| Title |
Ferumoxytol Is Not Retained in Kidney Allografts in Patients Undergoing Acute Rejection
|
|---|---|
| Published in |
Molecular Imaging and Biology, April 2017
|
| DOI | 10.1007/s11307-017-1084-8 |
| Pubmed ID | |
| Authors |
Maryam Aghighi, Laura Pisani, Ashok J. Theruvath, Anne M. Muehe, Jessica Donig, Ramsha Khan, Samantha J. Holdsworth, Neeraja Kambham, Waldo Concepcion, Paul C. Grimm, Heike E. Daldrup-Link |
| Abstract |
To evaluate whether ultrasmall superparamagnetic iron oxide nanoparticle (USPIO)-enhanced magnetic resonance imaging (MRI) can detect allograft rejection in pediatric kidney transplant patients. 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. 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). 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. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 25 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 4 | 16% |
| Lecturer | 3 | 12% |
| Student > Ph. D. Student | 3 | 12% |
| Student > Bachelor | 2 | 8% |
| Professor | 2 | 8% |
| Other | 4 | 16% |
| Unknown | 7 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 24% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
| Biochemistry, Genetics and Molecular Biology | 1 | 4% |
| Agricultural and Biological Sciences | 1 | 4% |
| Computer Science | 1 | 4% |
| Other | 6 | 24% |
| Unknown | 9 | 36% |
Attention Score in Context
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#20,660,571
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