Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.10.009
Jin Zhang, Xu-Tao Chen, Gang Huang, J. Qiu, Guodong Chen, Lizhong Chen, J. Fei
Objective To explore the clinical and prognostic features of lipoprotein glomerulopathy (LPG) in renal allografts. Methods Retrospective analysis was performed for two case of LPG in renal allografts. The onset time was 6 and 9 years after living transplantation respectively. Initial symptoms included proteinuria and hypoproteinemia. Color Doppler ultrasound showed an enlarged graft size and greater parenchymal echogenicity. One patient had hyperlipemia and elevated apolipoprotein E (ApoE). Methylprednisolone pulse was offered with an early control of hyperlipidaemia and proteinuria by fenofibrate and angiotensin-converting enzyme inhibitors (ACEIs). Yet it had no effect on graft function. The definite diagnosis was made by graft biopsy. Pathological examination indicated non-homogeneous lipid deposition in glomerular capillary, glomerular sclerosis, mesangial hypercellularity and tubular atrophy. Results During a follow-up period of 8 and 10 years post-transplantation, two cases eventually lost their grafts within 2 and 1 year after biopsy respectively. With long-term dietary control and drug therapy, regular dialysis continued and both awaited a second transplantation. Conclusions LPG is generally steroid-resistant and refractory in renal allografts. And routine biopsy is recommended for patients with a high risk of occurrence. Early controls of hyperlipemia and hypoproteinemia and other risk factors should be also properly managed. Key words: Kidney transplantation; Renal needle biopsy; Apolipoprotein E
{"title":"Clinicaland prognostic features of lipoprotein glomerulopathy in renal allografts","authors":"Jin Zhang, Xu-Tao Chen, Gang Huang, J. Qiu, Guodong Chen, Lizhong Chen, J. Fei","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.10.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.10.009","url":null,"abstract":"Objective \u0000To explore the clinical and prognostic features of lipoprotein glomerulopathy (LPG) in renal allografts. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis was performed for two case of LPG in renal allografts. The onset time was 6 and 9 years after living transplantation respectively. Initial symptoms included proteinuria and hypoproteinemia. Color Doppler ultrasound showed an enlarged graft size and greater parenchymal echogenicity. One patient had hyperlipemia and elevated apolipoprotein E (ApoE). Methylprednisolone pulse was offered with an early control of hyperlipidaemia and proteinuria by fenofibrate and angiotensin-converting enzyme inhibitors (ACEIs). Yet it had no effect on graft function. The definite diagnosis was made by graft biopsy. Pathological examination indicated non-homogeneous lipid deposition in glomerular capillary, glomerular sclerosis, mesangial hypercellularity and tubular atrophy. \u0000 \u0000 \u0000Results \u0000During a follow-up period of 8 and 10 years post-transplantation, two cases eventually lost their grafts within 2 and 1 year after biopsy respectively. With long-term dietary control and drug therapy, regular dialysis continued and both awaited a second transplantation. \u0000 \u0000 \u0000Conclusions \u0000LPG is generally steroid-resistant and refractory in renal allografts. And routine biopsy is recommended for patients with a high risk of occurrence. Early controls of hyperlipemia and hypoproteinemia and other risk factors should be also properly managed. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Renal needle biopsy; Apolipoprotein E","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85828993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.10.011
Jingyuan Lu, X. Hong, Y. Zhuang, Xiuzhen Yan, Jie Shi, Yamei Chen, Jia-sheng Hu
Objective To observe the efficacy and safety of intensive cladribine-based conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with major thalassemia. Methods Retrospective analysis was performed for the clinical data of 12 children with major thalassemia undergoing allo-HSCT from March 2017 to July 2018. All of them were diagnosed definitely and the median age at transplantation was 5 years (range: 2-13 years), including HSCT from HLA-matched unrelated donor (n=8), HLA8/10-matched unrelated donor (n=1), HLA-matched sibing donor (n=2) and haploidentical donor (n=1). They received a new intensive conditioning regimen of cyclophosphamide (CTX), cladribine, busulfan (Bu) and antithymocytic globulin. The median doses of mononuclear cell (MNC) and CD34 positive cell were 10.97×108/kg (range: 5.72-12.49×108/kg) and 12.2×106/kg (range: 6.7-22×106/kg). Graft-versus-host disease (GVHD) was prevented by cyclosporine A (CSA), methotrexate (MTX) and mycophenolate mofetil (MMF). Results Engraftment succeeded (n=11) and failed (n=1). The median time of neutrophil and platelet engraftment was 11 days (range: 8-17 