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A Case of Sparganosis in Renal Allograft Recipient.

Byung Hyun YOO ; Sung Ha HWANG ; Joo Hyun PARK ; Byung Soo KIM ; Ho Chul SONG ; Jong Min LEE ; Chul Woo YANG ; Suk Young KIM ; Byung Kee BANG ; Eun Deok CHANG

The Journal of the Korean Society for Transplantation.2000;14(1):115-117.

Human sparganosis is a rare parasitic disease infected by plerocercoid larva (sparganum) of Spirometra species. It was usually diagnosed accidentally. In this article, we report a 44-year-old woman reanl allofraft recipient on cyclosporine and prednisolone as the immunosuppressive agents. She presented an enlarging subcutaneous nodule in the left thigh for 20 days, which was excised in the belief that it was a seroma. Characteristic sparganum lava accompanied by granulomatous inflammation and cyst formation in the subcutaneous tissue were discovered under microscopic examination of the excised tissue. However, the infectious source was not clear.
Adult ; Allografts* ; Cyclosporine ; Female ; Humans ; Immunosuppressive Agents ; Inflammation ; Larva ; Parasitic Diseases ; Prednisolone ; Seroma ; Sparganosis* ; Sparganum ; Spirometra ; Subcutaneous Tissue ; Thigh

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A Case of Immune Hemolytic Anemia after Renal Transplantation.

Yong Ho CHOI ; Ho Yun CHUNG ; Hyeon Ok PARK ; Joo Hyun PARK ; Hye Soo KIM ; Jong Min LEE ; Yong Soo KIM ; Suk Young KIM

The Journal of the Korean Society for Transplantation.2000;14(1):109-114.

Several cases of immune hemolytic anemia have been reported after renal transplantation of ABO-minor-mismatch. We present a case of anti-B immune hemolytic anemia which developed on 11th day after renal transplantation. 48-year-old man, blood group Rh(+) AB, had a successful renal transplantation from his distant family, blood group Rh(+) A. He was maintained under immunosuppression with cyclosporine and prednisolone. On 11th day after renal transplantation he had a hemolytic episode. His hemoglobin dropped from 9.2 g/dl to 7.3 g/dl and corrected reticulocyte count increased to 3.7%. The peripheral blood morphology showed polychromatophilia, spherocytosis, and anisocytosis. Direct antiglobulin tests were positive with anti-IgG and anti-C3d. The antibody that caused hemolytic anemia was confirmed as anti-B IgG. The anti-B antibodies might be originated from passenger's donor B lymphocyte.
Anemia, Hemolytic* ; Antibodies ; Coombs Test ; Cyclosporine ; Humans ; Immunoglobulin G ; Immunosuppression ; Kidney Transplantation* ; Lymphocytes ; Middle Aged ; Prednisolone ; Reticulocyte Count ; Tissue Donors

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Four Cases of Posttransplant Lymphoproliferative Disease (PTLD) Following Renal Transplantation.

Seung Hee CHOI ; Jee Sook HAHN ; Yu Seun KIM ; Kiil PARK

The Journal of the Korean Society for Transplantation.2000;14(1):101-108.

Posttransplant lymphoproliferative disorder (PTLD) is now a well-documented and serious complication of organ transplantation, ranging from polyclonal lymphoid hyperplasia to malignant lymphoma. PTLD is due to the combined effects of lymphoid proliferation induced by Epstein-Barr virus (EBV) infection, and the disruption of normal immume control by cytotoxic T cells. It is also strongly related to the potency and the cumulative doses of immunosuppressants and the type of organ transplantation. We report four cases of PTLD after renal transplantation, for whom three cases were EBV-positive by in situ hybridization.
Herpesvirus 4, Human ; Hyperplasia ; Immunosuppressive Agents ; In Situ Hybridization ; Kidney Transplantation* ; Lymphoma ; Lymphoproliferative Disorders ; Organ Transplantation ; T-Lymphocytes ; Transplants

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Miliary Tuberculosis Following Renal Transplantation.

Ki Tae LEE ; Eun Ah HWANG ; Kyung Dae PARK ; Sung Bae PARK ; Hyun Chul KIM ; Hyung Tae KIM ; Won Hyun CHO ; Chaol Hee PARK

The Journal of the Korean Society for Transplantation.2000;14(1):93-100.

