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1.
M. Papachristou A. Fylaktou M. Daoudaki E. Cholongitas T. Karampatakis A. Anastasiou G. Chatzika F. Makrovasili L. Vagiotas K. Karakasi I. Fouzas 《Transplantation proceedings》2019,51(2):424-428
Introduction
The prevalence and impact of pre-existing and de novo anti-HLA donor-specific antibodies (DSAs) after orthotopic liver transplantation (OLT) is still controversial. We investigated the prevalence of DSAs and their implication in the development of allograft dysfunction after OLT.Patients and Methods
A total of 65 liver transplant patients were tested for anti-HLA antibodies, with single antigen bead technology, before, 1, 3, 6, and 12 months after transplantation, and thereafter annually, along with other risk factors. Sixteen out of 65 patients (24.6%) had circulating pre-existing anti-HLA antibodies, and 4 of them (25%) had DSAs. All patients positive for anti-HLA antibodies (100%) presented allograft dysfunction. Fourteen out of 65 patients (21.5%) had circulating de novo DSAs, and 12 out of 14 (85.7%) presented allograft dysfunction. The investigated risk factors for allograft dysfunction were: recipient and donor age, time on the waiting list, cold ischemia time, cytomegalovirus infection, immunosuppression regimen, de novo DSAs, Model for End-Stage Liver Disease, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase (GGT), direct bilirubin and total bilirubin peak post-transplant, and alkaline phosphatase. The multivariate analysis showed that de novo DSAs and time on the waiting list were independent risk factors for allograft dysfunction.Conclusion
Our results show that de novo DSAs are an independent risk factor for allograft dysfunction, along with time on the waiting list. 相似文献2.
C. Chatzikyrkou F.G. Scurt C. Clajus S. Roumeliotis P.R. Mertens H. Haller C. Blume V. Liakopoulos 《Transplantation proceedings》2019,51(2):396-404
Context
Living kidney donation is considered a safe procedure with excellent outcomes. The great demand for organs has changed the suitability criteria for donation and older or hypertensive donors are increasingly accepted.Methods
We reviewed the charts of 200 adults who donated a kidney at the University Hospital Hannover. Data regarding diastolic, systolic, mean blood pressure, renal function, and proteinuria at baseline and post-donation follow-up visits were recorded. A Mann-Whitney U test was performed to compare the post-nephrectomy development of blood pressure, estimated glomerular filtration rate (eGFR), and proteinuria between men and women, hypertensives and normotensives, and older (≥65 years) and younger (<65 years) donors. Multivariable time-dependent Cox regression models were used to evaluate eGFR decline post-donation, after adjustment for covariates.Results
The majority of donors were female (64.5%), and 29.0% had pre-existing hypertension. The mean age at donation was 49 years, and 9.5% were older than 65 years. During a median follow-up of 3 years, no significant differences in proteinuria and change in renal function were observed between both sexes or hypertensive and normotensive donors. In contrast, older donors exhibited a faster decline in renal function. Mean eGFR (chronic kidney disease epidemiology collaboration equation) pre-donation was 99.6 ± 21.9 mL/min in younger donors and 77.6 ± 17.7 mL/min in older donors (P < .001). The respective mean values at the last follow-up visit were 81.3 ± 24.0 and 46.8 ± 17.9 mL/min (P < .001). After adjustment for sex and preexisting hypertension, compared to younger donors, older donors had a 2.39 hazard ratio for eGFR decline.Conclusion
Older adults display a faster decline in renal function after donation and thus should be carefully evaluated for suitability before donation. 相似文献3.
