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Transplantation Proceedings

S D Hwang, J H Lee, S W Lee, J K Kim, M-J Kim, J H Song
BACKGROUND: Reactivation of BK polyomavirus causes destructive virus allograft nephropathy; however, treatment options are limited. Herein, we report a case in which a patient with T cell-mediated rejection was treated with steroid therapy. The patient subsequently developed BK viremia and was successfully treated by using intravenous immunoglobulin (IVIG) after failing to respond to conventional treatment. CASE PRESENTATION: A 54-year-old man had been undergoing peritoneal dialysis for 3 years before kidney transplantation...
June 2, 2018: Transplantation Proceedings
S D Hwang, J H Lee, S W Lee, J K Kim, M-J Kim, J H Song
BACKGROUND: Valganciclovir is widely used to prevent post-transplant cytomegalovirus (CMV) infection in kidney transplant patients. However, the currently used dose remains controversial because the continuous use of this drug decreases kidney function and can induce leukopenia. OBJECTIVE: The purpose of this study was to measure the appropriate dose of valganciclovir required to prevent CMV infection. METHODS: A systematic review and meta-analysis were performed by using a random effects model...
June 2, 2018: Transplantation Proceedings
D Kamińska, M Łukaszewski, N Kozera, K Kościelska-Kasprzak, D Bartoszek, O Mazanowska, W Goździk, P Chudoba, P Zaleska, A Lepiesza, M Klinger
Previously transplanted highly sensitized patients experience problems with subsequent transplantation. It is also difficult to provide optimal hemodynamic conditions during successive kidney transplantation in heart transplant recipients. PATIENT AND METHODS: We present a case of a 56-year old patient with end-stage renal failure after heart transplantation performed 21 years ago and hemodialyzed using arteriovenous fistula. The patient had 69% panel-reactive antibodies, had been on the active waiting list since 2013, and presented 335 positive crossmatches with deceased donors...
July 2018: Transplantation Proceedings
O Mazanowska, P Donizy, J Kuźmińska, K Roczek, A Zimny, M Banasik, D Kaminska, K Hap, M Klinger, A Halon
INTRODUCTION: Acute central nervous system (CNS) damage in a patient who has received organ transplant is an extremely difficult and complex clinical issue that spans a wide spectrum of differential diagnoses with ischemia, post-transplant lymphoproliferative disorders (PTLDs), infections, lymphomas, and progressive multifocal leukoencephalopathy (PML). PTLDs are a clinically and histopathologically heterogeneous group of diseases that most often occur in heavily immunocompromised populations after solid organ transplantation (SOT), probably related to the infection or reactivation of Epstein-Barr virus (EBV) infection, whereas PML is an infectious disease caused by the John Cunningham virus (JCV)...
July 2018: Transplantation Proceedings
M Wszola, A Berman, A Ostaszewska, L Gorski, M Serwanska-Swietek, J Gozdowska, K Bednarska, M Krajewska, A Lipinska, A Chmura, A Kwiatkowski
BACKGROUND: Islets transplantation is an established treatment method for patients suffering from brittle diabetes with hypoglycemia unawareness. The standard implantation technique is through the portal vein into the liver. In case of liver diseases or portal hypertension, finding an extra-hepatic site is recommended. There have been attempts to perform islets transplantations into muscles and into the gastric submucosa. OBJECTIVE: The aim of this study is to show a 4-year follow-up of allotransplantation into gastric submucosa in a case of portal hypertension observed during the procedure of islets infusion...
July 2018: Transplantation Proceedings
A Tarasewicz, A Dębska-Ślizień, B Rutkowska, E Szurowska, M Matuszewski
Mammalian target of rapamycin inhibitors (mTORI) are increasingly used in the treatment of tuberous sclerosis complex (TSC) and as immunosuppressants after organ transplantation. In TSC patients, mTORI are the treatment of choice after kidney transplantation. It is still under debate if benefits from long-term mTORI use will not be limited by side effects. MATERIALS AND METHODS: We report long-term follow-up data of the first TSC patient after kidney transplantation treated with sirolimus de novo...
July 2018: Transplantation Proceedings
E Wlodarczyk, Z Wlodarczyk, L Paczek, A Szymanska, M Glyda, A Adamowicz, G Baczyk, A Ulatowska
Kidney transplantation is an optimal method of renal replacement therapy in patients with phase V chronic kidney disease. Elderly patients (older than 60 years) with a kidney transplant create a significant and constantly growing pool of patients with this type of organ transplantation. In this group of patients, long-term care should be particularly stringent and vigilant. Apart from typical conditions associated with chronic kidney disease and possible post-transplant complications as well as side effects of immunosuppressive treatment, the patient also experiences changes and limitations associated with the progress of age and diseases typical for old age, characterized by a higher risk of infection, and changed pharmacokinetics/pharmacodynamics...
