2.Treatment of Late Bleb Leak with Human Amniotic Membrane Transplantation.
Seonghee KIM ; Sang Il CHOI ; Changwon KEE
Journal of the Korean Ophthalmological Society 2000;41(4):1023-1027
Late bleb leak after trabeculectomy is a serious and intractable complication and its frequency is increasing as antimetabolites are used in the surgery. Various modalities have been challenged in the treatment of late bleb leak but the results have not been satisfactory.Amniotic membrane is avascular tissue with thick basement membrane and rich stroma, and it can modulate wound.As it does not express HLA, it doesn t induce graft rejection. With the use of these characteristics of amniotic membrane, we report a case in which late bleb leak after trabeculectomy with MMC was successfully treated with amniotic membrane transplantation maintaining bleb function.
Amnion*
;
Antimetabolites
;
Basement Membrane
;
Blister*
;
Graft Rejection
;
Humans*
;
Membranes
;
Trabeculectomy
3.A Case of Heart Transplant Rejection Treated with Plasmapheresis.
Hyun Sook CHI ; Seog Woon KWON ; Jae Joong KIM ; Soo Youn LEE
Korean Journal of Blood Transfusion 1995;6(1):53-62
We describe a case of an acute heart transplant rejection treated with triple immunosuppression and plasmapheresis, resulting in evidence of improved clinical manifestation and hemodynamics. This case suggests that plasmapheresis may be useful in the treatment of possible acute humoral(vascular) rejection in heart transplantation.
Graft Rejection*
;
Heart Transplantation
;
Heart*
;
Hemodynamics
;
Immunosuppression
;
Plasmapheresis*
4.Lamellar Sclerokeratoplasty for Limbal Dermoids.
Journal of the Korean Ophthalmological Society 2002;43(10):1869-1875
PURPOSE: To evalute the surgical outcome of patients with limbal dermoid choristomata treated lay lamellar sclerokeratoplasty. METHODS: We performed lamellar sclerokeratoplasty on 13 patients with limbal dermoid in 14 eyes. Lamellar corneoscleral graft was used in this operation. We evaluated cosmetic effect, refractive change and graft survival/integrity after a follow up period of at least 3 months. RESULTS: All patients who underwent lamellar sclerokeratoplasty had good or excellent cometic result with good sclerocorneal alignment. There were no significant refractive changes following the surgery. Most (13 of 14) eyes had good graft integrity and survival without graft rejection. One of 14 eyes showed graft rejection sign, but it was subsided with systemic cyclosporine therapy. CONCLUSION: Lamellar sclerokeratoplasty is thought to be a good option for the primary surgery for limbal dermoid.
Cyclosporine
;
Dermoid Cyst*
;
Follow-Up Studies
;
Graft Rejection
;
Humans
;
Transplants
5.TLR4 and organ transplant rejection.
Journal of Zhejiang University. Medical sciences 2011;40(5):495-500
Organ transplant has become one of the strategies for treatment of malignant disease. The transplant-related complications restricted the further development of organ transplantation; graft rejection is most prominent among these complications, which remains a major cause of morbidity and mortality after organ transplant. Toll like receptors 4 (TLR-4) has been shown as a key molecule in innate immunity and immune tolerance. The role of TLR4 in graft rejection after organ transplant is still unknown. This article will review the role and the mechanism of TLR4 to control APC mature, activate T cells, trigger immune attack to organ graft; therefore bring new insights into the pathophysiology of graft rejection and foster the development of new therapies to control graft rejection after organ transplant.
Graft Rejection
;
immunology
;
Humans
;
Toll-Like Receptor 4
;
immunology
6.Living Related Conjunctival Limbal Allograft.
Journal of the Korean Ophthalmological Society 2005;46(2):243-249
PURPOSE: To evaluate the outcomes of living-related conjunctival limbal allograft for patients with bilateral total limbal stem cell deficiency. METHODS: Five eyes of 5 total limbal deficiency patients with severe conjunctivalization underwent living-related conjunctival limbal allograft. Limbal conjunctival tissues from ABO typing-matched relative donors were transplanted to the recipient eyes superiorly and inferiorly after excision of fibrovascular pannus. Systemic cyclosporine was administered to all recipients for a short period of mean 2.4 months. RESULTS: Satisfactory ocular surface stability was achieved in all 5 eyes (100%), with visual improvement and reduction of corneal opacification and neovascularization. Reepithelization occurred in four eyes (80%). Graft rejection did not develop. None of the donor eyes had any complication. CONCLUSIONS: Allograft conjunctival limbal transplantation from ABO typing-matched relative donor may be a viable means of ocular surface reconstruction in bilateral recalcitrant ocular surface disease caused by total limbal stem cell deficiency. Furthermore, this surgical approach has the advantage of reducing the duration of postoperative immunosuppression.
Allografts*
;
Cyclosporine
;
Graft Rejection
;
Humans
;
Immunosuppression
;
Stem Cells
;
Tissue Donors
7.Analysis of causes of graft loss in 135 kidney transplant recipients.
