Li-xin Yu

Nanfang Hospital, Shengcheng, Guangdong, China

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Publications (49)0 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the relationship between acute graft rejection early after renal transplantation and the variations of platelet parameters. We retrospectively analyzed the clinical data of 167 renal transplant recipients before and within 2 months after the surgery. Before and at 1-10 days, 15 days, 30 days, 45 days and 60 days after the transplantation, 5 platelet parameters, including platelet count (PLT), platelet hematocrit (PCT), mean platelet volume (MPV), platelet volume distribution width (PDW), and large platelet ratio (P-LCR), were detected in the 35 patients with acute graft rejection within two months (AR group) and in the other 132 recipients with good graft recovery (control group). The AR group and control group showed no significant difference in PLT, PCT, MPV, or P-LCR before the surgery, but the PDW was significantly higher in the AR group (t=2.18, P=0.035). These parameters were similar within 5 postoperative days between the two groups (P>0.05), but in postoperative days 6-15, the AR group showed significantly increased MPV, PDW and P-LCR compared with the control group (P<0.05). In postoperative days 6-9, MPV, PDW and P-LCR became stable in AR group but tended to decrease in the control group, showing obviously different patterns of variation between the two groups (P<0.05). Preoperative PDW may have a positive correlation with acute graft rejection after renal transplantation. Monitoring the variations of MPV, PDW and P-LCR may help in the diagnosis of acute graft rejection early after renal transplantation.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 03/2015; 35(3):413-6.
  • Li-Xin Yu · Min-Jie Zhou · Min Luo
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    ABSTRACT: To determine the optimal dose range (therapeutic window) of mycophenolate mofetil (MMF) for preventing acute graft rejection following renal transplantation. The trough concentration of MMF (MPA-C0) at 12 h after oral administration of the drug (two doses daily given at an interval of 12 h) was monitored in 110 renal transplant recipients within a month, in 2-3 months, and over 4 months after the transplantation using EMIT method. The occurrence of acute graft rejection and drug toxicity were observed in all the patients during the one-year follow-up. s The incidence of acute graft rejection after transplantation was 13.64% (15/110) in these patients. Drug toxicity and complications occurred in 32.73% (36/110) of the patients, including 12 cases with reduced white blood cell counts, 10 with MMF cid-associated diarrhea, 10 with infection, 4 with liver function damage. Acute rejection was successfully reversed after methylprednisolone treatment and drug toxicity was managed by corresponding treatment and adjustment of MMF dose. No deaths or graft removal occurred in these patients. The ROC curve showed that a MPA-C0 of 1.40-2.80 mg/L was optimal in preventing acute rejection after the transplantation and reducing adverse drug effects. Monitoring MPA-C0 and individualized MMF dosing help to prevent acute graft rejection, reducing drug toxicity and complications, and improving graft survival rate after renal transplantation.
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    ABSTRACT: To investigate the relationship between platelet parameters and delayed graft function (DGF) early after kidney transplantation.
  • Min Luo · Li-Xin Yu · Lu-Lu Xiao
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    ABSTRACT: To establish a calculated panel reactive antibody (CPRA) method to analyze the donor-recipient incompatibility rate in PRA-positive kidney recipients and estimate the probability of these recipients to receive kidney transplantation. Based on the database of HLA-A, -B, -DR genes and A-B, A-DR, B-DR, A-B-DR haplotype frequencies collected from 2004 donors from Jan 2000 to Dec 2012, we analyzed CPRA in 202 PRA-positive recipients and evaluated the consistency between PRA and CPRA assessments using a CPRA-Java calculator software, which returned a percentage of CPRA (representing the probability of unacceptable HLA in the donor group) after input of HLA-specific antibodies of a PRA-positive recipient. The mean PRA intensity of the 202 PRA-positive recipients was (23.12∓17.83)% with a mean CPRA% of (46.07∓23.30)%. A significant difference was found between the mean PRA% and CPRA% in low sensitized recipients (PRA 0-10%) [(6.87∓2.41)% vs (21.63∓11.75)%, P<0.05) and in moderately sensitized recipients (PRA 10%-30%) [(20.15∓5.70)% vs (50.56∓16.86)%, P<0.05), but not in highly sensitized recipients (PRA>30%); The concordance rates between PRA% and CPRA% in the 3 groups were 19.35% (P<0.05), 10.99% (P<0.05), and 100% (P>0.05), respectively. Lowly sensitized kidney recipients might have a lower probability of actually receiving a transplant than PRA% shows. A PRA%>30% is a risk factor for kidney transplantation. PRA reflects the sensitized level of a renal recipient, and reliable detection of HLA antibody specificity is of critical importance. CPRA accurately reflects the probability of a recipient to receive a transplant to assist clinicians in predicting the waiting time and selecting the transplant approach.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 04/2014; 34(4):477-81.
