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Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave:a single-center cohort study

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第6期25卷 529-540页

作者： Duo LV Xishao XIE Qinyun YANG Zhimin CHEN Guangjun LIU Wenhan PENG rending wang Hongfeng HUANG Jianghua CHEN Jianyong WU Department of Clinical Pharmacy the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research Hangzhou 310003China Kidney Disease Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Key Laboratory of Kidney Disease Prevention and Control Technology Zhejiang ProvinceHangzhou 310003China Institute of Nephrology Zhejiang UniversityHangzhou 310003China Zhejiang Clinical Research Center of Kidney and Urinary System Disease Hangzhou 310003China The Third Grade Laboratory under the National State Administration of Traditional Chinese MedicineHangzhou 310003China Information Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background:Following the short-term outbreak of coronavirus disease 2019(COVID-19)in December 2022 in China,clinical data on kidney transplant recipients(KTRs)with COVID-19 are ***:We conducted a single-center retrospective study to describe the clinical features,complications,and mortality rates of hospitalized KTRs infected with COVID-19 between Dec.16,2022 and Jan.31,*** patients were followed up until Mar.31,***:A total of 324 KTRs with COVID-19 were *** median age was 49 *** median time between the onset of symptoms and admission was 13 ***,azvudine,and nirmatrelvir/ritonavir were administered to 67(20.7%),11(3.4%),and 148(45.7%)patients,***-nine(9.0%)patients were treated with more than one antiviral ***-eight(14.8%)patients were treated with tocilizumab and 53(16.4%)patients received baricitinib *** acute kidney injury(AKI)occurred in 81(25.0%)patients and 39(12.0%)patients were admitted to intensive care *** infections were observed in 55(17.0%)***(15.4%)patients lost their *** 28-d mortality rate of patients was 9.0%and 42(13.0%)patients died by the end of *** Cox regression analysis identified that cerebrovascular disease,AKI incidence,interleukin(IL)-6 level of>6.8 pg/mL,daily dose of corticosteroids of>50 mg,and fungal infection were all associated with an increased risk of death for hospitalized ***:Our findings demonstrate that hospitalized KTRs with COVID-19 are at high risk of *** administration of immunomodulators or the late application of antiviral drugs does not improve patient survival,while higher doses of corticosteroids may increase the death risk.

关键词： Coronavirus disease 2019(COVID-19) Kidney transplant Hospitalization Mortality

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Long-term kidney transplant outcomes in Chinese patients with primary glomerulonephritis:A multicenter study in China

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Chinese Medical Journal 2024年第12期137卷 1492-1494页

作者： Kenan Xie Jinsong Chen Longshan Liu rending wang Baoshan Gao Xiaopeng Hu Xiaotian Tang Zheng Jin Ming Zhang Yong Han Turen Song Jiqiu Wen Jiong Zhang Department of Nephrology National Clinical Research Center of Kidney DiseasesJinling HospitalNanjing University School of MedicineNanjingJiangsu 210002China Department of Organ Transplantation The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510080China Department of Kidney Disease The First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouZhejiang 310003China Department II of Urology First Hospital of Jilin UniversityChangchunJilin 130021China Department of Urology Beijing Chao-Yang HospitalCapital Medical UniversityBeijing 100020China Department of Urology The Secend Xiangya Hospital of Central South UniversityChangshaHunan 410011China Department of Renal Transplantation Hospital of NephrologyThe First Affiliated Hospital of Medical CollegeXi’an Jiaotong UniversityXi’anShaanxi 710061China Department of Liver Surgery Shanghai Jiaotong University School of Medicine Affiliated Renji HospitalShanghai 200127China Department of Respiratory and Critical Care Medicine The Eighth Medical Center of PLA General HospitalBeijing Key Laboratory of OTIRBeijing 100091China Department of Urology West China Hospital of Sichuan UniversityChengduSichuan 610041China

To the Editor:The primary cause of end-stage kidney disease(ESKD)in China is chronic glomerulonephritis(GN),which accounts for 45%of ESKD patients.[1]There is currently no nationwide large-scale study on the longterm prognosis of kidney transplantation in patients with chronic GN in *** the past decade,however,few landmark studies from populations in Europe[2,3]and the United States[4]have provided important reference data for this ***,we propose to conduct a nationwide multicenter retrospective study,which was launched by the National Clinical Research Center of Kidney Diseases,Jinling Hospital,Nanjing University School of Medicine,from 2017 to 2020.