M.A. Moreno Gonzales D.G. Mitema B.H. Smith C.A. Schinstock M.D. Stegall L.L. Wakefield N.A. Henderson S.R. DeGoey J.D. Kreuter M.J. Gandhi 《Transplantation proceedings》2017,49(9):2031-2035
Background
Complement-binding donor-specific antibodies (DSAs) are associated with antibody-mediated rejection and allograft loss. Novel single antigen bead (SAB) assays—that is, complement component 1q (C1q) and complement component 3d (C3d) assays—have been developed to specifically detect complement-binding DSA, but it remains unclear whether these assays have an improved ability to detect complement-binding DSA as compared with using the total IgG SAB assay with a high mean fluorescence intensity (MFI) cutoff. The aim of this study was to compare the ability of the total IgG, C1q, and C3d SAB assays in detecting complement-binding anti-HLA antibodies.Methods
Twenty sera known to have complement-binding anti-HLA antibodies (serologic class I HLA typing by complement-dependent cytotoxicity method) were tested with 3 different SAB assays: total IgG (undiluted and 1:8 dilution), C1q, and C3d. Serologic anti-HLA specificities were compared with those obtained by IgG, C1q, and C3d SAB assays.Results
IgG SAB was more sensitive in detecting complement-binding antibodies (sensitivity 24 of 24 = 1, odds ratio infinity). Pearson correlation showed the association between (1) C1q and IgG SAB assays (cutoff C1q SAB 1000 MFI, cutoff IgG SAB 5000 MFI: r = 0.347, P < .0001) and (2) C3d and IgG SAB assays (cutoff 500 MFI C3d SAB, 5000 MFI for IgG SAB: r = ?0.173, P = .279).Conclusions
For class I anti-HLA antibodies, IgG SAB (cutoff MFI > 5000) was more sensitive in detecting complement-binding antibodies when compared with C1q and C3d SAB assays. 相似文献4.
A. Prodromidou N. Machairas Z. Garoufalia I.D. Kostakis P. Tsaparas A. Paspala P. Stamopoulos G.C. Sotiropoulos 《Transplantation proceedings》2019,51(2):440-442
Introduction
Despite their benign nature, liver hemangiomas (LH) are lesions that can cause major complications requiring intervention. Liver transplantation (LT) has been suggested as an effective treatment option in selected patients with giant LHs causing severe symptoms and cannot be treated otherwise. The aim of our study was to investigate the indications, aspects and post-operative outcomes of patients with a LH who underwent LT.Materials and methods
A meticulous search of the literature was performed. Studies presenting cases of LT due to LH were evaluated. Studies presenting patients characteristics and symptoms, aspects of the disease, transplantation indications and details were selected.Results
Fifteen studies were included in the present review that involved 16 patients. Among them, 4 were male while the remaining 12 were female with a mean age of 39.9 ± 8.7 years. The main indications for LT included respiratory distress, massive hemorrhage, Kasabach-Merritt syndrome, and unsuccessful previous treatment strategies. Four patients were transplanted from living donors and the remaining 12 from cadaveric donors. No post-operative deaths were reported and all patients returned to normal activity. No deaths during the long-term follow-up were reported.Conclusions
LH is an extremely rare indication for LT. Nevertheless, the currently available data suggest that LT is a safe and efficient treatment in the management of symptomatic or complicated LH in selected patients. 相似文献5.
Marine n-3 polyunsaturated fatty acids (PUFAs) may improve cardiovascular, renal, and mental health. No previous trial has investigated the effects of marine n-3 PUFA supplementation on quality of life (QoL) indices after renal transplant.
Methods
In this trial, 132 renal transplant recipients were randomized to receive daily either 2.6 g of marine n-3 PUFAs or an equivalent dose of olive oil (controls) on top of standard care for 44 weeks. We used a Short Form 36 (SF-36) questionnaire at baseline (8 weeks post transplant) and at the end of the study (1 year after transplant) to assess QoL. Results were expressed as net change (Δ) in SF-36 individual and composite mental and physical scores during follow-up.Results
We found no improvement of Δ SF-36 individual or composite scores after marine n-3 PUFA supplementation compared with controls. In per-protocol analysis, patients who received marine n-3 PUFAs had a Δ emotional role function (mean, 17% [SD, 50%] vs mean, 3% [SD, 37%]; P = .11). In addition, plasma marine n-3 PUFA levels showed a weak but statistically significant correlation with Δ composite mental function score (r = .18; P =? .04).Conclusion
Marine n-3 PUFA supplementation did not improve QoL after renal transplant. 相似文献6.
