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Article ; Online: Transplant Renal Artery Stenosis: A Case Report of Functional Recovery Six Months After Angioplasty.

Montali, Filippo / Panarese, Alessandra / Binda, Barbara / Lancione, Laura / Pisani, Francesco

2021 Volume 53, Issue 4, Page(s) 1272–1274

Abstract: Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation, leading to worsening or refractory hypertension, deterioration in renal function, and possible cause of graft loss. Early diagnosis and an appropriate ...

Abstract	Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation, leading to worsening or refractory hypertension, deterioration in renal function, and possible cause of graft loss. Early diagnosis and an appropriate treatment are crucial for organ preservation. Endovascular treatment, including percutaneous transluminal angioplasty and stent implantation, is considered the first-line therapy for TRAS. Here we report the case of a 69-year-old woman with end-stage renal disease for chronic kidney disease not biopsy proven, who underwent a kidney transplant from expanded criteria donors on December 2018. Postoperative course was characterized by delayed graft function. Doppler ultrasonography (US) showed an increase of peak systolic velocity at the origin of the renal artery, and parvus-tardus waveform in periferic graft arteries and an abdominal computed tomography scan confirmed a stenosis at the origin of the main renal artery (TRAS). The patient underwent a percutaneous transluminal angioplasty. It was not possible to place a stent at the particular location of the stenosis at the anastomosis. Despite the improvement of the graft's perfusion, monitored with Doppler US, the patient showed a very poor improvement in renal function and remained on hemodialysis for months. A percutaneous needle biopsy reported a normal renal parenchyma and excluded acute rejection. During this period, the patient received immunosuppressive therapy. About 6 months after the transplant, the patient had an unexpected and slow renal function recovery until she was weaned completely from hemodialysis.
MeSH term(s)	Aged ; Angioplasty/methods ; Female ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/surgery ; Kidney Transplantation/adverse effects ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Recovery of Function ; Renal Artery/physiopathology ; Renal Artery/surgery ; Renal Artery/transplantation ; Renal Artery Obstruction/etiology ; Renal Artery Obstruction/surgery
Language	English
Publishing date	2021-04-22
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.03.019
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Article ; Online: Early-Isolated V Lesion in Kidney Allograft: Acute Rejection or Ischemic Injury? A Case Report of Primary Nonfunction and Graft Loss.

Montali, Filippo / Panarese, Alessandra / Binda, Barbara / Lancione, Laura / Lupi, Diana / Pisani, Francesco

Transplantation proceedings

2021 Volume 53, Issue 8, Page(s) 2536–2538

Abstract: Intimal arteritis (v-lesion) is a negative prognostic factor for kidney allograft survival. Early isolated v-lesions do not always represent a pathologic marker of acute T cell- or antibody-mediated rejection. In particular, in the case of transplant ... ...

Abstract	Intimal arteritis (v-lesion) is a negative prognostic factor for kidney allograft survival. Early isolated v-lesions do not always represent a pathologic marker of acute T cell- or antibody-mediated rejection. In particular, in the case of transplant negative for C4d and donor-specific antibodies, such a finding can suggest an ischemic-reperfusion injury. There is an intense debate in the literature concerning the origin of this histologic feature. In the present study, we analyze how this argument can have a clinical relevance. Here we report a case of a 61-year-old woman with end-stage renal disease due to autosomal dominant polycystic kidney disease. The patient underwent kidney transplant from expanded criteria donor. Organs from expanded criteria donors are more prone to ischemic-reperfusion injury. Postoperative course was characterized by primary nonfunction of the graft. A first biopsy showed early isolated v-lesion in otherwise normal renal parenchymal. Simultaneously, a computed tomography scan revealed stenosis of the main renal artery. An endovascular stent was placed. Despite improved vascularization of the graft, no clinical response was observed and the patient remained anuric. A second biopsy was performed, showing T-cell mediated rejection (Banff Classification 1A). Despite pulse steroid, the patient lost the graft.
MeSH term(s)	Allografts ; Arteritis ; Biopsy ; Complement C4b ; Female ; Graft Rejection/etiology ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation/adverse effects ; Middle Aged
Chemical Substances	Complement C4b (80295-50-7)
Language	English
Publishing date	2021-08-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.08.005
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Article ; Online: Needlestick Injuries, Glove Perforation and Round-Tipped Blunt Needles.

