New scoring system identifies kidney outcome with radiation therapy in acute renal allograft rejection

Chen, Luci M.; Godinez, Juan; Thisted, Ronald A.; Woodle, E. Steve; Thistlewaite, J.Richard; Powers, Claire; Haraf, Daniel J.

doi:10.1016/s0360-3016(99)00474-5

Cited by 11 publications

(13 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In den letzten Jahren hat die Bestrahlung bei akuter Abstoßung von allogenen Nierentransplantaten ihre Bedeutung jedoch fast verloren [37]. Neuere Studien [18,28], speziell von Chen et al [6], belegen, dass bestimmte Patienten evtl. von der lokalen Transplantatbestrahlung profitieren könnten.…”

Section: Medikamentöse Therapie Bei Akuter Transplantatabstoßungunclassified

“…Diese Studien beruhen auf kleinen Kollektiven. Im angloamerikanischen Raum scheint die Radiotherapie wegen der geringen Kosten der Bestrahlung im Vergleich zu den Kosten der monoklonalen oder polyklonalen Antikörper an Bedeutung zu gewinnen [6]. In Deutschland ist diese Therapieoption weitgehend in Vergessenheit geraten.…”

Section: Medikamentöse Therapie Bei Akuter Transplantatabstoßungunclassified

“…Sutherland et al [38] sahen für die TLI bei der Nierentransplantation aber keinen signifikanten Vorteil gegenüber dem Einsatz von Cyclosporin A. Wegen der einfacheren Anwendung und der Schwierigkeit, direkt nach TLI ein geeignetes Spenderorgan zu identifizieren, bevorzugten sie daher den Einsatz von Cyclosporin A. Thomson [15] (1,5 Gy Einzeldosis) langfristig stabile Organfunktion medikamentösen Therapie Jagetia et al 6 4,5-6,0 Gy 2/6 (33%) Bestrahlung nach Versagen der 1996 [18] ( [28]. Langfristig wird etwa die Hälfte (12,5%-60%) der Organe durch lokale Bestrahlung stabilisiert.…”

Section: Potentielle Rolle Der Strahlentherapie Bei Organtransplantatunclassified

“…Langfristig wird etwa die Hälfte (12,5%-60%) der Organe durch lokale Bestrahlung stabilisiert. Chen et al [6] betonen die hohen Kosten der medikamentösen Therapie im Vergleich zu den niedrigeren Kosten der Bestrahlung. Die Erwartungen sind aber angesichts der schmalen Datenbasis verfrüht.…”

Section: Potentielle Rolle Der Strahlentherapie Bei Organtransplantatunclassified

See 3 more Smart Citations

Strahlentherapie im Rahmen der allogenen Nierentransplantation: eine Indikation zur lokalen Bestrahlung?

Micke

Seegenschmiedt

Bruns

et al. 2002

Strahlentherapie und Onkologie

View full text Add to dashboard Cite

show abstract

Section: Medikamentöse Therapie Bei Akuter Transplantatabstoßungunclassified

Section: Potentielle Rolle Der Strahlentherapie Bei Organtransplantatunclassified

See 2 more Smart Citations

Strahlentherapie im Rahmen der allogenen Nierentransplantation: eine Indikation zur lokalen Bestrahlung?

Micke

Seegenschmiedt

Bruns

et al. 2002

Strahlentherapie und Onkologie

View full text Add to dashboard Cite

show abstract

“…The results showed that radiation therapy resulted in reduction of urinary protein excretion, suggesting the potential advantage of radiation therapy for crescentic glomerulonephritis [12]. A novel scoring system has been described to predict the outcome of patients treated with radiation therapy for acute renal graft rejection [13]. However, the mechanism of the beneficial effect of irradiation remains obscure.…”

Section: Introductionmentioning

confidence: 99%

Low-Dose Local Kidney Irradiation Inhibits Progression of Experimental Crescentic Nephritis by Promoting Apoptosis

