Current Issue : April - June Volume : 2019 Issue Number : 2 Articles : 7 Articles
Objective: The aim of the present study was to investigate the clinical and nutritional\nfactors influencing the renal function of the transplanted kidney during\na one-year follow-up period after transplantation. Patients: The present\nprospective observational study included 52 patients who underwent kidney\ntransplantation at Jichi Medical University Hospital from 2014 to 2016. Results:\nThe serum creatinine (sCr) concentration at one month after transplantation\nwas closely related to the concentration at 12 months. The recipients were divided\ninto two groups based on the sCr concentration at one month after transplantation.\nRecipients with a sCr concentration greater than or equal to the median\nwere classified into Group H, while those with concentrations that were less\nthan the median were classified into Group L..................
Background: Parvovirus B19 is the agent causing a regenerative anemia in\norgan transplant recipients, due to their immunodepressive status. The diagnosis\nis usually confirmed by the presence of virus in the blood and bone\nmarrow via the PCR technique. There is a potential co-infection with other\nopportunistic viruses in the transplanted patients. However, this population is\nnot routinely screened for Parvovirus B19 infection. Case Report: A\n14-year-old male patient who received living-donor kidney transplantation\ndeveloped a severely progressive and aregenerative anemia four weeks later.\nPCR of Parvovirus B19 was positive from bone marrow aspiration. There\nwere concomittant CMV and BK virus co-infection. The treatment included\na reduction of immunosuppressants, intravenous gamma globulin.\nValganciclovir has been prescribed for three months that could negativate the\nCMV blood load. At the end, there was an eradication of parvovirus in the\nbone marrow. Conclusion : This first reported case in Viet Nam which informed\nthat infection with Parvovirus B19 should be investigated in the\ntransplanted population when a regenerative anemia is present. Otherwise, a\nscreening strategy for Parvovirus B19 should also be considered....
Background: Post-transplant diabetes mellitus (PTDM) is an emerging problem in kidney transplantation,\nrepresenting an important risk factor for kidney function loss. Diabetic nephropathy (DN) occurrence in transplanted\nkidneys is poorly investigated. Current knowledge describes DN recurrence in graft 5.9 years from kidney\ntransplantation however there is little data about PTDM and DN.\nHere, we report a clinical case peculiar for an early appearance of advanced glomerular diabetic lesions, after kidney\ntransplantation.\nCase presentation: A 45-year-old Caucasian male affected by autosomal polycystic kidney disease was\ntransplanted with a cadaveric-kidney-donor from 58-year-old male. Induction immunosuppressive therapy included\nbasiliximab and steroids while the maintenance treatment included, tacrolimus, mofetil micophenolate and\nmethylprednisolone.\nOne month after transplantation the patient developed diabetes requiring treatment with repaglinide quickly\nreplaced with insulin to obtain an acceptable glycemic control (HbA1c 52 mmol/mol). Glycosuria was detected\npersistently during the first six months after transplantation. To achieve further improvement in glycemic control, a\nshift from tacrolimus to cyclosporine (CyA) was made and steroids were rapidly tapered and stopped. To minimize\ncalcineurin inhibitors toxicity, which was revealed in the 1-year-protocol-biopsy, everolimus was introduced thereby\nlowering CyA through levels. Moderate hypertension was well controlled with doxazosin. Thirty months after\ntransplantation a second graft biopsy was performed owing to renal function decline and microalbuminuria\nappearance. Histological analysis surprisingly showed mesangiolysis and microaneurysms; glomerular sclerohyalinosis\nand basal membrane thickness and typical nodular glomerulosclerosis. C4d staining was negative and no\nevidence of immune deposits were detected. Donor Specific Antibodies, serum C3 and C4 levels and autoimmunity\ntests were negative. Retrospective analysis on donor history didnâ??t show diabetes or insulin resistance and no\ndiabetic lesions were found in kidney pre-implant biopsy.\nConclusions: In our knowledge, this is the first report describing a very early onset of advanced diabetic\nglomerular lesions in a graft biopsy after PTDM. We hypothesize that additional factors such as everolimus and\nhypertension, may have contribute to kidney damage....
