首页 > 最新文献

Annals of Transplantation最新文献

英文 中文
Evaluation and Use of Organs from Donors Poisoned by Organophosphorus Pesticide. 有机磷农药中毒供体器官的评价与利用。
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2023-03-31 DOI: 10.12659/AOT.939343
Ji-Hua Wu, Xi-Hua Ma, Jian-Hui Dong, Ning Wen, Ke Qin, Liu-Gen Lan, Ji-Xiang Liao, Zhi-Ying Lei, Hai-Bin Li, Xu-Yong Sun

BACKGROUND The aim of this study was to explore the evaluation and use of donor organs from donors with brain death caused by acute severe organophosphorus pesticides and provide a basis for the use of such donor organs. MATERIAL AND METHODS Seven cases of brain dead donors caused by acute organophosphorus pesticide poisoning from January 2014 to December 2018 in the hospital were collected, and a retrospective analysis was made of the donors' age, race, physiological and pathological changes, donor organ function changes and the organ use, liver or kidney function recovery, and complications of the recipients. The 18 recipients were followed up until June 31, 2022. RESULTS We found that 71.42% of organ donors were male, and 71.42% of organ donors were under 50 years old. The main cause of death was respiratory failure caused by organophosphorus pesticide poisoning. The liver and kidney functions of 7 donors were damaged, and 3 livers could not be used due to severe functional damage, but the liver or kidney function of 18 recipients gradually recovered after transplantation. Delayed recovery of graft function occurred after transplantation accounted for 21.43%, and the grafts had good short-term to medium-term performance. CONCLUSIONS Although the function of organs from donor with brain death due to acute severe organophosphorus pesticide poisoning is seriously damaged, most of the organs can still be used for transplantation. Individualized functional maintenance according to the situation of donors is conducive to improving the quality of organs.

背景本研究旨在探讨急性重度有机磷农药致脑死亡供体供器官的评价与利用,为该类供器官的利用提供依据。材料与方法收集2014年1月至2018年12月该院急性有机磷农药中毒致脑死亡供体7例,回顾性分析供体年龄、种族、生理病理变化、供体器官功能变化及器官使用、肝肾功能恢复、受者并发症等情况。这18名获奖者将被跟踪到2022年6月31日。结果男性供者占71.42%,50岁以下供者占71.42%。死亡原因主要为有机磷农药中毒引起的呼吸衰竭。7例供者肝肾功能受损,3例肝脏因功能损伤严重无法使用,18例受者移植后肝肾功能逐渐恢复。移植后移植物功能恢复延迟占21.43%,移植物中短期表现良好。结论急性重度有机磷农药中毒脑死亡供体器官虽然功能严重受损,但大部分器官仍可用于移植。根据供体情况进行个性化的功能维护,有利于提高器官质量。
{"title":"Evaluation and Use of Organs from Donors Poisoned by Organophosphorus Pesticide.","authors":"Ji-Hua Wu,&nbsp;Xi-Hua Ma,&nbsp;Jian-Hui Dong,&nbsp;Ning Wen,&nbsp;Ke Qin,&nbsp;Liu-Gen Lan,&nbsp;Ji-Xiang Liao,&nbsp;Zhi-Ying Lei,&nbsp;Hai-Bin Li,&nbsp;Xu-Yong Sun","doi":"10.12659/AOT.939343","DOIUrl":"https://doi.org/10.12659/AOT.939343","url":null,"abstract":"<p><p>BACKGROUND The aim of this study was to explore the evaluation and use of donor organs from donors with brain death caused by acute severe organophosphorus pesticides and provide a basis for the use of such donor organs. MATERIAL AND METHODS Seven cases of brain dead donors caused by acute organophosphorus pesticide poisoning from January 2014 to December 2018 in the hospital were collected, and a retrospective analysis was made of the donors' age, race, physiological and pathological changes, donor organ function changes and the organ use, liver or kidney function recovery, and complications of the recipients. The 18 recipients were followed up until June 31, 2022. RESULTS We found that 71.42% of organ donors were male, and 71.42% of organ donors were under 50 years old. The main cause of death was respiratory failure caused by organophosphorus pesticide poisoning. The liver and kidney functions of 7 donors were damaged, and 3 livers could not be used due to severe functional damage, but the liver or kidney function of 18 recipients gradually recovered after transplantation. Delayed recovery of graft function occurred after transplantation accounted for 21.43%, and the grafts had good short-term to medium-term performance. CONCLUSIONS Although the function of organs from donor with brain death due to acute severe organophosphorus pesticide poisoning is seriously damaged, most of the organs can still be used for transplantation. Individualized functional maintenance according to the situation of donors is conducive to improving the quality of organs.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e939343"},"PeriodicalIF":1.1,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/27/anntransplant-28-e939343.PMC10071879.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9669660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical Evaluation of Discarded Donor Livers in the Eurotransplant Region: Potential Implications for Machine Perfusion. 对欧洲移植区丢弃供肝的关键评估:对机器灌注的潜在影响。
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2023-03-17 DOI: 10.12659/AOT.938132
Falk Rauchfuß, Hans-Michael Tautenhahn, Felix Dondorf, Aladdin Ali-Deeb, Utz Settmacher

BACKGROUND There are still many offered donor livers that are declined during the allocation process. Machine perfusion offers the option to evaluate (especially marginal) donor organs and to better decide whether a graft has the potential of being transplanted or not. There is a lack of clear detailed data on why organs are declined and how many donor livers would have the potential of being evaluated in the machine. MATERIAL AND METHODS We retrospectively reviewed 1356 donor livers between 2016 and 2018, which were offered by Eurotransplant and were declined during the allocation process; 284 grafts were from donor after cardiac death (DCD) and 1072 donations were from after brain death (DBD). The analysis was performed independently and blinded by senior transplant surgeons. RESULTS There were 904 (66.6%) donor livers with potential to be evaluated as suitable grafts in machine perfusion, whereas 417 (30.8%) organs were definitely not-transplantable, mainly due to liver cirrhosis, (untreated) donor malignancy, cardiac diseases of the donor leading to a hepatic congestion, and/or systemic infections in the donor. Donors in blood group "AB" were disproportionally often rejected. Due to missing data, 35 (2.6%) organs could not be sufficiently evaluated. CONCLUSIONS Our data suggest that many declined donor livers have potential of being evaluated by machine perfusion. Comprehensive use of machine perfusion is necessary and useful to improve the current organ shortage.

