scholarly journals Predicting Post-Transplant Recurrence of IgA Nephropathy: The Importance of Crescents

2017 ◽  
Vol 45 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Rupali S. Avasare ◽  
Paul E. Rosenstiel ◽  
Ziad S. Zaky ◽  
Demetra S. Tsapepas ◽  
Gerald B. Appel ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Renal Allograft ◽  
Age Of Onset ◽  
Recurrent Disease ◽  
Medical Center ◽  
Multivariable Analysis ◽  
Columbia University ◽  
Post Transplant ◽  
Time To Recurrence ◽  
Recurrent Iga Nephropathy

Background: Most studies that have assessed the predictors of recurrent IgA nephropathy (IgAN) in the renal allograft have focused on post-transplant features. Identifying high-risk pre-transplant features of IgAN is useful for counseling patients and may help in tailoring post-transplant immunosuppression. Methods: We investigated the pre-transplant clinical and biopsy features of 62 patients with IgAN who received transplants at Columbia University Medical Center from 2001 to 2012 and compared the characteristics and outcomes of patients with IgAN recurrence to those without recurrence. The primary outcome was time to recurrent IgAN. Secondary outcomes were a composite of doubling of creatinine or allograft failure, and recurrent IgAN as a cause of allograft dysfunction. Results: Of the 62 patients, 14 had recurrent IgAN in the allograft. Mean time to recurrence was 2.75 years. Those with recurrent disease were younger at the time of native kidney biopsy (29 vs. 41 years, p < 0.0009). Black race and Hispanic ethnicity composed a higher proportion of the recurrent disease group. On multivariable analysis, significant predictors of recurrent IgAN included age at diagnosis (hazards ratio (HR) 0.911, 95% CI 0.85-0.98), burden of crescents on native biopsy (HR 1.21 per 10% increase in crescents, 95% CI 1.00-1.47) and allograft rejection (HR 3.59, 95% CI 1.10-11.7). Conclusions: Features of native IgAN can help predict the risk of recurrent disease in the renal allograft. In particular, immunologically active disease represented by earlier age of onset and greater burden of crescents on native biopsy is more likely to recur after transplant.

scholarly journals Radiation and Its Impact on Local Recurrence in Extremity and Trunk Well-Differentiated Liposarcomas

2019 ◽  
Vol 85 (1) ◽  
pp. 52-58
Author(s):  
Annabelle L. Fonseca ◽  
Christina L. Roland ◽  
Janice N. Cormier ◽  
Keila E. Torres ◽  
Kelly H. Hunt ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Recurrent Disease ◽  
Multivariable Analysis ◽  
Retrospective Chart Review ◽  
Cancer Center ◽  
Free Standing ◽  
Time To Recurrence ◽  
Increased Risk ◽  
Well Differentiated ◽  
Difficult Area

Patients with well-differentiated liposarcomas (WDLPS) of the extremity and trunk are treated primarily with surgical resection, with radiation used for a number of anecdotal reasons, including large size and positive margins. In this study, we evaluate the appropriate role for radiation in these tumors. A retrospective chart review of patients with extremity and trunk soft tissue liposarcomas referred to a free-standing cancer center from January 1995 to December 2011 was performed. One hundred eighty-three patients with extremity and trunk soft tissue WDLPS were identified: 61 per cent were female, median age was 60 years (range, 19–84 years) and 2 per cent had a focal area of dedifferentiation, margin status was positive in 57 per cent. Fourteen per cent of patients received radiation. Fifty patients developed recurrent disease; 28 per cent of these received radiation. Median time to recurrence was 18 years (range, 0.7–22 years). Of the 50 patients who recurred, 14 (28%) received radiation. Radiation was associated with decreased second recurrence when administered for recurrent disease (P = 0.03). On multivariable analysis, tumor size ≤ 10 cm (P = 0.014) and anatomically difficult area of resection (P = 0.008) were predictive of increased risk of recurrence. Older age (P = 0.02), dedifferentiated liposarcomas (P < 0.001), and difficult area of resection (P = 0.02) were associated with the administration of radiotherapy. Administration of radiation therapy was not associated with decreased time to recurrence in WDLPS overall; however, it should be considered in patients with recurrent disease.