days) and 13 days (range: 8-37 days) respectively. There were grade II acute GVHD (n=6) and grade IV intestinal acute GVHD (n=1) at 35 days post-transplantation. The latter one finally died of severe infection at 70 days post-transplantation. Two recipients of DLI developed limited chronic GVHD. Three cases (25%) developed cytomegaloviremia. None suffered from severe transplantation-related complications, such as cytomegalovirus diseases, hepatic veno-occlusive disease (HVOD), hemorrhagic cystitis or septicemia, etc. The median follow-up time was 15(8-18) months. Among 11 survivors, ten became transfusion-independent. Conclusions Cladribine-based conditioning regimen is both safe and effective for allo-HSCT in children with major thalassemia. However, vigorous immunosuppression may increase the risks of infection and viral activation after transplantation. Key words: Hematopoietic stem cell transplantation; Thalassemia; Pretreatment
{"title":"Efficacy and security of a new cladribine-based conditioning regimen for allogeneic hematopoietic stem cell transplantation in children with major thalassemia","authors":"Jingyuan Lu, X. Hong, Y. Zhuang, Xiuzhen Yan, Jie Shi, Yamei Chen, Jia-sheng Hu","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.10.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.10.011","url":null,"abstract":"Objective \u0000To observe the efficacy and safety of intensive cladribine-based conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with major thalassemia. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis was performed for the clinical data of 12 children with major thalassemia undergoing allo-HSCT from March 2017 to July 2018. All of them were diagnosed definitely and the median age at transplantation was 5 years (range: 2-13 years), including HSCT from HLA-matched unrelated donor (n=8), HLA8/10-matched unrelated donor (n=1), HLA-matched sibing donor (n=2) and haploidentical donor (n=1). They received a new intensive conditioning regimen of cyclophosphamide (CTX), cladribine, busulfan (Bu) and antithymocytic globulin. The median doses of mononuclear cell (MNC) and CD34 positive cell were 10.97×108/kg (range: 5.72-12.49×108/kg) and 12.2×106/kg (range: 6.7-22×106/kg). Graft-versus-host disease (GVHD) was prevented by cyclosporine A (CSA), methotrexate (MTX) and mycophenolate mofetil (MMF). \u0000 \u0000 \u0000Results \u0000Engraftment succeeded (n=11) and failed (n=1). The median time of neutrophil and platelet engraftment was 11 days (range: 8-17 days) and 13 days (range: 8-37 days) respectively. There were grade II acute GVHD (n=6) and grade IV intestinal acute GVHD (n=1) at 35 days post-transplantation. The latter one finally died of severe infection at 70 days post-transplantation. Two recipients of DLI developed limited chronic GVHD. Three cases (25%) developed cytomegaloviremia. None suffered from severe transplantation-related complications, such as cytomegalovirus diseases, hepatic veno-occlusive disease (HVOD), hemorrhagic cystitis or septicemia, etc. The median follow-up time was 15(8-18) months. Among 11 survivors, ten became transfusion-independent. \u0000 \u0000 \u0000Conclusions \u0000Cladribine-based conditioning regimen is both safe and effective for allo-HSCT in children with major thalassemia. However, vigorous immunosuppression may increase the risks of infection and viral activation after transplantation. \u0000 \u0000 \u0000Key words: \u0000Hematopoietic stem cell transplantation; Thalassemia; Pretreatment","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77328965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.10.010
Long Zhang, Jiangqiao Zhou, T. Qiu, Z. Chen, Jilin Zou
Objective To explore the diagnosis and treatment of BKV nephropathy after renal transplantation. Methods A total of 62 patients with progressive creatinine elevation were routinely examined by blood and urine BKV-DNA. And 21 patients with positive results underwent graft biopsies for confirming a diagnosis. Results Among 21 cases of BKV infection, 20 cases received leflunomide in replacing mycophenolate mofetil (MMF) and a lower dose of tacrolimus. One case with urine (-) & blood (+ ) received sirolimus in replacing tacrolimus and a lower dose of MMF. Among 11 cases with urine (+ ) and blood (-), urinary BKV-DNA turned negative & creatinine decreased markedly (n=4), urinary BKV-DNA load decreased & creatinine stablized (n=4), death from pulmonary infection with hepatic & renal failure (n=1), urine BKV-DNA load decreased & creatine increased (n=1), BKV–DNA load was not re-examined in 1 case of acute rejection and hydronephrosis with elevated creatine; Among 9 cases with urine (+ ) & blood (+ ), blood BKV-DNA turned negative with urinary BKV-DNA load & creatine decreased (n=6), blood BKV-DNA load decreased & creatine stablized (n=2) and no re-examination with a stable level of creatine (n=1); One case with urine (-) & blood (+ ) was not timely treated and ultimately leading to graft loss after an onset of acute rejection. Conclusions BKV nephropathy may be effectively treated by decreasing immunosuppressive intensity. However, clinicians should stay on a high alert for acute rejection due to an excessive reduction of immunosuppressive agents. Key words: Kidney transplantation; BK Virus; Acute rejection