背景:在分配过程中,仍有许多供体肝脏被拒绝。机器灌注提供了评估(特别是边缘)供体器官的选择,并更好地决定移植物是否具有移植的潜力。关于器官被拒绝的原因,以及有多少捐献的肝脏有可能在机器中被评估,目前还缺乏明确的详细数据。材料和方法我们回顾性分析了2016年至2018年期间1356例由Eurotransplant提供并在分配过程中被拒绝的供体肝脏;心脏死亡供体284例,脑死亡供体1072例。该分析由资深移植外科医生独立、盲法进行。结果904例(66.6%)供肝在机器灌注中有可能被评估为合适的移植器官,而417例(30.8%)器官绝对不可移植,主要原因是肝硬化、(未经治疗的)供肝恶性肿瘤、供肝心脏疾病导致肝脏充血和/或供肝全身感染。AB型血的献血者被排斥的比例过高。由于数据缺失,35个(2.6%)器官无法得到充分评估。结论:我们的数据表明,许多衰退的供肝有可能被机器灌注评估。综合运用机器灌注对改善目前器官短缺是必要和有益的。
{"title":"Critical Evaluation of Discarded Donor Livers in the Eurotransplant Region: Potential Implications for Machine Perfusion.","authors":"Falk Rauchfuß,&nbsp;Hans-Michael Tautenhahn,&nbsp;Felix Dondorf,&nbsp;Aladdin Ali-Deeb,&nbsp;Utz Settmacher","doi":"10.12659/AOT.938132","DOIUrl":"https://doi.org/10.12659/AOT.938132","url":null,"abstract":"<p><p>BACKGROUND There are still many offered donor livers that are declined during the allocation process. Machine perfusion offers the option to evaluate (especially marginal) donor organs and to better decide whether a graft has the potential of being transplanted or not. There is a lack of clear detailed data on why organs are declined and how many donor livers would have the potential of being evaluated in the machine. MATERIAL AND METHODS We retrospectively reviewed 1356 donor livers between 2016 and 2018, which were offered by Eurotransplant and were declined during the allocation process; 284 grafts were from donor after cardiac death (DCD) and 1072 donations were from after brain death (DBD). The analysis was performed independently and blinded by senior transplant surgeons. RESULTS There were 904 (66.6%) donor livers with potential to be evaluated as suitable grafts in machine perfusion, whereas 417 (30.8%) organs were definitely not-transplantable, mainly due to liver cirrhosis, (untreated) donor malignancy, cardiac diseases of the donor leading to a hepatic congestion, and/or systemic infections in the donor. Donors in blood group \"AB\" were disproportionally often rejected. Due to missing data, 35 (2.6%) organs could not be sufficiently evaluated. CONCLUSIONS Our data suggest that many declined donor livers have potential of being evaluated by machine perfusion. Comprehensive use of machine perfusion is necessary and useful to improve the current organ shortage.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e938132"},"PeriodicalIF":1.1,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/2c/anntransplant-28-e938132.PMC10029319.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Comparison of Biosimilar Filgrastim with Innovator Fligrastim for Peripheral Blood Stem Cells Mobilization, Collection of CD34+ Stem Cells, and Engraftment in Patients Undergoing Autologous and Allogeneic Stem Cell Transplantation: A Single-Center Experience. 生物仿制药 Filgrastim 与创新药 Fligrastim 在自体和异体干细胞移植患者外周血干细胞动员、CD34+ 干细胞收集和移植方面的比较:单中心经验。
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2023-03-03 DOI: 10.12659/AOT.938585
Maha M Islami, Mansoor Ahmed Khan, Mohammed A Aseeri, Majed A Alshamrani, Abdelmajid Alnatsheh, Sameer Alamoudi, Ahmed A Alzahrani

BACKGROUND In the Middle East, there is lack of data on peripheral blood CD34+stem cells mobilization by using biosimilar filgrastim. We have been using both Neupogen and a biosimilar G-CSF) Zarzio® (as a mobilizing agent since February 2014 for both allogenic and autologous stem cell transplantations. MATERIAL AND METHODS This was a single-center retrospective study. All patients and healthy donors who received either the biosimilar G-CSF (Zarzio®) or original G-CSF (Neupogen®) for mobilization of CD34+ stem cells were included in the study. The primary goal was to determine and compare the rate of successful harvest and amount of CD34+ stem cells collected in either adult cancer patients or healthy donors between Zarzio® and Neupogen® groups. RESULTS A total of 114 patients, including 97 cancer patients and 17 healthy donors, underwent successful CD34+ stem cell mobilization using G-CSF with chemotherapy (35 with Zarzio® +chemotherapy, 39 with Neupogen® +chemotherapy) or G-CSF as monotherapy (14 with Zarzio®, 9 with Neupogen®) in autologous transplantation. In an allogeneic stem cell transplantation, successful harvest was achieved by using G-CSF monotherapy (8 with Zarzio®, 9 with Neupogen®). There was no difference between Zarzio® and Neupogen® in the amount of CD34+ stem cells collected at leukapheresis. There was no difference with regards to secondary outcomes between the 2 groups. CONCLUSIONS Our study showed that biosimilar G-CSF (Zarzio®) has comparable efficacy to the original G-CSF (Neupogen®) when used for mobilization in both autologous and allogenic stem cell transplantation and was associated with significant cost saving.