Mingoli, Andrea / Brachini, Gioia / Sgarzini, Giovanna / Binda, Barbara / Zambon, Martina

World journal of surgery

2017 Volume 41, Issue 9, Page(s) 2413

Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Letter
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-017-3941-7
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Article ; Online: Longitudinal monitoring of mRNA levels of regulatory T cell biomarkers by using non-invasive strategies to predict outcome in renal transplantation.

Canossi, Angelica / Iesari, Samuele / Lai, Quirino / Ciavatta, Simone / Del Beato, Tiziana / Panarese, Alessandra / Binda, Barbara / Tessitore, Alessandra / Papola, Franco / Pisani, Francesco

BMC nephrology

2022 Volume 23, Issue 1, Page(s) 51

Abstract: Background: Acute T-cell mediated rejection (aTCMR) is still an issue in kidney transplantation, for it is associated with chronic rejection, graft loss, and overall worse outcomes. For these reasons, a standard non-invasive molecular tool to detect is ... ...

Abstract	Background: Acute T-cell mediated rejection (aTCMR) is still an issue in kidney transplantation, for it is associated with chronic rejection, graft loss, and overall worse outcomes. For these reasons, a standard non-invasive molecular tool to detect is desirable to offer a simpler monitoring of kidney transplant recipients (KTRs). The purpose of our study was to examine, in peripheral blood before and after transplantation, the expression patterns of regulatory T cell (Treg)-related genes: the forkhead box P3 (FOXP3) and the two CTLA-4 isoforms (full-length and soluble) to predict acute rejection onset, de novo donor-specific antibodies (DSA) development and renal dysfunction 1 year after transplantation. Methods: We profiled by using a relative quantification analysis (qRT-PCR) circulating mRNA levels of these biomarkers in peripheral blood of 89 KTRs within the first post-transplant year (at baseline and 15, 60 and 365 days, and when possible at the acute rejection) and compared also the results with 24 healthy controls. Results: The three mRNA levels drastically reduced 15 days after transplantation and gradually recovered at 1 year in comparison with baseline, with very low levels at the time of aTCMR for FOXP3 (RQ = 0.445, IQR = 0.086-1.264, p = 0.040), maybe for the pro-apoptotic role of FOXP3 during inflammation. A multivariate Cox regression analysis evidenced a significant relation between aTCMR onset and thymoglobuline induction (HR = 6.749 p = 0.041), everolimus use (HR = 7.017, p = 0.007) and an increased risk from the solCTLA-4 expression at 15 days, mainly considering recipients treated with Mycophelolic acid (HR = 13.94 p = 0.038, 95%CI:1.157-167.87). Besides, solCTLA-4 also predisposed to graft dysfunction (eGFR< 60 mL/min/1.73m Conclusions: mRNA levels of Treg-associated genes, mainly for solCTLA-4, in peripheral blood could put forward as candidate non-invasive biomarkers of cellular and humoral alloreactivity in clinical transplantation and might help shape immunosuppression, tailor monitoring and achieve better long-term outcomes of kidney transplantation in the wake of "precision medicine".
MeSH term(s)	Adult ; Biomarkers/blood ; CTLA-4 Antigen/genetics ; Female ; Forkhead Transcription Factors/genetics ; Gene Expression ; Graft Rejection/genetics ; Humans ; Kidney Transplantation ; Longitudinal Studies ; Male ; Middle Aged ; Postoperative Complications/genetics ; Predictive Value of Tests ; RNA, Messenger/blood ; T-Lymphocytes, Regulatory/physiology ; Treatment Outcome
Chemical Substances	Biomarkers ; CTLA-4 Antigen ; CTLA4 protein, human ; FOXP3 protein, human ; Forkhead Transcription Factors ; RNA, Messenger
Language	English
Publishing date	2022-02-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-021-02608-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Transplant Patients' Isolation and Social Distancing Because of COVID-19: Analysis of the Resilient Capacities of the Transplant in the Management of the Coronavirus Emergency.