Background. Organ transplantation is considered the best treatment for end-stage organ failure. However, the lack of available\norgans for transplantation and the increasing number of patients waiting for transplants are primary issues facing the transplant\ncommunity.Thus, developing strategies to increase the number of donors, especially for liver transplantation, has become a priority.\nThe use of organs acquired from donors who suffered cardiac related deaths has increased the pool of potential liver donors.\nHowever, donation after cardiac death (DCD) livers increases the risk of primary graft dysfunction. Methods. In the current\nstudy, we conducted transcriptome sequencing using livers from a DCD rat to assess the short-term feasibility and functional\nefficacy of DCD livers. RNA sequencing (RNAseq) data showed that the liver transcriptome varied greatly in rat livers subjected\nto 15 minutes of cardiac arrest. Results. The livers used in the current study had a significant loss of normal function before\ntransplantation. Functional and network analyses consistently indicated that transcription and translation processes were inhibited\nafter approximately 15 minutes of cardiac arrest. Moreover, the transcriptomic sequencing data provides significant insight for\nidentifying functional genes and testing additional biological questions in DCD liver transplantation in future studies....
Background. Recent changes in the demographic of cardiac donors and recipients have modulated the rate and risk, associated\nwith posttransplant diabetes mellitus (PTDM). We investigated the secular trends of the risk of PTDM at 1 year and 3 years after\ntransplantation over 30 years and explored its effect on major outcomes. Methods. Three hundred and three nondiabetic patients\nwere followed for a minimum of 36 months, after a first cardiac transplantation performed between 1983 and 2011. Based on the\nyear of their transplantation, the patients were divided into 3 eras: (1983-1992 [era 1], 1993-2002 [era 2], and 2003-2011 [era 3]).\nResults. In eras 1, 2, and 3, the proportions of patients with PTDM at 1 versus 3 years were 23% versus 39%, 21% versus 26%, and\n33% versus 38%, respectively. Independent risk factors predicting PTDMat one year were recipientâ??s age, duration of cold ischemic\ntime, treatment with furosemide, and tacrolimus. There was a trend for overall survival being worse for patients with PTDM in\ncomparison to patients without PTDM (p = 0.08). Patients with PTDM exhibited a significantly higher rate of renal failure over\na median follow-up of 10 years (p = 0.03). Conclusion. The development of PTDM following cardiac transplantation approaches\n40% at 3 years and has not significantly changed over thirty years.The presence of PTDM is weakly associated with an increased\nmortality and is significantly associated with a worsening in renal function long-term following cardiac transplantation....
Background: Contrast enhanced ultrasonography (CEUS) assessment of kidney allografts mainly focuses on graft\nrejection. However, studies on delayed graft function (DGF) without acute rejection are still lacking. The aim of this\nstudy was to build a time-intensity curve (TIC) using CEUS in non-immunological DGF to understand the utility of\nCEUS in early transplantation.\nMethods: Twenty-eight patients in the short-term postoperative period (<14 days) were divided according to the\nneed for dialysis (early graft function [EGF] and [DGF]) and 37 subjects with longer than 90 days follow-up were\ndivided into creatinine tertiles. Time to peak [TTP] and rising time [RT were compared between groups.\nResults: EGF and DGF were similar, except for creatinine. In comparison to the late group, medullary TTP and RT\nwere shorter in the early group as well as the delay regarding contrast arrival in the medulla (in relation to cortex)\nand reaching the medullary peak (in relation to artery and cortex). In the late group, patients with renal dysfunction\nshowed shorter temporal difference to reach medullary peak in relation to artery and cortex.\nConclusions: Although it was not possible to differentiate EGF and DGF using TIC, differences between early and\nlate groups point to blood shunting in renal dysfunction....
After undergoing liver transplantation, children are susceptible to oral lesions due to immunosuppressant drugs that\nare needed to maintain the transplant. In this context, it is important to understand how disease characteristics and\nage at transplantation influence the development of these lesions. Monitoring of lesions begins after transplantation\nand children are usually observed by a specialist in stomatology at periodic visits. Consequently, lesion development\nis estimated to occur between two observed times, and this is characterized as interval-censored data. However, in\nclinical practice, it is common to assume the moment of observation as the time of event occurrence, thereby\nexcluding interval-censored data. Here, we discuss the impact of excluding interval-censored mechanisms in\nstatistical analyses by using simulation studies to consider differences in sample sizes and amplitudes between\nobserved intervals. Then, application studies are presented which use a data set from a prospective study that was\nconducted to investigate oral lesions in patients after liver transplantation at the A.C.Camargo Cancer Center in Brazil\nbetween 2013 and 2016 and a data set involving recurrent ovarian cancer in patients diagnosed with high-grade\nserous carcinoma at the A.C.Camargo Cancer Center between 2003 and 2016....
Loading....