世界移植杂志(英文版)最新文献

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How and when of eyelid reconstruction using autologous transplantation. 自体移植眼睑重建的方法及时机。
世界移植杂志(英文版) Pub Date : 2022-07-18 DOI: 10.5500/wjt.v12.i7.175
Giovanni Miotti, Marco Zeppieri, Agostino Rodda, Carlo Salati, Pier Camillo Parodi
{"title":"How and when of eyelid reconstruction using autologous transplantation.","authors":"Giovanni Miotti,&nbsp;Marco Zeppieri,&nbsp;Agostino Rodda,&nbsp;Carlo Salati,&nbsp;Pier Camillo Parodi","doi":"10.5500/wjt.v12.i7.175","DOIUrl":"https://doi.org/10.5500/wjt.v12.i7.175","url":null,"abstract":"<p><p>Reconstructive surgery of the eyelid after tumor excision, trauma or other causes can be challenging, especially due to the complexities of the anatomic structures and to the necessity of both functional and aesthetic successful outcomes. The aim of this minireview was to investigate the use of tissue transplantation in eyelid reconstruction. Surgical procedures are various, based on the use of both flaps, pedicled or free, and grafts, in order to guarantee adequate tissue reconstruction and blood supply, which are necessary for correct healing. Common techniques normally include the use of local tissues, combining non-vascularized grafts with a vascularized flap for the two lamellae repair, to attempt a reconstruction similar to the original anatomy. When defects are too wide, vast, deep, and complex or when no adjacent healthy tissues are available, distant area tissues need to be recruited as free flaps or grafts and paired with mucosal layer reconstruction. With regards to the anterior lamella, full thickness skin grafts are commonly preferred. With regards to the reconstruction of posterior lamella, there are different graft options, which include conjunctival or tarsoconjunctival, mucosal or palatal or cartilaginous grafts usually combined with local flaps. Free flap transplantation, normally reserved for rare select cases, include the use of the radial forearm and anterolateral flaps combined with mucosal grafts, which are surgical options currently reported in the literature.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 7","pages":"175-183"},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/73/WJT-12-175.PMC9331409.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342798","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}
引用次数: 1
Risk factors of extraneural spreading in astrocytomas and oligodendrogliomas in donors with gliomas: A systematic review. 神经胶质瘤供体中星形细胞瘤和少突胶质细胞瘤神经外扩散的危险因素:一项系统综述。
世界移植杂志(英文版) Pub Date : 2022-06-18 DOI: 10.5500/wjt.v12.i6.131
Serena Ammendola, Valeria Barresi, Elena Bariani, Ilaria Girolami, Antonia D'Errico, Matteo Brunelli, Massimo Cardillo, Letizia Lombardini, Amedeo Carraro, Ugo Boggi, Owen Cain, Desley Neil, Albino Eccher
{"title":"Risk factors of extraneural spreading in astrocytomas and oligodendrogliomas in donors with gliomas: A systematic review.","authors":"Serena Ammendola,&nbsp;Valeria Barresi,&nbsp;Elena Bariani,&nbsp;Ilaria Girolami,&nbsp;Antonia D'Errico,&nbsp;Matteo Brunelli,&nbsp;Massimo Cardillo,&nbsp;Letizia Lombardini,&nbsp;Amedeo Carraro,&nbsp;Ugo Boggi,&nbsp;Owen Cain,&nbsp;Desley Neil,&nbsp;Albino Eccher","doi":"10.5500/wjt.v12.i6.131","DOIUrl":"https://doi.org/10.5500/wjt.v12.i6.131","url":null,"abstract":"<p><strong>Background: </strong>Patients with a history of primary brain tumors can be eligible for organ donation under extended criteria. The risk assessment of tumor transmission <i>via</i> organ transplant in primary brain tumors is primarily based on the assessment of tumor histotype and grade. Previous surgeries, chemo-/radiotherapy, and ventriculo-peritoneal shunt placement can lead to a disruption of the blood-brain barrier, concurring to an increase in the transmission risk.</p><p><strong>Aim: </strong>To investigate the role of tumor transmission risk factors in donors with oligodendrogliomas and astrocytomas.</p><p><strong>Methods: </strong>We searched PubMed and EMBASE databases for studies reporting extraneural spreading of oligodendrogliomas and astrocytomas and extracted clinical-pathological data on the primary tumor histotype and grade, the elapsed time from the diagnosis to the onset of metastases, sites and number of metastases, prior surgeries, prior radiotherapy and/or chemotherapy, ventriculo-atrial or ventriculo-peritoneal shunt placement, and the presence of isocitrate dehydrogenase 1/2 mutation and 1p/19q codeletion. Statistical analysis was performed using R software. Statistical correlation between chemotherapy or radiotherapy and the presence of multiple extra-central nervous system metastases was analyzed using <i>χ</i> <sup>2</sup> and Fischer exact test. The Kaplan-Meier method was used to evaluate the presence of a correlation between the metastasis-free time and: (1) Localization of metastases; (2) The occurrence of intracranial recurrences; and (3) The occurrence of multiple metastases.