背景 在中东地区,缺乏使用生物仿制药filgrastim动员外周血CD34+干细胞的数据。自2014年2月以来,我们一直使用Neupogen和生物仿制药G-CSF)Zarzio®(作为动员剂,用于异体和自体干细胞移植。材料与方法 这是一项单中心回顾性研究。所有接受生物类似物G-CSF(Zarzio®)或原始G-CSF(Neupogen®)动员CD34+干细胞的患者和健康捐献者均纳入研究。主要目的是确定并比较Zarzio®组和Neupogen®组在成年癌症患者或健康捐献者中的成功采集率和CD34+干细胞采集量。结果 共有114名患者,包括97名癌症患者和17名健康捐献者,在自体移植中使用G-CSF配合化疗(35人使用Zarzio®+化疗,39人使用Neupogen®+化疗)或G-CSF作为单一疗法(14人使用Zarzio®,9人使用Neupogen®)成功进行了CD34+干细胞动员。在异体干细胞移植中,使用G-CSF单药治疗(8例使用Zarzio®,9例使用Neupogen®)可成功收获干细胞。Zarzio®和Neupogen®在白细胞分离时收集的CD34+干细胞数量上没有差异。在次要结果方面,两组之间没有差异。结论 我们的研究表明,生物仿制药G-CSF(Zarzio®)在自体干细胞移植和异体干细胞移植中用于动员时,疗效与原始G-CSF(Neupogen®)相当,并可显著节约成本。
{"title":"Comparison of Biosimilar Filgrastim with Innovator Fligrastim for Peripheral Blood Stem Cells Mobilization, Collection of CD34+ Stem Cells, and Engraftment in Patients Undergoing Autologous and Allogeneic Stem Cell Transplantation: A Single-Center Experience.","authors":"Maha M Islami, Mansoor Ahmed Khan, Mohammed A Aseeri, Majed A Alshamrani, Abdelmajid Alnatsheh, Sameer Alamoudi, Ahmed A Alzahrani","doi":"10.12659/AOT.938585","DOIUrl":"10.12659/AOT.938585","url":null,"abstract":"<p><p>BACKGROUND In the Middle East, there is lack of data on peripheral blood CD34+stem cells mobilization by using biosimilar filgrastim. We have been using both Neupogen and a biosimilar G-CSF) Zarzio® (as a mobilizing agent since February 2014 for both allogenic and autologous stem cell transplantations. MATERIAL AND METHODS This was a single-center retrospective study. All patients and healthy donors who received either the biosimilar G-CSF (Zarzio®) or original G-CSF (Neupogen®) for mobilization of CD34+ stem cells were included in the study. The primary goal was to determine and compare the rate of successful harvest and amount of CD34+ stem cells collected in either adult cancer patients or healthy donors between Zarzio® and Neupogen® groups. RESULTS A total of 114 patients, including 97 cancer patients and 17 healthy donors, underwent successful CD34+ stem cell mobilization using G-CSF with chemotherapy (35 with Zarzio® +chemotherapy, 39 with Neupogen® +chemotherapy) or G-CSF as monotherapy (14 with Zarzio®, 9 with Neupogen®) in autologous transplantation. In an allogeneic stem cell transplantation, successful harvest was achieved by using G-CSF monotherapy (8 with Zarzio®, 9 with Neupogen®). There was no difference between Zarzio® and Neupogen® in the amount of CD34+ stem cells collected at leukapheresis. There was no difference with regards to secondary outcomes between the 2 groups. CONCLUSIONS Our study showed that biosimilar G-CSF (Zarzio®) has comparable efficacy to the original G-CSF (Neupogen®) when used for mobilization in both autologous and allogenic stem cell transplantation and was associated with significant cost saving.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e938585"},"PeriodicalIF":1.1,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/09/anntransplant-28-e938585.PMC9990321.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association Between Dietary Quality and Serum Cystatin C in Kidney Transplant Recipients Based on Chinese Diet Balance Index 2016 (DBI-16). 基于中国膳食平衡指数2016(DBI-16)的肾移植受者膳食质量与血清胱抑素C的关系
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2023-02-28 DOI: 10.12659/AOT.939149
Hailing Zhang, Ke Shi, Li Yuan, Xiaohong Guan, Haihui Yin, Wenjing Zhao, Xinyi Zhou, Aiqin Chu

BACKGROUND Cystatin C (Cys) is considered to be a better marker than serum creatinine in assessing kidney function, predicting cardiovascular events, and all-cause mortality. It seems to be associated with nutritional status in the general population, but little is known about kidney transplant recipients (KTRs). This study aimed to explore the relationship between dietary balance index and serum Cys in KTRs. MATERIAL AND METHODS In a cross-sectional study, 215 KTRs completed an FFQ questionnaire and information on serum Cys. Dietary intake was assessed using the Food Frequency Questionnaire (FFQ). Dietary Balance Index 2016 (DBI-16) edition scores were calculated as an indicator of dietary quality. Data on the patient's serum Cys were obtained through the hospital information system. RESULTS The majority of KTRs were male (75.34%), 76.74% were aged 18-44 years, and 79.53% were abnormal serum Cys. Dairy (z=-2.161, P<0.05), meat (z=-2.578, P<0.05), and dietary diversity (z=-3.393, P<0.05) in the normal group were higher than those in the abnormal group, and the dietary quality distance (DQD) score (t=-2.264, P<0.05) was lower than that in the abnormal group. After adjusting for confounders, a low-quality diet was a risk factor for maintaining the normal level of serum Cys (OR 3.022, 95% CI 1.263-7.231, P<0.05). CONCLUSIONS The present study suggested that KTRs with a high dietary quality might be associated with normal serum Cys levels. Dairy, meat, and varied diet seems to impact the serum Cys levels of KTRs. Dietary imbalances were prevalent among KTRs.

背景胱抑素 C(Cys)被认为是比血清肌酐更好的评估肾功能、预测心血管事件和全因死亡率的指标。胱抑素 C 似乎与普通人群的营养状况有关,但人们对肾移植受者(KTR)的胱抑素 C 却知之甚少。本研究旨在探讨肾移植受者膳食平衡指数与血清 Cys 之间的关系。材料和方法 在一项横断面研究中,215 名肾移植受者填写了 FFQ 问卷并提供了血清 Cys 的信息。膳食摄入量通过食物频率问卷(FFQ)进行评估。计算膳食平衡指数 2016(DBI-16)版得分,作为膳食质量指标。患者的血清 Cys 数据通过医院信息系统获得。结果 大多数 KTR 为男性(75.34%),76.74% 年龄在 18-44 岁之间,79.53% 血清 Cys 异常。乳制品(z=-2.161,P
{"title":"Association Between Dietary Quality and Serum Cystatin C in Kidney Transplant Recipients Based on Chinese Diet Balance Index 2016 (DBI-16).","authors":"Hailing Zhang, Ke Shi, Li Yuan, Xiaohong Guan, Haihui Yin, Wenjing Zhao, Xinyi Zhou, Aiqin Chu","doi":"10.12659/AOT.939149","DOIUrl":"10.12659/AOT.939149","url":null,"abstract":"<p><p>BACKGROUND Cystatin C (Cys) is considered to be a better marker than serum creatinine in assessing kidney function, predicting cardiovascular events, and all-cause mortality. It seems to be associated with nutritional status in the general population, but little is known about kidney transplant recipients (KTRs). This study aimed to explore the relationship between dietary balance index and serum Cys in KTRs. MATERIAL AND METHODS In a cross-sectional study, 215 KTRs completed an FFQ questionnaire and information on serum Cys. Dietary intake was assessed using the Food Frequency Questionnaire (FFQ). Dietary Balance Index 2016 (DBI-16) edition scores were calculated as an indicator of dietary quality. Data on the patient's serum Cys were obtained through the hospital information system. RESULTS The majority of KTRs were male (75.34%), 76.74% were aged 18-44 years, and 79.53% were abnormal serum Cys. Dairy (z=-2.161, P<0.05), meat (z=-2.578, P<0.05), and dietary diversity (z=-3.393, P<0.05) in the normal group were higher than those in the abnormal group, and the dietary quality distance (DQD) score (t=-2.264, P<0.05) was lower than that in the abnormal group. After adjusting for confounders, a low-quality diet was a risk factor for maintaining the normal level of serum Cys (OR 3.022, 95% CI 1.263-7.231, P<0.05). CONCLUSIONS The present study suggested that KTRs with a high dietary quality might be associated with normal serum Cys levels. Dairy, meat, and varied diet seems to impact the serum Cys levels of KTRs. Dietary imbalances were prevalent among KTRs.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e939149"},"PeriodicalIF":1.1,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/f5/anntransplant-28-e939149.PMC9985305.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9376906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Detecting Donor-Derived DNA by Real-Time PCR in Recipients Suspected of Graft-Versus-Host-Diseases After Liver Transplantation: A Case Series and Literature Review. 用实时荧光定量PCR检测肝移植后疑似移植物抗宿主病受者的供体来源DNA:病例系列和文献综述
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2023-02-25 DOI: 10.12659/AOT.938287
Changhee Ha, Sang Jin Kim, Jong Man Kim, Jae-Won Joh, Kee-Taek Jang, Gyu-Seong Choi, Eun-Suk Kang

