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Article ; Online: Medical Aspects of mTOR Inhibition in Kidney Transplantation.

Cuadrado-Payán, Elena / Diekmann, Fritz / Cucchiari, David

International journal of molecular sciences

2022 Volume 23, Issue 14

Abstract: The advances in transplant immunosuppression have reduced substantially the incidence of kidney graft rejection. In recent years, the focus has moved from preventing rejection to preventing the long-term consequences of long-standing immunosuppression, ... ...

Abstract	The advances in transplant immunosuppression have reduced substantially the incidence of kidney graft rejection. In recent years, the focus has moved from preventing rejection to preventing the long-term consequences of long-standing immunosuppression, including nephrotoxicity induced by calcineurin inhibitors (CNI), as well as infectious and neoplastic complications. Since the appearance in the late 1990s of mTOR inhibitors (mTORi), these unmet needs in immunosuppression management could be addressed thanks to their benefits (reduced rate of viral infections and cancer). However, management of side effects can be troublesome and hands-on experience is needed. Here, we review all the available information about them. Thanks to all the basic, translational and clinical research achieved in the last twenty years, we now use mTORi as de novo immunosuppression in association with CNI. Another possibility is represented by the conversion of either CNI or mycophenolate (MPA) to an mTORi later on after transplantation in low-risk kidney transplant recipients.
MeSH term(s)	Calcineurin Inhibitors/adverse effects ; Graft Rejection/prevention & control ; Graft Survival ; Immunosuppressive Agents/adverse effects ; Kidney Transplantation/adverse effects ; TOR Serine-Threonine Kinases
Chemical Substances	Calcineurin Inhibitors ; Immunosuppressive Agents ; TOR Serine-Threonine Kinases (EC 2.7.11.1)
Language	English
Publishing date	2022-07-12
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms23147707
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Article ; Online: Safety profile and clinical results of Remdesivir in Hemodialysis patients infected with SARS-CoV-2. A single-center Spanish cohort study.

Cuadrado-Payán, Elena / Rodríguez-Espinosa, Diana / Broseta, José Jesús / Guillén-Olmos, Elena / Maduell, Francisco

Journal of nephrology

2022 Volume 36, Issue 1, Page(s) 171–172

MeSH term(s)	Humans ; SARS-CoV-2 ; COVID-19 ; Cohort Studies ; COVID-19 Drug Treatment ; Renal Dialysis/adverse effects ; Antiviral Agents/adverse effects
Chemical Substances	remdesivir (3QKI37EEHE) ; Antiviral Agents
Language	English
Publishing date	2022-06-18
Publishing country	Italy
Document type	Letter
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-022-01364-3
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Article ; Online: Physiopathological role of extracellular vesicles in alloimmunity and kidney transplantation and their use as biomarkers.

Cuadrado-Payán, Elena / Ramírez-Bajo, María José / Bañón-Maneus, Elisenda / Rovira, Jordi / Diekmann, Fritz / Revuelta, Ignacio / Cucchiari, David

Frontiers in immunology

2023 Volume 14, Page(s) 1154650

Abstract: Antibody-mediated rejection is the leading cause of kidney graft dysfunction. The process of diagnosing it requires the performance of an invasive biopsy and subsequent histological examination. Early and sensitive biomarkers of graft damage and ... ...

Abstract	Antibody-mediated rejection is the leading cause of kidney graft dysfunction. The process of diagnosing it requires the performance of an invasive biopsy and subsequent histological examination. Early and sensitive biomarkers of graft damage and alloimmunity are needed to identify graft injury and eventually limit the need for a kidney biopsy. Moreover, other scenarios such as delayed graft function or interstitial fibrosis and tubular atrophy face the same problem. In recent years, interest has grown around extracellular vesicles, specifically exosomes actively secreted by immune cells, which are intercellular communicators and have shown biological significance. This review presents their potential as biomarkers in kidney transplantation and alloimmunity.
MeSH term(s)	Kidney Transplantation/adverse effects ; Extracellular Vesicles ; Kidney ; Exosomes ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-08-17
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1154650
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Article ; Online: Long-Term Outcomes of Incidental Liver Malignancies in Simultaneous Liver-Kidney Transplant Recipients.

