Background: Thrombotic microangiopathies (TMAs) are rare but can be severe in kidney transplant. recipients (KTR).
Methods: We analysed the epidemiology of adjudicated TMA in consecutive KTR during the. 2009-2021 period.
Results: TMA was found in 77/1644 (4.7%) KTR. Early TMA (n = 24/77 (31.2%); 1.5% of all KTR) occurred during the first two weeks ((median, IQR) 3 [1-8] days). Triggers included acute antibody-mediated rejection (ABMR, n = 4) and bacterial infections (n = 6). Graft survival (GS) was 100% and recurrence rate (RR) was 8%. Unexpected TMA (n = 31/77 (40.2%); 1.5/1000 patient-years) occurred anytime during follow-up (3.0 (0.5-6.2) years). Triggers included infections (EBV/CMV: n = 10; bacterial: n = 6) and chronic active ABMR (n = 5). GS was 81% and RR was 16%. Graft-failure associated TMA (n = 22/77 (28.6%); 2.2% of graft losses) occurred after 8.8 (4.9-15.5) years). Triggers included acute (n = 4) or chronic active (n = 14) ABMR, infections (viral: n = 6; bacterial: n = 5) and cancer (n = 6). 15 patients underwent transplantectomy. RR was 27%. Atypical (n = 6) and typical (n = 2) haemolytic and uremic syndrome, and isolated CNI toxicity (n = 4) were rare. Two-third of biopsies presented TMA features.
Conclusions: TMA are mostly due to ABMR and infections; causes of TMA are frequently combined. Management often is heterogenous. Our nosology based on TMA timing identifies situations with distinct incidence, causes and prognosis.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10512637 | PMC |
http://dx.doi.org/10.1186/s12882-023-03326-8 | DOI Listing |
Hippocampus
January 2025
Sechenov Institute of Evolutionary Physiology and Biochemistry, The Russian Academy of Sciences, Saint Petersburg, Russia.
Accumulating evidence indicates that inherited astrocyte dysfunction can be a primary trigger for epilepsy development; however, the available data are rather limited. In addition, astrocytes are considered as a perspective target for the design of novel and improvement of the existing antiepileptic therapy. Piracetam and related nootropic drugs are widely used in the therapy of various epileptic disorders, but detailed mechanisms of racetams action and, in particular, their effects on glial functions are poorly understood.
View Article and Find Full Text PDFJ Cell Physiol
December 2024
Department of Medical Research and Development, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
Excessive mechanical overloading of articular cartilage caused by excessive exercise or severe trauma is considered a critical trigger in the development of osteoarthritis (OA). However, the available clinical theranostic molecular targets and underlying mechanisms still require more elucidation. Here, we aimed to examine the possibility that bone morphogenetic proteins (BMPs) serve as molecular targets in rat cartilages and human chondrocytes under conditions of excessive mechanical overloading.
View Article and Find Full Text PDFJ Allergy Clin Immunol Pract
December 2024
Ochsner Health System, Department of Allergy/Immunology and Tulane University, School of Public Health and Tropical Medicine. Electronic address:
Flooding events, particularly those caused by hurricanes and other large storm events, are increasingly fueled by climate change. Stormwater intrusion into homes creates ideal conditions for mold growth. Homes inundated by floodwaters become vulnerable to production of mold spores, particulate matter, and volatile organic compounds, all of which trigger a variety of poor health outcomes.
View Article and Find Full Text PDFCell Mol Gastroenterol Hepatol
December 2024
Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Broad Institute, Cambridge, MA. Electronic address:
Background And Aims: Alcohol abuse is the most frequent precipitating factor of acute-on-chronic liver failure (ACLF). We aimed at developing an alcohol-induced ACLF model and dissecting its underlying molecular mechanisms.
Methods: ACLF was triggered by a single alcohol binge (5g/Kg) in a bile duct ligation (BDL) liver fibrosis murine model.
J Dent
December 2024
Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ). Rodolpho Paulo Rocco, 325, Rio de Janeiro, RJ, Brazil. ZIP Code: 21941-617. Electronic address:
Objectives: To identify and map the literature on the current state of pH-triggered strategies for resin-based materials used in direct restorative dentistry, focusing on innovative compounds, their incorporation and evaluation methods, and the main outcomes.
Data And Sources: Through a search across PubMed, Scopus, Embase, Web of Science, LILACS, Cochrane Library databases, and Google Scholar, this review identified studies pertinent to pH-responsive dental materials, excluding resin-modified glass ionomer cements.
Study Selection: From the 981 records identified, 19 in vitro studies were included, concentrating on resin-based composite resins (50%), dentin adhesives (25%), and sealants (25%).
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!