Chineae Journal of Organ Transplantation最新文献

{"title":"Role of cerebrospinal fluid chimerism in predicating central nervous relapse surveillance for patients of acute leukemia after allogeneic hematopoietic stem cell transplantation","authors":"Jun-ying Li, Z. Zhong, Y. You, Liang Tang, Xuan Lu, Han Yan, Huafang Wang, L. Xia, Yu Hu","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.03.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.03.004","url":null,"abstract":"Objective \u0000To explore the role of cerebrospinal fluid chimerism in central nervous relapse surveillance for patients of acute leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). \u0000 \u0000 \u0000Methods \u0000The follow-up data were retrospectively collected and analyzed in 104 patients with acute leukemia after allo-HSCT. Comparisons were made between patients with complete chimerism and mixed chimerism in cerebrospinal fluid. The role of recipient DNA percentage and its changing trend in predicting central nervous relapse were also explored. Analysis was conducted for determining the risk factors of central nervous relapse. And the effectiveness of prophylaxis with intrathecal injection was also examined. \u0000 \u0000 \u0000Results \u0000The incidence of relapse was higher in patients with mixed chimerism (P<0.001), high percentage of recipient DNA (P<0.05) and higher mixed chimerism (P<0.001). Hyperleukocytosis at an initial diagnosis was a risk factor of central nervous relapse. Whether or not intrathecal injection prophylaxis was applied showed no significant difference in relapsing rate. \u0000 \u0000 \u0000Conclusions \u0000Monitoring cerebrospinal fluid chimerism can effectively help predict central nervous relapse among patients of acute leukemia after allo-HSCT. Yet intrathecal injection prophylaxis failed to benefit recipients. \u0000 \u0000 \u0000Key words: \u0000Allogeneic hematopoietic stem cell transplantation; Cerebrospinal fluid; Central nervous relapse","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"63 1","pages":"138-143"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80906261","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}

{"title":"Efficacy of haploidentical allogeneic hematopoietic stem cell transplantation for severe aplastic anemia: a report of 40 cases","authors":"Hongfei Wu, Xinsheng Xie, D. Wan, R. Guo, Chong Wang, Ling Sun, Hui Sun, Zhongxing Jiang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.03.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.03.007","url":null,"abstract":"Objective \u0000To explore the efficacy and prognosis of haploidentical allogeneic hematopoietic stem cell transplantation (haplo-HSCT) for severe aplastic anemia (SAA). \u0000 \u0000 \u0000Methods \u0000The clinical data were retrospectively analyzed for 40 SAA cases undergoing haplo-HSCT from September 2013 to February 2018. The conditioning regimen contained cyclophosphamide, fludarabine and antithymocyte globulin with or without busulfan or low-dose total body irradiation. Cyclosporin A, short-term methotrexate and mycophenolate mofetil were dosed for preventing graft versus host disease (GVHD). The median counts of mononuclear cell and CD34+ stem cell were 5.3(2.0~13.5)×108/kg and 5.6(1.6~15.9)×106/kg respectively. \u0000 \u0000 \u0000Results \u0000Among them, hematopoietic reconstitution was achieved (n=36, 90.0 %). The median times for myeloid engraftment and platelet engraftment were 15(10-25) and 17(10~58) days respectively. The incidence of acute graft-versus-host disease(aGVHD)was (35.0±6.8) %. The incidence of chronic GVHD (cGVHD) was (23.0±7.4) %. And 28 SAA cases (70.0 %) survived during a median follow-up period of 353(30~1226) days, The cumulative overall survival (OS) was (67.8±7.8) %, the average survival time (883±82)days and transplantation-related death (TRM) within 100 days (10.0±3.1) %. \u0000 \u0000 \u0000Conclusions \u0000Haplo-HSCT is an effective treatment for SAA patients. And a larger number of cases are required for enhancing OS. \u0000 \u0000 \u0000Key words: \u0000Allogeneic hematopoietic stem cell transplantation; Aplastic anemia; Human leukocyte antigen","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"36 1","pages":"153-157"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80942487","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}