Lupi, Diana / Binda, Barbara / Montali, Filippo / Natili, Andrea / Lancione, Laura / Chiappori, Davide / Parzanese, Ida / Maccarone, Daniela / Pisani, Francesco

Transplantation proceedings

2020 Volume 52, Issue 9, Page(s) 2626–2630

Abstract: Background: One of the peculiar aspects of the transplant patient's life is that, in the post-surgery phase, the patient lives in an "isolation" condition, having to pay particular attention to the living environment and preferring a limited social life ...

Abstract	Background: One of the peculiar aspects of the transplant patient's life is that, in the post-surgery phase, the patient lives in an "isolation" condition, having to pay particular attention to the living environment and preferring a limited social life given that the immunosuppressive treatment entails immunodepression in the patient. With coronavirus disease 2019 (COVID)-19, as in a post-surgery situation, social isolation is being implemented. Materials and methods: The study started on March 17, 2020, and ended on April 24, 2020. Consulting/phone interviews were made. The phone questionnaire, submitted to 71 patients, consisted of a set of 15 questions that investigated structure and psychological resistance. Eight patients have been monitored exclusively for the psychological aspect through a more articulate supporting path. Results: In essence, from the overall analysis of the data derived from the study of the positioning of patients based on the stage of renal function, the bands related to the development of psychopathological aspects, and the use of positive personal resources, it emerges that patients in stage V kidney failure are in the first bracket as regards the development of psychopathological aspects (absence of these experiences) and in the third bracket as regards the good use of positive resources to deal with isolation. Therefore, it can be deduced that, although with data that can be expanded, a serious or medium-serious situation from an organic point of view in this socio-health emergency situation is well addressed by the transplanted patient. Conclusion: Transplant patients have faced the measure of social distancing adequately and in adherence to the treatment thanks to the phone assistance of all the medical-surgical and psychological team.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/prevention & control ; Coronavirus Infections/psychology ; Female ; Humans ; Male ; Middle Aged ; Organ Transplantation/adverse effects ; Organ Transplantation/psychology ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/psychology ; Postoperative Complications/prevention & control ; Postoperative Complications/psychology ; Postoperative Complications/virology ; Postoperative Period ; Psychological Distance ; Quarantine/psychology ; SARS-CoV-2 ; Social Isolation/psychology ; Surveys and Questionnaires
Keywords	covid19
Language	English
Publishing date	2020-05-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.05.031
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Article ; Online: Analysis of Psychopathologic Elements as a Compliance Limitation: Team Work as a Therapeutic Response.

Lupi, Diana / Binda, Barbara / Montali, Filippo / Mazzei, Rossella / Martinez, Viviana / Dufrusine, Maria Maddalena / Pisani, Francesco

Transplantation proceedings

2020 Volume 52, Issue 5, Page(s) 1577–1580

Abstract: Introduction: The psychological evaluation of the patient, carried out through psychodiagnostic tests, clinical interviews, and a joint work with the medical-surgical team, provided useful information to assess the compliance of the kidney transplant ... ...

Abstract	Introduction: The psychological evaluation of the patient, carried out through psychodiagnostic tests, clinical interviews, and a joint work with the medical-surgical team, provided useful information to assess the compliance of the kidney transplant recipient. Methodology: Two hundred and forty-five visits were carried out between September 2018 and May 2019 in the General Surgery and Organ Transplant Department of the San Salvatore Hospital, L'Aquila. The visits consisted of clinical interviews, targeted psychodiagnostic evaluations, graphic-projective tests, and personality and cognitive structure evaluation tests. These assessments were key not only to defining the patient's personality picture but also to offering suitable psychological support to patients on waiting lists for transplantation, during hospitalization, and during follow-up visits from transplantation phases. Results: From the analysis of the tests and from the clinical and support interviews, some of the patients presented forms of psycho-emotional immaturity that impaired the predisposition to compliance and ultimately the establishment of the therapeutic alliance. During 8 months, 18 compliance limit cases were observed, 5 patients were sent to mental health centers, and 13 psychological support courses were activated within the Regional Transplant Center-Abruzzo Region Molise Region. No structured psychological support courses were deemed necessary for 9 of these 13 cases, whereas 4 were sent to the mental health centers. Conclusions: By assessing the complexity of each patient from a medical and a psychological point of view and by considering the high number of transplant surgeries currently occurring, it can be noted that compliance to therapy is strongly linked to the reliability of the relationships between patients and caregivers.
MeSH term(s)	Adult ; Caregivers/psychology ; Female ; Humans ; Italy ; Kidney Transplantation/psychology ; Male ; Middle Aged ; Patient Compliance/psychology ; Patient Selection ; Personality ; Reproducibility of Results ; Waiting Lists
Language	English
Publishing date	2020-05-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.03.009
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Article ; Online: Evaluation of Plasma Levels of Soluble HLA-G and HLA-G Genotypes in Kidney Transplant Recipients.

