Abstract:
INTRODUCTION:Renal transplantation (RT) in patients infected with human immunodeficiency virus (HIV) has significantly improved under the advent of combined antiretroviral therapy (cART). The authors describe their experience in RT in patients with HIV from September 2010 to June 2013. CASES REPORT:Four patients underwent transplantation (3 with HIV-1 and 1 with HIV-2), three patients were male, and one was black. None were coinfected with hepatitis B virus (HBV) or hepatitis C virus (HCV). Etiology of kidney disease was HIV-associated nephropathy (2 patients), immunoglobulin (Ig)A nephropathy, and unknown. Average age at RT was 51 (range, 41-63) years. No patient was of high immunologic risk. Immunosuppression consisted of basiliximab for induction and prednisolone, tacrolimus (TAC), and mycophenolate mofetil for maintenance. TAC levels varied considerably in the early days (8.5-46 ng/mL), requiring major adjustments in TAC dose. Only the HIV-2 patient had delayed graft function. The follow-up of patients with HIV-1 was 37, 19, and 16 months, and 3 months for the HIV-2 patient. CD4+ T cells decreased in the early days after transplantation with subsequent improvement, along with persistent virological suppression. In the HIV-1 group there were no major infectious, cardiovascular, or neoplastic complications. Nevertheless, the HIV-2 patient died 3 months after RT due to H1N1 pneumonia complicated by pulmonary aspergillosis. Average estimated (CKD- EPI) glomerular filtration rate (eGFR) at 6 months was 85.6 mL/min/1.73 m(2). CONCLUSION:Besides the difficulty in adjusting calcineurin inhibitors levels due to its interaction with antiretroviral therapy, namely with protease inhibitors, no patient had acute rejection. Furthermore, all patients presented an excellent control of viro-immunologic parameters. At the last follow-up neither cardiovascular events nor neoplastic complications were observed. Our results highlight the favorable outcome of RT in HIV-1-infected patients. The HIV-2 patient died due to severe infection, and the clinical management and potential benefit of RT in HIV-2-infected patients needs further study.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Nunes AT,Pereira L,Cerqueira A,Bustorff M,Sampaio S,Ferreira I,Tavares I,Santos J,Pestana Mdoi
10.1016/j.transproceed.2014.05.030subject
Has Abstractpub_date
2014-07-01 00:00:00pages
1718-22issue
6eissn
0041-1345issn
1873-2623pii
S0041-1345(14)00378-9journal_volume
46pub_type
杂志文章abstract:INTRODUCTION:Heat shock proteins (HSP) play essential roles in the synthesis, transport, and folding of proteins. During ischemia/reperfusion (I/R) injury to orthotopic liver transplants (OLT), disassembly of oligomeric complexes and unfolding of proteins are likely to occur, producing a major burden on HSP to prevent ...
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pub_type: 临床试验,杂志文章,随机对照试验
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abstract:UNLABELLED:BK virus (BKV) reactivation in immunocompromised kidney transplant patients can produce a tubulointerstitial nephropathy (BKVN). Molecular tools that test for DNA-BKV provide early detection and assist in management, but some aspects of the pathogenesis of this infection, such as donor causality, remain uncl...
journal_title:Transplantation proceedings
pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2010-06-01 00:00:00
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
pub_type: 临床试验,杂志文章
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更新日期:2003-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2003-12-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2008-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.10.032
更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.10.070
更新日期:2015-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-03-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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更新日期:2006-03-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Transplantation proceedings
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更新日期:1982-12-01 00:00:00
abstract::In the present pilot study, we investigated which proteins are produced after donor stimulation of peripheral blood mononuclear cells from recipients of HLA-identical living related kidney transplant. We used a protein-array analysis to determine cytokines, chemokines, and growth factors in supernatant from donor-stim...
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pub_type: 杂志文章
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更新日期:2006-11-01 00:00:00
abstract::The efficacy of bromocriptine, chloroquine, and Cs was quantitated in an in vitro system, with the use of mitogen-stimulated human PBMC. A concentration-dependent effect was found for each drug. Based on counts of blast cells, Cs was roughly 70 times more effective than either bromocriptine or chloroquine. Besides qua...
journal_title:Transplantation proceedings
pub_type: 杂志文章
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更新日期:1988-04-01 00:00:00
abstract::A national database for orthotopic liver transplantation (OLT) among biliary atresia (BA) cases in Taiwan has not been reported. Using the National Health Insurance (NHI) database to investigate the prognostic features of patients with BA receiving OLT, we studied the prognosis of this procedure for BA. The NHI in Tai...
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pub_type: 杂志文章
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