关键词： nationwide patients glomerulonephritis

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Helper T Cell(CD4^(+))Targeted Tacrolimus Delivery Mediates Precise Suppression of Allogeneic Humoral Immunity

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Research 2022年第3期2022卷 189-203页

作者： Jia Shen Chang Liu Pengpeng Yan Meifang wang Luying Guo Shuaihui Liu Jianghua Chen Jessica MRosenholm Hongfeng Huang rending wang Hongbo Zhang Kidney Disease Center The First Affiliated HospitalCollege of MedicineZhejiang UniversityKey Laboratory of Kidney Disease Prevention and Control TechnologyZhejiang ProvinceChina Pharmaceutical Sciences Laboratory Faculty of Science and EngineeringÅbo Akademi UniversityTurku 20520Finland Turku Bioscience Centre University of Turku andÅbo Akademi UniversityTurku 20520Finland Organ Donation and Coordination Office The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China Department of Orthopaedics Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint DiseasesShanghai Institute of Traumatology and OrthopaedicsRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

Antibody-mediated rejection(ABMR)is a major cause of dysfunction and loss of transplanted *** current treatments for ABMR involve nonspecific inhibition and clearance of T/B cells or plasma ***,the prognosis of patients following current treatment is poor.T follicular helper cells(Tfh)play an important role in allograft-specific antibodies secreting plasma cell(PC)*** cells are therefore considered to be important therapeutic targets for the treatment of antibody hypersecretion disorders,such as transplant rejection and autoimmune ***(Tac),the primary immunosuppressant,prevents rejection by reducing T cell ***,its administration should be closely monitored to avoid serious side *** this study,we investigated whether Tac delivery to helper T(CD4^(+))cells using functionalized mesoporous nanoparticles can block Tfh cell differentiation after alloantigen *** showed that Tac delivery ameliorated humoral rejection injury in rodent kidney graft by suppressing Tfh cell development,PC,and donor-specific antibody(DSA)generation without causing severe side effects compared with delivery through the drug administration *** study provides a promising therapeutic strategy for preventing humoral rejection in solid organ *** specific and controllable drug delivery avoids multiple disorder risks and side effects observed in currently used clinical approaches.

关键词： Tacrolimus treatment donor

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Development of digital organ-on-a-chip to assess hepatotoxicity and extracellular vesicle-based anti-liver cancer immunotherapy

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Bio-Design and Manufacturing 2022年第3期5卷 437-450页

作者： Guohua Wu Jianguo Wu Zihan Li Shengyu Shi Di Wu Xuanbo wang Han Xu Hui Liu Yixiao Huang rending wang Jia Shen Zhihong Dong Shuqi wang The First Affiliated Hospital School of MedicineZhejiang UniversityHangzhou 310029China Institute for Translational Medicine Zhejiang UniversityHangzhou 310029China Department of Chemical Engineering University of Waterloo200 University Avenue WestWaterlooON N2L 3G1Canada Department of Building Environment and Energy Engineering Xi’an Jiaotong UniversityXi’an 710049China National Engineering Research Center for Biomaterials Sichuan UniversityChengdu 610065China Clinical Research Center for Respiratory Disease West China HospitalSichuan UniversityChengdu 610065China Kidney Disease Center The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310029China School of Mechanical Engineering Chengdu UniversityChengdu 610106China Institute for Advanced Study Chengdu UniversityChengdu 610106China

