Abstract:
:Kidney transplant obstruction (KTO) following renal transplantation remains an important reversible cause of allograft dysfunction, requiring prompt diagnosis to prevent long-term graft damage. Although ultrasound can accurately diagnose renal transplant hydronephrosis, it cannot be used to assess its functional significance. We prospectively assessed the utility of technetium-99m mercaptoacetyltriglycine (Tc99m MAG3) diuretic renography for the diagnosis of allograft KTO, using standard visual and quantitative parameters, as well as calculated renal output efficiency (OE), which has been postulated to improve diagnostic yield. From a cohort of 45 renal transplant patients, two subgroups were formed. The first group of transplant recipients (n = 21) with stable function and no obstruction was used to derive normal values for Tc99m MAG3 scans. A second group of transplant recipients with acute renal dysfunction in whom KTO was clinically suspected was used to test the diagnostic utility of these derived values (n = 43 scans). KTO was diagnosed independently of the MAG3 scans by a fall in the serum creatinine in response to renal pelvis urinary drainage. OE in 12 renal allografts with KTO was significantly reduced compared with 31 Tc99m MAG3 scans without KTO (59.6 +/- 18.9 vs. 81.6 +/- 5.4%, p < 0.001). In KTO, the mean time of isotope appearance in the bladder (time to bladder [TTB]) was extended compared with unobstructed allografts (7.9 +/- 4.1 vs. 3.6 +/- 1.5 min, p < 0.001). Measurement of OE significantly improved the accuracy of diuretic MAG3 renography in the diagnosis of renal allograft KTO, especially when supplemented by the TTB, parenchymal transit time and shape of the renogram curve. Ureteric obstruction of the kidney transplant can be diagnosed with an OE reduced to < 75% (sensitivity 92%, specificity 87%) and confirmed by isotope hold-up in the pelvicalyceal system. A normal or slowly declining renogram curve effectively excluded KTO (sensitivity of 96%, negative predictive value of 84%). A parenchymal transit time of > 5 min and a TTB of > 7 min both yielded a sensitvity of 92% and a specificity of 81%. In conclusion, MAG3 renography is a clinically useful investigation for the diagnosis of KTO.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Nankivell BJ,Cohn DA,Spicer ST,Evans SG,Chapman JR,Gruenewald SMdoi
10.1034/j.1399-0012.2001.150103.xsubject
Has Abstractpub_date
2001-02-01 00:00:00pages
11-8issue
1eissn
0902-0063issn
1399-0012pii
ctr150103journal_volume
15pub_type
杂志文章abstract::As there are other lesions in the cardiac allografts of long-term survivors, it is best to refer to the vascular lesion as "graft vascular disease". Graft vascular disease may be evident as early as 3 months after cardiac transplantation and may cause death in the recipient as late as 22 years post-transplant. The dis...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::Hepatic allograft rejection still remains an important problem following liver transplantation. Early acute rejection, occurring within three months of transplant, is a common event and usually of lesser significance with respect to prognosis than other non-immune-related post-transplant morbidities. However, little i...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00788.x
更新日期:2008-05-01 00:00:00
abstract::Acute allograft glomerulopathy (AAG) characterized by hypercellularity, enlargement of endothelial cells, infiltration of glomeruli by mononuclear cells and webs of PAS-positive material has been reported as an unusual but distinct form of acute rejection in kidney transplant recipients. We present a case of persisten...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2001.0150s5002.x
更新日期:2001-01-01 00:00:00
abstract::Of 1463 liver allograft recipients receiving the combination of FK506 and steroids as their primary immunosuppressive regimen, 2 patients developed Kaposi's sarcoma. Although previously described as a complication of organ transplantation, this is the first case report of Kaposi's sarcoma occurring in association with...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Progressive familial intrahepatic cholestasis (PFIC) results in liver cirrhosis. Therefore, some PFIC patients require liver transplantation (LT). Although three types of PFIC have been identified, their etiologies include unknown mechanisms. PATIENTS:A total of 717 recipients who underwent living-donor LT ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2010.01368.x
更新日期:2011-09-01 00:00:00
abstract::There is evidence to suggest that long-term survival of discordant xenografts may be possible if the organ is transplanted at a time when the host natural anti-species (xenoreactive) antibodies are temporarily absent or otherwise inhibited from reacting with the donor antigens. There is also evidence that the target ...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Previous studies indicate that obesity is a risk factor in renal transplantation. However, these analyses did not control for variable donor factors that may strongly influence outcome. To control for donor variables such as age, cause of death, procurement techniques, preservation methods, cold ischaemia ti...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.01080.x
