#09#
Revisiones-Ciencias
Básicas (todas) *** Reviews-Basic Sciences
TRASPLANTE
RENAL *** RENAL TRANSPLANTATION
(Conceptos
/ Keywords: Renal-Kidney transplantation; Kidney donation-procurement; etc).
Enero /
January 2001 --- Marzo / March 2004
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Only articles written in Spanish and/or English are included.
[1]
TÍTULO / TITLE: - Interleukin-2 receptor
monoclonal antibodies in renal transplantation: meta-analysis of randomised
trials.
REVISTA
/ JOURNAL: - British Medical J (BMJ). Acceso gratuito
al texto completo.
●●
Enlace a la Editora de la Revista http://bmj.com/search.dtl
●●
Cita: British Medical J. (BMJ): <> 2003 Apr 12;326(7393):789.
●●
Enlace al texto completo (gratuito o de pago) 1136/bmj.326.7393.789
AUTORES
/ AUTHORS: - Adu D; Cockwell P; Ives NJ; Shaw J;
Wheatley K
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology, Queen Elizabeth
Hospital, Birmingham, B15 2TH. dwomoa.adu@uhb.nhs.uk
RESUMEN
/ SUMMARY: - OBJECTIVE: To study the effect of
interleukin-2 receptor monoclonal antibodies on acute rejection episodes, graft
loss, deaths, and rate of infection and malignancy in patients with renal
transplants. DESIGN: Meta-analysis of published data. DATA SOURCES: Medline,
Embase, and Cochrane library for years 1996-2003 plus search of medical
editors’ trial amnesty and contact with manufacturers of the antibodies.
SELECTION OF STUDIES: Randomised controlled trials comparing interleukin-2
receptor antibodies with placebo or no additional treatment in patients with
renal transplants receiving ciclosporin based immunosuppression. RESULTS: Eight
randomised controlled trials involving 1871 patients met the selection criteria
(although only 1858 patients were analysed). Interleukin-2 receptor antibodies
significantly reduced the risk of acute rejection (odds ratio 0.51, 95% confidence
interval 0.42 to 0.63). There were no significant differences in the rate of
graft loss (0.78, 0.58 to 1.04), mortality (0.75, 0.46 to 1.23), overall
incidence of infections (0.97, 0.77 to 1.24), incidence of cytomegalovirus
infections (0.81, 0.62 to 1.04), or risk of malignancies at one year (0.82,
0.39 to 1.70). The different antibodies had a similar sized effect on acute
rejection (test for heterogeneity P=0.7): anti-Tac (0.37, 0.16 to 0.89), BT563
(0.37, 0.1 to 1.38), basiliximab (0.56, 0.44 to 0.72), and daclizumab (0.46,
0.32 to 0.67). The reduction in acute rejections was similar for all
ciclosporin based immunosuppression regimens (test for heterogeneity P=1.0).
CONCLUSIONS: Adding interleukin-2 receptor antibodies to ciclosporin based
immunosuppression reduces episodes of acute rejection at six months by 49%.
There is no evidence of an increased risk of infective complications. Longer
follow up studies are needed to confirm whether interleukin-2 receptor
antibodies improve long term graft and patient survival.
----------------------------------------------------
[2]
TÍTULO / TITLE: - Prognostic value of
myocardial perfusion studies in patients with end-stage renal disease assessed
for kidney or kidney-pancreas transplantation: a meta-analysis.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Feb;14(2):431-9.
AUTORES
/ AUTHORS: - Rabbat CG; Treleaven DJ; Russell JD;
Ludwin D; Cook DJ
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Division of
Nephrology, McMaster University, Hamilton, Ontario, Canada. rabbatc@mcmaster.ca
RESUMEN
/ SUMMARY: - The prognostic utility of myocardial perfusion
studies (MPS) such as thallium scintigraphy and dobutamine stress
echocardiography (DSE) for stratifying cardiac risk among candidates for kidney
or kidney-pancreas transplantation is uncertain. This study is a meta-analysis
to determine the prognostic significance of MPS results on future myocardial
infarction (MI) and cardiac death (CD) in patients with end-stage renal disease
(ESRD) assessed for kidney or kidney-pancreas transplantation. MEDLINE was
searched using combinations of MeSH headings and text words for
transplantation, coronary artery disease, prognosis, end-stage renal disease,
and noninvasive cardiac testing (nuclear scintigraphy and DSE) for primary
studies. Studies were included if they reported MPS results and cardiac events
in patients assessed for kidney or kidney-pancreas transplantation.