BACKGROUND Graft-versus-host disease (GVHD) after liver transplantation (LT) is a rare but fatal complication. GVHD diagnosis is usually based on clinical symptoms and pathologic confirmation. However, it is often misdiagnosed due to its non-specific symptoms. Here, we report the detection of donor-cell chimerism using peripheral blood (PB) donor-derived deoxyribonucleic acid (ddDNA) for 3 cases with suspected GVHD after LT (GVHD-LT) through real-time quantitative polymerase chain reaction (qPCR) assay targeting 39 insertions and/or deletions of chromosomes. MATERIAL AND METHODS The qPCR assay for detecting donor-cell chimerism was performed for 3 post-LT patients with suspected GVHD using KMRtype® and KMRtrack® assays (GenDx, Netherlands). The mean recipient/donor-cell fraction of informative markers unique to each recipient or donor was calculated. RESULTS In Case 1, who received living donor LT (LDLT) from his daughter, initial sign was diarrhea at post-operative day (POD) #23. Case 2 received unrelated deceased donor LT and initial sign was cytopenia at POD #29. Case 3 received LDLT from her son and GVHD associated cytopenia was developed at POD #80. Average PB ddDNA fractions in post-transplant samples of cases 1, 2, and 3 were 39.68%, 78.38%, and 4.76%, respectively. Despite an active treatment including steroid and tumor necrosis factor-alpha inhibitor, 2 patients (cases 1 and 2) died due to multiple organ failures. CONCLUSIONS Early detection of donor-cell chimerism may help halt fatal progression of GVHD-LT. A qPCR test targeting INDEL of chromosomes would be a helpful procedure for timely diagnosis of GVHD.

肝移植术后移植物抗宿主病(GVHD)是一种罕见但致命的并发症。GVHD的诊断通常基于临床症状和病理证实。然而,由于其非特异性症状,经常被误诊。在这里,我们报告了利用外周血供体来源的脱氧核糖核酸(ddDNA)检测3例疑似GVHD (GVHD-LT)后的供体细胞嵌合,通过实时定量聚合酶链反应(qPCR)检测39个染色体插入和/或缺失。材料和方法采用KMRtype®和KMRtrack®(GenDx,荷兰)检测方法,对3例疑似GVHD的lt后患者进行供体细胞嵌合检测。计算每个受体或供体独特的信息标记的平均受体/供体细胞分数。结果病例1接受了其女儿的活体肝移植(LDLT),术后第23天(POD)的初始体征为腹泻。病例2接受了无亲属关系的已故供者肾移植,初始体征为细胞减少。病例3接受了其子的LDLT,在POD #80时发现GVHD相关的细胞减少。病例1、2、3移植后标本中PB ddDNA的平均含量分别为39.68%、78.38%、4.76%。尽管积极治疗包括类固醇和肿瘤坏死因子- α抑制剂,2例患者(病例1和2)死于多器官衰竭。结论早期发现供体细胞嵌合可能有助于阻止GVHD-LT的致死性进展。针对染色体INDEL的qPCR检测将有助于GVHD的及时诊断。
{"title":"Detecting Donor-Derived DNA by Real-Time PCR in Recipients Suspected of Graft-Versus-Host-Diseases After Liver Transplantation: A Case Series and Literature Review.","authors":"Changhee Ha,&nbsp;Sang Jin Kim,&nbsp;Jong Man Kim,&nbsp;Jae-Won Joh,&nbsp;Kee-Taek Jang,&nbsp;Gyu-Seong Choi,&nbsp;Eun-Suk Kang","doi":"10.12659/AOT.938287","DOIUrl":"https://doi.org/10.12659/AOT.938287","url":null,"abstract":"<p><p>BACKGROUND Graft-versus-host disease (GVHD) after liver transplantation (LT) is a rare but fatal complication. GVHD diagnosis is usually based on clinical symptoms and pathologic confirmation. However, it is often misdiagnosed due to its non-specific symptoms. Here, we report the detection of donor-cell chimerism using peripheral blood (PB) donor-derived deoxyribonucleic acid (ddDNA) for 3 cases with suspected GVHD after LT (GVHD-LT) through real-time quantitative polymerase chain reaction (qPCR) assay targeting 39 insertions and/or deletions of chromosomes. MATERIAL AND METHODS The qPCR assay for detecting donor-cell chimerism was performed for 3 post-LT patients with suspected GVHD using KMRtype® and KMRtrack® assays (GenDx, Netherlands). The mean recipient/donor-cell fraction of informative markers unique to each recipient or donor was calculated. RESULTS In Case 1, who received living donor LT (LDLT) from his daughter, initial sign was diarrhea at post-operative day (POD) #23. Case 2 received unrelated deceased donor LT and initial sign was cytopenia at POD #29. Case 3 received LDLT from her son and GVHD associated cytopenia was developed at POD #80. Average PB ddDNA fractions in post-transplant samples of cases 1, 2, and 3 were 39.68%, 78.38%, and 4.76%, respectively. Despite an active treatment including steroid and tumor necrosis factor-alpha inhibitor, 2 patients (cases 1 and 2) died due to multiple organ failures. CONCLUSIONS Early detection of donor-cell chimerism may help halt fatal progression of GVHD-LT. A qPCR test targeting INDEL of chromosomes would be a helpful procedure for timely diagnosis of GVHD.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e938287"},"PeriodicalIF":1.1,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/9a/anntransplant-28-e938287.PMC9976475.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9383765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Non-Cryopreserved Peripheral Blood Stem Cell Graft for Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma and Lymphoma Patients. 非冷冻保存外周血干细胞移植用于多发性骨髓瘤和淋巴瘤患者自体造血干细胞移植。
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2023-01-17 DOI: 10.12659/AOT.938595
Panarat Noiperm, Jakrawadee Julamanee, Pongtep Viboonjuntra, Arnuparp Lekhakula

