Antibodies ; immunology ; Graft Rejection ; drug therapy ; immunology ; prevention & control ; Graft Survival ; immunology ; Humans

Kaposi's sarcoma is an unusual neoplasm that has proved to be an enigma in many ways since its original description by Kaposi in 1872. Of the several different type of Kaposi's sarcoma, iatrogenically immunosuppressed patients predisposed to Kaposi's sarcoma are usually either transplant recipients or patients receiving immunosuppressive therapy. We report a case of recurrent Kaposi's sarcoma in a 56 year old male, which has occurred during the cyclosporine therapy of kidney transplantation. Cyclosporine was discontinued and chemotherapy began and the resolution of Kaposi's sarcoma has been obtained. Cyclosporine maintenance therapy was started again for the prevention of graft rejection. But 1 year later, Kaposi's sarcoma recurred probably due to re-use of cyclosporine.
Cyclosporine* ; Drug Therapy ; Graft Rejection ; Humans ; Kidney Transplantation* ; Kidney* ; Male ; Middle Aged ; Sarcoma, Kaposi* ; Transplantation

OBJECTIVETo evaluate the possible role of alkaloid sinomenine (SIN) on chronic rejection in rat heart transplantation model.

METHODSAfter a brief course of cyclosporine A (CsA), DA recipients of PVG hearts were treated with placebo, SIN, CsA, or a combination of both drugs. Grafts were analyzed morphometrically and by immuno-histochemistry. Expressions of basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), and endothelin 1 (ET-1) were assessed by reverse transcription-polymerase chain reaction.

RESULTSCardiac grafts of SIN-treated rats showed a mild degree of vasculopathy compared with untreated rats or CsA-treated recipients. Degree of vasculopathy was significantly reduced in rats treated with combined SIN and CsA than rats receiving either drug alone. Treatment with SIN alone did not affect gene expressions of bFGF, VEGF, and ET-1 while expressions of bFGF, VEGF, and ET-1 were significantly reduced by combined treatment with SIN and CsA.

CONCLUSIONThese results demonstrated a potential value of SIN, in combination with low-dose CsA to attenuate the vasculopathy in this rat model of chronic cardiac allograft rejection.

Animals ; Disease Models, Animal ; Graft Rejection ; drug therapy ; Graft Survival ; Heart Transplantation ; Male ; Morphinans ; therapeutic use ; Phytotherapy ; Rats

In the past 50 years, organ transplantation has developed from an improbable laboratory exercise to a major therapeutic success. The surgical problems of organ grafting have, for the most part, been solved. Rejection of grafts is now partially understood and usually controllable by powerful immunosuppressive drugs. A steady improvement in patient outcome, especially following the introduction of cyclosporin as an immunosuppressive agent has resulted in a worldwide shortage of organs for transplantation. This has provoked serious ethical dilemmas in every country. These matters are summarised in the following text.
Biomedical Research ; Cyclosporine ; pharmacology ; Graft Rejection ; drug therapy ; prevention & control ; Humans ; Immunosuppression ; Immunosuppressive Agents ; pharmacology ; Transplants ; ethics

Adult ; Graft Rejection ; drug therapy ; Humans ; Immunosuppressive Agents ; therapeutic use ; Liver Transplantation ; Male ; Middle Aged ; Muromonab-CD3 ; therapeutic use

Asthma ; drug therapy ; Autoimmune Diseases ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Graft Rejection ; drug therapy ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Phytotherapy

OBJECTIVETo observe the clinic effect of combined use of berberin hydrochloride (Ber) with cyclosporine A (CsA) on the blood concentration of CsA in heart transplanted recipients.

METHODSThe blood concentration of CsA, liver-renal function and blood lipids in 22 heart transplanted recipients, who received Ber-CsA combined therapy, were measured.

RESULTSThe whole blood steady state concentration of CsA, C0 and C2, in recipients after being treated with Ber-CsA significantly increased than those before applying Ber-CsA (P < 0.01), with the mean increment of 26% and 18% respectively; the dosage of CsA used decreased in 21 patients by 25-100 mg/d; and the Ber-CsA showed no significant effect on liver-renal function or blood lipids (P > 0.05).

CONCLUSIONCombined use of CsA with Ber could markedly increase the blood concentration of CsA in heart transplanted recipients and reduce the dosage of CsA required, save the fee for medical service, and shows no obvious adverse reaction.

Adolescent ; Adult ; Aged ; Berberine ; administration & dosage ; Cyclosporine ; administration & dosage ; blood ; Drug Therapy, Combination ; Female ; Graft Rejection ; blood ; drug therapy ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo study the suppressive effect of indoleamine 2, 3-dioxygenase on transplantation rejection in mice heterotopic cardiac transplantation.