Rodríguez-Espinosa, Diana / Morantes, Laura / García, Jenmy / Broseta, José Jesús / Cuadrado-Payán, Elena / Colmenero, Jordi / Torregrosa, Josep Vicens / Diekmann, Fritz / Esforzado, Nuria

Transplantation proceedings

2024 Volume 56, Issue 2, Page(s) 330–334

Abstract: Background: The pretransplant diagnosis of liver malignancies in nodular cirrhotic livers remains a diagnostic challenge despite current advances. Although the prognostic impact of incidental hepatocellular carcinoma (HCC) or intrahepatic ... ...

Abstract	Background: The pretransplant diagnosis of liver malignancies in nodular cirrhotic livers remains a diagnostic challenge despite current advances. Although the prognostic impact of incidental hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (iCC) in liver transplant recipients is well documented, there are no data on the impact in simultaneous liver kidney transplant (LKT) recipients. Methods: This is a single-center observational, retrospective study of all LKT performed from May 1993 to April 2022. Among these patients, demographic data, immunosuppressive therapy, rejection episodes, and prevalence of incidental HCC or iCC were evaluated. Results: One hundred eight LKTs were performed and 6 were excluded. There were 13 patients with incidental carcinomas in the explanted liver: one of them with both an HCC and iCC, one with an iCC, and the remaining with an HCC. One case of iCC died. No other recurrences occurred. There were no cases of incidental HCC nor iCC in patients with a hereditary or metabolic LKT indication. We found no differences in the 5-year patient survival, and death-censored kidney and liver graft survival rates for those LKT with an incidental HCC and those without it (76.9% vs 84.2%, P = .5; 100% vs 91.6%, P = .28; and 100% vs 94.7%, P = 0.39, respectively). Finally, there were no significant associations between explant carcinoma and rejections of the liver (7.7% vs 17.9%, P = .34) or kidney graft (0% vs 16.8%, P = 0.11). Conclusion: Despite a high prevalence of incidental HCC or iCC, patient, kidney, and liver graft 5-year survival were unaffected by incidental HCC.
MeSH term(s)	Humans ; Liver Neoplasms/pathology ; Carcinoma, Hepatocellular/pathology ; Kidney Transplantation/adverse effects ; Retrospective Studies ; Cholangiocarcinoma ; Bile Ducts, Intrahepatic/pathology ; Bile Duct Neoplasms ; Kidney/pathology
Language	English
Publishing date	2024-02-12
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2024.01.004
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Article: Tricuspid regurgitation, right ventricular function, and renal congestion: a cardiorenal triangle.

Forado-Benatar, Ilana / Caravaca-Pérez, Pedro / Rodriguez-Espinosa, Diana / Guzman-Bofarull, Joan / Cuadrado-Payán, Elena / Moayedi, Yasbanoo / Broseta, José Jesús / Farrero, Marta

Frontiers in cardiovascular medicine

2023 Volume 10, Page(s) 1255503

Abstract: There is a growing interest in the evaluation of tricuspid regurgitation due to its increasing prevalence and detrimental impact on clinical outcomes. Historically, it has been coined the "forgotten" defect in the field of valvular heart disease due to ... ...

Abstract	There is a growing interest in the evaluation of tricuspid regurgitation due to its increasing prevalence and detrimental impact on clinical outcomes. Historically, it has been coined the "forgotten" defect in the field of valvular heart disease due to the lack of effective treatments to improve prognosis. However, the development of percutaneous treatment techniques has led to a new era in its management, with promising results and diminished complication risk. In spite of these advances, a comprehensive exploration of the pathophysiological mechanisms is essential to establish clear indications and optimal timing for medical and percutaneous intervention. This review will address the most important aspects related to the diagnosis, pathophysiology and treatment of tricuspid regurgitation from a cardiorenal perspective, with a special emphasis on the interaction between right ventricular dysfunction and the development of hepatorenal congestion.
Language	English
Publishing date	2023-10-04
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.1255503
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Article: The metabolomic differential plasma profile between dialysates. Pursuing to understand the mechanisms of citrate dialysate clinical benefits.

