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1.
Korean Journal of Nephrology ; : 96-102, 2009.
Artigo em Inglês | WPRIM | ID: wpr-90075

RESUMO

PURPOSE:Preconditioning due to activation of AMPK might reduce ischemia-reperfusion (I/R) injury in the kidney, based on the key role of AMPK in preserving ATP. To evaluate this possibility, the effect of preconditioning with 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR), AMPK activator, before sustained ischemia was investigated. METHODS:Adult male Sprague-Dawley rats weighing approximately 220-250 g were used. To induce renal ischemia, a laparotomy was performed under ketamine and xylazine hydrochloride, and the blood supply to both kidneys was interrupted by placement of vessel clamps at the level of the renal pedicles. Reflow was initiated by removing the clamps. The following experimental groups were defined 1. Acute renal ischemia 0 sec, 10 min, 15 min, 2. AICAR treatment, 3. Sham group (S), 4. Ischemia/ Reperfusion group (I/R), 5. AICAR+I/R group (A+I/R), 6. AraA (Adenine-9-b-D-arabinofuranoside, an AMPK) inhibitor+AICAR+I/R group (AraA+A+I/R) RESULTS:There was only faint AMPK phosphorylation in the sham group. After 10 minutes of ischemia, or AICAR preconditioning however, Thr172 phosphorylation of AMPK was increased (p<0.05). The serum levels of BUN and creatinine were significantly decreased in AICAR preconditioning group (A+I/R). (128.0+/-7.33 mg/dL, 4.18+/-0.27 mg/dL vs. 90.2+/-11.13 mg/dL, 2.58+/-0.7 mg/dL, p<0.05), but these effects were attenuated by AMPK inhibitor, AraA (AraA+A+I/R group). In quantitative analysis of tubular injury, tubular injury score in AICAR preconditioning group significantly decreased (p<0.05). CONCLUSION:The AMPK activator AICAR has a protective effect against renal I/R injury.


Assuntos
Humanos , Masculino , Trifosfato de Adenosina , Aminoimidazol Carboxamida , Proteínas Quinases Ativadas por AMP , Creatinina , Glicosaminoglicanos , Isquemia , Ketamina , Rim , Laparotomia , Fosforilação , Ratos Sprague-Dawley , Reperfusão , Traumatismo por Reperfusão , Ribonucleotídeos , Salicilamidas , Xilazina
2.
The Journal of the Korean Society for Transplantation ; : 22-27, 2009.
Artigo em Coreano | WPRIM | ID: wpr-101824

RESUMO

BACKGROUND: Rifampin reduces the blood levels of cyclosporin (CsA) and steroids by increasing the activity of hepatic cytochrome P450 system and the inclusion of rifampin in the anti-tuberculosis treatment protocol increases the risk of acute allograft rejection and mortality due to its interaction with cyclosporine. We report the successful treatment outcome of post-renal transplant tuberculosis patients who were treated with quinolone substituted for rifampin in anti-tuberculosis regimen. METHODS: This was a retrospective study of 14 patients with tuberculosis diagnosed among 218 transplant recipients from Feb. 1988 through Dec. 2003 at Daejeon St. Mary's hospital of catholic university of Korea and 6 patients with tuberculosis who underwent transplantation in other hospital and followed up in our hospital. RESULTS: The incidence of post-renal transplant tuberculosis was 6.4%. The mean time to diagnosis of tuberculosis after transplantation was 58.6 months (3.3~180.7). 9 were pulmonary and 11 were extrapulmonary tuberculosis. The graft failure was not occurred in quinolone group (0/15) and 2 of 3 in rifampin group. The serum creatinine levels before tuberculosis were not different to that of post-treatment in quinolone group. (P=0.58) The CsA levels before tuberculosis were not also different to that of posttreatment in quinolone group (P=0.68). CONCLUSIONS: The treatment of post-renal transplant tuberculosis with rifampin sparing anti-tuberculosis regimen was successful. Rifampin, although a mainstay drug in the treatment of tuberculosis, can be avoided in patients receiving cyclosporine, thus avoiding the risk of precipitating allograft rejection.


