Ferumoxytol Is Not Retained in Kidney Allografts in Patients Undergoing Acute Rejection.
Purpose: To evaluate whether ultrasmall superparamagnetic iron oxide nanoparticle (USPIO)-enhanced magnetic resonance imaging (MRI) can detect allograft rejection in pediatric kidney transplant patients.Procedures: The USPIO ferumoxytol has a long blood half-life and is phagocytosed by macrophages....
| Published in: | Molecular Imaging & Biology Vol. 20; no. 1; pp. 139 - 150 |
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| Main Authors: | , , , , , , , , , , |
| Format: | clinical trial diagnostic images pictorial research tables/charts Journal Article |
| Published: |
Springer Nature
Feb2018
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=127460436&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 127460436 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15361632 KJU jtl: Molecular Imaging & Biology issn: 15361632 maglogo: N pubinfo: dt: Feb2018 vid: 20 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 127460436 127460436 143927825 NLM28411307 127460436 10.1007/s11307-017-1084-8 NLM28411307 127460436 ppf: 139 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Ferumoxytol Is Not Retained in Kidney Allografts in Patients Undergoing Acute Rejection. aug: au: Aghighi, Maryam Pisani, Laura Theruvath, Ashok J. Muehe, Anne M. Donig, Jessica Khan, Ramsha Holdsworth, Samantha J. Kambham, Neeraja Concepcion, Waldo Grimm, Paul C. Daldrup-Link, Heike E. affil: Department of Radiology, Pediatric Molecular Imaging in the Molecular Imaging Program at Stanford (@PedsMIPS), Lucile Packard Children’s Hospital, Stanford University School of Medicine, 725 Welch Road, 94305, Stanford, CA, USA sug: subj: Kidney Transplantation Graft Rejection Immunology Allografts Receptors, Cell Surface Metabolism Adolescence Child Antigens, Surface Metabolism Kinetics Graft Rejection Magnetic Resonance Imaging Young Adult Human Validation Studies Comparative Studies Evaluation Research Multicenter Studies Funding Source Clinical Trials Adolescent: 13-18 years Child: 6-12 years ab: Purpose: To evaluate whether ultrasmall superparamagnetic iron oxide nanoparticle (USPIO)-enhanced magnetic resonance imaging (MRI) can detect allograft rejection in pediatric kidney transplant patients.Procedures: The USPIO ferumoxytol has a long blood half-life and is phagocytosed by macrophages. In an IRB-approved single-center prospective clinical trial, 26 pediatric patients and adolescents (age 10-26 years) with acute allograft rejection (n = 5), non-rejecting allografts (n = 13), and normal native kidneys (n = 8) underwent multi-echo T2* fast spoiled gradient-echo (FSPGR) MRI after intravenous injection (p.i.) of 5 mg Fe/kg ferumoxytol. T2* relaxation times at 4 h p.i. (perfusion phase) and more than 20 h p.i. (macrophage phase) were compared with biopsy results. The presence of rejection was assessed using the Banff criteria, and the prevalence of macrophages on CD163 immunostains was determined based on a semi-quantitative scoring system. MRI and histology data were compared among patient groups using t tests, analysis of variance, and regression analyses with a significance threshold of p < 0.05.Results: At 4 h p.i., mean T2* values were 6.6 ± 1.5 ms for native kidneys and 3.9 ms for one allograft undergoing acute immune rejection. Surprisingly, at 20-24 h p.i., one rejecting allograft showed significantly prolonged T2* relaxation times (37.0 ms) compared to native kidneys (6.3 ± 1.7 ms) and non-rejecting allografts (7.6 ± 0.1 ms). Likewise, three additional rejecting allografts showed significantly prolonged T2* relaxation times compared to non-rejecting allografts at later post-contrast time points, 25-97 h p.i. (p = 0.008). Histological analysis revealed edema and compressed microvessels in biopsies of rejecting allografts. Allografts with and without rejection showed insignificant differences in macrophage content on histopathology (p = 0.44).Conclusion: After ferumoxytol administration, renal allografts undergoing acute rejection show prolonged T2* values compared to non-rejecting allografts. Since histology revealed no significant differences in macrophage content, the increasing T2* value is likely due to the combined effect of reduced perfusion and increased edema in rejecting allografts. pubtype: Academic Journal doctype: clinical trial diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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