Kidney Transplantation* ; Respiratory Distress Syndrome, Adult ; Tuberculosis, Miliary*

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Varicella Pneumonia in Adult Following Renal Transplantation.

Kyung Dae PARK ; Mee Jung KANG ; Eun Ah HWANG ; Sung Bae PARK ; Hyun Chul KIM ; Hyung Tae KIM ; Won Hyun CHO ; Chaol Hee PARK

The Journal of the Korean Society for Transplantation.2000;14(1):87-92.

Varicella is usually a benign childhood disease, while in the adult is an infrequent but potentially serious infection. Varicella pneumonia is a potentially life-threatening complication that should be suspected in any adult with chickenpox and respiratory symptoms. In the adult it may be complicated by pneumonia with high morbidity and mortality rates. We present a case of varicella pneumonia complicated the course of chickenpox in the living-related donor renal transplant recipient. A 30-year-old male received an allograft kidney from his father following treatment with cyclosporine and low-dose steroids. Allograft function was stable over the next 27 months. He was admitted hospital with a week history of generalized varicelliform rash, malaise, fever, chills and a cough. Three weeks ago, his nephew (7-year-old) had chickenpox who was living together in the same house. On examination he looked severely ill, febrile and his skin was covered with typical chickenpox eruption. Auscultatory examination was unremarkable while chest X-rays revealed bilateral interstitial infiltration. HRCT findings showed multiple variable sized nodules, patchy ground-glass opacities, and some consolidation in both lower lung. Treament with i.v. acyclovir was started and continued for 10 days. The patient response to the treatment was excellent with complete resolution of pneumonia.
Acyclovir ; Adult* ; Allografts ; Chickenpox* ; Chills ; Cough ; Cyclosporine ; Exanthema ; Fathers ; Fever ; Humans ; Kidney ; Kidney Transplantation* ; Lung ; Male ; Mortality ; Pneumonia* ; Skin ; Steroids ; Thorax ; Tissue Donors ; Transplantation

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Malignancy Following Renal Transplantation.

Sun Hee PARK ; Ji Hyung CHO ; Min Hwa JANG ; Yong Bong SHIN ; Young Jun CHO ; Jun Chul KIM ; Seong Cho YONG ; Lim KIM ; Dong Kyu CHO ; Young Wook KIM ; Tae Gyun KWON ; Sae Kook CHANG

The Journal of the Korean Society for Transplantation.2000;14(1):81-86.

PURPOSE: Survival rate after renal transplantation has increased after intense immunosuppressive agents and sophisticated operative techniques were introduced, but incidences of malignancy increase with time after transplantation. METHODS: We reviewed our experiences about post-transplant malignancy in patients who received renal allografts in our hospital from January 1981 to December 1999. The incidences and types of malignancy were analysed in 241 renal allograft recipients, who were followed-up for 1265 patient-years. RESULTS: Seven malignancies were found in 241 patients (2.9%). The mean age of these patients at diagnosis of malignancy was 45.5 years and the average interval between transplantation and diagnosis of malignancy was 34.9 (9.8-71.6) months. The types of malignancy were non-Hodgkin's lymphoma (n=2; CNS and nasal cavity), colon cancer with metastasis (n=2), in situ carcinoma of uterine cervix (n=1), follicular carcinoma of thyroid (n=1) and transitional cell carcinoma of bladder (n=1). Surgical resection was performed in 5 patients and 2 of them developed distant metastasis during follow-up periods. Radiotherapy was performed in 2 patients with non-Hodgkin's lymphoma and 1 patient with cord compression due to vertebral metastasis. Four patients are now alive and 3 of them have functioning renal allografts. CONCLUSION: We reviewed the incidences and types of post-transplant malignancy in our center and concluded that regular screening for malignancy and meticulous diagnostic approach for suspected symptoms or signs are important to immunosuppressed renal allograft recipients.
Allografts ; Carcinoma, Transitional Cell ; Cervix Uteri ; Colonic Neoplasms ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation* ; Lymphoma, Non-Hodgkin ; Mass Screening ; Neoplasm Metastasis ; Radiotherapy ; Survival Rate ; Thyroid Gland ; Urinary Bladder

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Effect of Partial Portal Arterialization on Graft Survival in Experimental Liver Transplantation.

