ABSTRACT
Objective To investigate the incidence of and risk factors for benign prostatic hyperplasia (BPH) in transplant recipients.Methods 197 males aged 50 years and older who received kidney transplants were recruited if they were clinically stable.They were divided into three age groups:50 to 59 years (87 cases),60 to 69 years (64 cases) and ≥ 70 years (46 cases).Two hundred and forty people who had not undergone kidney transplant were randomly selected from the community as controls.A cross-sectional study was performed to study the BPH incidence in kidney transplant recipients according to standard diagnostic criteria.At the same time,the expression levels of keratinocyte growth factor,transforming growth factor-β and serum testosterone and the CD4/CD8 ratio in T lymphocytes were determined.Results There was no significant difference in age,PSA and the postmicturition residual volume between the study group and the control group.The total BPH incidence in kidney transplant recipients was 16.2％ (32/197).The symptomatic BPH incidence was 6.9％ (6/87) in the 50-to 59-year-old study group and 20.2％ (19/94) in the control group,representing a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.010).The symptomatic BPH incidence was 18.8％ (12/64) in the 60-to 69-year-old study group and 41.9％ (34/81) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.004).The symptomatic BPH incidence was 30.4％ (14/46) in the ≥ 70-year-old study group and 52.3％ (34/65) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.032).Compared to the control group,the peripheral blood serum testosterone level (9.4 ± 4.7,18.2 ± 5.6,P =0.040) and the CD4/CD8 ratio (1.1±0.3,1.8±0.3,P=0.014) of kidney transplant recipients was lower.The transforming growth factor-β expression level (5015± 1087,1829±963,P＜0.001) was higher in kidney transplant recipients than in the control group.The kasatinocyte growth factor expression levels (35.8±20.7,21.0± 18.3,P =0.064) was not statistically different than in the control group.Conclusions Kidney transplant recipients who had long-term administration of calcineurin inhibitor might have a low benign prostatic hyperplasia incidence,which might be related to transforming growth factor-β and keratinocyte growth factor expression,testosterone levels and the lymphocyte infiltration.Further high-quality prospective studies are still needed to confirm the conclusions.
ABSTRACT
ObjectiveTo evaluate the pregnancy outcomes in female kidney transplant recipients and the long-term follow-up for the health of the offspring. MethodsClinical data from April 1978 to April 2011 of 15 female renal transplant recipients who were pregnant more than 5 months and their offspring were retrospectively analyzed. ResultsThe 15 recipients were taking CsA or Tac based immunosuppressive regimens.Twelve had successful pregnancies with stable and functioning grafts ; 1 paitent died of pulmonary infection and cardiac failure with functioning graft after the delivery of a healthy male infant; 2 experienced chronic rejection proven by biopsy at week 21 and 23 respectively,the pregnancies were therefore terminated and the grafts were lost even after rescue.All 13 newborns were smoothly delivered by cesarean section,they had an average gestational age of 35.2 ± 4.0 weeks,and a mean birth weight of 2510 ± 68 g,Apgar scale for each infant was 10,respectively.There were no birth defects,structural malformations,nor learning disabilities in 13 newborns,and their mothers all chose to bottle-feed.Thirteen children had normal intelligence,physical and mental development.Seven children experienced repeated respiratory tract infections during 0- 2 years,and 1 was diagnosed with attention deficit hyperactivity disorder.The oldest offspring is 21 years old and the youngest is 3 years old. ConclusionsFemale renal kidney recipients could achieve successful pregnancies and deliveries 3 years post transplantation with strict criteria.Their offspring were healthy during follow-up.