scholarly journals Graft failure of IgA nephropathy in renal allografts following living transplantation: predictive factor analysis of 102 biopsies

2019 ◽  
Author(s):  
Jin Zhang ◽  
Guo-dong Chen ◽  
Jiang Qiu ◽  
Guo-chang Liu ◽  
Li-zhong Chen ◽  
...  

Abstract Background To investigate predictive factors related to graft failure of IgA nephropathy(IgAN) in renal allografts following living transplantation. Methods We identified a series of 102 biopsies diagnosed as IgAN in renal allografts following living transplantation from July 2004 to January 2017 at our center, and assess the predict value of the Lee's classification and the 2009 Oxford classification in IgAN in renal allografts, clinical, ultrasonic and pathological characteristics at biopsy and the outcomes were retrospectively analyzed. Results The 5-year graft cumulative survival rate after transplantation was 91.4%. The 4-year graft cumulative survival rate after biopsy diagnosis of IgAN in renal allografts was 59.6%. The mean time ± SD to disease was 4.7 ± 3.5 years. The color doppler ultrasound and blood flow imagine showed the echo enhancement, the reduced blood flow distribution, the reduced peak systolic velocity of main renal artery, and the increased resistance index of arcuate renal artery were valuable in evaluating the graft dysfunction. The Cox multivariate analysis revealed that the 24-h urinary protein level (HR 1.6 for 1-g increase, 95%CI 1.2-2.0), estimated glomerular filtration rate (eGFR) (HR 1.0 for 1-mL/min/1.73m^2 decline, 95%CI 1.0-1.1), and mesangial C1q deposition (HR 3.0, 95%CI 1.2-7.4) at biopsy were independent predictive factors of graft failure of IgAN in renal allografts. Conclusions IgAN in renal allografts occurred frequently within 5 years after transplantation. The risk of graft failure should be taken seriously in patients who exhibit heavy proteinuria and/or a declined eGFR as the initial symptoms; a high lesion grade (grade IV-V of Lee’s classification) and/or mesangial C1q deposition may also indicated a poor outcome.

2019 ◽  
Author(s):  
Jin Zhang ◽  
Guo-dong Chen ◽  
Jiang Qiu ◽  
Guo-chang Liu ◽  
Li-zhong Chen ◽  
...  

Abstract Background To investigate predictive factors related to graft failure of IgA nephropathy(IgAN) in renal allografts following living donor transplantation. Methods We identified a series of 102 biopsies diagnosed as IgAN in renal allografts following living donor transplantation from July 2004 to January 2017 at our center, and assess the predict value of the Lee's classification and the 2009 Oxford classification in IgAN in renal allografts, clinical, ultrasonic and pathological characteristics at biopsy and the outcomes were retrospectively analyzed. Results The 5-year graft cumulative survival rate after transplantation was 91.4%. The 4-year graft cumulative survival rate after biopsy diagnosis of IgAN in renal allografts was 59.6%. The mean time ± SD to disease was 4.7 ± 3.5 years. The color doppler ultrasound and blood flow imagine showed the echo enhancement, the reduced blood flow distribution, the reduced peak systolic velocity of main renal artery, and the increased resistance index of arcuate renal artery were valuable in evaluating the graft dysfunction. The Cox multivariate analysis revealed that the 24-h urinary protein level (HR 1.6 for 1-g increase, 95%CI 1.2-2.0), estimated glomerular filtration rate (eGFR) (HR 1.0 for 1-mL/min/1.73m^2 decline, 95%CI 1.0-1.1), and mesangial C1q deposition (HR 3.0, 95%CI 1.2-7.4) at biopsy were independent predictive factors of graft failure of IgAN in renal allografts. Conclusions IgAN in renal allografts occurred frequently within 5 years after transplantation. The risk of graft failure should be taken seriously in patients who exhibit heavy proteinuria and/or a declined eGFR as the initial symptoms; a high lesion grade (grade IV-V of Lee’s classification) and/or mesangial C1q deposition may also indicated a poor outcome.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Jin Zhang ◽  
Guo-dong Chen ◽  
Jiang Qiu ◽  
Guo-chang Liu ◽  
Li-zhong Chen ◽  
...  

Abstract Background To investigate predictive factors related to graft failure of IgA nephropathy(IgAN) in renal allografts following living donor transplantation. Methods We identified a series of 102 biopsies diagnosed as IgAN in renal allografts following living donor transplantation from July 2004 to January 2017 at our center, and assess the predict value of the Lee’s classification and the 2009 Oxford classification in IgAN in renal allografts, clinical, ultrasonic and pathological characteristics at biopsy and the outcomes were retrospectively analyzed. Results The 5-year graft cumulative survival rate after transplantation was 91.4%. The 4-year graft cumulative survival rate after biopsy diagnosis of IgAN in renal allografts was 59.6%. The mean time ± SD to disease was 4.7 ± 3.5 years. The color doppler ultrasound and blood flow imagine showed the echo enhancement, the reduced blood flow distribution, the reduced peak systolic velocity of main renal artery, and the increased resistance index of arcuate renal artery were valuable in evaluating the graft dysfunction. The Cox multivariate analysis revealed that the 24-h urinary protein level (HR 1.6 for 1-g increase, 95%CI 1.2–2.0), estimated glomerular filtration rate (eGFR) (HR 1.0 for 1-mL/min/1.73 m^2 decline, 95%CI 1.0–1.1), and mesangial C1q deposition (HR 3.0, 95%CI 1.2–7.4) at biopsy were independent predictive factors of graft failure of IgAN in renal allografts. Conclusions IgAN in renal allografts occurred frequently within 5 years after transplantation. The risk of graft failure should be taken seriously in patients who exhibit heavy proteinuria and/or a declined eGFR as the initial symptoms; a high lesion grade (grade IV-V of Lee’s classification) and/or mesangial C1q deposition may also indicated a poor outcome.


2019 ◽  
Author(s):  
Jin Zhang ◽  
Guo-dong Chen ◽  
Jiang Qiu ◽  
Guo-chang Liu ◽  
Li-zhong Chen ◽  
...  

Abstract Background To investigate predictive factors related to graft failure of IgA nephropathy(IgAN) in renal allografts following living donor transplantation. Methods We identified a series of 102 biopsies diagnosed as IgAN in renal allografts following living donor transplantation from July 2004 to January 2017 at our center, and assess the predict value of the Lee's classification and the 2009 Oxford classification in IgAN in renal allografts, clinical, ultrasonic and pathological characteristics at biopsy and the outcomes were retrospectively analyzed. Results The 5-year graft cumulative survival rate after transplantation was 91.4%. The 4-year graft cumulative survival rate after biopsy diagnosis of IgAN in renal allografts was 59.6%. The mean time ± SD to disease was 4.7 ± 3.5 years. The color doppler ultrasound and blood flow imagine showed the echo enhancement, the reduced blood flow distribution, the reduced peak systolic velocity of main renal artery, and the increased resistance index of arcuate renal artery were valuable in evaluating the graft dysfunction. The Cox multivariate analysis revealed that the 24-h urinary protein level (HR 1.6 for 1-g increase, 95%CI 1.2-2.0), estimated glomerular filtration rate (eGFR) (HR 1.0 for 1-mL/min/1.73m^2 decline, 95%CI 1.0-1.1), and mesangial C1q deposition (HR 3.0, 95%CI 1.2-7.4) at biopsy were independent predictive factors of graft failure of IgAN in renal allografts. Conclusions IgAN in renal allografts occurred frequently within 5 years after transplantation. The risk of graft failure should be taken seriously in patients who exhibit heavy proteinuria and/or a declined eGFR as the initial symptoms; a high lesion grade (grade IV-V of Lee’s classification) and/or mesangial C1q deposition may also indicated a poor outcome.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xia Gao ◽  
Qiuying Li ◽  
Yanwen Qu ◽  
Jinzhi Zhang ◽  
Yougang Xing ◽  
...  

Objective. To study the clinical efficacy of integrated traditional Chinese medicine (TCM) and Western medicine (WM) in treating endometrial cancer and the influence on ultrasound, magnetic resonance imaging (MRI), tumor markers, human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125). Method. A total of 152 cases of patients with endometrial carcinoma were randomly divided into two groups: the TCM + WM group and the WM group. The WM group was treated with megestrol acetate tablets, and the TCM + WM group was treated with Radix Astragali injection on the basis of the control group. The levels of inflammatory factors, HE4 and CA125 in serum, were detected using enzyme-linked immunosorbent assay (ELISA) or radioimmunoassay. The characteristics of ultrasound images and MRI images were observed and recorded. Toxicity, side effects, and the 3-year cumulative survival rate after treatment were assessed. Results. After treatment, the levels of interleukin-4 (IL-4), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) in both groups decreased, and the decrease in the TCM + WM group was more obvious than that in the WM group. There were statistically significant differences between the two groups in lesion shape, boundary, blood flow signal, lesion diameter, resistance index (RI), echo, intima thickness, and muscle layer infiltration from transvaginal ultrasound images after treatment. The diameter, echo, boundary, shape, composition, and enhancement degree of lesions between the two groups have a significant difference. Moreover, the levels of serum HE4 and CA125 in both groups decreased after treatment, and the decrease in the TCM + WM group was more obvious than that in the WM group. There were statistically significant differences between the two groups in the occurrence of myelosuppression, abnormal liver function, decreased platelet number, gastrointestinal reactions, leukopenia, and cardiotoxicity. After three years of follow-up, the cumulative survival rate of the TCM + WM group was 76.32%, and the cumulative survival rate of the WM group was 57.89%. Conclusion. Radix Astragali injection combined with megestrol acetate tablets has obvious therapeutic effects against endometrial cancer. Through vaginal ultrasonography and MRI, it can significantly improve the size, shape, and blood flow signals of patients’ lesions, reduce the level of serum inflammatory factors and tumor markers HE4 and CA125, reduce the incidence of toxic and side reactions, improve the patient’s immunity, improve the patient’s condition significantly, and prolong the survival time of patients.


2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Yang Tang

The purpose of the study was to analyze the clinical effect of stereotactic radiosurgery (SRS) (Cyberknife) on hepatocellular carcinoma with portal vein tumor thrombosis (HCC-PVTT). Data from 50 patients with HCC-PVTT who received Cyberknife from August 2013 to April 2016 was collected for efficacy analysis. Moreover, survival correlation was evaluated by Cox proportionalhazards model. The total effective rate in 1–3 months after treatment was 64.00%, including 7 cases in complete remission, 12 cases in partial remission, 13 cases in stable conditions, and 18 cases with enlargement; a 4–24-months follow-up (with an average of 11.58 ± 2.58 months) showed that median survival, 1-year cumulative survival rate, and 2-year cumulative survival rate were, respectively, 11.86 ± 1.79 months, 48.00%, and 20.00%. Moreover, the Cox proportional-hazards model indicates that it was with no correlation between lesion diameter, classification of liver function, pre-operative alphafetoprotein, types of hepatitis, number of tumors, ascites, types of tumor emboli, total dose, and survival rate. SRS is effective for HCC-PVTT and serves as an ideal treatment clinically to help preserve patients’ lives, which is worthy of clinical promotion and application.


2019 ◽  
Author(s):  
Carmen da Casa ◽  
Carmen Pablos-Hernández ◽  
Alfonso González-Ramírez ◽  
José Miguel Julián-Enriquez ◽  
Juan F Blanco

Abstract Background: The management of hip fractures is nowadays mainly performed in Orthogeriatric Units, one of whose fundamental tools is the application of geriatric scores. The purpose of this study is to establish the potential usefulness of Barthel Index, Katz Index, Lawton-Brody Index and Physical Red Cross Scale geriatric scores as predictors of survival rate and readmission rate in older patients after hip fracture surgery. Methods: We designed a prospective single-center observational study, including 207 older adults over age 65 who underwent hip fracture surgery in the first half of 2014 and followed up to September 2018. Cumulative survival and readmission rates were analyzed by Kaplan-Meier; group comparison, by Log-Rank and hazard ratio, by Cox regression. Results: We found statistical differences (p<0.001) for cumulative survival rate by every geriatric score analyzed (BI HR=0.98 [0.97,0.99]; KI HR=1.24 [1.13-1.37]; LBI HR= 1.25 [1.16, 1.36]; PCRS HR=1.67 [1.37,2.04]). Furthermore, we could determinate an inflection point for survival estimation by Barthel Index (BI 0-55/60-100*, p<0.001, HR=2.37 [1.59,3.53]), Katz Index (KI A-B*/C-G, p<0.001, HR=2.66 [1.80, 3.93], and Lawton-Brody Index (LBI 0-3/4-8*, p<0.001, HR=3.40 [2.09,5.25]). We reveal a correlation of the Charlson Index (p=0.002) and Katz Index (p=0.041) with number of readmissions for the study period. Conclusions: The geriatric scores analyzed are related to the cumulative survival rate after hip fracture surgery for more than 4 years, independently of other clinical and demographic factors. Katz Index in combination with Charlson Index could also be a potential predictor of the number of readmissions after surgery for hip fracture patients.


2011 ◽  
Vol 37 (4) ◽  
pp. 431-445 ◽  
Author(s):  
Charles A Babbush ◽  
Gary T Kutsko ◽  
John Brokloff

Abstract The All-on-Four treatment concept provides patients with an immediately loaded fixed prosthesis supported by 4 implants. This single-center retrospective study evaluated the concept while using the NobelActive implant (Nobel Biocare, Gothenburg, Sweden). Seven hundred eight implants placed in 165 subjects demonstrated a cumulative survival rate of 99.6% (99.3% in maxilla and 100% in the mandible) for up to 29 months of loading. The definitive prosthesis survival rate was 100%.


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