Abstract:
OBJECTIVE:BK virus nephropathy (BKVN) has been proposed as an important cause of allograft dysfunction and loss in kidney allograft recipient over the last decade. Intense immunosuppression and tubular injury have been shown to promote the replication of polyomavirus. 15-deoxyspergualin (DSG), an effective immunosuppressive agent, is used as a rescue drug for acute rejection in clinical renal transplantation in Japan. To determine whether DSG is a risk factor for BKVN and outline the relationship among BKVN, DSG, and other risk factors, we analyzed 88 patients who received living-related renal transplantation between January 1999 and April 2003. METHODS:A total of 114 biopsy specimens from 88 living-related kidney transplantation recipients (performed between January 1999 to April 2003) were retrospectively analyzed. Patients received immunosuppression therapy based on calcineurin inhibitors and corticosteroid [tacrolimus (TAC) 33 and cyclosporin (CyA) 55]. Additionally, mycophenolate mofeteil (MMF) was used in 21 patients; DSG was used in seven patients; and anti-CD3 monoclonal antibody was used in 16 patients. We analyzed the degree of donor/recipient human leucocyte antigen (HLA) compatibility assessed by the number of HLA-A, -B, and -DR-mismatched antigens in 88 patients. The diagnosis of BKVN was made by the light microscopic examination and a positive immunohistochemical staining of anti-40 antibody in biopsy specimens. Patients were divided into two groups of group A (mild histological change) and group B (moderate or severe histological change) to determine the risk factors in different histological staging. The clinical course of two typical patients in different histological stage is described briefly to outline the risk factors of BKVN. RESULTS:We identified seven cases of BKVN (8.0%) from 88 transplanted patients. Significantly higher incidence of combination regimen consisting of TAC and MMF in BKVN group was noticed compared with non-BKVN group (57.1% vs. 9.9%; p = 0.003). BKVN was associated with a significantly higher incidence of DSG administration compared with non-BKVN group (57.1% vs. 3.7%; p = 0.001). No difference was found in HLA mismatch between BKVN and non-BKVN group. Additionally, a significantly higher incidence of acute rejection episode prior to BKVN diagnosis was found in group B compared with group A (100% vs. 0%; p = 0.002), and the same statistical difference was shown in the number of anti-rejection therapy between group B and group A (100% vs. 0%; p = 0.002). We recognized a significant difference between group B and group A in terms of the combine regimen therapy of TAC with MMF (p = 0.002) and no difference in graft loss rate (p = 0.092), even though it was 50% in group B and was 0% in group A. CONCLUSIONS:In this study, our data indicated excessive intense immunosuppression with TAC-MMF is related to the development of BKVN. In addition, we found that anti-rejection therapy, especially with DSG, may accelerate the development of BKVN.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Shi Y,Moriyama T,Namba Y,Yamanaka M,Hanafuse T,Imamura R,Ichimaru N,Oka K,Kyo M,Tian Y,Takahara S,Ichikawa S,Okuyama Adoi
10.1111/j.1399-0012.2007.00677.xsubject
Has Abstractpub_date
2007-07-01 00:00:00pages
502-9issue
4eissn
0902-0063issn
1399-0012pii
CTR677journal_volume
21pub_type
杂志文章abstract::Auxiliary liver transplantation (ALT) is known to correct liver-based metabolic disorders. However, it remains unclear whether the presence of a native liver influences the long-term prognosis of ALT for metabolic diseases. We reported on a 4-yr-old girl who had undergone living-related auxiliary partial orthotopic li...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.1999.130404.x
更新日期:1999-08-01 00:00:00
abstract:BACKGROUNDS:Recurrent hepatitis C virus (HCV) infection is universal post-transplantation. Fibrosis (F) stage ≥2 at 12 months identifies patients with rapid fibrosis progression. Antiviral therapy (AVT) remains the only option to attenuate fibrosis progression. We hypothesized that CXCL10 levels can distinguish between...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12354
更新日期:2014-05-01 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::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:UNLABELLED:In order to determine risk factors for bone loss after renal transplantation, dual energy X-ray absorptiometry was performed in 125 renal transplant patients. The bone mineral density (BMD) was expressed as a percentage of the normal population (BMD%) and Z-score (SD from normal). The whole body, lumbar spin...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140503.x
更新日期:2000-10-01 00:00:00
abstract::Evaluation of potential kidney transplant recipients is important to identify and treat conditions that may influence graft or patient survival after transplantation. We performed a single-center, observational cohort study to determine whether pretransplant midodrine use influences outcomes after kidney transplantati...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13366
更新日期:2018-09-01 00:00:00
abstract::Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.13087
更新日期:2017-10-01 00:00:00
abstract::The amount of irreversible injury on renal allograft biopsy predicts function, but little is known about the early evolution of this damage. In a single-center cohort, we examined the relationship between donor-, recipient-, and transplantation-associated factors and change in a morphometric index of chronic damage (I...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12251
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:Autologous islet transplantation (IAT) following pancreatectomy is now a recognized, albeit highly specialized procedure carried out in a small number of centers worldwide. Current clinical principles and best practice with emphasis on examining the technical aspects of surgery in centers with significant IA...