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    ABSTRACT: To investigate the effects of donor and recipient anti-major histocompatibility complex class I-related chain A (MICA) antibodies on early renal graft function in renal transplant recipients. Using Luminex200 liquid chip technology, we detected anti-MICA antibodies in 26 deceased donors paired with 43 recipients. We divided the 43 pairs into 4 groups according to different donor and recipient anti-MICA antibody positivity statuses and compared the incidence of acute rejection (AR), serum creatinine at 1 week after transplantation, and renal function recovery time between the groups to assess the effect of donor and recipient anti-MICA antibodies on early graft function. Five of the 26 donors were positive for anti-MICA antibodies (19.2%), with the most common antibody being anti-MICA*019 (40%); 11 of the 43 recipients were positive for anti-MICA antibodies (25.6%), among which anti-MICA*018 was most frequently found (14.6%). AR did not occur in the only anti-MICA antibody-positive recipient receiving an anti-MICA antibody-positive donor graft; AR occurred in 2 (33.3%) of the 6 anti-MICA antibody-negative recipients receiving anti-MICA antibody-positive donor graft, in 4 (40%) out of the 10 anti-MICA antibody-positive recipients receiving anti-MICA antibody-negative donor graft, and in 10 (38.4%) of the 26 anti-MICA antibody-negative recipients receiving anti-MICA antibodies-negative donor graft. The incidences of AR were not significantly different between the groups (P>0.05), nor were serum creatinie levels or renal function recovery time at one week after surgery(P>0.05). Donor or recipient anti-MICA antibody positivity does not seem to significantly affect the incidence of AR or renal function recovery early after transplantation to justify the necessity of monitoring donor anti-MICA antibodies. But still, large-sample studies are needed to further investigate the potential impact of donor and recipient anti-MICA antibodies on the outcomes of renal transplantation.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 03/2014; 34(3):383-6.
  • Li-Xin Yu · Ren-Fei Xia · Min-Jie Zhou
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    ABSTRACT: To study the changes in sexual function in premenopausal women after renal transplantation. Forty-two married premenopausal women receiving dialysis therapy for at least 6 months with normal renal function for 6 months after renal transplantation were examined for hormonal profiles and menstrual cycles. The sexual functions of the patients were evaluated using Female Sexual Function Index (FSFI) before and 6 months after the transplantation. Before renal transplantation, amenorrhea, oligomenorrhea, polimenorrhea, and eumenorrhea were found in 18 cases (42.9%), 10 cases (23.8%), 5 cases (11.9%) and 9 cases (21.4%), as compared to 7 cases (16.7%), 5 cases (11.9%), 6 cases (14.3%) and 24 cases (57.1%) after the transplantation, respectively. Prolactin (PRL), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels significantly decreased and estradiol (E2) and progesterone (P) significantly increased after renal transplantation (P<0.001). Nineteen patients (45.2%) before and 36 patients (85.7%) after the surgery reported to have an active sexual life (P<0.001). The total incidences of female sexual dysfunction before and after kidney transplantation were 90.5% and 40.5% (P<0.001), respectively. The scores for sexual desire, arousal, lubrication, satisfaction, orgasm, and pain in FSFI were significantly increased after kidney transplantation (P<0.001). A successful renal transplantation can significantly improve sexual functions in premenopausal women.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 06/2013; 33(6):910-912.