Assuntos
Humanos , Protocolos Clínicos , Creatinina , Ciclosporina , Sistema Enzimático do Citocromo P-450 , Incidência , Coreia (Geográfico) , Rejeição em Psicologia , Estudos Retrospectivos , Rifampina , Esteroides , Transplante Homólogo , Transplantes , Resultado do Tratamento , Tuberculose
3.
Korean Journal of Nephrology ; : 102-109, 2008.
Artigo em Inglês | WPRIM | ID: wpr-157350

RESUMO

PURPOSE: Cardiovascular disease is one of the leading causes of mortality and morbidity in hemodialysis patients. Arterial stiffness is known to be associated with vascular calcification in HD patients. Post-dialysis hypotension is a risk factor for cardiovascular mortality. We evaluated the relation between arterial stiffness and post-dialysis blood pressure in maintained HD patients. METHODS: 72 HD patients were enrolled in this study. They had been under maintenance HD for more than 3 months. We checked the biochemical data, including the troponin T, CRP and OPG (osteoprotegerin) levels before their dialysis session and the baPWV (brachio-ankle pulse wave velocity) after the session. We defined post-dialysis BP decrease as a drop of BP of more than 5% of the average MAP for 2 weeks (6 sessions). RESULTS: There were 34 and 38 patients with and without post-dialysis BP decrease, respectively. The BP decrease group had higher CRP, troponin T and OPG levels (p<0.05, 0.01 and 0.01, respectively). The PWV was higher in the BP decrease group (p<0.001). The CRP and troponin T levels were positively correlated with the PWV (r=0.26, p<0.05; r=0.31, p<0.01, respectively). The OPG level was positively correlated with the PWV (r=0.44, p<0.001). Age, pre-dialysis pulse pressure and drops in the patients MAP were correlated with the PWV (r=0.33, p<0.05; r=0.31, p<0.05; r=0.30, p<0.05, respectively). On multivariate analysis, PWV was the independent factor related to the drops in the MAP of the patients (beta=0.311, p=0.021). CONCLUSION: Arterial stiffness is associated with post-dialysis blood pressure decrease.


Assuntos
Humanos , Aterosclerose , Pressão Sanguínea , Doenças Cardiovasculares , Diálise , Hipotensão , Análise Multivariada , Diálise Renal , Fatores de Risco , Troponina T , Calcificação Vascular , Rigidez Vascular
4.
Korean Journal of Nephrology ; : 589-593, 2008.
Artigo em Coreano | WPRIM | ID: wpr-24724

RESUMO

Severe hypercalcemia due to persistent hyperparathyroidism after kidney transplantation causes serious medical complications. Medical or surgical treatment is recommended to decrease serum calcium level, but percutaneous ethanol injection therapy (PEIT) is an also useful method for patients who are refractory to medical treatment and under poor condition for parathyroidectomy. Here, we report a case of successful PEIT of refractory hypercalcemia in a 62-year old patient after kidney transplantation. This patient underwent PEIT because of poor general condition. Just after PEIT, serum calcium level was normalized and biointact PTH level was markedly decreased without serious complications. He has been followed up for 6 months without recur so far. PEIT may be recommended for treatment of sustained hypercalcemia in kidney-transplant patients who are refractory to medical treatment or in poor condition for surgical treatment.


Assuntos
Humanos , Cálcio , Etanol , Hipercalcemia , Hiperparatireoidismo , Transplante de Rim , Paratireoidectomia , Transplantes
5.
Korean Journal of Nephrology ; : 433-438, 2008.
Artigo em Coreano | WPRIM | ID: wpr-27000

RESUMO

PURPOSE: Kidney size (KS) is used to diagnose the patients with renal disease. When the length of a kidney is measured under 9 cm, it is considered to indicate an irreversible disease. Because glomerular filtration rate (GFR) decreases with age, the normal range of KS in the elderly is indefinite. Therefore, we measured KS in adults older than 80 years old and investigated correlated factors. METHODS: One hundreds six adults (51 men, 55 women: mean age 83+/-0.3) without renal disease were included. Their serum creatinine (Scr) levels did not exceed 1.3 mg/dL, and the calculated GFR were over 60 mL/min/1.73m2. Abdominal ultrasonography were performed to all of them and their body indexes (BI) were measured. RESULTS: 1) The mean length of kidney was 9.9+/-0.07 cm. 2) KS in the early eighties was larger than that of adults over ninety. 3) KS showed negative correlations with age and Scr, but a positive correlation with body surface area . 4) The calculated GFR showed correlations with the surface areas of both kidney (BK) by C-G equation and with the size of BK by MDRD equation. 4) The GFR calculated by MDRD and C-G equation presented inverse correlations with Scr, but only MDRD equation showed a statistic significance. CONCLUSION:In the elderly, KS may be smaller than that of younger adults. Other factors such as either surface area or volume of BK and BI should be considered to estimate the individual KS to decide whether the size is within normal range.