J.L. Pérez-Canga L. Martín Penagos R. Ballestero Diego R. Valero San Cecilio E. Rodrigo Calabia L. Belmar Vega M. Serrano Soto L. Ruiz Martínez C. Lopez del Moral Cuesta J.C. Ruiz San Millán 《Transplantation proceedings》2019,51(2):321-323
Introduction
Kidney transplantation procedures commonly result in a cold ischemia time (CIT) gap when both kidney grafts are implanted in the same center. Owing to logistics, the procedure is usually consecutive, first accomplishing one surgery and then the other. CIT constitutes an independent risk factor for the development of delayed graft function (DGF) in kidney transplants. The effect that CIT exerts on graft and patient survival is still unclear. This study evaluates the relation of CIT and transplant outcomes by comparing paired kidney transplants in terms of survival and graft function.Methods
We accomplished a retrospective analysis of 402 kidney transplants performed in our center between 2000 and 2017. We selected all transplants where both organs from the same donor were implanted at our hospital, establishing 2 study groups (group 1: first graft implanted and group 2: second graft implanted) to compare by paired data statistical methods.Results
We found an increase in the incidence of DGF in group 2 (42% vs 28.8%; P < .05). Group 2 had significantly worse graft function on day 5 posttransplant (4.7 ± 2.88 vs 3.86 ± 2.8 mg/dL of serum creatinine; P < .05). No significant differences in graft function were found on days 30 and 90 posttransplant. We didn't find any difference in graft survival between both groups. Length of hospitalization stay (17.6 days [± 13] vs 21.6 days [± 17]) and hemodialysis sessions (mean of 2.8 [± 2] vs 3.6 [± 2.2]) were higher in group 2.Conclusion
CIT acts as an independent risk factor for the development of DGF in kidney transplantation. CIT had no isolated effect on graft survival. 相似文献7.
E. Cholongitas N. Antoniadis I. Goulis E. Theocharidou G. Ιmvrios O. Giouleme D. Filis E. Mouloudi E. Akriviadis I. Fouzas 《Transplantation proceedings》2019,51(2):450-453
Purpose
Everolimus, a mammalian target of rapamycin inhibitor, may have a protective role on hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT), but data regarding the impact of its trough serum levels on HCC recurrence are missing.Methods
Fifty-five patients (43 men, age 55 ± 8 years) who underwent LT for HCC were evaluated. Several demographic and clinical variables were recorded, including radiological and histological characteristics of HCC as well as dosages and trough levels of immunosuppressive regimens.Results
HCC recurrence occurred in 11 (20%) patients: 5 (25%) of 20 patients under calcineurin inhibitors and 6 (17%) of the 35 patients under everolimus (P = .48). The patients with HCC recurrence (n = 11, group 1), compared to those without recurrence (n = 44, group 2), had significantly more frequent HCC in the explant: outside Milan criteria (P = .001), microvascular invasion (P < .001), and higher number of nodules (P = .001). In multivariate analysis, microvascular invasion was the only independent factor significantly associated with HCC recurrence (OR: 2.3, 95% CI: 1.4–10.5, P = .03). Among the patients who received everolimus-based immunosuppression, the recipients with HCC recurrence, compared to those without HCC recurrence, had significantly lower mean trough levels of everolimus at 7–12 months post-LT (3.9 vs 5.9 ng/mL, P = .001), while the patients with mean trough levels of everolimus >6 ng/mL had decreased HCC recurrence rates (log rank: 2.3, P = .007).Conclusions
We found for the first time mean concentrations of everolimus between 7–12 months post-LT as the only modifiable variable related with HCC recurrence in LT recipients. However, larger studies are needed for final conclusions. 相似文献8.
