Transplantation Reports最新文献

{"title":"Cellular immunity in BK polyomavirus associated nephropathy following adult kidney transplantation","authors":"Laila Schneidewind ,&nbsp;Uwe Grunwald ,&nbsp;Desiree L. Dräger ,&nbsp;Thomas Neumann ,&nbsp;Jennifer Kranz ,&nbsp;Oliver W. Hakenberg","doi":"10.1016/j.tpr.2022.100093","DOIUrl":"https://doi.org/10.1016/j.tpr.2022.100093","url":null,"abstract":"<div><h3>Background</h3><p>BK polyomavirus (BKPyV) is the most important polyomavirus affecting renal transplant recipients. BKPyV associated nephropathy (BKVAN) is seen in about 5% of renal transplant patients and can lead to graft loss in up to 50% of cases. Monitoring of specific immunity combined with viral load could be used to individually assess the risk of viral reactivation. However, cellular immunity and targeting the immune system have also the potential to be used in therapy development. Consequently, we performed a rapid review about cellular immune responses to summarize the evidence for planning new research on treatment. Additionally, we present an immunologically interesting case of BKVAN.</p></div><div><h3>Methods</h3><p>We performed a rapid review with a search in MEDLINE from 1971 to 2021. Additionally, we present an immunological interesting case of BKVAN.</p></div><div><h3>Results</h3><p>The literature search for original studies yielded 92 results. Finally, nine studies were considered, two of them were experimental studies, three retrospective case series and four prospective clinical trials. On the whole, there is evidence that virus-specific T cells could be used for monitoring of BKVAN, but also for therapy.</p></div><div><h3>Conclusions</h3><p>Cellular immune response to BKVAN is complex, but further prospective clinical studies, especially in virus-specific T cells are necessary.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 1","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000026/pdfft?md5=dd0a4c668f399d13414f14f6b28e2aff&pid=1-s2.0-S2451959622000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136833973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical non-HLA AMR detection and monitoring with surveillance dd-cfDNA in a kidney transplant recipient","authors":"Erik L. Lum ,&nbsp;Sabrina Lee ,&nbsp;Jonathan Zuckerman ,&nbsp;Suphamai Bunnapradist","doi":"10.1016/j.tpr.2022.100092","DOIUrl":"https://doi.org/10.1016/j.tpr.2022.100092","url":null,"abstract":"<div><p>Elevations in dd-cfDNA at the time of kidney allograft dysfunction are associated with an increased risk of rejection. The utility of such measurements in a stable allograft is unknown. Herein we present a case utilizing routine surveillance dd-cfDNA to detect subclinical active BANFF rejection with persistent elevations and biopsy evidence of ongoing injury despite treatments. Due to treatment failure she developed chronic allograft nephropathy within six months of transplantation. Surveillance and post treatment monitoring of dd-cfDNA may be useful early detection and monitoring of rejection in kidney transplant recipients and as a marker in future studies.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 1","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000014/pdfft?md5=1127432b2f9dfc84560d097790aabfaf&pid=1-s2.0-S2451959622000014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136833969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-appropriation of a right anterior thoracotomy approach to portal-systemic bypass for liver transplantation in a patient with complete superior vena cava occlusion","authors":"Justin A. Steggerda ,&nbsp;Andre Y. Son ,&nbsp;Marcos E. Pozo ,&nbsp;Amit Pawale ,&nbsp;Aaron S. Reynolds ,&nbsp;Kush Desai ,&nbsp;Daniel Galvez-Lima ,&nbsp;Josh Herborn ,&nbsp;Andre DeWolf ,&nbsp;Daniela Ladner ,&nbsp;Juan Carlos Caicedo ,&nbsp;Nitin Katariya ,&nbsp;Daniel Borja-Cacho","doi":"10.1016/j.tpr.2021.100086","DOIUrl":"10.1016/j.tpr.2021.100086","url":null,"abstract":"<div><p>The utilization of venovenous bypass in liver transplantation (LT) has become less frequent and more center dependent over time. Unfortunately, this has left many transplant surgeons, particularly younger trainees, unfamiliar with the techniques and indications for its utilization. We present a case of LT in a patient with complete superior vena cava (SVC) occlusion prohibiting direct vascular access. A multi-disciplinary approach involving interventional radiology, anesthesiology, cardiac surgery, and transplant surgery, was used to diagnose, evaluate, and develop an operative plan for successful LT. In doing so, a novel approach to portosystemic bypass was utilized involving a right mini-thoracotomy with direct cannulation of the right atrium to gain central venous access and optimize venous return during LT. As a center that does not routinely use venovenous bypass, this multidisciplinary approach was crucial identifying the need for a rarely used technique for vascular access and performance of a successful LT.