Assuntos
Adulto , Idoso , Humanos , Masculino , Tamanho Corporal , Superfície Corporal , Creatinina , Taxa de Filtração Glomerular , Rim , Tamanho do Órgão , Valores de Referência
6.
The Journal of the Korean Society for Transplantation ; : 130-134, 2008.
Artigo em Inglês | WPRIM | ID: wpr-82402

RESUMO

No abstract available.


Assuntos
Aspergillus , Coinfecção , Citomegalovirus , Pneumonia
7.
Korean Journal of Medicine ; : 546-550, 2008.
Artigo em Coreano | WPRIM | ID: wpr-49183

RESUMO

A 51-year old man presented with generalized edema for 10 days. He was admitted to the hospital for a renal biopsy, and a pancreatic mass was incidentally detected by ultrasonography. The renal biopsy was consistent with membranous glomerulonephritis and the pancreas biopsy revealed chronic granulomatous inflammation with multinucleated giant cells, which was suggestive of tuberculosis of the pancreas. The patient was initially treated with a steroid and anti-tuberculosis drugs, but the proteinuria in the nephrotic range persisted throughout the 3-month follow-up. With the presumed diagnosis of tuberculosis-induced membranous nephropathy, immunosuppressant therapy was stopped and anti-tuberculosis drugs were administered for 31 months. With anti-tuberculous treatment, the proteinuria was reduced from 22 g/day to 0.57 g/day. A follow-up abdominal CT revealed a marked reduction in the size of the pancreatic mass. This finding suggests that the membranous nephropathy in our case was related to the pancreatic tuberculosis rather than it being related to primary nephrotic syndrome.


Assuntos
Humanos , Biópsia , Edema , Seguimentos , Células Gigantes , Glomerulonefrite Membranosa , Inflamação , Síndrome Nefrótica , Pâncreas , Proteinúria , Tuberculose
8.
Korean Journal of Medicine ; : 556-560, 2008.
Artigo em Coreano | WPRIM | ID: wpr-49181

RESUMO

Recurrent urinary tract infection due to vesicoureteral reflux is one of the important medical complications in renal transplant recipients. Injection of macroplastique is recommended to reduce the vesicoureteral reflux, but it can result in poor responses. Ureteroureterostomy is an invasive method, but it is advisable in patients with higher grades of vesicoureteral reflux that do not respond to medical or macroplastique injection. We here report on two cases of successful treatment of vesicoureteral reflux by ureteroureterostomy. These patients experienced repeated episodes of acute pyelonephritis in spite of long-term antibiotic treatment and repeated macroplastique injection. No more urinary tract infection was observed after ureteroureterostomy. We recommend ureteroureterostomy in renal transplant recipients who suffer with repeated acute pyelonephritis due to vesicoureteral refulx.


Assuntos
Humanos , Dimetilpolisiloxanos , Transplante de Rim , Pielonefrite , Transplantes , Infecções Urinárias , Refluxo Vesicoureteral
9.
The Journal of the Korean Society for Transplantation ; : 143-146, 2007.
Artigo em Coreano | WPRIM | ID: wpr-12825

RESUMO

Azathioprine is a conventional immunosuppressant in renal transplantation but long-term administration may lead to hematologic complications. We here report a cauda equina syndrome caused by spontaneous epidural hematoma in a renal transplant recipient who had undergone long-term azathioprine treatment. A 34 year-old male was admitted to our hospital with complaints of numbness of the lower extremities and back pain. He had received renal transplantation 14 years ago and had been on sole therapy with azathioprine for 11 years. Three months before admission, the patient developed pancytopenia, and a subsequent bone marrow biopsy revealed hypocellularity. Azathioprine was replaced by tacrolimus and steroids thereafter. After a three months discontinuation of azathioprine, an epidural hematoma developed and resulted in cauda equina syndrome. Regular follow-up of complete blood count and change of immunosuppressants with less bone marrow toxicity should be considered in patients receiving azathioprine for long-term period.


