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Simultaneous nephrectomy during kidney transplantation for polycystic kidney disease does not detrimentally impact comorbidity and graft survival

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World Journal of Transplantation 2022年第5期12卷 100-111页

作者： Tom Darius Sébastien Bertoni Martine De Meyer Antoine Buemi Arnaud Devresse Nada Kanaan Eric Goffin Michel Mourad Surgical and Abdominal Transplantation Unit University Clinics Saint LucBrussels 1200Belgium Division of Nephrology University Clinics Saint LucBrussels 1200Belgium

BACKGROUND The lack of space,as an indication for a native unilateral nephrectomy for positioning a future kidney graft in the absence of other autosomal dominant polycystic kidney disease-related symptoms,remains *** To evaluate the surgical comorbidity and the impact on graft survival of an associated ipsilateral native nephrectomy during isolated kidney transplantation in patients with autosomal dominant polycystic kidney *** One hundred and fifty-four kidney transplantations performed between January 2007 and January 2019 of which 77 without(kidney transplant alone(KTA)group)and 77 with associated ipsilateral nephrectomy(KTIN group),were retrospectively *** and surgical variables were analyzed and their respective impact on surgical comorbidity and graft *** Creation of space for future graft positioning was the main reason(n=74,96.1%)for associated ipsilateral *** significant difference in surgical comorbidity(lymphocele,wound infection,incisional hernia,wound hematoma,urinary infection,need for blood transfusion,hospitalization stay,Dindo Clavien classification and readmission rate)was observed between the two study *** incidence of primary nonfunction and delayed graft function was comparable in both groups[0%and 2.6%(P=0.497)and 9.1%and 16.9%(P=0.230),respectively,in the KTA and KTIN group].The 1-and 5-year graft survival were 94.8%and 90.3%,and 100%and 93.8%,respectively,in the KTA and KTIN group(P=0.774).The 1-and 5-year patient survival were 96.1%and 92.9%,and 100%and 100%,respectively,in the KTA and KTIN group(P=0.168).CONCLUSION Simultaneous ipsilateral native nephrectomy to create space for graft positioning during kidney transplantation in patients with autosomal dominant polycystic kidney disease does not negatively impact surgical comorbidity and short-and long-term graft survival.

关键词： Autosomal dominant polycystic kidney disease Complications Kidney transplantation graft survival Unilateral nephrectomy Surgical comorbidity

L-graft_(7) has High Accuracy in Predicting Early Allograft Failure after Liver Transplantation: A Multicenter Cohort Study in China

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Journal of Clinical and Translational Hepatology 2024年第1期12卷 62-69页

作者： Songming Li Qijie Luo Shirui Chen Zehua Jia Tielong Wang Xinyu Yu Wenjing Wang YuyiZhang Jiaxing Zhu Feiwen Deng Qiang Sun Zhiyong Guo Xiaoshun He Organ Transplant Center The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongChina Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology GuangzhouGuangdongChina Guangdong Provincial International Cooperation Base of Science and Technology GuangzhouGuangdongChina NHC Key Laboratory of Assisted Circulation(Sun Yat-sen University) GuangzhouGuangdongChina General Surgery Dept.1 Zhongshan People’s HospitalZhongshan Hospital of Sun Yat-Sen UniversityZhongshanGuangdongChina Department of Hepatobiliary Surgery The First People’s Hospital of FoshanFoshanGuangdongChina

Background and Aims:Increasing utilization of extended criteria donor leads to an increasing rate of early allograft failure after liver ***,consensus of definition of early allograft failure is ***:A retrospective,multicenter study was performed to validate the Liver graft Assessment Following Transplantation(L-graft)risk model in a Chinese cohort of 942 adult patients undergoing primary liver transplantation at three Chinese centers.L-graft(L-graft7 and L-graft10)was compared with existing models:the Early Allograft Failure Simplified Estimation(EASE)score,the model of early allograft function(MEAF),and the Early Allograft Dysfunction(EAD)*** and multivariate logistic regression were used to find risk factors of L-graft high-risk ***:L-graft7 had an area under the curve of 0.85 in predicting 90-day graft survival,significantly superior to MEAF[area under the curve(AUC=0.78,p=0.044)]and EAD(AUC=0.78,p=0.006),while there was no statistical significance between the predicting abilities of L-graft7 and EASE(AUC=0.84,p>0.05).Furthermore,L-graft7 maintains good predicting ability in the subgroup of high-donor risk index(DRI)cases(AUC=0.83 ***,p=0.007 ***,p=0.014)and recipients of donors after cardiac death(AUC=0.92 ***,pgraft7 high-risk ***:The accuracy of L-graft7 in predicting early allograft failure was validated in a Chinese multicenter cohort,indicating that it has the potential to become an accurate endpoint of clinical practice and transitional study of machine perfusion.