T. Nakamura H. Ushigome K. Watabe Y. Imanishi K. Masuda T. Matsuyama S. Harada K. Koshino T. Iida S. Nobori N. Yoshimura 《Transplantation proceedings》2017,49(5):955-958
Background
Advances in immunosuppressants enable organ transplantation for sensitized patients. However, influences of pre-formed donor-specific anti–human leukocyte antigen (HLA) antibodies (DSA) have not been fully understood in renal transplantation (RT). On the other hand, immunocomplex capture fluorescence analysis (ICFA) is a reliable method to detect donor-specific anti-HLA antibodies and HLA antigen complexes. Graft ICFA can detect DSA in an allograft (g-DSA).Methods
To elucidate the consequences of pre-formed DSA, 198 patients who underwent living-donor RT were enrolled for this study (observation period: 57.8 ± 34.9 months); 187 patients in the DSA? group (excluding ABO-incompatible cases) and 11 patients in the DSA+ group. Before RT, all DSA+ patients had undergone rituximab administration and plasmapheresis. For a graft ICFA, the biopsy specimen (1 × 105 cells) was dissolved, and HLA antigens were captured by anti-HLA beads. Finally, DSA-HLA complexes were detected by means of PE-conjugated anti-human IgG antibodies and analyzed by use of a Luminex system. A ratio (sample/blank beads, mean of fluorescence intensity) was calculated: ≥1.0 was determined as positive g-DSA.Results
There were no significant differences in 5-year graft survival (87.9%/100% in the DSA?/DSA+ groups, respectively). In terms of antibody-mediated rejection (AMR), within 1 month after RT, pathologically determined AMR occurred 3.2% and 63.4% in the DSA? and DSA+ groups, respectively (P < .0001). However, interestingly, more than half of them (57.1%) indicated only subclinical AMR, that is, no fluctuation of S-Cr. As representative of 2 cases of subclinical AMR, g-DSA deposition could be confirmed (1.15 ± 0.04) at 1 hour after reperfusion by graft ICFA. Furthermore, g-DSA shifted to 2.20 ± 0.98 at 3 weeks after transplantation, along with a decline in s-DSA mean of fluorescence intensity (1718-506.5).Conclusions
Although pathologically determined AMR occurred more frequently in pre-formed DSA+ recipients, it can be argued that a successful de-sensitization protocol inhibits further production of DSA and graft destruction. 相似文献9.
G.C. Sotiropoulos N. Machairas I. Fouzas S. Vernadakis A. Paul J. Wohlschlaeger 《Transplantation proceedings》2019,51(2):421-423
Introduction
Hepatocellular carcinoma (HCC) in cirrhosis is a widely accepted indication for liver transplantation (LT). Many scoring systems have been proposed intending to an extension of the established Milan criteria. Bridging treatments are systematically applied in order to maintain or to downstage such patients to the listing criteria. The objective of our study was to estimate the feasibility of the prediction of microvascular tumor invasion in transplant candidates.Patients and methods
Data corresponding to transplanted HCC patients were reviewed for the purposes of this study. All tumor slices were blindly re-evaluated by a single pathologist in order to score for tumor necrosis and microvascular invasion. Recipients of pediatric or split LT were excluded.Results
Eighty patients (30 women and 50 men) were included in the study. Tumor necrosis was absent in 29 of 80 liver explants (36.25%). In the majority of instances (63.75%) tumor necrosis was evident in proportions between 5% and 100%. In 58 liver explants showing 0%-60% tumor necrosis and 22 liver explants showing >?60% tumor necrosis, microvascular tumor invasion was detectable in 11 and 0 cases, respectively (P = .0385).Conclusion
In about one-fourth of the cases (27.5%) microvascular tumor invasion could not be detected due to extended areas of tumor necrosis. Preoperative detection of microvascular invasion is misleading. 相似文献10.
