Although ezetimibe therapy has been shown to be effective in lowering serum cholesterol level, it has not been reported to affect serum cyclosporine level in transplant recipients. Here, we describe a kidney transplant recipient who experienced acute kidney ALLOGRAFT dysFUNCTION after ezetimibe prescription. Our patient showed an increase in serum creatinine level as well as a decrease in serum cyclosporine levels 1 month after taking ezetimibe.This suggests that ezetimibe may interact with cyclosporine and decrease its serum level resulting in ALLOGRAFT dysFUNCTION. In this regard, careful monitoring of kidney FUNCTION along with the serum cyclosporine level in kidney ALLOGRAFT recipients is recommended when cyclosporine is co-administered with ezetimibe.

Introduction. Ultrasonography is the preferable imaging technique for monitoring and assessing complications in kidney ALLOGRAFT transplants. Computer-aided diagnostic system based on texture analysis in ultrasonographic imaging is recommended to identify changes in kidney FUNCTION after ALLOGRAFT transplantation. Materials and Methods. A total of 61 biopsy-proven kidney ALLOGRAFT recipients (11 rejected and 50 unrejected) were assessed by a computer-aided diagnostic system. Up to 270 statistical texture features were extracted as descriptors for each region of interest in each recipient. Correlations of texture features with serum creatinine level and differences between rejected and unrejected ALLOGRAFTs were analyzed. An area under the receiver operating characteristic curve was calculated for each significant texture feature. Linear discriminant analysis was employed to analyze significant features and increase discriminative power. Recipients were classified by the first nearest neighbor classifier. Results. Fourteen texture features had a significant correlation with serum creatinine level and 16 were significantly different between the rejected and unrejected ALLOGRAFTs, for which an area under the curve values were in the range of 0. 575 for difference entropy S(4, 0) to 0. 676 for kurtosis. Using all 16 features, linear discriminant analysis indicated higher performance for classification of the two groups with an area under the curve of 0. 975, which corresponded to a sensitivity of 90. 9%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 98. 0%. Conclusions. Texture analysis was a reliable method, with the potential for characterization, and can help physicians to diagnose kidney failure after transplantation on ultrasonographic imaging.

Introduction: Non-human leukocyte antigen antibodies are an independent risk factor for acute rejection in kidney transplant recipients. Among them, angiotensin II receptor type 1 (ART1) antibodies can induce various effects, but their clinical importance in kidney transplant recipients has not been properly explained. This study aimed to evaluate the effect of ART1 antibodies on ALLOGRAFT FUNCTION and hypertension in stable kidney transplant recipients.Materials and Methods: Eighty-one kidney recipients from non- human leukocyte antigen antibodies-matched donors with stable ALLOGRAFT FUNCTION were examined for estimated glomerular filtration rate (Chronic Kidney Disease-Epidemiology Collaboration formula) and ART1 antibodies (measured using an enzyme-linked immunosorbent assay method). The result was considered positive if the anti-ART1 level was greater than 17 U/mL.Results: The mean age of the participant was 51.1±11.9 years with the mean time from transplantation was 83.5±6.5 months. Fifteen recipients (18.5%) had a high ART1 antibodies level. Those with low titers of ART1 antibodies had better ALLOGRAFT FUNCTION. The mean estimated glomerular filtration rate was 63.0±13.7 mL/min in those with low ART1 antibodies and 42.3±13.9 mL/ min in those with high ART1 antibodies (P<.001). There were no significant correlation between high ART1 antibodies levels and hypertension, cause of end-stage renal disease, age, sex, transplant and dialysis duration, cytomegalovirus infection, antihypertensive medication, or immunosuppressive agents.Conclusions: A high level of ART1 antibodies was a risk factor for ALLOGRAFT FUNCTION; however this indicator was not correlated with hypertension in our study.

Background: While acute rejection and early graft loss rates have decreased substantially over the past four decades, progressive chronic ALLOGRAFT dysFUNCTION (CAD) still remains a common cause of late graft loss in kidney transplant recipients.Objective: This study was conducted to investigate the percentage of natural killer (NK) cell subsets and IL-2, 15 and 18 genes expression in two groups of CAD and well-FUNCTION graft (WFG) recipients.Methods: 30 renal ALLOGRAFT recipients with biopsy-proven interstitial fibrosis/tubular atrophy (IF/TA) and impaired renal FUNCTION, and 30 sex- and age-matched WFG patients were enrolled in this study. The percentage of NK cell subsets including NK CD56bright and NK CD56dim cells were determined by flowcytometry, IL-2, IL-15, and IL-18 genes expressions were assessed by real-time PCR.Results: Compared to WFG patients, there was a significant (p<0.05) increase in the percentage of NK CD56bright cells in CAD patients. However, the difference in percentage of NK CD56dim cells or CD56dim/ CD56bright ratio between the studied groups was not significant. In addition, IL-2, 15 and 18 genes expressions were almost similar in CAD and WFG patients.Conclusion: We found higher percentages of NK CD56bright subset in kidney transplant recipients with CAD without considerable changes in related cytokines’ gene expression, suggesting a possible defect of NK cells maturation in these patients.

Introduction: Development of delayed graft FUNCTION is more prevalent in patients receiving a kidney ALLOGRAFT from brain-dead than living donors. This study aimed to evaluate the association between urine neutrophil gelatinase-associated lipocalin (NGAL) levels in brain-dead donors and subsequent ALLOGRAFT FUNCTION.Materials and Methods: Urine NGAL concentration was measured in urine samples obtained from 24 brain-dead kidney ALLOGRAFT donors before organ retrieval. The 24 kidney recipients were followed for 6 months. The immunosuppressive therapy was similar for all of the recipients. Following transplantation, plasma creatinine was recorded daily during the recipient’s stay in the hospital and then at 1, 3, and 6 months after transplantation. Delayed graft FUNCTION was defined as the need for dialysis in the first 7 days after transplantation.Results: The mean age of the donors was 28.7 ± 11.2 years and 70.8% were men. Their median urine NGAL level was 7.4 ng/ml (range, 2 ng/mL to 45 ng/mL). Urine NGAL levels were only associated with the need for cardiopulmonary resuscitation (P=.007). On the 1st day after transplantation, 16.7% of the recipients developed delayed graft FUNCTION, which was declined to 12.5% on the 2nd day and to 8.3% during the 3rd day and the following days. No significant association was observed between the donor’s urine NGAL levels and graft FUNCTION (P=.86).Conclusions: Our results did not show any association between urine NGAL levels and outcome of ALLOGRAFT FUNCTION obtained from brain-dead donors. Larger studies are required to confirm this finding.