Methodologic study quality and outcome data were independently abstracted in
duplicate by two researchers. The relative risks (RR) of MI and CD were
calculated using a random effects model. Twelve articles met all inclusion
criteria; 12 studies reported CD, and 9 reported MI. In eight studies, thallium
scintigraphy was used (four with pharmacologic stress, four with exercise
stress), whereas four used DSE. When compared with negative tests, positive tests
had a significantly increased RR of MI (2.73 [95% CI, 1.25 to 5.97]; P = 0.01)
and CD (2.92 [95% CI, 1.66 to 5.12]; P < 0.001). Subgroup analyses of
studies of diabetic patients indicated that positive tests were associated with
a RR of CD 3.95 (95% CI, 1.48 to 10.5; P = 0.006) and a RR of MI 2.68 (95% CI,
0.95 to 7.57; P = 0.06) when compared with negative tests. In studies
evaluating mixed populations of diabetic and nondiabetic patients, positive
tests were associated with a RR of CD 2.52 (95% CI, 1.25 to 5.08; P = 0.01) and
with a RR of MI 2.79 (95% CI, 0.85 to 9.21; P = 0.09) when compared with a
negative test. The presence of reversible defects was associated with an
increased risk of MI in diabetic patients and of CD in both subgroups; fixed defects
were associated with an increased risk of CD but not MI. It is concluded that
positive MPS are useful in identifying patients with significantly increased
risk of future MI and CD in both diabetic and nondiabetic ESRD patients.
----------------------------------------------------
[3]
TÍTULO / TITLE: - Interleukin 2 receptor
antagonists for renal transplant recipients: a meta-analysis of randomized
trials.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 27;77(2):166-76.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000109643.32659.C4
AUTORES
/ AUTHORS: - Webster AC; Playford EG; Higgins G;
Chapman JR; Craig JC
INSTITUCIÓN
/ INSTITUTION: - Cochrane Renal Group, Centre for Kidney
Research, Children’s Hospital at Westmead, Westmead, NSW, Australia.
RESUMEN
/ SUMMARY: - BACKGROUND: Interleukin 2 receptor
antagonists (IL-2Ra) are increasingly used to treat renal transplant
recipients. This study aims to systematically identify and summarize the
effects of using IL-2Ra as induction immunosuppression, as an addition to
standard therapy, or as an alternative to other antibody therapy. METHODS:
Databases, reference lists, and abstracts of conference proceedings were
searched extensively to identify relevant randomized controlled trials in all
languages. Data were synthesized using the random effects model. Results are
expressed as relative risk (RR), with 95% confidence intervals (CI). RESULTS: A
total of 117 reports from 38 trials involving 4,893 participants were included.
When IL-2Ra were compared with placebo (17 trials; 2,786 patients), graft loss
was not significantly different at 1 year (14 trials: RR 0.84; CI 0.64-1.10) or
3 years (4 trials: RR 1.08; CI 0.71-1.64). Acute rejection was significantly
reduced at 6 months (12 trials: RR 0.66; CI 0.59-0.74) and at 1 year (10
trials: RR 0.67; CI 0.60-0.75). At 1 year, cytomegalovirus infection (7 trials:
RR 0.82; CI 0.65-1.03) and malignancy (9 trials: RR 0.67; CI 0.33-1.36) were
not significantly different. When IL-2Ra were compared with other antibody
therapy, no significant differences in treatment effects were demonstrated, but
IL-2Ra had significantly fewer side effects. CONCLUSIONS: Given a 40% risk of
rejection, seven patients would need treatment with IL-2Ra in addition to
standard therapy, to prevent one patient from undergoing rejection, with no
definite improvement in graft or patient survival. There is no apparent
difference between basiliximab and daclizumab.
----------------------------------------------------
[4]
TÍTULO / TITLE: - A randomized long-term
trial of tacrolimus/sirolimus versus tacrolimus/mycophenolate mofetil versus
cyclosporine (NEORAL)/sirolimus in renal transplantation. II. Survival,
function, and protocol compliance at 1 year.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 27;77(2):252-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000101495.22734.07
AUTORES
/ AUTHORS: - Ciancio G; Burke GW; Gaynor JJ; Mattiazzi
A; Roth D; Kupin W; Nicolas M; Ruiz P; Rosen A; Miller J
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Division of
Transplantation, University of Miami School of Medicine, Miami, FL 33101, USA. gciancio@med.miami.edu
RESUMEN
/ SUMMARY: - BACKGROUND: In an attempt to reduce
chronic calcineurin inhibitor induced allograft nephropathy in first cadaver
and human leukocyte antigen non-identical living-donor renal transplantation,
sirolimus (Siro) or mycophenolate mofetil (MMF) was tested as adjunctive
therapy, with planned dose reductions of tacrolimus (Tacro) over the first year
postoperatively. Adjunctive Siro therapy with a similar dose reduction
algorithm for Neoral (Neo) was included for comparison. METHODS: The detailed
dose reduction plan (Tacro and Siro, group A; Tacro and MMF, group B; Neo and
Siro, group C) is described in our companion report in this issue of
Transplantation. The present report documents function, patient and graft
survival, protocol compliance, and adverse events. RESULTS: As mentioned (in
companion report), group demographics were similar. The present study shows no
significant differences in 1-year patient and graft survival but does show a
trend that points to more difficulties in group C by way of a rising slope of
serum creatinine concentration (P=0.02) and decreasing creatinine clearance
(P=0.04). There were more patients who discontinued the protocol plan in group
C. Thus far, no posttransplant lymphomas have appeared, and infectious
complications have not differed among the groups. However, a greater percentage
of patients in group C were placed on antihyperlipidemia therapy, with an
(unexpected) trend toward a higher incidence of posttransplant diabetes
mellitus in this group. Group A required fewer, and group B the fewest,
antihyperlipidemia therapeutic interventions (P<0.00001). CONCLUSIONS: This
1-year interim analysis of a long-term, prospective, randomized
renal-transplant study indicates that decreasing maintenance dosage of Tacro
with adjunctive Siro or MMF appears to point to improved long-term function,
with reasonably few adverse events.