Tonsillectomy and steroid pulse therapy for recurrent IgA nephropathy in renal allograft

2010 ◽  
Vol 73 (01) ◽  
pp. 68-71 ◽  
Author(s):  
T. Tsuchiya ◽  
S. Ito ◽  
Y. Yamaguchi ◽  
Y. Moriyama ◽  
H. Ehara ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Renal Allograft ◽  
Pulse Therapy ◽  
Steroid Pulse Therapy ◽  
Steroid Pulse ◽  
Recurrent Iga Nephropathy

A Novel Biomarker for Post-Transplant Recurrent IgA Nephropathy

2017 ◽  
Vol 49 (3) ◽  
pp. 541-545 ◽  
Author(s):  
S. Temurhan ◽  
S.U. Akgul ◽  
Y. Caliskan ◽  
A.S. Artan ◽  
C. Kekik ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Post Transplant ◽  
Recurrent Iga Nephropathy

PROGRESSION OF RENAL ALLOGRAFT HISTOLOGY AFTER RENAL TRANSPLANTATION IN RECURRENT AND NON-RECURRENT IGA NEPHROPATHY

2008 ◽  
Vol 86 (Supplement) ◽  
pp. 579
Author(s):  
H J. Jeong ◽  
Y M. Cho ◽  
M S. Kim ◽  
Y S. Kim ◽  
S I. Kim ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Iga Nephropathy ◽  
Renal Allograft ◽  
Recurrent Iga Nephropathy

scholarly journals Recurrence after Curative Resection for Intrahepatic Cholangiocarcinoma: How to Predict the Chance of Repeat Hepatectomy?

2021 ◽  
Vol 10 (13) ◽  
pp. 2820
Author(s):  
Serena Langella ◽  
Nadia Russolillo ◽  
Paolo Ossola ◽  
Andrea-Pierre Luzzi ◽  
Michele Casella ◽  
...  
Keyword(s):  
Liver Resection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Major Hepatectomy ◽  
Multivariable Analysis ◽  
Study Data ◽  
Good Survival ◽  
Lower Probability ◽  
Factors Affecting ◽  
Time To Recurrence ◽  
Second Resection

(1) Background: Tumor recurrence after liver resection (LR) for intrahepatic cholangiocarcinoma (ICC) is common. Repeat liver resection (RLR) for recurrent ICC results in good survival outcomes in selected patients. The aim of this study was to investigate factors affecting the chance of resectability of recurrent ICC. (2) Methods: LR for ICC performed between January 2001 and December 2020 were retrospectively reviewed. Patients who had undergone first LR were considered for the study. Data on recurrences were analyzed. A logistic regression model was used for multivariable analysis of factors related to RLR rate. (3) Results: In total, 140 patients underwent LR for ICC. Major/extended hepatectomies were required in 105 (75%) cases. The 90-day mortality was 5.7%, Clavien–Dindo grade 3, 4 complications were 9.3%, N+ disease was observed in 32.5%, and the median OS was 38.3 months. Recurrence occurred in 91 patients (65%). The site of relapse was the liver in 53 patients (58.2%). RLR was performed in 21 (39.6%) patients. Factors that negatively affected RLR were time to recurrence ≤12 months (OR 7.4, 95% CI 1.68–33.16, p = 0.008) and major hepatectomy (OR 16.7, 95% CI 3.8–73.78, p < 0.001) at first treatment. Survival after recurrence was better in patients who underwent RLR as compared with not resected patients (31 vs. 13.2 months, p = 0.02). (4) Conclusions: Patients with ICC treated at first resection with major hepatectomy and those who recurred in ≤12 months had significantly lower probability to receive a second resection for recurrence.

scholarly journals Association between post-transplant uric acid level and renal allograft fibrosis: Analysis using Banff pathologic scores from renal biopsies

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Deok Gie Kim ◽  
Beom Seok Kim ◽  
Hoon Young Choi ◽  
Beom Jin Lim ◽  
Kyu Ha Huh ◽  
...  
Keyword(s):  
Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Renal Allograft ◽  
Post Transplant ◽  
Renal Biopsies
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