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Impact of pretransplant asplenia vaccination on anti-A/B antibody titers in prospective abo incompatible kidney transplant recipients

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Rheumatology & Autoimmunity 2023年第1期3卷 26-34页

作者： Elisa Bongetti Mauro s.sandrin William R.Mulley Department of Nephrology Monash HealthClaytonVictoriaAustralia Department of surgery Austin Health/Northern HealthThe University of MelbourneHeidelbergVictoriaAustralia

Background:Asplenia vaccination is employed before abo-incompatible(aboi)transplantation in case splenectomy is *** vaccines have been reported,in different patient groups,to increase anti-A/B titers,through cross-reactivity to shared polysaccharide *** investigated the impact of pretransplant asplenia vaccinations on anti-A/B antibody titers in prospective aboi renal transplant ***:Published asplenia vaccine microbial structures were reviewed to assess expression of A/B *** patients who underwent aboi transplantation at Monash Medical Centre with anti-A/B titers taken either side of asplenia vaccination were included in a retrospective cohort study between 2007 and *** with paired titers without intervening vaccination were included as *** titers were compared within ***:A and B antigens were found to be expressed by vaccine specific pneumococcal ***-nine aboi renal transplant recipients received vaccination including at least one pneumococcal *** most common donor to recipient combination was A1 to *** median pre-and postvaccination anti-A/B titers were 1:32 and there was no significant change in titers following vaccination(median change in titer 0 dilutions,range–2 to 3,P=0.43).The same findings were apparent in the control group(n=20).There was no significant change in titer by donor blood group or vaccine *** transplants were canceled or delayed by a rise in anti-A/B titers ***:Pneumococcal vaccination had no clinically relevant impact on anti-A/B titers before aboi transplantation in this *** results provide reassurance regarding the safety of asplenia vaccination before aboi transplantation.

关键词： abo blood-group system asplenia kidney transplantation molecular mimicry splenectomy vaccination

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Complement activation and long-term graft function in abo-incompatible kidney transplantation

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World Journal of Nephrology 2019年第6期8卷 95-108页

作者： Marit s van sandwijk Astrid Klooster Ineke JM ten Berge Arjan Diepstra sandrine Florquin Joris J Hoelbeek Frederike J Bemelman Jan-stephan sanders Department of Nephrology Amsterdam University Medical CentersAmsterdam NL-1105 AZNetherlands Dianet Dialysis Center Amsterdam NL-1105 AZNetherlands Department of Pathology and Medical Biology University Medical Center GroningenUniversity of GroningenGroningen NL-9700 RBNetherlands Department of Pathology Pathology FrieslandLeeuwarden NL-8917 ENNetherlands Department of Pathology Amsterdam University Medical CentersAmsterdam NL-1105 AZNetherlands Department of Internal Medicine Division of NephrologyUniversity Medical Center GroningenUniversity of GroningenGroningen NL-9700 RBNetherlands

BACKGROUND abo-incompatible and abo-compatible kidney transplantation are equivalent in terms of short-term graft and patient survival. This is thought to be the result of abo-incompatible graft accommodation, which occurs when anti-blood group antibodies re-occur after transplantation but somehow do not yield their detrimental effect. The underlying mechanism is unclear, but one of the hypotheses is that this is the result of complement inhibition. since virtually all abo-incompatible graft biopsies are C4d positive, this complement inhibition must occur somewhere in the complement cascade after the formation of C4d has already taken place, but where exactly is unclear. It is also unclear whether complement inhibition is complete. Incomplete accommodation could explain why recent studies have shown that long-term graft function in aboincompatible transplantation is somewhat inferior to abo-compatible kidney *** To unravel the relationship between pre-transplant anti-abo antibodies,complement activation, and long-term graft *** We included all 27 abo-incompatible transplantations that were performed between 2008 and 2013 at the Academic Medical Center Amsterdam and the University Medical Center Groningen. For each abo-incompatible transplantation, we included four abo-compatible controls matched by age, sex,and transplantation *** Graft and patient survival were not significantly different. The slope of kidney function during five-year follow-up was also not significantly different, but aboincompatible recipients did have a lower kidney function at three months(creatinine clearance 58 vs 69 mL/min, P = 0.02, Modification of Diet in Renal Disease 46 vs 52 mL/min/1.73 m^2, P = 0.08), due to a high rate of early rejection(33% vs 15%, P = 0.03), mostly T-cell mediated. Pre-transplant anti-abo Ig G titers were positively correlated with C5b-9 staining, which itself was positively correlated with the occurrence of T-cell mediated reje