{"title":"Analysis of influencing factors of blood concentration of tacrolimus in Chinese pediatric living donor liver transplant patients","authors":"Yi Qin, Xiaoshuo Wang, Meiling Yan, Wei Gao, Fan Chen, Yi Zhang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.009","url":null,"abstract":"Objective \u0000To explore the influencing factors of blood concentration of tacrolimus in pediatric living donor liver transplant recipients and provide rationales for individualized administration of tacrolimus. \u0000 \u0000 \u0000Methods \u0000Trough concentrations (C0), doses of tacrolimus, recipient age, gender, body weight, donor and recipient CYP3A5 genotypes, hematocrit (HCT) and liver/kidney function related indicators at 3, 5, 7, 14 days, 1 month, 2 months and 3 months post living donor liver transplantation were collected from a total of 100 pediatric recipients. Taking ratio of concentration to dose (C0/D) as a dependent variable, the influencing factors of blood concentration of tacrolimus were analyzed by multivariate stepwise regression. \u0000 \u0000 \u0000Results \u0000The influencing factors of blood tacrolimus concentration at 3d post-transplantation were recipient CYP3A5 genotyp, donor CYP3A5 genotype and weight of recipients. The major influencing factors at 5d post-transplantation were recipient & donor CYP3A5 genotypes, recipient weight and HCT. The major relevant factors at 7d post-transplantation were CYP3A5 of recipients, age and HCT. The influencing factors at 14 days were the same as those at 2 months, i. e. CYP3A5 genotype and weight of recipients. At 1 month the major influencing factors were weight of recipients, CYP3A5 of recipients and alkaline phosphatase (ALP); CYP3A5 genotype and weight of recipients at 3 months. Further study on CYP3A5 genotype of donors and recipients, the C0/D ratio of CYP3A5 genotype non-expression group was significantly higher than that of expression group in recipients and C0/D ratio of donor CYP3A5 genotype non-expression group was significantly higher than that of expression group. \u0000 \u0000 \u0000Conclusions \u0000The influencing factors of concentration of tacrolimusvary at different timepoints after liver transplantation. Paying close attention to the changes of CYP3A5 genotype, weight of recipients and related biochemical indexes and considering various influencing factors facilitate individualized dosing for improving the prognosis of pediatric recipients. \u0000 \u0000 \u0000Key words: \u0000Pediatric; Liver transplantation; Living donor; Tacrolimus; Blood concentration","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"1 1","pages":"102-106"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78188411","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}

{"title":"Protective effect of ETaR siRNA on renal ischemia-reperfusion injury in rats by changing the immuno-microenvironment of kidney","authors":"Yichen Jia, Long Zheng, Long Li, Jiawei Li, Ming Xu, T. Zhu","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.002","url":null,"abstract":"Objective \u0000To explore the protective effect of ETaR siRNA on renal ischemia reperfusion injury (IRI) by changing the immuno-microenvironment in rats. \u0000 \u0000 \u0000Methods \u0000A total of 40 male Sprague-Dawley (SD) rats were randomized into four groups of sham, IR, negative siRNA and ETaR siRNA. A renal IRI model was generated by clamping left renal artery. ETaR siRNA was delivered into kidney through renal vein by a retrograde 'hydrodynamic’ injection. Blood samples were collected for detecting renal function and kidney tissue harvested for Hematoxylin & Eosin (HE) staining, TdT-mediated dUTP Nick-End Labeling (TUNEL) staining, polymerase chain reaction (PCR) and Western blot at 48 h post-reperfusion. \u0000 \u0000 \u0000Results \u0000Serum creatinine, blood urea nitrogen and renal apoptotic cells increased and renal tissue was injured after IR. The changes were inhibited by ETaR siRNA. PCR showed that ETaR siRNA treatment significantly down-regulated the expressions of inflammatory factors TNF-α, IFN-γ and IL-6 and transcription factor NF-κB induced by IR. \u0000 \u0000 \u0000Conclusions \u0000ETaR siRNA can effectively improve the immuno-microenvironment and thereby alleviate renal ischemia reperfusion injury. \u0000 \u0000 \u0000Key words: \u0000Rats; Kidney; Endothelin receptor; Small interfering RNA; Immuno-microenvironment; Reperfusion injury","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"71 1","pages":"68-71"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75065342","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}

