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ABSTRACT: Our study aimed to determine the incidence of de novo renal cell carcinoma in the native kidneys of patients transplanted at our center and to identify possible risk factors.
We performed a retrospective, single-center cohort study, which included patients transplanted at the District Hospital in Poznan, Poland, during 1994-2011, among whom 836 were selected. Sixty-three patients with confirmed de novo cancer were found. Of those, 11 had renal cell carcinoma in the native kidney (1.3%) and 2 in the transplanted kidney (0.2%).
Mean follow-up was 10 ± 3.2 years. Mean age at renal cell carcinoma diagnosis was 52 ± 9.4 years, and mean time from transplant was 3 ± 2.6 years. A statistical analysis showed no significant differences in demographic or clinical characteristics between renal cell carcinoma and noncancer group, except for the prevalence of male sex and smoking in the cancer group (P < .05).
Renal cell carcinoma development in the native kidney seems to be an early event, frequently observed within 4 to 5 years after transplant. We believe that kidneys in renal transplant recipients should be routinely screened by ultrasound for early diagnosis.
Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 07/2012; 10(4):310-3. · 0.81 Impact Factor
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Inflammatory Bowel Diseases 11/2011; · 4.86 Impact Factor
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ABSTRACT: Acute rejection (AR) remains a major problem after kidney transplantation and crucial determinant of long-term graft function. Potent mediators of alloimmune response leading to AR are cytokines. To further explore the relation between cytokine pattern and frequency of AR episodes we analyzed Th1/Th2 cytokine concentrations in the urine of 44 patients prior to the kidney transplantation. During the 6-month period following the transplantation AR was diagnosed in 11 patients. Urine samples were collected 1day before the transplantation. Samples were cytometrically tested for concentrations of IL-2, IL-4, IL-5, IL-10, IFN-gamma and TNF-alpha. Analysis showed significantly higher pretransplant concentrations of IFN-gamma (P > .001), TNF-alpha (P < .05) and IL-10 (P < .001) in the urine of patients with diagnosed AR. No significant differences in the concentrations of IL-2, IL-4, IL-5 between the two groups were observed. Elevated pretransplant concentrations of urine IFN-gamma and TNF-alpha in AR patients, not accompanied by higher concentrations of IL-2, may suggest an ongoing undetected and local, non-specific Th1 immune response, capable of amplifying the alloimmune response in the early phase postsurgery. While higher concentrations of IL-10 can partially result from activation of monocytes/macrophages, and partially from peripheral regulatory mechanisms controlling the ongoing immune reaction.
Cytokine 07/2010; 51(1):10-1. · 3.02 Impact Factor
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ABSTRACT: Crucial inflammatory mediators involved in development of alloimmune response leading to AR are cytokines. Our project was aimed to investigate the relation between the urine cytokine profile and the development of acute rejection (AR) episodes in patients after kidney transplantation.
The project included 44 patients undergoing kidney transplantation. During the six-month period following the transplantation AR was diagnosed in 11 patients. Urine samples were collected 2, 4, 14 and 30 days posttransplantation and cytometrically tested for concentrations of IL-2, IL-4, IL-5, IL-10, IFN-gamma and TNF-alpha.
We found the elevated posttransplant concentrations of IFN-gamma, IL-10 and TNF-alpha in the urine of patients with diagnosed AR vs. NONAR (P<.05). No significant differences in the urine concentrations of IL-2, IL-4, IL-5 between the two groups were observed (P>.05). Elevated concentrations of urine IFN-gamma and TNF-alpha in AR patients, not accompanied by higher concentrations of IL-2, may suggest an ongoing undetected nonspecific Th1 immune response, capable of amplifying the alloimmune response in the early phase postsurgery, leading to AR. Higher concentrations of IL-10 found in the urine of AR patients, in turn, can partially result from peripheral regulatory mechanisms controlling the ongoing immune reaction, and partially from activation of monocytes/macrophages.
The results of our study suggest that higher concentrations of IFN-gamma, TNF-alpha and IL-10 in the urine of patients shortly after the kidney transplantation can be considered as risk factors increasing the probability of AR episodes.
Annals of transplantation: quarterly of the Polish Transplantation Society 14(3):25-8. · 2.02 Impact Factor