journal_title:Clinical transplantation
pub_type: 杂志文章,meta分析,评审
doi:10.1111/ctr.12695
更新日期:2016-04-01 00:00:00
abstract::The exact mechanism of acute and chronic allograft rejection still remains unclear. The chemokine SDF-1 as mediator of allograft rejection has been under intensive investigation in liver, cardiac and bone marrow transplantation, whereas in renal transplantation, there are no reports about SDF-1 to date. This study was...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00540.x
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:The shortage of grafts for kidney transplantation (Tx) has resulted in an expansion of criteria for pediatric donors. However, the limitations of pediatric donors for kidney Tx are not yet clearly established. We investigated the outcomes of recipients with pediatric kidney grafts from Colorado to elucidate ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of tuberculosis in the pre- and post-transplant period. The challenges of screening for both latent and active TB in the setting of transplantation are...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13513
更新日期:2019-09-01 00:00:00
abstract:UNLABELLED:Enteric-coated mycophenolate sodium (MPS) has been developed to help circumvent the upper gastrointestinal side-effects of mycophenolic acid by facilitating drug release in the small intestine. Many questions regarding the side-effect profile of MPS remain. Therefore, the purpose of this study is to review a...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00820.x
更新日期:2008-09-01 00:00:00
abstract::Pancreas retransplantation has become more frequent and represents a technical challenge for surgeons. Knowledge of alternative surgical options could be useful in difficult cases. We present a case of brutal diabetes mellitus in a patient with severe vascular disease that underwent a third pancreas transplant. Diffic...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01149.x
更新日期:2010-05-01 00:00:00
abstract::Optimization of maintenance immunosuppression (mIS) regimens in the transplant recipient requires a balance between sufficient potency to prevent rejection and avoidance of excessive immunosuppression to prevent toxicities and complications. The optimal regimen after simultaneous liver-kidney (SLK) transplantation rem...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14036
更新日期:2020-10-01 00:00:00
abstract::In Norway living kidney donors account for approximately 40% of all renal transplants. There is a shortage of information about how living kidney donors experience the donation process during the initial recovery from surgery. The aim of this study was to explore physical and psychosocial issues related to the experie...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00304.x
更新日期:2005-02-01 00:00:00
abstract::We prospectively studied efficacy and safety outcomes of two 10-mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2-week assessment post-transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT g...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13132
更新日期:2017-12-01 00:00:00
abstract::This study evaluated the efficacy of primary endovascular stenting in cases of transplant renal artery stenosis (TRAS) from cadaver and non-heart-beating donor kidneys. Patients with TRAS (n = 13) from a single-centre transplant population (n = 476) were treated by primary percutaneous angioplasty and endovascular ste...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00499.x
更新日期:2006-05-01 00:00:00
abstract::We report an adult liver transplant recipient with parvovirus B19 infection, presenting as chronic transfusion-dependent anemia ensuing 1 month post-transplantation. Both serum and bone marrow cells were positive for parvovirus B19 DNA detected by polymerase chain reaction. The bone marrow biopsy revealed erythroid hy...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether bacterial contamination of islets affects graft success after total pancreatectomy with islet autotransplantation (TPIAT). BACKGROUND:Factors associated with insulin independence after TPIAT are inconclusive. Although bacterial contamination does not preclud...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12842
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Methamphetamine (MA) has cumulative deleterious effects on multiple organ systems. A history of MA exposure in kidney donors may affect adversely graft function in recipients. METHODS:Between September 2000 and March 2004, all deceased kidney donors were identified from the local registry (97 donors). Twent...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00703.x
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:African American and non-African American pre-transplant patients' and their families' concerns about the financial costs of kidney transplantation have not been well studied. METHODS:We conducted structured group interviews among pre-transplant patients (seven African American, five non-African American) a...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12428
更新日期:2014-10-01 00:00:00
abstract::The benefits of HLA matching have been clearly demonstrated in renal and cardiac transplantation. Recent studies suggest that HLA matching may be associated with improved survival rates for transplantation as well. However, the effect of HLA matching for lung transplantation has not been clearly demonstrated. Despite ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract::The number of nonrenal solid-organ transplants increased substantially in the last few decades. Many of these patients develop renal failure and receive kidney transplantation. The aim of this study was to evaluate patient and kidney allograft survival in primary, repeat, and kidney-after-nonrenal organ transplantatio...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13108
更新日期:2017-11-01 00:00:00
abstract::We have developed a practical conditioning regimen without anti-thymocyte globulin (ATG), irradiation, or other myeloablative alkylating agent for low-income countries in which patients with severe aplastic anemia (SAA), who usually have heavily transfused and a prolonged disease history. The application of ATG, Busul...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12061
更新日期:2013-03-01 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::Patients with severe liver disease and accompanying malnutrition may exhibit electrolyte disturbances including the magnesium balance. In 18 patients plasma magnesium (p-Mg) was determined at the start of the liver transplantation and during the anhepatic and reperfusion phases of the operation. The blood loss was 6.9...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Invasive fungal infections are a feared complication in kidney transplant recipients (KTRs). Here we present the University of Wisconsin experience with 5 invasive fungal infections-aspergillosis, cryptococcosis, histoplasmosis, blastomycosis, and coccidioidomycosis-in KTRs transplanted between 01/01/1994 and 06/30/20...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13289
更新日期:2018-07-01 00:00:00
abstract::Mycophenolic acid (MPA) dose reduction is associated with increased risk of rejection and graft loss in renal transplantation. This analysis investigated the impact of MPA dose changes with enteric-coated mycophenolate sodium (EC-MPS) or mycophenolate mofetil (MMF) in de novo heart transplant recipients. In a 12-month...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1399-0012.2008.00887.x
更新日期:2008-11-01 00:00:00
abstract::Proven Pneumocystis carinii pneumonia (PCP) occurred in 8 (5.2%) of 154 adult liver transplant recipients between January 1986 and December 1992. The interval between transplantation and PCP ranged from 69 to 131 days with a mean of 95 days (SD 20 days). The PaO2 breathing room air at diagnosis ranged from 40 mmHg to ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00