{"title":"Diagnosis and treatment of BK virus-associated nephropathy after renal transplantation","authors":"Long Zhang, Jiangqiao Zhou, T. Qiu, Z. Chen, Jilin Zou","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.10.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.10.010","url":null,"abstract":"Objective \u0000To explore the diagnosis and treatment of BKV nephropathy after renal transplantation. \u0000 \u0000 \u0000Methods \u0000A total of 62 patients with progressive creatinine elevation were routinely examined by blood and urine BKV-DNA. And 21 patients with positive results underwent graft biopsies for confirming a diagnosis. \u0000 \u0000 \u0000Results \u0000Among 21 cases of BKV infection, 20 cases received leflunomide in replacing mycophenolate mofetil (MMF) and a lower dose of tacrolimus. One case with urine (-) & blood (+ ) received sirolimus in replacing tacrolimus and a lower dose of MMF. Among 11 cases with urine (+ ) and blood (-), urinary BKV-DNA turned negative & creatinine decreased markedly (n=4), urinary BKV-DNA load decreased & creatinine stablized (n=4), death from pulmonary infection with hepatic & renal failure (n=1), urine BKV-DNA load decreased & creatine increased (n=1), BKV–DNA load was not re-examined in 1 case of acute rejection and hydronephrosis with elevated creatine; Among 9 cases with urine (+ ) & blood (+ ), blood BKV-DNA turned negative with urinary BKV-DNA load & creatine decreased (n=6), blood BKV-DNA load decreased & creatine stablized (n=2) and no re-examination with a stable level of creatine (n=1); One case with urine (-) & blood (+ ) was not timely treated and ultimately leading to graft loss after an onset of acute rejection. \u0000 \u0000 \u0000Conclusions \u0000BKV nephropathy may be effectively treated by decreasing immunosuppressive intensity. However, clinicians should stay on a high alert for acute rejection due to an excessive reduction of immunosuppressive agents. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; BK Virus; Acute rejection","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86547763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.10.003
P. Sun, Haoyu Chen, Zhixiang Jia, Muqing Liu, Yan Qin, Yuan Dong, X. Hao, Huafeng Zhou
Objective Remuzzi scoring system is utilized for assessing the degree of renal tissue damage in donors with hypertensive cerebral hemorrhage and donors with brain trauma after cardiac death. To explore the prognosis of hypertensive cerebral hemorrhage donor kidney in renal transplant recipients. Methods The kidney donated by DCD between January 1, 2016 to June 1, 2018 were retrospectively reviewed. Pathological biopsy was performed before transplantation and hematoxylin-eosin (HE) staining after sectioning. The degree of renal tissue lesions was evaluated by Remuzzi scoring system. According to the source of donor kidney, they were divided into two groups of donors with heart failure due to hypertensive cerebral hemorrhage (HCH) and those with brain trauma (BT). Both groups of donor kidneys were preserved by low-temperature machine perfusion. The immunosuppressive regimen was identical in both groups. The prognosis of two groups was compared by serum creatinine (Scr) at Month 1/6/12 post-operation and cumulative graft survival rate over a follow-up period of 12-36 months. Results The renal Remuzzi score of HCH donors was significantly higher than that of BT donors. The maximal creatinine clearance rate was significantly lower than that of BT donors [(86.8±27.8) vs (115.4±23.2) ml/min, P<0.05]. At 1/6/12 months post-transplantation, serum creatinine levels were (76.1±18.5), (72.4±16.2) and (71.4±16.8) μmol/L in BT group and (160.3±33.4), (154.3±32.6) and (146.4±29.1) μmol/L in HCH group. The SCr in BT group at 1/6/12 months was lower than that in HCH group (P<0.05). Kaplan-meier analysis showed no significant inter-group difference in graft survival between two groups over a follow-up period of 12 to 36 months (Log-Rank test, P=0.485). Conclusions No significant difference exists in short-term survival rate of kidneys from HCH and BT donors. The recipients of HCH donor's kidney have higher serum creatinine levels than those of BT donors. Selective use of kidney transplants in patients with cardiac death caused by HCH may greatly reduce the waste of donor kidney and improve the quality-of-life of patients with end-stage renal disease. Key words: Kidney transplantation; Hypertension; Prognosis