2008

View full text Add to dashboard Cite

Background: Crescentic glomerulonephritis is a rapidly progressive form of nephritis and is usually resistant to therapeutic intervention. Apoptosis plays a role in the resolution of glomerulonephritis. We investigated the effects of local kidney irradiation on the progression of experimental crescentic glomerulonephritis. Methods: The following three experimental rat groups were generated: (1) Group I, sham-operated control (n = 12); (2) Group II, rats injected intravenously with rabbit anti-rat GBM antibody (nephrotoxic serum, NTS) (n = 23), and (3) Group III, a single low-dose irradiation of 0.5 Gy X-ray to both kidneys at days 6, 13, 20, and 27 after NTS injection (n = 55). Renal function and blood leukocyte count were examined in different groups of rats at various time points. Kidneys obtained at various time points were analyzed to determine the effects of radiation in experimental nephritis. Results: Radiation of the kidneys reduced the levels of blood urea nitrogen and serum creatinine compared with Group II nephritic rats of similar age (p < 0.05 or 0.001). No apparent changes in blood leukocyte counts were noted in various experimental groups. Glomerular hypercellularity, crescents, global sclerosis and tubulointerstitial damage developed gradually in Group II rats, but were decreased (p < 0.05 or 0.001) after radiation treatment. The extent of tubulointerstitial damage was also reduced, and radiation-associated histological improvements were accompanied by reduced infiltration of macrophages in the glomeruli and interstitium. The numbers of PCNA- and ED1-positive cells were reduced in the kidneys at 1 day post-irradiation, of rats irradiated at 6 and 13 days after NTS injection, compared with Group II at similar time intervals (p < 0.05). A larger numbers of TUNEL-positive cells were noted at 1 day post-irradiation in rats irradiated at 6 and 13 days after NTS injection, compared with Group II at similar time intervals (p < 0.05). Immunostaining for macrophages ED1 and TUNEL staining of serial sections of irradiated nephritic kidneys showed few ED1-positive macrophages stained for TUNEL. Overexpression of active caspases 3 and 7 was noted in irradiated kidneys, compared with the corresponding Group II rats at similar time intervals. Western blot analysis showed marked increase in active caspase 3 and active caspase 7 expression in irradiated kidneys compared with NTS injection only. A marked increase in the expression of p53 protein, which is closely related to radiation-induced apoptosis, was also observed in irradiated kidneys compared with NTS injection only. Conclusion: Our study showed that renal radiation can alter acute glomerular inflammation by inducing apoptosis of intrinsic and infiltrating cells in the kidney in a rat model of crescentic glomerulonephritis. Low-dose kidney irradiation can inhibit the progression of experimental nephritis through inducing apoptosis.

show abstract

Local allograft irradiation as an adjunct for treating severe resistant rejection after liver transplantation in adults

et al. 2014

View full text Add to dashboard Cite

Acute rejection after liver transplantation occurs in one-third of all recipients and can be managed with conventional rejection therapy in the majority of cases. In rare instances, patients with severe acute rejection may be refractory to or have contraindications for conventional therapies. This case series evaluates the role of local allograft irradiation (LAI) as an adjunct for patients with rejection that is refractory to or contraindicated for conventional therapies. Additionally, the literature on the use of radiation therapy for reversing rejection in solid organ transplantation is reviewed. Five patients underwent 9 LAI treatments: 2 had refractory rejection, and 1 each had a malignancy, a concurrent life-threatening infection, and serum sickness with antibody therapy. Conventional rejection therapies included steroids, calcineurin inhibitors, and antithymocyte globulin. LAI consisted of 3 cycles of 1.5 Gy directed toward the liver allograft. Two of the 5 patients remained alive with excellent graft function. Six of the 9 treatments were successful in rescuing the liver allograft (reversing the rejection episode). Treatment success was associated with lower pretreatment serum bilirubin levels and higher pretreatment alanine aminotransferase levels. Compared with patients with immunosuppression-responsive severe acute rejection, those requiring LAI trended toward a later onset of first rejection. In conclusion, local irradiation of liver allografts can be a useful adjunct in patients for whom conventional options have been exhausted or cannot be used. The ability of LAI to reverse allograft dysfunction and promote patient survival appears to be greatest before the onset of severe cholestatic injury. Liver Transpl 21:47-56, 2015. V C 2014 AASLD.

show abstract

New scoring system identifies kidney outcome with radiation therapy in acute renal allograft rejection

Cited by 11 publications

References 10 publications

Strahlentherapie im Rahmen der allogenen Nierentransplantation: eine Indikation zur lokalen Bestrahlung?

Strahlentherapie im Rahmen der allogenen Nierentransplantation: eine Indikation zur lokalen Bestrahlung?

Low-Dose Local Kidney Irradiation Inhibits Progression of Experimental Crescentic Nephritis by Promoting Apoptosis

Local allograft irradiation as an adjunct for treating severe resistant rejection after liver transplantation in adults

Contact Info

Product

Resources

About