Complications and adequacy of transplant kidney biopsies: A comparison of techniques

Plattner, Brett; Chen, Pauline; Cross, Richard; Leavitt, Matthew; Killen, Paul D.; Heung, Michael

doi:10.1177/1129729817747543

Cited by 24 publications

(17 citation statements)

References 21 publications

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“…Recognition of the susceptibility of the skin to acute rejection, and its accessibility for clinical monitoring, has prompted consideration of the broader utilization of transplanted skin for "sentinel" monitoring of the health of solid organ transplants. This is of potential benefit when reliable and timely diagnosis of rejection is challenging, and the process of obtaining diagnostic biopsies is not without risk to both the transplant and patient [71][72][73][74]. Perhaps the most obvious question, given the absence of a skin component within solid organs, is to what extent rejection of sentinel skin will be concordant with rejection of the transplanted organ?…”

Section: Sentinel Skin Flaps In Solid Organ Transplantationmentioning

confidence: 99%

Skin Immunology and Rejection in VCA and Organ Transplantation

et al. 2020

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Purpose of Review Skin provides a window into the health of an individual. Using transplanted skin as a monitor can provide a powerful tool for surveillance of rejection in a transplant. The purpose of this review is to provide relevant background to the role of skin in vascularized transplantation medicine. Recent Findings Discrete populations of T memory cells provide distributed immune protection in skin, and cycle between skin, lymph nodes, and blood. Skin-resident TREG cells proliferate in response to inflammation and contribute to long-term VCA survival in small animal models. Early clinical studies show sentinel flap rejection to correlate well with facial VCA skin rejection, and abdominal wall rejection demonstrates concordance with visceral rejection, but further studies are required. Summary This review focuses on the immunology of skin, skin rejection in vascularized composite allografts, and the recent advances in monitoring the health of transplanted tissues using distant “sentinel” flaps.

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Section: Sentinel Skin Flaps In Solid Organ Transplantationmentioning

confidence: 99%

Skin Immunology and Rejection in VCA and Organ Transplantation

et al. 2020

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“…Moreover, the risk of cancer-related mortality is increased in these patients ( Sigel et al, 2011 ; Au et al, 2019 ; Horner et al, 2020 ). Tissue biopsies performed on immunosuppressed patients entails an elevated risk of complications and demonstrates lower diagnostic yields and increased mortality ( Plattner et al, 2018 ; Cleveland et al, 2020 ). Compared with tissue biopsy, liquid biopsy such as cell-free DNA (cfDNA) has several benefits.…”

Section: Introductionmentioning

confidence: 99%

Low-Coverage Whole Genome Sequencing of Cell-Free DNA From Immunosuppressed Cancer Patients Enables Tumor Fraction Determination and Reveals Relevant Copy Number Alterations

Bouzidi

Labreche

Baron

et al. 2021

Front. Cell Dev. Biol.

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Cell-free DNA (cfDNA) analysis is a minimally invasive method that can be used to detect genomic abnormalities by directly testing a blood sample. This method is particularly useful for immunosuppressed patients, who are at high risk of complications from tissue biopsy. The cfDNA tumor fraction (TF) varies greatly across cancer type and between patients. Thus, the detection of molecular alterations is highly dependent on the circulating TF. In our study, we aimed to calculate the TF and characterize the copy number aberration (CNA) profile of cfDNA from patients with rare malignancies occurring in immunosuppressed environments or immune-privileged sites. To accomplish this, we recruited 36 patients: 19 patients with non-Hodgkin lymphoma (NHL) who were either human immunodeficiency virus (HIV)-positive or organ transplant recipients, 5 HIV-positive lung cancer patients, and 12 patients with glioma. cfDNA was extracted from the patients’ plasma and sequenced using low-coverage whole genome sequencing (LC-WGS). The cfDNA TF was then calculated using the ichorCNA bioinformatic algorithm, based on the CNA profile. In parallel, we performed whole exome sequencing of patient tumor tissue and cfDNA samples with detectable TFs. We detected a cfDNA TF in 29% of immune-suppressed patients (one patient with lung cancer and six with systemic NHL), with a TF range from 8 to 70%. In these patients, the events detected in the CNA profile of cfDNA are well-known events associated with NHL and lung cancer. Moreover, cfDNA CNA profile correlated with the CNA profile of matched tumor tissue. No tumor-derived cfDNA was detected in the glioma patients. Our study shows that tumor genetic content is detectable in cfDNA from immunosuppressed patients with advanced NHL or lung cancer. LC-WGS is a time- and cost-effective method that can help select an appropriate strategy for performing extensive molecular analysis of cfDNA. This technique also enables characterization of CNAs in cfDNA when sufficient tumor content is available. Hence, this approach can be used to collect useful molecular information that is relevant to patient care.

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“…Moreover, conventional histological analysis still requires an additional 4–5 h of sample preparation, which would significantly prolong cold ischemic time, and adversely influence graft outcome. In several cases, during the first year after transplantation, post‐op patients may be subjected to up to four biopsies, a procedure that entails a risk of bleeding complications [17]. Therefore, especially in Europe, the use of direct tissue analysis is limited to expanded criteria donors and donors after circulatory death [14].…”

Section: Introductionmentioning

confidence: 99%

Monitoring of the influence of long‐term oxidative stress and ischemia on the condition of kidneys using solid‐phase microextraction chemical biopsy coupled with liquid chromatography–high‐resolution mass spectrometry

Stryjak

Warmuzińska

Bogusiewicz

et al. 2020

J of Separation Science

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The limiting factor in conventional quality assessments of transplanted organs, namely the invasiveness of tissue sample collection, has prompted much research on the field of transplantology to focus on the development of alternative evaluation methods of organ quality. In the present project, we undertake the challenge to address the need for a new analytical solution for graft quality assessments by using a novel metabolomic diagnostic protocol based on low-invasive solid-phase microextraction. Solid-phase microextraction probes of ca. 0.2 mm coated with 4 mm long mixed-mode extraction phase were inserted into rabbit kidneys immediately following euthanasia and after 2, 4, 6, and 21 h of preservation. Liquid chromatography-mass spectrometry analysis of the extracts was performed with the use of a reversed phase column and a Q-Exactive Focus mass spectrometer operated in positive ionization mode. Statistical analysis of significantly changing compounds revealed metabolic profile changes in kidneys induced by ischemia and oxidative stress as a function of the duration of cold storage.The most pronounced alterations were reflected in levels of essential amino acids and purine nucleosides. Our findings demonstrate that the proposed approach may be successfully used to monitor changes in the metabolic profile of organs over time of preservation.

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Complications and adequacy of transplant kidney biopsies: A comparison of techniques

Abstract: Kidney biopsy complications appear to be similar when using any of the three techniques examined in our study. However, ultrasound-guided trocar technique may yield lower biopsy adequacy when compared to non-trocar techniques.

Cited by 24 publications

References 21 publications

Skin Immunology and Rejection in VCA and Organ Transplantation

Skin Immunology and Rejection in VCA and Organ Transplantation

Low-Coverage Whole Genome Sequencing of Cell-Free DNA From Immunosuppressed Cancer Patients Enables Tumor Fraction Determination and Reveals Relevant Copy Number Alterations

Monitoring of the influence of long‐term oxidative stress and ischemia on the condition of kidneys using solid‐phase microextraction chemical biopsy coupled with liquid chromatography–high‐resolution mass spectrometry

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