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Ester De Marco Daniela Corona Flavio Origlio Giuseppe Giuffrida Rossella Gioco Chiara Palermo Francesca Privitera Alessia Giaquinta Alba Ilari Sara D’Errico Flavia Pinto Fausto Carbone Anna Carbonaro Pierfrancesco Veroux Massimiliano Veroux 《Transplantation proceedings》2019,51(9):2906-2909
BackgroundA careful assessment of a living donor is mandatory to minimize the short- and long-term risk related to kidney donation. In this study, we evaluated the incidence of incidental findings (IFs) in a large population of potential living kidney donors. Moreover, this study evaluated if the presence of IFs could influence the chance of living kidney donation and post-transplant outcomes.MethodsOne hundred and sixty consecutive potential prospective living kidney transplant donors, who underwent a multidetector computed tomography angiography (MDCTA), were included in the study. An IF was defined as an incidentally discovered mass or lesion, detected by computed tomography angiography during the imaging evaluation of potential living donors. Clinical outcomes of living donors with IF were compared with those without IF.ResultsIn 10 patients (6.2%) an incidental finding was detected at MDCTA assessment. Among the 10 patients presenting with an IF, 7 patients (4.3%) were excluded from the living donation: 2 patients with an adrenal lesion, 3 patients with cancer, and 2 patients with a large (>8 cm) renal cyst. Graft and patient survival of kidney transplant recipients of donors with IFs were not significantly different to those receiving a kidney from living donors without IFs.ConclusionsIncidental findings are frequently discovered during living kidney donor evaluation. Whereas most are asymptomatic or not clinically relevant, predonation screening could identify potentially life-threatening diseases at an earlier stage, allowing for a more radical treatment. 相似文献
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Ester Orlandi MD Stefano Cavalieri MD Roberta Granata MD Piero Nicolai MD Paolo Castelnuovo MD Cesare Piazza MD Alberto Schreiber MD Mario Turri-Zanoni MD Pasquale Quattrone MD Rosalba Miceli MD Gabriele Infante PhD Fausto Sessa MD Carla Facco MD Giuseppina Calareso MD Nicola Alessandro Iacovelli MD Davide Mattavelli MD Alberto Paderno MD Carlo Resteghini MD Laura Deborah Locati MD Lisa Licitra MD Paolo Bossi MD 《The Laryngoscope》2020,130(4):857-865
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Corrado Girmenia Tiziana Lazzarotto Francesca Bonifazi Francesca Patriarca Giuseppe Irrera Fabio Ciceri Franco Aversa Franco Citterio Umberto Cillo Emanuele Cozzi Enrico Gringeri Fausto Baldanti Rossana Cavallo Pierangelo Clerici Giovanni Barosi Paolo Grossi 《Clinical transplantation》2019,33(10)
Cytomegalovirus (CMV) remains a major cause of morbidity and mortality in allogeneic hematopoietic stem cell transplantation (allo‐HSCT) and solid organ transplantation (SOT) recipients. In view of the uncertainties on the assessment and prevention of CMV infection in both transplant procedures, three Italian scientific societies for HSCT and SOT and for Clinical Microbiology appointed a panel of experts to compose a framework of recommendations. Recommendations were derived from a comprehensive analysis of the scientific literature and from a multidisciplinary consensus conference process. The lack of adequate clinical trials focused on certain diagnostic procedures, and antiviral intervention forced the panel to use the methods of consensus for shaping some recommendations. Recommendations concerning the two types of transplant were given for the following issues: assessment of pretransplant CMV serostatus, immunological monitoring after transplant, CMV prophylaxis with antivirals, CMV preemptive strategy, and CMV prophylaxis with immunoglobulin infusion and with adoptive immunotherapy. The questions raised by and the recommendations resulting from this consensus conference project may contribute to the improvement of certain crucial aspects of the management of CMV infections in allo‐HSCT and in SOT populations. 相似文献
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Elisa Rumi Emanuela Sant'Antonio Chiara Cavalloni Giuditta Comolli Virginia Valeria Ferretti Irene Cassaniti Daniela Pietra Chiara Trotti Michele Ciboddo Milena Furione Daniele Vanni Ilaria Carola Casetti Cristina Favaron Fausto Baldanti Luca Arcaini Mario Cazzola 《Hematological oncology》2020,38(4):554-559
Ruxolitinib is effective in myeloproliferative neoplasms (MPN) but can cause reactivation of silent infections. We aimed at evaluating viral load and T-cell responses to human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) in a cohort of 25 MPN patients treated with ruxolitinib. EBV-DNA and HCMV-DNA were quantified monthly using real-time polimerase chain reaction (PCR) on peripheral blood samples, and T-cell subsets were analyzed by flowcytometry. HCMV and EBV-directed T-cell responses were evaluated using the IFN-γ ELISPOT assay. Most patients had CD4+ and/or CD8+ T-cells below the normal range; these reductions were related to the duration of ruxolitinib treatment. In fact, reduced T-lymphocytes' subsets were found in 93% of patients treated for ≥5 years and in 45% of those treated for <5 years (P = .021). The former also had lower median numbers of CD4+ and CD8+ cells. Subclinical reactivation of EBV and HCMV occurred in 76% and 8% of patients. We observed a trend to an inverse relationship between EBV and CMV-specific CD4+ and CD8+ T-cell responses and viral load, and a trend to an inverse correlation with ruxolitinib dose. Therefore, our data suggest that the ruxolitinib treatment may interfere with immunosurveillance against EBV and HCMV. 相似文献