BACKGROUND Hematopoietic stem cell transplantation (HSCT) using cryopreserved grafts is time-consuming, expensive treatment, and may associated with dimethyl sulfoxide (DMSO) toxicity. Here, we assess the clinical utility and safety of non-cryopreserved peripheral blood stem cell graft in autologous HSCT. MATERIAL AND METHODS Medical data of multiple myeloma or lymphoma patients who underwent autologous non-cryopreserved HSCT were reviewed. RESULTS A total of 58 patients (40 myeloma and 18 lymphoma) were reviewed. The median myeloma and lymphoma CD34⁺ cell doses were 7.59 and 6.9 million/kg, respectively, with good viability after storage. The median times in neutrophil and platelet engraftment were 9 and 13 days and 11 and 14 days in myeloma and lymphoma, respectively. Only 5 patients in this cohort developed serious post-transplant complications. After transplantation, the cumulative incidence of relapse at 5 years was 34.4% in myeloma versus 19.1% in lymphoma patients. Notably, the mortality incidence rate rapidly increased within the first year and reached a plateau after 4 years, with cumulative incidence of 5.9% and 30.9% in myeloma and lymphoma, respectively. With a median follow-up time of 60 months, the median progression-free survival (PFS) and overall survival (OS) for lymphoma patients was 123.8 and 130 months, respectively. For the myeloma group, the median follow-up time was 38.6 months, the median PFS was 99.5 months, and OS was 157 months. CONCLUSIONS Non-cryopreserved HSCT is effective and safe. The long-term survival outcomes could be achieved by the shortening the duration of neutrophil and platelet engraftments and the complication rates are acceptable.

使用冷冻保存的造血干细胞移植(HSCT)是一种耗时、昂贵的治疗方法,并且可能与二甲亚砜(DMSO)毒性有关。在这里,我们评估非冷冻保存外周血干细胞移植在自体造血干细胞移植中的临床应用和安全性。材料与方法回顾多发性骨髓瘤或淋巴瘤患者接受自体非冷冻保存HSCT的医学资料。结果共回顾了58例患者,其中骨髓瘤40例,淋巴瘤18例。骨髓瘤和淋巴瘤CD34 +细胞的中位剂量分别为7.59和690万/kg,保存后活性良好。中性粒细胞和血小板植入的中位时间分别为9天和13天,骨髓瘤和淋巴瘤的中位时间分别为11天和14天。该队列中仅有5例患者出现了严重的移植后并发症。移植后,骨髓瘤患者5年的累计复发率为34.4%,淋巴瘤患者为19.1%。值得注意的是,死亡率在第一年迅速上升,4年后达到平稳期,骨髓瘤和淋巴瘤的累积发病率分别为5.9%和30.9%。中位随访时间为60个月,淋巴瘤患者的中位无进展生存期(PFS)和总生存期(OS)分别为123.8个月和130个月。骨髓瘤组中位随访时间为38.6个月,中位PFS为99.5个月,OS为157个月。结论非冷冻保存的HSCT是安全有效的。通过缩短中性粒细胞和血小板移植的时间,可以获得长期的生存结果,并发症发生率是可以接受的。
{"title":"Non-Cryopreserved Peripheral Blood Stem Cell Graft for Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma and Lymphoma Patients.","authors":"Panarat Noiperm,&nbsp;Jakrawadee Julamanee,&nbsp;Pongtep Viboonjuntra,&nbsp;Arnuparp Lekhakula","doi":"10.12659/AOT.938595","DOIUrl":"https://doi.org/10.12659/AOT.938595","url":null,"abstract":"<p><p>BACKGROUND Hematopoietic stem cell transplantation (HSCT) using cryopreserved grafts is time-consuming, expensive treatment, and may associated with dimethyl sulfoxide (DMSO) toxicity. Here, we assess the clinical utility and safety of non-cryopreserved peripheral blood stem cell graft in autologous HSCT. MATERIAL AND METHODS Medical data of multiple myeloma or lymphoma patients who underwent autologous non-cryopreserved HSCT were reviewed. RESULTS A total of 58 patients (40 myeloma and 18 lymphoma) were reviewed. The median myeloma and lymphoma CD34⁺ cell doses were 7.59 and 6.9 million/kg, respectively, with good viability after storage. The median times in neutrophil and platelet engraftment were 9 and 13 days and 11 and 14 days in myeloma and lymphoma, respectively. Only 5 patients in this cohort developed serious post-transplant complications. After transplantation, the cumulative incidence of relapse at 5 years was 34.4% in myeloma versus 19.1% in lymphoma patients. Notably, the mortality incidence rate rapidly increased within the first year and reached a plateau after 4 years, with cumulative incidence of 5.9% and 30.9% in myeloma and lymphoma, respectively. With a median follow-up time of 60 months, the median progression-free survival (PFS) and overall survival (OS) for lymphoma patients was 123.8 and 130 months, respectively. For the myeloma group, the median follow-up time was 38.6 months, the median PFS was 99.5 months, and OS was 157 months. CONCLUSIONS Non-cryopreserved HSCT is effective and safe. The long-term survival outcomes could be achieved by the shortening the duration of neutrophil and platelet engraftments and the complication rates are acceptable.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e938595"},"PeriodicalIF":1.1,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/f5/anntransplant-28-e938595.PMC9864439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10694964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and Relapse Settings: A Retrospective Study in China. 自体干细胞移植对原发性中枢神经系统淋巴瘤一线患者和复发患者的影响:一项中国回顾性研究
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2023-01-03 DOI: 10.12659/AOT.938467
Jing Liu, Haitao Wang, Xiaohong Li, Yamei Wu, Yuanyuan Ma, Zhenyang Gu, Fei Li, Meng Li, Jiayuan Guo, Yu Zhao, Quanshun Wang, Jian Bo, Wenrong Huang, Liping Dou, Yuanbo Liu, Daihong Liu, Xiaoxiong Wu, Chunji Gao