Piancatelli, Daniela / Maccarone, Daniela / Colanardi, Alessia / Sebastiani, Pierluigi / D'Anselmi, Fabrizio / Iesari, Samuele / Binda, Barbara / Pisani, Francesco

Transplantation proceedings

2020 Volume 52, Issue 5, Page(s) 1559–1561

Abstract: In the field of transplantation, expression of HLA-G, a nonclassical HLA molecule with immunosuppressive functions and limited gene polymorphism, is considered beneficial for graft acceptance; various studies have aimed to demonstrate this role in ... ...

Abstract	In the field of transplantation, expression of HLA-G, a nonclassical HLA molecule with immunosuppressive functions and limited gene polymorphism, is considered beneficial for graft acceptance; various studies have aimed to demonstrate this role in transplantation. Recently, in other clinical conditions, it has been observed that insulin resistance was associated with HLA-G14bpins/del polymorphism, the most studied regulatory polymorphism of this molecule. In the present study, plasma levels of the soluble form of HLA-G (sHLA-G) were analyzed in kidney transplant recipients (n = 103) with different HLA-G14bpins/del genotypes. In a group of 26 recipients, sHLA-G was detected before and after transplantation (1 year) to evaluate early variations. In 77 recipients, sHLA-G was detected after transplantation (3-24 years) and correlated with occurrence of long-term post-transplant morbidity (diabetes mellitus, hyperlipidemia, hypertension, obesity, etc.). Methods: Levels of sHLA-G were measured in plasma with an enzyme-linked immunosorbent assay; HLA-G14bpins/del and HLA-G+3142C>G genotypes were assessed using direct polymerase chain reaction. Results: Plasma levels of sHLA-G significantly decreased during the first year after transplantation (P = .019); no significant correlations were found with genotypes or early post-transplant events. Lower levels of sHLA-G were found in recipients with post-transplant diabetes mellitus or obesity carrying the HLA-G14bpins/ins (P = .006 and P = .003, respectively) or HLA-G+3142G/G genotypes. Conclusions: A complex modulation of HLA-G, which includes both immunologic and metabolic effects, could affect the risk for long-term post-transplant morbidity in kidney transplant recipients. Associations of HLA-G, diabetes, and obesity deserve to be investigated by deeply exploring HLA-G regulatory variants.
MeSH term(s)	Adult ; Diabetes Complications/blood ; Diabetes Complications/complications ; Diabetes Complications/genetics ; Enzyme-Linked Immunosorbent Assay ; Female ; Genotype ; Graft Rejection/blood ; Graft Rejection/epidemiology ; Graft Rejection/genetics ; HLA-G Antigens/blood ; HLA-G Antigens/genetics ; Humans ; Immunosuppressive Agents ; Kidney Transplantation/adverse effects ; Male ; Middle Aged ; Obesity/blood ; Obesity/complications ; Obesity/genetics ; Polymorphism, Genetic/genetics ; Postoperative Complications/blood ; Postoperative Complications/epidemiology ; Postoperative Complications/genetics
Chemical Substances	HLA-G Antigens ; Immunosuppressive Agents
Language	English
Publishing date	2020-03-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.02.044
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Article ; Online: Psychodiagnostic Examination of a Living Kidney Donor. Correlation Between the Scales Referred to the Paranoia of the Minnesota Multiphasic Personality Inventory-2: A Case Report.

Lupi, Diana / Binda, Barbara / Montali, Filippo / Parzanese, Ida / Maccarone, Daniela / Dufrusine, Maria Maddalena / Pisani, Francesco

Transplantation proceedings

2020 Volume 52, Issue 5, Page(s) 1623–1626

Abstract: Introduction: The study involves the psychodiagnostic evaluation of a 53-year-old female living kidney donor. The donation is in favor of the 56-year-old sister. The potential donor is separated, is currently unemployed, and holds a lower secondary ... ...