{"title":"Evaluations of kidney from hypertensive cerebral hemorrhage donor and prognosis of renal transplantation","authors":"P. Sun, Haoyu Chen, Zhixiang Jia, Muqing Liu, Yan Qin, Yuan Dong, X. Hao, Huafeng Zhou","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.10.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.10.003","url":null,"abstract":"Objective \u0000Remuzzi scoring system is utilized for assessing the degree of renal tissue damage in donors with hypertensive cerebral hemorrhage and donors with brain trauma after cardiac death. To explore the prognosis of hypertensive cerebral hemorrhage donor kidney in renal transplant recipients. \u0000 \u0000 \u0000Methods \u0000The kidney donated by DCD between January 1, 2016 to June 1, 2018 were retrospectively reviewed. Pathological biopsy was performed before transplantation and hematoxylin-eosin (HE) staining after sectioning. The degree of renal tissue lesions was evaluated by Remuzzi scoring system. According to the source of donor kidney, they were divided into two groups of donors with heart failure due to hypertensive cerebral hemorrhage (HCH) and those with brain trauma (BT). Both groups of donor kidneys were preserved by low-temperature machine perfusion. The immunosuppressive regimen was identical in both groups. The prognosis of two groups was compared by serum creatinine (Scr) at Month 1/6/12 post-operation and cumulative graft survival rate over a follow-up period of 12-36 months. \u0000 \u0000 \u0000Results \u0000The renal Remuzzi score of HCH donors was significantly higher than that of BT donors. The maximal creatinine clearance rate was significantly lower than that of BT donors [(86.8±27.8) vs (115.4±23.2) ml/min, P<0.05]. At 1/6/12 months post-transplantation, serum creatinine levels were (76.1±18.5), (72.4±16.2) and (71.4±16.8) μmol/L in BT group and (160.3±33.4), (154.3±32.6) and (146.4±29.1) μmol/L in HCH group. The SCr in BT group at 1/6/12 months was lower than that in HCH group (P<0.05). Kaplan-meier analysis showed no significant inter-group difference in graft survival between two groups over a follow-up period of 12 to 36 months (Log-Rank test, P=0.485). \u0000 \u0000 \u0000Conclusions \u0000No significant difference exists in short-term survival rate of kidneys from HCH and BT donors. The recipients of HCH donor's kidney have higher serum creatinine levels than those of BT donors. Selective use of kidney transplants in patients with cardiac death caused by HCH may greatly reduce the waste of donor kidney and improve the quality-of-life of patients with end-stage renal disease. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Hypertension; Prognosis","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77813452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.09.005
Ling-ling Wei, Shi Jing, Feng Tianhang, Chunyou Lai, Zhang Tianying, Yu-tong Yao, S. Deng, Xiaolun Huang
Objective To further observe the efficacy of combined transplantation of islet and bone marrow mesenchymal stem cells (BMSC) in diabetic rats, PET-CT was used to trace cells in vivo to determine the homing and distribution of cells in vivo. Methods Streptozotocin (STZ)was used to construct a rat model of diabetes mellitus. BMSC could be isolated and cultured by full adherence method; islets were isolated by collagenase; Islets and BMSC were labeled with 18F-FDG in vitro. Diabetic rats were randomly divided into 4 groups, 15 rats in each group: A, Control group; B, Stem cell transplantation group; C, Islet Transplantation group; D, Combined transplantation group, a total of four groups, all transplanted through portal vein, PET-CT tracing the distribution of cells transplanted into the body.7 days after transplantation, the livers of each group were taken, and the homing and distribution of transplanted cells were detected by immunofluorescent staining.The SUV was calculated by the analysis of variance of random block, and the difference between groups was compared by t-test. Results PET-CT results showed that BMSC were mainly distributed uniformly in the right liver, and the islets of the pancreas were mainly clustered in terminal branches of hepatic portal vein, and BMSC were around the islets of pancreas, but there was no obvious development in the liver of the control group. Conclusions PET-CT can directly reveal the distribution of islets and BMSC in liver after transplantation through portal vein. Key words: Islet transplantation; Bone marrow mesenchymal stem cell; Positron emission tomography and computed tomography
