收藏本站
收藏 | 投稿 | 手机打开
二维码
手机客户端打开本文

Clinical and pathological features of kidney transplant patients with concurrent polyomavirus nephropathy and rejection-associated endarteritis

Stephanie M McGregor  W James Chon  Lisa Kim  Anthony Chang  Shane M Meehan  
【摘要】:AIM: To describe the clinicopathologic features of concurrent polyomavirus nephropathy(PVN) and endarteritis due to rejection in renal allografts.METHODS: We searched our electronic records database for cases with transplant kidney biopsies demonstrating features of both PVN and acute rejection(AR). PVN was defined by the presence of typical viral cytopathic effect on routine sections and positive polyomavirus SV40 large-T antigen immunohistochemistry. AR was identified by endarteritis(v1 by Banff criteria). All cases were subjected to chart review in order to determine clinical presentation, treatment course and outcomes. Outcomes were recorded with a length of follow-up of at least one year or time to nephrectomy. RESULTS: Of 94 renal allograft recipients who developed PVN over an 11-year period at our institution, we identified 7(7.4%) with viral cytopathic changes, SV40 large T antigen staining, and endarteritis in the same biopsy specimen, indicative of concurrent PVN and AR. Four arose after reduction of immunosuppression(IS)(for treatment of PVN in 3 and tuberculosis in 1), and 3 patients had no decrease of IS before developing simultaneous concurrent disease. Treatment consisted of reduced oral IS and leflunomide for PVN, and antirejection therapy. Three of 4 patients who developed endarteritis in the setting of reduced IS lost their grafts to rejection. All 3 patients with simultaneous PVN and endarteritis cleared viremia and were stable at 1 year of follow up. Patients with endarteritis and PVN arising in a background of reduced IS had more severe rejection and poorer outcome.CONCLUSION: Concurrent PVN and endarteritis may be more frequent than is currently appreciated and may occur with or without prior reduction of IS.

