Pediatrics and Neonatology最新文献

英文中文

Upper Egyptian outcome of Kasai portoenterostomy in biliary atresia: A cross-sectional retrospective study. Kasai门肠造口术治疗胆道闭锁的上埃及疗效：一项横断面回顾性研究。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-02 DOI: 10.1016/j.pedneo.2025.05.013

Sarah Magdy Abdelmohsen, Ahmed Soliman, Mohamed Fathy, Mohammed Hamada Takrouney, Abdelbaset Ali Ahmed, Mohie El-Din Mostafa Madany, Ashraf Abou-Taleb, Tarek Abdelazeem Sabra

Background: Kasai portoenterostomy (KPE) is the key standard operation for biliary atresia (BA). Age at operation is an important factor that affects the outcome of KPE. The aim of the study is to evaluate the short-term outcome of KPE for biliary atresia infants in Upper Egypt.

Patients and methods: this was a cross-sectional, multicenter retrospective study done in three university hospitals in Upper Egypt. The data was collected from January 1, 2019 to September 30, 2021. All infants diagnosed with BA and managed by KPE were included in the study. The collected data were demographic data (age in months or days, sex, residence, parents' consanguinity, and parents' smoking status), history of present illness (the date of first symptoms, fecal color, skin itching, and associated anomalies), and general and abdominal examinations (liver size, skin, and sclera color).

Results: The total number of patients was 45 infants. Two-thirds of the cases were females. The mean age of KPE was 99 ± 13 days. The mean duration of jaundice clearance and resolution after surgery was 12.3 ± 5.5 weeks in 64.4 % of cases. During the five-year follow-up period, 26 (57.8 %) patients were still alive with native livers. Parental smoking, whether maternal or paternal, prenatal or postnatal, was present in 95.5 % of patients. A massive decrease in ALP level in the 1st postoperative week is an excellent predictor of a good outcome with a cutoff value of 560 U/L. Prophylaxis against developing cholangitis is important for the outcome.

Conclusion: Kasai portoenterostomy is an important operation for biliary atresia infants, whatever the age, under or above 4 months old. Kasai portoenterostomy increases the survival rate of native liver infants who suffer from BA. Jaundice clearance after KPE for BA can be predicted using postoperative AST, ALP, and GGT, as these enzymes decline dramatically at the end of the 3rd postoperative month. Unfortunately, the infants in this study had delayed diagnoses. To address this, targeted interventions such as continuing medical education for local doctors, improved transportation infrastructure, and financial support programs are needed to enhance early diagnosis. Despite the delay in the surgical intervention and the older infant's age, the results were good.

Clinicaltrials: gov Identifier: NCT05925543. Kasai portoenterostomy operation. in Biliary Atresia - Clinical Trials Registry - ICH GCP. The Registration Date was June 29, 2023.

背景：Kasai门肠造口术（KPE）是治疗胆道闭锁（BA）的关键标准手术。手术年龄是影响KPE预后的重要因素。该研究的目的是评估KPE治疗上埃及胆道闭锁婴儿的短期疗效。患者和方法：这是一项在上埃及三所大学医院进行的横断面、多中心回顾性研究。数据采集时间为2019年1月1日至2021年9月30日。所有被诊断为BA并接受KPE治疗的婴儿都被纳入研究。收集的数据包括人口统计数据（以月或天为单位的年龄、性别、居住地、父母的血缘关系、父母的吸烟状况）、现有病史（首次症状出现日期、粪便颜色、皮肤瘙痒及相关异常）、全身检查和腹部检查（肝脏大小、皮肤和巩膜颜色）。结果：患儿总数45例。三分之二的病例是女性。KPE的平均年龄为99±13天。术后黄疸清除和消退的平均时间为12.3±5.5周，占64.4%。在5年随访期间，26例（57.8%）患者仍然存活。父母吸烟，无论是母亲或父亲，产前或产后，存在于95.5%的患者。术后第一周ALP水平的大幅下降是预后良好的一个很好的预测指标，临界值为560u /L。预防发展为胆管炎对结果很重要。结论：开赛门肠造口术是治疗胆道闭锁婴儿的重要手术，无论年龄大小，4个月以下或以上。Kasai门静脉肠造口术可提高原生肝婴儿BA的生存率。KPE治疗BA后黄疸清除可以通过术后AST、ALP和GGT预测，因为这些酶在术后第3个月末显著下降。不幸的是，这项研究中的婴儿诊断延迟。为了解决这个问题，有针对性的干预措施，如对当地医生的继续医学教育，改善交通基础设施，以及财政支持计划，需要提高早期诊断。尽管手术干预的延迟和婴儿的年龄较大，但结果很好。临床试验：gov标识符：NCT05925543。开赛门静脉肠造口术。在胆道闭锁-临床试验注册- ICH GCP。注册日期为2023年6月29日。