Broseta, José Jesús / Roca, Marta / Rodríguez-Espinosa, Diana / López-Romero, Luis Carlos / Gómez-Bori, Aina / Cuadrado-Payán, Elena / Bea-Granell, Sergio / Devesa-Such, Ramón / Soldevila, Amparo / Sánchez-Pérez, Pilar / Hernández-Jaras, Julio

Frontiers in physiology

2022 Volume 13, Page(s) 1013335

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2022-11-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2022.1013335
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Article ; Online: Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism-A Targeted Metabolomics Approach.

Broseta, José Jesús / Roca, Marta / Rodríguez-Espinosa, Diana / López-Romero, Luis Carlos / Gómez-Bori, Aina / Cuadrado-Payán, Elena / Devesa-Such, Ramón / Soldevila, Amparo / Bea-Granell, Sergio / Sánchez-Pérez, Pilar / Hernández-Jaras, Julio

International journal of molecular sciences

2022 Volume 23, Issue 19

Abstract: Acetate is widely used as a dialysate buffer to avoid the precipitation of bicarbonate salts. However, even at low concentrations that wouldn't surpass the metabolic capacity of the Krebs tricarboxylic acid (TCA) cycle, other metabolic routes are ... ...

Abstract	Acetate is widely used as a dialysate buffer to avoid the precipitation of bicarbonate salts. However, even at low concentrations that wouldn't surpass the metabolic capacity of the Krebs tricarboxylic acid (TCA) cycle, other metabolic routes are activated, leading to undesirable clinical consequences by poorly understood mechanisms. This study aims to add information that could biologically explain the clinical improvements found in patients using citrate dialysate. A unicentric, cross-over, prospective targeted metabolomics study was designed to analyze the differences between two dialysates, one containing 4 mmol/L of acetate (AD) and the other 1 mmol/L of citrate (CD). Fifteen metabolites were studied to investigate changes induced in the TCA cycle, glycolysis, anaerobic metabolism, ketone bodies, and triglyceride and aminoacidic metabolism. Twenty-one patients completed the study. Citrate increased during the dialysis sessions when CD was used, without surpassing normal values. Other differences found in the next TCA cycle steps showed an increased substrate accumulation when using AD. While lactate decreased, pyruvate remained stable, and ketogenesis was boosted during dialysis. Acetylcarnitine and myo-inositol were reduced during dialysis, while glycerol remained constant. Lastly, glutamate and glutarate decreased due to the inhibition of amino acidic degradation. This study raises new hypotheses that need further investigation to understand better the biochemical processes that dialysis and the different dialysate buffers induce in the patient's metabolism.
MeSH term(s)	Acetates/pharmacology ; Acetylcarnitine ; Bicarbonates/pharmacology ; Citrates/pharmacology ; Citric Acid ; Citric Acid Cycle ; Dialysis Solutions/adverse effects ; Glutamates ; Glutarates ; Glycerol ; Humans ; Inositol ; Ketone Bodies ; Lactates ; Prospective Studies ; Pyruvic Acid ; Renal Dialysis/adverse effects ; Salts ; Triglycerides
Chemical Substances	Acetates ; Bicarbonates ; Citrates ; Dialysis Solutions ; Glutamates ; Glutarates ; Ketone Bodies ; Lactates ; Salts ; Triglycerides ; Citric Acid (2968PHW8QP) ; Inositol (4L6452S749) ; Acetylcarnitine (6DH1W9VH8Q) ; Pyruvic Acid (8558G7RUTR) ; Glycerol (PDC6A3C0OX)
Language	English
Publishing date	2022-10-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms231911693
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Article ; Online: SARS-CoV-2 and influenza virus co-infection.