  • Chuan-Fu DU · Li-Xin Yu · Shao-Jie Fu · Jian Xu · Qiang Wei
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    ABSTRACT: To investigate the changes of CD4(+)CD25(+) regulatory T cells (TREG) and TREG-related foxp3 gene expression in the peripheral blood at the onset of chronic allograft nephropathy (CAN) after kidney transplantation. Twenty-five patients with initial onset of CAN were examined for CD4(+)CD25(+)high/CD4(+) ratio and the expression of Foxp3 gene in the peripheral blood using the flow cytometry, and the data were compared with those of 30 kidney recipients with normal graft function, 20 patients with chronic renal function (CRF), and 20 normal subjects. All the recipients had no more than 1 HLA mismatch and received the same inductive and maintenance drug treatment. The recipients with CAN had significantly lower CD4(+)CD25(+)high/CD4(+) ratio and Foxp3 gene expression compared with those with normal graft function (0.71∓0.33 vs 1.17∓0.25 and 62.75∓10.80 vs 70.42∓6.8, respectively, P<0.01). The recipients with normal renal graft function showed no significant difference in CD4(+)CD25(+)high/CD4(+) ratio and Foxp3 gene expression from the normal control subjects. The peripheral blood CD4(+)CD25(+)high/CD4(+) ratio and Foxp3 expression in the kidney recipients with CAN are significantly lower than those of recipients with normal renal graft function, which does not correlate with elevated creatinine level, suggesting a role of TREG in the occurrence and development of CAN.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 09/2012; 32(9):1366-8.
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    ABSTRACT: To investigate the risk factors for sensitization of anti-MICA antibodies and their impact on the outcomes of renal transplantation. Luminex flow cytometry were used to identify 10 MICA antibodies and evaluate the antibody specificity in 98 uremic patients positive or negative for anti-MICA antibodies undergoing kidney transplantation. The factors contributing to MICA sensitization were analyzed, and the incidence of acute rejection and graft function recovery time were compared between the positive and negative cases for anti-MICA antibodies. Of the 98 uremic patients, 16 (16.3%) were positive for anti-MICA antibodies. The positive and negative cases showed significant differences in the history of blood transfusion, pregnancy, transplantation, and PRA status (P<0.05). In the 38 renal transplant recipients, 6 experienced acute graft rejection, which was reversed by methylprednisolone pulse therapy; of the 10 recipients positive for anti-MICA antibodies, 4 showed acute graft rejection as compared to 2 out of the 28 recipients negative for anti-MICA antibodies (P=0.031). The cases positive for anti-MICA antibodies showed a significantly longer graft function recovery time than the negative cases (14.6∓4.7 vs 8.2∓4.5 days, P=0.001). Blood transfusion, pregnancy, and transplantation all contribute to the production of anti-MICA antibodies. Patients positive for anti-MICA antibodies may require strict HLA matching and more potent immunosuppressive drugs to prevent renal graft rejection and improve graft survival.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 04/2011; 31(4):615-8.
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    ABSTRACT: To summarize the features of pulmonary infection (PI) in kidney transplant (Ktx) and liver transplant (Ltx) recipients for effective control measures. A retrospective analysis was conducted among Ktx recipients and Ltx recipients with PI during the period from Jan 2004 to Dec 2008. The clinical data concerning the infection was compared. Forty-five Ktx recipients and 23 Ltx recipients developed PI after the transplantation. The incidence of PI was 7.4% and 56.1% in (P<0.001), respectively, with severe PI occurring in 2.6% and 46.3% of the recipients (P<0.001). The median time from PI diagnosis to transplant was 230 days (29-1080 days) and 4 days (2-104 days) (P<0.001), the case-fatality rate for PI was 6.7% and 17.4% (P=NS), and the mortality rate was 0.5% and 9.8% (P<0.001) in Ktx and Ltx recipients, respectively; Gram-negative organisms were the most common in both Ktx and Ltx recipients, but Ltx recipients had significantly higher incidence of multidrug-resistant bacteria (12.9% vs 37.0%, P=0.005). The knowledge of PI after the transplantation will benefit appropriate prophylactic and empirical treatment to improve the survival of Ktx and Ltx recipients.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 07/2010; 30(7):1679-81.
