Chineae Journal of Organ Transplantation最新文献

{"title":"Protective effects of Dex on myocardial injury induced by hepatic cold ischemia reperfusion","authors":"Hongxia Li, Y. Weng, Wenli Yu","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.012","url":null,"abstract":"Objective \u0000To explore the effects of dexmedetomidine on myocardial injury during liver cold ischemia reperfusion in rats. \u0000 \u0000 \u0000Methods \u0000A total of 40 healthy male Sprague-Dawley (SD)rats with a weight of 220~250 gram and an age of 8~10 weeks were randomly divided into 5 groups of sham, model, Dex, Atip and AG490 by a random number table (n=8 each). At 8h post-reperfusion, blood samples were harvested from infra-hepatic vena cava and serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), creatine kinase-muscle/brain (CK-MB), troponin I (cTnI)and heart-type fatty acid binding protein (H-FABP)determined by enzyme-linked immunosorbent assay (ELISA). After blood sampling, the rats were sacrificed, the expression of activated caspase-3 was detected by immunohistochemistry and apoptotic cells by TUNEL.Apoptotic rate was calculated.And the phosphorylations of JAK2, STAT1 and STAT3 were assessed by Western blot. \u0000 \u0000 \u0000Results \u0000As compared with sham group, the levels of TNF-α, IL-6, CK-MB, cTnI and H-FABP significantly increased, apoptotic rate spiked, pathological damage worsened and the expressions of activated caspase-3, p-JAK2, p-STAT1 and p-STAT3 were up-regulated in other groups (P<0.05); As compared with model group, the levels of TNF-α, IL-6, CK-MB, cTnI and H-FABP significantly decreased, apoptotic rate declined, pathological damage became alleviated and the expressions of activated caspase-3, p-JAK2, p-STAT1 and p-STAT3 became down-regulated in groups Dex and AG490 (P<0.05); as compared with group Dex, the levels of TNF-α, IL-6, CK-MB, cTnI and H-FABP significantly increased, apoptotic rate rose, pathological damage worsened and the expressions of activated caspase-3, p-JAK2, p-STAT1 and p-STAT3 became up-regulated in group Atip (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Dexmedetomidine can ameliorate myocardial injury induced by liver cold ischemia-reperfusion in rats. \u0000 \u0000 \u0000Key words: \u0000Liver; Reperfusion injury; Myocardium; Apoptosis","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75318289","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":"Parvovirus B19 infection in patients after renal transplantation: a report of 22 cases","authors":"Xiaowei Zhang, Lei Zhang, Wen‐yu Zhao, Mingxing Sui, K. Lin, Zhe Liu","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.002","url":null,"abstract":"Objective \u0000To summarize the pathogenic characteristics and treatments of parvovirus B19 infection in patients after renal transplantation. \u0000 \u0000 \u0000Methods \u0000Twenty-two cases of parvovirus B19 infection after renal transplantation were diagnosed by quantitative polymerase chain reaction (qPCR) from March 2016 to January 2019. And the pathogenic characteristics and treatments of parvovirus B19 infection after renal transplantation were analyzed. \u0000 \u0000 \u0000Results \u0000The overall incidence rate of parvovirus B19 after renal transplantation was 2.97%. The median diagnostic time was 39 (15~572) days. Administration of intravenous immunoglobulin (IVIG), conversion of immunosuppressants and other comprehensive regimens were adopted. Except for 1 patient dying from cardiovascular accident at 4 days post-diagnosis, the remainders were cured. The accumulative dosage of IVIG was (7.7±3.8) g/kg in 5 patients with delayed conversion and un-conversion of immunosuppressants, and (2.7±1.9) g/kg in 16 patients with early conversion of immunosuppressants. During a follow-up period of (13.0±9.1) months, the level of hemoglobin remained stable. \u0000 \u0000 \u0000Conclusions \u0000Parvovirus B19 infection after renal is predominant immediately after transplantation. And the dosage of IVIG may be lowered by an early conversion of immunosuppressants after a definite diagnosis. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Virus; Infection; Anemia","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80702155","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":"Clinical analysis of posttransplant lymphoproliferative disorder in kidney transplant recipients and hematopoietic stem cell transplant recipients summary","authors":"Hongyi Liang, Jian Xu, Li-xin Yu, Leiyu Yao, Fangxiang Fu, Jiangtao Li, Jin-yan Peng, Yanna Liu, Guoming Deng, Y. Miao","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.006","url":null,"abstract":"Objective \u0000To provide theoretic rationales and clinical experience for post-transplant lymphoproliferative disorder (PTLD) by comparing the characteristics of PTLD in kidney and hematopoietic stem cell transplant recipients and reviewing the relevant literature reports. \u0000 \u0000 \u0000Methods \u0000Twenty-seven adult PTLD patients from 2000 to 2017 were retrospectively reviewed. There were 11 kidney transplant recipients (KT group) and 16 hematopoietic stem cell transplant recipients (HSCT group). Clinical characteristics and outcomes were analyzed between two groups. Cox’s proportional hazard model was utilized for evaluating the prognostic factors. \u0000 \u0000 \u0000Results \u0000The incidence of PTLD for KT and HSCT groups were 0.5 % and 1.1 % respectively. PTLD patients of KT group had a later onset than that of HSCT group (105.1 vs 3.1 months, P<0.01). Also Epstein-Barr virus was less frequently detected in KT group (36.4 % vs 81.3 %, P<0.05). The 5-year overall survival was (46.8%±10.5%). According to Cox analysis, application of antithymocyte globulin (ATG) and high ECOG scores were risk factors for a poor prognosis of PTLD. \u0000 \u0000 \u0000Conclusions \u0000Most cases of KT-PTLD have a late onset. In contrast, HSCT-PTLD has an earlier onset and a higher incidence of EBV infectious. And application of ATG and high ECOG scores are poor prognosis factors of PTLD. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Hematopoietic stem cell transplantation; Prognosis","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86864635","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":"Allogeneic hematopoietic stem cell transplantation for chronic myelomonocytic leukemia","authors":"Yuanyuan Shi, Yi He, Gui-xin Zhang, W. Zhai, Qiao-ling Ma, A. Pang, Donglin Yang, Rong-li Zhang, Jialin Wei, E. Jiang, M. Han","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.005","url":null,"abstract":"Objective \u0000To explore the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in chronic myelomonocytic leukemia (CMML) patients. \u0000 \u0000 \u0000Methods \u0000The clinical data were retrospectively analyzed for 19 CMML patients undergoing allo-HSCT. Engraftment, graft versus host disease (GVHD), infection, relapse, splenomegaly and survival were observed. And the clinical outcomes of allo-HSCT for CMML were analyzed. \u0000 \u0000 \u0000Results \u0000Hematopoiesis reconstitution was not attained in 2 recipients due to early death post-transplantation. Neutrophil engraftment was obtained in 17 recipients with a median time of 14(11-18) days. Neutrophil engraftment and platelet engraftment were achieved in 15 recipients with a median time of platelet engraftment at 15 (12~70) days. Seven patients developed acute GVHD (grade 1, n=5; grade 2~4, n=3) while another 8 patients had chronic GVHD (extensive, n=5). Ten patients (52.6 %)had palpable splenomegaly (SPM) before allo-HSCT, 8 patients were diagnosed ultrasonically after transplantation, all 4 patients without a significant reduction of spleen died while all 4 patients with a significant reduction of spleen survived. After a median follow-up period of 31 (6-68) months, 3-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were (58.2±12.5)%, (36.3±14)%, (39.9±19)% and (37±12.6)% respectively. \u0000 \u0000 \u0000Conclusions \u0000As an effective therapy for CMML, allo-HSCT may improve the survival of CMML patients. Palpable SPM pre-transplantation and no significant reduction post-transplantation are probably poor prognostic factor. \u0000 \u0000 \u0000Key words: \u0000Allogeneic hematopoietic stem cell transplantation; Leukemia; Splenomegaly","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75338346","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":"Diagnosis and treatment in 9 cases of donor-derivedcarbapenem-resistant Klebsiella pneumoniae Infection after kidney transplantation","authors":"Jiajin Wu, Dawei Li, Ming Zhang, Liang Ying, C. Zhong, R. Chen, F. Qiu, Shaoyong Zhuang, Haoyu Wu","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.004","url":null,"abstract":"Objective \u0000To explore the rapid diagnosis and clinic treatment of donor-derived carbapenem-resistant Klebsiella pneumoniae (CRKP) infection in renal transplant recipients. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis was performed for clinical data and the diagnosis and treatment of 9 renal transplant recipients with donor-derived CRKP infection from March 2017 to May 2019. \u0000 \u0000 \u0000Results \u0000Among 526 renal transplant recipients, nine were diagnosed with donor-derived CRKP infection by bacterial culture or KPC enzyme gene test. The infection rate was 1.71%. One recipient receiving carbapenem and tigecycline died while the remainders survived after a treatment of ceftazidime-avibactam and carbapenem. One recipient underwent graft resection. Among 8 recipients on ceftazidime-avibactam, 5 cases received a standard dose of 3.75 g/d while another 3 cases had a high dose of 7.5 g/d. One patient in standard-dose group underwent graft resection due to an arteriorrhexis of artery anastomosis. After graft resection, the patient received a high dose of ceftazidime-avibactam and survived to date. The grafts of three patients in high-dose treatment group survived. \u0000 \u0000 \u0000Conclusions \u0000KPC enzyme gene detection plus injecting lavage fluid into blood culture bottle for bacterial culture is rapid and accurate for diagnosing donor-derived CRKP infection. A combination of ceftazidime-avibactam plus carbapenem is effective for donor-derived CRKP infection. A high dose of ceftazidime-avibactam may improve the efficacy without obvious side effects. \u0000 \u0000 \u0000Key words: \u0000Renal transplantation; infection; resistant organism","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86765723","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":"Relationship between cellular rejection and development of rat transplanted metanephroi from different gestational ages","authors":"Jian Xu, Yahui Sun, Chunyue Xu, Yening Huang, Liang-jie Hong, F. Zeng","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.011","url":null,"abstract":"Objective \u0000To explore the relationship between cellular rejection and the development of allo-or xenografted primordia from different gestational ages. \u0000 \u0000 \u0000Methods \u0000Whole rat metanephroi from embryonic day E14~E19 were transplanted into omenta of outbred (SD→SD, 6 groups, n≥10 each; E15-E17SDCsA, 3 groups, n=15 each), syngeneic (Lewis→Lewis, 5 groups, n=8 each), allogeneic (Lewis→BN, E15BN n=6 each E15BNCsA n=10 each, E16BNCsA n=10 each) rats and xenogeneic (Lewis→C57groups, E15C57 n=10 each, E15C57CsA, n=8 each; Lewis→Balb/c nude mice, 3 groups, n=10 each) recipients. Histopathology, Banff’s grading and electron microscopy (EM) were utilized for assessing the graft development. Similarly, biochemical indicators and creatinine clearances were measured. \u0000 \u0000 \u0000Results \u0000At 4 weeks post-transplantation, in SD→SD groups, E14-E17SD metanephroi developed with Banff’s rejections. E14/E15SD was significantly lighter than E16/E17SD (P 0.05). E14Lewis and E18Lewis rats had significantly poorly differentiated metanephroi than those in E16 Lewis group. In Lewis→C57BL/6, E15 metanephroi were rejected at Day 14 post-transplantation (n=10) and no improvement was evident after CsA dosing (15 mg·kg-1·d-1, n=8). In Lewis→Balb/c nude mice, all E15~E17Balb/c metanephroi developed well. Both light microscopy and EM examination showed normal nephrons and collecting ducts and wet weight, creatinine or urea nitrogen of effusion showed no significant difference (P>0.05). E15Lewis and E16Lewis had significantly different values of wet weight and creatinine clearances from those of E15SDCsA and E16SDCsA. E15SDCsA had the greatest wet weight and the lowest creatinine clearance rate (P<0.01). \u0000 \u0000 \u0000Conclusions \u0000After controlling rejection during allo-and xenotransplantations, E15, E16 and E17 rat metanephros have similar development characteristics. And cellular immunogenic factors still remain the major barriers to their developments. \u0000 \u0000 \u0000Key words: \u0000metanephrogenic blastema; immunological rejection; immunosuppressant; organogenesis","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89263799","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":"Value ofmetagenomic next-generation sequencing in the diagnosis and treatment of severe pneumonia after renal transplantation","authors":"Huichang Zhuo, Jiandong Lin, Y. You","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.009","url":null,"abstract":"Objective \u0000To explore the value of metagenomic next-generation sequencing(mNGS)in the diagnosis and treatment of severe pneumonia after renal transplantation. \u0000 \u0000 \u0000Methods \u0000A total of 38 patients with severe pneumonia after renal transplantation from October 2017 to December 2018 were selected and divided into experimental group(A, n=15)and control group (B, n=23) based upon whether mNGS of bronchoalveolar lavage fluid was employed for detecting pathogenic microorganisms. Positive rate, clinical acceptance rate, hospitalization time, hospitalization expenses and 28-day mortality rate of two methods were compared. \u0000 \u0000 \u0000Results \u0000Positive rate and clinical acceptance rate of mNGS were higher in experimental group than those in traditional experimental and control groups (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000For patients with severe pneumonia after renal transplantation, mNGS of bronchoalveolar lavage fluid can improve positive rate of etiological diagnosis and clinical acceptance rate and reduce hospitalization time, hospitalization expenses and 28-day mortality. \u0000 \u0000 \u0000Key words: \u0000Renal transplantation; Pneumonia; Pathogenic microorganism","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73595780","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":"Single lung transplantation assisted by extracorporeal membrane oxygenation technique duringperioperative period: a report of 6 cases","authors":"Qian Xiaoliang, Yue Chen, Liang Jianchao, Dong-fang Yao, G. Chang, Hu Jiaxin, Meng Fanwei, Jian Zhao, Li Wei, Yang Leiyi, Zhaoyun Cheng","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.010","url":null,"abstract":"Objective \u0000To summarize the application experiences and curative efficacies of single lung transplantation assisted by extracorporeal circulation with coated lung, centrifugal pump and coated pipe. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis was conducted for clinical data of 6 adult patients with respiratory insufficiency undergoing single lung transplantation. The changes of hemodynamics and oxygenation before and after adjuvant treatment were observed, the effects of adjuvant evaluated and the experiences of application summarized. \u0000 \u0000 \u0000Results \u0000The hemodynamic parameters post-assistance significantly improved as compared with that pre-assistance and pulmonary arterial pressure dropped from (56±15) to (45±13) mmHg with statistically significant differences. Arterial blood gas parameters significantly improved. PO2 spiked from (47±12) to (68±9) mmHg and PCO2 declined from (65±14) to (55±12)mmHg. And there were statistically significant differences. All patients were discharged successfully. \u0000 \u0000 \u0000Conclusions \u0000The simple extracorporeal membrane oxygenation system of coated lung, centrifugal pump and coated pipe during routine extracorporeal circulation may guarantee the operative safety of single lung transplantation and provide a new therapeutic option. \u0000 \u0000 \u0000Key words: \u0000Single lung transplantation; Extracorporeal membrane oxygenation; Hemodynamics; Blood gas analysis","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80462543","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 liver transplantation for hepatic andhilar cholangiocarcinoma","authors":"Ensi Ma, Quan-bao Zhang, Yifeng Tao, Rui‐dong Li, Cong-huan Shen, Zhen-yu Ma, Jianhua Li, Yanting Jin","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.007","url":null,"abstract":"Objective \u0000To explore the clinical features and risk factors associated with intrahepatic and hilar cholangiocarcinoma after liver transplantation. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis of clinical data was performed for 20 hospitalized patients with intrahepatic and hilar cholangiocarcinoma from June 25, 2014 to October 31, 2018. Treatments and follow-up outcomes were analyzed. The survival rate was calculated by the Kaplan-Meier method and the survival curve plotted. Cox regression model was employed for analyzing the prognostic factors. \u0000 \u0000 \u0000Results \u0000The cumulative recurrence rate of patients with AJCC stage Ⅰ /Ⅱ was significantly lower than that in AJCC stage Ⅲ/Ⅳ. And the cumulative recurrence rate of stage Ⅰ/Ⅱ Patients was 0 and that of stage Ⅲ/Ⅳ 76% (P=0.042). Cox regression model showed that CA19-9 was the only prognostic factor. An elevated level of CA19-9 was associated with high recurrence post-transplantation (HR=1.001; 95% CI: 1.000~1.001; P=0.035). \u0000 \u0000 \u0000Conclusions \u0000During progressive stage, the recurrence rate is higher with a worse prognosis. And an elevation of CA19-9 is an independent poor prognostic factor after intrahepatic and hilar cholangiocarcinoma transplantation. \u0000 \u0000 \u0000Key words: \u0000Liver transplantation; Cholangiocarcinoma; Relapse; Clinical staging","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90269388","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":"Prevention and treatment of graft-carried carbapenem-resistant Klebsiella pneumoniae infection after kidney transplantation: a report of 13 cases","authors":"Lan Zhu, Zhi-qiang Wang, K. Ma, H. Feng, G. Zhao, J. Jia, Xinqiang Wang, Zheng-bin Lin, Gang Chen","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.003","url":null,"abstract":"Objective \u0000To evaluate the efficacy of tigecycline plus prolonged high-dose meropenem infusion in the prevention and treatment of early carbapenem-resistant Klebsiella pneumoniae (CRKP) infection after renal transplantation. \u0000 \u0000 \u0000Methods \u0000From January 2016 to December 2018, clinical data were retrospectively analyzed for 13 renal transplant recipients with graft-carried CRKP. The relevant clinical data included treatments and outcomes of grafts and recipients.KPC-2 gene was the only resistance gene detectable in all isolates of CRKP. Among 13 CRKP positive recipients, there were positive cultures of graft preservation solution, recipient blood & urine (n=1), positive cultures of graft preservation solution & urine (n=1), positive cultures of graft preservation solutions & peri-graft drainage (n=3), continuous positive cultures of peri-graft drainage more than twice (n=3) and positive culture of graft preservation solution (n=5). All patients received tigecycline plus prolonged high-dose meropenem infusion-based antibiotics. \u0000 \u0000 \u0000Results \u0000Five patients with CRKP positive in preservation solution were successfully prevented from infection after a treatment period of (12.4±2.1)days. Among another 8 cases, additional topical medications (n=3) and surgical debridement (n=1) were used. It took a median time of 16 (7~60) days until a negative culture and the total antibiotic treatment course was 20 (10~93) days. The average hospitalization duration was (50±35) days. During a median follow-up period of 25 (6~28) months, there was no onset of renal arterial rupture, graft nephrectomy or death. The survival rate was 100% for recipients and 92.3% for grafts. \u0000 \u0000 \u0000Conclusions \u0000For post-transplant infections due to graft-carried KPC-2 producing CRKP, rapid diagnostics and tigecycline plus prolonged high-dose meropenem infusion may optimize clinical outcomes by decreasing the rate of graft nephrectomy and the recipient mortality. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Donor; Klebsiella pneumoniae; Infection; Prognosis","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75165148","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}