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204例肾移植受者HLA-A、HLA-B、HLA-DRB11基因分型结果分析 总被引:2,自引:0,他引:2
采用PCR—SSP法对204例肾移植受者(观察组)进行HLA-A、HLA-B、HLA-DRB。座位基因分型,计算基因频率并与7t118例健康人(对照组)比较。结果观察组频率〉10%的等位基因有A*02、A*24、A*11、A*33、B*15、B*40、B*13、DRB1*15、RB1*04、DRB1*12、RB1*07、RB1*09。其中DRB1*15、DRB1*08、DRB1*04、A*02、A*34与对照组比较有统计学意义。认为具有与对照组相同高频基因的患者更易找到无关供体;DRB1*04、A*02、A*34可能为患肾脏疾病的风险基因,DRB1*15、DRB1*08则可能为保护基因。 相似文献
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肾移植受者在接受人类白细胞抗原 (HLA)不同的供者器官后 ,体内可产生抗HLA抗体而成为致敏状态。测定可溶性抗HLA抗体 (sHLA IgG)水平 ,可以作为评价受者致敏状态的指标。我院在国内首次开展PRA STAT酶联试剂盒 (SangStat公司 )检测sHLA IgG[1] ,于 1998年又引进了LambdaAntigenTray(LAT ,OneLambda公司 )检测系统。为了比较两种方法的异同 ,我们选择了部分长期存活的肾移植受者 ,分别用LAT和PRA STAT测定 ,比较分析两种方法检测的结果和各自的优缺点 ,报告… 相似文献
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我院1979年~1997年共行异体肾移植术754例,死亡162例,死亡率为21.5%。本文回顾分析其死亡原因,以寻求对策,进一步提高肾移植的长期存活率。1对象和方法本组754例接受异体肾移植术者,原发病为慢性肾炎741例,多囊肾9例,IgA肾病2例,... 相似文献
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陈劲松 《肾脏病与透析肾移植杂志》2006,15(6):536-538
部分肾移植受者由于妊娠、输血、感染或二次移植等导致群体反应抗体(PRA)增高,另外由于供体短缺导致一部分患者采用与供体血型不合的供肾行肾移植,使这类受者成为高敏受者。肾移植后发生超急性排斥反应(HAR)和急性排斥(AR)明显升高,由此严重影响移植肾存活。如何对这部分患者进行术前预处理、术后如何维持治疗和处理排斥反应已成为肾移植界的一个难点和热点,也成为提高肾移植近期和远期存活率一个重要因素,我们对这类患者的处理积累了一些自己的经验,并结合国内外文献抛砖引玉,向移植界提供可行的操作原则和方案。 相似文献
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张克勤 《肾脏病与透析肾移植杂志》2012,21(3):253-254
复杂而严重的尿路并发症是导致肾移植手术失败及移植肾带功死亡的重要原因.移植受者由于膀胱肌肉萎缩、组织纤维化明显,组织修复能力下降,加之老年男性患者多合并前列腺增生等下尿路疾病,术后易发生漏尿、膀胱输尿管反流、尿路感染及下尿路梗阻等并发症,故需高度重视,采取有效的防治措施. 相似文献
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肾脏移植后尿路感染(urinary tract infection,UTI)是移植肾功能衰竭和患者致死的原因之一。根据尿路感染的临床表现可分为症状性菌尿和无症状性菌尿。本文主要对尿路感染的影响因素、诊断和治疗作一综述。 相似文献
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肾移植受者的选择与准备 总被引:2,自引:0,他引:2
陈劲松 《肾脏病与透析肾移植杂志》1994,3(2):144-151
对p-幂零群、亚循环群、具有循环的换位子子群的计数函数,改进了已有的结果。 相似文献
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Vaccine‐preventable diseases remain at the forefront of challenges in the long‐term care of renal transplant recipients (RTR). Although global vaccination campaigns targeting patients with end‐stage renal disease or RTR are standard, rates of vaccination among renal transplant candidates and RTRs remain suboptimal. We highlight the multifactorial barriers leading to low vaccination rates in this vulnerable population. 相似文献
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D. Bhowmik A.K. Dinda I. Xess G. Sethuraman S. Mahajan S. Gupta S.K. Agarwal S. Guleria S.C. Tiwari 《Transplant infectious disease》2008,10(4):286-289
Abstract: Panniculitis may result due to various etiologies. In post-transplant immunosuppressed patients infection is the foremost cause of panniculitis. We present 2 cases of fungal panniculitis in renal transplant recipients. The first patient presented with non-tender firm erythematous plaques on the left thigh. Biopsy showed panniculitis with cryptococci. Subsequent investigations revealed the presence of cryptococcal antigens in the blood, urine, and bronchoalveolar lavage fluid. There was no evidence of cryptococcal meningitis. The second patient complained of subcutaneous nodules on the trunk and right thigh. Biopsy of one of the nodules showed panniculitis with histoplasma. This patient had been treated earlier (inadequately) for disseminated histoplasmosis. Both the cases responded well to conventional amphotericin B therapy. Their renal functions remained stable. 相似文献
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We identified 22 cases of influenza infection among renal transplant recipients and matched them with 66 controls by influenza season to explore risk factors for influenza infection. Active cigarette smoking was associated with influenza infection in this population (adjusted odds ratio 13.1; 95% confidence interval 2.3–76; P = 0.004). 相似文献