----------------------------------------------------
[5]
TÍTULO / TITLE: - Routes to allograft
survival.
REVISTA
/ JOURNAL: - J Clin Invest. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.jci.org/
●●
Cita: J Clinical Investigation: <> 2001 Apr;107(7):797-8.
AUTORES
/ AUTHORS: - Bromberg JS; Murphy B
INSTITUCIÓN
/ INSTITUTION: - Recanati/Miller Transplant Institute,
Mount Sinai School of Medicine, New York, New York 10029, USA. jon.bromberg@mountsinai.org N. Ref:: 21
----------------------------------------------------
[6]
TÍTULO / TITLE: - A meta-analysis from
the Cochrane Library reviewing interleukin 2 receptor antagonists in renal
transplantation.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 27;77(2):165.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000112919.54256.8D
AUTORES
/ AUTHORS: - Morris PJ; Monaco AP
----------------------------------------------------
[7]
TÍTULO / TITLE: - Treatment of hepatitis
B in special patient groups: hemodialysis, heart and renal transplant,
fulminant hepatitis, hepatitis B virus reactivation.
REVISTA
/ JOURNAL: - J Hepatol 2003;39 Suppl 1:S206-11.
AUTORES
/ AUTHORS: - Tillmann HL; Wedemeyer H; Manns MP
INSTITUCIÓN
/ INSTITUTION: - Department of Gastroenterology, Hepatology
and Endocrinology, Medizinische Hochschule Hannover, Carl-Neuberg-Strassel,
30623 Hannover, Germany. N.
Ref:: 81
----------------------------------------------------
[8]
TÍTULO / TITLE: - 4D imaging to assay
complex dynamics in live specimens.
REVISTA
/ JOURNAL: - Nat Cell Biol 2003 Sep;Suppl:S14-9.
AUTORES
/ AUTHORS: - Gerlich D; Ellenberg J
INSTITUCIÓN
/ INSTITUTION: - Gene Expression and Cell Biology/Biophysics
Programmes, European Molecular Biology Laboratory, Heidelberg, Germany.
RESUMEN
/ SUMMARY: - A full understanding of cellular dynamics
is often difficult to obtain from time-lapse microscopy of single optical
sections. New microscopes and image-processing software are now making it
possible to rapidly record three-dimensional images over time. This
four-dimensional imaging allows precise quantitative analysis and enhances
visual exploration of data by allowing cellular structures to be interactively displayed
from many angles. It has become a key tool for understanding the complex
organization of biological processes in live specimens. N. Ref:: 55
----------------------------------------------------
[9]
TÍTULO / TITLE: - Pretransplant blood
transfusions revisited: a role for CD(4+) regulatory T cells?
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S26-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106469.12073.01
AUTORES
/ AUTHORS: - Roelen D; Brand A; Claas FH
INSTITUCIÓN
/ INSTITUTION: - Department of Immunohematology and
Bloodtransfusion, Leiden University Medical Center, Leiden, The Netherlands. d.l.roelen@lumc.nl.
RESUMEN
/ SUMMARY: - Pretransplant blood transfusions have been
shown to improve organ allograft survival. However, the immunologic mechanism
leading to this beneficial effect of blood transfusions is still unknown. The
observation that transfusions sharing at least one HLA-DR antigen (human
leukocyte antigen) with the recipient are more effective than HLA-mismatched
transfusions has led to the hypothesis that CD(4+) regulatory T cells are
induced that recognize allopeptides of the blood transfusion donor in the
context of the self-HLA-DR molecule on the donor cells. In vitro studies showed
that CD(4+) T cells recognizing an allopeptide in the context of self-HLA-DR
are indeed able to decrease the alloimmune response of autologous T cells by affecting
the activated T cells directly or indirectly by their modulatory effect on
dendritic cells. The first studies in a patient with a well-functioning kidney
graft after receiving an HLA-DR-matched pretransplant blood transfusion showed
that the low organ donor-specific cytotoxic T-lymphocyte response after
transplantation was indeed attributable to the activity of regulatory CD(4+) T
cells. N. Ref:: 24
----------------------------------------------------
[10]
TÍTULO / TITLE: - Dendritic cells and the
mode of action of anticalcineurinic drugs: an integrating hypothesis.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2003 Mar;18(3):467-8;
discussion 469-70.
