76
|
Gaciong Z, Koziak K, Jarzyło I, Ludwicki K, Malanowska S, Paczek L, Szmidt J, Wałaszewski J, Lao M. Erythropoietin production after kidney transplantation. Ann Transplant 1998; 1:29-33. [PMID: 9869934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
We studied production of erythropoietin (EPO) in long-term renal allograft recipients with posttransplant erythrocytosis (PTE). Among 951 recipients we found 74 patients with persistent elevation of hematocrit (Htc) value (female > 50%, male > 55%). However, only 63.5% of them had increased red-cell mass ( = "true" erythrocytosis). In all recipients with PTE known causes of secondary erythrocytosis were not found. EPO titer in peripheral blood was significantly higher in recipients with PTE (median 13.5 mIU/mL, range: 0.1-71.5 mIU/mL) as compared to healthy blood donors (median 5.75 mIU/mL, range: 0.1-19.5 mIU/mL) but not different from the group of renal allograft recipients without PTE (median 13.0, range 0.1-71.7 mIU/mL). However, EPO level measured in pretransplant sera was significantly higher in patients who developed PTE (median 16.4 mIU/mL, range: 1.0-281.2 mIU/mL) than in recipients without PTE (median 8.3, range: 1.0-50.3 mIU/mL). A significant difference in EPO level between systemic and effluent blood from native kidneys was found in 6 out of 14 recipients with PTE who underwent catheterization. After phlebotomy patients with PTE responded with higher increase in peak EPO titer than healthy blood donors (527 +/- 473% versus 194.5 +/- 44.2%, p < 0.05). Our results suggest that PTE develops spontaneously due to increased EPO production. Despite elevated EPO levels, regulation of EPO release remains preserved.
Collapse
|
77
|
Durlik M, Gaciong Z, Rowińska D, Rancewicz Z, Lewandowska D, Kozłowska B, Wyzgał J, Soluch L, Walewska-Zielecka B, Rowiński W, Lao M. Long-term results of treatment of chronic hepatitis B, C and D with interferon-alpha in renal allograft recipients. Transpl Int 1998. [PMID: 9664963 DOI: 10.1111/j.1432-2277.1998.tb01097.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the efficacy and safety of interferon-alpha (IFN-alpha) therapy of chronic hepatitis B, C and D (HBV, HCV and HDV, respectively) in renal transplant recipients. A group of 42 patients (30 males, 12 females, mean age 38 years) with documented viraemia and chronic active hepatitis (CAH) were studied, of whom 1 had HBV infection alone, 11 had HCV infection alone, 3 had HBV and HDV infection concomitantly, 12 had HBV and HCV infection concomitantly, and 2 had HBV, HCV and HDV infection concomitantly. Patients received 3 MU IFN-alpha three times weekly for 6 months. After IFN-alpha therapy, 18 patients (43%) achieved normal alanine aminotransferase (ALT) activity and a partial response was observed in 12 (29%) patients. Two patients relapsed (one with HCV and one with HBV + HCV infection) immediately after the cessation of IFN-alpha therapy. Repeated liver biopsy was performed in 16 patients after 6-24 months of therapy and revealed progression to cirrhosis in five patients, remission in two and stable disease in nine. None of the patients cleared HCV RNA, four patients cleared HBeAg (two also HDV), and one both HBV and HCV. Five patients died during IFN-alpha therapy (one as a consequence of liver failure), and four died during the 6 months after therapy (two as a consequence of liver failure). During IFN-alpha therapy renal allograft function remained stable in 31 patients and acute rejection episodes occurred in 7, of whom 5 lost their graft and all had experienced rejection episodes before. In 16 patients normalization of ALT continued during long-term follow-up (median 22 months, range 0-84 months). IFN-alpha seemed to be moderately effective in the treatment of chronic HBV or HCV infections, but cannot be recommended for recipients infected with both HBV and HCV.
