Research progress on biomarkers of rejection risk in organ transplantation / 器官移植

Rejection is the main cause of transplantation failure. Currently, the specificity and sensitivity of clinical parameters are relatively poor, which cannot accurately prompt the exact cause of rejection. It is of great clinical significance to explore novel biomarkers for monitoring the rejection. In this article, the latest research progress on the biomarkers of rejection risk in organ transplantation were summarized from the perspectives of transplantation pathology, immune cells and regulatory immune cells, non-human leukocyte antigen antibodies, exosomes, cell-free DNA and combination gene prediction, aiming to provide reference for early warning and treatment of rejection in organ transplantation.

The function of regulatory immunological cell in xenotransplantation immunity / 器官移植

Xenotransplantation is the most promising method to resolve the organ shortage problem in the future. In recent years, the advances in gene editing and immunological technique have driven the rapid development of xenotransplantation. However, there are still many insurmountable obstacles in the clinical application of xenotransplantation, among which the rejection is the most important cause of the xenotransplantation failure. Regulatory immunological cells are a group of immunological cells with the negative regulation function in the body, which can inhibit allotransplantation rejection and prolong the survival time of the graft. This paper summarized the research progress of regulatory immunological cells in the xenotransplantation application in recent years, providing reference for the prevention and treatment of xenotransplantation rejection.

Preliminary study of cytomegalovirus infection and its correlation with NK cell subsets after renal transplantation / 器官移植

Objective To explore the variation trend of natural killer (NK) cell subsets in the recipients infected with cytomegalovirus (CMV) after renal transplantation. Methods Clinical data of 92 renal transplant recipients were retrospectively analyzed. All recipients were divided into the CMV infection group (n=43), CMV infection recovery group (n=13), stable renal function group (n=15), rejection group (n=11) and other infection group (n=10). In addition, healthy adult volunteers were enrolled in the healthy control group (n=15). The proportion of NK cells in peripheral blood, the expression proportion and the mean fluorescence intensity (MFI) of CD226 and CD16 in NK cells were observed and statistically compared among different groups. Results The proportion of NK cells was 4.9% (2.2%, 11.5%) in the CMV infection group and 3.7% (2.3%, 6.5%) in the CMV infection recovery group, which were significantly lower than those in the other groups (all P < 0.05). The expression proportion of CD226 and CD16 in NK cells in the CMV infection group was significantly lower compared with those in the healthy control group and stable renal function group(all P < 0.05). The expression proportion of CD226 and CD16 in NK cells in the CMV infection recovery group was remarkably higher than those in the CMV infection group (both P < 0.05). The MFI of CD226 and CD16 in the CMV infection group was significantly lower than those in the healthy control group (both P < 0.05). The MFI of CD226 and CD16 in the CMV infection recovery group was significantly higher than those in the CMV infection group (both P < 0.05). Conclusions The expression proportion and MFI of CD226 and CD16 in NK cells are down-regulated in CMV infection period, whereas up-regulated during the CMV infection recovery period, prompting that CD226 and CD16 expressed by NK cells are intimately correlated with the course of CMV infection.

To construct of quality improvement program system and to promote the transition development of organ transplantation / 器官移植

As proposed in 2019 Annual Congress of the Chinese Society of Organ Transplantation, the overall objective of the development of organ transplantation in China is to deepen the structural reform of the supply side comprehensively, to promote the transition of organ transplantation from the quantitative scale model to the quality-lifting type, and to promote the scientific, balanced, standardized and high-quality development of organ transplantation. This paper introduces the construction of quality management system and the implementation of quality improvement program in the field of surgery and transplantation in the United States, summarizes the preliminary work of how to combine foreign experience to promote the construction of quality improvement program of renal transplantation in our country, and proposes the idea of extending the quality improvement program of organ transplantation.

Changes of serum homocysteine level of renal transplant recipients / 器官移植

Objective To observe the changes of serum homocysteine (Hcy)level of renal transplant recipients before and after renal transplantation,and assess the correlation between serum Hcy level and graft function.Methods Thirty-three recipients were included into the transplantation group,who underwent renal allograft transplantation in the Organ Transplant Institute of the 309 th Hospital of People's Liberation Army and had renal function recovered stably from January 2013 to June 2014.And 65 patients who were confirmed as chronic renal failure (CRF)by clinical examinations were included into the CRF group and 30 healthy people were included into the control group.A retrospective cross-sectional study was conducted on all of these subjects.Serum Hcy,serum creatinine (Scr)and blood urea nitrogen (BUN)levels of these three groups were compared.Serum Hcy and Scr levels of the transplantation group were continuously monitored before transplantation and at 3,7,14 and 21d after transplantation.The correlation between the changes of serum Hcy levels and the renal function before and after transplantation was assessed.Results Serum Hcy level of the CRF group was (25 ±10)μmol/L,which was significantly higher than (9 ±4)μmol/L of the control group and (15 ±9)μmol/L of the transplantation group in stable period,with statistical significance (all in P <0.001).Serum Hcy level of the transplantation group was significantly higher than that of the control group(P <0.001).Scr level of the CRF group,the transplantation group and the control group was(708 ±302)μmol/L, (98 ±23)μmol/L and (72 ±18)μmol/L,respectively.Scr level of the CRF group was significantly higher than those of the transplantation group and the control group (all in P <0.001).BUN level of the CRF group, the transplantation group and the control group was (18.1 ±5.9)mmol/L,(10.9 ±5.3)mmol/L and (4.9 ± 1.3) mmol/L, respectively. BUN level of the CRF group was significantly higher than that of the transplantation group and the control group (all in P <0.001),and BUN level of the transplantation group was significantly higher than that of the control group (P <0.001).With the improvement in renal function after transplantation,Scr and serum Hcy levels of the transplantation group deceased gradually.At 14 d after transplantation,Hcy level decreased to the minimum of (15 ±5)μmol/L.Compared with (25 ±10)μmol/L before transplantation,the difference had statistical significance (P <0.05).Within 14 d after transplantation, serum Hcy level of the transplantation group was positively correlated with Scr level (r =0.761,P <0.05). Conclusions Serum Hcy level of the renal transplant recipients is correlated with the graft function.The combined detection of serum Hcy and renal function index has certain guiding significance in the prevention of hyperhomocysteinemia and the early assessment of graft function.