AUTORES
/ AUTHORS: - Fierro A; Mora JR; Bono MR; Morales J;
Buckel E; Sauma D; Rosemblatt M
INSTITUCIÓN
/ INSTITUTION: - Clinica las Condes, Transplantation Unit,
Santiago, Chile. afierro@vtr.net N. Ref:: 16
----------------------------------------------------
[11]
TÍTULO / TITLE: - Renal transplantation:
can we reduce calcineurin inhibitor/stop steroids? Evidence based on protocol
biopsy findings.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Mar;14(3):755-66.
AUTORES
/ AUTHORS: - Gotti E; Perico N; Perna A; Gaspari F;
Cattaneo D; Caruso R; Ferrari S; Stucchi N; Marchetti G; Abbate M; Remuzzi G
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine and
Transplantation, Ospedali Riuniti di Bergamo, Mario Negri Institute for
Pharmacological Research, Italy.
RESUMEN
/ SUMMARY: - How to combine antirejection drugs and
which is the optimal dose of steroids and calcineurin inhibitors beyond the
first year after kidney transplantation to maintain adequate immunosuppression
without major side effects are far from clear. Kidney transplant patients on
steroid, cyclosporine (CsA), and azathioprine were randomized to per-protocol
biopsy (n = 30) or no-biopsy (n = 29) 1 to 2 yr posttransplant. Steroid or CsA
were discontinued or reduced on the basis of biopsy to establish effects on
drug-related complications, acute rejection, and graft function over 3 yr of
follow-up. Serum creatinine, GFR (plasma clearance of iohexol), RPF (renal
clearance of p-aminohippurate), CsA pharmacokinetics, and adverse events were
monitored yearly. At the end, patients underwent a second biopsy. Per-protocol
biopsy histology revealed no lesions (n = 5, steroid withdrawal), CsA
nephropathy (n = 13, CsA discontinuation/reduction), or chronic rejection (n =
12, standard therapy). Reducing the drug regimen led to overall fewer side
effects related to immunosuppression as compared with standard therapy or
no-biopsy. Steroids were safely stopped with no acute rejection or graft loss.
Complete CsA discontinuation was associated with acute rejection in the first
four patients. Lowering CsA to low target CsA trough (30 to 70 ng/ml) never led
to acute rejection or major renal function deterioration. Biopsy patients on
conventional regimen had no acute rejection, one graft loss, no significant
change in GFR, and significant RPF decline. No-biopsy controls: no acute
rejection, one graft loss, significant decline of GFR and RPF. By serial biopsy
analysis, severe lesions did not develop in patients with steroid
discontinuation in contrast to patients on standard therapy over follow-up. CsA
reduction did not adversely affect histology. Per-protocol biopsy more than 1
yr after kidney transplantation is a safe procedure to guide change of drug
regimen and to lower the risk of major side effects.
----------------------------------------------------
[12]
TÍTULO / TITLE: - Regulatory T cells in
kidney transplant recipients: active players but to what extent?
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Jun;14(6):1706-8.
AUTORES
/ AUTHORS: - Zhai Y; Kupiec-Weglinski JW N. Ref:: 20
----------------------------------------------------
[13]
TÍTULO / TITLE: - Interleukin 2 receptor
antagonists for kidney transplant recipients.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2004;1:CD003897.
●●
Enlace al texto completo (gratuito o de pago) 1002/14651858.CD003897.pub2
AUTORES
/ AUTHORS: - Webster A; Playford E; Higgins G; Chapman
J; Craig J
INSTITUCIÓN
/ INSTITUTION: - Centre for Kidney Research, The Children’s
Hospital at Westmead, Locked Bag 4001, Westmead, NSW, AUSTRALIA, 2145.
RESUMEN
/ SUMMARY: - BACKGROUND: Interleukin 2 receptor
antagonists (IL2Ra) are used as induction therapy for prophylaxis against acute
rejection in kidney transplant recipients. Use of IL2Ra has increased steadily,
with 38% of new kidney transplant recipients in the United States, and 23% in
Australasia receiving IL2Ra in 2002. OBJECTIVES: This study aims to
systematically identify and summarise the effects of using an IL2Ra, as an
addition to standard therapy, or as an alternative to other antibody therapy.