关键词： Early allograft failure graft survival Liver transplantation Risk prediction model Multicenter study

Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

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World Journal of Transplantation 2024年第1期14卷 130-140页

作者： Geisiane Custodio Andrew Maykon Massutti Aline Caramori Taynara Gonçalves Pereira Augusto Dalazen Gabriela Scheidt Ludmilla Thomazini Cristiane Bauermann Leitão Tatiana Helena Rech Department of Intensive Care Unit Hospital Santa IsabelBlumenau-Santa Catarina CEP-89010906Brazil Transplant Division Hospital Santa IsabelBlumenau-Santa Catarina CEP-89010906Brazil School of Medicine Universidade Regional de Blumenau(FURB)Blumenau-Santa Catarina CEP-89010906Brazil School of Medicine Universidade Federal do Rio Grande do SulPorto Alegre 90035-903Brazil Departement of Endocrinology Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do SulPorto Alegre 90035-903Rio Grande do SulBrazil Department of Internal Medicine Hospital de Clínicas de Porto AlegreDivision of Intensive Care MedicinePorto Alegre 90035-903Brazil

BACKGROUND Prolonged donor hepatectomy time may be implicated in early and late complications of liver *** To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients,mainly early allograft *** This multicenter retrospective study included brain-dead donors and adult liver graft ***-recipient matching was obtained through a crossover *** and laboratory data were recorded for both donors and *** hepatectomy,cold ischemia,and warm ischemia times were *** outcome was early allograft *** outcomes included need for retransplantation,length of intensive care unit and hospital stay,and patient and graft survival at 12 *** From January 2019 to December 2021,a total of 243 patients underwent a liver transplant from a brain-dead *** these,57(25%)developed early allograft *** median donor hepatectomy time was 29(23–40)*** with early allograft dysfunction had a median hepatectomy time of 25(22–38)min,whereas those without it had a median time of 30(24–40)min(P=0.126).CONCLUSION Donor hepatectomy time was not associated with early allograft dysfunction,graft survival,or patient survival following liver transplantation.

关键词： Brain death Hepatectomy Liver transplantation Early allograft dysfunction graft survival

Predicting outcomes after kidney transplantation: Can Pareto’s rules help us to do so?

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World Journal of Transplantation 2024年第1期14卷 9-11页

作者： Fernando M Gonzalez Francisca Gonzalez Cohens Department of Nephrology Faculty of MedicineUniversidad de ChileSantiago 7500922Chile Web Intelligence Centre Faculty of Physics and Mathematical SciencesSantiago 7500922Chile

Kidney transplantation is the best option for kidney replacement therapy,even considering that most of the times the grafts do not survive as long as their *** the Khalil et al's experience,published in this issue of the Journal,they analyze their second kidney graft survival and describe those significant predictors of early *** editorial comments on the results and put in perspective that most of the times,long-term graft survival could be inadvertently jeopardized if the immunosuppressive therapy is reduced or withdrawn for any reason,and that it could happen frequently if the transplant physician intends to innovate with the clinical care without proper evidence-based data.

关键词： Kidney transplantation graft survival Acute rejection Interstitial fibrosis and tubular atrophy Immunosuppression

Role of the postoperative cholesterol in early allograft dysfunction and survival after living donor liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 610-616页

作者： Jian Yang Hai-Qing Wang Jia-Yin Yang Tian-Fu Wen Bo Li Wen-Tao Wang Lu-Nan Yan Department of Liver Transplantation Center West China Hospital of Sichuan University Chengdu 610041 China

BACKGROUND:Many studies have confirmed that serum total cholesterol(sTC) concentrations were associated with underlying liver damage and the synthesis capacity of ***, the role of postoperative sTC level on evaluating graft function and predicting survival of recipients who underwent liver transplantation has not been ***:Clinical data of 231 living donor liver transplantation recipients from May 2003 to January 2015 were retrospectively collected. Patients were stratified into the low sTC group(sTC graft dysfunction(38.6% vs 10.3%, Pgraft dysfunction and 90-day mortality, and patients with sTC graft survival rates at 1-, 3-, and 5-year than those with sTC ≥1.42 mmol/L(67%, 61% and 61% vs 83%, 71% and 69%, P=0.025; 65%, 59% and 59% vs 81%,68% and 66%, P=0.026, respectively). Cox multivariate anal-ysis showed that sTC survival(HR=2.043; 95% CI:1.173-3.560; P=0.012) and graft survival(HR=1.905; 95% CI:1.115-3.255; P=0.018).CONCLUSIONS:sTC graft dysfunction, 90-day mortality, recipient a

关键词： lipid metabolism graft survival early allograft dysfunction morbidity mortality

Transplantation of human hepatocytes into tolerized genetically immunocompetent rats

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World Journal of Gastroenterology 2001年第3期7卷 324-330页

作者： EdwinC.Ouyang CatherineH.Wu CherieWalton KittichaiPromrat GeorgeY.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterRm. AM-045263 Farmington AvenueFarmingtonCT 06030 Correspondence to:George Y.Wu.M.D. Ph.D.Department of Medicine.Division of Gastroenterology-Hepatology.University of Connecticut I lealth CenterRm.AM-045.263 Farmington Avenue.FarmingtonC T 06030

AIM: To determine whether normal genetically immunocompetent rodent hosts could be manipulated to accept human hepatocyte transplants with long term survival without immunosuppression. METHODS: Tolerance towards human hepatocytes was established by injection of primary human hepatocytes or Huh7 human hepatoma cells into the peritoneal cavities of fetal rats. Corresponding cells were subsequently transplanted into newborn rats via intrasplenic injection within 24h after birth. RESULTS: Mixed lymphocyte assays showed that spleen cells from non-tolerized rats were stimulated to proliferate when exposed to human hepatocytes, while cells from tolerized rats were not. Injections made between 15 d and 17 d of gestation produced optimal tolerization. Transplanted human hepatocytes in rat livers were visualized by immunohistochemical staining of human albumin. By dot blotting of genomic DNA in livers of tolerized rats 16 weeks after hepatocyte transplantation, it was found that approximately 2.5 X 10(5) human hepatocytes survived per rat liver. Human albumin mRNA was detected in rat livers by RT-PCR for 15 wk, and human albumin protein was also detectable in rat serum. CONCLUSION: Tolerization of an immuno-competent rat can permit transplantation, and survival of functional human hepatocytes.

关键词： Albumins Animals Cell Line, Transformed Disease Models, Animal Female Gene Expression graft survival Hepatitis Hepatoblastoma Hepatocytes Humans Immune Tolerance Immunocompetence Liver Liver Neoplasms Lymphocyte Culture Test, Mixed Microscopy, Confocal Pregnancy RNA, Messenger Rats Rats, Sprague-Dawley Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Porcine vesical acellular matrix graft of tunica albuginea for penile reconstruction

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Asian Journal of Andrology 2006年第5期8卷 543-548页

作者： Kwan-Joong Joo Byung-Soo Kim Jeong-Ho Han Chang-Ju Kim Chil-HunKwon Heung-JaePark Department of Urology Kangbuk Samsung HospitalSungkyunkwan University School of Medicine108 Pyung-DongJongro-KuSeoul 110-746Korea Department of Chemical Engineering Hanyang University College of Engineering 17 Hangdang-DongSeongdong-KuSeoul 133-791Korea Department of Pathology Samsung Medical CenterSungkyunkwan University School of Medicine50 Ilwon-DongGangnam-KuSeoul 135-710Korea Department of Physiology Kyung Hee University College of Medicine1 Hoegi-DongDongdaemun-Ku Seoul 130-701Korea

Aim： To characterize the feasibility of the surgical replacement of the penile tunica albuginea （TA） and to evaluate the value of a porcine bladder acellular matrix （BAM） graft. Methods： Acellular matrices were constructed from pigs＇ bladders by cell lysis, and then examined by scanning electron microscopy （SEM）. Expression levels of the mRNA of the vascular endothelial growth factor （VEGF） receptor, fibroblast growth factor （FGF）-1 receptor, neuregulin, and brain-derived neurotrophic factor （BDNF） in the acellular matrix and submucosa of the pigs＇ bladders were determined through the reverse transcription-polymerase chain reaction （PCR）. A 5 mm× 5 mm square was excised from the penile TA of nine rabbits. The defective TA was then covered in porcine BAM. Equal numbers of animals were sacrificed and histochemically examined at 2, 4 and 6 months after implantation. Results： SEM of the BAM showed collagen fibers with many pores. VEGF receptor, FGF-1 receptor and neuregulin mRNA were expressed in the porcine BAM; BDNF mRNA was not detected. Two months after implantation, the graft sites exhibited excellent healing without contracture, and the fusion between the graft and the neighboring normal TA appeared to be well established. There were no significant histological differences between the implanted tunica and the normal control tunica at 6 months after implantation. Conclusion： The porcine BAM graft resulted in a structure which was sufficiently like that of the normal TA. This implantation might be considered applicable to the reconstruction of the TA in conditions such as trauma or Peyronie＇s disease.

