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Imko-Walczuk B.,Pomeranian Trauma Center | Cegielska A.,Medical University of Gdansk | Placek W.,University of Varmia and Masuria | Kaszewski S.,Sexually Transmitted Diseases and Immunodermatology | Fiedor P.,Transplantation Institute
Transplantation Proceedings | Year: 2014

Background. Verrucous carcinoma is a slow-growing tumor with 3 main localizations: Oral cavity, ano-urogenital region, and plantar surface of the foot. On the sole it may rise adjacent to viral warts and very often is mistaken for the common verruca plantaris. Although both conditions - viral warts and cutaneous squamous cell carcinoma - are often diagnosed in immunosuppressed patients, in literature we have found only 3 case reports of verrucous carcinoma in organ transplant recipients.Case Report. We present a case of 26-year-old man after deceased donor renal transplantation with plantar verrucous carcinoma successfully treated with excision and 5% imiquimod. © 2014 Elsevier Inc. All rights reserved. Source

Chou H.-S.,Cleveland Clinic | Chou H.-S.,Transplantation Institute | Hsieh C.-C.,Cleveland Clinic | Charles R.,Digestive Disease Institute | And 7 more authors.
Transplantation | Year: 2012

BACKGROUND.: Side effects of lifetime immunosuppression for cell transplants often outweigh the benefits; therefore, induction of transplant tolerance is needed. We have shown that cotransplantation with myeloid-derived suppressor cells (MDSC) effectively protect islet allografts from rejection without requirement of immunosuppression. This study was to investigate the underlying mechanisms. METHODS.: MDSC were generated by addition of hepatic stellate cells from various stain mice into dendritic cell (DC) culture. The quality of MDSC was monitored by phenotype and function analyses. MDSC mixed with islet allografts were transplanted into diabetic recipients. T-cell response was analyzed after transplantation by using flow and histochemical analyses, and was compared with islet alone and islet/DC transplant groups. B7-H1 knockout mice were used to determine the role of B7-H1 on MDSC in regulation of T-cell response. RESULTS.: Cotransplantation with MDSC (not DC) effectively protected islet allografts without requirement of immunosuppression. This is associated with attenuation of CD8 T cells in the grafts and marked expansion of regulatory T (Treg) cells, which contributed to MDSC-induced T-cell hyporesponsiveness. Antigen-specific Treg cells were prone to accumulate in lymphoid organs close to the grafts. Both in vitro and in vivo data demonstrated that B7-H1 was absolutely required for MDSC to exert immune regulatory activity and induction of Treg cells. CONCLUSION.: The described approach holds great clinical application potential and may overcome the limitation of requiring chronic administration of immunosuppression in cell transplants. Understanding the underlying mechanisms will facilitate the development of this novel therapeutic strategy. © 2012 by Lippincott Williams & Wilkin. Source

Guo J.Y.,Key Laboratory of Transplant Engineering | Yang T.,Key Laboratory of Transplant Engineering | Sun X.G.,Key Laboratory of Transplant Engineering | Zhou N.Y.,Key Laboratory of Transplant Engineering | And 5 more authors.
Journal of Biomedical Science | Year: 2011

Background: Ischemic postconditioning (IPO) has been demonstrated to attenuate ischemia/reperfusion (I/R) injury in the heart and brain, its roles to liver remain to be defined. The study was undertaken to determine if IPO would attenuate liver warm I/R injury and its protective mechanism. Methods. Mice were divided into sham, I/R, IPO+I/R (occlusing the porta hepatis for 60 min, then treated for three cycles of 10 sec brief reperfusion consecutively, followed by a persistent reperfusion); L-NAME+ sham (L-NAME, 16 mg/kg, i.v., 5 min before repefusion); L-NAME+I/R; and L-NAME+ IPO. Blood flow of caudate and left lobe of the liver was blocked. Functional and morphologic changes of livers were evaluated. Contents of nitric oxide, eNOS and iNOS in serum were assayed. Concentration of eNOS, iNOS, malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in hepatic tissue were also measured. Expressions of Akt, p-Akt and HIF-1 protein were determined by western blot. Expressions of TNF- and ICAM-1 were measured by immunohistochemistry and RT-PCR. Results: IPO attenuated the dramatically functional and morphological injuries. The levels of ALT was significantly reduced in IPO+I/R group (p < 0.05). Contents of nitric oxide and eNOS in serum were increased in the IPO+I/R group (p < 0.05). IPO also up-regulated the concentration of eNOS, activity of SOD in hepatic tissue (p < 0.05), while reduced the concentration of MDA (p < 0.05). Moreover, protein expressions of HIF-1 and p-Akt were markedly enhanced in IPO+I/R group. Protein and mRNA expression of TNF- and ICAM-1 were markedly suppressed by IPO (p < 0.05). These protective effects of IPO could be abolished by L-NAME. Conclusions: We found that IPO increased the content of NO and attenuated the overproduction of ROS and I/R-induced inflammation. Increased NO contents may contribute to increasing HIF-1 level, and HIF-1 and NO would simultaneously protect liver from I/R injury. These findings suggested IPO may have the therapeutic potential through Akt-eNOS-NO-HIF pathway for the better management of liver I/R injury. © 2011 Guo et al; licensee BioMed Central Ltd. Source

