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Ehren R, Habbig S, Krupka K, Ernst A, Bald M, König S, Murer L, Özçakar ZB, Pohl M, Babenko N, Spartà G, Staude H, Dello Strologo L, Szabó AJ, Tönshoff B, Weber LT. Prevalence and potential relevance of hyperuricemia in pediatric kidney transplant recipients-a CERTAIN registry analysis. Pediatr Transplant 2022; 26:e14265. [PMID: 35263498 DOI: 10.1111/petr.14265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/27/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Asymptomatic hyperuricemia is frequently observed in pediatric kidney transplant recipients; symptomatic hyperuricemia, however, is a rare complication. Only few data are available in this patient population. We, therefore, investigated the prevalence of hyperuricemia and its association with kidney transplant function and blood pressure in a multicenter cohort of pediatric kidney transplant recipients. METHODS This is a retrospective, observational multicenter registry study. All pediatric kidney transplant recipients in the CERTAIN database with at least one documented serum uric acid level and a follow-up of 5 years posttransplant were eligible. We identified 151 patients with 395 measurements of serum uric acid. We calculated the prevalence of hyperuricemia, analyzed potential risk factors and clinical consequences such as elevated blood pressure and reduced estimated glomerular filtration rate (eGFR). Statistical analysis was performed using IBM SPSS Statistics 26. RESULTS One hundred and ten of 395 (27.8%) serum uric acid levels were above 416 µmol/L (7.0 mg/dL), defined as the upper limit of normal. Univariate analysis showed a significant (p = .026) inverse association of serum uric acid with eGFR overtime. There was no significant association of serum uric acid concentrations with body mass index (z-score), blood pressure (z-score), or sex. No episodes of gout were documented. CONCLUSION This study shows that hyperuricemia is present in a considerable number of patients sometime after pediatric kidney transplantation and is associated with lower eGFR. Whether hyperuricemia contributes to faster decline of graft function or to the overall cardiovascular risk of these patients remains to be elucidated.
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Affiliation(s)
- Rasmus Ehren
- Pediatric Nephrology, Children's and Adolescents' Hospital, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sandra Habbig
- Pediatric Nephrology, Children's and Adolescents' Hospital, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kai Krupka
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Angela Ernst
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Martin Bald
- Olga Children's Hospital, Clinic of Stuttgart, Stuttgart, Germany
| | - Sabine König
- Department of General Pediatrics, University Hospital Muenster, Muenster, Germany
| | - Luisa Murer
- Department of Woman's and Child's Health, Pediatric Nephrology Dialysis and Transplant Unit, Azienda Ospedaliera-University of Padova, Padova, Italy
| | - Zeynep Birsin Özçakar
- Division of Pediatric Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Michael Pohl
- KfH Kidney Center for Children and Adolescents, St. Georg Hospital, Leipzig, Germany
| | - Nadezhda Babenko
- National Medical Research Center for Children's Health, Organ Transplant Division, Moscow, Russian Federation
| | - Giuseppina Spartà
- Pediatric Nephrology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hagen Staude
- University Children's Hospital Rostock, Rostock, Germany
| | | | - Attila J Szabó
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.,MTA-SE (Hungarian Academy of Sciences - Semmelweis University) Pediatrics and Nephrology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Lutz T Weber
- Pediatric Nephrology, Children's and Adolescents' Hospital, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Kysielova H, Yampolska K, Dubrava T, Lutsenko O, Bondarovych M, Babenko N, Gaevska Y, Ostankov M, Goltsev A. Improvement of bone marrow mononuclear cells cryopreservation methods to increase the efficiency of dendritic cell production. Cryobiology 2022; 106:122-130. [PMID: 35245536 DOI: 10.1016/j.cryobiol.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 11/27/2022]
Abstract
Cryopreservation is now considered an integral part of the biotechnological process, exploiting different types of cells and tissues in clinical practice. Among them, dendritic cells (DCs) deserve special attention, notably the immature tolerogenic cells (tolDCs), which provide natural tolerance in humans and animals. High cryolability of tolDCs has necessitated the search for the methods that would provide cryopreservation of their precursors; those more resistant to negative effects of cryopreservation factors, in particular, bone marrow or peripheral blood mononuclear cells (MNCs). Based on this, the aim of our research was to optimize the cryopreservation conditions for mice bone marrow MNCs with further assessment of their ability to form tolDCs ex vivo. A cryopreservation mode for bone marrow MNCs has been developed which provides structural and functional completeness of tolDCs obtained from them ex vivo. The ability of DCs derived from cryopreserved MNCs by the developed mode to induce T-regulatory (FOXP3+) cells in vitro when co-cultured with CD4+-lymphocytes was shown.Tolerogenic properties of the DCs derived from cryopreserved MNCs are implemented by increasing the content of hsp70 heat shock proteins and the expression rate of glucocorticoid-induced leucine zipper (GILZ). DCs with increased tolerogenic activities, obtained by the developed cryopreservation regimen, can be used in treatment of autoimmune diseases. In this research we not only evaluated the qualitative characteristics and tolerogenic activity of DCs produced in vitro from cryopreserved MNCs, but also outlined the prospects of accumulating their reserves in low-temperature banks for clinical use.
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Affiliation(s)
- H Kysielova
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine.
| | - K Yampolska
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
| | - T Dubrava
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
| | - O Lutsenko
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
| | - M Bondarovych
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
| | - N Babenko
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
| | - Yu Gaevska
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
| | - M Ostankov
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
| | - A Goltsev
- Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine 23, Pereyaslavska str., Kharkiv, 61016, Ukraine
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Kaabak M, Babenko N, Kuznetsov O, Matveev A, Minina M, Platova E, Morozova M, Novozhilova T. Eculizumab reverses the potentially fatal effects of kidney graft reperfusion injury. Pediatr Transplant 2014; 18:E44-7. [PMID: 24330127 DOI: 10.1111/petr.12206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2013] [Indexed: 12/23/2022]
Abstract
Half an hour after reperfusion, the kidney, transplanted to the infant from an adult brain dead standard criteria donor, became flabby and acquired blue color. Hyperacute rejection was suspected as a consequence of false negative cross match, and eculizumab was administered with the purpose to treat antibody-mediated injury, with fast and clear effect. The patient's blood was tested for donor-specific antibodies on the next day, and results were negative. We attribute graft damage to reperfusion injury and explain eculizumab's effectiveness to its ability to prevent progression of reperfusion injury.
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Affiliation(s)
- Michael Kaabak
- Department of Kidney Transplantation, National Research Center for Surgery, Moscow, Russian Federation
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