SEARCH STRATEGY: The Cochrane Renal Group’s specialised register (June 2003),
the Cochrane Controlled Trials Register (in The Cochrane Library issue 3,
2002), MEDLINE (1966-November 2002) and EMBASE (1980-November 2002). Reference
lists and abstracts of conference proceedings and scientific meetings were
hand-searched from 1998-2003. Trial groups, authors of included reports and
drug manufacturers were contacted. SELECTION CRITERIA: Randomised controlled
trials (RCTs) in all languages comparing IL2Ra to placebo, no treatment, other
IL2Ra or other antibody therapy. DATA COLLECTION AND ANALYSIS: Data was
extracted and quality assessed independently by two reviewers, with differences
resolved by discussion. Dichotomous outcomes are reported as relative risk (RR)
with 95% confidence intervals (CI). MAIN RESULTS: One hundred and seventeen
reports from 38 trials involving 4893 participants were included. Where IL2Ra
were compared with placebo (17 trials; 2786 patients), graft loss was not
significantly different at one (RR 0.83, 95% CI 0.66 to 1.04) or three years
(RR 0.88, 95% CI 0.64 to 1.22). Acute rejection (AR) was significantly reduced
at six months (RR 0.66, 95% CI 0.59 to 0.74) and at one year (RR 0.67, 95% CI
0.60 to 0.75). At one year, cytomegalovirus (CMV) infection (RR 0.82, 95% CI
0.65 to 1.03) and malignancy (RR 0.67, 95% CI 0.33 to 1.36) were not
significantly different. Where IL2Ra were compared with other antibody therapy
no significant differences in treatment effects were demonstrated, but adverse
effects strongly favoured IL2Ra. REVIEWER’S CONCLUSIONS: Given a 40% risk of
rejection, seven patients would need treatment with IL2Ra to prevent one
patient having rejection, with no definite improvement in graft or patient
survival. There is no apparent difference between basiliximab and daclizumab.
IL2Ra are as effective as other antibody therapies and with significantly fewer
side effects
----------------------------------------------------
[14]
TÍTULO / TITLE: - Potential role of major
histocompatibility complex class II peptides in regulatory tolerance to
vascularized grafts.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S35-7.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106472.91343.8D
AUTORES
/ AUTHORS: - LeGuern C
INSTITUCIÓN
/ INSTITUTION: - Transplantation Biology Research Center,
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA. leguern@helix.mgh.harvard.edu
RESUMEN
/ SUMMARY: - The inactivation of persisting T
lymphocytes reactive to self- and non-self-antigens is a major arm of
operational immune tolerance in mammals. Silencing of such T cells proceeds
mostly by means of suppression, a process that is mediated by regulatory T-cell
subsets and especially by CD4(+)CD(25high) regulatory T cells (Treg). Although
Treg activation and ensuing suppressive activity appear to be major
histocompatibility complex class II dependent, the fine specificity of Treg
T-cell receptors has not yet been elucidated. Recent data from the author’s
laboratory on a class II gene therapy induction of tolerance to allogeneic
kidney grafts suggest that class II peptides are involved as generic signals
for Treg activation. A brief compilation of results that would support this
hypothesis is discussed in the present article. N. Ref:: 31
----------------------------------------------------
[15]
TÍTULO / TITLE: - Transcriptional
regulation of inflammatory genes before transplantation: a role for hypoxia
inducible factor-1alpha?
REVISTA
/ JOURNAL: - Transplantation 2003 Feb 27;75(4):437-8.
AUTORES
/ AUTHORS: - Koo DD; Fuggle SV
INSTITUCIÓN
/ INSTITUTION: - Nuffield Department of Surgery, University
of Oxford, Oxford Transplant Centre, United Kingdom. N. Ref:: 5
----------------------------------------------------
[16]
TÍTULO / TITLE: - Subcutaneous black
fungus (phaeohyphomycosis) infection in renal transplant recipients:three
cases.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1):140-2.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000107287.70512.E7
AUTORES
/ AUTHORS: - Yehia M; Thomas M; Pilmore H; Van Der
Merwe W; Dittmer I
INSTITUCIÓN
/ INSTITUTION: - Auckland Renal Transplant Group, Auckland
Hospital, Auckland, New Zealand. mahay@adhb.govt.nz
RESUMEN
/ SUMMARY: - We describe three cases of subcutaneous
phaeohyphomycosis developing in the lower limbs of renal transplant recipients
shortly after transplantation. Each case presented with dark-colored nodules
that subsequently ulcerated. Histopathologic examination revealed dematiaceous
fungal hyphae with a surrounding granulomatous reaction. The fungi were
subsequently identified as Alternaria alternatum in two cases and Phialophora
richardsiae in one case. In one case, the lesions resolved during a prolonged
(6-month) course of itraconazole without the requirement for surgical excision.
In the other two cases, combined medical and surgical treatment resulted in
cure. A review of the literature on phaeohyphomycosis is presented. N. Ref:: 11
----------------------------------------------------
[17]
TÍTULO / TITLE: - Complement and the
kidney.
REVISTA
/ JOURNAL: - J Immunol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jimmunol.org/
●●
Cita: J. of Immunology: <> 2003 Oct 1;171(7):3319-24.
AUTORES
/ AUTHORS: - Quigg RJ
INSTITUCIÓN
/ INSTITUTION: - Section of Nephrology, University of
Chicago, Chicago, IL 60637, USA. rqigg@medicine.uchicago.edu N. Ref:: 94
----------------------------------------------------
[18]
TÍTULO / TITLE: - The economic value of
valacyclovir prophylaxis in transplantation.
REVISTA
/ JOURNAL: - J Infect Dis. Acceso gratuito al texto
completo a partir de los 2 años de la publicación; - http://www.journals.uchicago.edu/
●●
Cita: J. of Infectious Diseases: <> 2002 Oct 15;186 Suppl 1:S116-22.
