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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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Infections Following kidney transplant in Children: A Single-center Study

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Open Journal of Nephrology 2014年第3期4卷 117-124页

作者： Alexandre Fernandes Liliana Rocha Teresa Costa Paula Matos Maria Sameiro Faria Laura Marques Conceicao Mota Antonio Castro Henriques Pediatric Infectious Diseases and Immunodeficiency Department Centro Hospitalar do PortoOportoPortugal Pediatric Nephrology Department Centro Hospitalar do PortoOportoPortugal kidney transplant Department Centro Hospitalar do PortoOportoPortugal

Introduction: Infections are a major cause of morbidity and mortality in pediatric patients undergoing kidney transplantation (KT). Aim and Methods: To determine the patterns of infectious complications during the first 6 months post transplantation, we report our single center experience with data from pediatric kidney recipients transplanted between 2006 and 2011. Results: Thirty-two children (20 males) were submitted to KT. The most common cause of end-stage renal disease (ESRD) was congenital anomalies of the kidney and urinary tract (CAKUT) accounting for 62%. Over the first 6 months post-transplant period, twenty-eight (87.5%) children developed a total of 77 infections, mainly urinary tract infections (UTI) (64.9%). CAKUT etiology of ESRD and UTI before KT increased the risk to develop more than one episode of UTI [71.4% vs. 14.3% and 81.8% vs. 18.2%, respectively;p transplantation. UTI are the most common type of infection, followed by viral infections, particularly CMV. Recognition, prevention and early treatment of infections are of major importance.

关键词： CMV Infection Immunosuppression kidney transplantation Urinary Tract Infections

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Comparative study of living donor kidney transplants:Right vs left

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World Journal of transplantation 2025年第1期15卷 115-123页

作者： Taqi Khan Nadeem Ahmad Qaisar Iqbal Muneeb Hassan Lajward Asnath Naveed Khan Sajid Shakeel kidney transplant Unit Rehman Medical InstitutePeshawar 25100Khyber PakhtunkhwaPakistan Department of Surgery Princess Noura Binti AbdulRehman UniversityRiyadh 84428Saudi Arabia

BACKGROUND transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft ***,circumstances may arise where selecting the RK over the left kidney(LK)is ***,it is crucial to thoroughly examine the implications of such a choice on the overall transplant *** To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these *** We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December *** included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based *** variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)*** used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney *** Of the 250 transplants performed during the period,56(22%)were *** recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for *** and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being *** complications,however,were not related to the venous *** RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical *** post-transplant SC trend and mean SC at the last follow-up were similar across both kidney *** The donor kidney side has little impact on post-transplant

关键词： Living donor Right kidney Right renal vein Venous anastomosis Technical graft loss Early graft function

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Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation

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World Journal of Hepatology 2018年第1期10卷 134-141页

作者： Rohan M Modi Dmitry Tumin Andrew J Kruger Eliza W Beal Don Hayes Jr James Hanje Anthony J Michaels Kenneth Washburn Lanla F Conteh Sylvester M Black Khalid Mumtaz Department of Internal Medicine Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Anesthesiology and Pain Medicine Nationwide Children’s HospitalColumbusOH 43205United States Department of General Surgery Division of TransplantationOhio State University Wexner Medical CenterColumbusOH 43210United States Comprehensive transplant center Ohio State University Wexner Medical CenterColumbusOH 43210United States Section of Pulmonary Medicine Nationwide Children’s HospitalColumbusOH 43205United States Department of Internal Medicine Division of GastroenterologyHepatology and NutritionOhio State University Wexner Medical CenterColumbusOH 43210United States

AIM To examine the effect of center size on survival differences between simultaneous liver kidney transplantation(SLKT) and liver transplantation alone(LTA) in SLKT-listed *** The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT between February 2002 and December 2015. Posttransplant survival was evaluated using stratified Cox regression with interaction between transplant type(LTA vs SLKT) and center *** During the study period, 393 of 4580 patients(9%) listed for SLKT underwent a LTA. Overall mortality was higher among LTA recipients(180/393, 46%) than SLKT recipients(1107/4187, 26%). The Cox model predicted a significant survival disadvantage for patients receiving LTA vs SLKT [hazard ratio, hazard ratio(HR) = 2.85; 95%CI: 2.21, 3.66; P centers performing 30 SLKT over the study period. This disadvantage was modestly attenuated as center SLKT volume increased, with a 3% reduction(HR = 0.97; 95%CI: 0.95, 0.99; P = 0.010) for every 10 SLKs *** In conclusion, LTA is associated with increased mortality among patients listed for SLKT. This difference is modestly attenuated at more experienced centers and may explain inconsistencies between smaller-center and larger registry-wide studies comparing SLKT and LTA outcomes.

关键词： kidney transplantation center volume Mortality Liver transplantation United network for organ sharing

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Liver transplantation using organs from deceased organ donors: a single organ transplant center experience

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Hepatobiliary & Pancreatic Diseases International 2014年第4期13卷 409-415页

作者： Ming Han Zhi-Yong Guo Qiang Zhao Xiao-Ping Wang Xiao-Peng Yuan Xing-Yuan Jiao Chun-Hua Yang Dong-Ping Wang Wei-Qiang Ju Lin-Wei Wu An-Bin Hu Qiang Tai Yi Ma Xiao-Feng Zhu Xiao-Shun He Organ transplant center First Affiliated HospitalSun Yat-Sen University

BACKGROUND： In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot ***： From July 2011 to August 2012, our center performed 26 liver transplants from a pool of 29 deceased donors. All organ donation and allograft procurement were conducted according to the national protocol. The clinical data of donors and recipients were collected and summarized ***： Among the 29 donors, 24 were China Category II donors（organ donation after cardiac death）, and five were China Category III donors（organ donation after brain death followed by cardiac death）. The recipients were mainly the patients with hepatocellular carcinoma. The one-year patient survival rate was 80.8% with a median follow-up of 422（2-696） days. Among the five mortalities during the follow-up,three died of tumor recurrence. In terms of post-transplant complications, 9 recipients（34.6%） experienced early allograft dysfunction, 1（3.8%） had non-anastomotic biliary stricture,and 1（3.8%） was complicated with hepatic arterial *** of these complications resulted in patient death. Notably,primary non-function was not observed in any of the ***： With careful donor selection, liver transplant from deceased donors can be performed safely and plays acritical role in overcoming the extreme organ shortage in China.

关键词： liver transplantation organ donors tissue and organ procurement

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Long term survival improved by optimization of immunosuppression strategy in renal transplant recepients:a single center experience

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外科研究与新技术 2011年第4期 281-282页

作者：邵琨 Div kidney transplant Dept Urol Ruijin Hosp Affil Shanghai Jiaotong Univ School Med

Objective To investigate influence of immunosuppression strategy optimization on outcomes of renal transplant recipients in the last decades. Methods Data from 404 renal transplant recipients from Jan. 1st,2001 to Dec... 详细信息

关键词： Long term survival improved by optimization of immunosuppression strategy in renal transplant recepients

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Insights into gastrointestinal manifestation of human immunodeficiency virus:A narrative review

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World Journal of Virology 2025年第1期14卷 51-62页

作者： Pratiksha Moliya Anmol Singh Navdeep Singh Vikash Kumar Aalam Sohal Department of transplant Hepatology University of Nebraska Medical CenterOmahaNE 69198United States Department of Medicine Tristar Centennial Medical CenterNashvilleTN 37203United States Department of Medicine Government Medical CollegeAmritsar 143001PunjabIndia Department of Gastroenterology and Hepatology Creighton University School of MedicinePhoenixAZ 85012United States

Human immunodeficiency virus(HIV)modifies CD4-positive cells,resulting in immunodeficiency and a wide range of gastrointestinal(GI)*** burden of HIV-related GI illnesses has significantly evolved with the widespread use of antiretroviral therapy(ART).While ART has effectively reduced the occurrence of opportunistic infections,it has led to an increase in therapy-related GI *** esophageal conditions in HIV patients include gastroesophageal reflux disease,idiopathic esophageal ulcers,herpes simplex virus,cytomegalovirus(CMV),and candidal ***’s sarcoma,a hallmark of acquired immunodeficiency syndrome,may affect the entire GI *** and peptic ulcer disease are also frequently seen in patients with ***,often linked to both opportunistic infections and ART,requires careful *** diarrhea,often a sign of colitis caused by bacterial infections such as Shigella or Clostridium difficile,is *** bowel lymphoma,although rare,is increasing in *** disorders,including proctitis,fissures,and anal squamous cell carcinoma,are particularly relevant in homosexual men,underlining the importance of timely *** review comprehensively explores the epidemiology,pathogenesis,and treatment considerations for the various GI disorders associated with HIV,highlighting the importance of accurate diagnosis and effective treatment to improve outcomes for HIV-infected patients.