更新日期:2002-08-01 00:00:00
abstract:INTRODUCTION:Either deceased or living-related renal transplantation constitutes the best therapeutic option for patients with end-stage renal disease. In this retrospective study, an attempt to identify parameters that affect allograft survival in living donor renal transplantation was made. METHODS:Between January 2...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12219
更新日期:2013-11-01 00:00:00
abstract::Cytokines, produced by both the recipient and the newly vascularized allograft, are central mediators in the inflammatory response to allografted tissue. This study examines the relationship between pre- and intraoperative levels of TNF, IL-1, IL-6, and IL-8 and hepatic allograft function in the early postoperative pe...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract::Although patients within a transplant program are awaiting or have received disease modifying or curative treatment, they are also facing advanced illness and the possibility of death. The involvement of specialized palliative care services for these patients may improve symptom management and facilitate advance care ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12838
更新日期:2016-12-01 00:00:00
abstract::Post-transplant lymphoproliferative disorders (PTLDs) are a heterogeneous set of complications of organ transplantation associated with poor patient prognosis. We analyzed the clinicopathological features of PTLDs in 43 adult and pediatric recipients of solid organ or bone marrow transplantation at a large transplant ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2010.01392.x
更新日期:2012-01-01 00:00:00
abstract::Flow cytometry crossmatch (FCXM) is a more sensitive technique than classical complement-dependent cytotoxicity (CDC) for the detection of donor-directed antibody before renal transplantation. Nevertheless, the role of FCXM in predicting long-term survival of kidney grafts is still unclear. The purpose of our study wa...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00226.x
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the efficacy of lamivudine (LAM) monoprophylaxis for patients with non-replicating hepatitis B virus (HBV) infection at orthotopic liver transplantation (OLT). METHODS:Among 128 liver recipients with HBV infection between 1994 and 2004 transplanted at our institution, 6...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00557.x
更新日期:2007-03-01 00:00:00
abstract::Whether extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation (BTT) can achieve a similar survival to non-BTT remains controversial. We conducted this meta-analysis to compare the outcomes between ECMO BTT and non-BTT to facilitate better clinical decision-making. Seven databases were searched...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14157
更新日期:2020-11-22 00:00:00
abstract::In live related renal transplant program, management of multiple renal arteries (MRA) is technically demanding and used to be considered a relative contraindication because of increased risk of vascular and urologic complications. We present a retrospective analysis of the outcome of grafts with MRA and suggest certai...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2001.150209.x
更新日期:2001-04-01 00:00:00
abstract::We investigated tolerability and efficacy of ezetimibe treatment (10 mg/d) in 25 heart allograft recipients already on stable statin therapy. Total cholesterol (TC), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C), triglycerides (TG), immunosuppressant drug levels, laboratory and clinical parameters ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2008.00838.x
更新日期:2008-09-01 00:00:00
abstract::Skin cancer is a common, potentially life-threatening malignancy in organ transplant recipients (OTR), and it is important for transplant physicians to be aware of patient history of skin cancer. Patient self-report represents a quick method of obtaining past medical history of skin cancer but no study has validated t...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2012.01601.x
更新日期:2012-03-01 00:00:00
abstract::The non-relapse mortality of autologous stem cell transplant is low enough that the procedure has been extended to older patients with non-Hodgkin's lymphoma. We treated 537 non-Hodgkin's lymphoma patients with high-dose chemotherapy consisting of busulfan, cyclophosphamide, and etoposide followed by autologous stem c...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00581.x