AUTORES
/ AUTHORS: - Squifflet JP; Legendre C
INSTITUCIÓN
/ INSTITUTION: - University Clinic Saint Luc, 1200
Brussels, Belgium. Jean-Paul.Squifflet@chir.ucl.ac.be
RESUMEN
/ SUMMARY: - Cytomegalovirus (CMV) infection and
disease, with its extensive direct and indirect consequences, adds considerably
to the cost of patient management in both solid organ and bone marrow transplantation.
Antiviral prophylaxis for CMV infection can offer cost advantages over
preemptive therapy and “wait-and-treat” approaches. Valacyclovir has
demonstrated efficacy for CMV prophylaxis in renal, heart, and bone marrow
transplantation and is cost-effective when compared with placebo in renal
transplant recipients at high risk of CMV infection. In reducing CMV infection
and disease, valacyclovir prophylaxis appears to be associated with reductions
in indirect effects of CMV (acute graft rejection, other opportunistic
infections) and, if these effects are considered, the potential exists for even
greater savings to be made with valacyclovir therapy. Benefits of valacyclovir
in transplantation extend beyond CMV to other herpesviruses and may be increased
in some clinical situations by prolonging prophylaxis beyond 3 months. N. Ref:: 32
----------------------------------------------------
[19]
TÍTULO / TITLE: - Renal function as a
predictor of long-term graft survival in renal transplant patients.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2003 May;18 Suppl 1:i3-6.
AUTORES
/ AUTHORS: - First MR
INSTITUCIÓN
/ INSTITUTION: - Research and Development, Fujisawa
Healthcare, Inc., Deerfield, IL 60015, USA. roy_first@fujisawa.com
RESUMEN
/ SUMMARY: - Acute rejection is a major risk factor for
kidney graft failure. However, as acute rejection has been progressively
reduced by recent immunosuppressive regimens, other risk factors are becoming
increasingly important. Evidence is accumulating that early renal function
predicts long-term outcome. A recent registry survey of more than 100 000 kidney
transplants found that 6- and 12-month serum creatinine levels, as well as the
change between 6 and 12 months, are strongly associated with long-term graft
survival. A survey of paediatric renal transplant recipients showed that poor
creatinine clearance (<50 ml/min) as early as 30 days post-transplant
predicted an annual rate of graft loss of 13% compared with <3% in patients
with 30-day clearance >50 ml/min. This association between early renal
function and long-term outcome was confirmed in multicentre studies. Renal
transplant recipients (n=572) with 6-month serum creatinine levels >1.5
mg/dl suffered 3-year graft loss of 19.3% compared with only 8.5% in patients
with levels <1.6 mg/dl (P<0.001). Significantly fewer patients receiving
tacrolimus had 12-month serum creatinine levels >1.5 mg/dl compared with
cyclosporin (42 versus 54%, P<0.05). Interestingly, a single-centre study
(n=436) found that while glomerular filtration rate (GFR) at 6 months
post-transplant had remained stable over the last decade, the rate of loss of
renal function had decreased. A lower rate of GFR loss was associated with
absence of rejection, use of mycophenolate mofetil rather than azathioprine and
use of tacrolimus rather than cyclosporin (P<0.01). In conclusion, early measures
of renal function allow identification of those patients at highest risk of
graft failure and provide an invaluable tool for improving outcomes by tailored
immunosuppression. The choice of such immunosuppression should be guided not
only by its ability to prevent rejection, but also by its impact on renal
function. N. Ref:: 11
----------------------------------------------------
[20]
TÍTULO / TITLE: - Postmenopausal
tubo-ovarian abscess due to Pseudomonas aeruginosa in a renal transplant
patient: a case report and review of the literature.
REVISTA
/ JOURNAL: - Transplantation 2001 Oct 15;72(7):1241-4.
AUTORES
/ AUTHORS: - El Khoury J; Stikkelbroeck MM; Goodman A;
Rubin RH; Cosimi AB; Fishman JA
INSTITUCIÓN
/ INSTITUTION: - Infectious Disease Division, GRJ 504,
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
RESUMEN
/ SUMMARY: - BACKGROUND: Pseudomonas aeruginosa is an
uncommon cause of infection in the female genital tract. We report a case of
postmenopausal tubo-ovarian abscess (TOA) due to P. aeruginosa in a renal
transplant recipient. The presentation included mild abdominal symptoms with
rapid progression of peritonitis and surgical abscess drainage. This is the
first such case in an organ transplant recipient described in the English
literature. METHODS AND RESULTS: Published reports of 1040 cases of TOA were
reviewed. The most common features were a history of sexually transmitted
disease or pelvic inflammatory disease, and symptoms including abdominal pain
and fever. Escherichia coli, Bacteroides spp., and Klebsiella pneumoniae were
the most frequently encountered pathogens. Neisseria gonorrhoeae and Chlamydia
trachomatis, which are frequently isolated from cervical cultures, are
uncommonly isolated from tubo-ovarian abscesses. Forty percent of patients were
treated with antibiotics alone, 18.8% with abdominal surgery, and 32% with
surgery and antimicrobial therapy. CONCLUSION: This report illustrates the
muted presentation and atypical microbiology of gynecologic infection in an
organ transplant recipient. N.
