Tonsillectomy ameliorates histological damage of recurrent immunoglobulin A nephropathy after kidney transplantation.

Aim: Recurrence of immunoglobulin A (IgA) nephropathy (IgAN) after renal transplantation is important as a cause of graft failure under improving rejection control. However, no specific therapy for recurrent IgAN is currently available. In this study, we evaluated the histological efficacy of tonsillectomy for allograft IgAN.

Clinical factor affecting the recovery of kidney function in clinically localized renal cell carcinoma patients who underwent nephron-sparing surgery.

Introduction: Nephron-sparing surgery (NSS) has become the standard treatment for small renal cell carcinoma because of its comparable oncological outcome and superior patient survival compared to total nephrectomy. However, the precise chronological course of recovery from initial kidney damage and the factors responsible for it remain unknown.

Materials And Methods: Seventy-one patients who underwent NSS were enrolled.

Peri-operative morbidity and mortality related to radical cystectomy: a multi-institutional retrospective study in Japan.

Unlabelled: What's known on the subject? and What does the study add? Radical cystectomy remains associated with comparatively high perioperative morbidity and mortality, despite improvements in surgical techniques and perioperative care. At present, most studies on the complications associated with open radical cystectomy were derived from Western academic high-volume centres, and data from Japan and other Asian countries were very limited. Using the modified Clavien grading system and 11 category grouping reported from MSKCC, we observed that 68% of patients experienced at least one complication within 90 days of surgery, and 17% of patients experienced major complications (90-day mortality rate = 2%), which were compatible with reports from Western high-volume centres.

Granulomatous tubulointerstitial nephritis in a renal allograft: three cases report and review of literature.

Granulomatous interstitial nephritis (GIN) is a rare histologic diagnosis in renal allografts. We report three cases with GIN. Case 1: a 37-yr-old woman received a kidney from her mother.

Regional secondary focal segmental glomerulosclerosis in a transplanted kidney: resolution with treatment of a segmental renal artery stenosis.

Background: Conditions associated with high intraglomerular filtration pressure can cause secondary focal segmental glomerulosclerosis (FSGS). Unilateral renal artery stenosis (RAS) or its occlusion results in FSGS-like changes and the nephrotic syndrome in the contralateral kidney due to hyperfiltration. However, it has been rarely reported that stenosis of a renal arterial branch can result in FSGS-like changes in a different portion in the same kidney allograft.

Impact of diagnostic ureteroscopy on intravesical recurrence and survival in patients with urothelial carcinoma of the upper urinary tract.

Purpose: We determined whether diagnostic ureteroscopy for upper urinary tract cancer affects intravesical recurrence and cancer specific mortality.

Materials And Methods: In a retrospective, multi-institutional study we evaluated 208 patients undergoing nephroureterectomy for upper urinary tract cancer who had no perioperative systemic chemotherapy, history of invasive bladder cancer, distant metastasis or incomplete followup data. Of these 208 patients 55 who composed the study group underwent diagnostic ureteroscopy before nephroureterectomy while 153 serving as controls did not.

A case of pregnancy-induced thrombotic thrombocytopenic purpura with a kidney allograft recipient.

A 32-yr-old female patient, who had been suffering from diffuse crescentic glomerulonephritis and a consequent end-stage renal disease, successfully underwent living-related ABO-incompatible kidney transplantation after a desensitization therapy including anti-CD20 monoclonal antibody. Forty-six months after the transplantation, the recipient became pregnant. At the 17th gestational week, the patient was admitted for the management of pregnancy-induced hypertension and aggressive deterioration of kidney graft function.

Pathological characteristics and clinical course of bladder tumour developing after nephroureterectomy.

Objectives: To determine the pathological features and clinical course of intravesical recurrence after nephroureterectomy (NU) for upper urinary tract (UUT) cancer.