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959621000147/pdfft?md5=e1146daad7e21051d270399a56159240&pid=1-s2.0-S2451959621000147-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41791653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal allograft torsion, is sirolimus a culprit– Case series and review of literature","authors":"Shobana Sivan ,&nbsp;Paolo Vincenzi ,&nbsp;Rushi Shah ,&nbsp;Morsi Mahmoud ,&nbsp;Mariella Ortigosa-Goggins","doi":"10.1016/j.tpr.2021.100087","DOIUrl":"10.1016/j.tpr.2021.100087","url":null,"abstract":"<div><h3>Background</h3><p>Torsion is defined as rotation of allograft around its renal pedicle. It is a rare complication with high rate of graft loss. The nonspecific presentation and inability to provide definitive diagnosis by imaging in cases of partial torsion may delay the diagnosis and treatment.</p></div><div><h3>Methods</h3><p>We present two patients who were diagnosed with kidney allograft torsion (KAT) and underwent surgical exploration with varying outcomes. We also included the review of literature on KAT, highlighting the clinical presentation, investigation modality, intervention, and outcome. We identified reports of KAT in PubMed and Cochrane from 1990 through January 2021.</p></div><div><h3>Results</h3><p>22 manuscripts with 30 intraperitoneal and 6 extraperitoneal cases of KAT were identified. Most common presenting symptom was oliguria/anuria (11 cases) and abdomen pain (11 cases). Acute kidney injury was reported in almost all cases. Diagnosis of KAT by imaging was diagnosed in 7 cases before exploration. Surgical exploration led to graft salvage in 25 (69.4%) of cases and immediate transplant nephrectomy was performed in 11 (30.5%) of cases. Recurrence was documented in 3 cases and none of them had recurrence after surgical intervention</p></div><div><h3>Conclusion</h3><p>Renal torsion presents with various non-specific symptoms that could often be misdiagnosed. Since early suspicion and diagnosis is critical to prompt therapy and better graft outcome, including KAT as a possible cause of allograft dysfunction of unclear etiology particularly in patients with intraperitoneally placed allograft and sirolimus use, will be crucial.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959621000159/pdfft?md5=d0057c1e7e6099d03609d92dabd875bc&pid=1-s2.0-S2451959621000159-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48660709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgent use of the heart autotransplantation procedure to remove the malignant tumor of left atrium","authors":"Maciej Rachwalik ,&nbsp;Agnieszka Hałoń ,&nbsp;Roman Przybylski ,&nbsp;Michał Zakliczyński","doi":"10.1016/j.tpr.2021.100085","DOIUrl":"10.1016/j.tpr.2021.100085","url":null,"abstract":"<div><p>Autotransplantation is a relatively rare method used in cardiac surgery. It gives the surgeon excellent opportunities for precise surgical treatment of hard-to-reach pathologies located in the heart cavities, which is especially important when the aim of procedure is to remove maximal amount of malignant neoplastic cells. In this article, we describe the use of autotransplantation in a 32-year-old man finally diagnosed with Undifferentiated Pleomorphic Sarcoma (UPS). The course of the disease, the operative strategy, and the most common pathologies will be described.