{"title":"PET-CT tracing and fluorescence imaging to monitor the colonization and distribution of combined transplantation of islets and BMSC","authors":"Ling-ling Wei, Shi Jing, Feng Tianhang, Chunyou Lai, Zhang Tianying, Yu-tong Yao, S. Deng, Xiaolun Huang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.09.005","url":null,"abstract":"Objective \u0000To further observe the efficacy of combined transplantation of islet and bone marrow mesenchymal stem cells (BMSC) in diabetic rats, PET-CT was used to trace cells in vivo to determine the homing and distribution of cells in vivo. \u0000 \u0000 \u0000Methods \u0000Streptozotocin (STZ)was used to construct a rat model of diabetes mellitus. BMSC could be isolated and cultured by full adherence method; islets were isolated by collagenase; Islets and BMSC were labeled with 18F-FDG in vitro. Diabetic rats were randomly divided into 4 groups, 15 rats in each group: A, Control group; B, Stem cell transplantation group; C, Islet Transplantation group; D, Combined transplantation group, a total of four groups, all transplanted through portal vein, PET-CT tracing the distribution of cells transplanted into the body.7 days after transplantation, the livers of each group were taken, and the homing and distribution of transplanted cells were detected by immunofluorescent staining.The SUV was calculated by the analysis of variance of random block, and the difference between groups was compared by t-test. \u0000 \u0000 \u0000Results \u0000PET-CT results showed that BMSC were mainly distributed uniformly in the right liver, and the islets of the pancreas were mainly clustered in terminal branches of hepatic portal vein, and BMSC were around the islets of pancreas, but there was no obvious development in the liver of the control group. \u0000 \u0000 \u0000Conclusions \u0000PET-CT can directly reveal the distribution of islets and BMSC in liver after transplantation through portal vein. \u0000 \u0000 \u0000Key words: \u0000Islet transplantation; Bone marrow mesenchymal stem cell; Positron emission tomography and computed tomography","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77768210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.09.004
Dan-zhi Wang, Yang Li, Ying Wang, Jin Zheng, W. Xue, Xiaoming Ding
Objective Engineer a scaffold with mesenchymal stem cells and small intestinal submucosal to evaluate the effect of islet transplantation in diabetic rats. Methods MSC and pancreatic islets were isolated from Sprague-Dawley rats, and SIS was isolated from Bamei pigs. MSC were seeded on the SIS to construct MSC-SIS scaffold. The STZ-induced diabetic rats were divided into three groups: islets, SIS, and MSC-SIS. The expressions of insulin and CD31 were detected by immunofluorescence on the 14th day after transplantation, and serum cytokines were detected by protein microarray.One-way ANOVA was used to compare the transplantation effect of each group. Results In MSC-SIS group, the expressions of insulin and CD31 were significantly higher than those in the other two groups. Cytokines of VEGFA were increased while TNF-α, IFN-γ and IL-6 decreased, showing a significant difference (P<0.05). These results suggest that MSC-SIS scaffold significantly improve graft function and promote the expression of insulin and CD31, which may be related to the angiogenesis and anti-inflammatory effects of MSC. Conclusions Mesenchymal stem cells combined with intestinal submucosal scaffold can improve the effect of islet transplantation and provide a new method for the treatment of diabetes. Key words: Islet transplantation; Mesenchymal stem cells; Small intestine; Stent
{"title":"Stndy on diabetic rat therapy by islet transplantation with rat mesenchymal stem cells and scaffold of pig small intestinal submucosal","authors":"Dan-zhi Wang, Yang Li, Ying Wang, Jin Zheng, W. Xue, Xiaoming Ding","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.09.004","url":null,"abstract":"Objective \u0000Engineer a scaffold with mesenchymal stem cells and small intestinal submucosal to evaluate the effect of islet transplantation in diabetic rats. \u0000 \u0000 \u0000Methods \u0000MSC and pancreatic islets were isolated from Sprague-Dawley rats, and SIS was isolated from Bamei pigs. MSC were seeded on the SIS to construct MSC-SIS scaffold. The STZ-induced diabetic rats were divided into three groups: islets, SIS, and MSC-SIS. The expressions of insulin and CD31 were detected by immunofluorescence on the 14th day after transplantation, and serum cytokines were detected by protein microarray.One-way ANOVA was used to compare the transplantation effect of each group. \u0000 \u0000 \u0000Results \u0000In MSC-SIS group, the expressions of insulin and CD31 were significantly higher than those in the other two groups. Cytokines of VEGFA were increased while TNF-α, IFN-γ and IL-6 decreased, showing a significant difference (P<0.05). These results suggest that MSC-SIS scaffold significantly improve graft function and promote the expression of insulin and CD31, which may be related to the angiogenesis and anti-inflammatory effects of MSC. \u0000 \u0000 \u0000Conclusions \u0000Mesenchymal stem cells combined with intestinal submucosal scaffold can improve the effect of islet transplantation and provide a new method for the treatment of diabetes. \u0000 \u0000 \u0000Key words: \u0000Islet transplantation; Mesenchymal stem cells; Small intestine; Stent","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90000653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.09.007