Li J.,Transplantation Institute | Chen H.,Transplantation Institute | Fan T.-Y.,Transplantation Institute | Wang X.,Transplantation Institute
Chinese Journal of Tissue Engineering Research | Year: 2013

Background: The causes for abnormal liver function after liver transplantation is complex, and it is important for the treatment to clarify the causes of abnormal liver function. Objective: To analyze the cause of abnormal liver function after liver transplantation, and to use it in clinical diagnosis and treatment. Methods: The CNKI database and FMJS database were retrieved by computer for articles published from January 1991 to July 2012. Articles were searched with the key words of "liver transplantation, abnormal liver function, transaminase abnormalities, bilirubin increased, causes" in Chinese and English. A total of 98 articles were retrieved. Thirty-five articles directly related to abnormal liver function after liver transplantation and those published in authoritative magazines were included to review. Results and Conclusion: Many reasons can lead to abnormal liver function after liver transplantation, with complex clinical manifestations. The most common causes were acute rejection, biliary complications and virus infection. When the abnormal liver function occurred in the early postoperative period, especially in one month after liver transplantation, the small size syndrome and primary graft non-function should be vigilant. The transaminase and bilirubin levels were different for different causes. Transaminase increased more significantly than bilirubin in acute rejection, autoimmune hepatitis, viral infection, ischemia-reperfusion injury, portal vein and hepatic vein stenosis. However, obstruction enzyme such as alkaline phosphatase, glutamyltransferase, total bilirubin and direct bilirubin was increased more significantly in chronic rejection, biliary complications, hepatic artery, primary biliary cirrhosis and primary sclerosing cholangitis; transaminase increasing mainly and bilirubin increasing mainly can both appear in the patients with tumor, and which one will happen depending on the size and oppression of the tumor. In addition, collecting the medical history carefully can help to diagnose early as each patient have his special medical history. In a word, It's important to collect medical history carefully in clinical work, and the common cause of abnormal liver function should be consider firstly according to the increasing of transaminase and bilirubin, and other relatively uncommon causes should be considered after remove the common causes through clinical proven. It can help to diagnose and treat as soon as possible to make full use of examinations, such as laboratory tests, imaging studies and liver puncture biopsy. Source

Huang Y.-F.,Transplantation Institute | Chen H.,Transplantation Institute | Wang X.,Transplantation Institute | Fan T.-Y.,Transplantation Institute
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: Cytomegalovirus is relatively common condition pathogenic virus after liver transplantation. It has many direct or indirect effects on the body, and seriously affects the long-term survival of patients. It should be paid more attention. OBJECTIVE: To analyze and summarize the outcomes of the epidemiology, risk factors, effects on the body, clinical manifestation, diagnosis, treatment and prevention for cytomegalovirus infection after liver transplantation. METHODS: Fitness database, PubMed database and China National Knowledge Infrastructure database were retrieved by computer for articles on cytomegalovirus infection after liver transplantation published from January 2006 to December 2013, and through manual refer to books. Articles were searched with the key words of "liver transplantation, cytomegalovirus infection, risk factors" in Chinese and English. A total of more than 200 articles were retrieved. Forty articles directly related to cytomegalovirus infection after liver transplantation and those published in authoritative magazines were included to review with good representativeness. RESULTS AND CONCLUSION: The positive rate of serum cytomegalovirus-IgG is high in the population. Risk factors of cytomegalovirus infection after liver transplantation include donor-recipient cytomegalovirus serologic status, low serum creatinine clearance, female patients, graft rejection, the use of immunosuppressant and donor-recipient MBL-2 and FCN-2 gene polymorphism. There are direct and indirect effects of this posttransplant opportunistic infection, such as cytomegalovirus syndrome, organ invasion lesions, graft loss, accelerated recurrence of hepatitis C, an increased risk of acute or chronic rejection, predisposition to other opportunistic infections, compromised immunity, accelerated atherosclerosis and the interaction between beta herpes virus. Therefore, prevention and early treatment are very crucial. A combination of pp65 antigen assay for screening and real-time RT-PCR methods for confirmation provides an optimal, low-cost diagnostic regimen for cytomegalovirus infection. Ganciclovir is the first selection for antiviral treatment after liver transplantation, but oral valganciclovir and intravenous ganciclovir are safe, feasible options for preemptive treatment of cytomegalovirus infection after liver transplantation. The plasma levels of CXCL16, PTX3 and von Willebrand factor at the start of treatment are independently associated with virologic and clinical treatment failure during anti-cytomegalovirus therapy in solid organ transplant recipients. We should choose different prevention programs for the patients of different donor-recipient cytomegalovirus serologic status. Source

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