Presence of T-275A and C-2152T Polymorphisms of the Promoter Region of Uridine Diphosphate-Glucuronosyltransferase 1A9 Increases Mortality From Digestive Tumors: Results After 10 Years of Follow-up in a Renal Transplant Population.

BACKGROUND: The aim of this study was to determine the distribution of uridine diphosphate-glucuronosyltransferase 1A9 (UGT1A9) promoter region T-275A and C-2152T single-nucleotide polymorphisms (SNPs) in stable transplant patients and to investigate the impact of these SNPs on the evolution of this population after 10 years of follow-up. METHODS: White renal transplant recipients (n = 873) were studied. The median time of follow-up was 91.8 months (P25-75 46-146). Amplification with specific "primers" to delimit the study area was performed for each polymorphism. Amplification was performed with the use of real-time polymerase chain reaction. RESULTS: T-275A promoter mutation was detected in 13% of patients and C-2152T in 12% of patients. Survival analysis was performed on 873 renal transplants, carried out between 2004 and 2013. We found a higher frequency of death from cancer among polymorphism carriers (P = .001). CONCLUSIONS: It appears that carriers of T-275A and C-2152T SNPs of the UGT1A9 gene promoter region show a greater incidence of death from cancer, with a significantly higher cumulative incidence of death from gastrointestinal tumors.

Surgical Complications in En Bloc Renal Transplantation.

En bloc pediatric transplantation (EBPT) began with the aim of increasing the donor pool due to the existing high demand for donors. At its inception, it was considered a type of suboptimal transplantation due to its association with a high incidence of vascular, urologic, and immunologic complications. The main objective of this study was to update information on EBPT with the largest case series that exists on a worldwide scale. In a retrospective study, the results obtained from brain-dead donors (BDDs; n = 770) were compared to those of EBPT (n = 100) from January 1990 to December 2012. The median of follow-up was 12.8 years (interquartile range 8.1 to 17.2). The variables collected for analysis were demographic factors (age and sex of recipients, age and weight of donors), renal function, graft survival, recipient survival, surgical complications (thrombosis, lymphocele, urologic complications, and renal artery stenosis and need for revascularization with angioplasty and/or stents). Subsequently in a second analysis, we studied the association between graft survival, thrombosis, angioplasty, stents, and appearance of lymphoceles with the different factors that were considered to be related in accordance with published literature and our own experience. Graft loss due to surgical complications was more frequent in EBPT than in BDD (15% vs 2.2 % in BDD; P < .001), and interstitial fibrosis and tubular atrophy were more frequent in BDD (13% vs 2%; P < .001). EBPT offers a good survival rate after overcoming the possible surgical complications that may arise.

Risk Factors of Recurrence of Diabetic Nephropathy in Renal Transplants.

BACKGROUND: Renal transplantation has been established as the treatment of choice for end-stage renal disease (ESRD) due to diabetic nephropathy. This study aimed to investigate the risk factors for recurrence of diabetic nephropathy (RDN) in renal allografts. METHODS: We studied 1,011 renal transplant patients from 1986 to 2003, of which 95 had ESRD due to diabetic nephropathy. We retrospectively analyzed the clinical characteristics and outcomes of RDN after renal transplantation. RESULTS: Of the 95 recipients with ESRD due to diabetic nephropathy, 41 developed RDN and 11 of those 41 underwent graft biopsy. The mean durations from transplantation to RDN and to renal replacement therapy was 81.58 months (range, 54-120 mo), and 109.66 months (range, 27-188.4 mo), respectively. At 5 years, treatment on statins and renin-angiotensin-aldosterone system (RAAS) blockers were associated with a higher survival free from RND (82.2% vs 63.2% [P = .070] and 100% vs 80% vs 0.6% [P = .013], respectively). Compared with cyclosporine, tacrolimus was associated with a higher risk for RND (odds ratio [OR], 4.27; 95% confidence interval [CI], 1.75-5.13; P = .047). High doses of prednisone (>0.06 mg/kg) were also associated with a higher risk of RDN (OR, 3.03; 95% CI, 1.19-8.30; P = .029). The combination of calcineurin inhibitor and mammalian target of rapamycin inhibitor (mTORi) demonstrated the highest risk of RDN (OR, 14.08; 95% CI, 3.72-53.29; P < .01). CONCLUSIONS: Treatment with tacrolimus and mTORi is the most diabetogenic immunosuppressive regimen. Treatment with tacrolimus entails a greater risk of RDN than with cyclosporine. The administration of statins or RAAS blockers could delay the progression of RDN.

Whooping cough in a renal transplant recipient.

Whooping cough is a respiratory infection with a severity that varies with age, immune status, and probably with other factors such as the degree of exposure and the virulence of the organism. The most frequent microorganism responsible for whooping cough is Bordetella pertussis. We present the case of a 62-year-old renal transplant recipient presenting with typical and severe manifestations of whooping cough caused by B. pertussis.

Malva parviflora extract assisted green synthesis of silver nanoparticles.

Five plant leaf extracts (Malva parviflora, Beta vulgaris subsp. Vulgaris, Anethum graveolens, Allium kurrat and Capsicum frutescens) were screened for their bioreduction behavior for synthesis of silver nanoparticles. M. parviflora (Malvaceae) was found to exhibit the best reducing and protecting action in terms of synthesis rate and monodispersity of the prepared silver nanoparticles. Our measurements indicate that biosynthesis of Ag nanoparticles by M. parviflora produces Ag nanoparticles with the diameters in the range of 19-25 nm. XRD studies reveal a high degree of crystallinity and monophasic Ag nanoparticles of face-centered cubic structure. FTIR analysis proved that particles are reduced and stabilized in solution by the capping agent that is likely to be proteins secreted by the biomass. The present process is an excellent candidate for the synthesis of silver nanoparticles that is simple, easy to perform, pollutant free and inexpensive.

In situ approach induced growth of highly monodispersed Ag nanoparticles within free standing PVA/PVP films.

Ag nanoparticles supported within polyvinyl alcohol (PVA)/polyvinyl pyrrolidone (PVP) films have been successfully synthesized using novel in situ method. PVA and PVP acted as stabilizer and polyol reductant, respectively. The successful incorporation of silver nanoparticles in PVA/PVP matrix was confirmed by UV-Vis spectroscopy, X-ray diffraction (XRD), transmission electron microscope (TEM) and Fourier transform infrared (FTIR) spectroscopy. It was found that PVA/PVP-stabilized silver nanocomposite film revealed the presence of well-dispersed and spherical silver nanoparticles with an average diameter of 30 nm, while the particle sizes were reduced as the PVP percentage increased. A possible formation mechanism of Ag nanoparticles is also proposed in this article.