scholarly journals Studying some lymphocyte subpopulations in search for predictors of renal graft dysfunction

2020 ◽  
Vol 12 (3) ◽  
pp. 189-198
Author(s):  
S. V. Zybleva ◽  
S. L. Zyblev ◽  
V. N. Martinkov
Keyword(s):  
Predictive Value ◽  
Scoring System ◽  
Graft Function ◽  
Suppressive Therapy ◽  
Graft Dysfunction ◽  
Timely Manner ◽  
Non Invasive ◽  
Allograft Function ◽  
Immune Suppressive Therapy ◽  
Logistic Regressions

Introduction. One of the main problems in transplantology is the detection of simple, reliable and non-invasive markers that could predict adverse immune reactions and adjust immune suppressive therapy in allograft recipients in a timely manner. Objective. To determine the immunological criteria for the prediction of a graft dysfunction. Material and methods. We have examined 197 recipients who underwent kidney transplantation. All of them were immunologically examined with the identification of more than 40 subpopulations of leukocytes. Allograft function was assessed on day 7 with the division of patients into two groups: with either primary or graft dysfunction. Simple and multiple logistic regressions were used to predict a graft dysfunction. Preliminary statistical analysis was performed using nonparametric statistics. Results and discussion. A scoring system to predict the graft function has been worked out. At CD19+IgD+CD27-<72.7%, score 1 is assigned, and 0 score is given at > 72.7%. At CD3+CD8+CD69+>9.7% score 1 is assigned, and 0 score is given at CD3+CD8+CD69+<9.7%. Total score is calculated by summing up the scores. The total score = 0 predicts a primary graft function; total score >1 predicts a graft dysfunction. This scoring system has the sensitivity of 91.9%, еру specificity of 100%, еру accuracy of 94.9%, positive predictive value of 1 and negative predictive value of 0.877. Conclusions. 1. Percentage of CD19+IgD+CD27- and CD3+CD8+CD69+ subpopulations can be used to predict a graft dysfunction. 2. At values of CD19+IgD+CD27- not exceeding 72.7% and CD3+CD8+CD69+ more than 9.7%, the development of a graft dysfunction can be anticipated.

Rejection evaluation after renal transplantation using MR diffusion tensor imaging

2017 ◽  
Vol 59 (7) ◽  
pp. 876-883 ◽  
Author(s):  
Emin Deger ◽  
Azim Celik ◽  
Hamad Dheir ◽  
Volkan Turunc ◽  
Ahmet Yardimci ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Renal Transplantation ◽  
Acute Rejection ◽  
Renal Cortex ◽  
Diffusion Tensor ◽  
Graft Function ◽  
The Other ◽  
Non Invasive ◽  
Transplant Patients ◽  
Allograft Function

Background Renal allograft dysfunction monitoring is mainly performed using the serum creatinine (SC) level, Doppler ultrasound (US), or renal biopsy. Recently proposed diffusion-based magnetic resonance imaging (MRI) methods have been explored as new, non-invasive tools for assessing renal function after transplantation. Purpose To investigate the value of fractional anisotropy (FA) measurements in the evaluation of acute rejection cases after renal transplant. Material and Methods Doppler US and MRI diffusion tensor imaging (DTI) were performed in 21 patients with graft dysfunction requiring graft biopsy after renal transplantation and in 21 patients with normal graft function. The MR examinations were performed on a 1.5-T MRI using two b-values (0 and 800 s/mm2). FA values were measured from the cortex and medulla of the transplanted kidney at the upper, middle, and lower poles. Results Twenty-one transplant patients diagnosed with acute rejection (Group 1) were compared to the control group of 21 transplant patients with normal graft function (Group 2). The measured FA values of the medulla were 0.19 ± 0.02 and 0.22 ± 0.05 ( P = 0.017) for Groups 1 and 2, respectively. On the other hand, the measured FA values of the renal cortex were 0.18 ± 0.04 and 0.18 ± 0.04 ( P = 0.97) for Groups 1 and 2, respectively. Conclusion The good correlation between the renal medulla FA values and allograft function shows that MR DTI has potential for non-invasive functional assessment of transplanted kidneys. On the other hand, the renal cortex FA values had no correlation with the allograft function.

scholarly journals Characteristics of B-lymphocyte subpopulations in renal transplant recipients

