Factors associated with acute rejection after pediatric kidney transplantation: a single-center cohort study / 中华器官移植杂志

Objective:To summarize the incidence of acute rejection (AR) after pediatric kidney transplantation (KT) at a single center and examine its impact on graft/patient survival and risk factors for AR.Methods:This is a retrospective cohort study including pediatric recipients who underwent kidney transplantation in past 8 years.After excluding recipients of graft thrombosis within a week post-transplant and lost to follow-ups, a total of 143 cases were ultimately recruited and assigned into two groups of AR (n=29) and non-AR (n=114).Basic profiles of both donors and recipients and graft/patient survival rate were compared between two groups.Relative risk factors for AR episodes were also examined by Logistic regression.Results:Renal grafts for 130/143 cases (90.9%) were harvested from deceased donors and 120(83.9%) cases from children.Twenty-seven transplants (18.9%) were performed in infants and young recipients aged < 3 years.During a median follow-up of 33 months, 34 AR episodes occurred in 29(20.3%) patients.Rate of re-transplantation (27.6% vs. 7.9%), pediatric donor (96.5% vs. 80.7%) and rabbit anti-human thymocyte globulin (rATG) induction (79.3% vs. 36%) were significantly higher in AR group than non-AR group ( P=0.007, P=0.046, P<0.001).Multivariate regression analysis indicated that basiliximab induction caused a significant reduction in the risk of AR incidence as compared with rATG induction (odds ratio 0.13, 95% confidence interval 0.04-0.43, P<0.001).The median time of AR incidence was 1.3 months post-transplantation and 23 episodes (67.6%) were confirmed by biopsy.After anti-rejection treatment, 52.9%(n=18) of the cases achieved a full recovery and 38.3% (n=13) had improved graft function.However, 3 cases (8.8%) developed irreversible graft failure.The 1/3-year graft survival rates were significantly lower in AR group than those in non-AR group (75.3% vs. 95.2%, 68.4% vs. 90.4%, P=0.01), and there was no significant difference in 1-and 3-year patient survival rates between two groups. Conclusions:The incidence of AR is relatively high in pediatric renal transplantation, which has an impact on graft survival.Basiliximab induction can effectively reduce the risk of AR.

Renal artery stenosis in children after pediatric donor kidney transplantation: a report of five cases / 中华器官移植杂志

Objective:To explore the clinical features of transplanted renal artery stenosis after pediatric donor kidneys in children.Methods:We retrospectively summarized the clinical data in five cases of transplanted renal artery stenosis undergoing deceased pediatric donor kidney transplantation from May 1, 2014 to June 30, 2021.Donor/receptor characteristics, diagnosis, treatment and prognosis were recorded.The median follow-up period was 29 months.The median age of five donors and recipients was 9 and 132 months respectively.En bloc renal allograft( n=2)and single kidney transplantation( n=3)were performed.End-to-side anastomosis was performed for renal arteries.The median diagnostic time of renal artery stenosis was 10(3-60)months post-transplantation.Except for one 3-year-old recipient with an earlier onset of stenosis, four stenotic cases during a rapid growth period had a maximal height increase of 30 cm post-transplantation.Three of them had a history of surgery at graft site, including previous kidney transplantation( n=1)and transplant urinary tract reconstruction( n=2). All five cases had hypertension and two showed an elevated serum level of creatinine.Ultrasound indicated a significantly elevated flow rate of >300 cm/s( n=4)and CTA/MRA indicated that the degrees of stenosis varied from 50% to 95%( n=5). Results:After balloon dilatation, stenosis either improved( n=2)or relapsed( n=2). Further stenting succeed( n=1)or failed( n=1). One case of stenosis was relieved partially after 6-month observation without any invasive treatment. Conclusions:As a serious complication, transplant renal artery stenosis is common after pediatric donor kidney transplantation.Too small size in donor kidney and rapid recipient growth may be specific risk factors.After diagnosis, balloon dilation is a preferred treatment.Stent placement should be cautiously employed.