BACKGROUND Myeloablative chemotherapy supported by autologous stem cell transplantation (ASCT) is an option for primary central nervous system lymphoma (PCNSL) in both the relapse setting and as postremission consolidation, but the level of evidence in this field is still low. MATERIAL AND METHODS We retrospectively analyzed 47 HIV-negative PCNSL patients from 2010 to 2021. To assess the outcomes in patients undergoing ASCT. RESULTS Of the 47 patients, the median age was 51 (range, 21-77) years, and 28 (59.6%) were male. After induction, 33 (70.2%) patients achieved complete remission, and 6 (12.8%) patients achieved partial remission. At a median follow-up of 21.4 months (95% CI 8.86-33.95), the median progression-free survival (PFS) was 23.3 months (95% CI 14.87-31.73), and the 4-year PFS rate was 14.6%. The median overall survival (OS) time was 62.4 months (95% CI 41.93-82.87), and the 4-year OS rate was 71.5%. Among 20 patients who received ASCT (10 consolidation, 10 salvage), the 4-year PFS and 4-year OS rates were 57.3% and 71.2%, respectively. In the multivariate analysis, ASCT therapy (hazard ratio [HR] 0.16, P=0.016) and early remission (HR 0.12, p=0.003) were found to be independent prognostic factors for a longer PFS. Two treatment-related deaths occurred in patients with multiple relapses before ASCT. Pancytopenia and diarrhea were the most common adverse events. CONCLUSIONS ASCT offers potential long-term PFS with good tolerability for patients with PCNSL. Our retrospective cohort adds to the currently available literature and identifies disease status after induction as a significant factor affecting survival.

自体干细胞移植(ASCT)支持的清骨髓化疗是原发性中枢神经系统淋巴瘤(PCNSL)复发和缓解后巩固的一种选择,但该领域的证据水平仍然很低。材料和方法我们回顾性分析了2010年至2021年47例hiv阴性PCNSL患者。评估ASCT患者的预后。结果47例患者中位年龄51岁(21 ~ 77岁),男性28例(59.6%)。诱导后,33例(70.2%)患者完全缓解,6例(12.8%)患者部分缓解。中位随访21.4个月(95% CI 8.86-33.95),中位无进展生存期(PFS)为23.3个月(95% CI 14.87-31.73), 4年PFS率为14.6%。中位总生存期(OS)为62.4个月(95% CI 41.93-82.87), 4年OS率为71.5%。在20例接受ASCT的患者中(10例巩固,10例挽救),4年PFS和4年OS率分别为57.3%和71.2%。在多因素分析中,ASCT治疗(风险比[HR] 0.16, P=0.016)和早期缓解(风险比[HR] 0.12, P= 0.003)是延长PFS的独立预后因素。在ASCT前多次复发的患者中发生2例与治疗相关的死亡。全血细胞减少症和腹泻是最常见的不良反应。结论:ASCT为PCNSL患者提供了潜在的长期PFS,耐受性良好。我们的回顾性队列增加了目前可用的文献,并确定了诱导后的疾病状态是影响生存的重要因素。
{"title":"Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and Relapse Settings: A Retrospective Study in China.","authors":"Jing Liu,&nbsp;Haitao Wang,&nbsp;Xiaohong Li,&nbsp;Yamei Wu,&nbsp;Yuanyuan Ma,&nbsp;Zhenyang Gu,&nbsp;Fei Li,&nbsp;Meng Li,&nbsp;Jiayuan Guo,&nbsp;Yu Zhao,&nbsp;Quanshun Wang,&nbsp;Jian Bo,&nbsp;Wenrong Huang,&nbsp;Liping Dou,&nbsp;Yuanbo Liu,&nbsp;Daihong Liu,&nbsp;Xiaoxiong Wu,&nbsp;Chunji Gao","doi":"10.12659/AOT.938467","DOIUrl":"https://doi.org/10.12659/AOT.938467","url":null,"abstract":"<p><p>BACKGROUND Myeloablative chemotherapy supported by autologous stem cell transplantation (ASCT) is an option for primary central nervous system lymphoma (PCNSL) in both the relapse setting and as postremission consolidation, but the level of evidence in this field is still low. MATERIAL AND METHODS We retrospectively analyzed 47 HIV-negative PCNSL patients from 2010 to 2021. To assess the outcomes in patients undergoing ASCT. RESULTS Of the 47 patients, the median age was 51 (range, 21-77) years, and 28 (59.6%) were male. After induction, 33 (70.2%) patients achieved complete remission, and 6 (12.8%) patients achieved partial remission. At a median follow-up of 21.4 months (95% CI 8.86-33.95), the median progression-free survival (PFS) was 23.3 months (95% CI 14.87-31.73), and the 4-year PFS rate was 14.6%. The median overall survival (OS) time was 62.4 months (95% CI 41.93-82.87), and the 4-year OS rate was 71.5%. Among 20 patients who received ASCT (10 consolidation, 10 salvage), the 4-year PFS and 4-year OS rates were 57.3% and 71.2%, respectively. In the multivariate analysis, ASCT therapy (hazard ratio [HR] 0.16, P=0.016) and early remission (HR 0.12, p=0.003) were found to be independent prognostic factors for a longer PFS. Two treatment-related deaths occurred in patients with multiple relapses before ASCT. Pancytopenia and diarrhea were the most common adverse events. CONCLUSIONS ASCT offers potential long-term PFS with good tolerability for patients with PCNSL. Our retrospective cohort adds to the currently available literature and identifies disease status after induction as a significant factor affecting survival.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e938467"},"PeriodicalIF":1.1,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/a0/anntransplant-28-e938467.PMC9825020.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10606696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Condition of the Oral Cavity in Patients After Heart Transplantation: A Preliminary Report. 心脏移植术后患者口腔状况的初步报告。
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2022-12-23 DOI: 10.12659/AOT.937734
Katarzyna Olek, Agnieszka Kuczaj, Olaf Gruca, Marcin Olek, Marek Ochman, Piotr Przybyłowski, Marta Tanasiewicz

BACKGROUND The constant impairment of the immune system caused by lifelong use of immunosuppressive drugs in patients after heart transplantation has a significant impact on oral cavity health. The aim of this study was to analyze the health of the oral cavity in patients after heart transplantation, with particular regard to occurring pathogens. MATERIAL AND METHODS The study included 25 patients after heart transplantation. The research scheme was divided into 2 parts. The first part consisted of a survey on general health and oral hygiene habits. The second part of the examination consisted of an analysis of the health of the oral cavity: the mucosa, periodontium, and hard dental tissues. Particular attention was paid to PET (test for the presence of pathogens causing periodontitis/periimplantitis) and CAT (diagnostic test for the presence of Candida in the oral cavity), which are real-time PCR tests used to detect pathogens causing periodontitis and microorganisms present in oral candidiasis. RESULTS The conducted research and in-depth analysis of the results showed that the oral health condition in patients after heart transplantation is not satisfactory, regardless of the time that has elapsed since the surgery, sex, age, hygiene habits, or the type of immunosuppression used. The oral cavity of patients after heart transplantation is colonized with Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Candida albicans. CONCLUSIONS The cooperation of the dentist with the attending physician at each stage of the treatment should play an unquestionable role.