Yan Zhong LIU ; Hong Wei BAI ; Ye Yong QIAN ; Chao LI ; Lu XIAO ; Run ZHU
Journal of Southern Medical University 2023;43(1):133-138
OBJECTIVE:
To investigate the causes of graft loss in kidney transplant recipients.
METHODS:
We retrospectively analyzed the clinical data of 135 recipients with graft loss after renal transplantation in the Eighth Medical Center of Chinese PLA General Hospital from January 1, 2002 to January 1, 2022.
RESULTS:
A total of 135 kidney transplant recipients experienced graft failure. The causes of graft loss included graft rejection (70 cases, 51.8%), death of the recipients with functional graft (37 cases, 27.4%), surgical complications (12 cases, 8.9%), drug toxicity (4 cases, 3.0%), carbapenem-resistant Klebsiella pneumoniae infection (4 cases, 3.0%), polyoma BK virus-related nephropathy (3 cases, 2.2%), primary nonfunctioning kidney (2 cases, 1.5%), recurrence of primary disease (2 cases, 1.5%), and prerenal acute renal failure (1 case, 0.7%).
CONCLUSION
The main cause of graft loss after renal transplantation is graft rejection, and the secondary cause is death of the recipient with functional graft, and other reasons can be rare.
Humans
;
Graft Rejection
;
Kidney Transplantation/adverse effects*
;
Retrospective Studies
9.The Role of Macrophages in Transplant Rejection.
Hye Jung YEOM ; Curie AHN ; Jaeseok YANG
The Journal of the Korean Society for Transplantation 2012;26(3):165-173
Macrophage accumulation has been recognized as a feature of allograft rejection, however, the role of macrophages in rejection remains underappreciated. Macrophages are present within graft tissues throughout the lifespan of the graft, including acute rejection episodes. Recent advances in macrophage biology have demonstrated that different types of macrophages in grafts serve a range of functions, including promotion or attenuation of inflammation, participation in innate and adaptive immune responses, and mediation of tissue injury, fibrosis, and tissue repair. Macrophages contribute to both the innate and acquired arms of the alloimmune response, and, thus, may be involved in all aspects of acute and chronic allograft rejection. Macrophages are also involved in hyperacute and acute vascular rejection of xenografts. A deeper understanding of how macrophages accumulate within grafts and of the factors that control differentiation and function of these cells could lead to identification of novel therapeutic targets in transplantation.
Arm
;
Biology
;
Fibrosis
;
Graft Rejection
;
Inflammation
;
Macrophages
;
Negotiating
;
Rejection (Psychology)
;
Transplantation, Heterologous
;
Transplantation, Homologous
;
Transplants
10.Optimized Tacrolimus Therapy in the Early Stage after Renal Transplantation.
Sang Il MIN ; Seong Yup KIM ; Sang Hyun AHN ; Chin Koo CHUNG ; Seung Kee MIN ; Jongwon HA ; Sang Joon KIM
Journal of the Korean Surgical Society 2010;79(6):428-435
PURPOSE: Immunosuppressive regimen based on reduced-dose Tacrolimus (TAC) is widely accepted in the field of renal transplantation. However, optimal targetsfor TAC whole blood trough concentrations during the early period after kidney transplantation remain uncertain. METHODS: A total of 184 consecutive adult renal transplant recipients with triple immunosuppression (TAC/Mycophenolate/corticosteroid) were included in this study. According to the trough level of TAC at day 7 after transplantation, patients were classified as low TAC concentration (LT, <10 ng/ml, n=85), intermediate TAC concentration (IT, 10~15 ng/ml, n=75), and high TAC concentration (HT, >15 ng/ml, n=24) groups. Rate of acute rejection, graft function and side effects of TAC within 1 yr after transplantation were evaluated. RESULTS: There was no difference in trough concentrations of TAC at 2 weeks, 1 month, 3 months, 6 months and 12 months after transplantation among the three groups. Significantly higher incidence of acute rejection within 2 weeks after transplantation was observed in LT group compared with IT and HT groups (17.4%, 5.6% and 4.8%, respectively, P=0.037). HT patients showed significantly better estimated glomerular filtration rates until 6 months after transplantation than IT and LT patients (75.5+/-24.8 vs. 63.8+/-12.8 and 64.3+/-15.2 ml/min at 6 months, P=0.03). There was no significant difference in TAC toxicity in terms of post-transplant diabetes and renal toxicity. CONCLUSION: Short-term high TAC exposure immediately after kidney transplantation may provide lower incidence of acute rejection and better restoration of graft function compared with low or intermediate TAC exposure.
Adult
;
Glomerular Filtration Rate
;
Graft Rejection
;
Humans
;
Immunosuppression
;
Incidence
;
Kidney Transplantation
;
Rejection (Psychology)
;
Tacrolimus
;
Transplants