Xue Li, Jinsong Chen, D. Cheng, K. Xie, X. Ni, J. Wen
Objective To evaluate the efficacy and safety of bortezomib in kidney transplant recipients with chronic active antibody-mediated rejection (cABMR). Methods A retrospective study wad conducted in patients(n=136)fulfilling the Banff 2017 criteria for cABMR from January 2004 to July 2017, including 29 patients bortezomib group and 97 patients in control group. Identified cABMR patients were dichotomized into bortezomib and control groups with a 1∶1 match using the propensity score matching method. The primary outcome was initiation of replacement therapy or an estimated glomerular filtration rate(eGFR)declined to <15 ml·min-1·(1.73m2)-1. The prognosis and adverse reactions of two groups were analyzed and evaluated. Results No significant inter-group differences existed in age, sex ratio, immunosuppressive regimen, allograft age, serum creatinine, eGFR, urine protein, serum albumin, hemoglobin or HCV positive rate(all P>0.05). There were no significant inter-group differences in Banff scores (g, i, t, v, ah, mm, ci, ct, cv, ptc, c4d, all P>0.05). The median survival for bortezomib group and control group was 40.7 months and 36.9 months respectively. No statistically significant difference in graft survival between the two groups was observed(P=0.83), even after propensity score adjustment(P=0.29). The incidence of nausea, diarrhea and thrombocytopenia in bortezomib group was higher than those in control group (P<0.05). Conclusions Bortezomib does not seem to improve the prognosis of cABMR while is associated with higher incidence of adverse reactions. Key words: Kidney transplantation; Graft rejection; Prognosis; Adverse reaction
{"title":"Bortezomib in chronic active antibody-mediated rejection: a single center experience","authors":"Xue Li, Jinsong Chen, D. Cheng, K. Xie, X. Ni, J. Wen","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.09.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.09.007","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of bortezomib in kidney transplant recipients with chronic active antibody-mediated rejection (cABMR). \u0000 \u0000 \u0000Methods \u0000A retrospective study wad conducted in patients(n=136)fulfilling the Banff 2017 criteria for cABMR from January 2004 to July 2017, including 29 patients bortezomib group and 97 patients in control group. Identified cABMR patients were dichotomized into bortezomib and control groups with a 1∶1 match using the propensity score matching method. The primary outcome was initiation of replacement therapy or an estimated glomerular filtration rate(eGFR)declined to <15 ml·min-1·(1.73m2)-1. The prognosis and adverse reactions of two groups were analyzed and evaluated. \u0000 \u0000 \u0000Results \u0000No significant inter-group differences existed in age, sex ratio, immunosuppressive regimen, allograft age, serum creatinine, eGFR, urine protein, serum albumin, hemoglobin or HCV positive rate(all P>0.05). There were no significant inter-group differences in Banff scores (g, i, t, v, ah, mm, ci, ct, cv, ptc, c4d, all P>0.05). The median survival for bortezomib group and control group was 40.7 months and 36.9 months respectively. No statistically significant difference in graft survival between the two groups was observed(P=0.83), even after propensity score adjustment(P=0.29). The incidence of nausea, diarrhea and thrombocytopenia in bortezomib group was higher than those in control group (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Bortezomib does not seem to improve the prognosis of cABMR while is associated with higher incidence of adverse reactions. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Graft rejection; Prognosis; Adverse reaction","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73758818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.09.006
Zhijian Yang, Shichen Zhang, Yanfeng Wang
Objective The epidemiological investigation of donor infection and the investigation of donor-derived infection(DDI)events in kidney transplantation to provide a basis for the prevention and treatment of donor infection and donor-derived infection events. Methods We retrospectively reviewed 170 donors and corresponding 316 kidney recipients between January 2014 with December 2017, pre-harvest blood, sputum, urine positive and negative culture were systematically recorded. We also collected donors/recipients demographics, transplant characteristics and recipients infection data within one month and focused on patient data of DDI events. Outcomes were followed up 6 months after surgery. Results Infection rate in 170 donors was 67.6 %, the positive rate of Gram-negative bacteria, Gram-positive bacteria and fungal were 48.3 %, 41.2 % and 10.4 %. Nine of 170 donors were DDI(5.29 %). Positive blood culture, urine culture and donor age were independent risk factors for DDI. Conclusions The incidence of donor infection is high. Although a few DDI events occur, the survival rate decreased. The positive blood culture and urine culture were important risk factors for the occurrence of DDI events. Therefore, it is necessary to focus on the monitoring of some high-risk strains and donors infected by high-risk infection sites. Key words: Renal transplantation; Infection; Epidemiology; Risk factor