Assuntos
Adulto , Humanos , Masculino , Azatioprina , Dor nas Costas , Biópsia , Contagem de Células Sanguíneas , Medula Óssea , Cauda Equina , Seguimentos , Hematoma , Hipestesia , Imunossupressores , Transplante de Rim , Extremidade Inferior , Pancitopenia , Polirradiculopatia , Esteroides , Tacrolimo , Transplante
10.
Korean Journal of Medicine ; : 67-75, 2007.
Artigo em Coreano | WPRIM | ID: wpr-16968

RESUMO

BACKGROUND: Strong immunosuppressive regimens have steadily improved both graft and patient survival, but posttransplant malignancy is still a clinical issue that needs to be resolved. METHODS: There were 1,500 transplant recipients between 1969 and 2005 at Kangnam St. Mary's hospital. The mean follow-up period was 108 77 months. We retrospectively analyzed the incidence, clinical course, treatment and prognosis of malignancy in the kidney transplant recipients. RESULTS: The incidence of malignancy after transplantation was 7.0% (10.5 cases out of 103 patients). The incidence of malignant lymphoma, thyroid cancer, renal cell carcinoma and Kaposi's sarcoma were higher in the renal transplanted patients than in the general population. The cancer incidence for women was higher than that for men, with stomach cancer being the most common in males and uterine cervix cancer the most common in females. The cumulative incidence of posttransplant malignancy at 1990, 1995, 2000 and 2005 were 0.72%, 2.91%, 4.62% and 7.0%, respectively. The cancer incidence with the use of initial immunosuppressive agents was 8.3% for azathioprine, 7.6% for cyclosporine, and 3.4% for tacrolimus. The mean times for making the diagnosis of malignancy after transplantation were 172+/-61 months for azathioprine, 91+/-49 months for cyclosporine, and 57+/-28 months for tacrolimus, respectively. During the observational period, 37 patients died (21 patients died of cancer) and 51 patients were still alive (7 grafts failed). CONCLUSIONS: The incidence of malignancy after renal transplantation increases according to the longer follow-up period. An active screening program is needed to lower the incidence of malignancy in renal transplant recipients.


Assuntos
Feminino , Humanos , Masculino , Azatioprina , Carcinoma de Células Renais , Colo do Útero , Ciclosporina , Diagnóstico , Seguimentos , Imunossupressores , Incidência , Rim , Transplante de Rim , Linfoma , Programas de Rastreamento , Prognóstico , Estudos Retrospectivos , Sarcoma de Kaposi , Neoplasias Gástricas , Tacrolimo , Neoplasias da Glândula Tireoide , Transplante , Transplantes
11.
Korean Journal of Nephrology ; : 725-731, 2007.
Artigo em Coreano | WPRIM | ID: wpr-15395

RESUMO

PURPOSE: Chronic hepatitis C is a common cause of liver disease in kidney transplant (KT) recipients and lessens the chances of patients and graft survival. We evaluated the efficacy and safety of IFN- alphaatherapy in KT recipients with chronic hepatitis C. METHOD: Ten KT recipients with chronic hepatitis C treated with recombinant IFN-alpha were enrolled. All the patients had stable graft function, serum alanine aminotransferase (ALT) and positive HCV viremia were raised at the start of treatment. Eight patients received IFN alpha 3 million units three times weekly and 3 of them in combination with ribavirin in dose of 600mg daily. Two patients received pegylated INF-alphaa90 microgram once weekly. RESULTS: In 7 patients serum ALT levels were normalized and in 6 patients HCV-RNA became negative at the end of treatment. Five patients had sustained remission (persistently negative HCV-RNA) at the end of the follow-up. One patient relapsed at 15 months after discontinuation of INF. During the course of INF therapy one patient died due to sepsis with bowel perforation. Three patients developed graft dysfunction. In all of them graft function returned with discontinuing of INF and steroid therapy. In all of three patients on INF plus ribavirin, hemolytic anemia was developed. After discontinuing of ribavirin hemolytic anemia was recovered and they were treated with INF alone. CONCLUSION: IFN-alpha therapy results in good biochemical response and virological clearance in KT recipients with chronic hepatitis C, but in about one third of the patients, the treatment had to do stopped prematurely due to graft dysfunction.


