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1.
Circ J ; 82(5): 1351-1359, 2018 04 25.
Artículo en Inglés | MEDLINE | ID: mdl-29618707

RESUMEN

BACKGROUND: Heart transplantation (HT) is a well-established lifesaving treatment for endstage cardiac failure. Antibody-mediated rejection (AMR) represents one of the main problems after HT because of its diagnostic complexity and the poor evidence for supporting treatments. Complement cascade and B-cells play a key role in AMR and contribute to graft damage. This study explored the importance of variants in genes related to complement pathway and B-cell biology in HT and AMR in donors and in donor-recipient pairs.Methods and Results:Genetic variants in 112 genes (51 complement and 61 B-cell biology genes) were analyzed on next-generation sequencing in 28 donor-recipient pairs, 14 recipients with and 14 recipients without AMR. Statistical analysis was performed with SNPStats, R, and EPIDAT3.1. We identified one single nucleotide polymorphism (SNP) in donors in genes related to B-cell biology,interleukin-4 receptor subunitα (p.Ile75Val-IL4Rα), which correlated with the development of AMR. Moreover, in the analysis of recipient-donor genotype discrepancies, we identified another SNP, in this case inadenosine deaminase(ADA; p.Val178(p=)), which was related to B-cell biology, associated with the absence of AMR. CONCLUSIONS: Donor polymorphisms and recipient-donor discrepancies in genes related to the biology of B-cells, could have an important role in the development of AMR. In contrast, no variants in donor or in donor-recipient pairs in complement pathways seem to have an impact on AMR.


Asunto(s)
Linfocitos B , Rechazo de Injerto , Trasplante de Corazón , Secuenciación de Nucleótidos de Alto Rendimiento , Isoanticuerpos/inmunología , Polimorfismo de Nucleótido Simple , Donantes de Tejidos , Adulto , Linfocitos B/inmunología , Linfocitos B/patología , Femenino , Rechazo de Injerto/genética , Rechazo de Injerto/inmunología , Rechazo de Injerto/patología , Humanos , Masculino , Persona de Mediana Edad
2.
Interact Cardiovasc Thorac Surg ; 19(3): 532-4, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24899594

RESUMEN

Peripheral extracorporeal membrane oxygenation (ECMO) is associated with a not negligible rate of vascular morbidity. Most vascular complications are related to limb ischaemia mainly due to insufficient limb perfusion or embolic events. To the best of our knowledge, this is the first report of a severe epidermolysis and overflow syndrome as a result of an overperfusion phenomenon through an unknown femoral arterio-venous fistula in a patient requiring ECMO support.


Asunto(s)
Fístula Arteriovenosa/complicaciones , Vesícula/etiología , Edema/etiología , Oxigenación por Membrana Extracorpórea/efectos adversos , Arteria Femoral/anomalías , Vena Femoral/anomalías , Extremidad Inferior/irrigación sanguínea , Anciano , Fístula Arteriovenosa/fisiopatología , Fístula Arteriovenosa/cirugía , Vesícula/diagnóstico , Vesícula/fisiopatología , Vesícula/cirugía , Edema/diagnóstico , Edema/fisiopatología , Edema/cirugía , Arteria Femoral/fisiopatología , Arteria Femoral/cirugía , Vena Femoral/fisiopatología , Vena Femoral/cirugía , Hemodinámica , Humanos , Masculino , Tomografía Computarizada Multidetector , Flujo Sanguíneo Regional , Síndrome
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