M. Kavousanaki Μ. Tzagournissakis I. Zaganas K.G. Stylianou A.P. Patrianakos M.K. Tsilimbaris A. Mantaka D.N. Samonakis 《Transplantation proceedings》2019,51(2):429-432
Background
Familial amyloidosis polyneuropathy (FAP) is a rare, progressive, and life-threatening disease inherited in the autosomal dominant pattern. Liver transplantation is the only proven disease-modifying treatment to date.Aim
To study the long-term outcomes of patients transplanted for FAP under a multidisciplinary team care.Methods
We included adult patients who were transplanted for FAP indication and were followed up in a relevant clinic or admitted in our department.Results
Twelve patients (6 male) with a mean age of 43 years and mean follow-up post-transplant of 100 months were included. Three patients died in this period, 1 due to a disease-related cause. All patients had peripheral neuropathy (25% severe). Eighty-three percent had autonomic nervous system dysfunction; all men, except one, erectile dysfunction; and half of the patients several genitourinary manifestations. Gastrointestinal involvement was present in 75% of the patients. The severity of several complications related to FAP was found to be associated with waiting on the transplant list for more than 12 months.Conclusions
Patients transplanted for FAP have a long survival. Prolonged stay on the transplant waiting list is associated with frequency and severity of disease complications. These patients are best managed in the context of multidisciplinary team care. 相似文献11.
Seung Bo Shim Jeung Yeol Jeong Dong Ho Keum Jae Chul Yoo 《Journal of orthopaedic science》2019,24(2):250-257
Purpose
Creating a trough on the anterior glenoid rim is one of the methods used for arthroscopic Bankart repair with suture anchors. The purpose of this study was to analyze clinical and radiological outcomes of arthroscopic Bankart repair with suture anchors; to compare between the outcomes of surgical procedures with and without trough.Methods
Clinical and radiological outcomes were evaluated for 116 patients who underwent arthroscopic Bankart repair at our institute from 2005 to 2011. The mean follow-up was 5.2 years (range, 2–8.8 years). All data were divided into trough group (n = 62) and non-trough group (n = 71). Clinical and functional outcomes were assessed pre- and postoperatively as range of motion (ROM), pain on the visual analog scale (p-VAS), function on the visual analog scale (f-VAS), and Rowe score. Radiological outcomes were also evaluated.Results
The overall postoperative clinical and functional outcomes improved significantly (P < .001). A total of 8 patients (6.8%) showed recurrent instability. Radiologic findings showed mild arthritis in 27 cases (23.1%), moderate arthritis in 6 cases (5.1%), and no severe arthritis. 32 patients showed anterior apprehension after surgery, and 22 out of those 32 patients were from non-trough group. However, no significant difference between the trough and non-trough groups was found with respect to clinical and functional outcomes (P > .05).Conclusion
The additional procedure of creating a trough did not improve clinical outcomes in terms of frank dislocation; however, at the final follow-up, patients with the trough showed less anterior apprehension. Overall, arthroscopic Bankart repair using suture anchors had relatively good clinical outcome, with a redislocation rate of 6.8%.Level of evidence
Level III, Case series. 相似文献12.
