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Recent Advances and Complications of Kidney Transplantation

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Special Issue Editor

Dr. Ioannis Bellos

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Guest Editor

Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: nephrology; kidney transplantation; meta-analysis

Special Issue Information

Dear Colleagues,

Kidney transplantation represents the optimal treatment for patients with kidney failure, as it is associated with better long-term survival and enhanced quality of life. Despite the recent advances in immunologic and nonimmunologic interventions, the improvement of long-term graft and patient survival remains a challenge, due to the unfavorable changes observed over time in the risk profile of both kidney donors and recipients. The present Special Issue welcomes research studies (original articles, and systematic reviews/meta-analyses) focusing on the evaluation of strategies aiming for the earlier recognition and effective management of kidney transplantation complications. Potential topics include, but are not limited to, the following:

Novel noninvasive biomarkers for the diagnosis of acute rejection.
Innovative therapies for T-cell-mediated and antibody-mediated rejection.
Newer approaches to desensitization protocols.
Evaluation of markers and models for the prediction of cardiovascular risk of kidney transplant recipients.
Primary and secondary prevention of cardiovascular diseases in kidney transplant recipients.
Post-transplant infections: risk factors and impact on graft survival.
Post-transplant cancer: impact of immunosuppression and screening protocols.

Dr. Ioannis Bellos
Guest Editor

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Keywords

kidney transplantation
immunosuppression
cardiovascular
infectious
complications
risk prediction

Published Papers (2 papers)

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Research

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12 pages, 2900 KiB

Open AccessArticle

Complement and Non-Complement Binding Anti-HLA Antibodies Are Differentially Detected with Different Antigen Bead Assays in Renal Transplant Recipients

by Konstantinos Ouranos, Manolis Panteli, Georgios Petasis, Marianthi Papachristou, Artemis Maria Iosifidou, Myrto Aikaterini Iosifidou, Aikaterini Anastasiou, Margarita Samali, Maria Stangou, Ioannis Theodorou, Georgios Lioulios and Asimina Fylaktou

J. Clin. Med. 2023, 12(24), 7733; https://doi.org/10.3390/jcm12247733 - 17 Dec 2023

Viewed by 769

Abstract

Two semi-quantitative, Luminex-based, single-antigen bead (SAB) assays are available to detect anti-HLA antibodies and evaluate their reactivity with complement binding. Sera from 97 patients with positive panel reactive antibody tests (>5%) were analyzed with two SAB tests, Immucor (IC) and One-Lambda (OL), for anti-HLA antibody detection and the evaluation of their complement-binding capacity. IC detected 1608/8148 (mean fluorescent intensity (MFI) 4195 (1995–11,272)) and 1136/7275 (MFI 6706 (2647–13,184)) positive anti-HLA class I and II specificities, respectively. Accordingly, OL detected 1942/8148 (MFI 6185 (2855–12,099)) and 1247/7275 (MFI 9498 (3630–17,702)) positive anti-HLA class I and II specificities, respectively. For the IC assay, 428/1608 (MFI 13,900 (9540–17,999)) and 409/1136 (MFI 11,832 (7128–16,531)) positive class I and II specificities bound C3d, respectively. Similarly, OL detected 485/1942 (MFI 15,452 (9369–23,095)) and 298/1247 (MFI18,852 (14,415–24,707)) C1q-binding class I and II specificities. OL was more sensitive in detecting class I and II anti-HLA antibodies than IC was, although there was no significant difference in the number of class II specificities per case. MFI was higher for complement vs. non-complement-binding anti-HLA antibodies in both assays. Both methods were equal in detecting complement-binding anti-HLA class I antibodies, whereas the C3d assay was more sensitive in detecting complement-binding anti-HLA class II antibodies. Full article

(This article belongs to the Special Issue Recent Advances and Complications of Kidney Transplantation)

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Review

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17 pages, 1327 KiB

Open AccessReview

New-Onset Diabetes Mellitus after Kidney Transplantation

by Salah Alajous and Pooja Budhiraja

J. Clin. Med. 2024, 13(7), 1928; https://doi.org/10.3390/jcm13071928 - 27 Mar 2024

Viewed by 830

Abstract

New-Onset Diabetes Mellitus after Transplantation (NODAT) emerges as a prevalent complication post-kidney transplantation, with its incidence influenced by variations in NODAT definitions and follow-up periods. The condition’s pathophysiology is marked by impaired insulin sensitivity and β-cell dysfunction. Significant risk factors encompass age, gender, obesity, and genetics, among others, with the use of post-transplant immunosuppressants intensifying the condition. NODAT’s significant impact on patient survival and graft durability underscores the need for its prevention, early detection, and treatment. This review addresses the complexities of managing NODAT, including the challenges posed by various immunosuppressive regimens crucial for transplant success yet harmful to glucose metabolism. It discusses management strategies involving adjustments in immunosuppressive protocols, lifestyle modifications, and pharmacological interventions to minimize diabetes risk while maintaining transplant longevity. The importance of early detection and proactive, personalized intervention strategies to modify NODAT’s trajectory is also emphasized, advocating for a shift towards more anticipatory post-transplant care. Full article

(This article belongs to the Special Issue Recent Advances and Complications of Kidney Transplantation)

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