The impact of cytomegalovirus infection ≥1 year after primary renal transplantation

This paper is part of an ongoing study of the psychiatric aspects of renal transplantation at Notre-Dame Hospital in Montreal, and deals specifically with the clinical significance of the patient's fantasies concerning the acquisition of a kidney. Fantasy material concerning the issues of life and death, the fantasies linking the acquired organ to libidinal drives and those concerning the impact of transplantation upon body image are examined. Patients defend against anxieties concerning living and dying by denial. Fantasies are described which suggest that transplantation is experienced on the genital level as a rephallicisation of doubtful outcome, following the castrative effect of the illness and hemodialysis. It was confirmed also that the archaic mental representation of the kidney was far more encompassing than that of a mere excretory organ, and thus the vicissitudes of the process of acceptance of the grafted body part appear as very complex phenomena which can have a bearing on clinical outcome.

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The impact of renal transplantation on survival in hepatitis C-positive end-stage renal disease patients

American Journal of Kidney Diseases ◽

10.1016/s0272-6386(97)90345-0 ◽

1997 ◽

Vol 29 (4) ◽

pp. 608-614 ◽

Cited By ~ 141

Author(s):

Greg A. Knoll ◽

Martha R. Tankersley ◽

Jeannette Y. Lee ◽

Bruce A. Julian ◽

John J. Curtis

Keyword(s):

Renal Transplantation ◽

Hepatitis C ◽

Renal Disease ◽

End Stage Renal Disease ◽

Stage Renal Disease ◽

End Stage ◽

The Impact

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P1652IMPACT OF HEPATITIS C VIRUS AND DIRECT ACTING ANTIVIRALS ON JAPANESE RENAL ALLOGRAFT RECIPIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1652 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Kazuaki Okino ◽

Keita Yamazaki ◽

Keiichiro Okada ◽

Keiji Fujimoto ◽

HIROKI ADACHI ◽

...

Keyword(s):

Renal Transplantation ◽

Renal Allograft ◽

Patient Survival ◽

Hcv Infection ◽

Hcv Rna ◽

Direct Acting Antivirals ◽

Group A ◽

Group B ◽

Direct Acting ◽

The Impact

Abstract Background and Aims The impact of hepatitis C virus (HCV) infection on patient survival after renal transplantation was worse. Previously, we found that continuous HCV infection was a significant independent risk factor for actuarial survival (especially at ≥20 years after the transplant procedure) among Japanese renal allograft recipients. This study evaluates the impact of HCV and of the new direct acting antivirals (DAAs) on patient outcomes in renal allograft recipients. Method We studied 46 cases (28 males, 18 females; 37 living-donor cases, 9 deceased-donor cases; mean follow-up period 305 months ranging from 2 to 420 months) out of the 315 renal transplanted patients who underwent the first renal transplantation in Kanazawa Medical University since 1974. They had antibodies against HCV: 11 were positive for HCV RNA and received DAAs (Group A, all of them genotype 1b); 27 were HCV RNA positive and did not receive any treatment (Group B); 8 were negative for HCV RNA (Group C) (Fig.1). Results All Group A patients had HCV RNA negativity after 2-12 weeks of treatment started, and 11 (100%) achieved a sustained virological response (SVR) at 24 weeks. All of them had no adverse effects by the use of DAAs. In this cohort, no patients in Group A died. On the other hand, 15 (55.5％) of 27 in Group B and 3 (37.5%) of 8 in Group C died. Causes of death among Group B were liver cirrhosis (5 cases), hepatocellular carcinoma (2 case), infections complicated with chronic hepatitis (6 cases) in chronic phase, fibrosing cholestatic hepatitis due to HCV (1 case) after surgery, and cardiovascular disease (1 case). The patient survival rate was significantly higher in Group A patients who received DAAs by Kaplan- Meier life table method (Log Rank test, Kay-square 11.7, p=0.004) (Fig.2). Conclusion Our results support the notion that continuous HCV infection was a harmful and that new DAAs were efficient and safe to treat HCV infection after renal transplantation.

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Donor genetic variants in interleukin-6 and interleukin-6 receptor associate with biopsy-proven rejection following kidney transplantation.

10.1101/2021.04.17.21255669 ◽

2021 ◽

Author(s):

Felix Poppelaars ◽

Mariana Gaya da Costa ◽

Siawosh K. Eskandari ◽

Jeffrey Damman ◽

Marc A. Seelen

Keyword(s):

Kidney Transplantation ◽

Renal Transplantation ◽

Renal Transplant ◽

Interleukin 6 ◽

Medical Center ◽

Organ Donors ◽

Nucleotide Polymorphisms ◽

Increased Risk ◽

Major Player ◽

The Impact

Rejection after kidney transplantation remains an important cause of allograft failure that markedly impacts morbidity. Cytokines are a major player in rejection, and we, therefore, explored the impact of interleukin-6 (IL6) and IL-6 receptor (IL6R) gene polymorphisms on the occurrence of rejection after renal transplantation. We performed an observational cohort study analyzing both donor and recipient DNA in 1,271 renal transplant-pairs from the University Medical Center Groningen in The Netherlands and associated single nucleotide polymorphisms (SNPs) with biopsy-proven rejection after kidney transplantation. The C-allele of the IL6R SNP (Asp358Ala: rs2228145 A>C, formerly rs8192284) in donor kidneys conferred a reduced risk of rejection following renal transplantation (HR 0.78 per C-allele; 95%-CI 0.67-0.90; P=0.001). On the other hand, the C-allele of the IL6 SNP (at position-174 in the promoter; rs1800795 G>C) in donor kidneys was associated with an increased risk of rejection for male organ donors (HR per C-allele 1.31; 95%-CI 1.08-1.58; P=0.0006), but not female organ donors (P=0.33). In contrast, neither the IL6 nor IL6R SNP in the recipient showed an association with renal transplant rejection. In conclusion, donor IL6 and IL6R genotypes but not recipient genotypes represent an independent prognostic marker for biopsy-proven renal allograft rejection.

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