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:As Gastroesophageal reflux disease (GORD) affects long-term survival in lung transplant recipients, the aim of this observational prospective study was to analyze the efficacy of The Reflux Symptom Index Questionnaire (RSI) compared to the esophageal impedance test. METHODS:Both esophageal impedance studies ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12656
更新日期:2016-01-01 00:00:00
abstract:AIMS:To evaluate the effect of donor liver resident mesenchymal cells, M2 macrophages on liver graft outcome after living donor liver transplantation. MATERIALS AND METHODS:Seventy donor biopsies were included in the study. Outcomes at day 3, 7, 30, and 180 postliver transplantation were assessed. Mesenchymal stem cel...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13197
更新日期:2018-03-01 00:00:00
abstract::To assess the prevalence and long-term impact of HCV on kidney transplant recipients, we assayed 716 pre-transplant sera using a first-generation ELISA. The anti-HCV positive sera were confirmed by a 6-antigen radioimmunoassay (RIA). Patients were followed up for 5 years. Graft survival, function, evidence of chemical...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::We report the case of a female with chronic pancreatitis who underwent multiple surgical procedures leading to total resection of the pancreas with successful islet auto-transplantation. Postoperatively, she developed heparin-induced thrombocytopenia. Heparinization prior to islet infusion is currently recommended to ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00457.x
更新日期:2006-03-01 00:00:00
abstract::Hepatitis C virus (HCV) is currently the leading indication worldwide for orthotopic liver transplantation. However, the majority of patients receiving transplant for HCV eventually develop histopathologic evidence of recurrent allograft HCV and approximately 10% die or require retransplantation within the first 5 pos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00049.x
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Severe systemic hypertension (HTN) is a risk factor for perioperative cardiovascular complications; however, its impact at the time of kidney transplantation (KTX) is not well defined. METHODS:A retrospective cohort study of adult kidney-only transplant recipients between October 2009 and December 2012 was ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12579
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:This study aimed to investigate the characteristics of lung transplant recipients requiring additional pleural drainage catheters early post-lung transplantation and to determine the safety and efficacy of intrapleural fibrinolytics in these patients. METHODS:A retrospective review of lung transplant recipi...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13592
更新日期:2019-06-01 00:00:00
abstract:UNLABELLED:Since the first description by Ratner and collegues in 1996, laparoscopic live-donor nephrectomy is gaining wide acceptance in an attempt to minimize the donor morbidity, length of hospital stay and length of time to return to work. It is unknown whether multiple renal arteries pose additional problems with ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2001.00012.x
更新日期:2001-01-01 00:00:00
abstract::Distinct histopathologic changes occur in acute cellular rejection (ACR), antibody-mediated rejection (AMR), and biopsy-negative rejection (BNR). Cardiovascular magnetic resonance (CMR)-based myocardial tissue characterization can be used to quantify these changes. We assessed T1, T2, and extracellular volume fraction...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13704
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:One severe side effect of calcineurin inhibitors (CNIs: such as cyclosporine [CsA] and tacrolimus [FK506]) is neurotoxicity. CNIs are substrates for CYP3A5 and P-glycoprotein (P-gp), encoded by ABCB1 gene. In the present study, we hypothesized that genetic variability in CYP3A5 and ABCB1 genes may be associa...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01181.x
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Urinary tract infections (UTIs) account for significant morbidity after kidney transplantation (KT). Screening for asymptomatic bacteruria (AB) has proven to be beneficial in certain population including pregnant women; however, it is not well-studied in KT population. We reviewed the incidence, clinical feat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12954
更新日期:2017-05-01 00:00:00
abstract::According to the EU Directive 2006/17/EC, European tissue banks are required to perform a physical examination on every potential tissue donor. The directive itself, however, does not specify the content of this examination. The aim of this study was to investigate the current practice of physical examination in Europ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01089.x
更新日期:2010-03-01 00:00:00