检索结果-南通市图书馆

Advancing immunosuppression in liver transplantation: A narrative review

Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 441-448页

作者： Samuele Iesari Francesca Laura Nava Ilaria Elena Zais Laurent Coubeau mariano ferraresso Evaldo Favi Jan Lerut General Surgery and Kidney Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico15 Via della Commenda20122 MilanItaly Institut de Recherche Expérimentale et Clinique Universitécatholique de Louvain10 Avenue Hippocrate1200 BrusselsBelgium Service de Chirurgie et Transplantation Abdominale Cliniques Universitaires Saint-Luc55 Avenue Hippocrate1200 BrusselsBelgium Department of Clinical Sciences and Community Health Universitàdegli Studi di Milano19 Via della Commenda20122 MilanItaly

Immunosuppression is essential to ensure recipient and graft survivals after liver transplantation(LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solidorgan transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting.

关键词： Liver transplantation Immunosuppression Drug development Long-term results Clinical operational tolerance

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Allograft artery mycotic aneurysm after kidney transplantation: A case report and review of literature

引用

World Journal of Clinical Cases 2020年第5期8卷 912-921页

作者： Marco Bindi mariano ferraresso Maria Letizia De Simeis Nicholas Raison Laura Clementoni Serena Delbue Marta Perego Evaldo Favi Renal Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilan 20122Italy Department of Clinical Sciences and Community Health University of MilanMilan 20122Italy MRC Centre for Transplantation King’s College LondonLondon WC2R 2LSUnited Kingdom Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20100Italy

BACKGROUND Allograft artery mycotic aneurysm(MA)represents a rare but life-threatening complication of kidney *** is widely considered the safest *** to the rarity of the disease and the substantial risk of fatal consequences,experience with conservative strategies is *** date,only a few reports on surgical repair have been *** describe a case of true MA successfully managed by aneurysm resection and arterial *** SUMMARY An 18-year-old gentleman,on post-operative day 70 after deceased donor kidney transplantation,presented with malaise,low urinary output,and worsening renal *** organ preservation fluid cultures,collected at the time of surgery,were positive for Candida *** ultrasound and contrastenhanced computer tomography showed a 4-cm-sized,saccular aneurysm of the iuxta-anastomotic segment of the allograft artery,suspicious for *** lesion was wide-necked and extended to the distal bifurcation of the main arterial branch,thus preventing endovascular stenting and *** multidisciplinary discussion,the patient underwent surgical exploration,aneurysm excision,and re-anastomosis between the stump of the allograft artery and the internal iliac *** procedure was *** and microbiology evaluation of the surgical specimen confirmed the diagnosis of MA caused by Candida *** years after the operation,the patient is doing very well with excellent allograft function and no signs of recurrent *** Surgical repair represents a feasible option in carefully selected patients with allograft artery ***-fungal prophylaxis is advised when preservation fluid cultures are positive.

关键词： Aneurysm Candida Kidney transplant Infection Complication Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Systematic review of ablative therapy for the treatment of renal allograft neoplasms

引用

World Journal of Clinical Cases 2019年第17期7卷 2487-2504页

作者： Evaldo Favi Nicholas Raison Federico Ambrogi Serena Delbue Maria Chiara Clementi Luca Lamperti Marta Perego Matteo Bischeri mariano ferraresso Renal Transplantation Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilan 20122Italy MRC Centre for Transplantation King’s College LondonLondon WC2R 2LSUnited Kingdom Department of Clinical Sciences and Community Health University of MilanMilan 20122Italy Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20100Italy

BACKGROUND To date,there are no guidelines on the treatment of solid neoplasms in the transplanted ***,allograft nephrectomy has been considered the only reasonable *** recently,nephron-sparing surgery (NSS) and ablative therapy (AT) have been proposed as alternative procedures in selected *** To review outcomes of AT for the treatment of renal allograft *** We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 *** was searched in March 2019 without time restrictions for all papers reporting on radiofrequency ablation (RFA),cryoablation (CA),microwave ablation (MWA),high-intensity focused ultrasound (HIFU),and irreversible electroporation (IRE) of solid tumours of the kidney *** original manuscripts describing actual cases and edited in English were *** relevant articles were accessed in full *** searches included all pertinent *** studies were also assessed for methodological quality using a tool based on a modification of the Newcastle Ottawa *** on recipient characteristics,transplant characteristics,disease characteristics,treatment protocols,and treatment outcomes were extracted and *** the nature and the quality of the studies available (mostly retrospective case reports and small retrospective uncontrolled case series),a descriptive summary was *** Twenty-eight relevant studies were selected describing a total of 100 AT procedures in 92 *** age at diagnosis ranged from 21 to 71 years whereas time from transplant to diagnosis ranged from 0.1 to 312 *** of the neoplasms were asymptomatic and diagnosed incidentally during imaging carried out for screening purposes or for other clinical *** diagnostic modality was Doppler-ultrasound scan followed by computed tomography scan,and magnetic resonance *** tumour types were: pa