Assuntos
Humanos , Alanina Transaminase , Anemia Hemolítica , Seguimentos , Sobrevivência de Enxerto , Hepatite C Crônica , Hepatite Crônica , Interferon-alfa , Interferons , Transplante de Rim , Rim , Hepatopatias , Ribavirina , Sepse , Transplante , Transplantes , Viremia
12.
Korean Journal of Nephrology ; : 373-377, 2007.
Artigo em Coreano | WPRIM | ID: wpr-162640

RESUMO

A 67-year old woman was admitted due to left femur neck fracture. Pre-operative laboratory data revealed azotemia, and kidney ultrasonogram and pelvis MRI showed bilateral hydronephrosis and huge uterine myoma. On past history, she had uterine myoma since her thirties, but she refused to undergo operation. We initially planned percutaneous nephrostomy (PCN). After stabilization of renal function, we performed subsequent total hysterectomy after insertion of catheters on both ureters, and PCN catheters were removed after confirming that both ureteral catheters worked well. During follow up period of two months after PCN, renal function was gradually improved, but it was not normalized. Size of removed myoma was about 25x15 cm, and histopathologic findings were consistent with leiomyoma. In conclusion, myoma uteri is one of the rare causes of bilateral hydronephrosis, and it may lead to irreversible damage to kidney if left untreated for a long time.


Assuntos
Idoso , Feminino , Humanos , Azotemia , Catéteres , Fraturas do Colo Femoral , Seguimentos , Hidronefrose , Histerectomia , Rim , Falência Renal Crônica , Leiomioma , Imageamento por Ressonância Magnética , Mioma , Nefrostomia Percutânea , Pelve , Carbonitrila de Pregnenolona , Ultrassonografia , Ureter , Cateteres Urinários , Útero
13.
Korean Journal of Nephrology ; : 806-809, 2007.
Artigo em Coreano | WPRIM | ID: wpr-107841

RESUMO

The lymphocele after renal transplantation is usually observed around the graft. We here report an unusual case of lymphocele mimicking hydrocele. The patient was admitted due to scrotal edema. We initially diagnosed this patient as a case of hydrocele, but biochemical data of aspirated fluid was consistent with lymphatic fluid, and abdominal CT revealed fistula between scrotum and graft. This finding suggests that the lymphatic fluid accumulated around the transplant kidney has migrated to the scrotum to form a lymphocele. In conclusion, lymphocele is a rare cause of scrotal swelling but should be considered as a possibility when a transplant patient develops scrotal swelling.


Assuntos
Humanos , Edema , Fístula , Transplante de Rim , Rim , Linfocele , Escroto , Hidrocele Testicular , Tomografia Computadorizada por Raios X , Transplantes
14.
Yonsei Medical Journal ; : 139-141, 2007.
Artigo em Inglês | WPRIM | ID: wpr-122260

RESUMO

The development of anuria after appendectomy is usually related to complications associated with appendicitis or with the surgical sequelae of appendectomy. We report an unusual case of anuria after appendectomy in a 20-year-old woman. The patient was transferred to our hospital due to a sudden cessation of urine output just after appendectomy. We initially suspected that the anuria was caused by a complication of surgery. However, a review of her medical history and an abdominal computed tomography (CT) scan revealed that a distal ureteral stone in a single kidney had caused the anuria. There are few cases in the literature regarding a distal ureteral stone in a single kidney. This case indicates the importance of radiological evaluation in the differential diagnosis of acute appendicitis, especially in patients with unilateral renal agenesis.