L. Ruiz-Martínez M. De-Cos-Gómez R. Valero-San-Cecilio E. Rodrigo-Calabia M. Heras-Vicario M. Serrano-Soto L. Belmar-Vega R. Palomar-Fontanet E. Miñambres-García J.C. Ruiz-San-Millán 《Transplantation proceedings》2019,51(2):337-340
Introduction
Our study compares 2 immunosuppressive strategies to reduce tacrolimus nephrotoxicity and its risk of acute tubular necrosis: delayed introduction of tacrolimus plus thymoglobulin vs initial tacrolimus plus basiliximab on the results of kidney transplant (KT) using type-III donation after circulatory death (III-DCD).Material and methods
We analyzed all the transplants performed using type-III DCD in our hospital (42 cases). They were distributed in a first stage with delayed tacrolimus (3°-4° day) + thymoglobulin and a second one with initial tacrolimus + basiliximab, with a follow-up of 6 months. The rate of delayed graft function, the evolution of renal function, and the incidence of rejection were compared.Results
28 patients received thymoglobulin with delayed tacrolimus, and 13 patients received basiliximab and tacrolimus from day 0 (1 excluded). There were no significant differences in delayed graft function (27% group 1 and 23% group 2) or in rejection (10.7% and 15.4%), respectively. Serum creatinine at day 3, 7, 14, 30, and 180 showed no statistically significant differences. The levels of tacrolimus measured at 10, 30, 90, and 180 days after transplantation were similar, except for the first month: 10.10 ± 2.3 in group 1 and 12 ± 1.7 ng/mL in group 2 (P = .007).Conclusions
Delayed introduction of tacrolimus does not seem to suppose a benefit in KT using type-III DCD; therefore, the use of thymoglobulin, with its higher profile of adverse effects, seems unjustified in patients with normal immunological risk. 相似文献13.
E. Massa E. Michailidou S. Papadopoulos D. Agapakis I. Kotsamidi D. Xarisopoulos E. Iosifidis M. Daoudaki D. Philis G. Imvrios E. Vagdatli D. Vasilakos V. Papanikolaou I. Fouzas E. Mouloudi 《Transplantation proceedings》2019,51(2):457-460
Introduction
The importance of preoperative donor/recipient colonization or donor infection by extensively drug-resistant Gram-negative bacteria (XDR-GNB) and its relation to serious post-transplantation infection pathogenicity in liver transplantation (LT) patients has not been clarified.Aim
Prevention of postoperative infection due to XDR-GNB with the appropriate perioperative chemoprophylaxis or treatment based on preoperative donor/recipient surveillance cultures in LT patients, as well as their outcome.Materials and Method
Twenty-six patients (20 male, 6 female) were studied (average preoperative Model for End-Stage Liver Disease score ≈15, range: 8–29) from January 2017 to January 2018. In all patients, blood, urine, and bronchial secretions culture samples as well as a rectal colonization culture were taken pre- and postoperatively, once weekly after LT, and after intensive care unit discharge. Recipients with positive XDR-GNB colonization and patients receiving a transplant from a donor with an XDR-GNB positive culture or colonization received the appropriate chemoprophylaxis one half hour preoperatively according to culture results. De-escalation of the antibiotic regimen was done in 2 to 5 days based on the colonization/culture results of the donor and recipient and their clinical condition. Evaluation for serious infection was done at 1 week and at 28 days for outcome results.Results
Fourteen out of 26 recipients (53.8%) were positive for XDR-GNB colonization preoperative, with 2/14 (14.28%) presenting serious infection due to the same pathogen. Intensive care unit length of stay was significantly longer in colonized with XDR-GNB patients (P < .0001). The outcome of colonized patients was 6/14 (42.8%) expired, but only in 2/14 (14.2%) was mortality attributable to infection.Conclusion
Administering appropriate perioperative chemoprophylaxis and treatment may limit the frequency of XDR-GNB infections and intensive care unit length of stay and may improve the outcome in LT recipients. 相似文献14.