Collapse
|
78
|
Kasprzycka M, Górski A, Nowaczyk M, Korczak-Kowalska G, Wierzbicki P, Durlik M, Wyzgał J, Gradowska L, Lao M. T-cell apoptosis following renal transplantation. Transplant Proc 1998; 30:2353-4. [PMID: 9723501 DOI: 10.1016/s0041-1345(98)00651-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
79
|
Kozłowska-Boszko B, Gaciong Z, Serafinowicz A, Majchrzak J, Durlik M, Rowiński W, Lao M. Cyclosporine A blood concentration during pregnancy in renal allograft recipients. Transpl Int 1998; 11 Suppl 1:S90-3. [PMID: 9664952 DOI: 10.1007/s001470050434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pregnancy-induced changes increase hazards associated with cyclosporine (CsA) treatment. Blood CsA trough levels (C0) were estimated in 15 pregnant renal allograft recipients treated with prednisolone + CsA + azathioprine using the TDx Abbott fluorescent polarization immunoassay. Despite therapeutical dose levels of CsA administered during pregnancy (3.52-3.67 and 3.59 mg/kg body weight in the first, second, and third trimesters, respectively), C0 significantly decreased (first trimester 130.8 +/- 36.9, second 92.0 +/- 32.7, and third 99.0 +/- 36.9 ng/ml). The mean increase of patient's body weight in mid-pregnancy was 3.0 +/- 2.19 kg and was associated with a significant (P < 0.05) fall in a hematocrit value (from 42 +/- 4.9% prior to pregnancy to 34 +/- 6% at the 20th week). We postulate that C0 concentration does not reflect the true exposure to CsA as no episodes of acute graft rejection were observed during pregnancy.
Collapse
|
80
|
Durlik M, Gaciong Z, Rowińska D, Rancewicz Z, Lewandowska D, Kozłowska B, Wyzgał J, Soluch L, Walewska-Zielecka B, Rowiński W, Lao M. Long-term results of treatment of chronic hepatitis B, C and D with interferon-alpha in renal allograft recipients. Transpl Int 1998; 11 Suppl 1:S135-9. [PMID: 9664963 DOI: 10.1007/s001470050445] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aim of this study was to evaluate the efficacy and safety of interferon-alpha (IFN-alpha) therapy of chronic hepatitis B, C and D (HBV, HCV and HDV, respectively) in renal transplant recipients. A group of 42 patients (30 males, 12 females, mean age 38 years) with documented viraemia and chronic active hepatitis (CAH) were studied, of whom 1 had HBV infection alone, 11 had HCV infection alone, 3 had HBV and HDV infection concomitantly, 12 had HBV and HCV infection concomitantly, and 2 had HBV, HCV and HDV infection concomitantly. Patients received 3 MU IFN-alpha three times weekly for 6 months. After IFN-alpha therapy, 18 patients (43%) achieved normal alanine aminotransferase (ALT) activity and a partial response was observed in 12 (29%) patients. Two patients relapsed (one with HCV and one with HBV + HCV infection) immediately after the cessation of IFN-alpha therapy. Repeated liver biopsy was performed in 16 patients after 6-24 months of therapy and revealed progression to cirrhosis in five patients, remission in two and stable disease in nine. None of the patients cleared HCV RNA, four patients cleared HBeAg (two also HDV), and one both HBV and HCV. Five patients died during IFN-alpha therapy (one as a consequence of liver failure), and four died during the 6 months after therapy (two as a consequence of liver failure). During IFN-alpha therapy renal allograft function remained stable in 31 patients and acute rejection episodes occurred in 7, of whom 5 lost their graft and all had experienced rejection episodes before. In 16 patients normalization of ALT continued during long-term follow-up (median 22 months, range 0-84 months). IFN-alpha seemed to be moderately effective in the treatment of chronic HBV or HCV infections, but cannot be recommended for recipients infected with both HBV and HCV.
