Association of Foxp3 Polymorphism With Allograft Outcome in Kidney Transplantation

BACKGROUND: Forkhead box P3 (Foxp3) is the most reliable marker for regulatory T cells, which play an important role in maintaining renal allograft tolerance. Recently, Foxp3 polymorphisms have been reported to be associated with graft outcome in kidney transplantation. We analyzed the association of Foxp3 polymorphisms with renal allograft outcome. METHODS: Foxp3 polymorphisms (rs3761548 A/C, rs2280883 C/T, rs5902434 del/ATT, and rs2232365 A/G) were tested by PCR with sequence-specific primers (PCR-SSP) in 231 adult kidney transplantation recipients from 1996-2004 at Seoul National University Hospital. RESULTS: Patients with the rs3761548 CC genotype showed better graft survival than those with the AC or AA genotype (log rank test, P=0.03). Patients with the rs3761548 CC genotype also showed a lower rate of recurrence of the original glomerular disease than those with the AC or AA genotype (P=0.01). The frequency of acute rejection (AR) in patients with the rs2280883 TT genotype was lower than that in patients with the rs2280883 CT or CC genotype (26.9% vs 53.3%, P=0.038). Patients with the rs2280883 TT genotype also showed better graft survival than those with the CT or CC genotype (P=0.03). CONCLUSIONS: Foxp3 rs3761548 CC and rs2280883 TT genotypes were associated with superior graft outcome of kidney transplantation. Further studies involving a larger number of patients are needed.

Does Pregnancy after Renal Transplantation Affect Their Allograft and Pregnancy Outcomes? / 대한이식학회지

BACKGROUND: The number of pregnancies in renal transplant recipients has increased. Many studies have shown that pregnancy increases the risk of graft, fetal, and maternal complications but does not affect the long-term outcome of the graft. We assessed the incidence and effect of pregnancy after renal transplantation and examined graft, fetal, and maternal outcomes. METHODS: Our study included 145 female recipients of child-bearing age (15~45 years) in our center from January 1990 to December 2011. The subjects were divided into two groups: pregnancy (n=17) and control (n=128). The 26 pregnancies in the 17 recipients were categorized as live births (n=10) or no-live births (n=16). These were analyzed for evaluation of pregnancy outcomes, graft function, and long-term graft survival. RESULTS: The pregnancy and control group had similar graft function and graft survival rates 5- and 10-year after renal transplantation. Outcomes of pregnancy were 10 live births, 8 therapeutic abortions, 7 spontaneous abortions, and 1 stillbirth. The mean serum creatinine levels of the pregnant recipients diminished during the first trimester (1.14+/-0.37 mg/dL) and increased slightly during the third trimester (1.18+/-0.37 mg/dL) to levels nearer the baseline (1.23+/-0.37 mg/dL). These ranges were stable. The mean time from transplantation to pregnancy was 20.73+/-3.57 months. Live birth rates were associated with the time from transplantation to pregnancy (71.78+/-37.75 months for live births and 19.38+/-12.71 months for no-live births, P=0.000). There were no significant differences in graft function, graft failure rates, and survival. CONCLUSIONS: Pregnancy does not appear to have an adverse effect on graft function and the long-term outcomes of renal transplantation. Recipients with stable renal function who want to become pregnant can have successful pregnancies.

A Study of Relationship between Body Mass Index and Short Term Outcome of Isolated Coronary Artery Bypass Graft Surgery

Coronary artery disease (CAD) is the most common cause of death in the industrialized world. Obesity is one of the risk factor for developing CAD and also postoperative morbidity and mortality. However, in published articles the relationship between body mass index (BMI) and outcome of coronary artery bypass graft surgery depict conflicting results. This study evaluated the relationship between BMI and outcome of isolated coronary artery bypass graft performed in Hospital Universiti Sains Malaysia (HUSM). Cardiothoracic Unit HUSM is a referral centre for east coast of West Malaysia. Data was retrospectively collected from the medical records retrieved from the hospital record office. All patients who underwent isolated CABG in Cardiothoracic Unit, Hospital Universiti Sains Malaysia Kubang Kerian, Kelantan from November 2001 till October 2004 were identified and their demographic and clinical data were collected. Patients were divided into non overweight (BMI= or 25 kg/m2) group. Data was then analyzed using SPSS version 12.0. There were 141 patients who underwent isolated CABG over the three year period. There were 80 patients with BMI 25 kg/m2. The demographic data of the two groups were similar. There was no statistical significant differences in the outcome of isolated coronary artery bypass graft. In conclusion, body mass index does not influence the outcome of isolated coronary artery bypass graft.