</p><p><strong>Results: </strong>Data on a total of 157 patients were retrieved. The time from the initial diagnosis to metastatic spread ranged from 0 to 325 mo in patients with oligodendrogliomas and 0 to 267 mo in those with astrocytomas. Respectively, 19% and 39% of patients with oligodendroglioma and astrocytoma did not receive any adjuvant therapy. The most frequent metastatic sites were bone, bone marrow, and lymph nodes. The lungs and the liver were the most commonly involved visceral sites. There was no significant correlation between the occurrence of multiple metastases and the administration of adjuvant chemo-/radiotherapy. Patients who developed intracranial recurrences/metastases had a significantly longer extraneural metastasis-free time compared to those who developed extraneural metastases in the absence of any intra- central nervous system spread.</p><p><strong>Conclusion: </strong>A long follow-up time does not exclude the presence of extraneural metastases. Therefore, targeted imaging of bones and cervical lymph nodes may improve safety in the management of these donors.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 6","pages":"131-141"},"PeriodicalIF":0.0,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/49/WJT-12-131.PMC9258267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40705642","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}
引用次数: 1
Reduced upper limb lean mass on dual energy X-ray absorptiometry predicts adverse outcomes in male liver transplant recipients. 双能x线吸收仪测量上肢瘦质量可预测男性肝移植受者的不良预后。
世界移植杂志(英文版) Pub Date : 2022-06-18 DOI: 10.5500/wjt.v12.i6.120
Penelope Hey, Rudolf Hoermann, Paul Gow, Timothy P Hanrahan, Adam G Testro, Ross Apostolov, Marie Sinclair
{"title":"Reduced upper limb lean mass on dual energy X-ray absorptiometry predicts adverse outcomes in male liver transplant recipients.","authors":"Penelope Hey,&nbsp;Rudolf Hoermann,&nbsp;Paul Gow,&nbsp;Timothy P Hanrahan,&nbsp;Adam G Testro,&nbsp;Ross Apostolov,&nbsp;Marie Sinclair","doi":"10.5500/wjt.v12.i6.120","DOIUrl":"https://doi.org/10.5500/wjt.v12.i6.120","url":null,"abstract":"<p><strong>Background: </strong>Pre-transplant muscle wasting measured by computed tomography has been associated with adverse clinical outcomes after liver transplantation including increased rates of sepsis and hospitalisation days. Upper limb lean mass (LM) measured by dual-energy X-ray absorptiometry (DEXA) was recently identified as a novel predictor of sarcopenia-associated mortality in men waitlisted for transplantation.</p><p><strong>Aim: </strong>To investigate the use of DEXA LM in predicting gender-stratified early post-transplant outcomes.</p><p><strong>Methods: </strong>Liver transplant recipients who underwent pre-transplant DEXA body composition imaging between 2002 and 2017 were included. Endpoints included post-transplant mortality and graft failure, bacterial infections, acute cellular rejection (ACR) and intensive care and total hospital length of stay.</p><p><strong>Results: </strong>Four hundred and sixty-nine patients met inclusion criteria of which 338 were male (72%). Median age was 55.0 years (interquartile range 47.4, 59.7) and model for end-stage liver disease (MELD) score 16. Median time from assessment to transplantation was 7 mo (3.5, 12). Upper limb LM was inversely associated with bacterial infections at 180 d post-transplant (hazard ratio = 0.42; 95% confidence interval: 0.20-0.89; <i>P</i> = 0.024) in males only. There was a negative correlation between upper limb LM and intensive care (τ<sub>b</sub> = -0.090, <i>P</i> = 0.015) and total hospital length of stay (τ<sub>b</sub> = -0.10, <i>P</i> = 0.0078) in men. In women, neither MELD nor body composition parameters were associated with post-transplant adverse outcomes or increased length of stay. Body composition parameters, MELD and age were not associated with 90-d mortality or graft failure in either gender. There were no significant predictors of early ACR.</p><p><strong>Conclusion: </strong>Sarcopenia is an independent and potentially modifiable predictor of increased post-transplant bacterial infections and hospital length of stay in men with cirrhosis. DEXA upper limb LM provides a novel measure of muscle wasting that has prognostic value in this cohort. The lack of association in women requires further investigation.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 6","pages":"120-130"},"PeriodicalIF":0.0,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/a8/WJT-12-120.PMC9258268.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40706600","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}
引用次数: 1