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    ABSTRACT: To summarize the experiences in high-risk renal transplant recipients for ketter long-term survival. From April 1991 to December 2008, a total of 921 kidney recipients with high-risk factors were divided into six groups as following: (1) pediatric patients (< 18 years old) (GI, n = 34); (2) retransplant recipients (GII, n = 169); (3) high sensitized patients (PRA> 30% or peak PRA > 50%)(GIII, n = 35); (4) elderly recipients (> 60 years old) (GIV, n = 297); (5) diabetic patients (GV, n = 112); (6) patients with HBV/HCV infection or HBV/HCV carrier (GVI, n = 274). Each group was compared to a control of 807 recipients without any above risk factor for patient and graft survival at 1, 3 and 5 years. Incidences of acute rejection (AR), chronic rejection (CR) and complication were analyzed and compared respectively between the studied subjects and the control group as well. Compared with the control group, patient/graft survivals were lower in GII, GIII and GVI (all P < 0.05), GIV had worse patient survival (P < 0.05); AR and CR incidences were greater in GI and GIII (all P < 0.05); GIV, GV and GVI had more complications. This study suggests the benefits for long-term outcome in high-immunological risk renal transplant recipients of low acute selection incidence rate, and reduction of complication incidences is the key to long term results for non-immunological high risk recipients.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 04/2010; 48(8):589-92.
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    ABSTRACT: To explore the effect of KIR/HLA ligand matching which mediates activated or inhibitory signal pathways on acute rejection (AR) after kidney transplantation. HLA and KIR genotype assortments were analyzed in 53 donor/recipient pairs of kidney transplantation. The recipients were divided into AR group (GI, n=19) and stable renal function group (GII, n=34) based on the early graft function. The impact of donor HLA, recipient KIR and distinct KIR/HLA class I ligand combinations on acute rejection after kidney transplantation was studied. No significant differences were found in donor HLA-C1/2, HLA-A3, HLA-A11, or HLA-Bw4 between GI and GII groups. The frequency for KIR2DL2/2DS2 and KIR genotype assortment (AA) of the recipients in GI group were significantly lower than that in GII group (26.3% vs 55.9%, P=0.038; 31.6% vs 67.6%, P=0.011). The incidence of AR was significantly lower in donor HLA-C1/1 than in non-C1/1 (31.6% vs 46.7%, P>0.05), and lower in recipient KIR genotype assortment (AA) than in non-AA (20.7% vs 52.2%, P=0.011). A significant higher number of matches for the KIR2DL2/ HLA-C1 and KIR2DL3/HLA-C1 were observed in GII group (P=0.030, P=0.028). Distinct KIR/HLA class I ligand combinations between the donor and recipient (such as KIR2DL2/ HLA-C1 and KIR2DL3/HLA-C1) may reduce the incidence of AR. A good KIR/HLA class I ligand matching will benefit the survival of the renal allograft.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 02/2010; 30(2):288-91.
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    ABSTRACT: To review the clinical experiences concerning simultaneous liver-kidney transplantation in polycystic kidney and hepatic disease with kidney and liver failure. This study involved 8 cases of simultaneous liver-kidney transplantation in polycystic kidney and hepatic disease with kidney and liver failure. There were 5 male and 3 female patients, aged from 41 to 67 years old with a mean of 52.8 years old. Six cases transplanted kidney after liver with orthotopic liver transplantation, and 2 cases transplanted liver after kidney with piggy-back liver transplantation. The acute rejections, complications, liver function, kidney functions, and survival rates of patient/liver/kidney were recorded. Within the follow-up of 28 to 65 months, all 8 patients are still alive with normal liver and kidney functions: 2 living more than 5 years, 2 living more than 4 years and 4 living more than 2 years. 2 cases of pleural effusion and 1 case of pneumonia were complications after operation, which had been cured successfully. No acute rejection of allograft was observed. Simultaneous liver-kidney transplantation is a safe and effective treatment for polycystic kidney and hepatic disease with kidney and liver failure.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 10/2009; 47(20):1557-9.