July 2018: Transplantation Proceedings
I Woźniak, A Kolonko, J Chudek, Ł Nowak, M Farnik, A Więcek
BACKGROUND: Kidney transplant recipients are frequently treated for other medical conditions and experience polypharmacy. The aim of our study was to evaluate quality of life in relation to medicines' burden in these patients. METHODS: We studied 136 unselected patients with mean post-transplant time of 7.2 ± 4.6 years. Quality of life was evaluated using a validated Polish version of the Kidney Disease Quality of Life-Short Form questionnaire. Data concerning the type (generic name) and number of currently prescribed medications were collected by interview survey...
July 2018: Transplantation Proceedings
D Warzecha, I Szymusik, B Grzechocińska, A Cyganek, B Kociszewska-Najman, N Mazanowska, A Madej, J Pazik, M Wielgoś, B Pietrzak
INTRODUCTION: Kidney transplantation (KTx) is the treatment of choice in patients with end-stage renal failure. Among various medical issues in female graft recipients, the need for maternity can become an overriding one. Gonadal dysfunction usually resolves within 6 months after transplantation; however, the prevalence of infertility is similar to this in the general population. MATERIALS AND METHODS: This case series describes the experience in infertility treatment and following perinatal care among KTx women who underwent successful in vitro fertilization (IVF)...
July 2018: Transplantation Proceedings
N Mazanowska, M Szpotańska-Sikorska, A Madej, J Pazik, M Wielgoś, B Pietrzak
BACKGROUND: Chronic immunosuppression constitutes a risk factor of human papillomavirus (HPV) related cervical cancer development. Maintenance immunosuppression with mammalian target of rapamycin (mTOR) inhibitors is associated with decreased incidence of de novo malignancies in kidney graft recipients. Recently published data suggest that mTOR inhibitors interfere with viral replication. The aim of the study was to assess if there is a difference in prevalence of HPV cervical infection in women on immunosuppressive regimens with or without mTOR inhibitors...
July 2018: Transplantation Proceedings
S Lizakowski, A Kolonko, B Imko-Walczuk, K Komorowska-Jagielska, B Rutkowski, A Więcek, A Dębska-Ślizień
BACKGROUND: Incidence of malignancy in transplant recipients is higher than in the general population. Malignancy is a major cause of mortality following solid organ transplantation and a major barrier to long-term survival for the kidney. The aim of this study was to estimate the incidence of solid organ malignancy (SOM) and melanoma in renal transplant recipients (RTR) transplanted at 2 representative transplant centers in Poland based on data from the Polish Tumor Registry. MATERIAL AND METHODS: We analyzed the medical data of 3069 patients who underwent kidney transplantation (KTx) between 1995 and 2015...
July 2018: Transplantation Proceedings
D Szubińska-Lelonkiewicz, M Osiak, P Wychowański, M Siewert-Gutowska, P Fiedor
Recipients of allotransplants are more susceptible to viral infections, among which the human papilloma virus infection is an independent factor inducing precancerous lesions and cancers of both the anogenital and the cervicocephalic region. MATERIALS AND METHODS: The study included a group of 69 allogenic kidney transplantation recipients aged 20 to 70, who were treated with cyclosporine, azathioprine, and prednisone. The patients in whom the macroscopic examination of the oral mucosa revealed lesions were qualified for a biopsy...
July 2018: Transplantation Proceedings
P Wilkowski, K Gajko, M Marczak, E Hryniewiecka, M Wojtowicz, K Dobrzaniecka, G Mlynarczyk, L Paczek, M Ciszek
The burden of Klebsiella pneumoniae (KP) producing extended-spectrum beta-lactamases (ESBL+) urinary tract infections (UTIs) is a growing problem after kidney transplantation (KTX). The study was aimed at evaluating the incidence of KP ESBL+ gut colonization in KTX recipients and its correlation with clinical outcomes with special regard to UTIs. The study included all KTX patients hospitalized in our department between January 2014 and December 2016. During this period 2018 KTX patients were admitted: 605 in 2014, 750 in 2015, and 663 in 2016, respectively...
July 2018: Transplantation Proceedings
K Komorowska-Jagielska, Z Heleniak, A Dębska-Ślizień
BACKGROUND: Cytomegalovirus (CMV) infection is associated with an increased risk of cardiac complications in kidney transplant recipients (KTRs). Some data suggest that CMV may be involved in atherogenesis. The aim of the study was the analysis of CMV medical history in KTRs and its influence on cardiovascular (CV) incidents. MATERIALS AND METHODS: The study observed 254 patients (165 male/89 female) with mean age of 47.2 (range, 15-81) years and duration of dialysis before transplantation 29...
July 2018: Transplantation Proceedings
M Jankowska, I Kuźmiuk-Glembin, P Skonieczny, A Dębska-Ślizień
INTRODUCTION: Patients with autosomal dominant polycystic kidney disease (ADPKD) represent about 10% of kidney transplant recipients (KTR) and have unique needs regarding acceptance for this procedure. Whether native kidney nephrectomy (NKN) affects kidney transplantation (KT) outcomes remains a matter of debate, and more data is needed to establish a standard approach to KTR with ADPKD. AIM: To analyze the prevalence, timing, and short- and long-term outcomes of NKN in a cohort of ADPKD recipients in a single institution...
July 2018: Transplantation Proceedings
B Bzoma, J Kostro, A Hellmann, A Chamienia, S Hać, A Dębska-Ślizień, Z Śledziński
BACKGROUND: The role of ureteric stenting in kidney transplant recipients is still debatable. Stenting can reduce the incidence of urine leaks and ureter stenosis, but can be also associated with specific complications, particularly urinary tract infections (UTIs). MATERIAL AND METHODS: To estimate the influence of ureteric stenting on urological complications in kidney transplantation (KTx), we retrospectively analyzed all KTx performed between January 2011 and December 2016 in Gdansk Transplantation Centre, a total of 628 patients...
July 2018: Transplantation Proceedings
K Letachowicz, T Królicki, K Bardowska, A Drabik, K Zajdel, D Kamińska, K Madziarska, M Banasik, O Mazanowska, M Krajewska, M Klinger
INTRODUCTION: The prevalence of hypertension in renal graft recipients is high. It was postulated that central arteriovenous anastomosis may significantly reduce blood pressure. This preliminary study evaluates the impact of functioning arteriovenous fistula (AVF) on blood pressure control and renal allograft function. MATERIALS AND METHODS: One hundred sixty-two previously hemodialyzed kidney transplant recipients (108 males, 54 females, aged 52.7 ± 13.2 years, mean 6...
July 2018: Transplantation Proceedings
E Hryniewiecka, J Zegarska, D Zochowska, E Samborowska, R Jazwiec, M Kosieradzki, S Nazarewski, M Dadlez, L Paczek
Cyclosporine A (CsA) is the first calcineurin inhibitor used as immunosuppressive agent. Its administration is associated with multiple adverse effects including cardiovascular diseases (CVDs), but their mechanisms have not been fully elucidated. Cyclosporine metabolites are not well studied in this context. This study was aimed at analysis of the incidence of CVDs and their association with concentrations of cyclosporine and its metabolites. Sixty patients after kidney transplantation (KTX) taking an immunosuppressive regimen including CsA participated in the study...
July 2018: Transplantation Proceedings
A Sas, P Donizy, K Kościelska-Kasprzak, D Kamińska, O Mazanowska, M Krajewska, P Chudoba, K Korta, A Hałoń, M Klinger, M Banasik
The occurrence of anti-angiotensin II type 1 receptor (AT1R) antibodies is thought to be a risk factor for transplant injury, but the relationship of AT1R to graft loss in renal transplantation has not been assessed. The aim of our study was to evaluate the expression of AT1R and its relationship with graft loss in patients who had a renal transplant biopsy for cause. METHODS: AT1R immunoreactivity was analyzed in 170 renal transplant biopsies. Immunohistochemical evaluation of AT1R expression was performed on 4 μm-thick paraffin sections mounted on silanized slides...
July 2018: Transplantation Proceedings
Z Heleniak, I Kuźmiuk-Glembin, D Adrych, H Garnier, J Wiśniewski, P Rutkowski, B Rutkowski, L Tylicki, A Dębska-Ślizień
Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are the cornerstone treatment in chronic kidney disease patients. Despite facilitating a reduction in blood pressure and albuminuria, there are insufficient data in kidney transplant recipients (KTRs). They are often administered for hypertension and polycythemia treatment. The aim of this study was to investigate the frequency and route of administration of ACEIs and ARBs and their early clinical effects in the KTR population...
July 2018: Transplantation Proceedings
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