Cuadrado-Payán, Elena / Montagud-Marrahi, Enrique / Torres-Elorza, Manuel / Bodro, Marta / Blasco, Miquel / Poch, Esteban / Soriano, Alex / Piñeiro, Gaston J

Lancet (London, England)

2020 Volume 395, Issue 10236, Page(s) e84

MeSH term(s)	Betacoronavirus ; COVID-19 ; China ; Coinfection ; Coronavirus Infections ; Humans ; Inpatients ; Orthomyxoviridae ; Pandemics ; Pneumonia, Viral ; Retrospective Studies ; Risk Factors ; Severe acute respiratory syndrome-related coronavirus ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-05
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(20)31052-7
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Article ; Online: Challenges in perioperative blood transfusions in kidney transplantation and the need for Patient Blood Management.

Rodríguez-Espinosa, Diana / Broseta, José J / Rosario, Anney / Cacho, Judit / Tena, Beatriz / Cuadrado-Payan, Elena / Marrero, Ramsés / Bayés, Beatriu / Esforzado, Nuria / Musquera, Mireia / Diekmann, Fritz / Cases, Aleix / Basora, Misericordia

Blood transfusion = Trasfusione del sangue

2023

Abstract: Background: Anemia is highly prevalent in end-stage chronic kidney disease patients, increasing their risk of receiving blood transfusions during and on the days after a kidney transplant (KTx) surgery. However, there is currently a lack of data that ... ...

Abstract	Background: Anemia is highly prevalent in end-stage chronic kidney disease patients, increasing their risk of receiving blood transfusions during and on the days after a kidney transplant (KTx) surgery. However, there is currently a lack of data that thoroughly describes this phenomenon in this population, the associated risk factors, and how they could benefit from the application of Patient Blood Management (PBM) guidelines. Materials and methods: Observational study. All adult patients who received a KTx between January 1 Results: We found that a high amount (39%) of KTx recipients required at least one blood transfusion during the perioperative period. And that 1) most of these patients had anemia at the time of transplantation (85.4%), 2) iron status upon admission was associated with the transfusion of more blood units (3.9 vs 2.7, p=0.019), 3) surgical reintervention (OR 7.28, 2.35-22.54) and deceased donor donation (OR 1.99, 1.24-3.21) were associated with an increased risk of transfusion, and finally, 4) there was an association between a higher number of blood units transfused and impaired kidney graft function six months after hospital discharge (1.6 vs 1.9, p=0.02). Conclusions: In conclusion, PBM guidelines should be applied to patients on the KTx deceased donor waiting list and especially those scheduled to receive a transplant from a living donor. This could potentially increase the utilization efficiency of blood products and avoid transfusion-related severe adverse effects.
Language	English
Publishing date	2023-10-09
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2135732-8
ISSN	2385-2070 ; 0041-1787 ; 1723-2007
ISSN (online)	2385-2070
ISSN	0041-1787 ; 1723-2007
DOI	10.2450/BloodTransfus.577
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Article ; Online: Use of remdesivir in kidney transplant recipients with SARS-CoV-2 Omicron infection.

Cacho, Judit / Nicolás, David / Bodro, Marta / Cuadrado-Payán, Elena / Torres-Jaramillo, Verónica / Gonzalez-Rojas, Ángela / Ventura-Aguiar, Pedro / Montagud-Marrahi, Enrique / Herrera, Sabina / Rico, Veronica / Cofàn, Frederic / Oppenheimer, Frederic / Revuelta, Ignacio / Diekmann, Fritz / Cucchiari, David

Kidney international

2022 Volume 102, Issue 4, Page(s) 917–921

MeSH term(s)	Adenosine Monophosphate/analogs & derivatives ; Alanine/analogs & derivatives ; COVID-19/drug therapy ; Humans ; Kidney Transplantation/adverse effects ; SARS-CoV-2 ; Transplant Recipients
Chemical Substances	remdesivir (3QKI37EEHE) ; Adenosine Monophosphate (415SHH325A) ; Alanine (OF5P57N2ZX)
Language	English
Publishing date	2022-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2022.08.001
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