关键词： abo-incompatible Kidney transplantation Complement Graft function Rejection

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结直肠癌患者abo组织血型与肿瘤突变负荷的关系

结直肠癌患者ABO组织血型与肿瘤突变负荷的关系

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作者：伊达（RAEDA H.s.JALAYTA）大连医科大学

学位级别：硕士

背景:结直肠癌是一种发生在结肠和（或）直肠中的癌症。结直肠癌的男性发病率在所有癌症中排名第三,女性发病率排名第二。根据国际癌症研究机构2018年的统计,结直肠的致死率在所有癌症中排名第二。无论是环境还是遗传因素的改变,都可能... 详细信息

背景:结直肠癌是一种发生在结肠和（或）直肠中的癌症。结直肠癌的男性发病率在所有癌症中排名第三,女性发病率排名第二。根据国际癌症研究机构2018年的统计,结直肠的致死率在所有癌症中排名第二。无论是环境还是遗传因素的改变,都可能造成结肠上皮细胞内发生基因组不稳定、基因突变、DNA修复机制沉默等癌症特征事件,从而导致结直肠癌的发生。另一方面,基因组及表观基因组稳定性的丧失,也会加速原癌基因、抑癌基因的基因突变和表观遗传改变的发生。然而,结直肠癌的形成,往往需要大量的突变累积,表观遗传的改变可能需要10-15年的时间才会出现症状。最近,研究人员发现了突变负荷与临床疗效之间的联系,许多不同组织来源的癌症,其突变数都与预后表现出了显著的相关性:突变数更高的患者拥有更高的生存率及更低的死亡风险。另外,在结直肠癌中,APC、TP53、KRAs、PIK3CA、FBXW7、sMAD4、TCF7L2和NRAs等基因发生突变的概率最高。而对于三期或高危二期的结直肠癌患者来说,高肿瘤突变负荷往往有着更好的预后。abo血型系统是最常用的人类血型分类系统。该系统根据人体内的两种抗原（A抗原和B抗原）将血液分为四种类型（A,B,AB和O型）。abo血型系统的抗原在红细胞以及几种其他组织来源细胞（如胃肠道来源细胞）的表面都有表达。据报道,在IP测定中测试了23个远端结肠的原发性腺癌样本（包括降结肠,乙状结肠和直肠）,其中22个表达Y半抗原,19个表达H2型抗原。在全部5个近端结肠原发性腺癌样本（包括盲肠,升结肠和横结肠）中,Y半抗原和H-2抗原均呈阳性。早在60多年前,研究者们就开始关注abo血型在癌症生物学中的作用,并确认了abo抗原和几种肿瘤（如胰腺癌和胃癌）的发生具有相关性。A型血的人患有胃癌,胰腺癌,乳腺癌,卵巢癌和鼻咽癌的概率都要高于非A型血的人群。最近的研究表明,血型与结直肠癌风险之间可能存在相关性。A型血的个体发生直肠癌的概率要高于O型血的群体,而AB型血的人结肠癌的预后更佳。那么,abo血型与结直肠癌患者肿瘤基因突变负荷之间是否存在着相关性,这种相关性又对结直肠癌的早期诊断有着怎样的指导价值,都是值得我们思考的问题。为了研究abo血型与结直肠癌之间的相关性,我们评估了血型和结直肠癌患者突变负荷的联系。在本研究中,我们使用了基于实验室设置的靶基因多重PCR文库（968个热点区域文库和48个癌症易感基因文库）二代靶向测序技术对结肠癌体细胞突变进行测序。在建库时使用ligated和分子条形码技术,使用Illumina Hiseq X-TEN平台进行测序（双端测序,2×150 bp）获得FAsTQ格式的原始文件,随后使用多种生物信息学方法对癌和癌旁组织的原始文件进行突变频率计算,最后使用snp Eff进行注释获得基因组的突变信息。研究结果显示,A型血的患者突变负荷高于其他血型（B,O,AB型）。O型血的突变负荷显著低于A型血（P≤0.05）。另外,肿瘤尺寸、肿瘤分期等临床数据也和abo血型有着相关性。例如,A型血的结直肠肿瘤尺寸显著小于B型血（P≤0.05）。这一结果对于肿瘤发病率的评估和治疗方案的选择有着重要的指导意义。研究目的:血型被认为是一种重要的遗传因素,可能与结直肠癌相关。研究评估了血型和结直肠癌相关基因突变的联系,并计算了患者的平均突变数。（1）通过第二代测序（靶向测序）技术检测了结直肠癌患者切除的肿瘤和癌旁组织中的突变类型、突变数目和突变基因。（2）观察结直肠肿瘤样本中基因突变的频率,探究不同abo血型、不同肿瘤解剖位置的基因突变频率。（3）探讨结直肠癌患者abo血型与肿瘤突变负荷之间的潜在关系。（4）结合结直肠癌患者体内的肿瘤病理特征,如肿瘤大小,肿瘤分期和肿瘤位置/来源,进一步探究血型与肿瘤突变负荷之间的相关性。材料与方法:实验流程如下:首先从所有组织中提取结肠DNA分子,然后按照扩增子文库制备方案扩增DNA样本。这种DNA测序方法被认为是鉴定结直肠癌突变的金标准。本实验在2013年至2016年间收集了来自19个结直肠癌患者的57份样本,包括新鲜肿瘤、癌旁组织和正常组织,运用二代测序技术对收集的样本进行靶向建库测序。靶向位点为结直肠癌癌症易感基因和突变热点区域。所有目标文库均已发送给测序公司,分析时将数据按分子条码进行分组,并检测了每个位置上的的碱基,以构建新的单链序列,检测突变并选择高可信度突变。我们使用了不同的软件程序来分析不同结直肠癌肿瘤组织和癌旁组织样本中突变的类型和频率,以确保结果准确、可靠、合理。数据分析流程:1使用Fast QC评估数据质量;2使用p Trimmer去除引物序列;3使用BWA将reads比对到参考基因组hg38上;4使用samtools去除比对到多个位置的reads;5使用GATK4 Mutect2检测突