  • Qiang Wei · Li-Xin Yu · Wen-Feng Deng · Jun-Sheng Ye
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    ABSTRACT: To identify the risk factors for cytomegalovirus (CMV) pneumonia after renal transplantation and investigate the early precaution measures. A retrospective study was conducted in a group of 28 patients undergoing renal transplantation who were readmitted because of CMV pneumonia between Jan, 2005 and Dec, 2007. Chi-square test and multivariate logistic regression were used to identity the significant risk factors. Seven factors, namely recipient age, acute graft rejection, pre-transplantation dialysis, delayed graft function recovery, recipient peak PRA level, donor CMV positivity and the use of MMF were found to significantly correlate to post-transplant CMV pneumonia. Multivariate logistic regression further confirmed that donor CMV IgG positivity, acute graft rejection and pre-transplantation dialysis for over 6 months were independent factors to predict the occurrence of CMV pneumonia. Acute graft rejection control, appropriate donor selection and shortened dialysis before the transplantation can be crucial factors to reduce the incidence of CMV pneumonia after renal transplantation.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 07/2009; 29(6):1182-4.
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    ABSTRACT: To investigate the genotypes of natural killer cell immunoglobulin-like receptor (KIR) genes and their frequencies in Chinese subjects and explore the mechanism of the actions of nature killer cells. The DNA samples were obtained from 67 randomly selected unrelated Chinese Han individuals for genotyping of the KIR genes using PCR with sequence-specific primers (PCR-SSP), and the frequencies of the KIR genes in these Chinese subjects were compared with the reported frequencies in populations of other nationalities. Sixteen KIR genes were identified in these Chinese subjects, and 87.5% of these genes were expressed at frequencies above 0.35. Fourteen functional KIR genes combined into 25 KIR genotypes, among which the most frequent genotype KIR-2DL1-2DL3-2DL4-3DL1-3DL2-3DL3-2DS4 showed a frequency of 0.373, while the frequencies of all the other genotypes were no greater than 0.09. Comparison of the KIR combinations in Chinese Han population with those of Japanese, Korean, and Caucasians populations identified 8.93% of the KIR combinations shared by all these populations; the Chinese, Koreans and Caucasians shared 5.36% common KIR combinations, whereas only 1.79% common combinations were found in Chinese and Caucasians. In this study, 16 new gene combinations were identified (25.28%). This study shows the high-frequency distribution of a single KIR gene polymorphism. The KIR combination KIR-2DL1-2DL3-2DL4-3DL1-3DL2-3DL3-2DS4 has the highest frequency in Chinese, Japanese, Korean and Caucasian populations, indicating that inhibitory signal transduction pathway plays an important role in the function of the natural killer cells. This study provide clues for new approaches for improving the prognosis of kidney transplantation by enhancing or inhibiting the function of the natural killer cells instead of life-time usage of immunosuppressive agents.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 02/2009; 29(1):109-13.
