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41.
Christina D. Mejia Adam M. Frank Pooja Singh Anju Yadav 《American journal of transplantation》2021,21(3):1322-1325
Immune checkpoint inhibitors (ICPIs) are monoclonal antibodies against inhibitory receptors on T cells resulting in anticancer activity. In kidney transplant (KT) recipients, ICPI use has been associated with acute allograft rejection. In failed allografts, however, the effects of ICPIs are unknown. We present a case of a 66-year-old man with a history of diabetes, renal cell cancer, left native nephrectomy, and end-stage kidney disease. He received a deceased donor KT which failed after 6 years due to biopsy-proven recurrent diabetic nephrosclerosis. He was started on hemodialysis and his immunosuppression was gradually weaned off. A year later, he was diagnosed with renal cell cancer in his right native kidney requiring nephrectomy. He later developed metastasis and was started on combination ICPIs. He developed hematuria, allograft pain, and malaise consistent with graft intolerance syndrome 28 days after starting ICPIs. Urine culture and cystoscopy were normal. A computed tomography scan of his abdomen revealed an enlarged allograft with patchy enhancement. After a multidisciplinary discussion, he underwent transplant nephrectomy. Histopathology showed chronic active T cell–mediated rejection. As ICPI use becomes prevalent, practitioners need to be aware of its potential complications among KT recipients both with functioning and failed allografts. 相似文献
42.
Keith S. Hansen Hila Ghersin Merisa Piper Mehdi Tavakol Brian Lee Laura J. Esserman John P. Roberts Chris Freise Nancy L. Ascher Rita A. Mukhtar 《American journal of transplantation》2021,21(9):3014-3020
Kidney transplantation reduces mortality in patients with end stage renal disease (ESRD). Decisions about performing kidney transplantation in the setting of a prior cancer are challenging, as cancer recurrence in the setting of immunosuppression can result in poor outcomes. For cancer of the breast, rapid advances in molecular characterization have allowed improved prognostication, which is not reflected in current guidelines. We developed a 19-question survey to determine transplant surgeons’ knowledge, practice, and attitudes regarding guidelines for kidney transplantation in women with breast cancer. Of the 129 respondents from 32 states and 14 countries, 74.8% felt that current guidelines are inadequate. Surgeons outside the United States (US) were more likely to consider transplantation in a breast cancer patient without a waiting period (p = .017). Within the US, 29.2% of surgeons in the Western region would consider transplantation without a waiting period, versus 3.6% of surgeons in the East (p = .004). Encouragingly, 90.4% of providers surveyed would consider eliminating wait-times for women with a low risk of cancer recurrence based on the accurate prediction of molecular assays. These findings support the need for new guidelines incorporating individualized recurrence risk to improve care of ESRD patients with breast cancer. 相似文献
43.
常压氧治疗胎儿-胎盘循环功能降低疗效的多普勒超声心动图观察 总被引:1,自引:0,他引:1
目的评价常压氧在胎儿-胎盘循环功能降低治疗中的疗效.方法应用超声心动图观察52例胎儿胎盘循环功能降低在常压氧治疗前后的变化情况并与45例普通吸氧组及41例未治疗组进行对照.结果52例胎盘循环功能降低胎儿中43倒常压氧治疗后胎盘循环功能恢复正常,有效率82.7%.明显高于对照组(P<0.01).结论常压氧是治疗胎儿胎盘循环功能降低安全、有效的方法. 相似文献
44.
电解铝厂职工恶性肿瘤死亡状况回顾性队列研究 总被引:1,自引:0,他引:1
对某电解铝厂职工恶性肿瘤死亡情况进行了10年回顾性队列研究,以宁夏1990 ̄1992年人口年龄死亡专率为参比,计算了观察队列标化死亡比(SMR)、癌症比例死亡比(PMR和PCMR),观察组肺癌超出量尤为显著,SMR为190(P〈0.01),PCMR为171(P〈0.05)。 相似文献
45.