{"title":"170donors infection distribution and risk factor analysis of donor-derived infection in kidney transplantation","authors":"Zhijian Yang, Shichen Zhang, Yanfeng Wang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.09.006","url":null,"abstract":"Objective \u0000The epidemiological investigation of donor infection and the investigation of donor-derived infection(DDI)events in kidney transplantation to provide a basis for the prevention and treatment of donor infection and donor-derived infection events. \u0000 \u0000 \u0000Methods \u0000We retrospectively reviewed 170 donors and corresponding 316 kidney recipients between January 2014 with December 2017, pre-harvest blood, sputum, urine positive and negative culture were systematically recorded. We also collected donors/recipients demographics, transplant characteristics and recipients infection data within one month and focused on patient data of DDI events. Outcomes were followed up 6 months after surgery. \u0000 \u0000 \u0000Results \u0000Infection rate in 170 donors was 67.6 %, the positive rate of Gram-negative bacteria, Gram-positive bacteria and fungal were 48.3 %, 41.2 % and 10.4 %. Nine of 170 donors were DDI(5.29 %). Positive blood culture, urine culture and donor age were independent risk factors for DDI. \u0000 \u0000 \u0000Conclusions \u0000The incidence of donor infection is high. Although a few DDI events occur, the survival rate decreased. The positive blood culture and urine culture were important risk factors for the occurrence of DDI events. Therefore, it is necessary to focus on the monitoring of some high-risk strains and donors infected by high-risk infection sites. \u0000 \u0000 \u0000Key words: \u0000Renal transplantation; Infection; Epidemiology; Risk factor","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90818625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.0254-1785.2019.09.008
Wei Chen, A. Gu, H. Ding, Yongxiang Yi, Guang‐shun Yang
Objective To analyze many indicators during perioperative period of liver transplantation in patients with end-stage liver disease, only to seek related factors that can accurately predict short-term(≤three months)outcome. Methods We analyzed retrospectively clinical data of consecutive patients with end-stage liver diseases undergone liver transplantation in a single treatment center. Logistic regression analysis was used to analyze the perioperative indicators including recipient gender, age, body mass index, preoperative serum albumin level, serum sodium concentration, urea nitrogen level and donor-recipient blood group, et al. Correlated factors were analyzed by the method of multivariate logistic regression. Statistical processing package was SAS 9.1.3 soft. The difference was statistically significant with P<0.05. Results 18/165 patients died within 3 months after transplantation(mortality rate: 10.9 %). According to the result of univariate analysis, the indicators correlated with early mortality which were statistically significant were preoperative serum sodium, blood urea nitrogen, PT-INR, CTP score, MELD score and MELD-Na score. On the base of the result of Logistic multiple regression. However, only MELD-Na score was associated with 3 months prognosis(P=0.001, β=-2.510, OR=0.088, 95 % CI=0.037~0.349). Conclusions Preoperative MELD-Na score is an independent risk factor for short-term survival in patients with end-stage liver disease. Higher MELD-Na score is, the early mortality is higher. Key words: Liver transplantation; Prognosis; Risk factor; Multiplicity analysis
{"title":"Multivariate analysis of short-term prognosis of liver transplantation in patients with end-stage liver disease","authors":"Wei Chen, A. Gu, H. Ding, Yongxiang Yi, Guang‐shun Yang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.09.