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O. Gheith T. Al‐Otaibi K.A. Tawab T. Said M.A. Balaha M.A. Halim M.P. Nair M.R.N. Nampoory 《Transplant infectious disease》2010,12(2):164-168
O. Gheith, T. Al‐Otaibi, K.A. Tawab, T. Said, M.A. Balaha, M.A. Halim, M.P. Nair, M.R.N. Nampoory. Erythema nodosum in renal transplant recipients: multiple cases and review of literature.Transpl Infect Dis 2010: 12: 164–168. All rights reserved Abstract: We report 4 renal transplant recipients with erythema nodosum. Erythema nodosum is a cutaneous inflammatory reaction located on the anterior aspects of the lower extremities. It may be associated with a wide variety of diseases, including infections (as in Cases 1 and 2), sarcoidosis, rheumatologic diseases, inflammatory bowel diseases (as in Case 3 ), medications (as in Case 4 ), autoimmune disorders, pregnancy, and malignancies. Histopathologically, erythema nodosum is the stereotypical example of a mostly septal panniculitis with no vasculitis, and the inflammatory infiltrate in the septa varies with age of the lesion. In early lesions edema, hemorrhage, and neutrophils are responsible for the septal thickening, whereas fibrosis, peri‐septal granulation tissue, lymphocytes, and multinucleated giant cells are the main findings in late stage. Etiological management – by anti‐tuberculous therapy in Cases 1 and 2, by salazopyrin in Case 3 , and by discontinuation of ciprofloxacin in Case 4 – was associated with regression. Erythema nodosum can develop in renal transplant patients who did not receive induction therapy, non‐rejecters, and those with steroid‐free protocols. Management of erythema nodosum should be directed to the underlying associated condition, which could be tuberculosis, inflammatory bowel disease, or drug related. 相似文献
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Seroprevalence of Leishmania infection among asymptomatic renal transplant recipients from southern Spain 下载免费PDF全文
E.K. Elmahallawy E. Cuadros‐Moronta M.C. Liébana‐Martos J.M. Rodríguez‐Granger A. Sampedro‐Martínez A. Agil J.M. Navarro‐Mari J. Bravo‐Soto J. Gutierrez‐Fernández 《Transplant infectious disease》2015,17(6):795-799
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Jean‐Baptiste de Freminville Louis‐Marie Vernier Jrome Roumy Frdric Patat Philippe Gatault Bndicte Sautenet Elodie Bailly Eloi Chevallier Christelle Barbet Hlne Longuet Elodie Merieau Christophe Baron Matthias Buchler Jean‐Michel Halimi 《Journal of clinical hypertension (Greenwich, Conn.)》2019,21(3):382-389
High renal resistive index (RI) is observed in diabetes and is associated with poor patient survival, but whether it is primarily due to renal vascular resistance or systemic vascular alterations is unclear. The respective impact of kidney transplant from diabetic donors or to diabetic recipients on RI would shed some light on this issue. The objective of the study was to analyze the impact of donor and recipient diabetes on RI in order to understand the respective impact of the kidney and the vascular environment. The authors conducted a retrospective study in 1827 renal transplant recipients who received a kidney between 1985 and 2017, and had Doppler measurements at 3 months after transplant. Donor and recipient characteristics at the time of transplant and at 3 months were reviewed. Both donor diabetes and recipient diabetes were associated with RI in univariate analysis, but only recipient diabetes remained significantly associated in stepwise multivariate analyses (effect estimate on RI: +0.03 ± 0.005, P < 0.001). These findings were confirmed when RI was expressed as a binary variable using a cutoff of 0.75 (OR = 2.50 [1.77, 3.54], P < 0.001). Other determinants of RI were recipient characteristics (age, sex, systolic and diastolic blood pressure, and duration of dialysis). Donor characteristics were not associated with RI. Our results suggest that high RI observed in diabetic recipients shortly after transplant is primarily due to the new vascular environment, rather than to characteristics of the transplanted kidney. Therefore, RI reflects systemic rather than intra‐renal changes. 相似文献