Abstract	Introduction: The study involves the psychodiagnostic evaluation of a 53-year-old female living kidney donor. The donation is in favor of the 56-year-old sister. The potential donor is separated, is currently unemployed, and holds a lower secondary education diploma. Methodology: The psychodiagnostic evaluation of the donor was carried out by means of clinical-anamnestic interviews, followed by Graphic-Projective Tests. The MMPI-2 Personality Test was administered at a later stage. Results: It was noted that the patient showed: an initial lack of collaboration to undergo the psychodiagnostic evaluation; limited cognitive aspects of flexibility, criticism, and judgment; a distinct emotive response, which manifested as closure, anxiety, and dependence on the other; and elements that resulted from MMPI-2. The analysis of the clinical interviews, of the tests and their correlations, shows the existence of a simple personality framework characterized by concrete thinking that seldom performs functions exceeding the limits by a tendency toward closure and introversion and by consistent mood tone. No elements of psychopathology were identified. Conclusions: The psychodiagnostic evaluation resulted in excluding the subsistence of psychopathologies and allowed for a positive judgment of the suitability for donation. The evaluation also provided significant information on the limited capacity for therapeutic alliance and on the general attitude of closure and rejection of inputs coming from the external world. Patient monitoring is recommended in case of actual donation.
MeSH term(s)	Donor Selection ; Female ; Humans ; Kidney Transplantation ; Living Donors/psychology ; MMPI ; Middle Aged ; Paranoid Disorders/diagnosis ; Personality ; Personality Inventory
Language	English
Publishing date	2020-05-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.03.010
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Article: Transplant Patients' Isolation and Social Distancing Because of COVID-19: Analysis of the Resilient Capacities of the Transplant in the Management of the Coronavirus Emergency

Lupi, Diana / Binda, Barbara / Montali, Filippo / Natili, Andrea / Lancione, Laura / Chiappori, Davide / Parzanese, Ida / Maccarone, Daniela / Pisani, Francesco

Transplant Proc

Abstract: BACKGROUND: One of the peculiar aspects of the transplant patient's life is that, in the post-surgery phase, the patient lives in an "isolation" condition, having to pay particular attention to the living environment and preferring a limited social life ... ...

Abstract	BACKGROUND: One of the peculiar aspects of the transplant patient's life is that, in the post-surgery phase, the patient lives in an "isolation" condition, having to pay particular attention to the living environment and preferring a limited social life given that the immunosuppressive treatment entails immunodepression in the patient. With coronavirus disease 2019 (COVID)-19, as in a post-surgery situation, social isolation is being implemented. MATERIALS AND METHODS: The study started on March 17, 2020, and ended on April 24, 2020. Consulting/phone interviews were made. The phone questionnaire, submitted to 71 patients, consisted of a set of 15 questions that investigated structure and psychological resistance. Eight patients have been monitored exclusively for the psychological aspect through a more articulate supporting path. RESULTS: In essence, from the overall analysis of the data derived from the study of the positioning of patients based on the stage of renal function, the bands related to the development of psychopathological aspects, and the use of positive personal resources, it emerges that patients in stage V kidney failure are in the first bracket as regards the development of psychopathological aspects (absence of these experiences) and in the third bracket as regards the good use of positive resources to deal with isolation. Therefore, it can be deduced that, although with data that can be expanded, a serious or medium-serious situation from an organic point of view in this socio-health emergency situation is well addressed by the transplanted patient. CONCLUSION: Transplant patients have faced the measure of social distancing adequately and in adherence to the treatment thanks to the phone assistance of all the medical-surgical and psychological team.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #606750
Database	COVID19

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Article ; Online: Transplant Patients’ Isolation and Social Distancing Because of COVID-19

Lupi, Diana / Binda, Barbara / Montali, Filippo / Natili, Andrea / Lancione, Laura / Chiappori, Davide / Parzanese, Ida / Maccarone, Daniela / Pisani, Francesco

Transplantation Proceedings

Analysis of the Resilient Capacities of the Transplant in the Management of the Coronavirus Emergency

2020 Volume 52, Issue 9, Page(s) 2626–2630

Keywords	Surgery ; Transplantation ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.05.031
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