Other papers by authors:
M Veroux,
D Corona,
G Giuffrida,
M Gagliano,
A Giaquinta,
T Tallarita,
D Zerbo,
A Cappellani,
M Sorbello,
P Veroux
Department of Surgery, Transplantation and Advanced Technologies, University Hospital of Catania, Catania, Italy.
INTRODUCTION: Renal vein thrombosis (RVT) has an incidence of .55% to 3.4% and accounts for as many as one-third of early allograft losses. Rarely, RVT may be a consequence of an extension of ipsilateral iliac vein thrombosis. We present a rare case of iliocaval thrombosis as a consequence of inferior vena cava compression by a large-for-size kidney transplant. CASE REPORT: A 20-year-old woman with spina bifida and kidney failure received a living donor kidney from her 52-year-old father. On postoperative day 8, the patient had right lower quadrant abdominal pain associated with oliguria. Graft duplex ultrasonography examination revealed venous thrombosis arising in the right femoral vein and extending to the iliac vein. An urgent second laparotomy was performed, and the kidney was finally placed in the peritoneal cavity. CONCLUSIONS: The eventuality of an inferior vena cava compression by a transplanted kidney should be considered in any recipient with sudden leg swelling and acute graft dysfunction. An early diagnosis and prompt intervention may reduce the progression to RVT and subsequent graft nephrectomy. When planning a kidney transplantation with a supposed size discrepancy between donor and recipient, positioning the kidney on the left side or in the peritoneal cavity may be preferred.
M Veroux,
D Corona,
G Scalia,
V Garozzo,
M Gagliano,
G Giuffrida,
C M Costanzo,
A Giaquinta,
I Palermo,
D ZappalĂ ,
T Tallarita,
D Zerbo,
R Russo,
A Cappellani,
C Franchina,
V Scriffignano,
P Veroux
Department of Surgical Sciences, Transplantation and Advanced Technologies, Vascular Surgery and Organ Transplant Units, University Hospital of Catania, Catania, Italy.
INTRODUCTION: Development of cancer after transplantation has rapidly became one of the leading causes of death in kidney transplant recipients with functioning grafts. Anogenital malignant neoplasms may occur with a 14-fold increased incidence, and human papilloma virus (HPV) infection has been recently identified as the leading cause of cervical carcinoma. We report the preliminary findings of a prospective study that evaluated the incidence of HPV infection and cervical carcinoma in a population of kidney transplant recipients. PATIENTS AND METHODS: The study included 35 female recipients of a deceased donor kidney with at least 6 months of follow-up. All patients underwent a cervicovaginal brushing, an HPV DNA test, and a Papanicolaou test. RESULTS: Twenty-two patients (62.8%) were positive for HPV DNA. Thirteen of 22 HPV DNA-positive recipients (59%) demonstrated a high-risk HPV genotype. No cytologic anomalies were detected in Papanicolaou smears. CONCLUSIONS: These preliminary data demonstrated a high incidence of HPV infection in renal transplant recipients. Most of our recipients exhibited a high-risk HPV genotype, which suggests higher aggressiveness of such infection in immunosuppressed patients. The HPV test is useful to monitor patients at higher risk of anogenital malignant neoplasms by identifying the cytologic anomalies at an earlier stage. This ongoing study will investigate the rate of progression of HPV infection and the clinical patterns of HPV-positive cytologic anomalies in renal transplant recipients.
A Mistretta,
M Veroux,
G Grosso,
F Contarino,
M Biondi,
G Giuffrida,
M Gagliano,
A Giaquinta,
D Zerbo,
T Tallarita,
D Corona,
P Veroux
Department of Hygiene and Public Health G.F. Ingrassia, Transplantation and Advanced Technologies, Vascular Surgery and Organ Transplantation Unit, University Hospital of Catania, Catania, Italy.
INTRODUCTION: While deaths with a functioning graft have occurred more frequently in recent years, other nonimmunologic factors may have an important role in late allograft loss. These variables include socioeconomic and cultural status as risk factors for posttransplantation noncompliance with therapy. We examined the effect of socioeconomic and cultural status on graft and patient survival in a population of kidney transplant recipients. PATIENTS AND METHODS: This retrospective study included 223 kidney transplantations performed between September 2000 and December 2006. RESULTS: A significant improvement in graft and recipient survival was observed with increased educational achievement level. Subjects with a high school diploma or college degree demonstrated significantly better outcome. Recipients who had attended intermediate or technical schools were also significantly more likely to have a better outcome than the lowest educational group. Using the lowest socioeconomic class as a reference, a proportional hazard model demonstrated statistically significant benefit for better outcome in patients with skilled occupations. CONCLUSIONS: Results of the present study showed a significant difference in kidney transplantation outcome between different socioeconomic and educational classes. These results could help physicians to educate patients with end-stage renal disease to better understand long-term recovery after transplantation.