Efficacy and safety of a novel Tripterygium preparation in the treatment of refractory proteinuria in kidney transplant recipients / 中华器官移植杂志

Objective:To explore the efficacy and safety of a novel Tripterygium preparation (Kunxian Capsules)in kidney transplant recipients developing refractory proteinuria after transplantation.Methods:A total of 59 kidney transplant recipients received regular follow-ups from August 2018 to July 2021.Severity of proteinuria, kidney graft function and adverse effects were retrospectively recorded before and at Month 1/2/3/6 months after Kunxian treatment.They were divided into two groups of effective and void to explore the potential effect-related factors.Results:Six-month treatment was completed in 57 patients except for 2 cases of discontinued treatment due to severe adverse effects.A significant reduction in amount of proteinuria was observed at Month 1 [1.09(0.42, 2.59 g/24 h)vs 1.82(1, 2.7 g/24 h, P<0.01)]and the trend continued during subsequent follow-ups.Twenty-nine patients(50.9%)responded remarkably.Eighteen patients(31.6%)showed no response.The overall effective rate was 68.4%.Inter-group comparison revealed strong correlations between treatment efficacy and baseline serum creatinine levels, early initiation of treatment and symptom duration from onset to treatment.Kidney graft IgA nephropathy demonstrated the highest effective rate(11/13, 84.6%). Furthermore, elevated blood concentration of tacrolimus hinted at a potential drug interaction. Conclusions:Kunxian Capsules is efficacious and safe for renal transplant recipients developing moderate-severe proteinuria and not responding to traditional medications.Early initiation of treatment before graft function decline is recommended.Reducing tacrolimus dose cautiously in advance and monitoring adverse events are also essential.

En-bloc kidney transplantation from small infant donors to adult recipients: a report of 22 cases / 中华器官移植杂志

Objective:To summarize the clinical outcomes of en-bloc kidney transplantation from small infant donors to adult recipients at a single center.Methods:A total of 22 en-bloc transplantations from pediatric donors to adult recipients were performed from July 2013 to October 2017 in Institute of Organ Transplantation Affiliated Tongji Hospital Tongji Medical College Huazhong University of Science. Clinical data were retrospectively analyzed. The average age of 22 donors was (2.9±1.7) months with an average weight of (4.9±1.4) kg and 15 of them were aged under 3 months. The average weight of 22 adult recipients was (46.3±5.6) kg and most recipients were female. The causes of early graft failure and recipient death were examined during follow-ups. The recipients with functioning grafts post-transplantation were divided into single kidney survival group and en-bloc kidney survival group based upon the occurrence of unilateral vascular thrombosis. Medium/long-term renal graft function was compared between two groups.Results:Early graft failure occurred in 4 recipients. The causes were bilateral renal vascular thrombosis ( n=2), renal rupture ( n=1) and multiple organ failure followed by death ( n=1). Eighteen recipients were discharged after a recovery of renal graft function. One case had a removal of bilateral renal grafts due to new-onset graft tumor and another two died from interstitial pneumonia and complicate systematic disorder respectively during follow-ups. Among the remaining 15 recipients, 10 achieved bilateral renal survival (median follow-up: 59 months) and 5 unilateral renal survival (median follow-up: 48 months). The average eGFR of bilateral renal survival group was significantly higher than that of unilateral renal survival group at Year 1 post-transplantation (95±27 vs 61±24 ml/min/1.73 m 2, P<0.05) while the gap narrowed at Year 3 and there was no statistical significance (95±21 vs 69±31 ml/min/1.73 m 2, P=0.12). Conclusions:Although en-bloc kidney transplantation from infant donors can expand organ donor pool, there is a higher risk of early graft failure and unilateral renal vascular thrombosis. Nevertheless, satisfactory renal transplant outcomes may be achieved in patients with unilateral renal graft survival.

Functional Diversity of Class XI Myosins in Arabidopsis thaliana.

