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Transplantation Proceedings May 2024The aim of this study was to present a rare cause of recurrent urinary tract infections (UTIs) in a patient after kidney transplantation.
BACKGROUND
The aim of this study was to present a rare cause of recurrent urinary tract infections (UTIs) in a patient after kidney transplantation.
METHODS
The patient's consent was obtained, and full medical documentation was reviewed. After analyzing the literature, only 3 case reports of post-transplant nephroptosis were found.
RESULTS
A 32-year-old woman with a history of type 1 diabetes, after kidney and pancreas transplantation a year earlier, was admitted to the hospital due to another incident of fever, dysuria, and pain in the lower abdomen. UTIs had been recurring for several months despite prophylaxis, initially with co-trimoxazole and then with fosfomycin. There were no anatomic abnormalities, and tacrolimus concentrations always remained at the lower range of normal. Kinking of the ureter was suspected because of a change in the position of the transplanted kidney. Ultrasonography performed in the standing and lying positions confirmed the diagnosis. A double J catheter was inserted into the ureter. In the following months, no UTI or urinary retention recurrence was observed.
CONCLUSIONS
Nephroptosis of a transplanted kidney is extremely rare. The standard place for graft implantation-the iliac fossasignificantly limits the potential for migration. Kidneys implanted intraperitoneally also do not show clinically significant mobility due to postoperative adhesions. Floating kidneys potentially lead to serious complications. In addition to pain, a migrating graft may cause urine retention, predisposing to UTI and acute kidney injury.
Topics: Humans; Female; Kidney Transplantation; Adult; Urinary Tract Infections; Recurrence
PubMed: 38710603
DOI: 10.1016/j.transproceed.2024.04.008 -
Transplant International : Official... 2024The KDIGO guideline for acute rejection treatment recommends use of corticosteroids and suggests using lymphocyte-depleting agents as second line treatment. Aim of the...
The KDIGO guideline for acute rejection treatment recommends use of corticosteroids and suggests using lymphocyte-depleting agents as second line treatment. Aim of the study was to determine the current practices of detection and treatment of TCMR of kidney allografts amongst European kidney transplant centres. An invitation was sent through ESOT/EKITA newsletters and through social media to transplant professionals in Europe for taking part in the survey. A total of 129 transplant professionals responded to the survey. There was equal representation of small and large sized transplant centres. The majority of centres treat borderline changes (BL) and TCMR (Grade IA-B, IIA-B) in indication biopsies and protocol biopsies with corticosteroids as first line treatment. Thymoglobulin is used mainly as second line treatment for TCMR Grade IA-B (80%) and TCMR IIA-B (85%). Treatment success is most often evaluated within one month of therapy. There were no differences observed between the large and small centres for the management of TCMR. This survey highlights the common practices and diversity in clinics for the management of TCMR in Europe. Testing new therapies for TCMR should be in comparison to the current standard of care in Europe. Better consensus on treatment success is crucial for robust study designs.
Topics: Humans; Kidney Transplantation; Graft Rejection; Europe; Surveys and Questionnaires; T-Lymphocytes; Immunosuppressive Agents; Adrenal Cortex Hormones; Biopsy; Antilymphocyte Serum
PubMed: 38699173
DOI: 10.3389/ti.2024.12283 -
Biological Research May 2024Diabetes mellitus (DM) is a global epidemic with increasing incidences. DM is a metabolic disease associated with chronic hyperglycemia. Aside from conventional...
BACKGROUND
Diabetes mellitus (DM) is a global epidemic with increasing incidences. DM is a metabolic disease associated with chronic hyperglycemia. Aside from conventional treatments, there is no clinically approved cure for DM up till now. Differentiating mesenchymal stem cells (MSCs) into insulin-producing cells (IPCs) is a promising approach for curing DM. Our study was conducted to investigate the effect of DM on MSCs differentiation into IPCs in vivo and in vitro.
METHODS
We isolated adipose-derived mesenchymal stem cells (Ad-MSCs) from the epididymal fat of normal and STZ-induced diabetic Sprague-Dawley male rats. Afterwards, the in vitro differentiation of normal-Ad-MSCs (N-Ad-MSCs) and diabetic-Ad-MSCs (DM-Ad-MSCs) into IPCs was compared morphologically then through determining the gene expression of β-cell markers including neurogenin-3 (Ngn-3), homeobox protein (Nkx6.1), musculoaponeurotic fibrosarcoma oncogene homolog A (MafA), and insulin-1 (Ins-1) and eventually, through performing glucose-stimulated insulin secretion test (GSIS). Finally, the therapeutic potential of N-Ad-MSCs and DM-Ad-MSCs transplantation was compared in vivo in STZ-induced diabetic animals.
RESULTS
Our results showed no significant difference in the characteristics of N-Ad-MSCs and DM-Ad-MSCs. However, we demonstrated a significant difference in their abilities to differentiate into IPCs in vitro morphologically in addition to β-cell markers expression, and functional assessment via GSIS test. Furthermore, the abilities of both Ad-MSCs to control hyperglycemia in diabetic rats in vivo was assessed through measuring fasting blood glucose (FBGs), body weight (BW), histopathological examination of both pancreas and liver and immunoexpression of insulin in pancreata of study groups.
CONCLUSION
Our findings reveal the effectiveness of N-Ad-MSCs in differentiating into IPCs in vitro and controlling the hyperglycemia of STZ-induced diabetic rats in vivo compared to DM-Ad-MSCs.
Topics: Animals; Cell Differentiation; Mesenchymal Stem Cells; Rats, Sprague-Dawley; Diabetes Mellitus, Experimental; Male; Insulin-Secreting Cells; Insulin; Rats; Mesenchymal Stem Cell Transplantation; Cells, Cultured; Streptozocin; Blood Glucose
PubMed: 38698488
DOI: 10.1186/s40659-024-00502-4 -
BMC Public Health May 2024Acute pancreatitis (AP) is a common acute digestive system disorder, with patients often turning to TikTok for AP-related information. However, the platform's video...
BACKGROUND
Acute pancreatitis (AP) is a common acute digestive system disorder, with patients often turning to TikTok for AP-related information. However, the platform's video quality on AP has not been thoroughly investigated.
OBJECTIVE
The main purpose of this study is to evaluate the quality of videos about AP on TikTok, and the secondary purpose is to study the related factors of video quality.
METHODS
This study involved retrieving AP-related videos from TikTok, determining, and analyzing them based on predefined inclusion and exclusion criteria. Relevant data were extracted and compiled for evaluation. Video quality was scored using the DISCERN instrument and the Health on the Net (HONcode) score, complemented by introducing the Acute Pancreatitis Content Score (APCS). Pearson correlation analysis was used to assess the correlation between video quality scores and user engagement metrics such as likes, comments, favorites, retweets, and video duration.
RESULTS
A total of 111 TikTok videos were included for analysis, and video publishers were composed of physicians (89.18%), news media organizations (13.51%), individual users (5.41%), and medical institutions (0.9%). The majority of videos focused on AP-related educational content (64.87%), followed by physicians' diagnostic and treatment records (15.32%), and personal experiences (19.81%). The mean scores for DISCERN, HONcode, and APCS were 33.05 ± 7.87, 3.09 ± 0.93, and 1.86 ± 1.30, respectively. The highest video scores were those posted by physicians (35.17 ± 7.02 for DISCERN, 3.31 ± 0.56 for HONcode, and 1.94 ± 1.34 for APCS, respectively). According to the APCS, the main contents focused on etiology (n = 55, 49.5%) and clinical presentations (n = 36, 32.4%), followed by treatment (n = 24, 21.6%), severity (n = 20, 18.0%), prevention (n = 19, 17.1%), pathophysiology (n = 17, 15.3%), definitions (n = 13, 11.7%), examinations (n = 10, 9%), and other related content. There was no correlation between the scores of the three evaluation tools and the number of followers, likes, comments, favorites, and retweets of the video. However, DISCERN (r = 0.309) and APCS (r = 0.407) showed a significant positive correlation with video duration, while HONcode showed no correlation with the duration of the video.
CONCLUSIONS
The general quality of TikTok videos related to AP is poor; however, the content posted by medical professionals shows relatively higher quality, predominantly focusing on clinical presentations and etiologies. There is a discernible correlation between video duration and quality ratings, indicating that a combined approach incorporating the guideline can comprehensively evaluate AP-related content on TikTok.
Topics: Humans; Video Recording; Pancreatitis; Reproducibility of Results; Acute Disease; Social Media
PubMed: 38698404
DOI: 10.1186/s12889-024-18708-2 -
Scientific Reports May 2024Exocrine and endocrine pancreas are interconnected anatomically and functionally, with vasculature facilitating bidirectional communication. Our understanding of this...
Exocrine and endocrine pancreas are interconnected anatomically and functionally, with vasculature facilitating bidirectional communication. Our understanding of this network remains limited, largely due to two-dimensional histology and missing combination with three-dimensional imaging. In this study, a multiscale 3D-imaging process was used to analyze a porcine pancreas. Clinical computed tomography, digital volume tomography, micro-computed tomography and Synchrotron-based propagation-based imaging were applied consecutively. Fields of view correlated inversely with attainable resolution from a whole organism level down to capillary structures with a voxel edge length of 2.0 µm. Segmented vascular networks from 3D-imaging data were correlated with tissue sections stained by immunohistochemistry and revealed highly vascularized regions to be intra-islet capillaries of islets of Langerhans. Generated 3D-datasets allowed for three-dimensional qualitative and quantitative organ and vessel structure analysis. Beyond this study, the method shows potential for application across a wide range of patho-morphology analyses and might possibly provide microstructural blueprints for biotissue engineering.