Patients And Methods: Among 325 patients undergoing NU with bladder cuff excision for UUT cancer, in this retrospective multi-institutional study we evaluated 113 who developed bladder tumour after NU. Excluding patients with (i) perioperative systemic chemotherapy or radiotherapy for UUT cancer; (ii) a history of previous or synchronous bladder cancer at the time of NU; (iii) distant metastasis at the time of NU; (iv) a follow-up of <1 year after the initial bladder cancer recurrence; or (v) missing data, 74 patients were included in this study.

Successful rescue of late-onset acute T-cell mediated rejection with anti-CD25 antibody: a case report.

Japan A 56-yr-old Japanese male with a history of diabetic nephropathy underwent a HLA 5/6 mismatch and ABO-compatible living-related kidney transplantation (donor: his 49-yr-old wife). A pre-transplant standard NIH complement-dependent cytotoxicity cross-match (Xm) test, a flow-cytometric T-cell Xm, and a FlowPRA test were totally negative. Inductionimmunosuppressive protocol consisted of tacrolimus, mycophenolate mofetil, methylprednisolone, and basiliximab (BAS).

The role of lymph-node dissection in the treatment of upper urinary tract cancer: a multi-institutional study.

Objectives: To determine the role of lymph-node (LN) dissection in patients undergoing surgery for upper urinary tract (UUT) cancer.

Patients And Methods: We reviewed the clinicopathological data from 312 patients with UUT cancer treated predominantly by nephroureterectomy. The relationship between clinical characteristics and cancer-specific survival (CSS) was analysed, focusing on node-related information.

Late corticosteroid withdrawal can be safely performed for kidney recipients with stable graft function under pathological confirmation.

Corticosteroid withdrawal (CSWD) protocols to minimize the risk of cardiovascular events after kidney transplantation have been reported. However, most of them were within one year post-transplant, and the pathological survey after CSWD was poorly done. We conducted the present retrospective study to elucidate the usefulness and safety of late-steroid withdrawal more than one year after transplantation in kidney recipients with pathological evaluation.

Epididymo-orchitis caused by intravesically instillated bacillus Calmette-Guérin: genetically proven using a multiplex polymerase chain reaction method.

The intravesical instillation of bacillus Calmette-Guérin (BCG) is a standard therapy for superficial bladder carcinoma. Tuberculosis-like inflammation in the genitourinary tract is a serious complication of BCG. It can occur after a long interval from the cessation of the intravesical BCG therapy.

Quadruple immunosuppression with basiliximab, tacrolimus, mycophenolate mofetil and prednisone is safe and effective for renal transplantation.

Introduction: Recent immunosuppression with tacrolimus and mycophenolate mofetil has improved the results of renal transplantation. In this study, we analyzed the effect and safety of basiliximab as an induction therapy.

Material And Methods: Forty-nine kidney recipients were given tacrolimus, mycophenolate mofetil and prednisone (non-Bas group), and 31 recipients were given basiliximab as an induction therapy in addition to the triple immunosuppressants (Bas group).

Peritoneal carcinomatosis in refractory seminoma.

Intraperitoneal metastasis from a testicular germ cell tumor is very rare. We report a case in a 33-year-old man who was referred to Hokkaido University Hospital, Hokkaido, Japan, for further therapy for refractory seminoma. Physical examination revealed abdominal distension as a result of ascites, and cytology of the ascites showed seminoma cells.

Squamous metaplasia mimicking papillary carcinoma in the upper urinary tract.

We experienced a case of squamous metaplasia mimicking papillary urothelial cell carcinoma in the upper urinary tract. A 69-year-old woman, who complained of gross hematuria and intermittent left flank dull pain underwent nephrectomy with the clinical diagnosis of papillary urothelial carcinomas in the left upper urinary tract according to positive split urine cytology and tumorous filling defects of contrast media by the abdominal CT scan. Pathological diagnosis was squamous metaplasia and concomitant foreign body granuloma.