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引用次数: 0

Type II reversible splenial lesion syndrome in a 6-year-old boy similar to adrenoleukodystrophy on imaging: A case report 6岁男孩ⅱ型可逆性脾损害综合征影像学表现与肾上腺脑白质营养不良相似1例。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.05.009

Baoyun Liang , Jing Liu , Lian Gu

引用次数: 0

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.08.005

Yu-Chin Chen , Ping-Yuan Chen , Chung-Han Ho , Tu-Hsuan Chang

引用次数: 0

Bilateral pleuropulmonary blastoma in an infant 婴儿双侧胸膜肺母细胞瘤。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.08.004

R. Guanà , E. Zambaiti , M.G. Sacco Casamassima , S. Garofalo , L. Lonati , E. Stanton , F. Gennari

引用次数: 0

Assessing the causal association between age at menarche and genetic susceptibility to future gastroesophageal reflux disease risks: A two-sample Mendelian randomization study 评估初潮年龄与未来胃食管反流疾病风险的遗传易感性之间的因果关系：一项双样本孟德尔随机化研究

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.10.012

Chung-Chih Liao , Chun-I Lee , Chia-Sheng Chu , Shih-An Wu , Jung-Miao Li

Objective

Evidence indicates that menarche onset is associated with various health outcomes. Gastroesophageal reflux disease (GERD) is a prevalent condition, which may be influenced by the age at menarche (AAM). The study aims to investigate the potential causal relationship between the AAM and GERD.

Methods

We conducted a two-sample Mendelian randomization (MR) analysis utilizing single nucleotide polymorphisms (SNPs) derived from genome-wide association studies summary statistics for AAM and GERD as instrumental variables. Various MR methods were applied to estimate causal effects, supplemented by sensitivity analyses to assess the robustness of our findings.

Results

Overall, 69 SNPs associated with the AAM were used after rigorous selection to ensure absence of linkage disequilibrium or association with confounding factors. The inverse variance-weighted (IVW) method indicated a significant inverse association between genetically predicted AAM and GERD (odds ratio, 0.89; 95 % confidence interval, 0.85–0.94). These findings were consistent across weighted median and weighted mode analyses. The MR-Egger regression analysis suggested no significant directional pleiotropy. Heterogeneity was detected among instrumental variables; however, the leave-one-out sensitivity analysis confirmed the association stability.

Conclusion

We provided robust evidence supporting an inverse causal relationship between the AAM and GERD risk.

目的：有证据表明初潮的发生与多种健康结果有关。胃食管反流病（GERD）是一种常见病，其发病可能与月经初潮年龄有关。本研究旨在探讨AAM与胃食管反流之间的潜在因果关系。方法：我们利用来自全基因组关联研究的单核苷酸多态性（snp）作为工具变量，对AAM和GERD进行了两样本孟德尔随机化（MR）分析。我们应用了各种核磁共振方法来估计因果效应，并辅以敏感性分析来评估我们研究结果的稳健性。结果：总的来说，经过严格的选择，使用了69个与AAM相关的snp，以确保没有连锁不平衡或与混杂因素相关。逆方差加权（IVW）方法显示遗传预测的AAM与GERD呈显著负相关(优势比0.89；95%置信区间，0.85-0.94)。这些发现在加权中位数和加权模式分析中是一致的。MR-Egger回归分析显示无显著的方向性多效性。工具变量间存在异质性；然而，留一敏感性分析证实了该关联的稳定性。结论：我们提供了强有力的证据支持AAM和GERD风险之间的反向因果关系。

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引用次数: 0

Effect of nocturnal enuresis on school-age children and their families in Thailand: A cross-sectional study 夜间遗尿对泰国学龄儿童及其家庭的影响：一项横断面研究。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.12.004

Ornatcha Sirimongkolchaiyakul , Chanon Sutheparank , Yupaporn Amornchaicharoensuk

Background

Nocturnal enuresis (NE) is a chronic problem that causes distress in children and their families. NE affects daily living activities, relationships, behavior, emotions, and social interactions. However, data on the effects of NE on Thai children are limited. This study aimed to evaluate the effects of NE and the associated factors on children with NE and their parents or guardians.

