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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  122. Kongress der Deutschen Gesellschaft für Chirurgie; 20050405-20050408; München; DOC05dgch3767 /20050615/
    Publication Date: 2005-06-16
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    Keywords: IMPACT ; HLA ; FAILURE ; BIOPSIES ; II TYPE-1 RECEPTOR ; ANTIBODY-MEDIATED REJECTION ; DONOR-SPECIFIC ANTIBODIES ; MICROCIRCULATION INFLAMMATION ; CELL-TYPES ; C4D
    Abstract: BACKGROUND: Renal transplant glomerulitis (G) is associated with acute antibody-mediated rejection (ABMR) in the presence of donor-specific antibodies. However, the long-term prognosis of isolated G (isG) in the absence of donor-specific antibodies or G in combination with T cell-mediated rejection (TCMR) remains unexplored. METHODS: Seventy recipients with G were included in this retrospective study and subdivided into 3 groups: isG, G with TCMR (G + TCMR), and G with acute ABMR. The control groups were: patients with TCMR Banff type I or II without G (TCMR) and patients without rejection (NR). Kaplan-Meier death-censored survival plots and Cox regression were used to analyze graft survival. The combined graft survival endpoint was defined as a return to dialysis or estimated glomerular filtration rate less than 15 mL/min/1.73 m. The median follow-up was 37 (14; 77) months from biopsy. RESULTS: Graft survival was significantly lower in patients with G than in the NR and TCMR groups. No significant differences were observed among the isG, G + TCMR, and ABMR groups. Graft survival was lower in the G + TCMR group than in the TCMR group. Glomerulitis was independently associated with the risk of adverse graft outcome in a multivariate Cox regression model adjusted for other confounders (hazard ratio, 4.52 [95% confidence interval, 2.37-8.68] vs controls; P 〈 0.001). CONCLUSIONS: Glomerulitis is strongly associated with increased risk of graft failure. Graft survival in patients with isG that do not meet the Banff criteria for acute/active ABMR and in patients with G accompanying TCMR is comparable to the ABMR group.
    Type of Publication: Journal article published
    PubMed ID: 25594551
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  • 3
    Keywords: tumor ; carcinoma ; CELL ; Germany ; DIAGNOSIS ; FOLLOW-UP ; HISTORY ; LONG-TERM ; RISK ; computed tomography ; PATIENT ; kidney ; TRANSPLANTATION ; METASTASIS ; metastases ; REGION ; RESECTION ; tomography ; COMPUTED-TOMOGRAPHY ; immunosuppression ; CELL CARCINOMA ; renal cell carcinoma ; MALIGNANCY ; TESTS ; HISTOLOGY ; RAPAMYCIN ; kidney transplantation ; Nephrectomy ; pre-existing tumor ; Thyroid gland
    Abstract: History and findings: An asymptomatic 70-year-old man was found to have a tumor in the region of the left adrenal gland, having undergone cadaveric kidney transplantation 23 years ago. Two years before this a right nephrectomy had been performed for a renal cell carcinoma. There was no left kidney because of agenesis. 14 years after the kidney transplantation a metastasis of the renal cell carcinoma was identified in the thyroid gland. After its resection no further metastases had been discovered. Investigations: Laboratory tests were unremarkable. But a tumor was detected in the left adrenal gland by computed tomography. Diagnosis, treatment and course: The left adrenal gland was successfully resected. Its histology confirmed a second metastasis of the renal cell carcinoma 23 years after renal transplantation, but no other metastases were found. Conclusions: Kidney transplantation can be successfully performed even in patients with pre-existing carcinoma. A late metastasis of a renal carcinoma may occur. Close long-term follow-up of the patients is therefore essential
    Type of Publication: Journal article published
    PubMed ID: 19707962
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