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959621000135/pdfft?md5=472dfd6e8c18f21278153b50e13bdfb2&pid=1-s2.0-S2451959621000135-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41390485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early cytomegalovirus reactivation after heart transplantation: A case report and literature review","authors":"Lan-Pin Kuo ,&nbsp;Meng-Ta Tsai ,&nbsp;Jui-Yin Kao ,&nbsp;Yu-Ning Hu ,&nbsp;Chi-Fu Cheng ,&nbsp;Chun-Hao Chang ,&nbsp;Jun-Neng Roan","doi":"10.1016/j.tpr.2021.100083","DOIUrl":"10.1016/j.tpr.2021.100083","url":null,"abstract":"<div><p>Reactivation of cytomegalovirus is one of the most significant morbidities in solid organ transplant recipients. Reports describing the risk factors for cytomegalovirus reactivation in heart transplantation are scarce. We present a case in which viral reactivation 9 days after heart transplantation resulted in cytomegalovirus enterocolitis. Before transplantation, the patient received extracorporeal membrane oxygenation. Cytomegalovirus reactivation occurred under prophylactic medication with valganciclovir and progressed to cytomegalovirus enterocolitis, complicated by ischemia and a small bowel perforation. The patient died of repeated septic shock, severe gastrointestinal tract complications, and cytomegalovirus hepatitis. A review of 70 heart transplant recipients at our hospital from 2005 to 2020 revealed that cytomegalovirus reactivation occurred more frequently in those who received pretransplantation extracorporeal membrane oxygenation than in those who did not (36.4% vs. 6.8%, <em>P</em> = 0.018). This finding suggests that early diagnosis and prompt management of cytomegalovirus reactivation in patients receiving extracorporeal membrane oxygenation as a bridge to heart transplantation is crucial.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tpr.2021.100083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45651391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-month protocol biopsies do not detect subclinical rejection in pediatric kidney transplant recipients at a single center","authors":"Erika T. Allred,&nbsp;Clarkson R. Crane,&nbsp;Elizabeth G. Ingulli","doi":"10.1016/j.tpr.2021.100082","DOIUrl":"10.1016/j.tpr.2021.100082","url":null,"abstract":"<div><p>Background Subacute allograft rejection (SAR) results in chronic allograft nephropathy and decreased allograft survival. Protocol biopsies (PB) are performed in many top centers to identify SAR. Our study aimed to evaluate the rate of SAR detected in PB at our single center. Methods Retrospective review of 38 pediatric patients (pts) who received a kidney allograft from April 2014 through January 2018. Induction immunosuppression consisted of basiliximab (<em>n</em> = 25). High risk pts received antithymocyte globulin (<em>n</em> = 13). Tacrolimus-based triple drug maintenance immunosuppression was used. PBs were performed 3–6 months after transplant. Pathology was evaluated by trained pathologists and classified using Banff criteria. Results Thirty-eight pts were included. Five pts underwent biopsy before 3 months due to elevated creatinine or BK viremia. Thirty-three pts underwent PB 12–23 weeks after transplant. Six pts had elevated creatinine at the time of PB; only 1/6 biopsies showed acute rejection. Of the remaining 27 PBs, only 1/27 showed acute rejection. The total rejection rate at 6 months post-transplant was 5.26%, with a SAR rate of 3.7%. Conclusions These findings do not substantiate early PB at our institution. Our study suggests that perhaps later time points for PB when immunosuppressive meds are at their lowest levels or use of novel biomarkers as an initial screen for biopsy in patients at risk for SAR would be more informative.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tpr.2021.100082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42151685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy outcomes after kidney transplantation","authors":"Sefik Gökce ,&nbsp;Dilşad Herkiloglu ,&nbsp;Murathan Uyar","doi":"10.1016/j.tpr.2021.100084","DOIUrl":"10.1016/j.tpr.2021.100084","url":null,"abstract":"<div><h3>Background</h3><p>Some complications are frequently seen in pregnancies with kidney transplantation and graft functions may be impaired. In this study, it was aimed to examine the course and results of pregnancies after transplantation, the effect of pregnancy on graft functions and the risk factors in complications in these pregnancies.</p></div><div><h3>Methods</h3><p>A total of 24 pregnancies conceived after kidney transplantation due to end-stage renal disease between January 2013 and December 2020 and followed up in the Obstetrics and Gynecology clinic of our hospital were included in the study.</p></div><div><h3>Results</h3><p>The mean age was 31.8±6.4, the mean time between transplantation and pregnancy was 54±36 months, and the mean newborn weight was 1945±529.5 grams.</p><p>Of the pregnancies, abortion occurred in one (4.2%), preterm delivery in 17 (70.3%), and intrauterine growth retardation (IUGR) in 10 (41.7%). Immunosuppressant treatment was given to all pregnant women due to transplantation, and all women used tacrolimus. No graft rejection was seen.