Methods

A cross-sectional study included 349 children with primary NE and 246 with secondary NE, all from Bangkok, Thailand. Their parents or guardians completed a validated questionnaire and rated the severity of the effects of NE on a Likert scale.

Results

Of the children with primary NE, 30.9 % rated it as not affecting them at all, 28.7 % as affecting them slightly, and 18.9 % as affecting them moderately. Of those with secondary NE, 36.2 % rated it as affecting them slightly, 28.9 % as not affecting them at all, and 18.3 % as affecting them moderately. Primary (32.1 %) and secondary NE (39.8 %) had the most effect on children's confidence. Primary and secondary NE affected 61.6 % and 60.2 % of parents or guardians, respectively, through the increased burden of housework from washing bedsheets.

Conclusion

NE demonstrated slight effects on children with NE and their parents or guardians. In the children, NE most affected their self-confidence, and in the parents and guardians, NE increased the burden of housework. In managing NE, physicians should evaluate its adverse effects on children and their parents or guardians.

背景：夜间遗尿症（NE）是一种给儿童及其家庭带来痛苦的慢性疾病。NE影响日常生活活动、人际关系、行为、情绪和社会互动。然而，关于NE对泰国儿童影响的数据是有限的。本研究旨在评估新脑障碍及其相关因素对新脑障碍患儿及其父母或监护人的影响。方法：一项横断面研究包括349名原发性NE和246名继发性NE，均来自泰国曼谷。他们的父母或监护人完成了一份有效的问卷，并在李克特量表上评估了NE影响的严重程度。结果：原发性NE患儿中，30.9%认为完全没有影响，28.7%认为轻微影响，18.9%认为中度影响。在继发性NE患者中，36.2%的人认为轻度影响，28.9%的人认为完全没有影响，18.3%的人认为中度影响。小学（32.1%）和中学（39.8%）对儿童自信心的影响最大。初级和次级NE通过增加洗床单的家务负担分别影响了61.6%和60.2%的父母或监护人。结论：NE对NE患儿及其父母或监护人的影响较小。在儿童中，NE对自信心的影响最大，在父母和监护人中，NE增加了家务劳动的负担。在处理NE时，医生应评估其对儿童及其父母或监护人的不良影响。

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引用次数: 0

Predictive risk factors for meconium-related ileus requiring surgical intervention in very low birth weight infants 极低出生体重儿需要手术干预的粪相关肠梗阻的预测危险因素。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.11.007

Yoshinobu Tsuno , Takeshi Kumagai , Mitsuhiko Riko , Taro Goda , Yasuyuki Mitani , Takuya Sugimoto , Mina Ueda , Manabu Kawai , Daisuke Tokuhara

Background

Meconium-related ileus (MRI) is a serious morbidity in very low birth weight infants (VLBWI). MRI can lead to intestinal perforation, which has a poor prognosis. Treatment may involve medical or surgical approaches. Our aim was to identify the risk factors predicting surgery in VLBWI with MRI, which are not well studied. We also compared clinical factors between VLBWI treated medically versus surgically.

Methods

We identified VLBWI with MRI who were admitted to our institution between January 2014 and December 2022. Infants were divided into those who underwent surgery and those who received conservative medical therapy. We compared various clinical factors between the groups. In each group, we calculated the ratio of maximum dilatational diameter of the intestinal tract to the maximum abdominal transverse diameter on abdominal X-rays at different time points; we called this ratio the “MRI index”. Using receiver operating characteristic curve analysis, we determined the MRI index cutoff value to predict surgery.

Results

We evaluated 34 VLBWI with MRI; 9 underwent surgery and 25 responded to conservative medical therapy. The MRI index on day 0 and the maximum MRI index in the surgical group were significantly higher than those in the medical group (p = 0.036 and p < 0.001, respectively). The MRI index cutoff value to predict surgery was 0.205 (area under the curve: 0.900, sensitivity: 0.92, specificity: 0.78). Compared with the medical group, the surgical group required significantly longer to achieve enteral feeding at 100 ml/kg/day, had a longer duration of hospital stay (p = 0.003 and p = 0.038, respectively) and a significantly higher incidence of sepsis (p = 0.042).

Conclusion

VLBWI with an MRI index ≥0.205 have a significantly high risk of requiring surgery.

