Abstract:
INTRODUCTION:Proteinuria is related to a poor prognosis for graft survival. MATERIALS AND METHODS:We undertook a retrospective study of renal transplant biopsies between 2006 and 2009 performed because of proteinuria. Data were collected on demographic, analytical, and histological characteristics. RESULTS:The study included 49 biopsies from 65% men with an overall mean age of 52 ± 13 years. The mean time from transplant to biopsy was 6.5 ± 5.3 years. All cases displayed proteinuria: 2.2 g/24 h (1.2-3.2). In 56% of cases, it was also associated with worsening glomerular filtration rate (GFR) (MDRDa 33 ± 16 mL/min). In 14% of cases, the sample was insufficient to determine glomerular pathology, whereas 51% displayed glomerular disease, among which were transplant glomerulopathy (40%), glomerulonephritis (48%), and diabetes (12%). Interstitial fibrosis and tubular atrophy (IFTA) was present in 85%: 33% mild, 27% moderate, and 25% severe. Arteriolar hyalinosis was present in 60%. Thirty-four percent of subject lost their grafts at a mean of 11 ± 9 months after the biopsy. The GFR at the time of biopsy was worse among those subjects who returned to dialysis than those who retained function (MDRDa 22 ± 7.5 vs 34 ± 15 mL/min; P = .006). Proteinuria was also greater among those who lost their grafts (4.1 ± 3.4 vs 2.1 ± 1.6 g/24 h; P = .007). The absolute increase in the risk of graft loss was 52% among subjects who displayed moderate to severe versus those who had mild IFTA (relative risk [RR] 7; confidence interval [CI] 1.8-28; P < .001). The presence of glomerulosclerosis >50% was also associated with a 48% absolute increased risk of graft loss compared with those patients with no glomerulosclerosis or <50% (RR 3; CI 1.5-12; P = .02). After the biopsy, the dose of angiotensin converting enzyme inhibitors and/or angiotensin receptor antagonist was increased in 90%, with 34% of subjects, experiencing a change in immunosuppression. CONCLUSIONS:Transplant patients undergoing a biopsy due to proteinuria, the occurrence of graft loss was associated with reduced GFR and the amount of proteinuria at the time of the biopsy, as well as with the degree of IFTA and of glomerular involvement.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
López V,Sola E,Jironda C,León M,García I,Gutierrez C,Cabello M,Burgos D,González-Molina M,Hernandez Ddoi
10.1016/j.transproceed.2011.05.027subject
Has Abstractpub_date
2011-07-01 00:00:00pages
2191-3issue
6eissn
0041-1345issn
1873-2623pii
S0041-1345(11)00792-5journal_volume
43pub_type
杂志文章abstract::In orthotopic liver transplantation, particular emphasis must be placed on the unique physiologic, pathologic, and clinical features in residents living in areas at high vs low altitude. Hypobaric hypoxia, hypothermia, heavy radiation, high wind speed, and superevaporation at high altitudes may lead to various disease...
journal_title:Transplantation proceedings
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doi:10.1016/j.transproceed.2009.01.115
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pub_type: 杂志文章
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journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2015.11.019
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abstract:AIM:This study analyzed a 10-year single-center experience in orthotopic liver transplantation (OLT) without venovenous bypass (VVB). METHODS:We retrospectively analysed a nonrandomized series (1999-2008) of 125 adult OLT patients without VVB. RESULTS:The main causes of liver failure were viral hepatitis (n = 39), al...
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.07.038
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.08.012
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.01.012
更新日期:2013-05-01 00:00:00
abstract::Bacterial infections are a contraindication to organ transplantation, but infective endocarditis may require heart transplantation when otherwise untreatable. We describe a heart transplant patient with cardiomyopathy and ongoing defibrillator endocarditis due to Staphylococcus epidermidis. An initial attempt at percu...
journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.transproceed.2010.09.095
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abstract:BACKGROUND:Renal cancers commonly occur in the native kidneys of renal transplant recipients, whereas renal cancer in the grafted kidney has been reported occasionally. Renal cancer in the grafted kidney occurred 16 years after graft loss in this case, which would be a more rare case. CASE REPORT:A 60-year-old man who...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.11.017
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.06.039
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.10.094
更新日期:2009-06-01 00:00:00
abstract::Severe renal dysfunction may occur after orthotopic liver transplantation (OLT). In this study, we retrospectively analyzed a single-center series of adult liver recipients (n = 62) seeking to identify patients prone to develop renal dysfunction during follow-up. Liver recipients (age range, 53.54 ± 8.19 years; female...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.06.017
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.09.032
更新日期:2007-12-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Damage provoked by ischemia in renal transplants is difficult to quantify. To determine whether a donated organ is fit for transplantation. We sought to correlate the findings of fluorescence spectroscopy (FS) with histologic evidence of ischemic injury and organ viability. METHODS:Kidneys of 33 rats were s...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.10.054
更新日期:2013-06-01 00:00:00
abstract::Rat 13762NF mammary adenocarcinoma mimics human breast cancer in its pathology and pathogenesis. We selected and cloned spontaneously metastasizing variant tumor cell lines that spread from mammary fat pad subcutaneous sites to regional lymph nodes and lung. The biologic properties of these tumor clones changed during...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract::The aim of this study was to evaluate cyclosporine (CyA) absorption profiles in heart transplantation to establish the most adequate monitoring strategy and determine the optimal therapeutic range for AUC(0-4) or C2 levels. A total of 22 full pharmacokinetic studies were performed at steady-state in 22 adult heart tra...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/s0041-1345(03)00657-2
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.01.063
更新日期:2012-03-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.12.029
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.01.080
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abstract:OBJECTIVE:The aim of this study was to evaluate the postoperative changes in hemodynamics and biochemical indices in pediatric recipients of live-donor liver transplants (LDLT). METHODS:Hemodynamics and biochemical indices (coagulation function, electrolytes, kidney function, liver function, and blood analysis) were m...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.04.013
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:
更新日期:1981-03-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2011.02.047
更新日期:2011-05-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.02.095
更新日期:2010-06-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.05.008
更新日期:2007-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.02.071
更新日期:2018-06-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1016/j.transproceed.2015.07.014
更新日期:2015-09-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.03.070
更新日期:2007-06-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.transproceed.2007.03.072
更新日期:2007-06-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.01.018
更新日期:2014-06-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2016.02.034
更新日期:2016-03-01 00:00:00