AIM To analyze the clinical impact of preformed antiH LA-Cw vs antiH LA-A and/or-B donor-specific antibodies(DSA) in kidney transplantation.METHODS Retrospective study, comparing 12 patients transplanted with DSA excl...AIM To analyze the clinical impact of preformed antiH LA-Cw vs antiH LA-A and/or-B donor-specific antibodies(DSA) in kidney transplantation.METHODS Retrospective study, comparing 12 patients transplanted with DSA exclusively antiH LA-Cw with 23 patients with preformed DSA antiH LA-A and/or B.RESULTS One year after transplantation there were no differencesin terms of acute rejection between the two groups(3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1). At one year, eG FR was not significantly different between groups(median 59 mL /min in DSA-Cw group, compared to median 51 mL /min in DSA-A-B group, P = 0.192). Moreover, kidney graft survival was similar between groups at 5-years(100% in DSA-Cw group vs 91% in DSA-A-B group, P = 0.528). The sole independent predictor of antibody mediated rejection(AMR) incidence was DSA strength(HR = 1.07 per 1000 increase in MFI, P = 0.034). AMR was associated with shortened graft survival at 5-years, with 75% and 100% grafts surviving in patients with or without AMR, respectively(Log-rank P = 0.005).CONCLUSION Our data indicate that DSA-Cw are associated with an identical risk of AMR and impact on graft function in comparison with "classical" class I DSA.展开更多
Background: Porto’s Hospital Centre is one of the most active Portuguese hospitals in renal transplantation (performed since 1983). Although increasingly rare, opportunistic infections in transplanted patients are as...Background: Porto’s Hospital Centre is one of the most active Portuguese hospitals in renal transplantation (performed since 1983). Although increasingly rare, opportunistic infections in transplanted patients are associated with high mortality rate in kidney transplantation and remain a major diagnostic challenge. Methods: We investigated 2041 cases of hospital admissions (from 2004 to 2012), any time after kidney transplantation. We described the infection location, the diagnostic techniques used and the mortality after the infection. Results: We found 82 cases of opportunistic infection caused by Herpes virus (Zoster and simplex), Cytomegalovirus, Polyomavirus, Aspergilus, Alternaria, Mucorales, Candida, Mycobacterium tuberculosis, Cryptococcus and Pneumocystis. Conclusions: In this article we highlight the important role of histology/cytology in the diagnostic process of these infections. In many cases prompt diagnosis and treatment are necessary to avoid life-threatening complications and may greatly improve prognosis.展开更多
文摘AIM To analyze the clinical impact of preformed antiH LA-Cw vs antiH LA-A and/or-B donor-specific antibodies(DSA) in kidney transplantation.METHODS Retrospective study, comparing 12 patients transplanted with DSA exclusively antiH LA-Cw with 23 patients with preformed DSA antiH LA-A and/or B.RESULTS One year after transplantation there were no differencesin terms of acute rejection between the two groups(3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1). At one year, eG FR was not significantly different between groups(median 59 mL /min in DSA-Cw group, compared to median 51 mL /min in DSA-A-B group, P = 0.192). Moreover, kidney graft survival was similar between groups at 5-years(100% in DSA-Cw group vs 91% in DSA-A-B group, P = 0.528). The sole independent predictor of antibody mediated rejection(AMR) incidence was DSA strength(HR = 1.07 per 1000 increase in MFI, P = 0.034). AMR was associated with shortened graft survival at 5-years, with 75% and 100% grafts surviving in patients with or without AMR, respectively(Log-rank P = 0.005).CONCLUSION Our data indicate that DSA-Cw are associated with an identical risk of AMR and impact on graft function in comparison with "classical" class I DSA.
文摘Background: Porto’s Hospital Centre is one of the most active Portuguese hospitals in renal transplantation (performed since 1983). Although increasingly rare, opportunistic infections in transplanted patients are associated with high mortality rate in kidney transplantation and remain a major diagnostic challenge. Methods: We investigated 2041 cases of hospital admissions (from 2004 to 2012), any time after kidney transplantation. We described the infection location, the diagnostic techniques used and the mortality after the infection. Results: We found 82 cases of opportunistic infection caused by Herpes virus (Zoster and simplex), Cytomegalovirus, Polyomavirus, Aspergilus, Alternaria, Mucorales, Candida, Mycobacterium tuberculosis, Cryptococcus and Pneumocystis. Conclusions: In this article we highlight the important role of histology/cytology in the diagnostic process of these infections. In many cases prompt diagnosis and treatment are necessary to avoid life-threatening complications and may greatly improve prognosis.