Topics: Animals; Imaging, Three-Dimensional; Pancreas; Swine; Multimodal Imaging; X-Ray Microtomography; Islets of Langerhans; Tomography, X-Ray Computed
PubMed: 38698049
DOI: 10.1038/s41598-024-60254-9 -
Experimental and Clinical... Mar 2024Cholangiocarcinoma is the second most common primary hepatic neoplasm, accounting for 10% to 20% of primary liver tumors and 3% of all gastrointestinal neoplasms. The 3... (Review)
Review
Cholangiocarcinoma is the second most common primary hepatic neoplasm, accounting for 10% to 20% of primary liver tumors and 3% of all gastrointestinal neoplasms. The 3 anatomic types (intrahepatic, perihilar, and distal) have distinct epidemiologies, etiopathogenesis, and clinical outcomes. Surgical resection remains the current standard of treatment, but outcomes remain poor. With the continued expansion of liver transplant programs, use of liver transplant for malignant indications has also increased, with reports of encouraging outcomes. However, given the scarcity of livers fortransplant and accompanying possible complications, liver transplant for treatment of patients with cholangiocarcinomas remains experimental in most of the world. We reviewed the existing literature on treatment modalities for cholangiocarcinoma with emphasis on the pros and cons of surgical resection and indications, protocols, and outcomes of liver transplant as a treatment modality for patients with cholangiocarcinoma.
Topics: Humans; Cholangiocarcinoma; Liver Transplantation; Bile Duct Neoplasms; Treatment Outcome; Risk Factors; Hepatectomy
PubMed: 38695585
DOI: 10.6002/ect.2023.0343 -
Frontiers in Pharmacology 2024Acute rejection (AR) is the predominant form of rejection observed in liver transplantation and plays a crucial role in transplant immunology. This study aims to...
Acute rejection (AR) is the predominant form of rejection observed in liver transplantation and plays a crucial role in transplant immunology. This study aims to utilize bibliometric analysis to understand the , hotspots, and future trends of research on AR after liver transplantation. We searched the Web of Science Core Collection (WoSCC) for studies on AR after liver transplantation published from 1988 to 2022. The Bibliometric Online Analysis Platform, VOSviewer, and CiteSpace were used for analysis of all extracted publications. This study included 2,398 articles published in 456 journals by 12,568 authors from 1,965 institutions in 55 countries/regions. The United States and its affiliated institution, the University of Pittsburgh, were the most productive contributors. (n = 12,435) was the most frequently cited journal. Neuhaus P (n = 38) was the highest output author, and Demetris AJ (n = 670) was the most co-cited author. The research hotspots of AR after liver transplantation include pathogenesis, immunosuppressive therapy, and prognosis. Emerging research directions include regulatory T cells, immunosuppression minimization, intra-patient variability (IPV) of tacrolimus, and novel non-invasive diagnostic markers. Our study utilized bibliometric methods to analyze the study of AR after liver transplantation over the past 35 years. With the prolonged survival of liver transplant recipients, the most active areas currently focus on individualized treatment and improving patient prognosis. Minimizing adverse reactions to immunosuppressive therapy while simultaneously avoiding an increase in the risk of AR remains a future research focus.
PubMed: 38694927
DOI: 10.3389/fphar.2024.1357468 -
Transplant International : Official... 2024Tacrolimus is pivotal in pancreas transplants but poses challenges in maintaining optimal levels due to recipient differences. This study aimed to explore the utility of...
Tacrolimus is pivotal in pancreas transplants but poses challenges in maintaining optimal levels due to recipient differences. This study aimed to explore the utility of time spent below the therapeutic range and intrapatient variability in predicting rejection and donor-specific antibody (dnDSA) development in pancreas graft recipients. This retrospective unicentric study included adult pancreas transplant recipients between January 2006 and July 2020. Recorded variables included demographics, immunosuppression details, HLA matching, biopsy results, dnDSA development, and clinical parameters. Statistical analysis included ROC curves, sensitivity, specificity, and predictive values. A total of 131 patients were included. Those with biopsy-proven acute rejection (BPAR, 12.2%) had more time (39.9% ± 24% vs. 25.72% ± 21.57%, = 0.016) and tests (41.95% ± 13.57% vs. 29.96% ± 17.33%, = 0.009) below therapeutic range. Specific cutoffs of 31.5% for time and 34% for tests below the therapeutic range showed a high negative predictive value for BPAR (93.98% and 93.1%, respectively). Similarly, patients with more than 34% of tests below the therapeutic range were associated with dnDSA appearance (38.9% vs. 9.4%, = 0.012; OR 6.135, 1.346-27.78). In pancreas transplantation, maintaining optimal tacrolimus levels is crucial. Suboptimal test percentages below the therapeutic range prove valuable in identifying acute graft rejection risk.
Topics: Humans; Graft Rejection; Tacrolimus; Pancreas Transplantation; Male; Retrospective Studies; Female; Adult; Immunosuppressive Agents; Middle Aged; Isoantibodies; Tissue Donors; Time Factors; Biopsy; Graft Survival
PubMed: 38694489
DOI: 10.3389/ti.2024.12591 -
American Journal of Transplantation :... Apr 2024The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article...
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
PubMed: 38692411
DOI: 10.1016/j.ajt.2024.04.016 -
Transplant International : Official... 2024
Topics: Humans; Abatacept; Pancreas Transplantation; Immunosuppressive Agents; Male; Female; Adult; Middle Aged; Graft Rejection; Cohort Studies; Graft Survival; Retrospective Studies
PubMed: 38689693
DOI: 10.3389/ti.2024.12778