背景心脏移植术后患者终身使用免疫抑制药物导致的免疫系统持续受损对口腔健康有显著影响。本研究的目的是分析心脏移植后患者的口腔健康状况,特别是发生的病原体。材料与方法本研究纳入25例心脏移植患者。研究方案分为两部分。第一部分包括对一般健康和口腔卫生习惯的调查。检查的第二部分包括对口腔健康的分析:粘膜、牙周组织和硬牙组织。特别注意的是PET(检测引起牙周炎/种植周炎的病原体)和CAT(检测口腔中是否存在念珠菌的诊断试验),这是用于检测引起牙周炎的病原体和口腔念珠菌病中存在的微生物的实时PCR试验。结果对心脏移植术后患者的口腔健康状况进行了研究和深入分析,结果表明,无论术后时间、性别、年龄、卫生习惯或使用的免疫抑制剂类型如何,心脏移植术后患者的口腔健康状况都不令人满意。心脏移植后患者的口腔中定植有放线菌聚集菌、牙龈卟啉单胞菌、牙齿密螺旋体和白色念珠菌。结论在治疗的各个阶段,牙医师与主治医师的配合应发挥不容置疑的作用。
{"title":"Condition of the Oral Cavity in Patients After Heart Transplantation: A Preliminary Report.","authors":"Katarzyna Olek,&nbsp;Agnieszka Kuczaj,&nbsp;Olaf Gruca,&nbsp;Marcin Olek,&nbsp;Marek Ochman,&nbsp;Piotr Przybyłowski,&nbsp;Marta Tanasiewicz","doi":"10.12659/AOT.937734","DOIUrl":"https://doi.org/10.12659/AOT.937734","url":null,"abstract":"<p><p>BACKGROUND The constant impairment of the immune system caused by lifelong use of immunosuppressive drugs in patients after heart transplantation has a significant impact on oral cavity health. The aim of this study was to analyze the health of the oral cavity in patients after heart transplantation, with particular regard to occurring pathogens. MATERIAL AND METHODS The study included 25 patients after heart transplantation. The research scheme was divided into 2 parts. The first part consisted of a survey on general health and oral hygiene habits. The second part of the examination consisted of an analysis of the health of the oral cavity: the mucosa, periodontium, and hard dental tissues. Particular attention was paid to PET (test for the presence of pathogens causing periodontitis/periimplantitis) and CAT (diagnostic test for the presence of Candida in the oral cavity), which are real-time PCR tests used to detect pathogens causing periodontitis and microorganisms present in oral candidiasis. RESULTS The conducted research and in-depth analysis of the results showed that the oral health condition in patients after heart transplantation is not satisfactory, regardless of the time that has elapsed since the surgery, sex, age, hygiene habits, or the type of immunosuppression used. The oral cavity of patients after heart transplantation is colonized with Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Candida albicans. CONCLUSIONS The cooperation of the dentist with the attending physician at each stage of the treatment should play an unquestionable role.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 ","pages":"e937734"},"PeriodicalIF":1.1,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/9b/anntransplant-27-e937734.PMC9793640.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Potential Utility of Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte, and Neutrophil, Lymphocyte, and Platelet Ratios in Differential Diagnosis of Kidney Transplant Acute Rejection: A Retrospective, Propensity Score Matched Analysis. 中性粒细胞对淋巴细胞、血小板对淋巴细胞、中性粒细胞、淋巴细胞和血小板比率在肾移植急性排斥反应鉴别诊断中的潜在效用:回顾性倾向评分匹配分析。
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2022-12-20 DOI: 10.12659/AOT.937239
Aureliusz Kolonko, Tomasz Dwulit, Michał Skrzypek, Andrzej Więcek

BACKGROUND Acute kidney transplant rejection can negatively affect long-term graft function. The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio have been proposed as non-invasive predictors of acute rejection in stable kidney transplant recipients. The aim of this study was to validate the predictive value of these ratios, as well as neutrophil, lymphocyte, and platelet ratios in the diagnosis of acute rejection during the early post-transplant period. MATERIAL AND METHODS After propensity score matching, we compared 71 kidney recipients with biopsy-proven acute rejection with 71 patients without rejection and also subjects with different histologic types of rejection. All 3 types of blood cell count-derived ratios were calculated 6 and 3 days prior to biopsy and on the day of biopsy. RESULTS There were 15 patients with T cell-mediated rejection, 33 with vascular rejection, and 23 with antibody-mediated rejection. The values of all examined ratios did not differ between subgroups with and without rejection. However, at all post-transplant study time-points, patients with antibody-mediated rejection had significantly higher values of all analyzed ratios than subjects with other types of rejection. In multivariate regression models, higher values of blood cell count-derived ratios were independently associated with the occurrence of antibody-mediated rejection. CONCLUSIONS In the early post-transplant period, the values of neutrophil-to-lymphocyte, platelet-to-lymphocyte, and neutrophil, lymphocyte, and platelet ratios were similar in patients with and without an acute rejection episode, but significantly higher values were found in subjects with antibody-mediated rejection as compared with other types of rejection and those without rejection. High values of analyzed ratios in patients with satisfactory early kidney graft function may be helpful in selecting subjects with increased risk of subclinical antibody-mediated rejection.