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    ABSTRACT: To identify the factors responsible for the inter-individual variations in the dosage/concentration of tacrolimus in renal transplant recipients. This study involved renal transplant recipients receiving immunosuppressive therapy with the tacrolimus, mycophenolate and prednisone regimen after the operation. The gender, age, height, body weight, tacrolimus dosage, hormone dosage, diarrhea, blood lipids, liver function, renal function, albumin, and hematocrit of the patients were recorded at different time points, namely in early stage (3, 7, 14, and 30 days postoperatively, 118 cases), at 3 months (103 cases), 6 months (75 cases) and over one year (119 cases) after the operation. The concentrations of tacrolimus and gene polymorphisms at CYP3A5, MDR1 3435, MDR1 2677 and MDR1 1236 were also determined in these patients. Multiple linear regression was used for analysis of these factors with tacrolimus concentration/dosage*body surface area as the independent variable. Patients in early stage following renal transplantation showed rather poor fitting of the stepwise regression model, which increased obviously 3 months after the operation and further increased till reaching a stable level at 6 months. Multiple factors were found to affect tacrolimus concentration/dosage in the early postoperative stage, during which period these factors underwent drastic variations and became stable 3 months later. In terms of pharmacogenomics, the major factors affecting tacrolimus concentration/dosage included MDR1 3435, MDR1 2677 and MDR1 1236 polymorphisms, which vastly varied between the patients early after the operation. Of these polymorphic sites, CYP3A5 produced only minor effects on tacrolimus concentration/dosage, and was not included as an active factor until the stable phase (over 1 year) following the transplantation; MDR1 3435 was found to be the predominant factor affecting tacrolimus metabolism in the stable phase. Age, liver function, albumin and hematocrit were found to be positively correlated to the independent variable tacrolimus concentration/dosage*body surface area, and identified as important factors responsible for the intra-individual variation of tacrolimus dosage/concentration. The variations in the factors affecting tacrolimus dosage/concentration after renal transplantation are consistent with the clinical features of the patients, and these factors vary with the postoperative stages. Pharmacogenomic factors produce the most conspicuous effect on tacrolimus dosage/concentration, and agents that may interfere with tacrolimus metabolism should be avoided after the operation. Age, liver function, albumin and hematocrit are also important factors responsible for the variation of tacrolimus dosage/concentration.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 01/2009; 28(12):2161-4.
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    ABSTRACT: To study the changes in Notch1 expression on peripheral lymphocytes after acute graft rejection after renal transplantation. Twenty renal transplant recipients experiencing acute graft rejection and 20 without acute rejection were enrolled in this study. Flow cytometry was used to detect the expression of Notch1 on peripheral lymphocytes of the patients before operation, at the occurrence of acute rejection and after anti-rejection therapy. The rates of Notch1-positive lymphocytes measured at different time points were compared between the two groups. In patients with acute graft rejection, Notch1 expression at the time of rejection onset was significantly higher than that before operation (t=4.245, P=0.000) and that of patients with graft rejection (t=3.839, P=0.000), and was obviously decreased after anti-rejection therapy (t=3.102, P=0.004). Patients without graft rejection showed no significant changes in Notch1 expression after the transplantation (P=0.409). Notch1 expression was comparable between the recipients receiving Tac therapy and those with CsA therapy (P>0.05). Monitoring Notch1 expression on the peripheral lymphocytes after renal transplantation may help in the diagnosis of acute graft rejection and prediction of the effect of an anti-rejection therapy.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 01/2009; 29(1):172-4.
  • Lu-Lu Xiao · Min Luo · Li-Xin Yu · Wei Zhu
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    ABSTRACT: To study the frequency of major histocompatibility complex class I-related chain A (MICA) antibody in patients with end-stage renal disease (ESRD). Luminex flow cytometry and beads loaded with 11 MICA antigens were used to identify the MICA antibody and evaluate the antibody specificity in 110 patients with ESRD. The positivity rate of MICA antibody was 40% (12/30) in PRA-positive patients, significantly higher than the rate of 17.5% (14/80) in PRA-negative patients (chi(2)=6.120, P=0.013). MICA-specific antibodies against 10 of the 11 MICA antigens were detected in 26 MICA antibody-positive patients, and 26.92% of the MICA antibody-positive patients had antibodies with single-specificity and 73.08% had polyspecific antibodies. Three MICA antibody-positive patients with cadaveric kidney transplantation showed good function of the graft without acute rejection 2 months after the operation. The positivity rate of MICA antibody is significantly higher in PRA-positive patients, suggesting a strong correlation between MICA and PRA positivity. The MICA antibodies are polyspecific and probably consist of IgM and IgG. These data can be used as prospective data for these ESRD patients considering potential renal transplantation, and may facilitate further investigation of the association of MICA with renal transplantation.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 12/2008; 28(11):1999-2001.
