Tài liệu Kidney transplantation – new perspectives Edited by Magdalena Trzcińska

KIDNEY TRANSPLANTATION – NEW PERSPECTIVES
Edited by Magdalena Trzcińska

Contents
Preface IX


Chapter 1 Mechanisms of T Lymphocytes in the Damage and
Repair Long Term after Renal Ischemia Reperfusion Injury 3
Dolores Ascon and Miguel Ascon
Chapter 2 Characteristics, Detection, and Clinical Relevance
of Alloantibodies in Kidney Transplantation 15
Andrew Lobashevsky
Chapter 3 Urothelial Carcinoma in Renal Transplant Recipients 55
Ming-Kuen Lai, Shuo-Meng Wang and Huai-Ching Tai
Chapter 4 Immune Monitoring of Kidney Recipients:
Biomarkers to Appreciate Immunosuppression
-Associated Complications 65
Philippe Saas, Jamal Bamoulid, Béatrice Gaugler and Didier Ducloux
Chapter 5 Urinary Fructose-1,6-Bisphosphatase (FBP-1,6)
and N-Acetyl-β-Hexosaminidase (HEX) in Monitoring
Kidney Transplantation - Literature Review 89
Alina Kępka, Sławomir Dariusz Szajda,
Napoleon Waszkiewicz, Sylwia Chojnowska,
Paweł Pludowski, Jerzy Robert Ładny and Krzysztof Zwierz
Chapter 6 Evaluation of CTLA-4, CD28 and CD86 Genes
Polymorphisms in Acute Renal Allograft
Rejection among Tunisian Patients 111
Henda Krichen, Imen Sfar, Taieb Ben Abdallah, Rafika Bardi,
Ezzeddine Abderrahim, Saloua Jendoubi-Ayed, Mouna Makhlouf,
Houda Aouadi, Hammadi Ayadi, Khaled Ayed and Yousr Gorgi
Chapter 7 Urinary Proteomics and Renal Transplantation 127
Elisenda Banon-Maneus, Luis F Quintana and Josep M Campistol
Chapter 8 Pharmacogenetics and Renal Transplantation 147
Chi Yuen Cheung
Chapter 9 Tolerance in Kidney Transplantation 163
Faouzi Braza, Maud Racape, Jean-Paul Soulillou
and Sophie Brouard
Chapter 10 Mechanisms of Tolerance: Role of the Thymus and
Persistence of Antigen in Calcineurin-Induced Tolerance
of Renal Allografts in MGH Miniature Swine 179
Joseph R. Scalea, Isabel Hanekamp and Kazuhiko Yamada
Chapter 11 Operational Tolerance after Renal Transplantation
in the Regenerative Medicine Era 193
Giuseppe Orlando, Pierpaolo Di Cocco, Lauren Corona,
Tommaso Maria Manzia, Katia Clemente, Antonio Famulari
and Francesco Pisani
Chapter 12 Ischemia Reperfusion Injury in Kidney Transplantation 213
Bulent Gulec
Chapter 13 Transforming Growth Factor-Beta in Kidney
Transplantation: A Double-Edged Sword 223
Caigan Du
Chapter 14 The Impact of Ischemia and Reperfusion
Injury in Kidney Allograft Outcome 235
Valquiria Bueno
Chapter 15 ROCK Inhibition – A New Therapeutic Avenue
in Kidney Protection 249
Stefan Reuter, Dominik Kentrup and Eckhart Büssemaker
Chapter 16 Post-Tx Renal Monitoring with B-Flow Ultrasonography 275
Paride De Rosa, Enrico Russo andVincenzo Cerbone
Chapter 17 Immune Gene Polymorphisms Associate
with Outcome in Kidney Transplantation 291
Katri Haimila, Noora Alakulppi and Jukka Partanen
Chapter 18 Sleep Disturbances Among Dialysis Patients 317
Gianluigi Gigli, Simone Lorenzut, Anna Serafini
and Mariarosaria Valente
Chapter 19 Bridging the ‘Gap’ in Developing
Countries: At what Expense? 329
Chulananda DA Goonasekera


Preface
To our Patients without whose effort, goodwill and trust
no progress in medicine would be possible
The emergence of transplantology has definitely launched a new era in the history of
medicine. And although the first attempts at transplanting organs would frequently
end up with a failure, it is thanks to the determination and courage of pioneer doctors
and sacrificial attitude of the patients that we can enjoy today’s state of knowledge and
potential in the field of organ transplantation. It should also not be forgotten that
clinical transplantology owes its development and getting well-grounded to the
development of such fields of medicine as nephrology or clinical immunology. A clear
dynamic development has been observed over the last decades also in the field of
immunosuppressant treatment. At present immunosuppressant drugs are more
effective and safer, posing a lower risk for side-effects to the patients.
Many years have passed since the first successful kidney transplantation and the
method, although no longer considered a medical experiment, is still perceived as
controversial and, as such, it triggers many emotions. And even though family
transplants attract more social understanding, unfortunately the same is still not true
for recovering and transplanting organs from a dead donor. Much confusion concerns
mostly the concept of brain death and its diagnostic procedures. Doubt is found even
among medical doctors or heath-care related communities, most frequently due to a
lack of knowledge or wrong understanding of the concept of brain death.
Many years and conscious educational efforts are still needed to make kidney
transplantation, for many people the only chance for an active lifestyle and improved
quality of life, win common social acceptance and stop triggering negative
connotations. The need of mass transplantology education has been already effectively
implemented in many EU countries, the United States and in Canada; it is spread not
only by the medical community but also by the emerging and already active
associations of organ transplant patients.
The statistics gathered by the World Health Organization (WHO) show that in 2009 in
27 EU countries 17886 thousand kidney transplants were performed, namely 668
(0.6%) transplantation cases more than in 2008. The statistics demonstrate that the
number of transplantations performed has been regularly increasing for more than
twenty years.
Apart from the transplantation controversies piling up over the years and
transplantation not always winning social acceptance, transplantologists also face
many other medical difficulties. Much research covers the phenomenon of graft
rejection and algorithms of post-kidney-transplant procedure, and the effectiveness of
new drugs is being tested. A growing potential of transplantology is also due to the
advancement of research into the significance of gene polymorphism, the potential of
the application of the achievements of proteomics in diagnostics (e.g. allowing for
identifying urine proteins differentiating between active inflammatory changes in
kidneys) or numerous research on various aspects of the immune system functioning.
The authors of chapters published herein are experts in their respective fields. The
chapters selected are of high level of content, and the fact that their authors come from
many different countries, and sometimes even cultures, has facilitated a
comprehensive and interesting approach to the problem of kidney transplantation.
The authors cover a wide spectrum of transplant-related topics: significance of
research into gene polymorphism, possibilities of applying techniques offered by
proteomics, the effect of ischemia or flow disturbances on the kidney graft, monitoring
its function after transplantation as well as multi-aspect research and analyses of
immunologic mechanisms. The book does not disregard the problem of mental
aspects, essential especially from the patient’s perspective.
As the editor, I wish to thank all the authors for their cooperation, research efforts,
literature reviews and their precious clinical observations as well as for their desire to
share with the medical community their precious experience without which this book
would not be possible.
Finally, on behalf of all the authors I wish to express hope that our publication will not
only facilitate access to the latest scientific achievements in the field but also enhance a
further progress in transplantology and propagating the idea all across the world.
Magdalena Trzcińska, MD.
University Hospital of Collegium Medicum in Bydgoszcz,
Psychiatry Department, Nicolaus Copernicus University in Torun,
Poland