关键词：结直肠癌 abo血型系统突变负荷靶向测序

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Past, present and future of kidney paired donation transplantation in India

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World Journal of Transplantation 2017年第2期7卷 134-143页

作者： Vivek B Kute Himanshu V Patel Pankaj R shah Pranjal R Modi Veena R shah sayyed J Rizvi Bipin C Pal Manisha P Modi Priya s shah Umesh T Varyani Pavan s Wakhare saiprasad G shinde Vijay A Ghodela Minaxi H Patel Varsha B Trivedi Hargovind L Trivedi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research CentreDr HL Trivedi Institute of Transplantation Sciences(IKDRC-ITS) Department of Urology and transplantation Department of Anaesthesia IKDRC-ITS Department of Pathology Laboratory MedicineTransfusion Services and Immunohematology

One third of healthy willing living kidney donors are rejected due to abo blood group incompatibility and donor specific antibody. This increases pre-transplant dialysis duration leading to increased morbidity and mortality on the kidney transplantation waiting list. Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. In a kidney transplantation program dominated by living donor kidney transplantation, kidney paired donation is a legal and valid alternative strategy to increase living donor kidney transplantation. This is more useful in countries with limited resources where abo incompatible kidney transplantation or desensitization protocol is not feasible because of costs/infectious complications and deceased donor kidney transplantation is in initial stages. The matching allocation, abo blood type imbalance, reciprocity, simultaneity, geography were the limitation for the expansion of kidney paired donation. Here we describe different successful ways to increase living donor kidney transplantation through kidney paired donation. Compatible pairs, domino chain, combination of kidney paired donation with desensitization or abo incompatible transplantation, international kidney paired donation, nonsimultaneous, extended, altruistic donor chain and list exchange are different ways to expand the donor *** absence of national kidney paired donation program,a dedicated kidney paired donation team will increase access to living donor kidney transplantation in individual centres with team work. Use of social networking sites to expand donor pool, HLA based national kidney paired donation program will increase quality and quantity of kidney paired donation transplantation. Transplant centres should remove the barriers to a broader implementation of multicentre, national kidney paired donation program to further optimize potential of kidney paired donation to increase transplantation of O group and sensitized patients. T

关键词： Living donor kidney transplantation Kidney paired donation Renal replacement therapy Developing country

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six end-stage renal disease patients benefited from first non-simultaneous single center 6-way kidney exchange transplantation in India

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World Journal of Nephrology 2016年第6期5卷 531-537页

