Successful renal transplantation across HLA barrier in sensitized individuals has been on the rise during the past decade, primarily due to improved desensitization regimes. The aim of this study was to share outcome of desensitization in renal transplant recipients with donor‐specific anti‐HLA antibodies (DSA). This was a retrospective analysis of all HLA immunized individuals who were prospective renal transplant recipients. All such patients underwent preconditioning as per the institutional desensitization protocol. Complement‐dependent cytoxicity‐based crossmatch (CDC‐XM), luminex‐based crossmatch (LM‐XM) and flowcytometry‐based crossmatch (FC‐XM) were done in all cases. If any of these tests turned out positive, single antigen bead assay (SAB) was performed. Desensitization for DSA was performed in 55 patients and all patients were followed‐up for 1 year to assess graft function and patient outcome. CDC‐XM being a less sensitive assay, could not detect incompatibility in 29 (52.73%) cases. After desensitization, even though SAB and LM‐XM results revealed an MFI within acceptable range, FC‐XM being an extremely sensitive assay, continued to give a positive result in eight (14.55%) cases. The mean ± SD number of pretransplant TPE were 3.44 ± 0.98 (2‐11). Out of 55, there were 10 patients who were lost to follow up. Patient and graft survival of 45 patients at 1 year was found to be 100%. Preconditioning for renal transplants in the form of immunosuppression with TPE is an extremely useful auxiliary for transplantation in HLA sensitized renal transplant recipients. 相似文献
Nanogels (NGs) are considered as one of the most suitable nanocarrier matrices for drug, gene and protein delivery. There are many methods of synthesis of NGs but polymerizable bioionic liquids are not being applied so far for the synthesis of such nanocarriers. The synthesis of a stimuli‐responsive NG system having average hydrodynamic size of 41 ± 15 nm is reported here, obtained by the simultaneous polymerization and crosslinking of a polymerizable biobased ionic liquid. The NG thus obtained shows prolonged drug delivery for 5‐fluorouracil, an anticancer drug, at pH 1.2 (stomach pH) for 10 days at physiological human body temperature (37 °C). However, no substantial drug delivery is observed at pH 5 and 7.4. Such a prolonged drug release profilemakes the reported NG system a potential candidate in the formulation of a pH‐sensitive drug nanocarrier vehicle for in vivo delivery of stomach‐specific therapeutic agents.