背景：粪相关肠梗阻（MRI）是极低出生体重儿（VLBWI）的一种严重发病率。MRI可导致肠穿孔，预后较差。治疗可能包括药物或手术方法。我们的目的是通过MRI确定预测VLBWI手术的危险因素，这些因素尚未得到很好的研究。我们还比较了药物治疗和手术治疗VLBWI的临床因素。方法：对2014年1月至2022年12月在我院就诊的VLBWI患者进行MRI确诊。婴儿被分为接受手术的和接受保守药物治疗的两组。我们比较了两组间的各种临床因素。在每组中，我们计算不同时间点腹部x线上肠道最大扩张直径与腹部最大横径的比值；我们称这个比率为“MRI指数”。通过受试者工作特征曲线分析，我们确定了MRI指标临界值来预测手术。结果：我们对34例VLBWI进行MRI评估；9人接受手术治疗，25人接受保守药物治疗。手术组第0天MRI指数和最大MRI指数均显著高于内科组（p = 0.036和p）。结论：MRI指数≥0.205的VLBWI需要手术的风险显著增高。

{"title":"Predictive risk factors for meconium-related ileus requiring surgical intervention in very low birth weight infants","authors":"Yoshinobu Tsuno , Takeshi Kumagai , Mitsuhiko Riko , Taro Goda , Yasuyuki Mitani , Takuya Sugimoto , Mina Ueda , Manabu Kawai , Daisuke Tokuhara","doi":"10.1016/j.pedneo.2024.11.007","DOIUrl":"10.1016/j.pedneo.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Meconium-related ileus (MRI) is a serious morbidity in very low birth weight infants (VLBWI). MRI can lead to intestinal perforation, which has a poor prognosis. Treatment may involve medical or surgical approaches. Our aim was to identify the risk factors predicting surgery in VLBWI with MRI, which are not well studied. We also compared clinical factors between VLBWI treated medically versus surgically.</div></div><div><h3>Methods</h3><div>We identified VLBWI with MRI who were admitted to our institution between January 2014 and December 2022. Infants were divided into those who underwent surgery and those who received conservative medical therapy. We compared various clinical factors between the groups. In each group, we calculated the ratio of maximum dilatational diameter of the intestinal tract to the maximum abdominal transverse diameter on abdominal X-rays at different time points; we called this ratio the “MRI index”. Using receiver operating characteristic curve analysis, we determined the MRI index cutoff value to predict surgery.</div></div><div><h3>Results</h3><div>We evaluated 34 VLBWI with MRI; 9 underwent surgery and 25 responded to conservative medical therapy. The MRI index on day 0 and the maximum MRI index in the surgical group were significantly higher than those in the medical group (p = 0.036 and p < 0.001, respectively). The MRI index cutoff value to predict surgery was 0.205 (area under the curve: 0.900, sensitivity: 0.92, specificity: 0.78). Compared with the medical group, the surgical group required significantly longer to achieve enteral feeding at 100 ml/kg/day, had a longer duration of hospital stay (p = 0.003 and p = 0.038, respectively) and a significantly higher incidence of sepsis (p = 0.042).</div></div><div><h3>Conclusion</h3><div>VLBWI with an MRI index ≥0.205 have a significantly high risk of requiring surgery.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 6","pages":"Pages 601-605"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giant Omental Lipoma in a Child 儿童巨大网膜脂肪瘤。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2025.08.003

Hyun Beak Shin , Yeon Jun Jeong

引用次数: 0

lncRNA HCP5 regulates inflammation and oxidative stress of neonatal sepsis via modulating miR-93–5p lncRNA HCP5通过调节miR-93-5p调节新生儿脓毒症的炎症和氧化应激。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.10.013

Yueying Qi , Xin Li , Yuting Cai , Jiaxi Xie , Jinkai Yang

Background

Due to the high sensitivity to pathogenic microorganisms, newborns showed a high incidence and mortality of sepsis. The dysregulation of non-coding RNAs may play a key role in the immune regulation of neonatal sepsis. This study aimed to evaluate the potential function of lncRNA human histocompatibility leukocyte antigen complex P5 (HCP5) in the inflammation and oxidative stress of neonatal and to disclose its potential molecular mechanism.