Organ-on-a-chip systems have been increasingly recognized as attractive platforms to assess toxicity and to develop new therapeutic ***,current organ-on-a-chip platforms are limited by a“single pot”design,which inevitably requires holistic analysis and limits parallel ***,we developed a digital organ-on-a-chip by combining a microwell array with cellular microspheres,which significantly increased the parallelism over traditional organ-on-a-chip for drug *** to 127 uniform liver cancer microspheres in this digital organ-on-a-chip format served as individual analytical units,allowing for analysis with high consistency and quick *** platform displayed evident anti-cancer efficacy at a concentration of 10μM for sorafenib,and had greater alignment than the“single pot”organ-on-a-chip with a previous in vivo *** addition,this digital organ-on-a-chip demonstrated the treatment efficacy of natural killer cell-derived extracellular vesicles for liver cancer at 50μg/*** successful development of this digital organ-on-a-chip platform provides high-parallelism and a low-variability analytical tool for toxicity assessment and the exploration of new anticancer modalities,thereby accelerating the joint endeavor to combat cancer.

关键词： Digital Organ-on-a-chip Microwell array Microspheres Extracellular vesicles

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Outcomes of allograft from donor kidney microthrombi and secondary recipient thrombotic microangiopathy: should we consider loosening the belt?

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2023年第6期24卷 524-529页

作者： Yamei CHENG Luying GUO Xue REN Zhenzhen YANG Junhao LV Huiping wang Wenhan PENG Hongfeng HUANG Jianyong WU Jianghua CHEN rending wang Kidney Disease Center the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China Key Laboratory of Kidney Disease Prevention and Control Technology Zhejiang ProvinceHangzhou 310003China National Key Clinical Department of Kidney Diseases Hangzhou 310003China Institute of Nephrology Zhejiang UniversityHangzhou 310003China Zhejiang Clinical Research Center of Kidney and Urinary System Disease Hangzhou 310003China

There is currently a huge worldwide demand for donor kidneys for organ ***,numerous marginal donor kidneys,such as kidneys with microthrombi,are used to save patients'*** some studies have shown an association between the presence of microthrombi in donor kidneys and an increased risk for delayed graft function(DGF)(McCall et al.,2003;Gao et al.,2019),other studies have demonstrated that microthrombi negatively impact the rate of DGF(Batra et al.,2016;Hansen et al.,2018),but not graft survival rate(McCall et al.,2003;Batra et al.,2016;Gao et al.,2019).In contrast,Hansen et al.(2018)concluded that fibrin thrombi were not only associated with reduced graft function six months posttransplantation but also with increased graft loss within the first year of *** the other hand,Batra et al.(2016)found no significant differences in the DGF rate or one-year graft function between recipients in diffuse and focal microthrombi *** date,however,the overall influence of donor kidney microthrombi and the degree of influence on prognosis remain controversial,necessitating further research.

关键词： kidney throm donor

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Urinary donor-derived cell-free DNA as a non-invasive biomarker for BK polyomavirus-associated nephropathy

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2021年第11期22卷 917-928页

作者： Jia SHEN Luying GUO Wenhua LEI Shuaihui LIU Pengpeng YAN Haitao LIU Jingyi ZHOU Qin ZHOU Feng LIU Tingya JIANG Huiping wang Jianyong WU Jianghua CHEN rending wang Kidney Disease Center the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China National Key Clinical Department of Kidney Diseases Hangzhou 310003China Key Laboratory of Kidney Disease Prevention and Control Technology of Zhejiang Province Hangzhou 310003China Zhejiang University Institute of Nephrology Hangzhou 310003China AlloDx(Shanghai)Biotech. Co.Ltd.Shanghai 201100China Organ Donation and Coordination Office the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China