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.09.008","url":null,"abstract":"Objective \u0000To analyze many indicators during perioperative period of liver transplantation in patients with end-stage liver disease, only to seek related factors that can accurately predict short-term(≤three months)outcome. \u0000 \u0000 \u0000Methods \u0000We analyzed retrospectively clinical data of consecutive patients with end-stage liver diseases undergone liver transplantation in a single treatment center. Logistic regression analysis was used to analyze the perioperative indicators including recipient gender, age, body mass index, preoperative serum albumin level, serum sodium concentration, urea nitrogen level and donor-recipient blood group, et al. Correlated factors were analyzed by the method of multivariate logistic regression. Statistical processing package was SAS 9.1.3 soft. The difference was statistically significant with P<0.05. \u0000 \u0000 \u0000Results \u000018/165 patients died within 3 months after transplantation(mortality rate: 10.9 %). According to the result of univariate analysis, the indicators correlated with early mortality which were statistically significant were preoperative serum sodium, blood urea nitrogen, PT-INR, CTP score, MELD score and MELD-Na score. On the base of the result of Logistic multiple regression. However, only MELD-Na score was associated with 3 months prognosis(P=0.001, β=-2.510, OR=0.088, 95 % CI=0.037~0.349). \u0000 \u0000 \u0000Conclusions \u0000Preoperative MELD-Na score is an independent risk factor for short-term survival in patients with end-stage liver disease. Higher MELD-Na score is, the early mortality is higher. \u0000 \u0000 \u0000Key words: \u0000Liver transplantation; Prognosis; Risk factor; Multiplicity analysis","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88040198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the effect factors of liver enzymes elevation by monitoring the liver function changes before and after intraportal islet transplantation. Methods 16 diabetic patients who received intraportal islet transplantation in our hospital were analyzed. The levels of aspartic aminotransferase (AST), alanine aminotransferase (ALT)and total bilirubin (TBil)were monitored after islet transplantation. Results Among those 16 diabetic patients who received intraportal islet transplantation, 11 patients showed an increased AST and 8 patients showed an increased ALT, among which a 2.5-fold increase in AST was observed in 4 patients and over 1.5-fold elevation of ALT was observed in 3 patients. The level of TBil were in the normal range before and after transplantation in all patients. Transplanted tissue volume of islet was the main factor for significantly increased AST (P<0.05) in this study. It is also shown that the change in portal pressure is related to the AST elevation after islet transplantation. Conclusions The amount of transplanted islet tissue volume is related to the liver enzymes elevation after intraportal islet transplantation. Therefore, the improvement of the purity of islet to reduce the amount of transplanted tissue could be benefit to prevent the liver injury after islet transplantation. Meanwhile, the purified islets should be injected as slowly as possible to maintain a stable portal pressure. Key words: Islet transplantation; Diabetes mellitus; Transaminase
{"title":"Effect factors of liver enzymes elevation afterintraportal islet transplantation","authors":"Boya Zhang, Jing-Na Zhang, Guang-hui Pei, Jinshan Wang, Yaojuan Liu, Xuejie Ding, Zhiping Wang, Shusen Wang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.09.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.09.003","url":null,"abstract":"Objective \u0000To investigate the effect factors of liver enzymes elevation by monitoring the liver function changes before and after intraportal islet transplantation. \u0000 \u0000 \u0000Methods \u000016 diabetic patients who received intraportal islet transplantation in our hospital were analyzed. The levels of aspartic aminotransferase (AST), alanine aminotransferase (ALT)and total bilirubin (TBil)were monitored after islet transplantation. \u0000 \u0000 \u0000Results \u0000Among those 16 diabetic patients who received intraportal islet transplantation, 11 patients showed an increased AST and 8 patients showed an increased ALT, among which a 2.5-fold increase in AST was observed in 4 patients and over 1.5-fold elevation of ALT was observed in 3 patients. The level of TBil were in the normal range before and after transplantation in all patients. Transplanted tissue volume of islet was the main factor for significantly increased AST (P<0.05) in this study. It is also shown that the change in portal pressure is related to the AST elevation after islet transplantation. \u0000 \u0000 \u0000Conclusions \u0000The amount of transplanted islet tissue volume is related to the liver enzymes elevation after intraportal islet transplantation. Therefore, the improvement of the purity of islet to reduce the amount of transplanted tissue could be benefit to prevent the liver injury after islet transplantation. Meanwhile, the purified islets should be injected as slowly as possible to maintain a stable portal pressure. \u0000 \u0000 \u0000Key words: \u0000Islet transplantation; Diabetes mellitus; Transaminase","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75366722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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