A. Prodromidou I.D. Kostakis N. Machairas Z. Garoufalia P. Stamopoulos A. Paspala G.C. Sotiropoulos 《Transplantation proceedings》2019,51(2):446-449
Purpose
Liver transplantation (LT) constitutes a major therapeutic option for a number of patients suffering from liver pathologies. Pregnancy outcomes in patients who have undergone LT are assessed by a number of studies. The aim of our systematic review was to present the currently available evidence concerning the results of pregnancy in patients with LT.Materials and Methods
A meticulous systematic search of the literature published before September 2017 for studies relevant in this field was conducted. All studies, which presented obstetric and maternal outcomes of patients with prior LT, were included.Results
Nineteen studies, which comprised 1290 pregnancies in 885 female LT recipients, were reviewed. A total of 1014 live births were recorded, and the incidence of spontaneous abortions ranged from 0.5% to 33.3%. Concerning live births, a proportion of 32% of pregnancies resulted in preterm births (345 preterm births in 1079 pregnancies, range 0%-39%), and in 16% of pregnancies preeclampsia was reported (188 cases from 1173 pregnancies, range 2%-33.3%). The most commonly administered immunosuppressive drugs were cyclosporine and tacrolimus alone or with steroids. Cesarean section rates ranged from 20% to 67.9% among the included studies, concerning live birth. Moreover, approximately one-third of them resulted in preterm birth. Spontaneous abortions were reported in 176 cases (range: 0.5%-33.3%), and preeclampsia occurred in 188 patients (range: 2%-33.3%).Conclusion
Pregnancy outcomes from the included studies are encouraging, nonetheless pregnant patients who have undergone LT are at high risk and therefore require close monitoring by a multidisciplinary team. 相似文献15.
A. Ríos S. López-Gómez J. Belmonte A. López-Navas A. Sánchez J. Carrillo J.J.A. Ruiz-Manzanera A.M. Hernández P. Ramírez P. Parrilla 《Transplantation proceedings》2019,51(2):283-285
Introduction
The refusal to consider death and the donation and transplantation of organs make Gypsies one of the subpopulation groups with the lowest donation rates in Europe. The approach of this social group implies the support of the most favorable social groups within their own ethnic group. In this sense, the young population with a high level of education is usually the most favorable toward organ donation.Objective
To analyze the attitude toward the donation of one's own organs for transplantation among the Gypsy population under 45 years and with secondary or university studies.Method
Population under study: The Gypsy population under 45 years old with secondary or university studies who currently reside in Spain. Assessment instrument: The attitude questionnaire for organ donation for transplantation PCID–DTO Ríos. Fieldwork: A random selection based on stratification. Anonymity and self-administered fulfillment. Statistics: Student t test and χ2.Results
A total of 44 Gypsy people under 45 years of age were surveyed (mean age 31 ± 8.9 years); 66% were women, and the rest were men. Of these, 20 had university studies, and 24 had secondary or vocational studies. The attitude is favorable toward organ donation in 64% of the respondents, with 80% among university students and 50% among those with secondary or vocational education (P < .005).Conclusions
The young Gypsy population with university studies has a very favorable attitude toward organ donation. This population subgroup must be key in the promotion of organ donation in the Gypsy population, so the transplant coordinators must request their collaboration in the promotion campaigns of organ donation and transplantation. 相似文献16.
G. Imvrios E. Tzitzili A. Pyrpasopoulou G. Miserlis M. Daoudaki A. Fouza A. Mavroudi E. Mouloudi N. Antoniadis N. Salveridis I. Fouzas 《Transplantation proceedings》2019,51(2):408-412
Purpose
We investigated the association of ureteral stenting after kidney transplantation with the development of urinary tract infections (UTIs) and/or urinary tract colonization, in a hospital environment considered endemic for multidrug resistant (MDR) Gram-negative Enterobacteriaceae.Methods
Seventy-five recipients of deceased donor grafts were divided in groups A and B. Group A (with subgroups A1 and A2) included 45 transplanted patients without urinary stenting, and group B 30 patients with stenting. Subgroup A1 consisted of 30 patients transplanted before 2006, and A2 of 15 patients transplanted after 2006, when MDR, mainly carbapenem-resistant, Enterobacteriaceae, frequency has risen in our hospital.Results
The incidence and the number of UTIs per patient were significantly higher in patients without stenting compared to those with stenting. (Group A: 32/45 vs group B: 9/30, P < .001, and group A: 2.86 ± 0.43 vs group B: 0.6 ± 0.19, P < .01 respectively). Patients without stenting tended to have a higher frequency of recurrent UTIs compared to those with stenting (group A: 16/45 vs group B: 4/30, P < .05). Asymptomatic bacteriuria was more frequent in the patients with stent (group A: 8/45 vs group B: 14/30, P < .05). Further sub-comparison of the A1 and A2 subgroups with group B did not change the statistical results.Conclusions
There is no clinically significant association of ureteral stenting after kidney transplantation with the high frequency of MDR Gram-negative bacteria in our hospital. 相似文献17.
