Everolimus in immunosuppressive treatment after kidney transplantation in a patient with tuberous sclerosis: case report.

Background: Tuberous sclerosis complex (TSC) is an inherited disorder caused by mutations of TSC1 or TSC2 genes, resulting in constitutive activation of the mammalian target of rapamycin (mTOR) and impairment of the cell cycle. As a consequence, hamartomatous tumors of multiple organs may develop, but generally skin, brain, kidneys, and lungs are involved. mTOR inhibitors (mTOR-I, rapamycin/everolimus) may correct underlying defects in TSC.

Sebaceous carcinoma in patients receiving long-term immunosuppresive treatment: case report and literature review.

Background: Sebaceous carcinoma (SC) is a very rare and aggressive malignant skin cancer that appears to occur with a greater frequency in the clinical setting of chronic immunosuppression; however, it is not reported in the literature as frequently as is squamous cell carcinoma (SCC). We report 2 cases of SC in organ transplant patients from clinical and histopathological points of view.

Methods: A 48-year-old patient after 3 renal transplantations (1986, 1986, and 1998) was presented to the Dermatology Department in 1999 because of a papillomatous lesion along her right upper eyelid.

Klebsiella spp urinary tract infections during first year after renal transplantation.

Background: Urinary tract infections (UTIs) are the most common infections in renal transplant recipients (RTR). Klebsiella spp is a well-recognized source of nosocomial infections in immunocompromised patients and is also the most common pathogen capable of producing extended-spectrum β-lactamases (ESBLs).

Methods: We performed a retrospective cohort study reviewing medical records of patients followed-up at Gdańsk Transplantation Centre.

Acute graft pyelonephritis during the first year after renal transplantation.

Introduction: Urinary tract infections are the most common infections in renal transplant recipients. Acute graft pyelonephritis (AGPN) is considered a potential risk factor for poorer graft outcomes; however, its clinical impact still remains controversial.

Methods: This study analyzed urine cultures performed within the first 12 months after renal transplantation with reference to clinical data of patients who received a renal transplant at Gdańsk Transplantation Centre between January 2007 and December 2009.

Superficial fungal infections in renal transplant recipients.

Background: Renal transplant recipients (RTRs) are predisposed to fungal infections because of long-term graft-preserving immunosuppressive therapy.

Methods: We prospectively enrolled 223 consecutive adult RTRs. Patients were transplanted at 1 of 2 transplant centers in Poland.

Assessment of cardiovascular risk during peritransplant period in renal transplant recipients.

Background: Cardiovascular (CV) diseases are the leading cause of death among patients with chronic kidney disease, including patients on dialysis and after kidney transplantation. The aim of study was the retrospective assessment of CV risk in renal transplant recipients during the peritransplant period.

Material And Methods: Evaluation of CV risk was made using the Revised Cardiac Risk Index (RCRI).

Open prospective study to evaluate cardiovascular risk factors and renal function in 2 dosage regimens of tacrolimus combined with mycophenolate mofetil and steroids in renal transplant patients: 5-year results.

Background: Cyclosporine and tacrolimus (TAC) are the most potent immunosuppressants. TAC is considered less nephrotoxic, but may be an important factor in chronic graft dysfunction. The aim of the study was to evaluate kidney function and cardiovascular risk profile in 2 groups of low immunological risk kidney allograft recipients receiving 2 TAC dosages.

Generic formulation of mycophenolate mofetil (Myfenax) in de novo renal transplant recipients: results of 12-month observation.

Background: The aim of this study was to show the preliminary outcomes of transplantation in patients treated with the generic formulation of mycophenolate mofetil (Myfenax, Teva).

Materials And Methods: Over the past 4 years, 60 patients received generic mycophenolate mofetil (Myfenax) after renal transplantation at the Gdansk Transplantology Center. During the same time period, another 273 kidney transplantations were performed in our department, and these patients were treated with other formulations of mycophenolate (CellCept [Roche], Myfortic, or mycophenolate mofetil-Apotex) as a part of the immunosuppressive plan.

Pregnancy after kidney transplantation: a single-center experience and review of the literature.

After kidney transplantation (KT), pregnancy is possible, although the risk of maternal and fetal complications is much higher than in the general population. Outcome of 22 pregnancies in 17 patients transplanted in the Gdańsk center in the period 1980-2012 was studied. Mean maternal age at pregnancy was 30 ± 5 (range, 23-39) years, interval between transplantation and conception 3.

The modification of diet in renal disease and chronic kidney disease epidemiology collaboration formulas versus measured or estimated creatinine clearance in kidney transplant recipients.

Background: Estimation of glomerular filtration rate (eGFR) after renal transplantation is performed with the use of methods that are standardized for a population of nontransplantation patients with chronic kidney disease. The aim of the study was to compare the performance of GFR estimation formulas in renal transplant recipients.

Methods: The Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas were compared with measured creatinine clearance or clearance estimated by the Cockroft-Gault (C-G) formula.

Epidemiology of posttransplantation chronic kidney disease can be altered by choice of formula estimating glomerular filtration rate.

Background: Epidemiology of posttransplantation chronic kidney disease (CKDPT) has different characteristics than in the general population. Precise determination of glomerular filtration rate (GFR) is essential in the clinical decision making process as well as in management of a population that is based on epidemiological data. The aim of our study was to analyze the impact of an applied GFR estimation method on the epidemiology of CKDPT during the first year after transplantation.

Preemptive kidney transplantation: analysis of kidney grafts from the same donor.

Background: From November 2003 to December 2012, in the Gdańsk Center, 64 patients received preemptive transplantation (PET). PET comprised 8% of 794 kidney transplantations performed during this time. The benefits for individual patients and for the health care system are discussed.