BK polyomavirus-associated nephropathy(BKPyVAN)is a common cause of allograft ***,differentiation between BKPyVAN and type I T cell-mediated rejection(TCMR)is challenging when simian virus 40(SV40)staining is negative,because of the similarities in *** study investigated whether donor-derived cell-free DNA(ddcfDNA)can be used to differentiate *** region capture sequencing was applied to detect the ddcfDNAs of 12 recipients with stable graft function,22 with type I TCMR,21 with proven BKPy VAN,and 5 with possible Py *** found that urinary ddcfDNA levels were upregulated in recipients with graft injury,whereas plasma ddcfDNA levels were comparable for all *** median urinary concentrations and fractions of ddcfDNA in proven BKPyVAN recipients were significantly higher than those in type I TCMR recipients(10.4 vs.6.1 ng/mL,P<0.001 and 68.4%vs.55.3%,P=0.013,respectively).Urinary ddcfDNA fractions(not concentrations)were higher in the BKPyVAN-pure subgroup than in the BKPyVAN-rejection-like subgroup(81.30%vs.56.64%,P=0.025).With a cut-off value of 7.81 ng/m L,urinary ddcf DNA concentrations distinguished proven BKPyVAN from type I TCMR(area under the curve(AUC)=0.848,95%confidence interval(95%CI):0.734 to 0.963).These findings suggest that urinary ddcf DNA is a non-invasive biomarker which can reliably differentiate BKPy VAN from type I TCMR.

关键词： Donor-derived cell-free DNA(ddcfDNA) BK polyomavirus-associated nephropathy(BKPyVAN) T cell-mediated rejection(TCMR) Urine Differential diagnosis

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Multiple relapses of parvovirus B19 infection after renal transplant:a case report and review of the literature

Multiple relapses of parvovirus B19 infection after renal tr...

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2013中国器官移植大会

作者： rending wang Anup Patel Yanyan Chen Jianghua Chen Kidney disease center the first affiliated hospitalCollege of medicineZhejiang university

Background Anemia due to parvovirus B19(PVB19) infection has been reported in renal transplant *** first case of PVB19 infection in a renal transplant patient was reported in *** early descriptions of PVB19 infection in renal transplant recipients,only 133 cases of PVB19-related aplastic anemia in kidney transplant recipients have been reported to *** intravenous immunoglobulin(IVIG) is the treatment of choice for PVB19 related anemia,some recipients still experience multiple *** ability to minimize relapse rates and reduce the of cost of treating PVB19 is important. Method We describe in detail a renal transplant recipient who experienced multiple relapses of PVB19-related *** performed a literature review of the PubMed database from 1986 to April 2013 with the keywords of "B19," "transplant," "renal," and "kidney".We included the cases of relapsing PVB19 infection and also enrolled pertinent articles obtained from searching references in the articles found in the primary search.

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病原体宏基因检测在肾脏疾病感染患者中的应用

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肾脏病与透析肾移植杂志 2022年第2期31卷 149-150页

作者：陈江华王仁定浙江大学医学院附属第一医院肾脏病中心杭州310003

1998年提出的宏基因组概念最初指土壤标本中所有微生物基因组信息的总和,包括无法培养的基因组信息。后来宏基因组概念被应用于临床标本中的生物遗传信息特征。宏基因组二代测序(mNGS)主要通过以二代测序为代表的高通量测序技术,对临床... 详细信息

1998年提出的宏基因组概念最初指土壤标本中所有微生物基因组信息的总和,包括无法培养的基因组信息。后来宏基因组概念被应用于临床标本中的生物遗传信息特征。宏基因组二代测序(mNGS)主要通过以二代测序为代表的高通量测序技术,对临床标本进行宏基因组学分析,从而获取病原体的分类、血清型、耐药性以及毒力等一系列生物学信息。

关键词：宏基因组二代测序肾脏疾病感染

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细胞色素P450 3A5基因分型对肾移植受者他克莫司剂量的影响

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中华器官移植杂志 2014年第1期35卷 25-28页

作者：冯时羊仙黄洪锋吴建永王仁定陈江华 310003杭州浙江大学医学院附属第一医院肾脏病中心浙江省肾脏病防治技术研究重点实验室国家中医药管理局三级实验室“肾脏病免疫实验室”卫生部器官联合移植研究重点实验室

目的探讨细胞色素P4503A5（CYP3A5）＊1和CYP3A5＊3基因型对肾移植受者他克莫司药物剂量的影响。方法单中心肾移植后服用他克莫司的受者69例，移植后1和2个月采集受者外周血，提取DNA，用序列特异性引物聚合酶链反应技术检测受者的CYP3A... 详细信息