R. Valero A. Sanchez-Fructuoso E. Rodrigo L. Belmar M.A. Cos I. Perez-Flores J. Delgado J.C.R. San Millan 《Transplantation proceedings》2019,51(2):341-343
Background
Many studies demonstrate the relationship between the high intrapatient variability of calcineurin inhibitor (CNI) levels and poor long-term renal graft outcome. Our objective is to analyze the intrapatient variability observed in the mammalian target of rapamycin inhibitors (mTOR-i) blood levels, to compare the variability of sirolimus (SRL) with that of everolimus (EVL) in kidney transplant patients converted to an mTOR-i, and to analyze whether the coefficient of variation (CV) was correlated with long-term graft survival.Methods
We analyzed 279 adult renal transplant patients converted to an mTOR-i. CV was calculated using at least 3 blood trough levels between 3 and 18 months postconversion.Results
The mean and median CV of the entire group was 25.54% and 23.7%, respectively. SRL and EVL mean CV was 23.8% and 27.1% (P = .03), respectively. The group of patients into the last tertile with CV> 28.52% presented a lower death-censored graft survival (75.26% vs. 93.01%, P < .0001) with a mean follow-up of 66.5 months.Conclusion
The CV of mTOR-i is correlated with long-term renal graft survival, so it should be considered a prognostic factor. SRL has a lower CV than EVL in renal transplant patients converted to mTOR-i in the stable posttransplant phase. 相似文献18.
19.
A. Ríos S. López-Gómez J. Belmonte A. López-Navas A. Sánchez J. Carrillo J.J. Ruiz-Manzanera A.M. Hernández P. Ramírez P. Parrilla 《Transplantation proceedings》2019,51(2):296-298
Introduction
Negative organ donation rates among the Gypsies is much higher than that of any other social group in Spain. However, living donation rates have not been raised much in this social group, despite the existence of several Gypsy patients on the waiting list for transplantation.Objective
To analyze the attitude toward related living donation among the Gypsy population who reside in Spain.Methods
This type of study is an observational sociological study. The study consisted of the adult Gypsy population residing in Spain, and a random sampling of 230 adult gypsies was conducted. Attitude questionnaires for live donation, both hepatic PCID-DVH-Ríos and renal PCID-DVR-Ríos, were used, and random selection was based on stratification. Questionnaires were self-administered and completed anonymously. Student t test, χ2, Fisher, and a logistic regression analysis were used.Results
A sample of 206 Gypsies (52% women) with a mean age of 34 years is obtained. Seventy-two percent (n = 150) would donate an organ to a relative in life, 8% (n = 16) would not donate it, and 20% (n = 41) have doubts. Respondents with a favorable attitude toward living donation presented a more favorable attitude toward cadaveric organ donation (55% vs 0%, P < .001). The attitude toward living kidney donation was more favorable (81% in favor) than toward living liver donation (P < .001).Conclusions
The Gypsy ethnic group is sensitized to live donor transplantation. The family and cultural roots of Gypsy people could condition this favorable attitude, a fact to be taken into account to sensitize this social group and promote donation campaigns with the aim of increasing donation rates. 相似文献20.
Kidney Transplantation in Patients With Chronic Kidney Disease After a Previous Lung Transplantation
M. Serrano-Salazar L. Medina-Zahonero D. Janeiro-Marín C. Contreras-Lorenzo M. Aguilar-Pérez B. Sánchez-Sobrino P. López-Sánchez P. Ussetti-Gil J. Portoles-Perez 《Transplantation proceedings》2019,51(2):324-327