关键词： tissue engineering extracellular matrix penis reconstructive surgical procedure graft survival

Effect of sorafenib in a murine high risk penetrating keratoplasty model

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International Journal of Ophthalmology(English edition) 2017年第6期10卷 834-839页

作者： Yang Kyung Cho Eun Young Shin Hironori Uehara Balamurali K Ambati Department of Ophthalmology St.Vincent＇s Hospital College of Medicine the Catholic University of Korea Suwon Gyeonggi-Do 16247 Korea Research Institute of Medical Science St.Vincent＇s Hospital College of Medicine the Catholic University of Korea Suwon Gyeonggi-Do 16247 Korea Department of Ophthalmology University of Utah School of Medicine Salt Lake City Utah 84132 USA

AIM： To evaluate the effect of sorafenib in murine high risk keratoplasty model. ~ METHODS： graft survival, corneal neovascularization, and corneal lymphangiogenesis were compared among the sorafenib, dexamethasone, dimethyl sulfoxide （DMSO）, and phosphate buffered saline （PBS） groups following subconjunctival injection in mice that underwent high risk penetrating keratoplasty （HRPK）. Real-time polymerase chain reaction was performed to quantify the expression of inflammatory cytokines and vascular endothelial growth factor （VEGF）-A, VEGF-C, vascular endothelial growth factor receptor （VEGFR）-2, VEGFR-3. RESULTS： The two-month graft survival rate for HRPK was 42.86% in sorafenib group, 37.50% in dexamethasone group, 0 in DMSO group, and 0 in PBS group. Sorafenib significantly increased graft survival compared to the DMSO and PBS group （P〈0.05）. The sorafenib didn＇t show significant effect in decreasing neovascularization compared with dexamethsone, DMSO, and PBS group. The sorafenib showed less total lymphangiogenesis than the dexamethasone, DMSO, and PBS group （P=0.011, P〈0.001, P〈0.001, respectively）. The sorafenib group showed reduced expression of VEGF-C, tumor necrosis factor （TNF）-alpha, interleukin （IL）-6, VEGFR-2 and VEGFR-3 compared with DMSO group and PBS group （all P〈0.05）. The sorafenib group didn＇t show difference in the expression of VEGF-A compared with DMSO, neither withPBS. The sorafenib group showed reduced expression of VEGFR-3 compared with dexamethasone （/〉=-0.051）. CONCLUSION： The subconjunctivally administered sorafenib shows significant anti-lymphangiogenic effect, resulting in increased transplant survival in a murine high risk keratoplasty model. We suggest that a close linkage between decreased VEGF-C/VEGFR-2 and -3 signaling and increased corneal graft survival by sorafenib seems to exist.

关键词： Sorafenib neovascularization graft survival lymphangiogenesis dexamethasone

Effect of airplane transport of donor livers on post-liver transplantation survival

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World Journal of Gastroenterology 2016年第41期22卷 9154-9161页

作者： Yi Huang Gerry MacQuillan Leon A Adams George Garas Megan Collins Albert Nwaba Linjun Mou Max K Bulsara Luc Delriviere Gary P Jeffrey School of Medicine and Pharmacology University of Western Australia Western Australian Liver Transplantation Service Sir Charles Gairdner Hospital Institute of Health Research University of Notre Dame

AIM To evaluate the effect of long haul airplane transport of donor livers on post-transplant outcomes. METHODS A retrospective cohort study of patients who received a liver transplantation was performed in Perth, Australia from 1992 to 2012. Donor and recipient characteristics information were extracted from Western Australian liver transplantation service database. Patients were followed up for a mean of six years. Patient and graft survival were evaluated and compared between patients who received a local donor liver and those who received an airplane transported donor liver. Predictors of survival were determined by univariate and multivariate analysis using cox *** One hundred and ninety-three patients received alocal donor liver and 93 patients received an airplane transported donor liver. Airplane transported livers had a significantly lower alanine transaminase(mean: 45 U/L vs 84 U/L, P = 0.035), higher donor risk index(mean: 1.88 vs 1.42, P graft failure. Multivariate analysis found only airplane transport retained significance for graft loss(HR = 1.92, 95%CI: 1.16-3.17). One year graft survival was 0.88 for those with a local liver and was 0.71 for those with an airplane transported liver. One year graft loss was due to primary graft non-function or associated with preservation injury in 20.8% of recipients of an airplane transported liver compared with 4.6% in those with a local liver(P = 0.027). CONCLUSION Airplane transport of donor livers was independently associated with reduced graft survival following liver transplantation.

关键词： Airplane transportation Cold ischemic time graft survival Donor location Organ damage