</p><p>The median serum creatinine level did not show a significant change during pregnancy according to the prenatal value (p&gt;0.05 for each), and it increased significantly in the 6th month (p=0.006) and 3rd year (p=0.007) measurements. Urine protein level increased significantly in the third trimester compared to pre-pregnancy (p=0.009).</p></div><div><h3>Conclusion</h3><p>The findings show that pregnancy does not have a significant effect on maternal and fetal survival, graft rejection and graft function in pregnancies with kidney transplantation, but that complication rates such as hypertension, preterm delivery and low birth weight are high.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tpr.2021.100084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47626641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of efficiency and safety between dual and triple immunosuppressive regimens in pediatric living donor liver transplantation at King Chulalongkorn Memorial Hospital","authors":"Athaya Vorasittha ,&nbsp;Methee Sutherasan ,&nbsp;Wipusit Taesombat ,&nbsp;Pongserath Sirichindakul ,&nbsp;Supanit Nivatvong ,&nbsp;Bunthoon Nonthasoot","doi":"10.1016/j.tpr.2021.100088","DOIUrl":"10.1016/j.tpr.2021.100088","url":null,"abstract":"","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959621000160/pdfft?md5=290ba0d1f3a5e1d265d0aab4a3dbf52f&pid=1-s2.0-S2451959621000160-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41481073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent hungry bone syndrome in a kidney transplant recipient with a history of parathyroidectomy: A case report","authors":"Ho-Kwan Sin,&nbsp;Ping-Nam Wong,&nbsp;Kin-Yee Lo,&nbsp;Man-Wai Lo,&nbsp;Shuk-Fan Chan,&nbsp;Kwok-Chi Lo,&nbsp;Yuk-Yi Wong,&nbsp;Lo-Yi Ho,&nbsp;Wing-Tung Kwok,&nbsp;Kai-Chun Chan,&nbsp;Siu-Ka Mak","doi":"10.1016/j.tpr.2021.100074","DOIUrl":"10.1016/j.tpr.2021.100074","url":null,"abstract":"<div><p><strong>Background:</strong> The hungry bone syndrome (HBS) is a well described phenomenon occurring shortly after parathyroidectomy characterized by rapid bone formation with concomitant hypocalcemia, hypophosphatemia and hypomagnesemia requiring intensive management. Recurrent HBS occurring in isolation from parathyroidectomy has not been reported.</p><p><strong>Case presentation:</strong> We describe a case of recurrent HBS in a kidney transplant recipient (KTR) developing years after parathyroidectomy. The KTR was a 49 year-old lady who had undergone successful total parathyroidectomy without re-implantation 14 years prior and cadaveric kidney transplantation 12 years prior. She had a stable creatinine level of 220μmol/L and an estimated glomerular filtration rate (eGFR) of 20 mL/min^-1.73m². She presented to us with severe hypercalcemia, likely a result of excessive calcium and vitamin D supplementation, and acute kidney injury. Serum creatinine, calcium, phosphate, magnesium, alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) levels on admission were 743μmol/L, 4.8 mmol/L, 1.8 mmol/L, 0.75 mmol/L, 48IU/L and &lt;0.1 pmol/L, respectively. Vigorous intravenous fluids were given in addition to withdrawal of calcium carbonate and calcitriol. Clinical improvement was evident with falling serum creatinine and calcium levels. However, this was followed 2–3 days after admission by an unexplained rise in ALP from a baseline of 48IU/L to a peak level of 1150IU/L over the next week, accompanied by the development of severe hypocalcemia, hypomagnesemia and a persistent drop in phosphate levels. The patient required large doses of calcium carbonate, calcitriol and magnesium lactate to maintain blood mineral levels. The ALP progressively decreased subsequently and the serum levels of calcium, phosphate and magnesium began to stabilize in the next 2–3 weeks.</p><p><strong>Conclusion:</strong> Recurrent HBS can occur years after parathyroidectomy in KTRs. We hypothesize that hypercalcemia and its rapid correction might have been the trigger in this particular patient. The mechanism is not well understood but might involve bone remodeling pathways that are independent of parathyroid hormone.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 3","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tpr.2021.100074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47284366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}