Chang Hyun YOO ; Dae Sik RIM ; Jong Min KIM

The Journal of the Korean Society for Transplantation.2000;14(1):75-80.

PURPOSE: In liver transplantation, low portal perfusion pressure may result in underperfusion of grafts and be the cause of primary nonfunction. Partial arterialization of portal vein could preserve graft perfusion. Up till now, there have been several clinical cases of temporary or permanent portal arterialization in liver transplantation. METHODS: In this study, we designed rat model for evaluating the effect of portal arterialization to improve survival of the under-perfused graft. Partial heterotopic non-regenerative liver transplantation was used with portal inflow only from inferior vena cava, which is known as portal under-perfusing liver transplantation model. Partial portal arterialization was performed by fenestration of the common wall between the IVC and the aorta through venotomy which was made for portacaval anastomosis. RESULTS: Immediate after arterialization, satisfactory macroscopic and duplex ultrasonographic liver perfusion were seen and the arterialized-graft survival was significantly improved to 95% (19/20) vs. 35% (7/20) of nonarterialized grafts. At 2-week after transplantation, the arterialized liver graft was atrophied showed normal gross appearance. The histopathologic examination with light microscope revealed no significant pathologic abnormality. CONCLUSION: Partial portal arteria;ization improved graft-survival of the under-perfusing liver grafts significantly and not affects the histologic hepatic structure adversely.
Aorta ; Graft Survival* ; Liver Transplantation* ; Liver* ; Models, Animal ; Perfusion ; Portacaval Shunt, Surgical ; Portal Vein ; Transplants* ; Vena Cava, Inferior

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Expression of HLA-DR, ICAM-1, IL-2 and IL-4 in Renal Biopsy of Trasplanted Patient.

Eun Sook NAM ; Hyang Im LEE ; Duck Hwan KIM ; Hyung Sik SHIN ; Samuel LEE ; Joo Seop KIM ; Soo Tae KIM ; Dong Wan CHAE

The Journal of the Korean Society for Transplantation.2000;14(1):65-74.

PURPOSE: We performed this study to evaluate the value as early markers predicting the acute rejection and differential diagnosis with other causes of renal dysfunction. METHODS: Immunohistochemical stains for HLA-DR, ICAM-1, IL-2 and IL-4 were performed on 44 cases of implantation biopsies which were divided into cases with acute rejection (R group, 14 cases) and cases without rejection episode (N group, 30 cases), and 45 gun biopsies for renal dysfunction which divided into cases diagnosed as rejection (A group, 28 cases) and cases diagnosed as other causes rather than rejection (B group, 17 cases). We analysed immunohistochemical results, various clinical datas such as age and sex of donor, living or cadaveric status of donor, the mean number of HLA-DR mismatch, age and sex of patient, serum creatinine level at post op 2 day for implantation biopsy and at the day on biopsy for renal dysfunction between above groups. RESULTS: 1) In 44 cases of implantation biopsies, positive immunohistochemical stains for HLA-DR were more frequent in R goup (71.43%) than in N group (26.66%). There was no significant difference of clinical datas and immunohistochemical stains for ICAM-1, IL-2 and IL-4. 2) In 45 cases of gun biopsies for renal dysfunction, immunohistochemical stains for HLA-DR were all positive in A group (100%) with higher rate of 3 stains (39.28%) than B group (positive; 70.58%, 3 ; 5.88%). Immunohistochmical stains for ICAM-1 were more frequently expressed in A group (100%) than B group (76.47%). Both stains revealed no significant difference according to the grades of rejection, disease other than rejection. There was no significant diffrence of immunohistochemical stains for IL-2 and IL-4, and clinical datas between two groups. CONCLUSION: We can conclude that the immunohistochemical stains for HLA-DR on implantation biopsies may predict the devepoment of the acute rejection and the immunohistochemical stains for HLA-DR and ICAM-1 on gun biopsies at the time of renal dysfunction may differentiate the reje.
Biopsy* ; Cadaver ; Coloring Agents ; Creatinine ; Diagnosis, Differential ; HLA-DR Antigens* ; Humans ; Intercellular Adhesion Molecule-1* ; Interleukin-2* ; Interleukin-4* ; Kidney Transplantation ; Living Donors ; Tissue Donors

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Serum Interleukin-6 Changes according to Rejection after Heterotopic Partial Liver Transplantation in Rat.