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    ABSTRACT: To explore the etiopathogenesis, therapy and incidence of pulmonary infection in kidney transplantation recipients taking new immunosuppressant. The clinical data from 752 kidney transplant recipients were retrospectively analyzed, who were divided into 3 groups according to the immunosuppressants administered, namely group A (CsA+MMF+Pred, n=226), group B (FK506+MMF+Pred, n=386) and group C (FK506+Rap+Pred, n=140). The incidence and mortality of pulmonary infection were recorded and the analysis of etiopathogenesis, diagnosis and therapy of pulmonary infection were carried out in the 3 groups. Fifty-three patients acquired post-transplant pulmonary infection. The incidence of pulmonary infection was 7.08% (16/226) in group A, 7.25% (28/386) in group B and 6.43% (9/140) in group C. One patient died in group A and 2 in group B. Among the 53 patients, 24 had simple bacterial infection, 9 had cytomegalovirus infection, 1 had mycotic infection, 17 had combined infection, and 2 had unidentified pathogen infection. Of the pathogenic bacteria detected, 68.35% were Gram-negative. Gram-negative bacteria are most likely responsible for pulmonary infection after kidney transplantation, which most possibly occurs within 6 months after kidney transplantation. Early diagnosis and early treatment are critical for decreasing the mortality of severe pneumonia and for improving the survival rate of the patients and grafts.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 07/2008; 28(6):1037-40.
  • Qiang Wei · Li-xin Yu · Wen-feng Deng · Jun-sheng Ye
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    ABSTRACT: To investigate the effect of trichostatin A (TSA) on proliferation and interleukin-2 (IL-2) expression of mouse T cells in mixed lymphocyte culture (MLC), and explore its effect on T cell-mediated immune response. BALB/c and C57BL mouse MLC was treated with different concentrations of TSA for different durations, and the lymphocyte inhibition ratio was measured by MTT assay. With CTX as the control, one-way MLC system of BALB/c and C57BL mouse was treated with the same concentrations of TSA, and IL-2 expression in the T cells was observed by flow cytometry. TSA inhibited the proliferation of T cells in the MLC in a time- and dose-dependent fashion. It also reduced the IL-2 expression in one-way MLC dose-dependently, showing it significantly differed from the effect of CTX (P<0.01). Histone deacetylase inhibitor TSA can inhibit the proliferation and reduce IL-2 expression of the T cells in MLC of mice, and therefore inhibit the T cell-mediated immune response.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 04/2008; 28(3):467-9.
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    ABSTRACT: To study the value of detection of both preoperative soluble CD30 (sCD30) and hepatocyte growth factor (HGF) level 5 days after transplantation in the diagnosis of acute rejection of renal allograft. Preoperative serum sCD30 levels and HGF level 5 days after transplantation were determined in 65 renal-transplant recipients using enzyme-linked immunosorbent assay. The recipients were divided according to the sCD30 levels positivity. Receiver operating characteristic (ROC) curves were used to assess the value of HGF level on day 5 posttransplantation for diagnosis of acute renal allograft rejection, and the value of combined assay of the sCD30 and HGF levels was also estimated. After transplantation, 26 recipients developed graft rejection and 39 had uneventful recovery without rejection. With the cut-off value of sCD30 of 120 U/ml, the positivity rate of sCD30 was significantly higher in recipients with graft rejection than in those without (61.5% vs 17.9%, P<0.05). Recipients with acute rejection showed also significantly higher HGF levels on day 5 posttransplantation than those without rejection (P<0.05). ROC curve analysis indicated that HGF levels on day 5 posttransplantation was a good marker for diagnosis of acute renal allograft rejection, and at the cut-off value of 90 ug/L, the diagnostic sensitivity was 84.6% and specificity 76.9%. Evaluation of both the sCD30 and HGF levels significantly enhanced the diagnostic accuracy of acute graft rejection. Combined assay of serum sCD30 and HGF levels offers a useful means for diagnosis of acute renal allograft rejection.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 02/2008; 28(2):241-2.