背景:急性肾移植排斥反应会对移植物的长期功能产生负面影响。中性粒细胞与淋巴细胞的比率和血小板与淋巴细胞的比率已被提出作为稳定肾移植受者急性排斥反应的非侵入性预测指标。本研究的目的是验证这些比率以及中性粒细胞、淋巴细胞和血小板比率在移植后早期诊断急性排斥反应中的预测价值。材料和方法经过倾向评分匹配后,我们比较了71例活检证实急性排斥反应的肾受体和71例无排斥反应的肾受体以及不同组织学类型的排斥反应的肾受体。在活检前6天和3天以及活检当天计算所有3种类型的血细胞计数衍生比率。结果T细胞性排斥反应15例,血管性排斥反应33例,抗体性排斥反应23例。所有检查的比率值在有排斥反应和没有排斥反应的亚组之间没有差异。然而,在移植后的所有研究时间点,抗体介导的排斥反应患者的所有分析比率值都明显高于其他类型排斥反应的受试者。在多元回归模型中,较高的血细胞计数衍生比率值与抗体介导的排斥反应的发生独立相关。结论:在移植后早期,有和没有急性排斥反应的患者的中性粒细胞对淋巴细胞、血小板对淋巴细胞、中性粒细胞、淋巴细胞和血小板比值相似,但抗体介导的排斥反应明显高于其他类型的排斥反应和没有排斥反应的患者。在早期肾移植功能令人满意的患者中,较高的分析比率值可能有助于选择亚临床抗体介导的排斥反应风险增加的受试者。
{"title":"Potential Utility of Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte, and Neutrophil, Lymphocyte, and Platelet Ratios in Differential Diagnosis of Kidney Transplant Acute Rejection: A Retrospective, Propensity Score Matched Analysis.","authors":"Aureliusz Kolonko,&nbsp;Tomasz Dwulit,&nbsp;Michał Skrzypek,&nbsp;Andrzej Więcek","doi":"10.12659/AOT.937239","DOIUrl":"https://doi.org/10.12659/AOT.937239","url":null,"abstract":"<p><p>BACKGROUND Acute kidney transplant rejection can negatively affect long-term graft function. The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio have been proposed as non-invasive predictors of acute rejection in stable kidney transplant recipients. The aim of this study was to validate the predictive value of these ratios, as well as neutrophil, lymphocyte, and platelet ratios in the diagnosis of acute rejection during the early post-transplant period. MATERIAL AND METHODS After propensity score matching, we compared 71 kidney recipients with biopsy-proven acute rejection with 71 patients without rejection and also subjects with different histologic types of rejection. All 3 types of blood cell count-derived ratios were calculated 6 and 3 days prior to biopsy and on the day of biopsy. RESULTS There were 15 patients with T cell-mediated rejection, 33 with vascular rejection, and 23 with antibody-mediated rejection. The values of all examined ratios did not differ between subgroups with and without rejection. However, at all post-transplant study time-points, patients with antibody-mediated rejection had significantly higher values of all analyzed ratios than subjects with other types of rejection. In multivariate regression models, higher values of blood cell count-derived ratios were independently associated with the occurrence of antibody-mediated rejection. CONCLUSIONS In the early post-transplant period, the values of neutrophil-to-lymphocyte, platelet-to-lymphocyte, and neutrophil, lymphocyte, and platelet ratios were similar in patients with and without an acute rejection episode, but significantly higher values were found in subjects with antibody-mediated rejection as compared with other types of rejection and those without rejection. High values of analyzed ratios in patients with satisfactory early kidney graft function may be helpful in selecting subjects with increased risk of subclinical antibody-mediated rejection.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 ","pages":"e937239"},"PeriodicalIF":1.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/a9/anntransplant-27-e937239.PMC9789674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10480047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Pancreatitis in Patients After Liver Transplantation. 肝移植术后急性胰腺炎的研究。
IF 1.1 4区 医学 Q3 SURGERY Pub Date : 2022-12-16 DOI: 10.12659/AOT.938114
Alzbeta Hujova, Peter Macinga, Jana Jarosova, Jiri Fronek, Pavel Taimr, Julius Spicak, Tomas Hucl

BACKGROUND Acute pancreatitis (AP) is a relatively rare but serious complication that can occur after organ transplantation. MATERIAL AND METHODS The aim of this study was to evaluate the incidence, potential risk factors, and course of AP in patients following liver transplantation at a single large-volume transplant center. RESULTS Out of a total of 1850 transplanted patients, 49 (2.8%) were diagnosed with AP. Of this group, 37 (75.5%) had a mild form of AP and 12 (24.5%) had a severe form of AP. The mortality rate was 10% overall and 42% in the group of patients with severe AP. An early form of AP (<30 days from transplantation) occurred in 13 patients (26.5%), most of whom presented with severe AP (10 patients, 76.9%); 4 patients died (40%). A late form of AP was diagnosed in 36 patients (73.5%), most of whom had mild AP (34 patients, 94.4%); 1 of 2 patients with severe AP died. The most common AP etiologies were post-ERCP (38.8%), idiopathic (34.7%), and postoperative (18.4%). Chronic HBV infection was a risk factor for development of AP (P=0.01). CONCLUSIONS AP in liver transplant recipients was more frequent and more severe than in the general population. This unfavorable course was associated with the occurrence of AP in the early post-transplant period. Liver transplantation due to complications of HBV infection was a risk factor for the development of AP.

背景:急性胰腺炎(AP)是器官移植后发生的一种相对罕见但严重的并发症。材料和方法本研究的目的是评估单个大容量肝移植中心肝移植术后患者AP的发生率、潜在危险因素和病程。结果:在总共1850例移植患者中,49例(2.8%)被诊断为AP,其中37例(75.5%)为轻度AP, 12例(24.5%)为重度AP。总体死亡率为10%,重度AP组死亡率为42%。
{"title":"Acute Pancreatitis in Patients After Liver Transplantation.","authors":"Alzbeta Hujova,&nbsp;Peter Macinga,&nbsp;Jana Jarosova,&nbsp;Jiri Fronek,&nbsp;Pavel Taimr,&nbsp;Julius Spicak,&nbsp;Tomas Hucl","doi":"10.12659/AOT.938114","DOIUrl":"https://doi.org/10.12659/AOT.938114","url":null,"abstract":"<p><p>BACKGROUND Acute pancreatitis (AP) is a relatively rare but serious complication that can occur after organ transplantation. MATERIAL AND METHODS The aim of this study was to evaluate the incidence, potential risk factors, and course of AP in patients following liver transplantation at a single large-volume transplant center. RESULTS Out of a total of 1850 transplanted patients, 49 (2.8%) were diagnosed with AP. Of this group, 37 (75.5%) had a mild form of AP and 12 (24.5%) had a severe form of AP. The mortality rate was 10% overall and 42% in the group of patients with severe AP. An early form of AP (<30 days from transplantation) occurred in 13 patients (26.5%), most of whom presented with severe AP (10 patients, 76.9%); 4 patients died (40%). A late form of AP was diagnosed in 36 patients (73.5%), most of whom had mild AP (34 patients, 94.4%); 1 of 2 patients with severe AP died. The most common AP etiologies were post-ERCP (38.8%), idiopathic (34.7%), and postoperative (18.4%). Chronic HBV infection was a risk factor for development of AP (P=0.01). CONCLUSIONS AP in liver transplant recipients was more frequent and more severe than in the general population. This unfavorable course was associated with the occurrence of AP in the early post-transplant period. Liver transplantation due to complications of HBV infection was a risk factor for the development of AP.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 ","pages":"e938114"},"PeriodicalIF":1.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/11/anntransplant-27-e938114.PMC9764668.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10841294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Annals of Transplantation
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1