Collapse
|
81
|
Kozlowska-Boszko B, Gaciong Z, Serafinowicz A, Majchrzak J, Durlik M, Rowiński W, Lao M. Cyclosporine A blood concentration during pregnancy in renal allograft recipients. Transpl Int 1998. [DOI: 10.1111/j.1432-2277.1998.tb01204.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
82
|
Lao M, Gradowska L, Stryjecka-Rowińska D, Szmidt J, Rowiński W, Wałaszewski J. [Kidney transplantation in Warsaw and Poland in the years 1966-1996]. POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ 1997; 98:294-303. [PMID: 9557082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
83
|
Rutkowski B, Puka J, Lao M, Baczyk K, Chrzanowski W, Kokot F, Ksiaźek A, Nartowicz E, Popławski A, Sułowicz W, Szewczyk Z. Renal replacement therapy in an era of socioeconomic changes--report from the Polish Registry. Nephrol Dial Transplant 1997; 12:1105-8. [PMID: 9198036 DOI: 10.1093/ndt/12.6.1105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
|
84
|
Kozłlowska-Boszko B, Lao M, Gaciong Z, Sicińska J, Durlik M, Morzycka M, Szmidt J, Rowiński W. Chronic rejection as a risk factor for deterioration of renal allograft function following pregnancy. Transplant Proc 1997; 29:1522-3. [PMID: 9123410 DOI: 10.1016/s0041-1345(96)00660-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
85
|
Serafinowicz A, Gaciong Z, Majchrzak J, Baczkowska T, Nowacka E, Gradowska L, Rowiński W, Lao M. Abbreviated kinetic profiles to estimate exposure to CyA in renal allograft recipients treated with Sandimmun-Neoral. Transplant Proc 1997; 29:277-9. [PMID: 9122994 DOI: 10.1016/s0041-1345(96)00092-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
86
|
Durlik M, Gaciong Z, Soluch L, Rowińska D, Rancewicz Z, Kozłowska-Boszko B, Lewandowski Z, Rowiński W, Szmidt J, Lao M. Effect of chronic liver disease on clinical outcome in renal allograft recipients. Transplant Proc 1997; 29:787-90. [PMID: 9123526 DOI: 10.1016/s0041-1345(96)00102-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
87
|
Kozłowska-Boszko B, Korczak G, Wierzbicki P, Lis K, Gaciong Z, Lao M, Sicińska J, Górski A. Pregnancy following kidney transplantation: risk for offsprings. Transplant Proc 1997; 29:262-5. [PMID: 9122989 DOI: 10.1016/s0041-1345(96)00088-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
88
|
Paczek L, Bill M, Wyzgał J, Gaciong Z, Gradowska L, Juskowa J, Durlik M, Lao M. [The effect of hypolipidemia treatment on the function of kidney transplanted from cadavers]. POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ 1997; 97:144-56. [PMID: 9312763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The high prevalence of hypercholesterolemia (HCh) in kidney transplant recipients probably contributes to the high cardiovascular mortality of these patients. Additionally, HCh is a contributing factor to the progression of renal failure. We conducted a prospective, randomised study with low dose Lovastatin in 42 kidney transplant recipients during 32 weeks, focusing on side effect and kidney function 42 consecutive patients with kidney transplanted in our Institute, with stable renal function (creatinine level < 160 mmol/l) treated with ciclosporine, azathioprine, prednisone were enrolled for the study (regardless of the initial cholesterol level). Every second patient was given Lovastatin 20 mg/night. In the Lovastatin group total cholesterol (TC) and LDL concentration were significantly lower after 6 months of treatment (TC was reduced from 242.5 +/- 12.8 to 220 +/- 15.4 mg/dl, p < 0.05) in Lovastatin group whereas in control group it increased nonsignificantly. Similarly LDL in Lovastatin group decreased from 140.0 +/- 7.0 to 121.3 +/- 10.8 mg/dl, p < 0.02 whereas in control group it increased from 143.6 +/- 5.4 to 169.9 +/- 10.3 mg/dl, p < 0.01. HDL and trigliceride concentrations were unchanged. The Lovastatin treatment did not results in more adverse events than the placebo treatment. Notably, the tendency to increase creatinine level in Lovastatin group was observed from 1.59 +/- 0.17 to 1.74 +/- 0.22 in Lovastatin group versus 1.89 +/- 0.22 to 2.21 +/- 0.35 mg/dl (NS). Low dose Lovastatin treatment seems to be safe and efficient cholesterol-lowering procedure. However we did not observe beneficial effect on kidney graft function.