2021 ◽  
Vol 13 (2) ◽  
pp. 141-150
Author(s):  
S. V. Zybleva ◽  
S. L. Zyblev
Keyword(s):  
Kidney Transplantation ◽  
B Lymphocytes ◽  
B Lymphocyte ◽  
Graft Function ◽  
Lymphocyte Subpopulations ◽  
Cell Subpopulation ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Allograft Function

Introduction. The presence of multiple subsets of B-cells with specific regulatory functions capable of modulating inflammatory responses havebeen detected. Most of the studies of Bregs function were carried out in the context of autoimmune and infectious diseases, whereas the objective of this research was to study the characteristics of the main, activated and tolerogenic subpopulations of B lymphocytes in patients who underwent kidney transplantation. Objective. To study the indices of B-lymphocyte subpopulations and determine their role in the development of immunological tolerance after kidney transplantation.Material and methods. We have examined 197 recipients who underwent kidney transplantation. We determined B lymphocyte subpopulation levels (CD19+IgD+CD27+ and CD19+IgD-CD27+) before transplantation, on the 1st, 3rd, 7th and 30th days after the transplantation. Allograft function was assessed on day 7 with the division of patients into two groups: with primary graft function and graft dysfunction.Results and discussion. Significant differences were revealed between the groups of recipients over three months in the following cell subpopulation levels CD19+IgD+CD27+ and CD19+IgD-CD27+. During the first 7 days, lower levels of these subpopulations were associated with satisfactory allograft function. However, by the 90th day after surgery, an increase in CD19+IgD+CD27+ B lymphocytes was noted in the group of patients with graft dysfunction.Conclusions. Low levels of not-switched (CD19+IgD+CD27+) and switched (CD19+IgD-CD27+) memory В lymphocytes in the peripheral blood of kidney transplant recipients are associated with a favorable postoperative course. We have found that on the 3rd post-transplant day, the relative level of non-switched memory B lymphocytes (CD19+IgD+CD27+) exceeding or equal to 11.47%, and the level of switched memory B lymphocytes (CD19+IgD-CD27+) exceeding or equal to 20.74% might predict the development of early renal graft dysfunction with a sensitivity and specificity of 88.40% and 84.30% for the former parameter and of 88.70% and 82.40% for the latter one, respectively.

scholarly journals Micro RNA 146a-5p expression in Kidney transplant recipients with delayed graft function

2019 ◽  
Vol 41 (2) ◽  
pp. 242-251 ◽  
Author(s):  
Patricia Milhoransa ◽  
Carolina Caruccio Montanari ◽  
Rosangela Montenegro ◽  
Roberto Ceratti Manfro
Keyword(s):  
Kidney Transplant ◽  
Peripheral Blood ◽  
Graft Function ◽  
Renal Tissue ◽  
Delayed Graft Function ◽  
Kidney Graft ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients ◽  
Non Invasive

ABSTRACT Introduction: The development of novel non-invasive biomarkers of kidney graft dysfunction, especially in the course of the delayed graft function period would be an important step forward in the clinical practice of kidney transplantation. Methods: We evaluated by RT-PCR the expression of miRNA-146 to -5p ribonucleic micro-acids (miRNAs) in the peripheral blood and renal tissue obtained from kidney transplant recipients who underwent a surveillance graft biopsy during the period of delayed graft function. Results: In biopsy samples, the expression of miR-146a-5p was significantly increased in the group of patients with delayed graft function (DGF) (n = 33) versus stables patients (STA) (n = 13) and patients with acute rejection (AR) (n = 9) (p = 0.008). In peripheral blood samples, a non-significant increase of miR-146a-5p expression was found in the DGF group versus STA and AR groups (p = 0.083). No significant correlation was found between levels of expression in biopsy and plasma. ROC curve analysis revealed an AUC of 0.75 (95% CI: 0.62-0.88) for the renal tissue expression and 0.67 (95% CI 0.52-0.81) for the peripheral blood expression. Conclusion: We conclude that miR-146a-5p expression has a distinct pattern in the renal tissue and perhaps in the peripheral blood in the setting of DGF. Further refinements and strategies for studies should be developed in the field of non-invasive molecular diagnosis of kidney graft dysfunction.

scholarly journals A Scoring System To Predict Mortality In Patients Admitted To Hospital With Covid-19

2020 ◽  
Author(s):  
Yanet Pedroso ◽  
Armando Aguirre-Jaime ◽  
Zaida Díaz-Cuevas ◽  
María José Ramos-Real ◽  
Óscar Abreu-Trujillo ◽  
...  
Keyword(s):  
Predictive Value ◽  
Scoring System ◽  
Validation Cohort ◽  
Disease Risk ◽  
Invasive Mechanical Ventilation ◽  
Risk Of Death ◽  
Non Invasive ◽  
Probability Of Death ◽  
Development And Validation ◽  
First Time

Abstract Background: Mortality from COVID-19 has reached rates approaching 13,0%, and it is necessary to have tools to predict the course of the disease, risk of aggravation and probability of death. We propose a predictive mortality score in patients admitted with COVID-19.Methods: We have collected and analysed more than 50 epidemiological, clinical, analytical and treatment variables in a referral cohort of 303 patients admitted for COVID-19. Those variables retained after multivariate analysis that compared survivors and non-survivors patients became the components of the risk of death score. To check the validity of the score, a validation cohort of patients admitted for COVID-19 was used.Results: Mortality was 17% in the referral cohort. Candidate variables to predict risk of death were age ≥65 years, cardiovascular disease, dyspnoea, pneumonia, acute respiratory distress, non-invasive mechanical ventilation, abnormal prothrombin, elevated D-dimer, and abnormal lactate dehydrogenase. The proposed cut-off point in the scale was 7 (with 0-6 points representing a low risk of death and 7-17 a high risk). Application of the score in the validation cohort obtained a sensitivity of 100% and a specificity of 92%, with a positive predictive value of 71% and a negative predictive value of 100%.Conclusions: Our study presents for the first time the development and validation of a risk-of-death scoring system for patients hospitalised with COVID-19 using clinical and laboratory parameters that can be retrieved from patients’ admission records.

Diagnosis of Deep Vein Thrombosis by Combination of Doppler Ultrasound Flow Examination and Strain Gauge Plethysmography

1982 ◽  
Vol 47 (02) ◽  
pp. 141-144 ◽  
Author(s):  
H Bounameaux ◽  
B Krähenbühl ◽  
S Vukanovic
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Doppler Ultrasound ◽  
Strain Gauge ◽  
Predictive Value ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Deep Vein

SummaryDoppler ultrasound flow examination, strain gauge plethysmography and contrast venography were performed in 160 lower limbs of 80 in-patients. Deep vein thrombosis (DVT) was suspected in 87 limbs. Using measurement of venous stop-flow pressure, the Doppler method had an overall sensitivity of 83%. By combined use of Doppler and Plethysmography, sensitivity was increased to 96%. Specificity was 62% and 51%, respectively. With a positive and a negative predictive value of 80% and 73%, respectively, the combination of both non-invasive methods cannot reliably replace venography in the diagnosis of DTV, although all (40/40) thromboses proximal to or involving the popliteal segment were detected by either Doppler and Plethysmography or both.After exclusion of 14 patients (18%) suffering from conditions known to alter the results of these non-invasive methods, the positive predictive value of abnormal findings in both Doppler and Plethysmography was increased to 94% for suspected limbs, whilst negative predictive value of both negative Doppler and Plethysmography was 90%, allowing the avoidance of venography in these patients.

Noninvasive Assessment of Liver Diseases using 2D Shear Wave Elastography

2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Liver Diseases ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Two Dimensional ◽  
Non Invasive ◽  
Examination Technique

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated. Key words:  –  –  – Two-dimensional Shear Wave Elastography. Abbreviations: 2D- SWE: Two-dimensional Shear Wave Elastography; 3D- SWE: Three-dimensional Shear Wave Elastography; AUROC: area under the receiver operating characteristic curves; ARFI Acoustic Radiation Force Impulse Elastography; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology; HVPG: hepatic venous pressure gradient; LS: liver stiffness; LR: likelihood ratio; NPV: negative predictive value; PPV: positive predictive value; ROI: region of interest; RT-E: Real Time-Elastography; Se: sensitivity; Sp: specificity; TE: Transient Elastography; US: ultrasound; VM: valid measurement; E: Young’s modulus

A Novel Risk Scoring System for Predicting Primary Graft Dysfunction after Orthotopic Heart Transplantation