知网文化
【相似文献】
中国期刊全文数据库 前20条
1 ;Diagnosis and differentiation of rejection after liver transplantation: report of 5 cases[J];Hepatobiliary & Pancreatic Diseases International;2005年02期
2 ;EXPERIMENTAL INVESTIGATION OF THREE IMMUNO-SUPPRESSIVE DRUGS IN XENOTRANSPLANTATION[J];Chinese Medical Journal;1995年03期
3 倪晓光;The diagnostic role of heat shock protein 70 in acute rejection after pancreatioduodenal transplantation in rats[J];China Medical Abstracts;2003年02期
4 顾晓;Expression of fractalkine and its receptor in acute cardiac allografts rejection[J];China Medical Abstracts;2003年02期
5 ;Effect of 1,25-dihydroxyvitamin D3 on preventing allograft from acute rejection following rat orthotoic liver transplantation[J];World Journal of Gastroenterology;2003年05期
6 ;Effect of local CTLA4Ig gene transfection on acute rejection of small bowel allografts in rats[J];World Journal of Gastroenterology;2004年06期
7 ;Liver biopsy in evaluation of complications following liver transplantation[J];World Journal of Gastroenterology;2004年11期
8 谢海洋;黄东胜;贾长库;郑树森;;Infusion of nonmyeloablative bone marrow alleviates acute rejection reaction in liver allotransplantation[J];Journal of Zhejiang University Science;2005年12期
9 ;Correlation of CD95 and soluble CD95 expression with acute rejection status of liver transplantation[J];World Journal of Gastroenterology;2005年11期
10 孟春营;黄克力;罗滨;温定国;;Monitoring of Acute Rejection after Orthotopic Heart Tranplantation[J];South China Journal of Cardiology;2006年01期
11 ;Virus rejection with two model human enteric viruses in membrane bioreactor system[J];Science in China(Series B:Chemistry);2007年03期
12 ;Daclizumab prevents acute renal allograft rejection: 1 year analysis[J];Journal of Nanjing Medical University;2007年04期
13 ;Allograft rejection-related gene expression in the endothelial cells of renal transplantation recipients after cytomegalovirus infection[J];Journal of Zhejiang University(Science B:An International Biomedicine,Biochemistry & Biotechnology Journal);2009年11期
14 ;Liver[J];China Medical Abstracts(Surgery);2009年04期
15 ;Th17 promotes acute rejection following liver transplantation in rats[J];Journal of Zhejiang University-Science B(Biomedicine & Biotechnology);2010年11期
16 史加海;;Reliability of using tslew of intramyocardial electrogram to diagnose acute rejection after heart transplantation in rats[J];China Medical Abstracts(Surgery);2011年03期
17 刘永光;;Application of Rituxmab in antibodymediated rejection among renal transplantation recipients[J];China Medical Abstracts(Surgery);2011年04期
18 ;Total body irradiation of donors can alter the course of tolerance and induce acute rejection in a spontaneous tolerance rat liver transplantation model[J];Science China(Life Sciences);2012年09期
19 王世强;庄建;陈寄梅;朱平;;Regulatory T cells in transplantation from rejection to tolerance[J];South China Journal of Cardiology;2014年01期
20 吴建永,陈江华,王逸民,张建国,朱琮,寿张飞,王苏娅,张萍,黄洪锋,何强;Impact of acute rejection episodes on long-term renal allograft survival[J];Chinese Medical Journal;2003年11期
中国重要会议论文全文数据库 前10条
1 ;A Retrospective study of Plasma Cell Infiltrate in Explanted Renal Allograft[A];第十五届全国泌尿外科学术会议论文集[C];2008年
2 ;Recipient cytotoxic T lymphocyte antigen 4 +49 single-nucleotide polymorphism is not associated with acute rejection after liver transplantation in Chinese population[A];2012中国器官移植大会论文汇编[C];2012年
3 Zhigang Ren;Guangying Cui;Jianwen Jiang;Lin Zhou;Haifeng Lu;Nan Qin;Haiyang Xie;Shusen Zheng;;Deeply dynamic analysis of intestinal microecology in acute rejection of rats following liver transplantation[A];2013年浙江省肠外肠内营养学学术年会论文汇编[C];2013年
4 Jianghua Ran;Li Li;Jing Liu;Shengning Zhang;Xibing Zhang;;Variation of expression of T cell subset within acute rejection after liver transplantation in Rhesus Monkey[A];2013中国器官移植大会论文汇编[C];2013年
5 Jun He;Yang Li;Xuedong Wei;Hao Zhen;Jianquan Hou;;Immune function assay(ImmuKnow)as a predictor of allograft rejection and infection in kidney transplantation[A];2013中国器官移植大会论文汇编[C];2013年
6 ;The study of HCMV infection on the pathogenesis of rat chronic liver rejection[A];2012中国器官移植大会论文汇编[C];2012年
7 ;Osteopontin level as a predicted factor in acute cellular renal allograft rejection[A];2012中国器官移植大会论文汇编[C];2012年
8 ;A new candidate as predictor of acute renal allograft rejection:notch receptor-1[A];2012中国器官移植大会论文汇编[C];2012年
9 Kai Zheng;Weizhen Wu;Shunliang Yang;Jinquan Cai;Tingzhao Xu;Jianming Tan;;A new candidate as predictor of acute renal allograft rejection:notch receptor-1[A];2013中国器官移植大会论文汇编[C];2013年
10 ;Detection on Dynamic Changes of Endothelial Cell Specific Molecule-1 in Acute Rejection After Renal Transplantation[A];2012中国器官移植大会论文汇编[C];2012年
中国博士学位论文全文数据库 前1条
1 王思桦;IL-23/IL-17轴在心脏移植排斥反应的免疫学机制研究[D];华中科技大学;2012年
中国知网广告投放
 快捷付款方式  订购知网充值卡  订购热线  帮助中心
  • 400-819-9993
  • 010-62982499
  • 010-62783978