five doses. Specifically, pausing MPA before the fourth vaccination improved the response rate to 75%, compared to lower rates with no adjustment or dose reduction.
The study provides evidence of bidirectional causal effects between urate and both eGFR and blood pressure, suggesting that controlling urate levels could help reduce blood pressure and slow the decline in kidney function.
The study found an increase in the median paid amount for kidney biopsies, indicating a rising financial burden on patients and payers, with specific increases noted for both adult and pediatric populations.
After the third dose of mRNA vaccines, 67% of KTRs developed anti-wild-type spike antibodies, and neutralizing responses to wild-type and Delta variants were observed in 61% and 59% of KTRs, respectively. However, only 12% had neutralizing responses to the Omicron variant after vaccination.
Only 9.5% of patients who received Evusheld™ were able to neutralize the omicron variant, indicating limited effectiveness. In contrast, 71% of convalescent patients had neutralizing activity, suggesting that Evusheld™ may not provide adequate protection.
The incidence of active tuberculosis was significantly lower in patients who completed INH prophylaxis (5%) compared to historical controls (15%). There was a notable reduction in TB cases during the first two years post-transplant, particularly in the first year.
Vaccination was associated with lower risks of COVID-19-related hospitalization and death among CDR, despite declining vaccine coverage with each booster dose.
Post-booster, 93% of dialysis patients and 58% of transplant patients achieved protective antibody levels, indicating a significant increase in immune response. The booster led to a more robust and sustainable immune response compared to previous doses, particularly in kidney transplant recipients who showed a >5.5-fold increase in protective antibody levels.
High cumulative vaccine coverage was achieved: 97.5% for the first dose, 97.0% for the second dose, and 93.5% for the third dose among the cohort. However, disparities in uptake were noted based on ethnicity, social deprivation, and mental health status.
Despite the risks, kidney transplantation can improve survival and quality of life compared to dialysis, although outcomes may be inferior in marginal donor-recipient pairs.
Early graft function was excellent in most survivors after COVID-19, and hospitalized patients showed better kidney function post-discharge. No significant differences in outcomes were observed between full- and reduced-dose IST.
The study found that patients switched to everolimus showed improved diffusivity and a tendency for better tissue oxygenation in kidney grafts compared to those maintained on ciclosporin.
The implementation of the personalized RRT initiation strategies improved average hospital-free days at day 60 by 13.7 days for the crude strategy and 14.9 days for the stringent strategy compared to current best practices.
Adolescents had a higher rate of biopsy-proven acute rejection episodes in the first year post-transplant compared to infants, suggesting age-related differences in rejection risk.
The study identified 72 metabolites in preservation fluids, with variations in metabolomic content based on perfusion time, although neither the metabolomic profile nor transporter expression were predictive of graft outcome.
The study found that while humoral immune responses (anti-RBD IgG titers) were significantly lower in kidney transplant recipients compared to controls, cell-mediated immune responses (T-cell responses) were significantly increased post-vaccination and comparable to those in controls.
The study found that while ART is essential for managing HIV, certain regimens, particularly those including tenofovir, were associated with a more rapid decline in kidney function, highlighting the need for careful monitoring of renal health in patients receiving these treatments.
The use of 1.5 g/day of MMF resulted in a lower incidence of gastrointestinal complications requiring medical attention (88% survival free) compared to the standard dose group (45% survival free). Additionally, the incidence of acute rejection was low at 5%.
Significant antibody responses (90.9-100% seropositive) and T cell responses were elicited by the vaccines, with preserved T cell response against Omicron BA.1, indicating potential protection against severe disease.
Two doses of BNT162b2 provided stronger protection against SARS-CoV-2 infection and severe disease compared to AZD1222. After a third dose of BNT162b2, the effectiveness of both vaccination schedules was similar during the Omicron variant period.
Both IE and CE resulted in increased noradrenaline concentrations, indicating a similar effect on renal haemodynamics. Urinary biomarkers for renal injury showed an increase but did not indicate significant renal damage.
The study found no statistically significant differences in mortality rates among patients undergoing different dialysis modalities, suggesting that mortality is a common complication across all types of dialysis.
Increased deceased donation among ethnic minority communities could improve the availability of organs and potentially enhance compatibility for Asian and black recipients, although it may not necessarily improve allograft outcomes.
Despite improvements in post-transplant survival rates over the years, solid organ transplant recipients continue to experience significantly higher mortality rates compared to the general population, with specific organ types showing varying levels of risk.
Good performers showed increased urine output and creatinine clearance, peaking at 6 hours post-perfusion. Poor performers exhibited higher levels of urinary NGAL, indicating worse kidney function. BCAA metabolism was identified as a key factor in determining organ function and resilience.
The integration of proteomic data with clinical metadata enhances the ability to predict transplant outcomes, allowing for better stratification of donor kidney quality and identification of potential interventions to improve posttransplant function.
A higher renal venous oxygen pressure (PO) was associated with lower serum creatinine (SCr) levels and higher glomerular filtration rates (GFR), indicating better renal function post-transplant.
Patients treated with sotrovimab had a substantially lower risk of 28-day COVID-19 related hospitalization or death (HR=0.35) compared to those treated with molnupiravir, indicating its effectiveness in preventing severe outcomes.
Among 823 transplant patients, 30.6% had mild COVID-19, 27.2% moderate, and 42.2% severe or critical. Major outcomes included 14.7% requiring intensive care unit admission, 11.8% needing invasive ventilation, and 19.4% mortality.
Genetically proxied SLC13A5 inhibition was associated with higher estimated glomerular filtration rates (eGFR) and lower BUN levels, suggesting improved kidney function.
No significant difference in the incidence of acute kidney injury between adjusted and non-adjusted dosing groups, suggesting that both dosing strategies have similar safety profiles.
The study found a pooled prevalence of depression at 27.6% among CKD patients, highlighting the importance of addressing this issue to improve patient outcomes. Routine evaluation and management of depression could lead to better adherence to treatment and improved quality of life.
Patients with AVFs placed in the non-dominant arm experienced superior quality of life and better quality-adjusted survival compared to those with AVFs in the dominant arm.
Despite changes in treatment strategies, the 60-day mortality rate remained statistically unchanged between the first and second waves, indicating that the new management approaches did not improve survival rates for kidney transplant recipients.
The study highlights significant evidence gaps in the efficacy of CVRM medications for CKD patients, particularly those with advanced stages (CKD stage 4-5). It emphasizes the need for more inclusive trials to better understand treatment effects in this high-risk population.