A literature search was conducted to report all cases of documented transmission of infectious diseases from donors to recipients of corneal transplants. Fourteen such cases have been reported. There is no experimental or clinical evidence to suggest the transmissions of either hepatitis or syphilis via corneal grafting. Available evidence regarding a number of neurologic and other disorders in which a slow virus etiology has been implicated were reviewed. On the basis of this review, we are able to draw certain conclusions and guidelines for selection or rejection of donor material for transplant surgery. 相似文献
46.
G. Francesconi C. Grassi O. Fenili C. Chiocchetti 《European journal of plastic surgery》1981,6(2):135-140
Summary The authors, based on their own experience in this field suggest their own therapeutical view which can be described as follows: a much more frequent use of plastic procedures using sliding flaps from the cheek, associated usually with chondromucosal free grafts from the septum, will give not only much better aesthetic results but also a better guarantee against neoplastic recurrence due to the possibility of being able to carry out a much larger ablation. 相似文献
47.
John Fitzpatrick Arvind Bhargava Ramez Bedwani Marcel Gagnon 《Journal of surgical oncology》1981,16(1):37-41
Whole blood catalase levels were estimated using a disc flotation method in 209 random patients with a wide variety of malignancies. Fifty patients had received no treatment, and the remainder, although having undergone prior therapy, had recurrent or metastatic disease at the time of the study. No relationship was found between the presence of cancer and catalase levels. A direct relationship was found for catalase with hemoglobin levels in both normal and patients' samples. Whole blood catalase is of no value in diagnosis and monitoring of cancer. The decreased catalase values found here and reported previously by others are the result of low hemoglobin levels found in many patients with cancer. 相似文献
48.
Shan Ray Baker 《Journal of surgical oncology》1981,17(1):25-32
One hundred and twenty patients with malignancy of the nasopharynx were reviewed. The most common presenting symptoms of this disease were cervical mass and hearing loss. Neoplasm occurred three times more frequently in males than in females. Cranial nerve dysfunction was present in 17.5% of patients at the time of initial evaluation. The overall 3- and 5-year determinate survival for the entire series of nasopharyngeal malignancies was 38.9, and 27.0%, respectively. Nonsquamous cell malignancies demonstrated a better 5-year survival (42%) than squamous cell and undifferentiated neoplasms (24%). The presence of cervical metastases offered a poorer prognosis. A 39.6% 5-year survival was recorded for patients without nodal disease. Massive lymphadenopathy or bilateral cervical metastases forecasted an ominous 5-year survival of 13.6%. Control rate was greatest among patients with tumors restricted to one area of the nasopharynx and without regional metastases. The 5-year survival of such patients was 71.4% compared to 13.3% for patients having tumor extension beyond the nasopharynx producing cranial nerve impairment or bone erosion. 相似文献
49.
目的观察门冬酰胺酶(L-ASP)在儿童急性淋巴细胞白血病(ALL)及Ⅲ、Ⅳ期非霍奇金淋巴瘤(NHL)应用中严重并发症,探讨L-ASP化疗顺利完成的有效对策。方法针对L—ASP的各种主要并发症制定相应的检测手段及监测指标,在应用L—ASP期间对患儿进行监测,对出现并发症采取相应的检测。统计各并发症的发生率、发生时间。结果用L—ASP化疗的ALL和NHL患儿总计301例次,其中L-ASP相关严重并发症20例次(6.6%),高血糖7例次(2.32%);低血糖1例次(0.33%);胰腺炎6例次(1.99%);脑栓塞2例次(0.66%);弥散性血管内凝血(DIC)6例次(1.99%);脏器出血4例次(1.32%);休克7例次(2.3%);死亡10例(3.3%)。结论L-ASP的细胞毒作用可造成人体各系统的损害,严重者甚至危及生命。严密、合理的监测手段及早期干预可明显降低L-ASP并发症。 相似文献
50.