15.
Journal of Korean Medical Science ; : 1074-1078, 2007.
Artigo em Inglês | WPRIM | ID: wpr-204036

RESUMO

Acute post-streptococcal glomerulonephritis (PSGN) is characterized by an abrupt onset of edema, hypertension, and hematuria. Life-threatening diffuse alveolar hemorrhage (DAH) is rarely associated with acute PSGN. There have been only two reported cases worldwide, and no case has been reported previously in Korea. Here, we present a patient who clinically presented with pulmonary-renal syndrome; the renal histology revealed post-infectious glomerulonephritis of immune complex origin. A 59-yr-old woman was admitted with oliguria and hemoptysis two weeks after pharyngitis. Renal insufficiency rapidly progressed, and respiratory distress developed. Chest radiography showed acute progressive bilateral pulmonary infiltrates. The clinical presentation suggested DAH with PSGN. Three days after treatment with high-dose steroids, the respiratory distress and pulmonary infiltrates resolved. Electron microscopy of a renal biopsy specimen sample revealed diffuse proliferative glomerulonephritis with characteristic subendothelial deposits of immune complex ("hump''). The renal function of the patient was restored, and the serum creatinine level was normalized after treatment.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Biópsia , Glomerulonefrite/etiologia , Hemorragia/etiologia , Rim/patologia , Pneumopatias/etiologia , Alvéolos Pulmonares , Infecções Estreptocócicas/complicações
16.
Korean Journal of Nephrology ; : 637-640, 2007.
Artigo em Coreano | WPRIM | ID: wpr-226299

RESUMO

Spontaneous bleeding in various parts of the body has been reported in patients receiving maintenance hemodialysis, but reports on spontaneous subcapsular hematoma of the liver are scarce. We present a case of spontaneous subcapsular hematoma of the liver which developed in a 53-year-old man with maintenance hemodialysis. He was admitted to our hospital with epigastric pain and abnormal liver function test. On abdominal computed tomographic (CT) scan, a large, well-defined subcapsular mass of the liver with a density consistent with blood was observed. We performed embolization of the bleeding vessel and percutaneous drainage of the hematoma. Five months later, follow up abdominal CT scan revealed a moderate reduction of the subcapsular hematoma. In conclusion, the possibility of spontaneous hematoma of the liver should be considered in hemodialysis patients with epigastric pain, unexplained anemia and abnormal liver function.


Assuntos
Humanos , Pessoa de Meia-Idade , Anemia , Drenagem , Seguimentos , Hematoma , Hemorragia , Testes de Função Hepática , Fígado , Diálise Renal , Tomografia Computadorizada por Raios X
17.
Korean Journal of Nephrology ; : 646-650, 2007.
Artigo em Coreano | WPRIM | ID: wpr-226297

RESUMO

Rituximab, chimeric murine/human anti-CD20 monoclonal antibody, has been currently used as treatment of follicular non-Hodgkins lymphoma and posttransplantation lymphoproliferative disease. Nowadays, rituximab has also been utilized in the renal transplantation to get over acute rejection in highly sensitized patients. We hereby report a case of successful renal transplantation in a highly sensitized patient, who has been done the 3rd renal transplantation. A 44-year-old male patient admitted for the 3rd renal transplantation. His previous 2 transplantations failed because of acute rejection. We tried plasmapheresis and intravenous immunoglobulin, widely used as pretransplantation management in high risk patients. In addition to these, we applied 2 times of rituximab (375 mg/m2) before transplantation at interval of 1 week. The renal function of the patient has been within the normal range without any evidence of rejection 6 months after transplantation.


Assuntos
Adulto , Humanos , Masculino , Rejeição de Enxerto , Imunoglobulinas , Transplante de Rim , Linfoma não Hodgkin , Plasmaferese , Valores de Referência , Rituximab
18.
The Journal of the Korean Society for Transplantation ; : 58-62, 2007.
Artigo em Coreano | WPRIM | ID: wpr-199127

RESUMO

PURPOSE: Pigs are promising donor species for xenotransplantation. This study was performed to examine acute cyclosporine (CsA) nephrotoxicity in a pig model. METHODS: Adult pigs were treated daily for 1 week with vehicle (VH), or 7.5 mg/kg (CsA7.5), 15 mg/kg (CsA15), and 30 mg/kg (CsA30) CsA. The renal function, electrolyte levels, whole- blood CsA levels, and histopathological results (vacuolization and tubulointerstitial fibrosis) were compared among the different treatment groups. RESULTS: After 1 week of treatment, it was found that CsA induced characteristic lesions that were remarkably similar to those of chronic CsA nephropathy in humans. Compared with the results obtained for the VH group, CsA reduced renal function and yielded poor histopathological results. With an increase in the CsA concentration, the renal function and histological parameters worsened in a dose-dependent manner. CONCLUSION: The study showed that CsA dose-dependently induced renal injury in a pig model. These results provide basic data to estimate or prevent the adverse renal effects of immunosuppressants during porcine xenotransplantation in the future.