Ref:: 59
----------------------------------------------------
[21]
- Castellano -
TÍTULO / TITLE:Polimorfismo del receptor de la
vitamina D y enfermedad osea postrasplante renal. Polymorphism of the vitamin D
receptor and bone disease after renal transplantation.
REVISTA
/ JOURNAL: - Nefrologia. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/
●●
Cita: Nefrologia: <> 2001;21 Suppl 1:56-60.
AUTORES
/ AUTHORS: - Torres A; Barrios Y; Salido E
INSTITUCIÓN
/ INSTITUTION: - Servicio de Nefrologia y, Hospital
Universitario de Canarias, Instituto Reina Sofia de Investigacion Nefrologica,
Tenerife, España. atorres@ull.es N. Ref:: 29
----------------------------------------------------
[22]
TÍTULO / TITLE: - Ambulatory blood
pressure measurement in kidney transplantation: an overview.
REVISTA
/ JOURNAL: - Transplantation 2003 Dec 15;76(11):1643-4.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000091289.03300.1A
AUTORES
/ AUTHORS: - Tomson CR
INSTITUCIÓN
/ INSTITUTION: - Department of Renal Medicine, Southmead
Hospital, Bristol, UK. charlie.tomson@north-bristol.swest.nhs.uk
RESUMEN
/ SUMMARY: - Adequate control of hypertension is among
the most important aims of medical management of the kidney transplant
recipient, with the aim of reducing the risk of premature cardiovascular
disease and preserving graft function. Antihypertensive therapy should be
adjusted according to the best available estimates of usual resting blood
pressure. If clinic measurements are used, care should be taken to ensure that
these measurements are taken under optimal conditions. Home blood pressure
monitoring is a useful adjunct in many patients. Ambulatory blood pressure
monitoring gives valuable additional data; mean ambulatory blood pressure
correlates better with markers of target organ damage such as left ventricular
hypertrophy. However, current treatment thresholds and targets are based on
clinic measurements. Ambulatory blood pressure monitoring is certainly a useful
adjunct to clinic and home blood pressure measurement, but its role in routine
clinical practice in the transplant clinic remains to be defined. N. Ref:: 11
----------------------------------------------------
[23]
TÍTULO / TITLE: - European best practice guidelines
for renal transplantation. Section IV: Long-term management of the transplant
recipient. IV.3.2. Long-term immunosuppression. Therapy conversion.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002;17 Suppl 4:20-1.
RESUMEN
/ SUMMARY: - GUIDELINE: Conversion of immunosuppressive
drug therapy is recommended to avoid or reduce drug-specific adverse effects,
and is generally safe for long-term graft outcome.
----------------------------------------------------
[24]
TÍTULO / TITLE: - Disseminated ochroconis
gallopavum infection in a renal transplant recipient: the first reported case
and a review of the literature.
REVISTA
/ JOURNAL: - Clin Nephrol 2003 Dec;60(6):415-23.
AUTORES
/ AUTHORS: - Wang TK; Chiu W; Chim S; Chan TM; Wong SS;
Ho PL
INSTITUCIÓN
/ INSTITUTION: - Centre of Infection, Department of
Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR,
China.
RESUMEN
/ SUMMARY: - Ochroconis gallopavum is a potentially
fatal dematiaceous fungus causing opportunistic infections in immunocompromised
hosts. We report the first case of disseminated O. gallopavum infection in a
13-year-old renal transplant recipient, which involved the brain, lung and
spleen. He was treated with amphotericin B, itraconazole and voriconazole, a
new antifungal agent first used to treat such an infection. Besides antifungal
treatment, all immunosuppressive agents were stopped and automated peritoneal
dialysis was resumed. The initial infection was under control with both
clinical and radiological improvements after treatment. However, the patient
later acquired Acremonium spp. peritonitis; he failed to respond to high-dose
amphotericin B, and finally succumbed. A total of 13 reported O. gallopavum
human infections, including the one described here, are reviewed. The most
common site of involvement is the brain and the crude mortality rate is up to
46%. As the disease is potentially lethal in immunocompromised hosts, empirical
antifungal coverage should be considered in post-renal transplant recipients
with suspected brain abscess. Early biopsy of lesion for histopathological and
microbiological diagnosis would be essential in managing such cases. N. Ref:: 23
----------------------------------------------------
[25]
- Castellano -
TÍTULO / TITLE:La influencia de los factores
geneticos en la patogenesis de dislipidemias posteriores al trasplante renal.
The effect of genetic factors on the pathogenesis of the dyslipidemias
following kidney transplantation.
REVISTA
/ JOURNAL: - Rev Invest Clin. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.imbiomed.com/
●●
Cita: Revista de Investigacion Clinica: <> 2002 Sep-Oct;54(5):472-3.
