RESUMEN
Diarrhea is a frequent complication after kidney transplantation, which is a common clinical manifestation of prevalent diseases following multiple types of organ transplantation. The common causes of diarrhea after kidney transplantation include adverse reactions of immunosuppressants, infectious diseases and de novo postoperative inflammatory bowel disease, etc. Diarrhea could seriously affect the quality of life of kidney transplant recipients, and may lead to allograft dysfunction or even death of recipients. Because the causes of diarrhea after kidney transplantation are complicated and probably overlap with each other, along with individual differences among recipients, the etiological diagnosis and targeted treatment of diarrhea after kidney transplantation should follow the principles of gradual and phased treatment. In this article, the epidemiology and harm, common causes and management strategies of diarrhea after kidney transplantation were summarized, aiming to deepen the clinicians' understanding and enhance the diagnosis and treatment levels of diarrhea after kidney transplantation, thereby improving the quality of life and prognosis of kidney transplant recipients.
RESUMEN
In recent years, clinical efficacy of pediatric kidney transplantation has been gradually enhanced with persistent progress of organ allocation policy, surgical technologies and perioperative management, etc. However, immunosuppressive management still plays a significant role in the long-term prognosis of pediatric kidney transplant recipients. Due to the disparity from adults in physiology, psychology, immune system and drug metabolism, immunosuppressive management in children should be delivered in a specific manner. Therefore, it is necessary to select appropriate immunosuppresants and formulate individualized immunosuppressive regimens according to the characteristics of pediatric kidney transplant recipients in clinical practice. In this article, the characteristics of immunosuppressive therapy, selection of immunosuppresants, glucocorticoid withdrawal, immune monitoring and medication compliance management of pediatric kidney transplant recipients were investigated, aiming to provide reference for optimizing immunosuppressive management and improving clinical prognosis of pediatric kidney transplant recipients.
RESUMEN
This study examined the effect of long-term administration of low-dose FTY720 on survival of murine cardiac allograft and the possible mechanism.Murine models of abdominal heterotopic heart transplantation were established.Low-dose FTY720 (0.3 mg/kg) was administrated to the animals 4 days before the transplantation of cardiac allografis until the occurrence of rejection or the observation terminals.The animals without FTY720 treatment and those with syngencic cardiac grafts transplanted served as controls.The mean survival time (MST) of grafts,and T lymphocyte subsets in gratis,peripheral blood and lymphoid organs were measured by histopathological examination or flow cytometry,and compared among groups.The results showed that the MST of allografts in FTY720-treated mice was more than 40 days,significantly longer than that in the untreated group (MST=8 days,P＜0.01).After the long-term administration of FTY720,the proportion of CD4+ and CD8+ lymphocytes in peripheral blood was diminished significantly,but the proportion ofCD4+ lymphocytes was increased in mesenteric lymph nodes (MLNs) and spleen.lmmunofluorescence staining revealcd that the infiltration of CD4+ and CD8+ lymphocytes in allografts was significantly inhibited after long-term administration of low-dose FTY720.It was concluded that low-dose long-term administration of FTY720 could promote T lymphocytes in lymphatic organs and decrease their infiltration in allografts,resulting in the inhibition of rejection and the long-term survival of allografts.