Assuntos
Adulto , Humanos , Ciclosporina , Imunossupressores , Suínos , Doadores de Tecidos , Transplante Heterólogo
19.
The Journal of the Korean Society for Transplantation ; : 69-74, 2007.
Artigo em Coreano | WPRIM | ID: wpr-199125

RESUMO

PURPOSE: To evaluate the pathology of prospective kidney donors and assess the clinical outcomes of the renal allografts. METHODS: We reviewed the records of 12 prospective kidney donors who underwent kidney biopsy. The indications of kidney biopsy were asymptomatic microscopic hematuria (n=88, 66.7%), decreased glomerular filtration rate (GFR, n=22, 16.7%), mild proteinuria (n=11, 8.3%), history of gross hematuria (n=11, 8.3%). RESULTS: Kidney biopsy in 8 prospective donors with asymptomatic microscopic hematuria showed: 5 (62.5%) thin basement membrane disease (TBMD); 1 IgA nephropathy; 1 Alport's syndrome; 1 mild mesangial widening. Two prospective donors with decreased GFR showed IgA nephropathy and tubulointerstitial lesion. The one with mild proteinuria showed arterionephrosclerosis and the one with a history of gross hematuria showed tubulointerstitial lesion. 4 (33.3%) of the 12 who underwent kidney biopsy were accepted as kidney donors.; 3 donors with TBMD and the donor with mild mesangial widening, who all had microscopic hematuria. Among the 4 donations, there was 1 graft failure and 3 allografts (1 mild mesangial widening, 2 TBMD) have maintained graft function at latest follow up. CONCLUSION: The most common cause of asymptomatic microscopic hematuria in prospective kidney donors was TBMD. Long-term follow up is needed to assess the clinical outcomes of these allografts.


Assuntos
Humanos , Aloenxertos , Membrana Basal , Biópsia , Seguimentos , Taxa de Filtração Glomerular , Glomerulonefrite por IGA , Hematúria , Rim , Nefrite Hereditária , Patologia , Estudos Prospectivos , Proteinúria , Doadores de Tecidos , Transplantes
20.
The Journal of the Korean Society for Transplantation ; : 88-93, 2007.
Artigo em Coreano | WPRIM | ID: wpr-199122

RESUMO

PURPOSE: Transplant renal artery stenosis (TRAS) is a potentially treatable complication of kidney transplantation. Color doppler ultrasound (doppler US) is recommended as primary diagnostic method, but it has some limitations. METHODS: We analyzed with 3D computed tomography angiography (3D-CTA) compared doppler US in the diagnosis of TRAS. Eleven transplant recipients (4 women, 7 men) with new developed or uncontrolled hypertension underwent 3D-CTA. We compared 3D-CTA with the dopper US in all TRAS recipients diagnosed 3D-CTA (n=6). RESULTS: The median age at transplantation was 42 year (Range: 27~55 year), mean systolic blood pressure +/-SD was 163+/-9.9 mmHg and median HLA mismatch was 2 (0~4). The 3D-CTA showed significant TRAS (>70% luminal narrowing) in six recipients. Most commonly stenosis occurred at the anastomotic site (anastomic site, 4; pre-anastomotic 1; diffuse 1 recipients). The dopper US showed suspected TRAS in four recipients but no evidence of TRAS in two recipients. But these all patients showed significant stenosis (>70% luminal narrowing) of transplant renal artery by the percutaneous angiography. All six TRAS recipients successfully were treated by primary percutaneous angioplasty and endovascular stenting. Arterial blood pressure showed significantly improvement after post-endovascualr therapy (Presystolic, 170+/-8 mmHg; postsystolic, 151+/-16 mmHg; P=0.012 and prediastolic, 104+/-4; postdiastolic 92+/-8; P=0.007). CONCLUSION: The 3D-CTA is highly accurate and noninvasive screening test for detecting TRAS than dopper US.


Assuntos
Feminino , Humanos , Angiografia , Angioplastia , Pressão Arterial , Pressão Sanguínea , Constrição Patológica , Diagnóstico , Hipertensão , Transplante de Rim , Programas de Rastreamento , Fenobarbital , Obstrução da Artéria Renal , Artéria Renal , Stents , Transplante , Ultrassonografia
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