{"title":"Inhibition of islet allograft rejection by Qa-1/PD-L1 artificial liposome","authors":"M. Guo, Zhao Yuanyu, Hao Yin, Jia-Yong Dong, Ji Junsong, Lu‐Yue Qi, Hang Yuan, F. Teng, Wen-Yuan Guo","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.003","url":null,"abstract":"Objective \u0000To explore the effects of Qa-1 and PD-L1 loaded artificial liposomal treatment in allograft rejection and its outcomes. \u0000 \u0000 \u0000Methods \u0000The extracellular domains of Qa-1 and PD-L1 were loaded on liposome surface by streptavidin-biotin system. Mixed lymphocyte reaction (MLR) was performed for measuring Qa-1/PD-L1 liposome biological function. Then liposome was co-transplanted with allo-islets via portal vein. The levels of blood glucose and C-peptide were detected daily after transplantation. Also hepatic lymphocytes after transplantation were isolated for determining the proportion of activated cells and signaling pathway changes. \u0000 \u0000 \u0000Results \u0000Artificial liposome could be easily loaded with biotinylated peptide and its diameter was between 50 to 500 nm. Qa-1/PD-L1 liposome could significantly suppress lymphocyte proliferation, activation and secretion of IFN-γ in MLR by an activation of SHP1/2 and an inhibition of Syk pathway. Qa-1/PD-L1 liposomes could suppress the activation of hepatic lymphocytes in vivo by activating SHP1/2, protecting islet allografts and maintaining a normal level of blood glucose in recipients. \u0000 \u0000 \u0000Conclusions \u0000Qa-1/PD-L1 loaded liposome can effectively suppress allograft rejection and improve the outcomes of islet transplantation. \u0000 \u0000 \u0000Key words: \u0000Mouse; Islet transplantation; Qa-1; PD-L1; Graft rejection; SHP1/2","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"32 1","pages":"72-77"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77559206","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}

{"title":"A comparative study of unrelatedversus matched-sibling donor allogeneic hematopoietic stem cell transplantation for leukemic children","authors":"Binglei Zhang, Jian Zhou, Yanli Zhang, R. Gui, Yuewen Fu, Y. Zu, F. Yu, Hui-fang Zhao, Zhen Li, B. Fang, Xudong Wei","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.012","url":null,"abstract":"Objective \u0000To evaluate the efficacy of unrelated donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for leukemic children. \u0000 \u0000 \u0000Methods \u0000Clinical data of 54 leukemic children undergoing allo-HSCT were retrospectively analyzed from May 2006 to March 2018. According to the source of donor, they were divided into matched sibling donor allo-HSCT group (MSD, n=27) and unrelated donor group (URD, n=27). The clinical outcomes of leukemic children receiving URD allo-HSCT were assessed and those in MSD allo-HSCT group were enrolled as control. \u0000 \u0000 \u0000Results \u0000One patient with refractory AML was not implanted in URD group and the remaining 53 cases were successful in hematopoietic reconstitution. The time of neutrophil and platelet, the incidence of acute graft-versus-host disease (aGVHD), chronic GVHD (cGVHD), generalized cGVHD and their transplant-related complications including pulmonary complications, hemorrhagic cystitis between two groups were not statistically different (P>0.05). The incidence of serious aGVHD, cytomegalovirus (CMV) and EB virus (EBV) infection was significantly higher in URD group than that in MSD group (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000In leukemic children, although the incidence of complications post URD allo-HSCT is significantly increased, the prognosis is comparable to MSD allo-HSCT. It is a good choice when there is no suitable sibling donor. \u0000 \u0000 \u0000Key words: \u0000Allogeneic hematopoietic stem cell transplantation; Children; Leukemia; Unrelated donor; Matched sibling donor","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"33 1","pages":"116-120"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74631264","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}