Vitamin B6 status, immune response and inflammation markers in kidney transplant recipients treated with polyclonal anti-thymocyte globulin.

Background/objectives: Vitamin B6 status has an impact on the body's inflammatory and immune responses. Immunosuppressive therapy may influence vitamin B6 metabolism in kidney transplant recipients. Treatment with polyclonal anti-thymocyte globulin (ATG) is associated with long-term changes in inflammatory and immune parameters.

Nutritional status and carnitine level in kidney transplant recipients.

Introduction: Overweight/obesity, malnutrition, and abnormalities in carnitine metabolism are recognized in kidney transplant recipients (KTRs).

Aim: The aim of this study was to evaluate the prevalence of nutritional abnormalities and carnitine status in KTRs.

Methods: The study was performed in 80 stable KTRs aged 52.

Adipokines and nutritional status in kidney transplant recipients.

Background: Obesity and disturbances of adipokine concentrations are often recognized in kidney transplant recipients (KTRs). Leptin plays a key role in regulating energy intake and expenditure, including appetite and hunger, metabolism, and behavior. Adiponectin modulates certain metabolic processes, including glucose regulation and fatty acid oxidation, and exerts some weight-reduction effects.

Urinary tract infections during the first year after renal transplantation: one center's experience and a review of the literature.

Background: The aim of the study was to evaluate the incidence, clinical manifestations, microbiology, risk factors, and the influence of UTIs on renal graft function.

Methods: We analyzed clinical data, urine cultures performed within the first 12 months after RTx, and renal function within 24 months in consecutive patients undergoing RTx at Gdańsk Transplantation Centre between January 2007 and December 2009.

Results: We studied data from 209 RTx recipients, 59.

Prophages in enterococcal isolates from renal transplant recipients: renal failure etiologies promote selection of strains.

Infections caused by commensal bacteria may be fatal for the patients under immunosuppressive therapy. This results also from difficulty in identification of high risk strains. Enterococcal infections are increasingly frequent but despite many studies on virulence traits, the difference between commensal and pathogenic strains remains unclear.

Results of the HepZero study comparing heparin-grafted membrane and standard care show that heparin-grafted dialyzer is safe and easy to use for heparin-free dialysis.

Heparin is used to prevent clotting during hemodialysis, but heparin-free hemodialysis is sometimes needed to decrease the risk of bleeding. The HepZero study is a randomized, multicenter international controlled open-label trial comparing no-heparin hemodialysis strategies designed to assess non-inferiority of a heparin grafted dialyzer (NCT01318486). A total of 251 maintenance hemodialysis patients at increased risk of hemorrhage were randomly allocated for up to three heparin-free hemodialysis sessions using a heparin-grafted dialyzer or the center standard-of-care consisting of regular saline flushes or pre-dilution.

Treated asymptomatic bacteriuria during first year after renal transplantation.

Background: Urinary tract infections (UTIs) are widespread in renal transplant (RTx) recipients with asymptomatic bacteriuria (AB) as the predominant form. It is necessary to determine if AB is a risk factor for symptomatic UTIs.

Methods: We analyzed clinical data and urine cultures performed within the first 12 months after RTx in 209 consecutive patients undergoing RTx at Gdańsk Transplantation Center between January 2007 and December 2009.

Identification of patients with increased immunological risk among potential kidney recipients in the Polish population.

Pretransplant identification of allosensitized patients is possible thanks to new technologies, which allow for accurate detection of clinically relevant alloantibodies. Implementation of these methods in the screening of patients awaiting transplantation increased their chance for successful donor-recipient matching. Here, 1460 patients reported to the Polish National Waiting List were screened with the Luminex Screen (LS) solid phase test for anti-HLA antibodies.

[The nephrological knowledge of patricipants of World Kidney Day 2012 in Gdańsk center].

Introduction: In many countries on different continents, at least 10-12% of people are suffering from chronic kidney disease (CKD). These data indicate that CKD is a big problem, much more than previously expected. Therefore, programs should be promoted for early detection of kidney diseases and carry out public education and also the medical community.

Influence of hemodialysis on circulating CD4(low)CD25 (high) regulatory T cells in end-stage renal disease patients.

Objective: Immunodeficiency of end-stage renal disease (ESRD) is caused by several factors including uremic toxins and biocompatibility reactions due to the repeated hemodialysis (HD) procedure. It has also been suggested that poor T cell responses could be associated with the increased number of regulatory T cells (Tregs) which are necessary to limit the function of activated T cells. The aim of the study was to determine the proportion of CD4(+)CD25(+) cells (activated T cells) to CD4(low)CD25(high) cells (Tregs) within the CD4(+) population in ESRD patients.

Changes of PBP5 gene expression in enterococcal isolates from renal transplantation recipients.

The aim of the study was to evaluate changes in expression of PBP5 gene associated with immunosuppression. A linear locked nucleic acid (LNA) probe was used to measure resistance gene expression by the Flow-FISH method. Expression of the PBP5 gene measured by Flow-FISH was higher in enterococcal strains isolated from renal transplantation (RTx) recipients than in commensal strains.

Modified flow cytometry crossmatch detecting alloantibody-related cytotoxicity as a way to distinguish lytic antibodies from harmless in allosensitised kidney recipients.

The serological complement-dependent cytotoxicity crossmatch (CDC-XM) permits routine identification of anti-donor alloantibodies in the sera of allotransplant recipients. However, in a small group of recipients, antibodies below the threshold of detection may still be responsible for hyperacute rejection. For the same reason, approximately 20% of recipients develop acute rejection episodes.