Methods

The neonatal sepsis animal models were established with newborn rat pups by cecal ligation and perforation (CLP). The macrophage cells were induced by lipopolysaccharide (LPS) to mimic the sepsis injury. The expression of HCP5 was detected by polymerase chain reaction (PCR) and regulated by corresponding transfections. The inflammatory response was estimated by the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) using enzyme-linked immunosorbent assay (ELISA); and the oxidative stress was assessed by the levels of malondialdehyde (MDA) and superoxide dismutase (SOD). The proliferation of macrophage cells was evaluated by the CCK8 assay.

Results

HCP5 was significantly upregulated in neonatal sepsis rat models, of which the knockdown suppressed the inflammation and oxidative stress induced by CLP. In vitro, HCP5 was found to negatively regulate miR-93–5p in LPS-induced macrophage cells, which co-regulated the proliferation, inflammatory response, and oxidative stress in macrophage cells.

Conclusion

Upregulated HCP5 in neonatal sepsis rats regulated inflammation and oxidative stress, and it also modulated macrophage cell via regulating miR-93–5p.

背景：新生儿由于对病原微生物的高度敏感，脓毒症的发病率和死亡率较高。非编码rna的失调可能在新生儿败血症的免疫调节中起关键作用。本研究旨在评估lncRNA人组织相容性白细胞抗原复合物P5 （human histocompatibility leukocyte antigen complex P5, HCP5）在新生儿炎症和氧化应激中的潜在功能，并揭示其潜在的分子机制。方法：采用盲肠结扎穿孔法（CLP）建立新生儿脓毒症动物模型。采用脂多糖（LPS）诱导巨噬细胞模拟脓毒症损伤。采用聚合酶链反应（PCR）检测HCP5的表达，并通过相应的转染调节HCP5的表达。采用酶联免疫吸附试验（ELISA），通过白细胞介素-6 （IL-6）、白细胞介素-8 （IL-8）和肿瘤坏死因子-α (TNF-α)的水平来评估炎症反应；通过丙二醛（MDA）和超氧化物歧化酶（SOD）水平评估氧化应激。CCK8法检测巨噬细胞的增殖情况。结果：HCP5在新生儿脓毒症大鼠模型中显著上调，下调后可抑制CLP诱导的炎症和氧化应激。在体外实验中，我们发现HCP5在lps诱导的巨噬细胞中负调控miR-93-5p，共同调控巨噬细胞的增殖、炎症反应和氧化应激。结论：新生儿脓毒症大鼠HCP5上调可调节炎症和氧化应激，并通过调节miR-93-5p调节巨噬细胞。

{"title":"lncRNA HCP5 regulates inflammation and oxidative stress of neonatal sepsis via modulating miR-93–5p","authors":"Yueying Qi , Xin Li , Yuting Cai , Jiaxi Xie , Jinkai Yang","doi":"10.1016/j.pedneo.2024.10.013","DOIUrl":"10.1016/j.pedneo.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Due to the high sensitivity to pathogenic microorganisms, newborns showed a high incidence and mortality of sepsis. The dysregulation of non-coding RNAs may play a key role in the immune regulation of neonatal sepsis. This study aimed to evaluate the potential function of lncRNA human histocompatibility leukocyte antigen complex P5 (HCP5) in the inflammation and oxidative stress of neonatal and to disclose its potential molecular mechanism.</div></div><div><h3>Methods</h3><div>The neonatal sepsis animal models were established with newborn rat pups by cecal ligation and perforation (CLP). The macrophage cells were induced by lipopolysaccharide (LPS) to mimic the sepsis injury. The expression of HCP5 was detected by polymerase chain reaction (PCR) and regulated by corresponding transfections. The inflammatory response was estimated by the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) using enzyme-linked immunosorbent assay (ELISA); and the oxidative stress was assessed by the levels of malondialdehyde (MDA) and superoxide dismutase (SOD). The proliferation of macrophage cells was evaluated by the CCK8 assay.</div></div><div><h3>Results</h3><div>HCP5 was significantly upregulated in neonatal sepsis rat models, of which the knockdown suppressed the inflammation and oxidative stress induced by CLP. <em>In vitro</em>, HCP5 was found to negatively regulate miR-93–5p in LPS-induced macrophage cells, which co-regulated the proliferation, inflammatory response, and oxidative stress in macrophage cells.</div></div><div><h3>Conclusion</h3><div>Upregulated HCP5 in neonatal sepsis rats regulated inflammation and oxidative stress, and it also modulated macrophage cell via regulating miR-93–5p.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 6","pages":"Pages 566-572"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The outcome of kidney transplantation in lupus patients 狼疮患者肾移植的结果。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 DOI: 10.1016/j.pedneo.2024.09.008

Ting-Chih Lin , Meng-Kun Tsai , Jyh-Hong Lee , Yao-Hsu Yang , Yu-Tsan Lin , Hsin-Hui Yu , Bor-Luen Chiang , Li-Chieh Wang

Background

Kidney transplantation represents a therapeutic option for individuals with end-stage renal disease due to lupus. However, the influence of lupus activity and immunosuppressive medications on graft survival remains a matter of concern and it has not been thoroughly elucidated.