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Tuberculosis in renal transplant recipients 总被引:1,自引:0,他引:1
Tuberculosis (TB) has been described in kidney transplant recipients as an infection with predominantly pulmonary involvement. We report the impact of TB in kidney transplantation. Clinical records of adult kidney recipients, transplanted between 1 January 1986 and 31 December 1995 were analyzed for sex, age, graft origin, immunosuppressive therapy, TB sites, diagnostic methods and concomitant infections. Annual incidence, mean time of onset, relation to rejection treatment, tuberculin skin test (PPD) and outcome were analyzed. Patients with a history of TB or graft loss in the first month were excluded. TB was diagnosed in 14 of 384 (3.64%). Mean age at transplantation was 35 years. Twelve of these received the graft from a living donor. All had triple immunosuppression with cyclosporine. Ten had pulmonary TB, three extrapulmonary infection and one disseminated disease. In 13 cases an invasive diagnostic procedure was performed. Mycobacterium tuberculosis cultures were positive in all cases; microscopy revealed acid-fast bacilli (AFB) in 6, and adenosine deaminase was elevated in CSF and pleural effusion in 2. Annual incidence varied from 0% to 3.1%. At the time of TB presentation 8 patients had other concomitant infections (cytomegalovirus, nocardia, Pneumocystis carinii, disseminated herpes simplex virus). Median time of onset was 13 months. Diagnostic results became available post-mortem in 2 cases, and one had TB in a failing allograft. TB was treated with 4 drugs including rifampin in 10 patients. Cyclosporine was discontinued in one, lowered in one and increased in 8. During treatment 5 patients had rejection episodes. At 1 year, graft survival was 72.7% and patient survival 90.9%. TB was more prevalent when recipient and donor were both PPD positive. In summary: although TB is a growing threat in the transplant setting, early and aggressive diagnosis with meticulous monitoring of immunosuppression allows a successful outcome for both patient and graft. Optimal prophylaxis guidelines have yet to be completely defined. 相似文献
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Tuberculosis (TB) is a frequent infectious complication in patients on renal replacement therapy, as a result of immunosuppression from uremia and drugs in the post-transplantation period. A retrospective study of all renal transplantation patients from 1989 to date was conducted. This study tried to examine the prevalence, course, and outcome of TB in renal transplant recipients. A comparison with the occurrence of TB in other modalities of renal replacement therapy was also made. We also discussed the treatment protocols for TB in this group of patients. No difference in the prevalence, age, or male/female ratio of TB was seen among the 3 modes of renal replacement therapy. TB of the lung was the more favored site of infection in patients on hemodialysis (77.3%), when compared with those on CAPD (30%) and renal transplant recipients (33.3%). In renal transplant recipients, no deaths occurred due to TB. In 7 patients there was co-infection with cytomegalovirus and in 3 patients there was Aspergillus lung infection. 相似文献
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