作者： Vivek B Kute Himanshu V Patel Umesh T Varyani Pankaj R shah Pranjal R Modi Veena R shah sayyed J Rizvi Bipin C Pal Priya s shah Pavan s Wakhare Vijay A Ghodela saiprasad G shinde Varsha B Trivedi Minaxi H Patel Hargovind L Trivedi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research Center Dr HL Trivedi Institute of Trans-plantation Sciences Department of Urology and Transplantation Dr HL Trivedi Institute of Trans-plantation Sciences Department of Anesthesia Dr HL Trivedi Institute of Transplantation Sciences Department of Pathology and laboratory medicine Dr HL Trivedi Institute of Transplantation Sciences

AIM To avoid desensitization protocols and abo incompatible kidney transplantation(KT) due to high costs and increased risk of infections from intense *** We present institutional ethical review board- approved study of single center 6-way kidney exchange transplantation. The participants comprised abo incompatibility(n = 1); positive cross-match and/or presence of donor specific antibody(n = 5). The average time required from registration in kidney paired donation(KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo. REsULTs Graft and patient survival were 100%, and 100%, respectively. One patient had biopsy-proven acute borderline T cell rejection(Banff update 2013, type 3). Mean serum creatinine was 0.8 mg/dL at 9 mo followup. The waiting time in KPD was short as compared to deceased donor KT. CONCLUsION We report first non-simultaneous, single center, 6-way kidney exchange transplantation from India. Our experience will encourage other centers in India to undertake this practice.

关键词： Kidney transplantation/methods Kidney paired donation Living donors/supply and distribution Donor selection/methods

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International kidney paired donation transplantations to increase kidney transplant of O group and highly sensitized patient: First report from India

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World Journal of Transplantation 2017年第1期7卷 64-69页

作者： Vivek B Kute Himanshu V Patel Pankaj R shah Pranjal R Modi Veena R shah sayyed J Rizvi Bipin C Pal Priya s shah Pavan s Wakhare saiprasad G shinde Vijay A Ghodela Umesh T Varyani Minaxi H Patel Varsha B Trivedi Hargovind L Trivedi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research Center Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) Department of Urology and transplantation IKDRC-ITS Department of Anesthesia IKDRC-ITS Department of Pathology Laboratory Medicine Transfusion Services and Immunohematology IKDRC-ITS

AIM To report the first international living related two way kidney paired donation(KPD) transplantation from India which occurred on 17 th February 2015 after legal per-mission from authorization committee. METHODs Donor recipient pairs were from Portugal and India who were highly sensitized and abo incompatible with their spouse respectively. The two donor recipient pairs had negative lymphocyte cross-matching, flow cross-matchand donor specific antibody in two way kidney exchange with the intended KPD donor. Local KPD options were fully explored for Indian patient prior to embarking on international KPD. REsULTs Both pairs underwent simultaneous uneventful kidney transplant surgeries and creatinine was 1 mg/d L on tacrolimus based immunosuppression at 11 mo follow up. The uniqueness of these transplantations was that they are first international KPD transplantations in our *** International KPD will increases quality and quantity of living donor kidney transplantation. This could be an important step to solving the kidney shortage with additional benefit of reduced costs, improved quality and increased access for difficult to match incompatible pairs like O blood group patient with non-O donor and sensitized patient. To the best of our knowledge this is first international KPD transplantation from India.

关键词： Kidney paired donation International kidney paired donation Living donor kidney transplantation

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An Inventory of some Relatively Large Marine Mammals, Reptiles, and Fishes sighted,Caught, By-Caught, or stranded in the Mediterranean Coast of the Gaza strip-Palestine

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Open Journal of Ecology（生态学期刊） 2023年第2期

作者： Abdel Fattah N.Abd Rabou Kamal E.Elkahlout Kamal J.Elnabris Adel J.Attallah Jehad Y.salah Mohammed A.aboutair Waleed M.Thabit sahar K.serri Hassan G.Abu hatab sameeh M.Awadalah Wajdi M.saqallah Mokhles s.Alhawajri Tariq K.Al-sammak Bashar s.Jarayseh sinaa A.Ababsa Daoud I.Al-Hali Aysha A.Rafeea Doaa s.Ghattas Huda E.Abu Amra Israa M.Jaber Nedal A.Fayyad Ashraf A.shafei Inas A.Abd Rabou Othman A.Abd Rabou Mohammed A.Abd Rabou Mazen T.Abualtayef Mohammed R.Al-Agha Yousif K.Ibrahim Rimel M.Benmessaoud Mourad M.Cherif Hashem A.Madkour

