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Medicina
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Antibody Mediated Rejection in Kidney Transplantation and Incorporation of Newer...
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Antibody Mediated Rejection in Kidney Transplantation and Incorporation of Newer Non-Invasive Markers in Evaluation and Management

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Urology & Nephrology".

Deadline for manuscript submissions: closed (17 April 2021) | Viewed by 7108

Special Issue Editors

Prof. Pradeep V. Kadambi

E-Mail Website
Guest Editor
College of Medicine, University of Florida, Jacksonville, FL, USA
Interests: kidney allograft dysfunction; acute rejection; immunosuppression; BK virus nephropathy; CMV infection; recurrent disease in kidney transplantation
Dr. W James Chon

E-Mail Website
Guest Editor
Missouri School of Medicine, University of Kansas, Kansas City, MO, USA
Interests: kidney allograft dysfunction; acute rejection; immunosuppression; BK virus nephropathy; CMV infection; recurrent disease in kidney transplantation

Special Issue Information

Dear Colleagues,

Kidney transplant is still the best treatment for the management of end-stage kidney disease, and we need to strive to get patients transplanted in a timely manner. Over the past several years, with the change in kidney allocation methodology in the United States, more patients who are highly sensitized have been transplanted. In addition, many centers have also employed desensitization techniques and paired kidney exchange to transplant these patients. This is inherently a risk factor for antibody mediated rejection (AMR).

In this Special Issue of Medicina, two important and related topics will be discussed:

  1. Perspectives in the evaluation and management of antibody-mediated rejection;
  2. Donor-derived cell-free DNA and active rejection in kidney transplantation.

Antibody-mediated rejection (AMR) remains elusive both in the short term but especially in the long term. While the conventional approaches of augmenting anti-rejection therapy, plasmapheresis, and anti-B cell agents might be appropriate for acute AMR, there are a still a lot of unknowns. How do we manage chronic AMR? Are there different strategies for management of AMR due to HLA Class I vs. Class II donor-specific antibodies or both? How do we monitor success and long term outcomes? There are lots of questions with relatively few answers.

In recent years, there has been an addition of newer non-invasive markers of active rejection in kidney transplantation. We will specifically focus on donor-derived cell-free DNA (ddcf-DNA) and how we can incorporate this additional non-invasive marker in the evaluation and management of kidney transplant recipients.

Prof. Pradeep V. Kadambi
Dr. W James Chon
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Antibody-mediated rejection
  • Donor-derived cell free DNA (ddcf-DNA)
  • Donor-specific antibodies
  • Immunosuppression
  • Plasmapheresis or plasma exchange

Published Papers (3 papers)

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Review

4 pages, 217 KiB  
Review
Donor-Derived Cell-Free DNA in Kidney Transplantation: Origins, Present and a Look to the Future
by Sam Kant and Daniel C. Brennan
Medicina 2021, 57(5), 482; https://doi.org/10.3390/medicina57050482 - 12 May 2021
Cited by 5 | Viewed by 2063
Abstract
Since its first detection in 1948, donor-derived cell-free DNA (dd-cfDNA) has been employed for a myriad of indications in various medical specialties. It has had a far-reaching impact in solid organ transplantation, with the most widespread utilization in kidney transplantation for the surveillance [...] Read more.
Since its first detection in 1948, donor-derived cell-free DNA (dd-cfDNA) has been employed for a myriad of indications in various medical specialties. It has had a far-reaching impact in solid organ transplantation, with the most widespread utilization in kidney transplantation for the surveillance and detection of allograft rejection. The purpose of this review is to track the arc of this revolutionary test—from origins to current use—along with examining challenges and future prospects though the lens of transplant nephrology. Full article
(This article belongs to the Special Issue Antibody Mediated Rejection in Kidney Transplantation and Incorporation of Newer Non-Invasive Markers in Evaluation and Management)
9 pages, 563 KiB  
Review
Challenges of Diagnosing Antibody-Mediated Rejection: The Role of Invasive and Non-Invasive Biomarkers
by Sambhavi Krishnamoorthy and Yousuf Kyeso
Medicina 2021, 57(5), 439; https://doi.org/10.3390/medicina57050439 - 03 May 2021
Cited by 3 | Viewed by 2469
Abstract
Kidney transplantation is the best treatment modality for end-stage kidney disease, leading to improvement in a patient’s quality and quantity of life. With significant improvements in short-term outcomes, prolonging long-term allograft and patient survival remain ongoing challenges. The ability to monitor allograft function, [...] Read more.
Kidney transplantation is the best treatment modality for end-stage kidney disease, leading to improvement in a patient’s quality and quantity of life. With significant improvements in short-term outcomes, prolonging long-term allograft and patient survival remain ongoing challenges. The ability to monitor allograft function, immune tolerance and predict rejection accurately would enable personalization and better prognostication during post-transplant care. Though kidney biopsy remains the backbone of transplant diagnostics, emerging biomarkers can help detecting kidney allograft injury early enough to prevent permanent damage and detect injury before it is clinically apparent. In this review, we summarize the recent biomarkers that have shown promise in the prediction of acute rejection with a focus on antibody-mediated rejection in kidney transplantation. Full article
(This article belongs to the Special Issue Antibody Mediated Rejection in Kidney Transplantation and Incorporation of Newer Non-Invasive Markers in Evaluation and Management)
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6 pages, 256 KiB  
Review
Donor-Derived Cell-Free DNA (ddcf-DNA) and Acute Antibody-Mediated Rejection in Kidney Transplantation
by Vishal Jaikaransingh and Pradeep V. Kadambi
Medicina 2021, 57(5), 436; https://doi.org/10.3390/medicina57050436 - 01 May 2021
Cited by 5 | Viewed by 2112
Abstract
Monitoring kidney transplant recipients for evidence of allograft rejection is essential to lower the risk of graft loss. The traditional method relies on serial checks in serum creatinine with a biopsy of the allograft if dysfunction is suspected. This is invasive, labor-intensive and [...] Read more.
Monitoring kidney transplant recipients for evidence of allograft rejection is essential to lower the risk of graft loss. The traditional method relies on serial checks in serum creatinine with a biopsy of the allograft if dysfunction is suspected. This is invasive, labor-intensive and costly. As such, there is widespread interest in the use of biomarkers to provide a noninvasive approach to detecting allograft rejection. One such biomarker is donor-derived cell-free DNA (ddcf-DNA). Here, we review the methodology for the determination of the amount/fraction of ddcf-DNA, evaluate the available data of its use in kidney transplantation and render an opinion in the clinical decision-making of these patients. Full article
(This article belongs to the Special Issue Antibody Mediated Rejection in Kidney Transplantation and Incorporation of Newer Non-Invasive Markers in Evaluation and Management)
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