Tolerance protocol of living kidney transplant for developing countries through basic strategy of lymphocyte depletion. 发展中国家以淋巴细胞耗竭为基本策略的活体肾移植耐受方案。
世界移植杂志(英文版) Pub Date : 2022-06-18 DOI: 10.5500/wjt.v12.i6.112
Sufi M Suhail
{"title":"Tolerance protocol of living kidney transplant for developing countries through basic strategy of lymphocyte depletion.","authors":"Sufi M Suhail","doi":"10.5500/wjt.v12.i6.112","DOIUrl":"https://doi.org/10.5500/wjt.v12.i6.112","url":null,"abstract":"<p><p>End-stage kidney failure (ESKD) is a global issue where kidney replacement therapy imposes enormous economic burden to people of developing countries, in addition to the severe limitations to the availability of hemodialysis and peritoneal dialysis technique. The best option of kidney transplantation also requires lifelong combination immunosuppressive medicines, the cost of which is equally comparable to lifelong dialysis. A strategy of achieving transplant tolerance that requires minimum immunosuppressive medicines, although in experimental stage, also requires state-of-art technology with costly medicines and interventions. This is evidently beyond the reach of ESKD patients of developing countries. Hence, globally in developing countries, a need for an innovative but cost-effective tolerance protocol is a burning need for a successful transplant program. In brief, transplant tolerance is defined as a state of donor-specific unresponsiveness to the allograft antigens without the need for ongoing pharmacologic immunosuppression or with a minimal need. Current state-of-art techniques involves: (1) A state of hematological chimera, for complete tolerance; (2) Prope or partial tolerance where immune-reactive T-lymphocytes are inhibited using monoclonal antibodies; and (3) Chimeric antigen receptor for T-regulatory (T-reg) cell therapy using genetically engineered T-reg cells targeting specific T-lymphocyte receptors for inducing anergy. From our real-world experience in transplant management in post-transplant lympho-proliferative disorders (PTLD), we noticed frequently a drastic reduction in the need of immunosuppressive medicines following lympho-ablative therapy for PTLD. We recently published a case study on a real-world experience transplant case where we explained a partial or prope tolerance that developed after lymphocyte ablation therapy, following which the allograft was maintained with low dose dual standard immunosuppressive medicines. Based on this publication, we propose here an innovative tolerance protocol for living related low risk kidney transplantation for developing countries, in this opinion review.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 6","pages":"112-119"},"PeriodicalIF":0.0,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/ba/WJT-12-112.PMC9258266.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40705643","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}
引用次数: 0
Pediatric transplantation during the COVID-19 pandemic. COVID-19大流行期间的儿童移植
世界移植杂志(英文版) Pub Date : 2022-05-18 DOI: 10.5500/wjt.v12.i5.88
Christos Dimitrios Kakos, Ioannis A Ziogas, Georgios Tsoulfas
{"title":"Pediatric transplantation during the COVID-19 pandemic.","authors":"Christos Dimitrios Kakos, Ioannis A Ziogas, Georgios Tsoulfas","doi":"10.5500/wjt.v12.i5.88","DOIUrl":"10.5500/wjt.v12.i5.88","url":null,"abstract":"<p><p>Children infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seem to have a better prognosis than adults. Nevertheless, pediatric solid organ transplantation (SOT) has been significantly affected by the unprecedented coronavirus disease 2019 (COVID-19) pandemic during the pre-, peri-, and post-transplant period. Undoubtedly, immunosuppression constitutes a real challenge for transplant clinicians as increased immunosuppression may prolong disease recovery, while its decrease can contribute to more severe symptoms. To date, most pediatric SOT recipients infected by SARS-CoV-2 experience mild disease with only scarce reports of life-threatening complications. As a consequence, after an initial drop during the early phase of the pandemic, pediatric SOTs are now performed with the same frequency as during the pre-pandemic period. This review summarizes the currently available evidence regarding pediatric SOT during the COVID-19 pandemic.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 1","pages":"88-99"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9136715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42022177","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}
引用次数: 0
Innovative immunosuppression in kidney transplantation: A challenge for unmet needs. 肾移植中创新性免疫抑制:未满足需求的挑战
世界移植杂志(英文版) Pub Date : 2022-03-18 DOI: 10.5500/wjt.v12.i3.27
Maurizio Salvadori, Aris Tsalouchos