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282例新生儿溶血症临床分析

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新生儿科杂志 2003年第4期18卷 145-147页

作者：刘家应上海市儿童医院检验科 200040

本文按照新生儿溶血症(Hemolytic Disease of Newborn)HDN中,三项试验诊断标准,十年中共检出新生儿溶血症282例。男性156例,占55.31％,女性126例,占44.68％。年龄在出生后9小时至12天。在282例新生儿溶血症,抗体依次为抗A 124例(44％)、... 详细信息

本文按照新生儿溶血症(Hemolytic Disease of Newborn)HDN中,三项试验诊断标准,十年中共检出新生儿溶血症282例。男性156例,占55.31％,女性126例,占44.68％。年龄在出生后9小时至12天。在282例新生儿溶血症,抗体依次为抗A 124例(44％)、抗B 97例(34％)、抗D 45例(16％)、抗E 9例(3％)、抗cE 5例(2％)、抗Ce及抗C各1例。所占比例分别为:43.97％、34.39％、15.9％、3.19％、1.77％、0.71％。直接抗人球蛋白试验阳性115例占40.78％,释放试验阳性265例,占94.15％。游离试验阳性249例,占88.3％。结果提示,除abo以外,Rh血型系统是引起上海地区HDN的主要血型抗体。对高危孕妇进行血清学检测来预报HDN,以便做到早发现、早治疗。

关键词：新生儿溶血症临床分析抗体血清学检测诊断标准核黄疸

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abo血型不合的活体肝移植受者胆道狭窄的CT表现

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国际医学放射学杂志 2018年第4期 498-498页

作者： s.H.Choi K.W.Kim s.Y.Kim J.s.Kim J.H.Kwon s.G.Lee 郑孝飞 Department of Radiology and the Research Institute of Radiology University of Ulsan College of MedicineAsan Medical Center

目的评估abo血型不合的活体供肝移植(LDLT)受者胆道狭窄的CT表现,重点放在移植后1个月的CT检查结果,并评估临床结果。方法在351例abo血型不合的受者中,回顾性评估65例胆道狭窄病人的CT扫描。CT扫描的胆道狭窄分为A型(门静脉型)和B型(弥... 详细信息

目的评估abo血型不合的活体供肝移植(LDLT)受者胆道狭窄的CT表现,重点放在移植后1个月的CT检查结果,并评估临床结果。方法在351例abo血型不合的受者中,回顾性评估65例胆道狭窄病人的CT扫描。CT扫描的胆道狭窄分为A型(门静脉型)和B型(弥漫型)。在移植后1个月后评估先前的CT异常表现和门静脉环状晕征,并评估每例病人的临床结果。结果在65例有胆道狭窄的abo血型不合受者中,36.9%的人有B型狭窄。与诊断时的胆管狭窄相比,移植后1个月,A型和B型狭窄与先前CT表现类似的比例分别为84.4%和86.4%。B型狭窄在移植后1个月CT上表现为复杂的门静脉周围晕征比A型狭窄更常见(86.4%∶3.1%,Pabo血型不合的LDLT受者的胆管狭窄有临床意义。

关键词：胆道狭窄血型不合 abo CT

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保存液保存高浓度血小板的产率和体外质量

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国际输血及血液学杂志 2006年第3期29卷 279-282页

作者： Ringwald J Walz s Zimmermann R 洪缨（节译）叶兰（节译）史久华（校）成都市血液中心 610041 不详

与血浆保存的浓缩血小板(PC)相比,血小板保存液(PAs)保存的PC具有的优点是减少了血浆含量,从而减少过敏和发热输血反应,适合abo血型不相配的血小板输注,使更多的血浆可用于蛋白分离.近来,病原体灭活的可能性更增加了使用PAs保存PC的兴趣... 详细信息

与血浆保存的浓缩血小板(PC)相比,血小板保存液(PAs)保存的PC具有的优点是减少了血浆含量,从而减少过敏和发热输血反应,适合abo血型不相配的血小板输注,使更多的血浆可用于蛋白分离.近来,病原体灭活的可能性更增加了使用PAs保存PC的兴趣,因为PC中血浆含量少,是一些病原体灭活方法的先决条件.

关键词：浓缩血小板输血反应保存液病原体灭活血浆含量质量体外产率浓度献血

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