关键词： Ablative therapy Cryoablation Radiofrequency ablation Microwave ablation High-intensity focused ultrasonography Irreversible electroporation Neoplasm Kidney transplant Renal allograft Systematic review

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Incidence, risk factors, and outcome of BK polyomavirus infection after kidney transplantation

引用

World Journal of Clinical Cases 2019年第3期7卷 270-290页

作者： Evaldo Favi Carmelo Puliatti Rajesh Sivaprakasam mariano ferraresso Federico Ambrogi Serena Delbue Federico Gervasi Ilaria Salzillo Nicholas Raison Roberto Cacciola Renal Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico Renal Transplantation Barts Health NHS Trust Royal London Hospital Department of Clinical Sciences and Community Health University of Milan Department of Biomedical Surgical and Dental Sciences University of Milan MRC Centre for Transplantation King’s College London

BACKGROUND Polyomavirus-associated nephropathy is a leading cause of kidney allograft failure. Therapeutic options are limited and prompt reduction of the net state of immunosuppression represents the mainstay of treatment. More recent application of aggressive screening and management protocols for BK-virus infection after renal transplantation has shown encouraging results. Nevertheless,long-term outcome for patients with BK-viremia and nephropathy remains obscure. Risk factors for BK-virus infection are also *** To investigate incidence, risk factors, and outcome of BK-virus infection after kidney *** This single-centre observational study with a median follow up of 57(31-80) mo comprises 629 consecutive adult patients who underwent kidney transplantation between 2007 and 2013. Data were prospectively recorded and annually reviewed until 2016. Recipients were periodically screened for BK-virus by plasmaquantitative polymerized chain reaction. Patients with BK viral load ≥ 1000 copies/mL were diagnosed BK-viremia and underwent histological assessment to rule out nephropathy. In case of BK-viremia, immunosuppression was minimized according to a prespecified protocol. The following outcomes were evaluated: patient survival, overall graft survival, graft failure considering death as a competing risk, 30-d-event-censored graft failure, response to treatment,rejection, renal function, urologic complications, opportunistic infections, newonset diabetes after transplantation, and malignancies. We used a multivariable model to analyse risk factors for BK-viremia and *** BK-viremia was detected in 9.5% recipients. Initial viral load was high(≥ 10000 copies/mL) in 66.7% and low(< 10000 copies/mL) in 33.3% of these ***-associated nephropathy was diagnosed in 6.5% of the study population. Patients with high initial viral load were more likely to experience sustained viremia(95% vs 25%, P < 0.00001), nephropathy(92.

关键词： Polyomavirus BK virus Kidney transplantation Outcome Risk factors Immunosuppression Human leukocyte antigen Rejection Cytomegalovirus Ethnicity

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Treatment options for localised renal cell carcinoma of the transplanted kidney

引用

World Journal of Transplantation 2020年第6期10卷 147-161页

作者： Gloria Motta mariano ferraresso Luca Lamperti Dhanai Di Paolo Nicholas Raison Marta Perego Evaldo Favi Urology IRCCS Policlinico San DonatoSan Donato Milanese 27288Italy Renal Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilan 20122Italy Department of Clinical Sciences and Community Health University of MilanMilan 20122Italy MRC Centre for Transplantation King’s College LondonLondon WC2R 2LSUnited Kingdom

Currently,there is no consensus among the transplant community about the treatment of renal cell carcinoma(RCC)of the transplanted *** recently,graftectomy was universally considered the golden standard,regardless of the characteristics of the *** to the encouraging results observed in native kidneys,conservative options such as nephron-sparing surgery(NSS)(enucleation and partial nephrectomy)and ablative therapy(radiofrequency ablation,cryoablation,microwave ablation,high-intensity focused ultrasound,and irreversible electroporation)have been progressively used in carefully selected recipients with early-stage allograft *** reports show excellent patient survival,optimal oncological outcome,and preserved renal function with acceptable complication ***,the rarity and the heterogeneity of the disease,the number of options available,and the lack of long-term follow-up data do not allow to adequately define treatment-specific advantages and *** role of active surveillance and immunosuppression management remain also *** order to offer a better insight into this difficult topic and to help clinicians choose the best therapy for their patients,we performed and extensive review of the *** focused on epidemiology,clinical presentation,diagnostic work up,staging strategies,tumour characteristics,treatment modalities,and follow-up *** research confirms that both NSS and focal ablation represent a valuable alternative to graftectomy for kidney transplant recipients with American Joint Committee on Cancer stage T1aN0M0 *** on T1bN0M0 lesions are scarce but suggest extra *** designed multi-centre prospective clinical trials are warranted.

关键词： Renal cell carcinoma Kidney transplant Graftectomy Nephron-sparing surgery Focal ablation Review

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：