{"title":"Berberine prevents steatotic liver ischemia reperfusion injury by inhibiting endoplasmic reticulum stress and autophagy","authors":"Nan Zhang, M. Sheng, Man Wu, Xinyue Zhang, Yijie Ding, Wenli Yu, H. Du","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.013","url":null,"abstract":"Objective \u0000To explore the effect of berberine (BBR) on steatotic liver ischemia reperfusion injury and analyze the role of endoplasmic reticulum stress and autophagy. \u0000 \u0000 \u0000Methods \u0000Thirty-four Wistar rats were fed with a high-fat diet for 12 weeks and 2 rats were randomly selected after 8 weeks to observe pathological changes and confirm the model of steatotic liver successfully. Then before opening and closing abdominal cavity, 32 rats were divided into I/R group (normal saline was intragastrically 4 weeks before performing cold I/R treatment), BBR group (normal saline was replaced by BBR, BBR was intragastrically at a dose of 300 mg·kg-1·d-1 weeks and others were the same as I/R group) and TG group (TG was intraperitoneally at a dose of 0.2 mg·kg-1 24h pre-operation and others were the same as BBR group ). Then the rats were sacrificed at 6h post-reperfusion. Blood samples were collected from inferior vena cava and hepatic tissues harvested. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected, histopathologic changes observed by Hematoxylin & Eosin (HE) staining, oxidative stress and inflammation determined by ELISA kit and the expressions of p-PERK, CHOP, Bip, LC3, Beclin-1 and p62 detected by Western blot. \u0000 \u0000 \u0000Results \u0000As compared with Sham group, the serum levels of ALT and AST were significantly higher in I/R, BBR and TG groups (P<0.05). And hepatic histological changes were severe and oxidative stress increased in parallel with the enhancement of pro-inflammation (P<0.05). In BBR group, the level of hepatic enzymes declined, liver injury was milder, oxidative stress decreased and pro-inflammation was lesser compared with I/R and TG groups (P<0.05). Additionally, as compared with sham group, the expressions of p-PERK, CHOP, Bip, LC3, Beclin-1 and p62 were up-regulated in I/R and BBR groups (P<0.05). TG group increased the levels of LC3, Beclin-1 and p62 (P<0.05). Interestingly, compared with I/R group, BBR pretreatment down-regulated the expressions of p-PERK, CHOP, Bip, LC3, Beclin-1 and p62 (P<0.05). TG group had the higher expressions of LC3, Beclin-1 and p62 than those of BBR group (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000BBR pretreatment can protect steatotic liver ischemia reperfusion injury. And the mechanisms may be attributed to the inhibitions of endoplasmic reticulum stress and autophagy. \u0000 \u0000 \u0000Key words: \u0000Rat; Steatotic liver; Berberine; Ischemia reperfusion injury; Endoplasmic reticulum stress; Autophagy","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"31 1","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88210528","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}

{"title":"Application of image post-processing technique to measure spleen volume and evaluate the effect of orthotopic liver transplantation on relieving hypersplenism","authors":"Jian He, Qingjun Guo, Yan Xie, Li Zhang, D. Tian, Hong-hai Wang, Chiyi Chen, Wentao Jiang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.010","url":null,"abstract":"Objective \u0000To employ image post-processing technique measuring splenic volume for evaluating the mitigation effect of end-stage liver disease patients complicated with different degrees of hypersplenism undergoing orthotopic liver transplantation. \u0000 \u0000 \u0000Methods \u0000For 55 end-stage liver disease patients with hypersplenism undergoing orthotopic liver transplantation, the changes in splenic volume were measured before and after transplantation by image post-processing system Advantage Workstation 46 (AW46) and the changes of splenic thickness, portal flow velocity and platelet counts observed during perioperative period. \u0000 \u0000 \u0000Results \u0000Postoperative splenic volumes of 55 recipients were (562.90±49.16) cm3, significantly decreased than preoperative (850.50±77.99) cm3 (P<0.05) and reduction ratio was (31.70±2.76)%. Splenic thickness at different postoperative timepoints was significantly lower than that pre-operation (P<0.05) and stabilized at 1 month post-transplantation; Splenic volume was positively correlated with splenic thickness (r=0.78, P<0.05). Portal flow velocity at different postoperative timepoints increased significantly as compared with preoperative (P<0.05), peaked at (380.70±21.80) mm/s at 1 month post-transplantation, declined and stabilized at 3 months post-transplantation. Platelet counts (PLT) at different postoperative timepoints were significantly higher than those at pre-operation (P<0.05), peaked (193.40±10.36)×109/L at 2 weeks post-transplantation, dropped and remained at 2 months post-transplantation; Splenic volume was negatively correlated with PLT (r=-0.44, P<0.05). And hypersplenism recovery rate and recurrence rate within 10 months post-transplantation was (78.79±2.29)% and (17.75±2.31)% respectively. \u0000 \u0000 \u0000Conclusions \u0000Orthotopic liver transplantation can effectively alleviate hypersplenism for most end-stage liver diseases. Using image post-processing system, splenic volume may be calculated and blood routine and ultrasound are simultaneously used for assessing the outcomes of liver transplantation on hypersplenism. \u0000 \u0000 \u0000Key words: \u0000Hypersplenism; Liver transplantation; Spleen volume; Platelet","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"7 1","pages":"107-110"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91328210","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}