Collapse
|
89
|
Rowinski WA, Walaszewski J, Lao M. Factors limiting renal transplantation in Poland. Transplant Proc 1996; 28:3413-4. [PMID: 8962332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
90
|
Tałałaj M, Gradowska L, Marcinowska-Suchowierska E, Durlik M, Gaciong Z, Lao M. Efficiency of preventive treatment of glucocorticoid-induced osteoporosis with 25-hydroxyvitamin D3 and calcium in kidney transplant patients. Transplant Proc 1996; 28:3485-7. [PMID: 8962355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
91
|
Serafinowicz A, Gaciong Z, Baçzkowska T, Durlik M, Lao M. Cyclosporine pharmacokinetics in renal allograft recipients with diabetes mellitus with Sandimmune and Sandimmune Neoral. Transplant Proc 1996; 28:3140-1. [PMID: 8962217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
92
|
Gaciong Z, Paczek L, Bojakowski K, Socha K, Wiśniewski M, Lietz K, Lao M, Heidland A. Protease therapy alleviates allograft arteriosclerosis in rats. Transplant Proc 1996; 28:3439-40. [PMID: 8962341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
93
|
Paczek L, Bartłomiejczyk I, Gradowska L, Szmidt J, Gaciong Z, Lao M, Heidland A. Intraglomerular protein accumulation in chronically rejected human kidney allografts. Transplant Proc 1996; 28:3449-51. [PMID: 8962345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
94
|
Serafinowicz A, Gaciong Z, Baçzkowska T, Rell K, Lao M, Wałaszewski J. Limited sampling strategy to estimate exposure to cyclosporine A in renal allograft recipients treated with Sandimmune-Neoral. Transplant Proc 1996; 28:3138-9. [PMID: 8962216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
95
|
Kokot F, Wiecek A, Grzeszczak W, Lao M, Kuśmierski S, Cierpka L, Gradowska L, Jagiełło R. Serum erythropoietin and parathyroid hormone concentrations in kidney transplant patients during acute graft rejection. Transplant Proc 1996; 28:3477-9. [PMID: 8962352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
96
|
Lao M, Rowiński W, Wałaszewski J, Szmidt J. Renal transplantation in Warsaw: a registry report. Transplant Proc 1996; 28:3497-503. [PMID: 8962360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In a country undergoing socioeconomic transformation, with all the attendant financial difficulties, it is rather difficult to obtain very good results in this expensive and advanced method of therapy. However, in spite of such difficulties, the results obtained are equal to the European standards, with 85% and 65% one- and five-year graft survival, respectively.
Collapse
|
97
|
Lao M, Rowinski WA, Szmidt J, Walaszewski J, Frunze S, Pazik J, Nowacka E, Rowinska D, Gradowska L. Living donor renal transplantations in Poland. Transplant Proc 1996; 28:3573-4. [PMID: 8962383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
98
|
Rowiński W, Lao M, Cajzner S, Lagiewska B, Lazowski T, Pacholczyk M, Szostek M, Wałaszewski J. The influence of endocrine changes in donors and recipients on the immediate outcome of kidney transplantation. Transplant Proc 1996; 28:3494-6. [PMID: 8962359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
99
|
Durlik M, Gaciong Z, Soluch L, Rowińska D, Kozłowska-Boszko B, Rowiński W, Szmidt J, Lao M. Results of kidney transplantation in HBsAG and anti-HCV seropositive renal allograft recipients. Transplant Proc 1996; 28:3459-60. [PMID: 8962347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
100
|
Grochowiecki T, Szmidt J, Madej K, Frunze S, Gałazka Z, Nazarewski S, Barański A, Jabłoński D, Nowacka E, Debicki G, Lao M. Spontaneous kidney allograft rupture and cyclosporine immunosuppressive therapy. Transplant Proc 1996; 28:3461-2. [PMID: 8962348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|