ABSTRACT
The modulation of the immune response by interaction of prolactin and cyclosporin has been investigated in a total of 181 subjects, 121 males and 60 females. This study demonstrates a significant difference in the magnitude and fluctuation in prolactin and cyclosporin concentrations between males and females receiving cyclosporin as the single immunosuppressant. Levels of both analytes are lower in the male and show markedly less fluctuation than in the female. It is proposed that prolactin levels should be taken into account when determining the appropriate dosage regimen of cyclosporin in those patients receiving cyclosporin alone as immunosuppressant therapy.
ABSTRACT
Among a population of 600 renal transplant patients, only three cases (0.5%) have developed a non-Hodgkin's lymphoma, while in the same population, 28 cases (4.6%) have developed a Kaposi's sarcoma. The significant low incidence of lymphoma in the Saudi grafted population must be underlined, particularly because of the very high incidence of this malignancy among either the post-transplant Western population, up to 20% of the cancers, or the Saudi general population where the incidence can reach 15% of malignancies.
ABSTRACT
We report a patient who developed generalized Kaposi's sarcoma (extensive skin and stomach lesions) 24 months after renal transplantation whilst on cyclosporin (CyA) and prednisolone. Kaposi's sarcoma disappeared completely upon withdrawal of CyA. The patient remained with a well-functioning graft and free of Kaposi's sarcoma for 36 months on prednisolone alone. CyA was reintroduced following an episode of acute rejection. Within 8 weeks, Kaposi's sarcoma reappeared on the skin at the same sites as the previously healed lesions. They completely disappeared again upon withdrawal of CyA. Azathioprine was then introduced and Kaposi's sarcoma lesions reappeared 6 months later.
Subject(s)
Immunosuppression Therapy , Kidney Transplantation/pathology , Neoplasm Recurrence, Local/pathology , Postoperative Complications/pathology , Sarcoma, Kaposi/pathology , Skin Neoplasms/pathology , Stomach Neoplasms/pathology , Biopsy , Humans , Immunosuppression Therapy/adverse effects , Immunosuppression Therapy/methods , Male , Middle Aged , Neoplasm Recurrence, Local/etiology , Postoperative Complications/etiology , Remission Induction , Sarcoma, Kaposi/etiology , Skin/pathology , Skin Neoplasms/etiology , Stomach Neoplasms/etiology , Time FactorsABSTRACT
We report 20 cases of non-typhoid Salmonella infection that occurred over a period of 10 years in 592 renal transplant recipients followed by our unit, and present a review of 58 previously reported cases. Analysis of these data suggests that infection occurs when immunosuppression is high (early in the post-transplant period, or after anti-rejection therapy). A significant number of patients have bacteraemia and widespread focal manifestations are common. Despite prolonged antibiotic therapy, relapses occur commonly causing significant morbidity, occasional graft loss and even death.
Subject(s)
Kidney Transplantation , Opportunistic Infections/etiology , Postoperative Complications/etiology , Salmonella Infections/etiology , Adolescent , Adult , Child , Child, Preschool , Female , Graft Rejection , Humans , Immunosuppression Therapy/adverse effects , Male , Middle Aged , Recurrence , Retrospective Studies , Salmonella Infections/epidemiologyABSTRACT
Cyclosporine and rifampicin were used simultaneously in 6 renal transplant patients with tuberculosis. The total daily dose of cyclosporine had to be increased 3-5 fold, with the frequency of administration increased from twice to thrice daily. With this regimen, satisfactory cyclosporine levels were attained and there was no adverse affect on graft function.
Subject(s)
Cyclosporins/administration & dosage , Kidney Transplantation , Rifampin/administration & dosage , Tuberculosis, Pulmonary/drug therapy , Adult , Cyclosporins/blood , Cyclosporins/therapeutic use , Drug Administration Schedule , Drug Interactions , Female , Humans , Male , Rifampin/therapeutic useSubject(s)
Commerce , Kidney Transplantation/mortality , Tissue and Organ Procurement/methods , Graft Survival , Humans , IndiaABSTRACT
A patient with Alport's syndrome and chronic renal failure received a cadaver kidney graft. Four months after the transplantation, he developed glomerulonephritis induced by anti-glomerular basement membrane (GBM) antibody. The graft failed, and the patient returned to haemodialysis. Twenty-two months later the patient received a second cadaver kidney graft. Ten months after the second transplant, he developed a recurrent anti-GBM glomerulonephritis. This observation suggests that anti-GBM disease can recur in a second transplanted kidney in a patient with Alport's syndrome.