{"title":"Innovative immunosuppression in kidney transplantation: A challenge for unmet needs.","authors":"Maurizio Salvadori, Aris Tsalouchos","doi":"10.5500/wjt.v12.i3.27","DOIUrl":"10.5500/wjt.v12.i3.27","url":null,"abstract":"<p><p>Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries, new innovative drugs in kidney transplantation are difficult to be encountered. The best strategy to find the new drugs recently developed or under development is to search in the sections of kidney transplantation still not completely covered by the drugs on the market. These unmet needs are the prevention of delayed graft function (DGF), the protection of the graft over the long time and the desensitization of preformed anti human leukocyte antigen antibodies and the treatment of the acute antibody-mediated rejection. These needs are particularly relevant due to the expansion of some kind of kidney transplantation as transplantation from non-heart beating donor and in the case of antibody-incompatible grafts. The first are particularly exposed to DGF, the latter need a safe desensitization and a safe treatments of the antibody mediated rejections that often occur. Particular caution is needed in treating these drugs. First, they are described in very recent studies and the follow-up of their effect is of course rather short. Second, some of these drugs are still in an early phase of study, even if in well-conducted randomized controlled trials. Particular caution and a careful check need to be used in trials launched 2 or 3 years ago. Indeed, is always necessary to verify whether the study is still going on or whether and why the study itself was abandoned.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 1","pages":"27-41"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8968476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48026179","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}
引用次数: 0
Assessment of advanced age candidates for liver transplantation warrants more caution. 对高龄肝移植候选者的评估需要更加谨慎。
世界移植杂志(英文版) Pub Date : 2022-02-18 DOI: 10.5500/wjt.v12.i2.24
Alessandro Parente, Vincenzo Ronca
{"title":"Assessment of advanced age candidates for liver transplantation warrants more caution.","authors":"Alessandro Parente,&nbsp;Vincenzo Ronca","doi":"10.5500/wjt.v12.i2.24","DOIUrl":"https://doi.org/10.5500/wjt.v12.i2.24","url":null,"abstract":"<p><p>For patients with fulminant liver failure and end-stage liver disease, liver transplantation remains the only effective treatment. Over the years, as a result of the ageing population, the average age of liver transplant donors and recipients has increased and currently about one quarter of patients receiving transplantation in the United States are above the age of 65. Recently, a study reported that patients aged 65 years or older had lower one-year survival compared to a younger cohort. Herein, we express our opinion about this interesting publication.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 2","pages":"24-26"},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/e5/WJT-12-24.PMC8855142.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39960348","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}
引用次数: 0
Immunosuppressive regimens and outcomes of inflammatory bowel disease patients requiring kidney transplantation. 需要肾移植的炎症性肠病患者的免疫抑制方案和结果。
世界移植杂志(英文版) Pub Date : 2022-02-18 DOI: 10.5500/wjt.v12.i2.21
Urvashi Singh, Baljit Singh, Maria Irene Bellini
{"title":"Immunosuppressive regimens and outcomes of inflammatory bowel disease patients requiring kidney transplantation.","authors":"Urvashi Singh,&nbsp;Baljit Singh,&nbsp;Maria Irene Bellini","doi":"10.5500/wjt.v12.i2.21","DOIUrl":"https://doi.org/10.5500/wjt.v12.i2.21","url":null,"abstract":"<p><p>Patients with inflammatory bowel disease (IBD) can develop extra-renal complications and as a result, suffer from end stage renal failure requiring kidney transplantation (KT). A brief review of available literature revealed that IBD patients undergoing KT have shorter overall survival rates compared to their controls. Literature reporting steroid regimens and survival outcomes specific to IBD and post kidney transplant are scarce and these studies have small sample sizes thus making it difficult to draw accurate conclusions. Further research is required in the form of a randomized controlled study to clarify the effect and mechanism of steroid immunosuppression on the prognosis of renal transplant recipients and explore new treatment schemes.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 2","pages":"21-23"},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/16/WJT-12-21.PMC8855143.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39960347","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}
引用次数: 0
Human pegivirus infection after transplant: Is there an impact? 移植后人类培吉病毒感染:有影响吗?