METHODSAdenovirus vector containing IDO gene was used to infect donor (C57BL/6) DC to obtain IDO(+)DC. Mouse heterotopic cardiac transplantation models were established (C57BL/6-BALB/c) and the following groups were set up, including the control group, DC injection group, TC injection group, IDO(+)DC injection group and co-injection group of IDO(+)DC and TC, 12 donors and 12 recipients in each group.Survival time of the donor heart in every group was observed. Meanwhile, donor hearts were harvested 7 days post transplantation for different examinations, including pathological examination, mRNA expression of IDO through real-time PCR, IDO protein expression through Western blot. Peripheral blood of recipients was also harvested for CD3(+)T lymphocyte apoptosis rate examination through fluorescence-activated cell sorting.One-way ANOVA and Kaplan-Meier Survival Analysis were used for statistic analysis of IDO expression, CD3(+)T lymphocyte apoptosis rate and survival time of the donor heart respectively.

RESULTSCadiac allograft median survival time of each group were 7.0, 7.5, 11.0, 17.5, 24.0 days respectively. Compared with control and DC injection group, IDO(+)DC, TC and co-injection group significantly prolonged the survival time of donor hearts (t = 3.523-8.449, P < 0.01). Both IDO mRNA and protein expression showed significant increase(t = 5.974-16.176, P < 0.01). The CD3(+)T lymphocyte apoptosis rate was also significantly increased (t = 6.324-38.120, P < 0.01). Compared with IDO(+)DC or TC group alone, co-injection group significantly prolonged the survival time of the donor heart (t = 5.971 and 2.831, P < 0.05). Both IDO mRNA and protein expression showed significant increase (t = 2.853-15.194, P < 0.01).Furthermore, the CD3(+)T lymphocyte apoptosis rate was significantly increased as well (t = 26.069 and 7.643, P < 0.05).

CONCLUSIONSSuppressive effect of co-injection of IDO(+)DC and TC is much more effective than administration of IDO(+)DC or TC alone, which suggests that IDO achieved immune suppressive effect through the pathway of tryptophan depletion and accumulation of TC.

Animals ; Gene Transfer Techniques ; Graft Rejection ; drug therapy ; Heart Transplantation ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; therapeutic use ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL

BACKGROUNDAcute rejection is one of the most important factors for prognosis following liver transplantation. With the use of potent immunosuppressants, acute rejection does not always present typical manifestations. Moreover, other complications often occur concomitantly after liver transplantation, which makes early diagnosis of acute rejection more difficult. Acute rejection is best diagnosed by liver biopsy. Differentiation of clinical manifestations and pathological features plays an important role in achieving individualized immunosuppressive treatment and prolonging long term survival of patients given orthotopic liver transplants.

METHODSFrom January 2004 to December 2006, 516 orthotopic liver transplantations were performed at the First Affiliated Hospital, Sun Yat-sen University. For patients who suffered acute rejection, clinical manifestations, histopathological features, diagnosis and anti-rejection treatment were summarized and analyzed.

RESULTSIn 86 cases (16.7%), of the 516 recipients, 106 episodes of acute rejection occurred, which included 9 with histopathological borderline changes, 36 Banff I rejections, 48 Banff II and 13 Banff III. Among these, 36 were cured by adjusting the dose of immunosuppressant and 65 were reversed by methylprednisolone pulse treatment. Five were methylprednisolone resistant, 3 of whom were given OKT3 treatment and 2 underwent liver retransplantation.

CONCLUSIONSDue to potent immunosuppressive agents, acute rejection following an orthotopic liver transplantation lacks typical clinical manifestations and pathological features. Acute rejection is best diagnosed by liver biopsy. Designing rational individualized immunosuppressive regimen based on clinical and pathological features of acute rejection plays an important role in prolonging long term survival of patients.

Adolescent ; Adult ; Aged ; Child ; Female ; Graft Rejection ; drug therapy ; pathology ; Humans ; Immunosuppressive Agents ; therapeutic use ; Liver Transplantation ; adverse effects ; Male ; Methylprednisolone ; therapeutic use ; Middle Aged ; Young Adult

OBJECTIVETo explore the effect of CD40 blockade in suppressing acute rejection of renal graft in rats.

METHODSWith Wistar rats as the donor and male SD rats as the recipients, rat models of acute renal graft rejection was established. The rat models were divided into therapy group and control group, and in the former group, CD40 ligand (CD40L) monoclonal antibody was injected daily for 4 consecutive days starting on the next day following kidney transplantation. On day 5 after the transplantation, the renal graft was harvested for histological examination, and graft rejection was evaluated semiquantitatively.

RESULTSThe mean semiquantitative score of the renal graft was 0.63∓0.52 in the therapy group, significantly lower than that of the control group (3.72∓1.48, P<0.05).

CONCLUSIONCD40L monoclonal antibody can inhibit acute renal graft in rats.

Animals ; Antibodies, Monoclonal ; pharmacology ; therapeutic use ; CD40 Antigens ; antagonists & inhibitors ; immunology ; CD40 Ligand ; immunology ; Female ; Graft Rejection ; drug therapy ; prevention & control ; Graft Survival ; drug effects ; Kidney Transplantation ; adverse effects ; Male ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar