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  • 1
    Keywords: CANCER ; EXPOSURE ; TISSUE ; FAILURE ; CHINESE HERBS NEPHROPATHY ; INHIBITORS ; DNA-ADDUCTS ; UROTHELIAL CARCINOMA ; fibrosis ; RECIPIENTS
    Abstract: Intravesical instillation of bacillus Calmette-Guerin (BCG) is the treatment of choice for non-muscle-invasive bladder cancer (NMIBC) of high grade and/or carcinoma in situ. This study evaluated the feasibility, efficacy, and tolerance of BCG instillations in eight kidney recipients for end-stage aristolochic acid nephropathy (AAN), a condition at high risk of urothelial carcinoma, and diagnosed for NMIBC. Five of them had relapsed after mitomycin C treatment. Tolerance to BCG was evaluated clinically and regular follow-up with fluorescence cystoscopy was performed along with renal graft function monitoring. Immunosuppression doses were adjusted and prophylactic anti-tuberculous treatment given to reduce risks of graft rejection and infection. After a mean follow-up period of 50 months, seven of the eight patients are free of relapse and kidney graft function remained unchanged. Tolerance was good, except for one episode of fever and one early discontinuation because of subjective discomfort. No systemic tuberculous infection was observed. This is the first clinical observation of successful BCG therapy for NMIBC in patients given transplant for end-stage AAN. Under standardized conditions, immunotherapy based on intravesical BCG is feasible, effective, and well tolerated in renal transplantation.
    Type of Publication: Journal article published
    PubMed ID: 25377421
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  • 2
    Abstract: Transplant recipients frequently exhibit an increased Epstein-Barr virus (EBV) load in the peripheral blood. Here we quantitated the EBV-infected cells in the peripheral blood of these patients and defined the mode of viral infection, latent or lytic. These data indicated that there is no strong correlation between the number of infected cells and the EBV load. This can be explained by a highly variable number of EBV copies per infected cell and by lytic replication in some cells. The plasma of these patients did not contain any free infectious viruses, but contained nevertheless EBV DNA, sometimes in large amounts, that probably originates from cell debris and contributed to the total EBV load. Some of the investigated samples carried a highly variable number of infected cells in active latency, characterized by an expression of the EBNA2 protein. However, a third of the samples expressed neither EBNA2 nor lytic proteins. Patients with an increased EBV load represent a heterogeneous group of patients whose infection cannot be characterized by this method alone. Precise characterization of the origin of an increased EBV load, in particular in terms of the number of EBV-infected cells, requires additional investigations including the number of EBER RNA-positive cells. This article is protected by copyright. All rights reserved.
    Type of Publication: Journal article published
    PubMed ID: 27717030
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  • 3
    Keywords: DISEASE ; antibody ; RECURRENCE ; REJECTION ; CHILDREN ; glomerulonephritis ; FOCAL SEGMENTAL GLOMERULOSCLEROSIS ; rituximab ; ALLOGRAFTS ; PLASMAPHERESIS ; CYCLOSPORINE THERAPY ; kidney transplantation
    Abstract: Relapse of focal segmental glomerulosclerosis (FSGS) after renal transplantation is 20-40%. Recurrence after a first relapse is 80%. The only current treatment is plasmapheresis and/or cyclophosphamide. We report successful treatment of a second relapse in a 48-year-old patient. At age 33, FSGS was diagnosed. The patient began hemodialysis 1 year later. In her first renal transplant, she developed recurrent FSGS and reached terminal transplant failure 3 years later. Eight years later, a second transplant was performed. Immunosuppressive regimen: steroids, mycophenolate mofetil (MMF), tacrolimus (TAC), and rabbit anti-thymocyte globulin. Proteinuria of 2-6 g/day was detected and a biopsy showed recurrent FSGS. Plasmapheresis was started without success. Another biopsy still showed FSGS. The patient received two doses of rituximab (375 mg/m(2) each) i.v. Three weeks later, proteinuria was 350 mg/day (serum-creatinine 1.6 mg/dl). Twelve months later, proteinuria was at 90 mg/day. Rituximab might be an option for recurrent FSGS after renal transplantation.
    Type of Publication: Journal article published
    PubMed ID: 17433091
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Transplant international 1 (1988), S. 95-98 
    ISSN: 1432-2277
    Keywords: Pediatric transplant patients ; Recipient and donor age
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The influnece of recipient and donor age on the outcome of first cadaver kidney transplants was analyzed in a series of 1325 pediatric recipients and in 4230 transplants from pediatric kidney donors. Graft survival improved significantly with increasing recipient age (P〈0.0001) and donor age (P〈0.0001). Combined analysis of recipient and donor age groups revealed an overriding effect of donor age on graft outcome. Kidneys from donors younger than 3 years old consistently yielded poor results regardless of recipient age. Kidneys from adult donors gave the best results even in young recipients 0–5 years of age. With adult donor kidneys in cyclosporin-treated patients, high 1-year graft survival rates of 86±9% (SE) in 15 0-to 5-year-old recipients, 85±3% in 137 6-to 12-year-old recipients, and 83±1% in 6027 13-to 40-year-old recipients were observed.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2277
    Keywords: Heart ; Graft survival ; Cyclosporine ; Sulfasalazine ; Rats
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sulfasalazine (SASP) has been used for many years as a disease-modifying agent in inflammatory bowel disease and in rheumatoid arthritis. However, its mode of action is not entirely clear. Evidence has been accumulated which indicates that its efficacy is due to an immunomodulatory effect. In the present communication, we report that SASP has an immunomodulatory capacity in an experimental rat cardiac allograft model. A combination of 100 mg/kg per day of SASP given orally until rejection and 10 mg/kg per day of cyclosporine A (CyA) given orally for 10 days resulted in a significantly increased graft survival time as compared to that in animals given CyA alone.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2277
    Keywords: Transplantation tolerance ; Intraportal injection ; Allogeneic bone-marrow transplantation ; Chimeras
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intraportal inoculation of C57BL/6 marrow cells into sublethally (400 rad) irradiated BALB/c recipients resulted in durable chimerism and the permanent acceptance of C57BL/6 skin allografts. Sublethally irradiated recipients of a similar number of marrow cells inoculated systemically did not develop chimerism or any significant prolongation of the survival of C57BL/6 skin allografts. Consequently, lethal graft-versus-host disease developed only in recipients of intraportal marrow allografts (80%). The intraportal injection of allogeneic C57BL/6 marrow cells into nonirradiated recipients resulted in significant, although not permanent, prolongation of skin allograft survival without durable chimerism, suggesting that the introduction of alloantigens intraportally may favor the induction of nonresponsiveness to alloantigens even across strong major histocompatibility barriers. The relevance of these findings is discussed regarding the intraportal inoculation of allogeneic bone marrow cells for the treatment of genetic disorders in utero through the induction of neonatal tolerance.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Transplant international 1 (1988), S. 118-118 
    ISSN: 1432-2277
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-2277
    Keywords: Human orthotopic liver transplantation ; Complications ; Biliary tract ; Primary sclerosing cholangitis ; Recurrent disease ; Rejection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract One of 55 patients transplanted for sclerosing cholangitis during the cyclosporin-steroid era (March 1980–June 1986) developed intrahepatic biliary strictures in the absence of allograft rejection within the 1st year posttransplantation. Although many causes underlie biliary pathology in the postoperative period (i.e., arterial injury, ischemia, chronic rejection, cholangitis), recurrent disease remains a possibility.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-2277
    Keywords: Elderly patients ; Renal transplantation ; Renal replacement therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of renal replacement therapy (RRT) in elderly patients in Norway were evaluated. During the 5-year period between 1981 and 1985, 368 patients at least 60 years of age (mean, 66.7 years) at the start of RRT were included and followed until 15 February 1987. Transplantation was planned for 249 patients; of these 127 were not grafted. The actuarial survival in this group was 64%, 44%, and 7% at 6, 12, and 48 months, respectively. Survival in 122 grafted patients was 93%, 87%, and 62%, respectively, and the corresponding graft survival was 70%, 67%, and 48%. The remaining 119 patients were allocated to long-term dialysis, with a survival of 63%, 48%, and 13%, respectively. Our results describe the outcome of a treatment program available to the entire elderly population accepted for RRT. In two-thirds of the patients transplantation was planned, and one-third of all patients were actually grafted, with good patient and graft survival. The results suggest that transplantation is the treatment of choice for most elderly patients.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-2277
    Keywords: Liver transplantation ; Aspiration cytology ; Rejection ; Fine needle aspiration ; Total corrected increment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The role of aspiration cytology (AC) and the total corrected increment (TCI) in the diagnosis of hepatic rejection was assessed in 30 patients following 36 liver transplants. A total of 174 AC specimens were “blindly” evaluated. Patients underwent protocol AC twice weekly and when biochemical or clinical parameters suggested rejection. Hepatic rejection was only confirmed when clinical and biochemical changes were accompanied by positive histological diagnosis. In all, 103 specimens were matched against histology, the remainder assessed against retrospective clinical and biochemical diagnoses. There were 80 cytological diagnoses of rejection, confirmed in 69 specimens, and 94 diagnoses of no rejection, confirmed in 73 specimens. These figures give a sensitivity of 76.7%, a specificity of 86.9% and a positive predictive value of 86.3%. Overall, 39.7% of specimens taken more than 2 months after grafting proved to be incorrectly diagnosed. However, the accuracy was higher in 145 specimens taken within 8 weeks of transplantation, with a sensitivity of 81.3%, a specificity of 90%, a positive predictive value of 89.7% and an accuracy of 85.5%. Although histology remains the gold standard in the diagnosis of acute rejection after hepatic grafting, AC using a TCI with a positive predictive value of 86.3% may prove to be of value in monitoring liver transplant patients in the first 2 months after grafting.
    Type of Medium: Electronic Resource
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