目的探讨细胞色素P4503A5（CYP3A5）＊1和CYP3A5＊3基因型对肾移植受者他克莫司药物剂量的影响。方法单中心肾移植后服用他克莫司的受者69例，移植后1和2个月采集受者外周血，提取DNA，用序列特异性引物聚合酶链反应技术检测受者的CYP3A5基因分型。统计不同基因型受者肾移植后l和2个月时的他克莫司剂量，计算血他克莫司浓度／N量（C／D值）。结果69例中，CYP3A5＊1／＊1基因型6N（8．7％），CYP3A5＊1／＊3基因型22例（31．9oA），CYP3A5＊3／＊3基因型41例（59．4%）。移植后1和2个月时，CYP3A5＊1基因型受者他克莫司剂量显著高于CYP3A5＊3／＊3型受者（均为P〈0．0001）；CYP3A5＊1基因型受者血他克莫司浓度低于CYP3A5＊3／＊3型受者（P=0．0208，P=0．0191）。CYP3A5＊1基因型受者在移植后1个月的C／D值显著低于CYP3A5＊3／＊3型受者（P〈0．0001）；CYP3A5＊1基因型的受者在移植后2个月的C／D值也显著低于CYP3A5＊3／＊3型受者（P=0．0191）。受者的肝、肾功能对移植后1和2个月的C／D埴无显著影响。性别对他克莫司的剂量无影响。结论携带CYP3A5＊1基因型的受者与CYP3A5＊3／＊3型受者相比较，需要更高的他克莫司剂量才能达到目标血药浓度。

关键词：细胞色素P450 他克莫司肾移植

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肾移植术后三发性甲状旁腺功能亢进诱导持续高钙血症伴骨质疏松

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中华器官移植杂志 2019年第2期40卷 92-97页

作者：王苏娅吴建永彭文翰王仁定黄洪锋陈江华浙江大学医学院附属第一医院肾脏病中心浙江省肾脏病防治技术研究重点实验室国家临床重点专科浙江大学肾脏病研究所国家中医药管理局三级实验室“肾脏病免疫实验室”杭州310003

目的调查肾移植术后三发性甲状旁腺功能亢进(THPT)的临床特点。方法对36例移植肾功能稳定合并高钙血症受者的血清矿物质、骨密度、甲状旁腺激素(iPTH)及骨代谢指标进行回顾性分析。结果36例受者血清总钙持续增高(6~170个月),最高达(2.97... 详细信息

目的调查肾移植术后三发性甲状旁腺功能亢进(THPT)的临床特点。方法对36例移植肾功能稳定合并高钙血症受者的血清矿物质、骨密度、甲状旁腺激素(iPTH)及骨代谢指标进行回顾性分析。结果36例受者血清总钙持续增高(6~170个月),最高达(2.97±0.20)mmol/L;术后1个月高钙组血清磷较术前显著降低(P=0.001),并显著低于对照组(P=0.003);血清碱性磷酸酶增高(295.73±194.22)U/L;骨密度T值下降(腰椎T值为-2.78±0.84,髋关节T值为-2.09±0.66)。11例(30.6%)合并骨外钙化。17例(47.2%)甲状旁腺增生。术前和术后1周,高钙组iPTH分别为(859.50±495.44)和(759.25±907.07)pg/ml,显著高于血钙正常组的(345.56±216.55)和(197.45±249.31)pg/ml(P=0.001,P=0.001)。高钙组末次iPTH为(198.26±155.22)pg/ml(高于正常值),多因素逐步回归分析显示,其增高与术前iPTH、血钙,术后血磷、ALP、25OHD3相关(P=0.024,P=0.002,P=0.001,P=0.037,P=0.026)。结论肾移植术后iPTH增高伴持续高钙、低磷、骨质疏松、骨外钙化等三发性甲状旁腺功能亢进的临床特征。

关键词：肾移植三发性甲状旁腺功能亢进高钙血症骨质疏松

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