| 1. |
- Jordan, Stanley C., et al.
(författare)
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Imlifidase desensitization in crossmatch-positive, highly-sensitized kidney transplant recipients : Results of an international phase 2 trial (Highdes)
- 2021
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Ingår i: Transplantation. - 0041-1337 .- 1534-6080. ; 105:8, s. 1808-1817
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Highly-HLA sensitized patients have limited access to life-saving kidney transplantation due to a paucity of immunologically suitable donors. Imlifidase is a cysteine protease that cleaves IgG leading to a rapid decrease in antibody level and inhibition of IgG-mediated injury. This study investigates the efficacy and safety of imlifidase in converting a positive crossmatch test to negative, allowing highly sensitized patients to be transplanted with a living or deceased donor kidney.METHODS: This open-label, single arm, phase 2 trial conducted at five transplant centers, evaluated the ability of imlifidase to create a negative crossmatch test within 24 hours. Secondary endpoints included post-imlifidase DSA levels compared to pre-dose levels, renal function, and pharmacokinetic/pharmacodynamic profiles. Safety endpoints included adverse events and immunogenicity profile.RESULTS: 89.5% of the transplanted patients demonstrated conversion of baseline positive crossmatch to negative within 24 hours after imlifidase treatment. DSA most often rebounded 3-14 days post-imlifidase dose, with substantial interpatient variability. Patient survival was 100% with graft survival of 88.9% at 6 months. 38.9% had early biopsy proven antibody mediated rejection with onset 2-19 days post-transplantation. Serum IgG levels began to normalize after ~3-7 days post-transplantation. Anti-drug antibody levels were consistent with previous studies. Seven adverse events in six patients were classified as possibly or probably related to treatment and were mild-moderate in severity.CONCLUSIONS: Imlifidase was well tolerated, converted positive crossmatches to negative, and enabled patients with a median cPRA of 99.83% to undergo kidney transplantation resulting in good kidney function and graft survival at 6 months.
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| 2. |
- Kjellman, Christian, et al.
(författare)
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Outcomes at 3 years posttransplant in imlifidase-desensitized kidney transplant patients
- 2021
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Ingår i: American Journal of Transplantation. - : Elsevier. - 1600-6135 .- 1600-6143. ; 21:12, s. 3907-3918
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Tidskriftsartikel (refereegranskat)abstract
- Imlifidase is a cysteine proteinase which specifically cleaves IgG, inhibiting Fc-mediated effector function within hours of administration. Imlifidase converts a positive crossmatch to a potential donor (T cell, B cell, or both), to negative, enabling transplantation to occur between previously HLA incompatible donor-recipient pairs. To date, 39 crossmatch positive patients received imlifidase prior to a kidney transplant in four single-arm, open-label, phase 2 studies. At 3 years, for patients who were AMR+ compared to AMR-, death-censored allograft survival was 93% vs 77%, patient survival was 85% vs 94%, and mean eGFR was 49 ml/min/1.73 m2 vs 61 ml/min/1.73 m2 , respectively. The incidence of AMR was 38% with most episodes occurring within the first month post-transplantation. Sub-analysis of patients deemed highly sensitized with cPRA ≥ 99.9%, and unlikely to be transplanted who received crossmatch-positive, deceased donor transplants had similar rates of patient survival, graft survival, and eGFR but a higher rate of AMR. These data demonstrate that outcomes and safety up to 3 years in recipients of imlifidase-enabled allografts is comparable to outcomes in other highly sensitized patients undergoing HLA-incompatible transplantation. Thus, imlifidase is a potent option to facilitate transplantation among patients who have a significant immunologic barrier to successful kidney transplantation.
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| 3. |
- Saltzman, Katarina, 1966, et al.
(författare)
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Gardeners’ perspectives and practices in relation to plants in motion
- 2021
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Ingår i: Routledge Handbook of Biosecurity and Invasive Species. - Abingdon, Oxon ; New York, NY : Routledge, 2021. : Routledge. - 9780815354895 ; , s. 226-239
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Bokkapitel (refereegranskat)abstract
- The establishment of introduced species in new environments is today widely acknowledged as a potential threat to biodiversity, and many plants that are known to be invasive have obviously spread from gardens. Thus, in the context of biosecurity, we need to consider how contemporary gardeners think about which plants and animals are welcome in their gardens. In this chapter we look at vegetation in motion from a cultural and social point of view, with a particular focus on some of many different ways in which people are involved in spreading of plants, both desired and undesired ones. We do this by investigating everyday practices of gardeners in Sweden, and not least the common habit of sharing plants, in order to highlight the social and cultural aspects of the spread of species. Among the gardeners in this study it is obvious that the dynamics and vitality of plants is often regarded as an asset, but also sometimes as problem, when plants simply grow too much. Understandings of the relationship between gardens and surrounding environments, as well as between nature and culture, have changed over time, and are continuously changing. As plants have the ability to multiply and spread in various ways, both on their own and with the help of humans, there is a need to acknowledge the role of human as well as non-human agencies in order to understand the complexity of these interactions. Inspired by Tim Ingold we find it useful to think about both gardeners and plants as ‘biosocial becomings’. In order to address the threat posed by invasive species, we propose that it is important to improve our understanding of what happens in everyday biosocial encounters between people, plants and other species.
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| 4. |
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Veni, veni Emmanuel : Uppsala domkyrkas gosskör 100 år
- 2020
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Bok (populärvet., debatt m.m.)abstract
- Körsång har klingat genom seklerna och speglat samhället. 100-årsjubilerande Uppsala domkyrkas gosskör är en del av detta genom vardagligt slit, konstnärliga framgångar, söndagligt gudstjänstsjungande och musikalisk glädje. Klingande musikalisk verksamhet är också en del av en tradition för Uppsala universitet och har så varit under dess drygt 500-åriga tillvaro. Kyrka och universitet har följts åt i samarbete och samverkan där musiken ofta varit en gemensam nämnare. Boken innehåller en längre historik samt kortare bidrag från personer som varit och är engagerade i Uppsala domkyrkas gosskörs verksamhet.
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