M Veroux,
G Giuffrida,
M Gagliano,
A Giaquinta,
T Tallarita,
M Sorbello,
D Corona,
D Zerbo,
D Vizcarra,
V Scriffignano,
M A Cannizzaro,
P Veroux
Department of Surgery, Transplantation and Advanced Technologies, Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Catania, Italy.
INTRODUCTION: Diagnosis of thyroid disease is fundamental in the evaluation of patients awaiting kidney transplantation. We analyzed the incidence of thyroid disease in patients with end-stage renal disease (ESRD) and evaluated its evolution before and after kidney transplantation. PATIENTS AND METHODS: Between January 2000 and May 2008, we evaluated 323 candidates for kidney transplantation. In all patients, serum concentrations of free triiodothyronine, free thyroxine, and thyroid-stimulating hormone were determined and a ultrasonography of the neck was performed. Patients with thyroid cancer were considered eligible for kidney transplantation after at least 2 years since treatment. RESULTS: One-hundred-four patients with ESRD (44%) had functional or morphologic changes in the thyroid gland. Forty-one patients (17.4%) underwent fine-needle aspiration cytology; 3 demonstrated showed papillary carcinoma; 3, follicular adenomas; 8, uncertain cytologic lesions; and 27, a nodular goiter. Seventeen patients underwent surgery. Six of 11 patients with thyroid cancer underwent transplantation: two patients underwent laterocervical lymph node dissection because of local recurrence within 2 years after successful transplantation; the other 4 patients are alive with a functioning graft. Of the 184 transplant recipients, 10 underwent surgery to treat thyroid disease: 8 with multinodular goiter, 1 with micropapillary carcinoma, and 1 with follicular adenoma. All 10 patients are alive with a well-functioning graft and no signs of disease recurrence. CONCLUSIONS: Thyroid diseases are common in patients with ESRD. Early diagnosis and treatment significantly decreased morbidity and mortality in patients awaiting transplantation.
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Seiichi Yamazaki,
Shintaro Kanda,
Masanori Yasuo,
Kazuhisa Urushihata,
Tomonobu Koizumi,
Keisaku Fujimoto,
Keishi Kubo,
Shuichi Ikeda
First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi Matsumoto 390-8621, Japan.
Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
Using restriction endonucleases DraI, AseI, and I-CeuI in conjunction with pulsed-field gel electrophoresis, we have shown that Spirochaeta aurantia M1 possesses a circular 3.98-Mb genome. This is the second largest spirochete chromosome yet analyzed. The observation that the latter enzyme cuts in 3 places suggests the presence of 3 copies of the large subunit (23S) rRNA gene (rrl), which was confirmed by Southern hybridizations. The complete sequence of 2 of the ribosomal RNA operons was determined, revealing that their structure resembled that of the typical member of the bacterial superkingdom: rrs (16S; 1561 bp), tRNA, rrl (23S; 2972 bp), and rrf (5S; 110 bp). The S. aurantia rrs-rrl intergenic regions, as with Treponema denticola, contain genes specifying a 73-nt tRNA(Ala)(anticodon TGC) and a 77-nt tRNA(Ile)(anticodon GAT).
Evgeny Vinogradov,
Catherine J Paul,
Jianjun Li,
Yuchen Zhou,
Elizabeth A Lyle,
Richard I Tapping,
Andrew M Kropinski,
Malcolm B Perry
Institute for Biological Sciences, National Research Council, Ottawa, ON, Canada. evguenii.vinogradov@nrc-cnrc.gc.ca
In an attempt to isolate lipopolysaccharide from Spirochaeta aurantia, Darveau-Hancock extraction of the cell mass was performed. While no lipopolysaccharide was found, two carbohydrate-containing compounds were detected. They were resolved by size-exclusion chromatography into high molecular mass (LGLA) and low molecular mass (LGLB) fractions. Here we present the results of the analysis of the glycolipid LGLB. Deacylation of LGLB with hydrazine and separation of the products by using anion-exchange chromatography gave two major products. Their structure was determined by using chemical methods, NMR and mass spectrometry. All monosaccharides had the D-configuration, and aspartic acid had the L-configuration. Intact LGLB contained two fatty groups at O-2 and O-3 of the glycerol residue. Nonhydroxylated C14 to C18 fatty acids were identified, which were predominantly unsaturated or branched. LGLB was able to gel Limulus amebocyte lysate, albeit at a lower level than that observed for Escherichia coli O113 lipopolysaccharide. However, even large amounts of LGLB were unable to stimulate any Toll-like receptor (TLR) examined, including TLR4 and TLR2, previously shown to be sensitive to lipopolysaccharide and glycolipids from diverse bacterial origins, including other spirochetes.
