Although the triple immunosuppressive regimen based on calcineurin inhibitors(CNIs)has greatly improved the short-term prognosis of renal transplantation,the longterm prognosis of renal transplantation has not signifi...Although the triple immunosuppressive regimen based on calcineurin inhibitors(CNIs)has greatly improved the short-term prognosis of renal transplantation,the longterm prognosis of renal transplantation has not significantly improved.CNIs associated nephrotoxicity is a major risk factor affecting the graft survival.[1]It is feasible to improve the long-term prognosis by reducing the dose of CNIs or removing the CNIs.Studies have demonstrated that the combination of sirolimus(SRL)with low-dose CNIs can both reduce CNI-related nephrotoxicity and improve graft function without increasing the risk of acute rejection(AR),which helps to improve long-term graft survival.[2]However,the validation of mammalian target of rapamycin inhibitor as an immunosuppression regimen and the timing of its application in renal transplantation is still needed.The aim of this study was to investigate the effects of early conversion to low-dose CNIs and SRL on the long-term prognosis of renal transplantation.展开更多
To the Editor:Ureterostenosis is one of the most common complications after kidney transplantation,with an incidence rate of 1.0–8.3%according to a relevant report.[1,2]This complication may cause postrenal obstructi...To the Editor:Ureterostenosis is one of the most common complications after kidney transplantation,with an incidence rate of 1.0–8.3%according to a relevant report.[1,2]This complication may cause postrenal obstruction,affecting the function of the transplanted kidney and increasing the risk of kidney loss.展开更多
Background:Delayed graft function(DGF)is the main cause of renal function failure after kidney transplantation.This study aims at investigating the value of hypothermic machine perfusion(HMP)parameters combined with p...Background:Delayed graft function(DGF)is the main cause of renal function failure after kidney transplantation.This study aims at investigating the value of hypothermic machine perfusion(HMP)parameters combined with perfusate biomarkers on predicting DGF and the time of renal function recovery after deceased donor(DD)kidney transplantation.Methods:HMP parameters,perfusate biomarkers and baseline characteristics of 113 DD kidney transplantations from January 1,2019 to August 31,2019 in the First Affiliated Hospital of Xi’an Jiaotong University were retrospectively analyzed using univariate and multivariate logistic regression analysis.Results:In this study,the DGF incidence was 17.7%(20/113);The multivariate logistic regression results showed that terminal resistance(OR:1.879,95%CI 1.145-3.56)and glutathione S-transferase(GST)(OR=1.62,95%CI 1.23-2.46)were risk factors for DGF;The Cox model analysis indicated that terminal resistance was an independent hazard factor for renal function recovery time(HR=0.823,95%CI 0.735-0.981).The model combining terminal resistance and GST(AUC=0.888,95%CI:0.842-0.933)significantly improved the DGF predictability compared with the use of terminal resistance(AUC=0.756,95%CI 0.693-0.818)or GST alone(AUC=0.729,95%CI 0.591-0.806).Conclusion:According to the factors analyzed in this study,the combination of HMP parameters and perfusate biomarkers displays a potent DGF predictive value.展开更多
To the Editor:Thereiscurrentlya serious shortage oforgan sources.Therefore,living donorkidney is a critical source in addition to deceased donor kidney.Open donor nephrectomy is one of the most difficult operations in...To the Editor:Thereiscurrentlya serious shortage oforgan sources.Therefore,living donorkidney is a critical source in addition to deceased donor kidney.Open donor nephrectomy is one of the most difficult operations in the field of kidney transplantation,and the core issues are the safety of the donor and the psychological stress to the surgeon,such as trying to minimize the surgical complication to the donor,maximize the success rate,and deal with the high expectation from the recipient.展开更多
基金China International Medical Foundation(No.RUPUS-ISRT-20180114)
文摘Although the triple immunosuppressive regimen based on calcineurin inhibitors(CNIs)has greatly improved the short-term prognosis of renal transplantation,the longterm prognosis of renal transplantation has not significantly improved.CNIs associated nephrotoxicity is a major risk factor affecting the graft survival.[1]It is feasible to improve the long-term prognosis by reducing the dose of CNIs or removing the CNIs.Studies have demonstrated that the combination of sirolimus(SRL)with low-dose CNIs can both reduce CNI-related nephrotoxicity and improve graft function without increasing the risk of acute rejection(AR),which helps to improve long-term graft survival.[2]However,the validation of mammalian target of rapamycin inhibitor as an immunosuppression regimen and the timing of its application in renal transplantation is still needed.The aim of this study was to investigate the effects of early conversion to low-dose CNIs and SRL on the long-term prognosis of renal transplantation.
文摘To the Editor:Ureterostenosis is one of the most common complications after kidney transplantation,with an incidence rate of 1.0–8.3%according to a relevant report.[1,2]This complication may cause postrenal obstruction,affecting the function of the transplanted kidney and increasing the risk of kidney loss.
基金This work was supported by the grants from the National Natural Science Foundation of China(Nos.81670681,81760137,81870514,81970668 and 81970670)the Fundamental Research Funds for the Central Universities(No.xjj2018091)+1 种基金the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University(No.XJTU1AF-CRF-2019-008)the Special Supportive Program for Organ Transplantation by COTDF(No.2019JYJH04).
文摘Background:Delayed graft function(DGF)is the main cause of renal function failure after kidney transplantation.This study aims at investigating the value of hypothermic machine perfusion(HMP)parameters combined with perfusate biomarkers on predicting DGF and the time of renal function recovery after deceased donor(DD)kidney transplantation.Methods:HMP parameters,perfusate biomarkers and baseline characteristics of 113 DD kidney transplantations from January 1,2019 to August 31,2019 in the First Affiliated Hospital of Xi’an Jiaotong University were retrospectively analyzed using univariate and multivariate logistic regression analysis.Results:In this study,the DGF incidence was 17.7%(20/113);The multivariate logistic regression results showed that terminal resistance(OR:1.879,95%CI 1.145-3.56)and glutathione S-transferase(GST)(OR=1.62,95%CI 1.23-2.46)were risk factors for DGF;The Cox model analysis indicated that terminal resistance was an independent hazard factor for renal function recovery time(HR=0.823,95%CI 0.735-0.981).The model combining terminal resistance and GST(AUC=0.888,95%CI:0.842-0.933)significantly improved the DGF predictability compared with the use of terminal resistance(AUC=0.756,95%CI 0.693-0.818)or GST alone(AUC=0.729,95%CI 0.591-0.806).Conclusion:According to the factors analyzed in this study,the combination of HMP parameters and perfusate biomarkers displays a potent DGF predictive value.
文摘To the Editor:Thereiscurrentlya serious shortage oforgan sources.Therefore,living donorkidney is a critical source in addition to deceased donor kidney.Open donor nephrectomy is one of the most difficult operations in the field of kidney transplantation,and the core issues are the safety of the donor and the psychological stress to the surgeon,such as trying to minimize the surgical complication to the donor,maximize the success rate,and deal with the high expectation from the recipient.