世界移植杂志(英文版) Pub Date : 2022-01-18 DOI: 10.5500/wjt.v12.i1.1
Anna Mrzljak, Bojana Simunov, Ivan Balen, Zeljka Jurekovic, Tatjana Vilibic-Cavlek
{"title":"Human pegivirus infection after transplant: Is there an impact?","authors":"Anna Mrzljak,&nbsp;Bojana Simunov,&nbsp;Ivan Balen,&nbsp;Zeljka Jurekovic,&nbsp;Tatjana Vilibic-Cavlek","doi":"10.5500/wjt.v12.i1.1","DOIUrl":"https://doi.org/10.5500/wjt.v12.i1.1","url":null,"abstract":"<p><p>The microbiome's role in transplantation has received growing interest, but the role of virome remains understudied. Pegiviruses are single-stranded positive-sense RNA viruses, historically associated with liver disease, but their path-ogenicity is controversial. In the transplantation setting, pegivirus infection does not seem to have a negative impact on the outcomes of solid-organ and hematopoietic stem cell transplant recipients. However, the role of pegiviruses as proxies in immunosuppression monitoring brings novelty to the field of virome research in immunocompromised individuals. The possible immunomodulatory effect of pegivirus infections remains to be elucidated in further trials.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/8f/WJT-12-1.PMC8771596.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39749929","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}
引用次数: 3
Is de novo membranous nephropathy suggestive of alloimmunity in renal transplantation? A case report. 肾移植中新生膜性肾病是否提示同种异体免疫?一份病例报告。
世界移植杂志(英文版) Pub Date : 2022-01-18 DOI: 10.5500/wjt.v12.i1.15
Prakash I Darji, Himanshu A Patel, Bhavya P Darji, Ajay Sharma, Ahmed Halawa
{"title":"Is <i>de novo</i> membranous nephropathy suggestive of alloimmunity in renal transplantation? A case report.","authors":"Prakash I Darji,&nbsp;Himanshu A Patel,&nbsp;Bhavya P Darji,&nbsp;Ajay Sharma,&nbsp;Ahmed Halawa","doi":"10.5500/wjt.v12.i1.15","DOIUrl":"https://doi.org/10.5500/wjt.v12.i1.15","url":null,"abstract":"<p><strong>Background: </strong>Post-transplant nephrotic syndrome (PTNS) in a renal allograft carries a 48% to 77% risk of graft failure at 5 years if proteinuria persists. PTNS can be due to either recurrence of native renal disease or <i>de novo</i> glomerular disease. Its prognosis depends upon the underlying pathophysiology. We describe a case of post-transplant membranous nephropathy (MN) that developed 3 mo after kidney transplant. The patient was properly evaluated for pathophysiology, which helped in the management of the case.</p><p><strong>Case summary: </strong>This 22-year-old patient had chronic pyelonephritis. He received a living donor kidney, and human leukocyte antigen-DR (HLA-DR) mismatching was zero. PTNS was discovered at the follow-up visit 3 mo after the transplant. Graft histopathology was suggestive of MN. In the past antibody-mediated rejection (ABMR) might have been misinterpreted as <i>de novo</i> MN due to the lack of technologies available to make an accurate diagnosis. Some researchers have observed that HLA-DR is present on podocytes causing an anti-DR antibody deposition and development of <i>de novo</i> MN. They also reported poor prognosis in their series. Here, we excluded the secondary causes of MN. Immunohistochemistry was suggestive of IgG1 deposits that favoured the diagnosis of <i>de novo</i> MN. The patient responded well to an increase in the dose of tacrolimus and angiotensin converting enzyme inhibitor.</p><p><strong>Conclusion: </strong>Exposure of hidden antigens on the podocytes in allografts may have led to subepithelial antibody deposition causing <i>de novo</i> MN.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"12 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/d9/WJT-12-15.PMC8771595.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39749928","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}
引用次数: 2
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