AUTORES
/ AUTHORS: - Lerman Garber I
INSTITUCIÓN
/ INSTITUTION: - Departamento de Endocrinologia y
Metabolismo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador
Zubiran. lerman@netservice.com.mx N. Ref:: 11
----------------------------------------------------
[26]
TÍTULO / TITLE: - A benefit-risk
assessment of basiliximab in renal transplantation.
REVISTA
/ JOURNAL: - Drug Saf. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.csmwm.org/
●●
Cita: Drug Safety: <> 2004;27(2):91-106.
AUTORES
/ AUTHORS: - Boggi U; Danesi R; Vistoli F; Del Chiaro
M; Signori S; Marchetti P; Del Tacca M; Mosca F
INSTITUCIÓN
/ INSTITUTION: - Division of General Surgery and
Transplants, Department of Oncology, Transplants and Advanced Technologies in
Medicine, University of Pisa, Pisa, Italy. uboggi@med.unipi.it
RESUMEN
/ SUMMARY: - Interleukin-2 (IL-2) and its receptor
(IL-2R) play a central role in T lymphocyte activation and immune response
after transplantation. Research on the biology of IL-2R allowed the
identification of key signal transduction pathways involved in the generation
of proliferative and antiapoptotic signals in T cells. The alpha-chain of the
IL-2R is a specific peptide against which monoclonal antibodies have been
raised, with the aim of blunting the immune response by means of inhibiting
proliferation and inducing apoptosis in primed lymphocytes. Indeed,
basiliximab, one of such antibodies, has proved to be effective in reducing the
episodes of acute rejection after kidney and pancreas transplantation. The use
of basiliximab was associated with a significant reduction in the incidence of
any treated rejection episodes after kidney transplantation in the two major
randomised studies (placebo 52.2% vs basiliximab 34.2% at 6 months, European
study; placebo 54.9% vs basiliximab 37.6% at 1 year, US trial). Basiliximab and
equine antithymocyte globulin (ATG) administration resulted in a similar rate
of biopsy-proven acute rejection at 6 months (19% for both) and at 12 months
(19% and 20%, respectively). The use of basiliximab appears not to be
associated with an increased incidence of adverse events as compared with
placebo in immunosuppressive regimens, including calcineurin inhibitors,
mycophenolate mofetil or azathioprine and corticosteroids, and its safety
profile is superior to ATG. Moreover, a similar occurrence of infections is
noted in selected studies (65.5% after basiliximab vs 65.7% of controls),
including cytomegalovirus infection (17.3% vs 14.5%), and cytokine-release
syndrome is not observed. Finally, economic analysis demonstrated lower costs of
overall treatment in patients treated with basiliximab. Therefore, the use of
basiliximab entails a very low risk, allows safe reduction of corticosteroid
dosage and reduces the short- and mid-term rejection rates. However, the
improvement in the long-term survival of kidney grafts in patients treated
according to modern immunosuppressive protocols is still to be demonstrated.
These conclusions are based on a systematic review of the scientific
literature, indexed on Medline database, concerning the mechanism of action,
therapeutic activity, safety and pharmacoeconomic evaluation of basiliximab in
renal transplantation. N.
Ref:: 62
----------------------------------------------------
[27]
TÍTULO / TITLE: - Updated protocol for
the examination of specimens from patients with carcinoma of the urinary
bladder, ureter, and renal pelvis.
REVISTA
/ JOURNAL: - Arch Pathol Lab Med. Acceso gratuito al
texto completo.
●●
Enlace a la Editora de la Revista http://arpa.allenpress.com/
●●
Cita: Archives of Pathology & Laboratory Medicine: <> 2003
Oct;127(10):1263-79.
AUTORES
/ AUTHORS: - Amin MB; Srigley JR; Grignon DJ; Reuter
VE; Humphrey PA; Cohen MB; Hammond ME
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology, Emory University
Hospital, Atlanta, Ga, USA.
----------------------------------------------------
[28]
TÍTULO / TITLE: - Renal transplantation
in HBsAg+ patients: is lamivudine your “final answer”?
REVISTA
/ JOURNAL: - J Clin Gastroenterol 2003 Jul;37(1):9-11.
AUTORES
/ AUTHORS: - Fontana RJ N. Ref:: 30
----------------------------------------------------
[29]
- Castellano -
TÍTULO / TITLE:Aneurisma disecante de la arteria
renal en paciente trasplantado. Presentacion de un caso. Revision de la
literatura. Dissecting aneurysm of the renal artery in patient with
transplantation. Report of a case. Review of the literature.
REVISTA
/ JOURNAL: - Arch Esp Urol 2003 Nov;56(9):1059-62.
AUTORES
/ AUTHORS: - Canovas Ivorra J; Guardiola Mas A; Nicolas
Torralba JA; Jimeno Garcia L; Llorente Vinas S; Garcia Hernandez JA; Polo Perez
J; Banon Perez V