Methods

In this study, we conducted a retrospective review of 45 lupus patients who underwent kidney transplantation, with the aim of analyzing graft survival and identifying factors influencing the outcome of kidney transplantation in lupus patients.

Results

Graft survival rates at 1, 5, 10, 15, and 20 years were 98%, 98%, 88%, 85%, and 78%, respectively. Univariate logistic regression revealed hypertension, positive panel reactive antibodies against HLA class II antigens, retransplant, young age at lupus nephritis onset, low postoperative C4 levels, and HBsAg and/or anti-HBe antibody presence were significantly correlated with decreased graft survival (p < 0.05). Multiple regression confirmed the significant association of HBsAg and/or anti-HBe antibody with graft failure (p = 0.0161), with all patients testing negative for anti-HBc antibody. Preoperative markers (C3, C4, anti-dsDNA antibody) and recurrent lupus nephritis did not impact graft failure.

Conclusion

In lupus patients undergoing kidney transplantation, hepatitis B serology emerges as a potential singular predictor for graft failure, while preoperative lupus activity markers and recurrent lupus nephritis do not affect outcomes.

背景：对于狼疮引起的终末期肾病患者，肾移植是一种治疗选择。然而，狼疮活动和免疫抑制药物对移植物存活的影响仍然是一个值得关注的问题，并没有完全阐明。方法：本研究对45例接受肾移植的狼疮患者进行回顾性分析，目的是分析狼疮患者的移植物存活情况，并找出影响狼疮患者肾移植预后的因素。结果：移植1、5、10、15、20年生存率分别为98%、98%、88%、85%、78%。单因素logistic回归显示，高血压、HLAⅱ类抗体阳性、再移植、狼疮性肾炎发病年龄小、术后C4水平低、HBsAg和/或抗hbe抗体存在与移植物存活率降低显著相关(p)。在接受肾移植的狼疮患者中，乙型肝炎血清学成为移植失败的潜在单一预测因子，而术前狼疮活动标志物和复发性狼疮肾炎不影响结果。

{"title":"The outcome of kidney transplantation in lupus patients","authors":"Ting-Chih Lin , Meng-Kun Tsai , Jyh-Hong Lee , Yao-Hsu Yang , Yu-Tsan Lin , Hsin-Hui Yu , Bor-Luen Chiang , Li-Chieh Wang","doi":"10.1016/j.pedneo.2024.09.008","DOIUrl":"10.1016/j.pedneo.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplantation represents a therapeutic option for individuals with end-stage renal disease due to lupus. However, the influence of lupus activity and immunosuppressive medications on graft survival remains a matter of concern and it has not been thoroughly elucidated.</div></div><div><h3>Methods</h3><div>In this study, we conducted a retrospective review of 45 lupus patients who underwent kidney transplantation, with the aim of analyzing graft survival and identifying factors influencing the outcome of kidney transplantation in lupus patients.</div></div><div><h3>Results</h3><div>Graft survival rates at 1, 5, 10, 15, and 20 years were 98%, 98%, 88%, 85%, and 78%, respectively. Univariate logistic regression revealed hypertension, positive panel reactive antibodies against HLA class II antigens, retransplant, young age at lupus nephritis onset, low postoperative C4 levels, and HBsAg and/or anti-HBe antibody presence were significantly correlated with decreased graft survival (p < 0.05). Multiple regression confirmed the significant association of HBsAg and/or anti-HBe antibody with graft failure (p = 0.0161), with all patients testing negative for anti-HBc antibody. Preoperative markers (C3, C4, anti-dsDNA antibody) and recurrent lupus nephritis did not impact graft failure.</div></div><div><h3>Conclusion</h3><div>In lupus patients undergoing kidney transplantation, hepatitis B serology emerges as a potential singular predictor for graft failure, while preoperative lupus activity markers and recurrent lupus nephritis do not affect outcomes.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 6","pages":"Pages 534-541"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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