{"title":"ABO-incompatible kidney transplantation in highly presensitized recipients using deceased donors: a case report and literature review","authors":"Lan Zhu, H. Feng, Lu Wang, Zhiliang Guo, Juan Wang, Liang Huang, Hui Guo, Gang Chen","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.005","url":null,"abstract":"Objective \u0000To explore the feasibility and safety of kidney transplantation in highly sensitized recipients by using ABO incompatible (ABOi) and yet human leucocyte antigen (HLA) supremely matched deceased donor kidneys and summarize the literatures as well. \u0000 \u0000 \u0000Methods \u0000A kidney graft from a deceased donor of blood type B was transplanted to a highly presensitized recipient of blood type O to achieve a HLA matching number of 7/8 in May 2018. Donor specific antibody (DSA) against HLA was negative and baseline anti-B IgM 1∶16. Plasmapheresis (PP) plus intravenous immunoglobulin (IVIG) plus anti-CD20 antibodies were offered on operation day. Clinical data was retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000Renal graft functioned immediately and achieved a normal level of serum creatinine (SCr) at d2 after transplantation. However, the value of SCr increased to 131 μmol/l at d9 with a simultaneously elevated level of anti-B IgM from 1∶2 at d7 to 1∶16. A renal graft biopsy at d11 showed mild inflammation in peritubular capillaries and focal tubulitis with minimal interstitial infiltration. No de novo DSA was detected. Then PP plus IVIG were then given twice, followed by an administration of IVIG alone for another 2 days (20 g/d). After treatments, SCr had a range of 120-140 μmol/l and anti-B IgM level decreased to 1∶4 at d21 post-transplantation. During a follow-up of 6 months, there was no onset of proteinuria or infection and the last value of SCr was 114 μmol/L. \u0000 \u0000 \u0000Conclusions \u0000In HLA highly sensitized recipients awaiting for transplant opportunities, successful prevention of HLA antibodies-mediated rejection may be achieved by using ABO incompatible and yet HLA compatible deceased donors. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Sensitization; ABO incompatible; HLA; Donor specific antibodies","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"36 1","pages":"83-87"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77990119","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}

{"title":"Three cases of orthotopic cardiac transplantation for congenital dextrocardia","authors":"N. Dong, Jin-ping Liu, Guo-hua Wang, Yixuan Wang, Jie Cai, Jing Zhang","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.02.011","url":null,"abstract":"Objective \u0000To summarize the surgical strategies of orthotopic cardiac transplantation for congenital dextrocardia. \u0000 \u0000 \u0000Methods \u0000Three patients with congenital dextrocardia suffered from end-stage heart failure and underwent orthotopic cardiac transplantation from March 2014 to September 2017. They were aged 10, 29, 13 years respectively. Donor hearts were from brain death donors and procured with extra length on inferior vena cava, aorta and pulmonary artery tissues. After cardiectomy, left atrial-atrial anastomosis was performed initially between donor’s left-upper pulmonary vein orifices and recipient’s left-lower pulmonary vein orifices. Apex was orientated at a 90 degrees’ clockwise to right. Then aorta, inferior and superior vena cava and last pulmonary artery were anastomosed continuously. The prosthetic conduits were also used owing to a lack of tissue. \u0000 \u0000 \u0000Results \u0000All operations were successful. The cold ischemic time was (130-375)(251.00±122.53) min, cardiopulmonary bypass time (127-212)(179.67±55.72) min and aortic clamp time (38-105)(65.33±35.166) min. Two patients had stable hemodynamics and recovered well after HTx. During a follow-up period of 1.5-3.5 years, echocardiography showed excellent cardiac functions without blood flow obstruction. Chest radiology showed well-placed donor heart in right mediastinum. One left-sided patient with total cavopulmonary connection before HTx died at 59 days after HTx because of pneumonia and multiple organ failure. \u0000 \u0000 \u0000Conclusions \u0000Heart transplantation is curative for patients with congenital dextrocardia and surgical strategies are the key factor of successful treatment. \u0000 \u0000 \u0000Key words: \u0000Congenital heart disease; Dextrocardia; Heart transplantation","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"20 1","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83606748","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}