Sang Ho LEE ; Mung Hi YOON ; Chung Han LEE

The Journal of the Korean Society for Transplantation.2000;14(1):59-64.

PURPOSE: Liver transplantation has been accepted as the treatment for end-stage-liver diseases. However, despite the development of more powerful and selective immunosuppressive agents to improve survival following transplantation, graft rejection remains a major cause of morbidity and mortality. It is not always easy to diagnose rejection precisely at an early stage even by liver biosy, which can involve risk, especially when the recipient shows coagulation disorder. Therefore, it is important to develop noninvasive diagnostic approach that can supplement or substitute for histological examination in order to diagnose the rejection response earlier and more precisely. METHODS: In this study, as the experimental group (rejection combination strains), 30% partial liver of Dark-Agauti (DA) rat was transplanted heterotopically to Sprague-Dawly (SD) rat by microsurgical technique. As the control group, partial liver of SD rat was transplanted heterotopically to SD rat. After liver transplantation, serum inteleukin-6 (IL-6), GOT/GPT and histological findings of grafts were evaluated. RESULTS: In the experimental group, serum IL-6 was 84.6 pg/ml on postoperative 2 days, and not decreased so much, remained 28.9 pg/ml on postoperative 8 days. In the control group, serum IL-6 was 58.8 pg/ml on postoperative 2 days, after then decreased to 6.72 pg/ml. In the experimental group, serum IL-6 was already increased, in which rejection was histologically confirmed. CONCLUSION: Therefore, IL-6 may be used as the noninvasive diagnostic parameter to predict rejection of graft after liver transplantation.
Animals ; Graft Rejection ; Immunosuppressive Agents ; Interleukin-6* ; Liver Transplantation* ; Liver* ; Mortality ; Rats* ; Transplants

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Study for the Improvement of Early Implantation and Long Term Graft Survival in Pancreatic Islet Cell Transplantation by Induction of Angiogenesis with Gene Transfection of Vascuar Endothelial Growth Factor.

Song Cheol KIM ; Tae Hee KIM ; You Me WE ; Hee Young PARK ; Kyung Min CHO ; Duck Jong HAN

The Journal of the Korean Society for Transplantation.2000;14(1):47-58.

PURPOSE: Transplantation of pancreas islet has been worldwidely studied as a one of therapeutic modalities to achieve the insulin independence. We studied whether the expression of vascular endothelial growth factor (VEGF) on pancreas islets with liposomal VEGF gene transfer could improve the efficacy of early implantation and long term graft survival in pancreatic islet cell transplantation. METHODS: Syngenic pancreas islets were transplanted beneath the renal capsule. Islets were transfected with plasmid VEGF c-DNA using cationic liposome DMRIE-C. Glucose metabolism and histologic findings were compared between the groups transplanted with VEGF DNA containing islets (n=5) and the control group with (n=5) or without (n=4) local recombinant VEGF adminstration during islet transplant. RESULTS: Glucose was controlled at 5.5 days after transplantation in control group without r-VEGF adminstration, at 4 days in group with recombinant VEGF adminstration, and at 6.6 days in group with VEGF DNA transfected islets. Euglycemia was maintained over 150 days in control group. However, graft failure was developed in 22 days after transplantation in group with VEGF DNA transfected islet. Histologically there were severe infiltrations of neutrophil and lymphocyte in VEGF DNA transfected grafts from 5 days after transplantation. CONCLUSION: Although VEGF could be a favorable angiogenic factor in pancreas islet transplantation, VEGF expression following VEGF DNA transfection into islets could not increase the graft survival due to inflammatory process. More investigations are needed to clarify the mechanism on destructive process of islets after gene transfection into islets, and another approaches to get the effect of gene transfection should be followed.
Angiogenesis Inducing Agents ; Cell Transplantation* ; DNA ; Endothelial Growth Factors* ; Glucose ; Graft Survival* ; Insulin ; Islets of Langerhans Transplantation ; Islets of Langerhans* ; Liposomes ; Lymphocytes ; Metabolism ; Neutrophils ; Pancreas ; Plasmids ; Transfection* ; Transplants* ; Vascular Endothelial Growth Factor A

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