2020 ◽  
Vol 26 (10) ◽  
pp. S136-S137
Author(s):  
Syed Adeel Ahsan ◽  
Jasjit Bhinder ◽  
Syed Zaid ◽  
Parija Sharedalal ◽  
Chhaya Aggarwal-Gupta ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Scoring System ◽  
Orthotopic Heart Transplantation ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Risk Scoring ◽  
Risk Scoring System

scholarly journals Efficiency of non-invasive prenatal screening in pregnant women at advanced maternal age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Zhu ◽  
Xiaoxiao Jin ◽  
Yuqing Xu ◽  
Weihua Zhang ◽  
Xiaodan Liu ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Predictive Value ◽  
Trisomy 21 ◽  
Maternal Age ◽  
Prenatal Screening ◽  
Advanced Maternal Age ◽  
Youden Index ◽  
Non Invasive ◽  
Sensitivity Specificity

Abstract Background Non-invasive prenatal screening (NIPS) is widely used as the alternative choice for pregnant women at high-risk of fetal aneuploidy. However, whether NIPS has a good detective efficiency for pregnant women at advanced maternal age (AMA) has not been fully studied especially in Chinese women. Methods Twenty-nine thousand three hundred forty-three pregnant women at AMA with singleton pregnancy who received NIPS and followed-up were recruited. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), receiver operating characteristic (ROC) curves and the Youden Index for detecting fetal chromosomal aneuploidies were analyzed. The relationship between maternal age and common fetal chromosomal aneuploidy was observed. Results The sensitivity, specificity, PPV, NPV of NIPS for detecting fetal trisomy 21 were 99.11, 99.96, 90.98, and 100%, respectively. These same parameters for detecting fetal trisomy 18 were 100, 99.94, 67.92, and 100%, respectively. Finally, these parameters for detecting trisomy 13 were 100, 99.96, 27.78, and 100%, respectively. The prevalence of fetal trisomy 21 increased exponentially with maternal age. The high-risk percentage incidence rate of fetal trisomy 21 was significantly higher in the pregnant women at 37 years old or above than that in pregnant women at 35 to 37 years old. (Youden index = 37). Conclusion It is indicated that NIPS is an effective prenatal screening method for pregnant women at AMA.

CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture

2021 ◽  
pp. 1-12
Author(s):  
Bo-wen Zheng ◽  
Shu-hong Yi ◽  
Tao Wu ◽  
Mei Liao ◽  
Ying-cai Zhang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Predictive Value ◽  
Biliary Stricture ◽  
Characteristic Curve ◽  
Validation Group ◽  
Gamma Glutamyl Transpeptidase ◽  
Full Cohort ◽  
Non Invasive ◽  
Invasive Method ◽  
Nas Score

BACKGROUND: Biliary ischaemia is an important factor in the pathogenesis of non-anastomotic biliary stricture (NAS) after liver transplantation (LT). Contrast-enhanced ultrasound (CEUS) can be used to detect biliary ischaemia, but no study has examined the utility of CEUS in predicting NAS. OBJECTIVE: To evaluate whether repeated CEUS as a non-invasive method of biliary ischaemia can identify NAS. METHODS: Consecutive LT patients who underwent CEUS examinations at 1–4 weeks after LT from September 2012 to December 2015 at our institution were included. The CEUS images and clinical data were analysed. RESULTS: Among 116 eligible LT patients, 39 (33.6%) were diagnosed with NAS within 1 year after LT. The patients with NAS had a significantly higher CEUS score at weeks 2–4 (all P <  0.05) and a higher slope of CEUS score progression (0.480 vs –0.044, P <  0.001). The accuracy of CEUS in identifying NAS improved over time after LT, reaching its maximum at week 4, with a sensitivity of 66.7%, a specificity of 87.9%, a positive predictive value (PPV) of 75.9%, a negative predictive value (NPV) of 82.3%, and an accuracy of 80.2%in the full cohort when a CEUS score≥3 was used as the cut-off. Multivariate analysis identified gamma-glutamyl transpeptidase (GGT), alanine transaminase (ALT) and the CEUS score at week 4 as independent predictors of NAS. In the task of identifying NAS, an NAS score combining the above 3 variables at week 4 showed areas under the receiver operating characteristic curve of 0.88 (95%CI, 0.78–0.99) in the estimation group (n = 60) and 0.82 (95%CI, 0.69–0.96) in the validation group (n = 56). An NAS score cut-off of 0.396 identified 87.2%of NAS cases in the estimation group, with a PPV of 93.3%; and 75.0%of NAS cases in the validation group, with a PPV of 58.8%. CONCLUSIONS: CEUS examination during the first 4 weeks is useful in assessing the risk of NAS within 1 year after LT. In particular, an NAS score combining the CEUS score, GGT level, and ALT level at week 4 can be used to accurately predict the risk of NAS in LT patients.

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