关键词： Human immunodeficiency virus Opportunistic infections Antiretroviral treatment Gastrointestinal

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Ginger extract attenuates ethanol-induced pulmonary histological changes and oxidative stress in rats

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The Journal of Biomedical Research 2017年第6期31卷 521-527页

作者： Alireza Shirpoor Farzaneh Hosseini Gharalari Yousef Rasmi Elaheh Heshmati Department of Physiology Faculty of Medicine Nephrology and kidney transplant Research center Departments of Biochemistry Department of Nutrition Faculty of MedicineUrmia University of Medical SciencesUrmiaIran

Chronic ethanol consumption is associated with changes in the function and structure of the lungs. The aim of this study was to investigate the effect of chronic ethanol exposure on the lungs and whether ginger extract mitigated pulmonary abnormalities induced by ethanol in rats. Male Wistar rats were divided into the control group, the ethanol group, and the ethanol plus ginger extract group. Six weeks of ethanol treatment increased the proliferation of lung cells, and induced fibrosis, inflammation and leukocyte infiltration. A significant rise in the level of 8-hydroxydeoxyguanosine, NADPH oxidase, and oxidized low-density lipoprotein was also observed. Ginger extract significantly ameliorated the above changes. These findings indicate that ethanol induces abnormalities in the lungs by oxidative DNA damage and oxidative stress, and that these effects can be alleviated by ginger, which may function as an antioxidant and anti-inflammatory agent.

关键词： ethanol lung oxidative stress DNA damage rat fibrosis ginger

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Using on-site liver 3-D reconstruction and volumetric calculations in split liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2016年第6期15卷 587-592页

作者： Trevor W Reichman Brittany Fiorello Ian Carmody Humberto Bohorquez Ari Cohen John Seal David Bruce George E Loss Ochsner Multi-Organ transplant Institute Ochsner Medical Center

BACKGROUND： Split liver transplantation increases the number of grafts available for transplantation. Pre-recovery assessment of liver graft volume is essential for selecting suitable recipients. The purpose of this study was to determine the ability and feasibility of constructing a 3-D model to aid in surgical planning and to predict graft weight prior to an in situ division of the donor liver. METHODS： Over 11 months, 3-D volumetric reconstruction of 4 deceased donors was performed using Pathfinder Scout liver volumetric software. Demographic, laboratory, operative, perioperative and survival data for these patients along with donor demographic data were collected prospectively and analyzed retrospectively. RESULTS： The average predicted weight of the grafts from the adult donors obtained from an in situ split procedure were 1130 g （930-1458 g） for the extended right lobe donors and 312 g （222-396 g） for left lateral segment grafts. Actual adult graft weight was 92% of the predicted weight for both the extended right grafts and the left lateral segment grafts. The predicted and actual graft weights for the pediatric donors were 176 g and 210 g for the left lateral segment grafts and 308 g and 280 g for the extended right lobe grafts,respectively. All grafts were transplanted except for the right lobe from the pediatric donors due to the small graft ***： On-site volumetric assessment of donors provides useful information for the planning of an in situ split and for selection of recipients. This information may expand the donor pool to recipients previously felt to be unsuitable due to donor and/or recipient weight.

关键词： split liver transplantation reduced-size liver transplantation 3-D reconstruction

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Impact of non-oncological factors on tumor recurrence after liver transplantation in hepatocellular carcinoma patients

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World Journal of Gastroenterology 2016年第9期22卷 2749-2759页

作者： Xiang-Qian Gu Wei-Ping Zheng Da-Hong Teng Ji-San Sun Hong Zheng Organ transplant center The First Central Clinical College Tianjin Medical University Organ transplant center Tianjin First Central Hospital

Hepatocellular carcinoma (HCC) is the most common primary neoplasm of the liver and is one of the leading causes of cancer-related death worldwide. Liver transplantation (LT) has become one of the best curative therapeutic options for patients with HCC, although tumor recurrence after LT is a major and unaddressed cause of mortality. Furthermore, the factors that are associated with recurrence are not fully understood, and most previous studies have focused on the biological properties of HCC, such as the number and size of the HCC nodules, the degree of differentiation, the presence of hepatic vascular invasion, elevated serum levels of alpha-fetoprotein, and the tumor stage outside of the Milan criteria. Thus, little attention has been given to factors that are not directly related to HCC (i.e., “non-oncological factors”), which have emerged as predictors of tumor recurrence. This review was performed to assess the effects of non-oncological factors on tumor recurrence after LT. The identification of these factors may provide new research directions and clinical strategies for the prophylaxis and surveillance of tumor recurrence after LT, which can help reduce recurrence and improve patient survival.

关键词： Liver transplantation Immunosuppressive agents Hepatocellular carcinoma Recurrence Living donor Deceased donor

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