Plant myosin XI acts as a motive force for cytoplasmic streaming through interacting with actin filaments within the cell. Arabidopsis thaliana (At) has 13 genes belonging to the myosin XI family. Previous reverse genetic approaches suggest that At myosin XIs are partially redundant, but are functionally diverse for their specific tasks within the plant. However, the tissue-specific expression and enzymatic properties of myosin XIs have to date been poorly understood, primarily because of the difficulty in cloning and expressing large myosin XI genes and proteins. In this study, we cloned full-length cDNAs and promoter regions for all 13 At myosin XIs and identified tissue-specific expression (using promoter-reporter assays) and motile and enzymatic activities (using in vitro assays). In general, myosins belonging to the same class have similar velocities and ATPase activities. However, the velocities and ATPase activities of the 13 At myosin XIs are significantly different and are classified broadly into three groups based on velocity (high group, medium group and low group). Interestingly, the velocity groups appear roughly correlated with the tissue-specific expression patterns. Generally, ubiquitously expressed At myosin XIs belong to the medium-velocity group, pollen-specific At myosin XIs belong to the high-velocity group and only one At myosin XI (XI-I) is classified as belonging to the low-velocity group. In this study, we demonstrated the diversity of the 13 myosin XIs in Arabidopsis at the molecular and tissue levels. Our results indicate that myosin XIs in higher plants have distinct motile and enzymatic activities adapted for their specific roles.

Measurement of enzymatic and motile activities of Arabidopsis myosins by using Arabidopsis actins.

There are two classes of myosin, XI and VIII, in higher plants. Myosin XI moves actin filaments at high speed and its enzyme activity is also very high. In contrast, myosin VIII moves actin filaments very slowly with very low enzyme activity. Because most of these enzymatic and motile activities were measured using animal skeletal muscle α-actin, but not plant actin, they would not accurately reflect the actual activities in plant cells. We thus measured enzymatic and motile activities of the motor domains of two Arabidopsis myosin XI isoforms (MYA2, XI-B), and one Arabidopsis myosin VIII isoform (ATM1), by using three Arabidopsis actin isoforms (ACT1, ACT2, and ACT7). The measured activities were different from those measured by using muscle actin. Moreover, Arabidopsis myosins showed different enzymatic and motile activities when using different Arabidopsis actin isoforms. Our results suggest that plant actin should be used for measuring enzymatic and motile activities of plant myosins and that different actin isoforms in plant cells might function as different tracks along which affinities and velocities of each myosin isoform are modulated.

Study on anti-tumor effect of medicinal fungiPhellinus igniarius extracts / 国际中医中药杂志

Objective To study the inhibiting effects of phellinus igniarius extractive (PLE) on tumor growth of tumor-bearing mice in vivo, and the direct inhibiting action to human tumor in vitro. Methods ①Models of hepatoma,sarcoma, lung cancer in mice were established. Experiments in studying the effect of PLE on the above three animal models were repeated for three times. ②The suppression of cellular growth of human tumor was detected by MTT assay. Results PLE (250.500 and 1000 mg/kg, ig, d1 to d11) could inhibit the growth of H22 tumor cells in mice at the inhibitory rate of 57%,63% and 46%,respectively; slow down the growth of S180 tumor cells in mice at the inhibitory rate of 27.9%, 75%, and 31.2%,respectively; suppress the growth of Lewis lung cancer in mice at the inhibitory rate of 57.1%, 54.5%, 45.9%; and hold back the proliferation of MCF7 cells and OVCA2780 cells (P＜0.01). Conclusion PLE (250.500 and 1000 mg/kg, ig, d1 to d11)could inhibit the growth of H22 tumor cells, S 180 tumor cells, and Lewis lung cancer in mice. PLE could significantly reduce the proliferation of MCF7 cells and OVCA2780 cells (P＜0.05).

Evaluation of milk quality in delivering sterilized milk with soft tank transportation system.

A new transportation system is proposed recently to improve the defects of liquid transportation by tank trucks. This method is called "soft tank transportation system"; a driver installs a sac-like container (soft tank), which is made from a tarpaulin with high-pressure resistant-waterproof zippers, in a general cargo vehicle. To evaluate the quality of sterilized milk by using the soft tank transportation system, ground and marine transportation for a long distance which took about 36 h from the shipper's loading to the receiver's unloading in a high-temperature summer season (average outside temperature was 33.4 degrees C) were carried out. Although the difference of milk temperature before and after the delivery varied from -0.7 to +1.4 degrees C, there was no difference in milk quality (fat, nonfat solids, total dissolved solids, and pH) and no coliform bacteria were detected. It can be evaluated that sterilized milk was carried in keeping good conditions by soft tank transportation system.